A good start to making clinical trials even more robust

A final year PhD student with the HRB Trials Methodology Research Network, Marina Zaki is studying how we can improve statistical thinking in clinical trials, and as she is inspiring a whole new generation about evidence-based medicine. She talks to Dr Claire O'Connell ...

Marina Zaki

Getting clinical trials right is key to making sure that innovations in research turn into benefits for patients. Clinical trials have gone from strength to strength in Ireland in recent decades, and Marina Zaki, wants to build even more evidence to improve trial methods.

A PhD researcher at University College Dublin with the HRB Trials Methodology Research Network (HRB-TMRN), Marina is exploring how those designing, carrying out and analysing trials can incorporate more statistical thinking and clinical data management into their work. Meanwhile, she is also helping to inspire a whole new generation to understand more about evidence-based medicine.

Her PhD research involves visiting centres where trials are run and speaking to those who design and run them. ‘I go off around the country with my voice-recorder and I talk with triallists to see how they view statistics and data management and how we might improve the rigour of their statistical thinking and approaches’, explains Marina. ‘The work I do is mainly on the qualitative side, hearing from them about issues like how they use statistics, how data gets reported, research integrity, disclosing conflicts of interest and publishing’.

Her hope is that the research will support trials in Ireland to improve even further. ‘Trial methodology research is quite new in Ireland’, she says. ‘We have done clinical trials internationally for so long, we want to see can we make them even more robust. We owe so much to the patients and participants who give their time and their samples to enable these trials. We can't have rigorous results without accurate and complete data and it’s really important that statistically significant findings from those trials are accurately translated into clinical practice’.

Translational direction

Now into the final year of her PhD studies, Marina has already packed a lot into her career to date. It started when she was doing the Leaving Cert and knew she loved biology. ‘My Dad is a medical doctor and he encouraged me to study pharmacology, which is the study of how drugs work in the body’, she recalls. ‘So I studied science at University College Dublin and specialised in my final years there in pharmacology’.
During her time as an undergraduate, Marina got the opportunity to study in Copenhagen, Denmark, on a European Erasmus scheme for six months, and while there she developed an interest in translational medicine, where discoveries in science and technology are brought towards the clinic for patients.

She packed her bags again and moved to England, to do a Masters in Translational Medicine at Kings College London, and then returned to Dublin to do a PhD based at UCD’s School of Nursing, Midwifery and Health Systems as part of the Health Systems Research Group. Her project is supported by the HRB-TMRN under the supervision of Professor Eilish McAuliffe, Dr Marie Galligan and Professor Declan Devane.

One of the most rewarding aspects of that PhD work is getting new perspectives on how trials work, says Marina. ‘I love being at the forefront of talking to the people who are running the trials, because you get to see the behind the scenes and you find out about the very practical elements, like how expensive trials are’, she explains.

That said, doing any PhD can be a challenge. ‘It’s a rollercoaster sometimes’, says Marina. ‘I think one of the biggest challenges is getting clearance from different ethics boards to carry out my studies at different centres, that can be time consuming. And the nature of doing a PhD is that it is a lone journey, there is no-one else doing exactly the same study as you, so while everyone is supportive and the team around me is great, it’s inevitable that you still feel that sometimes. Other than that, I thank the stars that I have been given all these opportunities’.

Broadening vision

Those opportunities for Marina have included a six-week secondment where she travelled on a Marie-Curie Fellowship to Madrid through the 3DNEONet Consortium, a UCD-led European group that looks at drug treatments for eye disease. ‘I got to spend time in Madrid getting a sense of industry involvement in trials and looking at how clinical trials are regulated’, says Marina.

She is also broadening the perspectives of primary school children as an ambassador for the HRB-TMRN’s annual START competition that encourages young students to design and carry out randomised control trials in the classroom - for example, whether singing out spellings can help you to learn them better, or if doing some skipping before a test will help you get better results on a maths test.

‘The idea of the competition is to encourage kids to think critically and not to just rely on what people say’, she says. ‘It also introduces them to evidence-based medicine and they get an insight into what it is like to do research’.

As a START ambassador, Marina sometimes gets calls and emails from teachers looking to get their classes involved in the competition and she has also built up her mentoring experience, supervising two summer internship students.

Organisational skills

During her time in UCD, Marina has been heavily involved in the student pharmacology society PharmTox, which she chaired for two years and through which she has gained valuable experience. ‘We organise lots of events like public talks and our annual mid-summer science soiree which raises funds for charity’, she explains. ‘It is an amazing way to learn by doing and it’s brilliant for developing your network’.

Marina also applies her organizational talents to the youth group in her Church, which is one of her main activities outside of university life. ‘I am Coptic Orthodox and the Church is important to me, we have an active youth group here and we organise speakers and international conferences’, she says. ‘I was born in Ireland and I am originally Egyptian, and for a lot of us in the Church our families are in Egypt so we made our own family here’.