Claes-Fredrik Helgesson on studying valuation practices in medical research

This fall, Claes-Fredrik Helgesson, Professor at the Department of Thematic Studies at Linköping University in Sweden, visited InSIS for a couple of weeks. Dr Tanja Schneider asked what he is up to at the moment.

Claes-Fredrik HelgessonClaes-Fredrik, you are Professor of Technology and Social Change at the University of Linköping, Sweden, and are currently a Visiting Fellow at InSIS. What brings you to Oxford?

I’m here to do some research, meet people, write stuff, and thinking through stuff. And the secret thing is that I’m also escaping a few meetings.

Last week you gave a work-in-progress presentation about your current research, which focuses on valuation practices in medical research and I was curious to hear what got you interested in the topic initially?

I have for a very long time wanted to develop ways to examine how the economic is intertwined with scientific practice and the shaping of technology. Both because I think it is important, and because I think it is something that has not received sufficient attention within STS. I have grappled with how to do that and previously did work on the every day management and coordination of clinical large trials. When I did that work I also tried to investigate the economic aspects of large trials, for instance, how physicians are remunerated for recruiting patients but this was a bit difficult.

I have been thinking for quite a while that maybe the design of large clinical trials could be an interesting place because there appear to be many calculations involved; calculations that are both scientific calculations but also calculations about the costing of trials such as how much you can spend on it and maybe also about the commercial possibilities. That was more of an unpolished idea for quite some time but then Francis Lee was recruited into a position to work with me on questions about the design of research, and then we developed this research project together into a few different grant applications which we are still waiting to hear if they will be funded or not.* It’s been a long, abstract journey in terms of wanting to investigate the topic of science and economic practice but the development of this particular project is the result of perhaps one and a half years or so and we worked most hard on developing it this spring by writing grant applications.

So what will be your site of study? Where will you explore these issues?

Francis will look at experiments related to biomarkers and I will focus on the design of large randomized controlled trials (RCTs). We are currently investigating different possible sites and have some contacts already with people involved in clinical trials as well as experiments related to biomarkers. We both intend to do some of the fieldwork in the UK.

Can you say a bit more about how you will go about studying how the economic is intertwined with scientific practices.

We are planning to look at a few different experiments – or rather the design phase of these experiments – and we plan to do repeated interviews with those involved in the design efforts. One part of the exercise is thus to investigate who is involved in this work: maybe there is an investigator, a sponsor, representatives of patient organisations that can be involved but that has to be an empirical question. So, the methodology will be repeated interviews following the design process, which can take a few months or half a year, sometimes even longer. Hopefully, we will also be able to sit in on meetings where different kinds of designs are discussed.

It sounds like you are focusing on a laboratory site primarily. In how far do you plan to also consider/research how potentially other sites beyond the laboratory – I’m thinking, for instance, of Research Council’s and their annual research priorities and their grant evaluation practices – are intertwined with valuation practices in the laboratory?

I guess we have to start somewhere, where we think that the centre of this design work is going on but of course there is presumably a lot of stuff that is influencing and involved in that process. In our interviews done for preparing the grant applications, we have also begun asking about what kinds of tools are used, such as tools with the standard costing figures that contains a black-boxed kind of valuation. These come from somewhere and we have to make a reasonable attempt to investigate where this stuff comes from and what influence they have. And, of course, if it is a trial sponsored by a pharmaceutical company, how they evaluate different aspects of a trial. So probably there are several sites involved in a single design. And from what I understand there is a lot of emailing and teleconferencing going on as well. Hence there is no single point in time or space where the design is made. That are simultaneously interesting and challenging aspects of this topic.

While you are visiting InSIS you are also involved with organizing a workshop…

…yes, on the 21st of October a group came from the University of Linköping, Sweden, Tema T, the unit were I work – technology and social change – to visit InSIS. The visiting group of about ten to 15 people is part of a research programme called ValueS, which stands for Science, Technology and Valuation practices, and we are interested in STS and valuation as a practice. The purpose of the InSIS-ValueS meeting is to discuss each other’s research, explore ways to collaborate and establish regular exchange between the two groups. And we actually have a specific site for this meeting!

What else are you currently working on?

I’m finishing up an old paper, which I wrote about the study of the everyday coordination of large trials. What else? I’m working on a book proposal for an edited volume on value practices in life science, which is a volume that brings together different contributions from different aspects of life science, from different researchers. We have 13 contributions. So, I’m working on the book proposal with Francis Lee and Isabelle Dussauge, my co-editors from Sweden, who will also come to Oxford for the InSIS-ValueS meeting.

Did you find some time to explore Oxford so far? How are you finding it?

I’m finding it very nice and I’m enjoying it a lot. The weather has been good and the dining has been excellent. And I have a nice jog along the Thames in the mornings. It’s perfect.

It’s great to hear that you enjoy Oxford. Thank you very much for the interview!

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* In the meantime, Claes-Fredrik Helgesson and Francis Lee have received research funding from Riksbankens Jubileumsfond for 3,5 MSEK [appr £ 325.000] for their research project “Trials of Value”. Congratulations!

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