Ian Roberts is an epidemiologist, but he's venturing into territory usually reserved for breakfast cereal ads and Rudolph the Red-Nosed Reindeer. He's created a claymation cartoon to boost the use of a drug that could keep trauma patients from bleeding to death.
The drug, tranexamic acid, stops bleeding by helping the blood clot. In 2010, Roberts, a professor at the London School of Hygiene and Tropical Medicine, tested it in adult trauma patients who were bleeding excessively in a large clinical trial called CRASH-2.
As far as these large trials go, tranexamic acid was a success. In more than 10,000 patients who took it within eight hours of their injury, the drug lowered the risk of death to 14.5 percent and the risk of bleeding to death to less than 5 percent, compared with 16 percent and 5.7 percent for injured patients who got a placebo.
The drug is inexpensive, costing about $10 per patient, and Roberts estimates that this generic, off-patent drug could save 140,000 lives around the world each year.
Despite the success of the experiment, there was one major problem: Almost no one was using this life-saving drug. In a 2011 analysis of hospitals in the United Kingdom, Roberts found that of 412 trauma patients who were eligible to take tranexamic acid, only 12 got it.
"I've been doing clinical trials for 20 years, and you just don't get better results than what we got for tranexamic acid. It's cheap, it's safe and it's effective," Roberts said. "But lots of people don't even know about these results."
Roberts decided to spread the word about the drug. He recruited his nephew, Hywel Roberts, a 22-year-old animation student at the University of Bristol, to help him create a 40-second stop motion, claymation video to describe the drug and encourage viewers to see the evidence of its effectiveness for themselves by reading the results of the CRASH-2 trial.
The video is geared toward doctors, a group that relies heavily on evidence and data to determine how to treat patients. But Roberts said he tried to use something other than cold, hard facts to catch the eye of medical professionals.
"What makes things move on the Web is emotion," Roberts said. "It's not a funny problem, but we were looking to inject surprise and a bit of emotion into it. That's the bit that scientists take out of their research."
But some doctors may not be that receptive.
"For most physicians, what will change their practice will not be a clever animation," said Dr. Ronald Simon, director of the trauma center at Bellevue Hospital in New York City. "In order for there to be a real buy-in, they'll need real evidence that it works."
Although the CRASH-2 trial was well done, Simon said that because it was not conducted in the U.S., American doctors will be more reluctant to adopt tranexamic acid as a treatment for their trauma patients. They'll be more likely to use drugs with which they're more familiar, such as Factor VII, even though these drugs are often more expensive and perhaps less effective than tranexamic acid.
"The data on Factor VII is nowhere near as strong as in the CRASH-2 trial," Simon said. "But because American surgeons have more experience with it, they use it much more."
Roberts noted that the British and U.S. militaries both use tranexamic acid to treat bleeding soldiers on the battlefield. The drug is also promising for hospitals with limited resources in countries around the world, and Roberts' claymation video has been translated into Chinese, Portuguese, Russian, Spanish and Japanese to reach an international audience of doctors.
Dr. Michael West, a trauma surgeon at the University of California, San Francisco, said although the drug is beneficial in hospitals in more austere environments, it may not be applicable to major trauma centers in the U.S., which have a wide variety of treatments at their disposal to treat bleeding patients, such as frozen blood plasma or recombinant clotting factors.
"Other treatments, although admittedly expensive or resource-intensive, may be much more effective," West said. "But I don't see where any harm can come from disseminating information using this creative approach," noting that he was motivated to look at the data on tranexamic acid after watching the video.
Roberts said he's unsure if his video will go viral, but he plans to conduct follow-up studies to see if the cartoon boosts the use of the drug.
"We'll send the video to the appropriate people and then we'll just see what happens. And whether or not it works, we'll learn something from it, I think," Roberts said. "But there will certainly be no Oscars for us in this."