Working Life: Professor Sheila M. Bird
Programme Leader in Biostatistics Research at the MRC Biostatistics Unit (BSU), Professor Sheila Bird OBE FRSE, has spent the past 35 years applying her statistical skills to a range of areas that have direct public health policy implications, from transplantation to prisoners’ mortality. As she retires from the MRC, she tells us about some of her research highlights, why she chose a career in biostatistics and provides words of wisdom for future biostatisticians.
Career in brief
- Part-time PhD while lecturer in statistics at Aberdeen University
- Joined the MRC Biostatistics Unit in Cambridge in 1980
- Made an MRC programme leader in 1996
- Made an OBE in 2011
It has been an enormous privilege, and a strong motivation, to use statistical science to make a difference to public health. Public and press understanding of statistical science are also very important to me. As statisticians, we are privileged to analyse data about patients, and I believe that people who provide data for research should benefit.
Sometimes those whose health problems concern us may be hard-to-reach, such as people who inject drugs or former prisoners, and research teams may need to advocate on behalf of these client-groups. Their altruism, as contributors to research, merits our going the extra mile to make sure that discoveries do not go unheeded. In holding this view, my late husband, Dr A. Graham Bird, and I were soulmates and partners in crime!
That’s how I’d like to be remembered, as a statistician-scientist who tried to make a difference to public health, by making waves, if necessary.
I started making waves in the 1970s. When I was a research assistant, I led a team analysing statistical misuse in the BMJ.
— ben goldacre (@bengoldacre) November 25, 2015
The then editor Dr Stephen Locke took this criticism on the chin, published our paper and editorialised it. This led to my BMJ series on Statistics in Question and to statistical guidelines for contributors to medical journals.
It’s very difficult to pick out highlights from such a varied career. My PhD research looked at survival in breast cancer. To allow covariates, such as tumour size, to influence survival differently in the first and second five years versus the second decade of follow-up, I applied Cox proportional hazards analysis to distinct epochs of follow-up. This approach was then applied to UK kidney graft survival and guided how kidney donors and recipients were matched in the UK for about a decade.
In 1991 I began a quarter-century as a ‘biostatistician behind bars’. Studying Scotland’s HIV epidemic meant research in prisons. Among Edinburgh’s heroin injectors, there had been early, rapid HIV transmission and heroin injectors were imprisoned for crimes they committed to pay for drugs. Devising a study-design – acceptable to inmates – to find out how many prisoners were HIV-infected (including undiagnosed infections) and how they had become infected – outside or inside of prison – was essential. Graham Bird and I called the design WASH surveillance; and conducted studies throughout 1991-96. In 1996, using data from our WASH studies, we showed that random mandatory drugs testing of prisoners would severely underestimate the inside-use of heroin.
Drug-related deaths (DRDs) have been a neglected epidemic. My research group at BSU was the first to quantify the high risk of DRDs in the first fortnight after prison-release. More recently, we discovered that, for Scotland’s ever-injectors, the four weeks after hospital discharge are also a period of high DRD risk, roughly half the risk that applies in the four weeks after prison release. Unusually, the MRC-funded prison-based N-ALIVE pilot trial in England, and Scotland’s science-led before/after evaluation of its National Naloxone Policy, have investigated contemporaneously whether take-home naloxone (issued by prisons or in the community) is effective at reducing opioid-related deaths in the four weeks after prison-release. Policy evaluation has produced the evidence faster but needed to refer to Bradford Hill’s criteria for appraising causality.
We were also involved in looking at exposure to dietary BSE. Jason Cooper and I quantified UK dietary consumption of BSE by gender and birth cohort and showed that the 1940-69 cohort had greater dietary exposure than those born in 1970 onwards. This meant that the young age of the UK’s vCJD cases could only be explained if there was also age-related susceptibility to progression from dietary BSE exposure to clinical vCJD.
My father played mental arithmetic games with me which sparked my childhood enthusiasm for maths: “If it takes a hen and a half a day and a half to lay an egg and a half, how long does it take a hen to lay an egg?” I was later inspired by my maths teacher at Elgin Academy, Lewis Grant, and Professor David Kerridge at Aberdeen University to take up a career in biostatistics.
Days as a biostatistician can be very varied, from research-focused days to those spent attending or speaking at conferences. I’ve spent some of my most enjoyable days completely absorbed in designing studies, but it is also quite wonderful when analysis leads to new insights with important implications for the public health.
I haven’t achieved everything I’d hoped to in my career. An obstacle that I have not yet surmounted is parliamentary unwillingness to legislate to end the late registration of fact-of-death in England and Wales. This failure to count the dead properly is a serious indictment of the statistical system and hinders record-linkage studies unnecessarily. The Royal Statistical Society has been calling for reform for more than five years with support from the Chief Medical Officers, Government Chief Scientists, National Statisticians, Royal College of Pathologists and parliamentarians. This challenge continues…
I’m immensely proud to have received four medals from the Royal Statistical Society. As Sir Austin Bradford Hill was a past director of MRC Biostatistics Unit, I am particularly pleased to have received the ABH medal in 2000 for contributions to medical statistics. The Howard Medal in 2015, which commemorates the 18th century prison-reformer John Howard, and which I received for my research work in prisons, is especially dear to me because it was with Graham in 1991 that I began that work.
My advice for future biostatisticians is inspired by two pieces of father’s advice which have stood me in good stead: “It’s not the wind but the set of your sail that determines the way you go.” (His father was a trawler skipper . . . but good advice also for study-design!). “Principle is the only thing worth fighting for.” (Scientific method matters hugely; and good scientists are intrinsically principled).