A self-described “long-shot” and in the first generation of her family to attend university, Donna Ohnmeiss speaks to Spinal News International about why she chose to put her degree in mathematics to use in clinical research, and how her work on healthcare outcomes ultimately led to her position on the Board of Directors of the North American Spine Society. She warns readers of the rise in predatory publishing, explaining how it is threatening the peer-review process, and explains how she believes improvements in diagnostics is the most exciting development in today’s spinal space.
When did you know you wanted to go into research, and what drew you to spine research specifically?
Clinical research was not something I had ever thought of entering into as a career. Coming out of graduate school with my Master’s in Mathematics and some computer programming background, the opportunity arose. I have always enjoyed working with numbers, and clinical outcome studies seemed to be a good fit. It was also great to think that I could use my love of numbers to impact healthcare.
Have you had important mentors throughout your career? What have they taught you?
My first research mentor was Heikki Vanharanta from Finland. He taught me very much about how to think about designing research studies and the data generated from them. I will also always be very grateful to Jan Ekholm at the Karolinska Institute in Stockholm, Sweden, for allowing me to study under him for my doctorate.
What is your proudest career achievement to date?
It is difficult to say. Getting my doctoral degree was wonderful, particularly considering I was somewhat of a long-shot growing up in a small town and being in the first generation of my family to go to college. It was also an achievement for me to get comfortable presenting at conferences. It can be intimidating to take the podium at a large meeting. It has been great to be involved with professional societies. This year I was the co-chair of the NASS annual meeting and also served on their Board of Directors. It is a real honour to work with such a committed group of professionals.
How has the field changed since you started your career?
I have been in it so long there have been many changes. Much of the data collection has gone to electronic capture, the development of registries, and now it is much easier to access literature online. But the increasing use of technology has also created some
problems related to just “slicing and dicing” large databases multiple times to generate presentations and publications rather than taking more time and effort to generate something potentially more useful and meaningful. Also, online journal access has given rise to the problem of predatory journals, which threatens the credibility and quality of the peer-review process and publishing.
In your opinion, what are the most exciting new developments in spine care that we can expect in the next five to ten years?
There is a lot of excitement about stem cells and minimally invasive surgery. However, I think what is likely more important for spine is in the basic areas of diagnosis and getting better at matching specific treatments with specific patients. This involves imaging,
psychology, biomechanics, and solid clinical diagnostic skills, as well as continually improving technologies and collecting data to generate evidence for specific interventions in defined patient subsets.
What is the biggest challenge in spinal research at the moment?
One of the greatest challenges for spine research remains adequate funding. While back pain is a major cost to healthcare, there is very little funding dedicated in this area. Back pain is a very complex, multifactorial problem. Much work is needed to optimise the cost-effectiveness of care and get patients the most appropriate care as soon as possible. This will take many large-scale studies. Such work is expensive to do.
You have a background in mathematics. How has this been important throughout your research career?
My work in spine research began with organising databases for various studies and analysing the data. My background in maths was a great benefit not only in this obvious
application, but I think also in developing study protocols and writing papers. Mathematics requires organised, focused, persistence and stepwise critical thinking skills—these are very helpful in medical research.
You have been very involved with the North American Spine Society, currently sitting on the Board of Directors. What is the society’s greatest achievement whilst you have been on the Board?
I think one of the greatest achievements has been the recent launch of the NASS registry. It provides all spine care providers with a platform to collect data on their patients in a standardised fashion using appropriate outcome measures. The registry was designed specifically for back pain patients and can be used for non-operative as well as operative care. I also think NASS’ ongoing work in advocacy and supporting evidence-based care is very important.
In addition to holding several journal positions, you were honoured as one of only nine Top Reviewers in 2016 for The Spine Journal—what did this achievement mean to you?
When I think of the high calibre of people associated with The Spine Journal, to be recognised as one of the top reviewers was great.
There is still a gender disparity among the top researchers in spine. How well do you think institutions are doing in assisting more women into following a career in spine, and could this be improved?
Traditionally, there have not been many women choosing to go into the sciences, including spine research. There have also been very few female spine surgeons. In the past few years, this has been changing. We are seeing more women getting involved, taking leadership positions in professional organisations, and becoming spine surgeons or non-operative spine specialists. I think this trend will likely continue as the opportunities increase and women continue to be successful in these roles.
What advice would you give to someone wishing to start their career in spine research?
Never sacrifice quality. Be patient, be persistent, and always try to do the right thing. There are inevitably unanticipated obstacles when trying to execute a study; recruitment and data collection generally go slower than desired. Regardless of how good the intention, there are occasionally studies that just are not going to be executable as planned. Learn from these and apply the experience when planning future projects. Although most clinical research studies take several years to complete, it is a great feeling when a good study comes to fruition and the results are presented at conferences and published, and hopefully produces helpful information for providers to use inpatient care.
I encourage everyone to get involved with professional societies. This provides a great opportunity to know more professionals in the field and gain exposure and experiences outside of your workplace.
What are your interests and hobbies outside spinal?
I really enjoy working in the yard. I also like doing needlework such as counted cross stitch, and just having a good time playing cards or games with family and friends. I am interested in WWII and related history, as my father served in Europe and I also learned a lot from my mother talking about what life was like in the USA during the war.