Prof Anne Abbott wins John Maddox Prize

A/Prof Anne Abbott has won the John Maddox
Prize for Early Career

Associate Professor Anne Abbott, an Australian neurologist at the Central Clinical School at Monash University in Melbourne, has been awarded the 2020 John Maddox Prize for Early Career individuals. She received the award for her innovative research on, and tireless advocacy for, “evidence-true” stroke and arterial disease prevention treatment.

A/Prof Abbott’s innovative research was first published in 2009. It showed that in people without referable stroke symptoms, non-invasive medical intervention is at least as effective as carotid artery surgery (endarterectomy). The carotid artery is the main brain artery and commonly affected by arterial disease. Medical intervention, consisting of lifestyle changes and medication, has improved in stroke prevention effectiveness by at least 65% over the last 3-4 decades.  Medical intervention reduces all arterial disease complications, healthcare costs and healthcare risk.

Arterial disease causes stroke and heart attack and is the lead cause of death worldwide. Carotid surgery and stenting are invasive, expensive and (especially in the case of stenting) often harmful. These procedures are a multi-billion dollar global industry, well established in patient treatment guidelines, despite limited or biased evidence in their favour.

A/Prof Abbott encountered strong opposition as she attempted to publicise her research findings. This ranged from lack of institutional support to her employment being discontinued at multiple institutions, exclusion from professional networks, and even death threats. Nonetheless, A/Prof Abbott continued to challenge the status quo at great personal cost, placing patients’ health and research integrity above all else.

A/Prof Abbott reached out globally. She formed an action group of clinicians and scientists, known as Faculty Advocating Collaborative and Thoughtful Carotid Artery Treatments (FACTCATS), who share and debate the scientific evidence. Frustrated by a barrage of misinformation being promoted by the medical industry, in 2011 Abbott contacted the president of the United States of America and subsequently testified at the pivotal United States Medicare carotid disease policy meeting in 2012.

A/Prof Abbott’s multiple-method reform approach also includes tireless communication through professional and lay-press publications, conference presentations and debates, creation of the FACTCATS website (FACTCATS.org), critical comparative guideline audit, “evidence-true guideline” creation and new research.

Ultimately, A/Prof Abbott’s efforts created and continue to drive a paradigm shift away from unnecessary carotid procedures and towards safer and more effective “evidence-true” treatment. Her research and translational methods are generalisable and have potential to improve treatment standards across many medical specialties.

A/Prof Abbott said, "My main feeling is one of relief - that I have been able to share something of the unexpected difficulties I have faced in simply doing my job as a patient advocate. There is also a sense of empowerment to address other barriers to improving patient outcomes globally. I am very glad the Maddox Prize initiative exists. It imparts new hope."