Sheep research saves lives

The Herald has a story about premature birth rates across the world, which I will hijack to write about an important NZ scientific contribution, and a revolution in medical statistics.

One of the basic treatments for premature babies, which unfortunately is not available everywhere, is a simple $1 shot of corticosteroids.   This treatment was discovered accidentally by the great NZ medical researcher Graham Liggins.  Liggins was interested in what triggered preterm birth, and hypothesised that steroids were involved.  In experiments on sheep he didn’t find any effect on prematurity, but noticed huge differences in lung development in premature lambs given steroids.   A clinical trial in people found a dramatic reduction in deaths, but no-one really paid attention. After rejection from the Lancet, the trial results were published in another journal in 1972.

Over the following 20 years several additional trials were conducted, most of them too small to show a convincing effect. Finally  all the evidence was put together and obstetricians accepted that corticosteroids had an almost magical effect on lung development in premature babies.  The results of all the trials and the summary of their collective evidence forms the logo of the Cochrane Collaboration, an organisation dedicated to ensuring that randomized trial data doesn’t get lost, but ends up being incorporated in medical knowledge.

This September, the annual meeting of the Cochrane Collaboration is being held in Auckland, so if you see nerdy medical types roaming the streets, be nice to them. They can be useful.