Thinking outside the box with Ana C. Hernandez
This is the first article in the new series "Purpose-driven, people-centred: The people behind the science". In the coming months, we will be shining a spotlight on some of the brilliant scientists and project operatives working on Ecraid’s studies and the activities supporting them. Although you might not hear their names outside of academia, rest assured that their hard work and dedication impact millions of lives affected by infectious diseases and antimicrobial resistance in Europe and beyond.
Originally from Colombia where she studied medicine, Ana C. Hernandez moved to France five years ago to work at the Clinical Research Centre of Limoges. When we met, she was eager to tell the story behind this life-changing move.
“Back in Bogota, I was doing research on HIV patients. We cautiously submitted our abstract to ESCMID and it got accepted. Next thing I know, we are at the ECCMID in Vienna! My boss was supposed to present, but her speech got lost together with our luggage. We entered a random room where I could sit and write it all down again. When done, I looked up and there was Bruno (Francois) talking about using monoclonal antibodies to treat Ventilator Associated Pneumonia (VAP). He explained how through public-private partnership, smart planning and networking, the conventional process of testing new treatments could be decreased substantially. I was in awe.”
Ana was among many at that conference to approach one of France's leading experts on infectious diseases. But her passion and persistence ultimately secured her a spot in his team. She focused on analysing unused data, including some from trials under COMBACTE. Now that the extensive clinical research infrastructure built within COMBACTE is transitioning to Ecraid, Ana has taken on a new challenge – Perpetual Observation Study on VAP (POS-VAP).
“This study has been an adventure! Normally, you’d begin with a research question and build the protocol around it. POS-VAP is quite innovative in that it is a 'warm base' trial. We started with developing a master protocol, while the research questions will be added as we go. We call that “plugging” studies into the main POS. Our main objective now is to create a structure for all those involved to work in.”
This is no easy task. Ana’s team coordinates dozens of sites spread across Europe, all of which need to embrace this novel way of doing clinical research.
"For this to work out, we need to keep the sites motivated despite the lack of concreteness. At the beginning, it's a huge effort that probably won't produce publications anytime soon. The researchers joining the study need to keep a long-term perspective. We try our best to help them with that.”
Doing clinical trials differently
But why would you conduct research without a research question? Ana explained that the answer lies in the flexibility and efficiency provided by this novel approach.
“Our sites already have the necessary experience and access to patients under mechanical ventilation. They can easily include every patient who is at risk of developing VAP and track their progress in time. All of that data is saved and ready for testing hypotheses. Also, new patients and treatments can be added to the existing structure. It’s an incredibly smart approach.”
It is not difficult to imagine that not everyone might be open to changing the way they have been doing clinical trials for years, or even decades. Ana sees this as one of the biggest challenges in science today.
"The paradox is that even though scientists seek new discoveries, many are confined to old, rigid structures. This is why I like translational research; it helps you break free of those. Sometimes, you can’t solve a problem because you are stuck in a box. But if you change your perspective – say, you adopt a physician’s perspective while solving a problem in the lab – you might reach a breakthrough much faster.”
“A major challenge for me has been to be humble enough to accept that there is so much I don’t know. I learn from the people around me every single day. I also try to accept that things are not always going to work. You can do an experiment ten times and only succeed at the eleventh. Be stubborn and don’t take failure personally.”
Still, Ana does hope that POS-VAP will yield results sooner rather later. The team has set clear goals: start patient inclusion and design the first embedded study by the end of the year.
“I look forward to starting adding embedded studies and producing interesting publications. Seeing tangible results would convince more hospitals of the potential of what we are doing and motivate them to jump in.”
Which also happens to be one of Ecraid’s top priorities – making sure that more bright, passionate people like Ana join our pan-European movement for sustainable clinical research in infectious diseases.