Dr. Daphne Ling — Centre for Health Evaluation and Outcome Sciences

Dr. Daphne Ling is a postdoctoral fellow in Personalized Medicine, a joint position with the Centre for Health Evaluation and Outcome Sciences (CHÉOS) at PHC and the UBC Faculty of Pharmaceutical Sciences.

Dr. Ling received her BA in Public Health from the University of California-Berkeley in 2004, when she became the first graduate of their new undergraduate program. After staying at UC-Berkeley to complete a joint MPH degree in Epidemiology and Biostatistics, she then attended McGill University from 2008–2012 to complete her PhD in Epidemiology.

Prior to joining CHÉOS, she worked as an epidemiologist in the areas of HIV, STIs and TB. Her research interests include diagnostic research, prediction modelling, operational research and knowledge synthesis (systematic reviews and meta-analyses).

We asked her about her research and the importance of personalized medicine today.

What is personalized medicine?
Personalized medicine refers to the use of an individual’s genetic makeup to inform health decisions. These decisions could include determining a person’s risk of disease or prescribing a medication that actually works. Some doctors will argue that they’ve been practicing personalized medicine all along because they treat patients one at a time based on his or her profile. However, their decisions are based on findings from epidemiological studies of populations, so the law of averages is at play. With personalized medicine, we’re moving away from one-size-fits-all to the individual patient — because we’re all unique at the molecular level.

Why all the buzz about personalized medicine? Why is it so important?
There is certainly a lot of hype, but we have to be cautiously optimistic. Caution is warranted because the field is still in the early stages, and personalized medicine is not yet ready for mass consumption. This is where my epidemiologist’s perspective comes in. We have to gather more evidence on whether associations between genetic variants and certain diseases are real, and this will take some time. Associations have already been shown for some diseases but not for most. But there is also reason for optimism because this is going to be a very powerful tool in the medical toolbox once the evidence shows that it’s ready to be put into practice. Personalized medicine can be used for prevention, diagnosis, treatment, and prognosis, so the potential is huge. The use of genomic technologies will result in better medical decisions and fewer mistakes. The day will come when a genomic test will be just another routine test that the doctor orders.

Tell me about your research focus.
My PhD research focused on evaluating new diagnostic tests for TB. Whenever there’s a new test on the market, it’s important to assess whether it adds any value to health decisions. This assumes that the test has already been shown to be highly accurate at the pre-market stage. That same paradigm can also be applied to personalized medicine because it involves tests based on genomic data or molecular biomarkers. Now for my postdoctoral fellowship, I will focus on the health economics of personalized medicine. These new tests will have high upfront costs, but will they actually save us money in the long run through better decision-making? Through my work experience, I know that cost considerations will trump everything else because there are always financial realities. So it was a natural progression to go from clinical effectiveness to cost-effectiveness.

What are your long-term goals in health care research?
As I was finishing my PhD, I felt that I was lacking real-world experience. So I decided to enter the working world and get a real job. After two years, I was starting to miss research.  My work was descriptive rather than analytical in nature. I decided to come back to an academic setting and look for a postdoctoral fellowship position. There is a learning curve for my current work because epidemiologists and health economists think quite differently, but that was part of the appeal. The fit feels right now, and the end goal is a faculty position somewhere.

Any advice for up-and-coming researchers?
I still consider myself an up-and-coming researcher!  I’m glad that I tried something outside of academia. It’s just as important to know what doesn’t suit you. This is the “life isn’t linear” cliché. Sometimes you have to go from point A to B in order to get to C, even if there are times when you wonder why you’re at point B. Also, I think that the leader of the group, whether it’s the head of an organization or your direct supervisor, is really important. His or her vision will set the tone for your work and the opportunities that you have.  The thing is to make sure that you and your best interests are included in that vision.