Farewell to Professor Alessandro Liberati

Alessandro Liberati, 57, died on 1st January 2012, more than eight years after being diagnosed with multiple myeloma. He felt that the disease had started even earlier, as Monoclonal Gammopathy of Undetermined Significance (MGUS). It is paradoxical that the name of the disease that took him from us contains the word ‘undetermined’, when Alessandro spent his life trying to limit uncertainty. His sense of irony, affability, smiles, communication skills, enthusiasm, energy, vision, and hard work were central to the launch, diffusion and growth of evidence based medicine in Italy. He passed this to thousands of students during his years as a University Professor and to vast numbers of others through his research, writing and presentations.

Alessandro became involved in clinical research during a spell of voluntary service in the early 1980s. Being a doctor he was assigned to the Mario Negri, an institute for pharmacological research in Milan, where he met Prof. Silvio Garattini. His interest in evidence based medicine increased as he became closer to Prof Thomas C. Chalmers and Sir Iain Chalmers. When Iain invited Alessandro to take up the task of establishing the Italian Cochrane Centre in 1994, as one of the first Centres in the young Cochrane Collaboration, Alessandro accepted with enthusiasm.

Alessandro and Italian Cochrane colleagues

Alessandro’s systematic reviews of chemotherapy for breast cancer and antibiotic prophylaxis in intensive care were key-milestones of research in their fields. But, after his diagnosis of multiple myeloma, Alessandro started to look at research on a broader basis. He strove to reduce distortions in the prioritization of research questions, to make them more relevant to patients’ needs. In 2004, he wrote a BMJ personal view talking of his disease and the uncertainties he faced “Research results should be easily accessible to people who need to make decisions about their own health.[…] Why was I forced to make my decision knowing that information was somewhere but not available? Was the delay because the results were less exciting than expected? Or because in the evolving field of myeloma research there are now new exciting hypotheses (or drugs) to look at? How far can we tolerate the butterfly behaviour of researchers, moving on to the next flower well before the previous one has been fully exploited? Unfortunately this is possible in a world where clinical research has become dominated by commercial interests. When you are a patient you wonder how (we) researchers can keep forgetting the principle that the priority should be collaboration for better hypotheses, not competition.”

In the same year, Alessandro was appointed to drive an integrated research system, bringing together medical schools and public hospitals in Emilia Romagna. This was his last appointment as a research officer, in a long career which spanned decades and involved a dedication to helping people make the best possible choices in health care and healthcare research. Alessandro served not only his country but colleagues across the world, and countless others who never met him but who benefit from his work.

Alessandro leaves a wife, Mariangela, and two daughters, Elisa and Valeria.

Alessandro requested that those wishing to note his passing should not buy flowers, but should donate to the charity that he founded (AREAS – Italian Cochrane Centre, Banca Popolare di Sondrio, IBAN IT44R0569601607000005656X67).

This obituary also appeared, in slightly different form, in Sole 24 Ore. The Cochrane Collaboration gratefully acknowledges permission to reprint from the journal and the authors of this piece, Lorenzo Moja and Roberto D’Amico.

Alessandro and his wife, Mariangela in September 2011

In October 2011 at the Madrid Colloquium, Alessandro Liberati sat down with writer Alan Cassels and shared his thoughts on the accomplishments of the Cochrane Collaboration and explained why he became involved and committed to the work of the Collaboration. The full interview was recorded and edited by Richard Davis with photos supplied by Jini Hetherington and Kay Dickersin. Watch the video below:

Colleagues have also prepared an audio podcast containing excerpts from an interview with Alessandro in October 2011 (see link above), when he described challenges for the Collaboration's future and how he got involved in its work. Listen to the podcast below:

Alessandro’s colleagues and friends have gathered a collection of links which commemorate his life and work:

• A web page has been created for people to express condolences, recount memories and share photographs: http://www.cochrane.org/alessandro-memory-book
• Obituary (in Italian) from Sole 24 Ore
• Obituary from the Lancet
• Obituary from the BMJ (requires subscription)
• Iain Chalmers, one of the founding members of The Cochrane Collaboration along with Alessandro, has prepared a piece entitled “Alessandro Liberati: a personal appreciation”, published in Italian and English for the journal Epidemiologia e prevenzione (Italian Review of Epidemiology). Access the piece here.
• Marina Davoli, one of Alessandro’s colleagues in the Italian healthcare research community and a fellow Cochrane contributor, also prepared a piece for Epidemiologia e prevenzione, entitled “Alessandro Liberati: a national and international reference point for clinical epidemiology and health services research”. Access the piece here.
• An editorial that Alessandro wrote on the importance of re-aligning the goals of commercial and academic research with the needs of patients; originally published in the Lancet, it was recently featured on the Cochrane Library here.
• Alessandro’s colleagues from the Italian Cochrane Centre have translated his final post from his own blog into English for publication on the Cochrane Blog. Access the post here.

This page will be available on cochrane.org for viewing until the week of 20 February, and the tribute page until the week of 19 March. After these dates, both pages will be archived, but still accessible.