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A Career in Research: Methodological Advancements, Evidence Synthesis,
and AI-Driven Innovations in Healthcare
Thakkinstian’s two-decade career has been dedicated to impactful contributions in evidence
synthesis and generation, integrating rigorous methodological development, large-scale data analysis,
and cutting-edge artificial intelligence (AI) applications.
Since 2000, leadership has been provided in approximately 150 systematic reviews (SR) and
meta-analyses (MA), significantly impacting clinical practice and informing healthcare policy. These
studies cover a wide spectrum of research areas, including therapeutic interventions, diagnostic test
accuracy, risk and disease prognosis, genetic association studies, text and image analytics, and cost-
effectiveness analyses. The resulting evidence has been instrumental in shaping and refining clinical
practice guidelines across multiple medical specialties.
A major focus has been on methodological innovation, particularly in the area of genetic
association studies. Between 2000 and 2007, novel approaches to SRMAs of genetic association studies
were developed including: MAs of molecular association studies; The choice of a genetic model in the
meta-analysis, the handling of Hardy-Weinberg equilibrium deviations, and the quality assessment of MAs.
These publications have had a substantial impact, cited hundreds of times in subsequent research.
A novel one-stage network meta-analysis method was developed (2008-2009) for aggregated
binary and continuous outcome data. This method allows for indirect comparisons of multiple active
treatment regimens using a common comparator, employing robust statistical techniques such as
generalized estimating equations or multilevel models. This methodology has been successfully applied
in numerous studies, addressing clinically important questions in diverse areas: Management of chronic
prostatitis/chronic pelvic pain syndrome; NMA of indomethacin versus ibuprofen versus placebo for PDA
in preterm infants; Bell’s palsy treatment; Reno-protective effects of renin-angiotensin system blockade
in type 2 diabetic patients.
From 2017 onward, a significant focus has been on economic evaluations, including the
development of advanced MA methods for pooling incremental net benefit. This work established
innovative approaches to data harmonization and providing robust methods for synthesizing evidence on
cost-effectiveness, applied in INB of Bariatric Surgery; Cost Utility of Sodium-Glucose Cotransporter 2
Inhibitors in Type 2 Diabetes (T2D); rotavirus vaccine in low-income/lower-middle-income countries.
These methods have been widely adopted, evident in over one hundred subsequent publications that have
applied these INB pooling techniques.
Beyond evidence synthesis, a substantial body of work has been dedicated to generating evidence
directly through randomized controlled trials (RCTs) and the creation of large-scale real-world cohorts. A
total of 25 RCTs, considered the standard for evaluating interventions, have been conducted, involving
single-center and multicenter center collaborations including partnerships with Thammasat University
Hospital; King Chulalongkorn Memorial Hospital, Chulalongkorn University; Phramongkutklao Hospital,
Rajavithi Hospital, and Ramathibodi Hospital.
Harmony in health: Innovation for Sustainable Medicine 23