Professor Ian T. Russell 1944-2022
Our mentor, colleague and friend Professor Ian Russell, who has died age 78, was one of the most eminent researchers of his generation who trained many of todays leading global health researchers. During a remarkable career that spanned nearly 60 years, his pioneering research improved the lives of patients by determining the effectiveness and costs of treatments and helped health, public health, community and social services run more efficiently. His innovative trial designs have influenced the design and conduct of trials around the world. He was a statistician by training who always thought of himself as a general health services researcher. His work further evolved to use complex methods in answering important health care delivery and policy questions.
Ian was a pioneer in the 1980s and 90s of the pragmatic trial design, which he felt was more appropriate to answer pressing clinical questions than the standard double-blind placebo-controlled trial. His trials routinely incorporated patient reported outcome measures (PROMS), economic evaluations and process measures - whilst these elements are commonplace now, he was 20 years ahead of his time. He was highly creative in his trial designs, examples include: use of Latin and Graeco-Latin Squares; one of the first trials evaluating keyhole versus conventional surgery; one of the first patient preference trials evaluating surgical and medical termination of pregnancy approaches. His trial ‘North of England Study of Standards and Performance in General Practice’ undertaken at Newcastle University in the 1980s that replicated 5x5 Graeco-Latin Squares and included patient reported outcomes is still considered one of the most ambitious and innovative trials of quality improvement. His research also supported methodological developments for example, he developed and evaluated PROMS in the early 1990s and he was an early adopter of stepped-wedge trial designs using them to assess a newly introduced reform for critical care patients in the NHS in the early 2000s. He was an early and enthusiastic supporter of Cochrane (launched by Professor Sir Iain Chalmers in 1993) and evidence-based care. Ian pioneered the conduct of systematic reviews for answering policy questions, overviews of systematic reviews, and understood the importance of qualitative research and patient and public involvement well ahead of such methods being used by others.
Born in Exeter in 1944 to Joseph Henry Russell and Muriel Florence Russell (nee Durrant), Ian read mathematics at St. John’s College Cambridge (1963-1966), followed by a MSc in mathematical statistics at Birmingham University (1966-1967). He became a Fellow of the Royal Statistical Society in 1968. He started a PhD in Health Services Research when a Research Assistant at the University of Essex (1968-1970). His PhD was awarded in 1977. Ian met fellow statistician Daphne through the Methodist Society at Cambridge University in 1965 and they married in 1969. Their sons Mark (1974) and Luke (1978) completed their family, of which he was immensely proud. Daphne collaborated with Ian for much of his career and was a statistician on several research projects and in both his final trial units.
Across his career Ian created many new departments and led several initiatives that were interdisciplinary and ahead of their time. On leaving Newcastle University in 1987, he became Founding Director, Health Services Research Unit, University of Aberdeen (until 1993), Founding Director of Research and Development NHS Wales (1993-1994), Chair of the Commissioning Board for Health Technology Assessment, NHS Executive (1993-1996), Founding Head of Department of Health Sciences, University of York (1994-2001) during which he set up a clinical trials unit and the Hull York Medical School, Founding Professor of Public Health, University of Wales Bangor (2002-2008) during which he set up a clinical trials Unit (NWORTH), Founding Professor of Clinical Trials, Swansea University (2008-2015) during which he led the Swansea Trials Unit, Director of Research, Swansea University Medical School (2010-2013), and Senior Research Leader, Health & Care Research Wales (2013-2016).
As an illustration of the vast range and impact of Ian’s research, he published over 340 peer-reviewed or invited publications that covered eight fields – public health, secondary care, primary care, clinical governance, balance of care between hospital and community, social care, health promotion and medical education. His research spanned eight disciplines or techniques – randomised trials, other multi-disciplinary health care research, systematic reviews, survey research, biostatistics, economics, epidemiology and qualitative research.
Ian’s passion, enthusiasm and energy inspired both the clinicians he worked closely with and a generation of researchers. Although Ian was extremely busy, he always had time for junior contract researchers and he fired many students’ interests in trial methodology or the application of health services research methods to policy questions. He supervised PhD students from different countries, many of whom went on to major positions of academic and health policy leadership in the UK and globally (e.g. in Canada, Egypt, Iran, the US, Norway). Ian and Daphne welcomed colleagues and students into their home with warm hospitality and lots of food. His former students and colleagues recall spending time with him on research related discussions that could extend to late hours in the evenings or on Saturdays.
Whilst Ian was well ahead of his time concerning many aspects of research, he did not get round to editing documents electronically until the new millennium and thereafter he commonly defaulted to paper and pen. He would work on hard copies (often obliterating the author’s precious text with gallons of tipex, and if really bad by stapling paper over and completely re-writing a section. He used three different colours for edits: blue (very frequent proposed edits which always made the text better), red (infrequent but fundamental issues that needed to be addressed before the manuscript was ready to go) and green (for interesting ideas to be picked up on later ie after the manuscript was submitted). The only problem was that he often did his editing on train journeys during which he would try and dissuade other passengers from sitting next to him by covering the table with various papers and boxes full of pens. Ian would then fax the edited paper back to the author who then could not make sense of his colour coding because faxes were black and white! He also offered any of his staff a free copy of ‘Complete Plain Words’ (1986 Edition) by Ernest Gowers to encourage them to write simply and legibly.
Ian was honoured in both England and Scotland: Hon FRCGP Royal College of General Practitioners (1993), FRCP, Edin, Royal College of Physicians of Edinburgh (1997), FFPH, Royal College of Physicians (2003), Hon DSc University of Aberdeen (2008), Hon FRCP London, Royal College of Physicians of London (2013).
A keen cyclist and a season ticket holder of Newcastle United with his sons, he also embraced life and embedded himself in the communities he lived and worked with, including in local churches of his community. He was a passionate walker (especially in Scotland). He was very proud of his University of Aberdeen kilt, which he wore whenever formal dress was required. When he moved to Wales he learned Welsh and became a lay preacher. Following his retirement, Ian initially split his time between Wales and Scotland, before finally returning to Scotland with Daphne where his two sons and their families were based and he could walk in his beloved Scottish hills. Although ‘officially’ retired at the time of his death Ian was still involved in contributing to health services research and he will be an immense loss to the profession. The news of his death was sudden, and to those who loved and cherished him, too early.
He is survived by Daphne, Mark, Luke and eight grandchildren.
Professor Ian T. Russell, statistician and health services researcher, born 30th August 1944; died 18th September 2022
Professor Jane Noyes
Professor Arash Rashidian
Professor Sir Iain Chalmers
Professor Jeremy Grimshaw
Professor David Torgerson
Professor Cam Donaldson
Professor Marion Campbell
Dr Zoe Hoare
Emeritus Professor Cathryn Glazener
Emeritus Professor Ceri Phillips
Emeritus Professor Elizabeth Russell
Professor Rhiannon Tudor Edwards
Publication date: 13 October 2022