Elina Hemminki

Many of Hemminki's research focused on reproduction, first pregnancy and birth, and later more broadly, menopause. The interest in menopause started in a research visit to John and Sonja McKinley's research unit in Boston in 1987, later known as the New England Research Institutes, which at the time had interest in menopause. That was the time of a hot debate of the benefits of hormone replacement therapy (HRT), mainly based on non-experimental data. The subsequent study in Finland on the menopause as a health service question, widened into involvement into study and debate on health effects of HRT. That interest produced a number of important publications, including the selection bias to HRT and the use of non-public documents of drug control authorities to study adverse effects of drugs. The interest led also to a small trial in Estonia, originally planned to be part of a large WISDOM study.

In 1979 Hemminki visited Oxford Perinatal Epidemiology Unit, then headed by Iain Chalmers, at the time when the idea of evidence-based medicine and systematic reviews was developed. Even though she did not become an active member of Cochrane Collaboration, later rising from the ideas in Oxford, the critical thinking and ways of approaching the value of individual health technologies were important for her later work. She was active in various international networks, including ISTAHC (International society of technology assessment in health care), later transformed into Health Technology Assessment International (HTAi).

Her plans to continue research on physicians’ drug prescribing changed in her postdoctoral studies in the US in 1977. For family reasons she was tied to Baltimore, and she started a new field, technology and reproductive health, which was more suitable to her study with Barbara Starfield in Johns Hopkins University. Working with Starfield, Hemminki did reviews on iron-prophylaxis and drugs against premature labor, using approaches which today would be called systematic reviews or meta-analyses. The reviews were made before electronic data searches of medical literature or the current methodology were available. The good local library was invaluable.

The work with HRT health effects concretely showed what it was like to have a varying view with local establishment, as well as the needs and working habits of media. This experience activated Hemminki's old interest in commercial factors influencing physicians and conflict of interests (COI). In her 1977 paper in Social Science & Medicine, Hemminki had empirically showed that many Finnish key-physicians had associations with drug industry. The potential consequences of such close collaboration include merging of the interest of commercial actors, particularly drug industry, and medical establishment, and confusing the voice of the scientific world. This is likely to have adverse effects on medical practice and health policy.

Hemminki graduated from a high school in Hyvinkää, Finland in 1967. She received her medical degree from the University of Helsinki (Licentiate of Medicine, MD) in 1973, and her DrPH, from the University of Tampere. She was a postdoctoral fellow in the Department of Health Services Administration, School of Public Health, the Johns Hopkins University, from 1976 to 1978.

Kirsti Elina Hemminki (born 22 August 1948) is a Finnish academic who was trained in medicine and public health. She has wide research experience in health services and epidemiological research. Her research interests include use, determinants and consequences of medical technology, particularly in the field of preventive services. Many of her examples come from women's and children's health and drugs (medicines). Her interests include health services trials, and how ethical and governance rules apply to them. Her other research interests have included research policy and research regulation.