While the main John Maddox Prize for 2020 goes to Anthony Fauci and Salim Abdool Karim for their communication of evidence during the Covid-19 pandemic, the judges have again this year chosen to award an additional prize to an early career researcher in recognition of the barriers they have overcome to gain a public hearing on important research evidence.
This year that researcher is Australia’s Anne Abbott, a neurologist at the Central Clinical School at Monash University in Melbourne. She receives the award for her tireless promotion of evidence for non-invasive stroke and arterial disease prevention treatment. Or perhaps we should say evidence against invasive stroke and arterial disease prevention treatment. Abbott’s research in 2009 showed that in people without referral stroke symptoms, non-invasive intervention is at least as effective as carotid artery surgery (endarterectomy). Carotid surgery and stenting are invasive, expensive and (especially in the case of stenting) often harmful.
Yet these procedures are a multi-billion dollar global industry and established in patient treatment guidelines. Abbott, now a professor, encountered strong opposition as she attempted to publicise her research findings. This ranged from lack of institutional support to her employment being discontinued at multiple institutions, exclusion from professional networks and threats. Abbott continued to challenge the status quo at personal cost, placing patients’ health and public knowledge first.
This “John Maddox Prize for Standing up for Science” recognises her efforts in reaching out globally and spending eight years pressing publicly for discussion of the evidence for this treatment of the world’s biggest cause of death, including contacting the president of the United States in 2011.
Learning of the award, Anne Abbott said: “My main feeling is one of relief — that I have been able to share something of the unexpected difficulties I have faced in simply doing my job as a patient advocate. There is also a sense of empowerment to address other barriers to improving patient outcomes globally. I am very glad the Maddox Prize initiative exists. It imparts new hope.”
The word has, it seemed, spread. Bill Bryson highlighted in his popular book ‘The Body – A Guide For Occupants’ that by the year 2000, a million precautionary angioplasties were being undertaken in the US alone every year, without any proof that they saved lives. He also notes that remarkably, even with all the improvements in medicine, you are 70% more likely to die from heart disease today than in 1900. “That’s partly because other things used to kill people first, and partly because a hundred years ago people didn’t spent five or six hours an evening in front of a television with a big spoon and a tub of ice cream,” he writes.
Sir John Maddox (1925-2009) was editor of Nature from 1966 to 1973, and from 1980 until 1995. Now in its 9th year, the John Maddox Prize commemorates Sir John as a passionate and tireless communicator and defender of science, and is a joint initiative of the charity ‘Sense about Science’ and the scientific journal Nature. It is awarded to one or two people a year for standing up for sound science in public, and the Maddox Prize 2020 received over 100 nominations from 34 different countries.
