Jos Kleijnen, professor of Systematic Reviews in Health Care
“CAPHRI gives systematic reviews a prominent role”
As far as he knows, Jos Kleijnen is the first person ever to be appointed a professorship in Systematic Reviews in Health Care. “I’m certainly proud of this,” says the newly appointed professor, “but it also shows CAPHRI’s ambitions to give systematic reviews a prominent role”.
Jos Kleijnen is known worldwide as a pioneer in systematic reviews. Systematic reviews provide comprehensive summaries of previously conducted research on a particular topic, and evaluate the quality of these research findings. “At the end of the whole process an overall conclusion is drawn. It’s done in a very systematic, scientific way, so the reader can follow the process step by step.”
Systematic reviews concentrate on studies that examine, among other things, the effectiveness of therapies and diagnostics in health care, as well as the use and effectiveness of medical equipment and prevention. In doing so, they provide summaries of the best available evidence. “They help practitioners to make the right decisions about therapy. Since the early 1990s, evidence has been considered the key principle that has to underlie all doctor–patient decisions. This is what we call evidence-based medicine.”
Reliable
In Kleijnen’s view, systematic reviews provide more than just a reliable source of information for the treatment of individual patients. “They’re also used at a national level to assist in decision-making processes on issues such as reimbursement for medical treatments.”
Even during his time as a medical student in Maastricht, Kleijnen was interested in systematic reviews. “Only they had a different name back then.” Later he obtained his PhD in Epidemiology with a dissertation full of systematic reviews. “It was very exciting. We were by no means certain that you could perform science based on the research of others.” His supervisor, Paul Knipschild, used to compare him to a stamp collector who would not rest until a series was complete. “This is the same principle I apply to my work; if there’s a study missing from my summary, there’s the chance that the conclusions may not be correct.”
After having worked in Maastricht on systematic reviews for 6 years, Kleijnen moved to the Academic Medical Center in Amsterdam. There he founded the Dutch Cochrane Centre as part of the Cochrane Collaboration. This is an international organisation of volunteer scientists and clinicians who conduct, update and publish systematic reviews.
Business owner
In 1998, at the age of 34, Kleijnen was approached by the University of York with the position of professor and director of the Centre for Reviews and Dissemination. “At the time this was the largest centre for systematic reviews worldwide. It was an offer I couldn’t refuse.”
Seven years later Kleijnen left the centre and started his own commercial business: Kleijnen Systematic Reviews Limited (KSR). The company now has a staff of seventeen and an international team of ten freelancers. They specialise in systematic reviews that provide health insurance associations with information for making policy decisions regarding the coverage of medicine and health care. KSR has received commissions from the Dutch Health Care Insurance Board and a range of similar bodies, such as the British National Institute for Health and Clinical Excellence (NICE) and the German Institute for Quality and Economical Efficiency in Health Care, and from various organisations within the pharmaceutical industry. Part of Kleijnen’s role as professor will be to form a three-way partnership between CAPHRI and his York company along with a third partner, the Erasmus University in Rotterdam, and in particular with Hans Severens. This former professor of Medical Technology Assessment in Maastricht is now a professor of Evaluation in Health Care in Rotterdam.
Kleijnen’s plans are for CAPHRI and Severens to carry out the necessary economic and cost-effectiveness analyses for the systematic reviews conducted by KSR. The group will provide their services to clients including NICE: “They’re an important client. The decisions made at NICE serve worldwide as a model for issues such as reimbursement for expensive therapies.”
Kleijnen also expects an increase in commissions from other, new sources. “I’ll be bringing with me the contacts that I’ve built up over the years, and in this sense my appointment will certainly be beneficial to CAPHRI.” According to Kleijnen, CAPHRI also stands to benefit from subsidies and publications that the partnership will generate. “There’s a great need for this type of work, and our partnership will lead to synergies that benefit all parties.”