Kelly West (1925-1980)

With typical modesty, Kelly West comments in his landmark book, The Epidemiology of Diabetes and it Vascular Complications that "the author of this book did not even realize his own work constituted epidemiology until he was informed of this by a 'real' epidemiologist in 1966!". Prior to this, there had been little systematic study of the topic, and the word epidemiology was not mentioned in the 1959 Joslin textbook.

His textbook, which amassed 2300 references, brought everything in the field into one place, and saw the "epidemiology of diabetes coming of age"[1]. Harry Keen called it "a masterpiece of intelligent and assiduous literature research, a selective gleaning and refining process which extracted some flecks of golden understanding from the most unpromising pile of factual rock"[2].

Kelly West was a notable athlete in his youth until he suffered a subarachnoid haemorrhage, a precursor of the event that finally killed him at the age of 55. "Few suspected the calm choices that Kelly made in the light of his full knowledge of his persisting cerebral aneurysm", wrote Harry Keen: "He knew and occasionally discussed this threat to his existence, and he fashioned his life accordingly. The equanimity and placidity he showed in, sometimes, the most provocative of circumstances were in large part the result of a philosophical process which involved looking daily at the possibility of extinction. It contained no hint of heroics, no suspicion of self-pity, no trace of resentment".

From his position as Professor of Biostatistics and Epidemiology and Clinical Professor of Medicine at the University of Oklahoma Health Center he worked with Amerindian populations[3] and initiated comparative studies with other ethnic and national groups around the world, establishing a basis for the comparative epidemiology of diabetes[4]. His international perspective on diabetes was remarkable, and he died during one of his many travels, in Hong Kong.

Epidemiological studies were at that time plagued by lack of standardization of methods and criteria, and West took the lead in bringing people together to try and sort things out. His most famous paper, evidently written tongue in cheek, had the following abstract:

"A survey of twenty diabetologists revealed that they employ diagnostic criteria differing quite substantially. In some populations, including the general population of the United States, these disparities would result in very major differences in the rates of 'diabetes.' Under certain common circumstances, some diabetologists would classify as normal more than half of the one- and two-hour values considered to be abnormal by other well-qualified diabetologists"[5].

This activity paved the way to the meeting of the WHO Expert Committee on Diabetes which met in Geneva in 1979, in which he played a key role. During one hectic week much of our current approach to diabetes was formulated. He helped to found the WHO Multinational Study of Vascular Disease and became the inaugural chairman of the Diabetes Epidemiology Group of the IDF. His life is commemorated in the Kelly West Lectureship of the American Diabetes Association.

Harry Keen described Kelly West as characterized by generosity of spirit, deeply human and humorous, deliberate of address, modest, conciliatory and untiringly persevering. Few people have done so much to change the landscape of diabetes.

References

  1. ^ Zimmet P. Epidemiology of diabetes - its history in the last 50 years. British Journal of Diabetes and Vascular Disease 2002;2:435. Available at http://www.bjdvd.com/content/2/6/435.full.pdf+html

  2. ^ Keen H. Kelly McGuffin West 1925-1980. Diabetologia 1980;19:482-3

  3. ^ West KM. Diabetes in American Indians and other native populations of the New World. Diabetes 1974;23:841-55

  4. ^ West KM. Standardization of definition, classification and reporting in diabetes-related epidemiologic studies. Diabetes Care 1979;2:65-76

  5. ^ West KM. Substantial differences in the diagnostic criteria used by diabetes experts". Diabetes 1975;24:641-4

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