My research

My research focuses on the use of blood transfusion products for preterm infants in intensive care units. I perform national and international clinical medical research studies to generate evidence to support clinicians in their decision making. I am cofounder and steering board member of the only international research network on this topic, called the Neonatal Transfusion Network.

IAS fellowship

The use of blood products in neonates is complex at many levels, including biological complexity, multimorbidity, social complexity, but also health care system level complexity, with unexplained variation in practice and rampant lack of high quality evidence. Despite this complexity, current research is mostly based on reductionist assumptions, targeting single interventions, assuming linearity, and largely ignoring context. As a result, clinical neonatal transfusion practice is at risk of wasting research resources and promoting unwarranted standardization. The aim of this fellowship is to design three proof of concept studies to operationalize complexity theory in neonatal transfusion research, in order to explore whether complexity theory can help us improve research quality and ultimately to support better clinical practice, to inform current neonatal transfusion practices and to form the basis for follow up research grant applications.

In addition, while incorporating complexity in research design is part of the solution, complexity theory also emphasizes the fact that ultimately, the effects of interventions in complex systems are extremely difficult if not impossible to predict. This realization may require a reorientation of medicine from evidence based guidelines which are regulated and monitored towards a more adaptive, flexible and learning-based approach. Ultimately, these projects could be stepping stones towards a wider discussion in the medical world on the use of evidence in medical decision making and guideline development.