Karen's Story

Dr Karen Leong is a paediatrician from Malaysia. As a paediatrician working at a large referral centre for paediatric endocrinology, she would see many children with hormone problems. For example, some children lived with health issues such as short stature, obesity or diabetes (diabetes can develop as a consequence of obesity). Dr Leong wanted to learn more about issues and interventions related to obesity.

Dr Leong came to New Zealand in 2017 to do a year-long fellowship in paediatric endocrinology with Professor Wayne Cutfield. Following this, Prof. Cutfield suggested the idea of doing a PhD as part of the Gut Bugs trial. Karen is now a PhD student, working as a Clinical Research Fellow at the Liggins Institute, The University of Auckland. When her PhD is completed in 2020, Karen will be a medical doctor and a PhD - a Doctor of Philosophy.

Karen was first involved in the Gut Bugs pilot trial and subsequently became involved in the main trial. The main trial is on-going, with first results anticipated towards the end of 2019. The Gut Bugs research is conducted by a large team of people which consists of sub-teams such as the clinical team, the gut microbiome team (for example, Thilini Jayasinghe and Dr Justin O’Sullivan), the nutrition/dietetics team, pharmacists and drug delivery. 

Dr Leong is involved with the clinical team and works closely with participants in recruitment, clinical assessment and follow up.

The focus for the pilot trial was a ‘proof of concept’ - to see if there was any change in recipients’ gut bacteria following the faecal microbiome transplant (FMT). Because this change was observed, the team were able to continue with the main trial. One of Karen’s tasks is to conduct laboratory analyses of blood samples collected throughout the main trial. These samples will be correlated with other data collected when results are analysed. The data is very complex and analysis of the main trial is taking a long time because many different aspects need to be carefully considered. At the moment, Dr Leong is still ‘blinded’ - she does not know the significance of any changes she has seen until ‘un-blinding’ happens after the data has been cleaned, locked and analysed.

Nature of Science Ideas

• Science is a collaborative process and scientists often work in teams
  • Most big ideas take so much work, and so many resources, that no one can do them alone any more
• Science often involves carefully controlled experimental designs to reduce bias and ensure the results are reliable
• Science can involve exploratory pilot studies 
  • Pilot studies are a way to check whether an investigation is likely to work out, or to refine a method, with fewer risks of harming people or producing inadequate data

One of Dr Leong’s tasks as a member of the clinical team was to contact participants during the recruitment phase. She would tell them about the trial and gather more information. If prospective participants were interested and eligible, they were invited to come in for further assessment. The sheer number of personal contacts was both overwhelming and challenging. Out of 600 initial responses, Karen spoke with over 300 people and worked with 87 participants for assessment and follow up on the main trial.

Nature of Science Ideas

• Scientists’ work can be challenging and repetitive. They work in the lab but also need to be able to communicate with others.
• Science is innovative, exciting and breaks new ground

Dr Leong was surprised at how much attention the trial received and how interested people were. Even though the assessments were not always pleasant and took a long time, those who were recruited to the trial stayed on for the full six months - there were very few who dropped out. 

Participants were interested in the trial for reasons other than the possibility of losing weight. Only half of the participants received the treatment capsules, while the other half were receiving a placebo, and no one knew which capsules they were receiving. Dr Leong says, “they were quite excited about the science, and that’s why they joined.” Some participants came all the way from Wellington to participate.

Dr Leong also had to engage in the delicate task of finding donors: “It was quite tough, trying to find people who were fit, healthy, free from infections and ready to come in, commit their time to donate.” She worked hard to build relationships with the donors and make them feel comfortable so that when faeces were needed, she could pick up the phone and ask, ‘do you mind coming in at 8am tomorrow to help me out?’ And they would say ‘oh, sure, I’ll come…’

Nature of Science Ideas

• Being a researcher means that you are doing challenging and absorbing work where learning happens every day – you need to find your way, develop techniques, find out how to do things, ask others and work with others.