Project Background & Lessons Learned Pascal Vuilleumier, MD.

Project Background &

Lessons Learned

Pascal Vuilleumier, MD

No conflicts to declare

Who I am?

• Attending Anesthesiologist in University Hospital Bern, Switzerland

• Staff in level 1 trauma and transplant center• Mainly digestive, oncologic, thoracic and

gynecologic anesthesia • Research in spinal pain modulation on a Swiss

National Grant for 3 years. Leading current projects in volunteer studies within Gaba & Oxytocin receptors, EEG and pain.

And why I came to UWMC• Learn and understand research on genetics of

pain• Perform a prospective study in Brazil in the

Women’s Hospital of Santa Johana, in Sao Paulo, on the effects of low dose gabapentin and ketamine on post cesarean pain

• Data analysis on oxytocin receptor genotype and haplotype and post-cesarean pain

OB Fellowship

• A good opportunity to see how others do & perform

&• An excellent opportunity to combine my

primary aim of research with protected research time and a clinical commitment allowing a salary that is adequate to feed and house my wife and now 2 kids

Current picture of the projects

• Brazil: First study protocol written 12.2011, but considered too complex after my fellowship started. A second study protocol was written and complete by 11.2012 , nevertheless unknown issues seem to delay study start to unknown date.

• My clinical commitment seems to make this project impossible to pursue.


• Promise to perform QST measures in regard to opiate hyperalgesia with human volunteers in a project in preparation by Dr. P. Richebe in replacement of the Brazil study

• Philippe Richebe decided to resign his position at UWMC in early 02.2013


• Oxytocin receptor and post cesarean pain: Abstracts accepted for the SOAP congress and for ASA. Major issues with data quality with > 35% of missing results, making statistic analysis challenging. Data is back in Singapore, where it originated, to be reanalyzed by local statistician in possession of complete database.

• Outcome, results and publication ?


• Book chapter on post partum hemorrhage written, third author

• Which book it was for remains unknown


• Review article on pain after delivery written, third author


• Small analysis on post IVF pain and plasmatic estradiol levels (n=9, now n=16).

• Positive correlation found, presented as poster at the SOAP congress and the UW academic evening.

• Third place award for excellence in research received

• Manuscript in preparation

Current picture of the projects• Epigenetic impact of in utero exposure to opiates in

the generation Z’• Project defined as faculty fellow project Sept. 2012• Submitted in my name for a SOAP grant, not received• Submitted for ITHS grant, approx 15000 USD awarded

to Dr. R. Landau• Genetic samples were analyzed in July; results, data

analysis and manuscript preparation handed over to a medical student

Lessons learned• Proper preparation prevents poor performance– Have one or several study protocols ready for IRB

submission when starting in your new position– Timing is of prime importance: IRB approvals, grant

submissions, writing good study protocols are all extremely time-consuming

– If not properly prepared with grants and IRB submissions prospective studies may need 6-12 months to be on track

Lessons learned• Trust your “gut feeling”– Your mentor is of prime importance to complete a

study– Your mentor has to know you, be one of your

closest allies, confident and guide, in professional and sometimes also private matters

– If there is no professional “love story” there may be difficulties

Lessons learned

• Protected research time

– Is not every week after a 24h call– Is not good-will time that is offered to you out of

human generosity

• If you are called in clinic just anytime you perform research duties: you will perform poorly in research

Lessons learned

• No study without grants– Trust your future to groups that have shown

excellence in research; – in the US NIH granted groups are the benchmark– Industry or other sponsors are also a good

alternative, but there needs to be proper funding for what you aim to study is

Lessons learned

• Why and what to study?– Continuity, personal interests, anesthesia practice

• What are your aims?– Academic career vs private practice

• In what does research help in/for your future?– Ranking of publications– Prospective studies vs retrospective data analysis– Original pubications vs reviews

Conclusions• Research needs a huge investment in time,

energy, preparation and patience• To trust is ok, to control is better• Chose your mentor with care in regard to

personality, availability, past publications and received grants

• Have an aim, and pursue this aim, don’t challenge your aim every other week

Conclusions

• The academic way is long & difficult; fences and obstacles in research are increasing and will be your daily life

• Do never neglect other really important things in life; without family and/or friends human beings do not survive and perform well on the long run

Thank you&

Good Luck!

Project Background & Lessons Learned Pascal Vuilleumier, MD.

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