Together with the Collective Expert Review structure that he leads, Laurent Fleury is at the interface between science and society taking stock of scientific knowledge on a health subject at a given moment in time. The objective is twofold: aid political decision-making and inform citizens. The expert reviews and the value created from them are acknowledged by the Opecst-Science and Society Prize.
Following a PhD in pharmacy and ten years spent in the field of health security in hospitals, Laurent Fleury joined French regulatory agency Afssaps in 2000, which became the National Agency for the Safety of Medicines and Health Products (ANSM) in 2012. A role in which he developed public communication – a link between science and society to which he is highly attached. It was therefore with enthusiasm that in 2016 he became head of the Inserm Collective Expert Review structure, endorsing its mission to shed independent scientific light on health questions in order to aid public decision-making. Enthusiasm that remains unabated. “I am surrounded by a dream team of eight people, which is extraordinary and highly professional. What is more, we have the freedom to work, move forward, and make proposals, he emphasizes. Which is priceless!“
An independent and validated synthesis
The strength of these expert reviews is based on a methodology that guarantees scientific validity and independence. “Once we have agreed with the review’s commissioner on the scientific questions being asked, he or she goes off radar until the results come back, describes Fleury. Then, the expert review is based on scientific literature. This bibliography of several thousand articles also makes it possible to identify the multidisciplinary group of experts who, after a year of monthly interactions, will draft the review and make its recommendations. These recommendations constitute a specific feature of the expert reviews published by Inserm. »
Since its creation in 1993, the structure has produced 90 reviews with around ten recommendations each, which have contributed to decisions more or less quickly. “Parkinson’s disease was recognized as an occupational illness for farmers in the wake of the first expert review on pesticides in 2013 (only available in French), » illustrates Fleury. On the other hand, it took four years for earphones, earpieces, and headphones to be banned whilst driving. “It is often a question of whether or not the context is favorable, he explains. The recommendations are therefore not systematically followed. It should be understood that reviews are only there to inform decisions that remain political. »
The reviews are also tools serving citizen reflection. That is why Fleury launched the principle of a conference for their delivery. “The patient associations must make use of it. We are trying to work with them more. For example, at the start of the expert review on fibromyalgia (only available in French) published in 2020, a meeting with the associations enabled us to identify certain questions,” he adds. Inserm also has the power to act on its own initiative on matters it deems important.
Acting for and with society
The team also makes its expertise available to society. During the first six months of the COVID-19 pandemic, it sorted and indexed nearly 30,000 scientific articles. Following analysis, a summary was sent every Thursday to the interministerial unit in charge of steering the crisis.
Finally, despite the pandemic, the structure completed four expert reviews and held the conferences in the form of interactive web events, with more than 800 participants for some. “Now, we cannot wait for the expert meetings, which are impossible to hold remotely, to resume in early 2022,” concludes Fleury.