Melissa Muko, ASA Graphic Designer/Production Coordinator

Sandra Stinnett

Biostatisticians are a vital part of any medical research team. They collaborate with researchers to gather and analyze data that will provide answers to important medical questions. Physicians rely on this research to determine whether a medication will work for his or her patient or what medical procedure will be most effective. Without correct data, it is impossible to know what new treatments and techniques will be beneficial to patients. At Duke Eye Center, that biostatistician is Sandra Stinnett.

It might be surprising to learn that Stinnett did not take a single mathematics course as an undergraduate student studying psychology at the University of Houston. After earning her bachelor’s of science degree in 1970, she realized she did not have that many employable skills. She decided to rethink her future by exploring her growing interests in both math and Spanish. Over three years, she began taking math courses at the University of Houston and Spanish classes at Berlitz, a school for language instruction and cross-cultural training.

In 1973, Stinnett discovered The University of Texas School of Public Health. She intended to go into international health, but had a chance encounter with an epidemiology professor while interviewing at the university. The professor asked her if she had an interest in math (which she did) and suggested she go into biometry and work for him on a study of hypertension and African Americans in Panama. After the professor explained that biometry was the application of statistics to biology and health, Stinnett knew this program would be a good fit for her and her career goals. She entered the master’s program and, in 1975, traveled to Panama to collect data for the professor’s hypertension study.

While working on her master’s thesis on regression to the mean in repeated measurements of blood pressure, Stinnett learned of Sir Francis Galton (1822–1911), who first used the term “regression to the mean.” She found it interesting how Galton worked out the details in ways that were easy to understand. She enjoyed reading not only about his statistical role models, but also the many careers he had. “He was an English Renaissance man who traveled in Africa and was a tropical explorer, a geographer, an anthropologist, a meteorologist, a geneticist, and a psychometrician, as well as a statistician,” she said. “What a romantic time that must have been! It inspires me to explore many fields and interests …”

Sandra Stinnett prepares a presentation in the OCT Reading Center of the Duke Eye Center while (from left) Cynthia Toth, a retinal surgeon; Char DeCroos, a resident at the eye center; and Cynthia Heydary, an employee who works with the data in the reading center, look on.

After completing her master’s degree in 1977, Stinnett began working at The University of Texas School of Public Health in the epidemiology research unit. She worked as a statistician on grants funded by the National Institutes of Health and Environmental Protection Agency related to health effects of petrochemical plants—facilities that produce substances such as methanol, ethylene, toluene, propylene, vinyl acetate, vinyl chloride, and styrene—in several Texas counties.

After working at the UT School of Public Health for several years, Stinnett decided she wanted to continue her studies and chose The University of North Carolina School of Public Health as the place to pursue her doctoral degree in biostatistics. In 1981, Stinnett moved to North Carolina after a series of what she called “cosmic events.” “I kept meeting people from Chapel Hill, found a house on my first visit, and got a job in the biostatistics department. And my employer in Houston allowed me to continue working remotely in Chapel Hill. It was a heady time.”

In the fall of 1982, Stinnett entered UNC as a doctoral student. “I remember sitting in the orientation for new students in Rosenau Hall. As I listened to Bernie Greenberg, a biostatistician and the dean of the school, tell his vision for the future of health care and research, I got chills. I was so inspired. I knew that I had come to the right place.”

While at UNC, Stinnett wanted to understand more about her field of study. Why are we here? Who came before us? How useful is this field? What is this all about? So, she began to do research on the history of statistics in North Carolina. She sought out many of the pioneering statisticians and interviewed them individually. Following the interviews, she scheduled talks, which she videotaped. The tape that resulted from Greenberg’s talk was one of the few audio-visual legacies left when he died shortly thereafter. Her investigations led to the creation of a departmental seminar series that was so successful the faculty voted to send her a letter of commendation.

As part of her tenure as a student, Stinnett was the coordinator of the Biometric Consulting Laboratory in the department of biostatistics. The lab was comprised of students who wanted to gain consulting experience by working on projects under the faculty supervision of professors Dennis Gillings and Gary Koch. Stinnett credits Koch as her mentor during this time. He coached Stinnett on management of the lab and analysis for projects. She had the opportunity to develop course materials while serving as Koch’s teaching assistant for several classes, some of which were used in workshops in which he included her as a presenter. “He served on my dissertation committee and freely gave career advice—whether I asked for it or not! He was the ultimate mentor,” recalls Stinnett.

While working in the lab, Stinnett realized all students in the department could benefit from a consulting experience. In 1986, she developed and presented a proposal for a course on statistical consulting. (She was always looking for innovative teaching ideas and received weekly advice from Doug Zahn—a statistics professor at Florida State and prominent figure in the consulting field.) The proposal was accepted and Stinnett began teaching her first statistical consulting course. For the class, Stinnett developed a series of role-play situations, in which students would act out both the client and consultant roles. She taught the course as a student for five semesters from 1988–1990. While working for Duke in 2001, she was invited back to UNC to teach the statistical consulting course, which she did for eight years. During her last tenure there, she developed a course pack, PowerPoint presentations, video examples of consultations, and full-fledged consulting projects for use in the class.

In 1987, Stinnett took a break from her studies to work for Dennis Gillings and his rapidly developing company, Quintiles—a fully integrated bio and pharmaceutical services provider offering clinical, commercial, consulting, and capital solutions—in Chapel Hill. For six months, she lived in London while developing Quintiles’ first foreign office. At the end of a hectic year, she spent a month at a language school in Spain and, after taking the opportunity to travel abroad, returned to UNC in the spring of 1988 to finish her dissertation, consult independently, and teach her consulting course. That same year, she wrote an article for the ASA Section on Consulting’s newsletter titled, “Statistical Consulting for the Pharmaceutical Industry,” which recounted her work with Quintiles.

While completing her dissertation, Stinnett worked at Rho as a consultant for Ron Helm, one of her dissertation advisers. She graduated with a DrPH in biostatistics in December 1993.

After all her experience, Stinnett knew when she took her first “real” job, it would have to special. In 1994, she saw an advertisement for someone to manage the statistical group at the Duke Clinical Research Institute. “I felt that it had my name on it,” said Stinnett.

Stinnett has taken on several roles since her appointment at Duke in 1994. She has been an assistant research professor in the department of biostatistics and bioinformatics at Duke University Medical Center. For more than four years, she was director of statistical operations at the Duke Clinical Research Institute, where she was responsible for managing approximately 35 statisticians who assisted with the design and analysis of clinical trials. From 1995–2000, she taught the introductory statistics course to physicians in the Duke Clinical Research Training Program. Finally, she received a secondary appointment in the department of ophthalmology in 2001.

As a biostatistician for the Duke Eye Center (ranked one of the top 10 U.S. ophthalmology centers in U.S. News & World Report’s best hospital edition), she works with faculty, fellows, and residents in a variety of roles. She assists with the planning and implementation of research projects, including creating data-collection instruments and data files, executing statistical analyses, and interpreting results for publications and presentations. In addition, she provides sample size estimates for the planning of new projects and assists with writing grant proposals. Projects she has analyzed data for include risk factors for peripheral vascular disease, associated factors in age-related macular degeneration (AMD), impact on visual acuity of translocation surgery for AMD, and the assessment of physician skills with respect to guidelines of the practice of ophthalmology.

Another component of the Duke Eye Center is the OCT Reading Center. It specializes in the imaging technology known as optical coherence tomography. Staff grade OCT images of patients’ eyes. Stinnett assists with the assessment of quality assurance for the grading process and produces reports for study sponsors and data and safety monitoring.

Recently, she assisted the departments of radiology, orthopedic trauma surgery, and general surgery at Duke with their data analysis and provided lectures for residents. Additional responsibilities include serving on the thesis committees for physicians in the Duke Clinical Research Training Program, serving on the Duke Institutional Review Board, and teaching medical statistics to Duke third-year medical students. At the moment, she is redesigning her course in medical statistics to use term-based learning.

What does Stinnett love about being a statistician and her current position? “I enjoy working at the Duke Eye Center,” Stinnett says. “I get to be involved in exciting, cutting-edge research, and I appreciate the recognition I get as part of the research team. The faculty and staff here are wonderful—it’s like working with a great family.” She appreciates the freedom to do her work whether she’s at the office or home. She also finds that combining teaching with consulting is enriching. “I am never bored!”

In 2007, Stinnett was invited to give a lecture series on research designs and statistical methods at Elias Santana Hospital in Santo Domingo, Dominican Republic. She covered research methods, planning a research project, reading and writing of medical literature, and an overview of statistical methods.
At this charity ophthalmology hospital, residents gain experience while working with some of the poorest patients in the country. An important part of their curriculum is an individual research project. Residents have earned top prizes for these at the annual Dominican Republic congresses of ophthalmology and other Latin-American congresses; however, some of their research lacked the proper statistical analysis and study design needed to be published in respected ophthalmology journals. After giving the lecture series, Stinnett said, “The gratitude and warmth of these residents will stay with me forever. … What I gained from the experience was a new confidence in what I have to offer and a thrill from knowing that I provided a service. And, oh yes, I had some incredible food!”

Stinnett has been a member of the ASA for 35 years and has held several offices, including president of the Caucus for Women in Statistics and chair of the Committee on Women in Statistics and Section on Statistical Consulting. She has organized and chaired several invited sessions at national meetings, including The Past, Present, and Future of Women in Statistics (1989), Women in Clinical Trials: Policy, Science, Statistics (1991), Training Statistical Consultants Using Videotaping and Coaching (1992), and Can a Statistician Earn a Living on Her Own? (1993). She also has made several presentations, primarily on the training of statistical consultants.

At the 1987 annual meeting, Stinnett participated in an invited session organized by Terry Smith. The session featured a live, unrehearsed role-play demonstration in which Stinnett played the part of the client and others played the consultant and coach. Zahn was the discussant. Both Stinnett and Zahn used the video of the session while teaching their consulting class, as did others, including a former student of Stinnett’s.

Along with Janice Derr, Stinnett was invited to present three all-day continuing education workshops on consulting, two of which were at the 1993 and 1994 Joint Statistical Meetings. In 1994, the two teamed up again to write an article for CHANCE magazine, titled “The Interesting Life of a Practicing Statistician.”

Throughout her education and career, Stinnett has learned the following:
• You can help to create a destiny by visualizing it.
• Believe in synchronicity. It’s a sign you are on the right path.
• If you feel that you are “right” for a job, insist on having it.
• Persevere. You could be “three feet from the gold.”
• Your worth is not the same as others’ opinions of you.

Finally, Stinnett has a few words of encouragement for recent graduates and those deciding upon a career path: “Don’t let setbacks discourage you; use what you learn from them to help plan your next steps. Don’t confuse a lack of success in a difficult situation with a lack of your value; just change the situation. Follow your interests even if they appear to be off the beaten path of statistics. It is the unique combination of fields of study that makes for a rich contribution.”