Neil Singla, MD
Owner, Managing Member
Lotus Clinical Research, LLC
What is your area of specialty?
I am an anesthesiologist by training, but I spend most of my time performing analgesic research studies. I work out of an early phase analgesic research unit located inside Huntington Hospital (Lotus Clinical Research) in Pasadena, CA. My main academic interest lies in improving experimental methods to decrease the alarmingly high rate of false negative analgesic trials we are currently seeing in our field. Of all the methodological flaws that may be contributing to experimental error in analgesic trials, I think some of the most important and “most fixable” are patient-related factors. The fact that patients cannot accurately report pain in analgesic trials is often lamented among researchers. I tend to believe that most subjects are well-meaning and, with proper instruction, can provide reliable data. Improving our process for educating study subjects and clinical trials staff is my main passion and area of specialty.
What initially sparked your interest in working in your field? Briefly describe your career path.
When I was a resident, I loved anesthesia and was very much looking forward to a long clinical career. In my final year of residency, I started to have pain in both of my arms. The pain made it difficult for me to perform the repetitive manipulations that are required in clinical anesthesia. At first I thought it was not a big deal and that the issue would resolve itself, but after a period of time, I could tell that it was a serious problem. As one can imagine, this came as quite a shock, and I was forced to scramble to figure out what I was going to do as an alternate career path. I had always had an interest in clinical research and therefore found a mentor inside my residency program, Lowell Reynolds, MD, who helped me understand the field of anesthetic research. I naturally gravitated toward analgesic studies, because I was having my own complex analgesic problem.
My battle with chronic pain went on for several years, as I continued to perform research in the field. It was a surreal experience, reading and performing research on the cycle of anxiety, depression, and chronic pain—and experiencing these issues simultaneously. I found my path out of this conundrum using the clinical knowledge that I garnered through years of work in the field of analgesics, namely, a multimodal approach that included physical therapy, nonopioid-based medications, and exercise. My arms still bother me to some degree but are more of a nuisance now than a serious issue. I don't have chronic pain anymore and have been grateful that the appropriate clinical advice was available to help me with my situation.
What has been a highlight of your work? Perhaps you and your staff are proud of a certain project or accomplishment.
I think our group has done a nice job when it comes to actually performing analgesic studies. We have done a lot of work in understanding how to select patients and then subsequently gathered appropriate pain data from them without unduly biasing them or exaggerating their natural placebo response. We do this through a multilevel process that includes site education and patient discussion and education. Controlling placebo response and increasing effect size makes analgesic studies more reliable, which in turn, makes it more likely that we will efficiently develop better analgesic therapies.
How has membership in APS been of value to you and your professional development?
I have been a member of APS for several years. For the last couple of years, I have been heavily involved in the Clinical Trials special interest group (SIG), which I now chair. This group has been of immense value for me in that it allows me to get together with fellow researchers and discuss a critical topic that we normally sweep under the rug—our failures. Methodological understandings can only be garnered through a discussion of failures. So many of our missteps remain unpublished (sadly) and, therefore, opportunities to learn are lost. At the SIG conference, we have an opportunity to openly discuss and share what has worked and, more importantly, what has not worked. I learn a lot from discussions I have at the actual SIG meeting and also in the hallways and planned meetings that occur during the APS Annual Scientific Meeting. After the meeting is over, I continue to receive e-mails and phone calls on important topics that originated in the SIG. These conversations are extremely useful, interesting, and productive.
Featured in the November 2013 Issue of E-News