Researcher of the Month March 2017: Professor Simon Travis FRCP is the lead clinician for the Clinical IBD Group
How did you become interested in translational gastroenterology? Clinical IBD has been the core of Oxford Gastroenterology since Sidney Truelove, who performed the first randomised controlled clinical trial in Gastroenterology (steroids for ulcerative colitis) in 1955.
Sidney had worked with the eminent biostatistician RA Fisher (he of the Exact Test) during the war, when investigating an outbreak of hepatitis A in North Africa. Clinical trials and IBD have therefore been part of the Oxford scene for decades, although it is a sadness that Oxford never contributed to the ground breaking trials on biological therapy in the late 1990s/early 2000s. It has been an immense pleasure to work with colleagues in building up the strength of the Unit in the past 10 years. Then there were 2 IBD specialists and 4 gastroenterologists. Now there are 5 IBD specialists and 14 gastroenterologists, with clinical trials one of the three pillars of the TGU (basic science and clinical care are the other two, in case you were wondering!).
What are you currently working on and what importance does your work hold for current patients with gastrointestinal issues?
Clinical IBD in Oxford is leading the way in novel thinking about approaches to care and real, patient-reported outcomes in IBD. Oxford has lead the development of the first global consensus on these outcome measures, with the International Consortium on Health Outcome Measures (ICHOM, www.ichom.org). A new Oxford AHSN-IBD network is being established across the region, so that these outcomes can be captured, using the TrueColours app also developed in Oxford: this involves patients in their own data collection. We have also established predictive indices that help stratify patients at diagnosis of ulcerative colitis, or during treatment of acute severe colitis, which are about to enter a new phase with machine learning interrogating routinely collected clinical data. The ‘USP’ of Clinical IBD in Oxford, however, is the integration of science with clinical practice: it is no accident that the TGU labs are co-located with the Gastro ward, Day Case Unit and Clinical Trials Facility, immediately above Endoscopy and Outpatients. This way we can concentrate on the mechanistic components of novel therapy, adding value to proof of concept trials and searching for biomarkers that will guide treatment for selected patients.
What do you enjoy most about scientific research?
Answering the question ‘Why?’. Clinicians can (and must) ask the questions that matter most to their patients. That means collaborating with really bright scientists who have a passion for discovery, interest in the topic and determination to search for new answers, which is enormously invigorating. It opens new horizons: thinking laterally through networks is so much more rewarding than working in a hierarchical straight line.
What’s the best part of being an Oxford University TGU member?
The people. The infectious enthusiasm and critical mass that has now been achieved has created its own momentum that makes the TGU one of the leading centres for gastro research in the world. First Fiona and now Paul have provided the right scientific leadership that has enabled others to flourish: the friendliness, encouragement and support for young clinicians or scientists to develop has meant that people work for the benefit of the TGU, rather than just their own advantage. It’s a bit daunting to begin with, but when you realise that everyone is genuinely committed to making care through science improve patient outcomes, it is not difficult to become fully engaged. Everyone has a contribution to make. It’s a privilege to work with such committed colleagues as Satish Keshav, Holm Uhlig and Carolina Arancibia who have established the 3300 patient IBD cohort and to admire the exceptional work performed by Simon Leedham, Alison Simmons, Fiona and Paul, with their respective groups. Meanwhile the future of clinical IBD is secure with newer colleagues such as Oliver Brain and Rebecca Palmer. Diversity really matters, so it is great to see people from many nations and backgrounds in the TGU which has to, must, trump Brexit.