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- Honorary Professor
- Eastman Dental Institute
- Faculty of Medical Sciences
Professor Joanna M. Zakrzewska BDS, MB BChir, MD, FDSRCS, FFDRCSI, FFPM RCA, FHEA
After obtaining dental (Kings College, London), medical (University of Cambridge ) degrees Joanna Zakrzewska underwent specialist training in oral medicine. Initially specialised in oral cancer screening programs in industry and then set up and ran for ten years the first oral and dental clinic for patients with HIV and AIDS. Joanna Zakrzewska went on to specialize in orofacial pain. After gaining an MD on trigeminal neuralgia she transferred to an academic post at Queen Mary’s Dental School, London were she ran the oral medicine department for ten years. She was awarded a personal chair in pain in relation to oral medicine and became the first non-anaesthetist fellow of the Faculty of Pain Medicine. In 2007 Joanna Zakrzewska moved to University College London Hospitals NHS Foundation Trust, to set up and led the largest multidisciplinary facial pain unit in the UK. The unit sees over 700 new patients a year and over 1,500 follow ups and runs an evidence based, patient centred service. Supervised an interdisciplinary PhD on visualisation of pain through photography led to further post doctoral funding to develop the generated pain cards into tools that can be used in pain consultations to improve communication. She has written 4 books on orofacial pain including one for patients, 22 chapters and over 120 papers. Her main area of research is in trigeminal neuralgia and she is a Trustee and head of medical advisory board for the Trigeminal Neuralgia Association UK, a support group for patients. Currently she is principle investigator of international trials of a new drug for trigeminal neuralgia, now published first results. With Uof Leeds has published the first paper on the impact that trigeminal neuralgia on quality of life and is aiming to set up a national centre for this rare and potentially devastating disease. She lectures extensively both nationally and internationally and has played a prominent role in the International Association for the Study of Pain’s global campaign to increase awareness of orofacial pain.
My research on orofacial pain and particularly trigeminal neuralgia is clinically based and I am working not only with multidisciplinary teams at UCLH/UCL, but also with teams nationally and internationally. I am committed to evidence based medicine as shown by my long association with the Cochrane Collaboration but equally believe in the need for narrative medicine especially in the field of pain.
The following are my current key areas of research :
i. Clinical trials in trigeminal neuralgia (TN)
I helped to conceive the design and then was chief investigator on a multicentre, multinational phase IIa study to evaluate the safety and efficacy of CNV1014802, the first new drug for TN. Based on my experience with other trials we used a novel design of enhancement enriched trial to take into account the difficulty of using placebos or active controls in this severe pain. Details on http://clinicaltrials.gov/ and NIHR CRN Portfolio - UKCRN ID 11675 – 3. The trial is now published in Lancet Neurology. We have now started preparation for another international phase 3 study.
ii. Cohort data on TN
I currently have ethics approval for a natural history cohort study of TN with 284 recruited patients since 2007, the largest cohort of non surgical treated patients in the UK. We published baseline data on 225 which for the first time highlights the impact this disorder has on quality of life using validated outcome measures. This is part of a collaboration with a research group in UoLeeds. Currently assessing management of TN in the USA through insurance claims data.
iii. Surgical management of TN
We undertook a Cochrane systematic review of surgical management of TN. We have now published a scoring system for improving the quality of reporting of surgical outcomes in TN. In collaboration with the Society of Neurological Surgeons UK looking to audit surgical management of TN using HES data.
iv.Improving classification, diagnosis and care-pathways
I was section lead of a multinational group revising chapter 13 of the International Headache Society classification to try and bring it into line with ontological principles. I was part of the international team from IASP to operationalize the diagnosis of TN (published in Neurology)
v.Visualisation of pain through photographic images –face2face, Pain: speaking the threshold
An innovative project with the Slade at UCL is using images created by patients and an artist Deborah Padfield, to improve our understanding of pain, its communication and progress through management. I was supervisor for Deborah’s PhD, which resulted in exhibitions and publications e.g . the Jones D Exhibition Portraits of Pain Lancet;2011:378: 391). We received further three years post doctoral funding for an interdisciplinary project which culminated in the first ever conference for patients, carers, HCP, scientist, humanities on Encountering pain hearing, seeing and speaking, https://www.ucl.ac.uk/encountering-pain in June 206. The results of this study are now being published in the Lancet Perspectives March 2017 and being prepared for a book to be published by UCL Press. We have taken part in Wellcome's night spectacular in pursuit of pain.
I am an enthusiastic committed teacher who takes pride in her teaching. Not only do I want to teach effectively but I also wish to understand the basis of educational theory. I was one of the first in the dental school to gain HFEA membership and assisted 4 others (through seminars which also encouraged the spread of good practice) to gain membership. I insist that my juniors take up training in learning and teaching as part of their normal pattern of career development. Effective professional practise entails lifelong learning so I regularly read educational journals and books, am a member of medical educational societies such as ASME and AMME, participate in staff development, maintain a teaching portfolio, reflect on my teaching and publish in peer reviewed journals.
I aim to inspire students by example and show especially our undergraduate students how theoretical teaching is put into clinical practise which includes bringing patients to lectures and using evidence based medicine at the chair side. The advent of HIV/AIDS led to a need to train not just undergraduates but also the teaching staff both medical and dental. I established a teaching package for consultants and students which I then trialled at the University of Perambuco in Brazil.Further developments included a course on oral awareness developed with Dr H. Fry , now Head of Education at Imperial College, for medical undergraduates which we hope other medical schools will adopt . I have now taken up the challenge of increasing the teaching of Pain at all levels of the medical and dental curricula. I introduced a special thread on pain in the new 1999 dental curriculum and would like to introduce it into the medical curriculum.
I take the training of my junior staff seriously and in order to understand better the problems they are facing I undertook a UK wide study into the training of oral medicine and I was chair of the Speciality Training Committee for the Additional Dental Specialties in the London Deanery for a term of five years.
I now supervise MSc projects and try to ensure that they get published. Annually supervise medical students as part of their Aca Medicus research projects which have led to publications and provide independent observers when evaluating innovative services introduced into our facial pain service.