Research
Focus on Clinical Trials of Infant Formula
As a part of an international research team devoted to enhancing the scientific and ethical rigor in the field of infant nutrition, I have conducted investigations into clinical trials of infant formula.
Through a comprehensive global survey that spanned 15 countries, we’ve critically assessed the health and nutritional claims commonly made in infant formula marketing, discovering that only 26% are supported by cited scientific literature.
In a systematic review of 307 formula trials published between 2006 and 2020, we identified alarming shortcomings, such as lack of transparency and a high risk of bias. To address these ethical quandaries, we collaboratively developed a robust set of guidelines for conducting breast milk substitute trials. Formulated through a modified Delphi method and involving 23 international experts, these guidelines are geared to emphasize research integrity, meaningful outcome measures, and the promotion of breastfeeding within trial settings.
Moreover, our team critically re-evaluates the biological assumptions commonly accepted in infant formula use to guide infant feeding practices more effectively. To bolster the impact of our findings, we’ve undertaken a comprehensive health policy analysis, advocating for a precautionary approach that emphasizes rigorous methods and enhanced regulations.
Altogether, our work is designed to create a lasting impact on public health by significantly improving the quality of evidence that shapes medical practice and policy in the vital domain of infant nutrition.
Focus on Evidence-Based Mental Health
We are critically examining key aspects of psychiatric treatments, currently preparing a comprehensive comparative analysis of clinical trials for the treatment of depression. This investigation seeks to bridge the disciplinary gaps between clinical psychology and psychiatry, shedding light on differences in trial conduct, reporting, conflicts of interest, and risk of bias. Our goal is to clarify key differentiators and predictors of treatment efficacy, thereby shaping more effective mental health interventions.
We have previously debunked prevailing myths that psychotherapy is essentially a psychosocial, and pharmacotherapy is a biological intervention. Utilizing insights from modern cognitive neuroscience, we argue that both are biological treatments and should not be differentially regarded in terms of scientific validity. This foundational work directly challenges the declining use of psychotherapies in favour of pharmacotherapy.
In the realm of schizophrenia, I have contributed to a series of Cochrane Reviews examining various pharmacological treatments, enriching the evidence base that guides clinical practice. Additionally, we’ve conducted major systematic reviews and meta-analyses that scrutinize the efficacy, acceptability, and tolerability of different antipsychotics and adjunctive antidepressants in treatment-resistant schizophrenia.
To further our commitment to evidence-based mental health care, we are currently working on developing international guidelines for the management of borderline personality disorder in emergency settings.
Focus on Research Methods
In our ongoing quest to advance methodological rigor in academic research, we have made significant contributions across a range of research methods and metrics. To address the pressing need for quantifying the impact of isolation interventions in infectious diseases, we developed a novel population health metric—Number Needed to Isolate (NNI). This metric, an extension of the familiar Number Needed to Treat (NNT), allows for the quantification of transmission reductions resulting from isolation strategies. Our model, which was validated with real-world data on SARS-CoV-2, serves as a powerful tool for informing public health interventions.
In the realm of pharmacotherapy, we’ve scrutinized the efficacy of common medications through a meta-analytic approach, revealing that many medications show low effect sizes and are often judged based on surrogate rather than patient-oriented outcomes. This work aims to redress potential overtreatment and to push for a more nuanced understanding of medication efficacy among clinicians.
Furthermore, we conducted a systematic examination of recent meta-analyses in pharmacological treatments, investigating their referencing practices of previous systematic reviews and meta-analyses. Alarmingly, our findings indicate that a substantial proportion of recent meta-analyses neither cite, describe, nor discuss prior works adequately. This neglect not only generates research waste but also fosters confusion for readers and stakeholders. As a corrective measure, we propose that journals should mandate the inclusion and thorough discussion of related meta-analyses to ensure a more comprehensive representation of existing evidence.
Focus on Developmental Psychopatholog
In my exploration into the realm of developmental psychopathology, we’ve made key contributions to understanding the nuanced interactions between cognitive, emotional, and neurophysiological factors in adults with Attention Deficit Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD).
Our research has shed light on the significant roles that mind wandering, emotional lability, and sleep quality play in adult ADHD symptomatology. These factors not only predict the severity of ADHD symptoms but also contribute to the cognitive and emotional deficits often associated with the disorder. For instance, on-task sleepiness was shown to substantially impact cognitive performance, with electroencephalogram (EEG) metrics, particularly frontal EEG slowing, substantiating the relationship between sleep quality and ADHD symptom severity.
In studies involving Facial Emotion Recognition Tasks, we observed a speed-accuracy trade-off in neurodevelopmental groups (ADHD and ASD). Although these groups identified target emotions accurately, they took considerably more time than neurotypical controls. This finding could have broad implications for interventions that aim to ameliorate social cognition deficits in these populations.
Our findings underscore the complexity of emotional dysregulation and excessive mind wandering across ADHD and ASD populations, indicating that these features do not differ statistically between these clinical groups. However, upon controlling for self-reported ADHD and ASD symptom severity, mind wandering appeared to be distinctly linked with each disorder’s respective symptomatology.
Furthermore, our pupillometric studies in fast/incentive conditions showed a noteworthy decrease in tonic pupil diameter and an increase in phasic pupil response. This suggests intricate neurophysiological mechanisms likely play a role in attention and processing speed, especially under conditions that presumably engage the reward systems differently in ADHD and neurotypical populations.
These findings offer a multifaceted view of developmental psychopathology, enhancing our understanding of ADHD and ASD while highlighting the importance of considering multiple domains—cognitive, emotional, and neurophysiological—in research and clinical practice.