Dr Andrew McArdle wins the Lorber Award 2022

During the COVID-19 pandemic, rapid evidence in its treatment of children and young people was crucial, and Dr McArdle's research in this area became of international importance.
Dr Andrew McArdle

Dr Andrew McArdle is a paediatric infectious diseases and immunology trainee in London, currently studying for a PhD at Imperial College. He studies Kawasaki Disease and Multisystem Inflammatory Disease in Children. 

Dr McArdle has had the incredible opportunity within recent years to take part in the RCPCH Global Links programme, in which Paediatricians, Neonatologists, Obstetricians, Paediatric and Neonatal Nurses and Midwives are trained and placed in medical centres across the world in low-resourced locations such as; Sierra Leonne, Rwanda, Nepal and Lebanon. 

Dr Mcardle did a one year placement in the Emergency Department of Ola During Children’s Hospital, Sierra Leone’s national children’s hospital in Freetown.

The full story of his time there can be read in the Our History, Your Future blogs on this website.

About the Lorber Award

The Lorber Award was established in memory of Professor John Lorber (1915-1996) who made major contributions to the field of medical ethics, childhood tuberculosis and neural tube defects.

Every two years the Lorber Award is given to a pre-consultant grade medical practitioner working in the UK for the best scientific paper related to paediatrics.  

Submitted articles are judged by an adjudicating committee, established by the Academic Board of the RCPCH, with respect to scientific content, clinical contribution and presentation. The committee may in exceptional circumstances offer the award jointly. The winner is awarded at RCPCH Conference and Exhibition. The winner receives £200 and a certificate, in addition to expenses covered for travel, and a day entry pass to Conference.

On Dr McArdle's submission, Professor Paul Dimitri, Vice President for Science and Research said:

As the world faced the emergence of a new disease during the COVID-19 pandemic known as 
PIMS-TS (paediatric multisystem inflammatory syndrome temporally associated with COVID-19 also known as multi-system inflammatory syndrome) rapid evidence was needed to understand how children and young people responded to therapies.

Professor Levin and colleagues led on this work published in the New England Journal of Medicine in collaboration with colleagues from across the globe, to aggregate information from a significant number of children with PIMS-TS, to demonstrate that glucocorticoids were as effective in treating PIMS-TS as IV immunoglobulin used as a single agent or when these agents were given in combination. 

At a time where rapid evidence was critical in the treatment of SARS-Cov2 in children and young people, this research was of international importance.

 We spoke to Dr McArdle about his research, the award and plans for the future.

Can you tell us about your publication? 

The Best Available Treatment Study (BATS) is an international cohort study of Paediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 (PIMS-TS, also known as MIS-C). Prof Mike Levin recognised the critical importance of understanding the effectiveness of treatments. He assembled a team in May 2020 mere weeks after the first description of the syndrome, without specific funding. An amazing group of hundreds of clinicians around the world submitted extensive data on the presentation, progress, management and treatment of over 600 patients.

Partnering with Ortensia Vito (joint first author) who has continuously supported the consortium, I led the analysis with an amazing group of colleagues, including Harsita Patel, Ellie Seaby, Ortensia and Priyen Shah. Working to tight deadlines and with rigorous peer review, we were delighted to share the first output with the world in mid-2021.

We provided estimates of treatment efficacy of the two main treatments (immunoglobulin and corticosteroids), alone or in combination, which sit alongside other work from colleagues in France and the USA.

What does it mean to you to win this award?

This is a personal award, but neither the data gathering, cleaning, analysis or publication would have proceeded without the extraordinary collaborative work of our team. I can in no way see the award as resting primarily on my work. The four intense months of work came at the expense of many evenings and weekends, and I would not seek to repeat the performance in a hurry - especially not now with twins! However, I and the analysis team have developed our skills in so many ways, and I believe it will remain a seminal experience in our careers. 

I receive this recognition from my UK colleagues with gratitude and satisfaction, but the honour is shared with the team and consortium. 

What is the importance of this paper to child health?

Being a rare condition, gold-standard randomised-controlled trials would always be a challenge (though commendably, colleagues have undertaken these) and the time to results long. Our study provides pragmatic, globally relevant real-world data, not just on treatment efficacy, but also severity and outcomes. Because of our large cohort, we could look at steroids alone as first-line treatment - an option of particular relevance in settings with more limited resources.

Our paper has attracted a global readership, with over 100 000 views online.

What is your advice for aspiring researchers?

I agreed to take on the role as lead analyst with trepidation - whilst the foundation was there, the experience and specific knowledge was lacking! Considerable confidence came from the supportive team. It might be tempting to assume that we felt assured of a high impact publication in a prestigious 
journal. This was far from the case for me - I was committed throughout because of the clinical and scientific value, the potential for personal and professional development, and to ensure the work of hundreds bore fruit. 

I consciously chose to judge the outcome on this basis - the journal of publication and this award are a wonderful addition.

On this basis, I would advise:

  1. Whatever their value, do not set your heart on or judge your (or others') success by crude metrics, focus on more substantial matters.
  2. Unless you brim with overconfidence, you probably underestimate what the future you can achieve - look for those opportunities which will stretch you. They might just give you an opportunity to shine!