Created on Tuesday, 10 Mar 2020. Posted in Toolkit/Database
A new package of interactive learning resources is now available to support research delivery professionals in promoting research to colleagues across the NHS. These resources have been developed to support and inspire research delivery staff in their pledge to embed research in innovative ways across their organisation.
The ‘Engaging with your local NHS’ package sits on NIHR Learn, the NIHR online Learning Management platform, used to deliver its accredited learning programmes. You can access NIHR Learn if you are employed by the NIHR, NHS, a UK university or other publicly funded organisation conducting and supporting clinical research. If your email address ends in one of these pre-approved domains you can self-register for the system. If you do not have an email address from a pre-approved domain your application will be considered for approval.
Created on Tuesday, 10 Mar 2020. Posted in Funding
Two NIHR funding programmes are joining forces as part of a pilot to provide health researchers the opportunity to undertake a career development award alongside leading an NIHR programme funded clinical study.
For the first time, the Efficacy and Mechanism Evaluation (EME) programme is inviting applications for clinical studies to be led by a chief investigator who is also applying for an NIHR Advanced Fellowship Award. Researchers from across all areas of health are encouraged to apply. The study proposal should evaluate an intervention or medical test with the potential to maintain health, treat disease or improve recovery.
The EME programme is a partnership between the Medical Research Council (MRC) and the NIHR, and both are keen to explore new ways to support the development of capacity and expertise in conducting clinical trials.
Applications to the EME programme are now being accepted and the deadline for these is 16 April 2020. Applications to round four of the Advanced Fellowship scheme will launch at the beginning of April with a deadline for submissions in early June.
Find out more here
Created on Tuesday, 10 Mar 2020.
The remit for the researcher-led HTA stream hasn't been changed, but now remit and competitive checks now go out to a wider range of people including funding committee chairs and panel chairs and the feedback researchers receive is slightly more helpful and explains why the project isn't in remit.
Remit itself remains as knowing the intervention can work and asking does it work when tested in a national study and is it cost effective for the NHS.
To prove an intervention can work HTA need to see a good signal that it will work if applied across the NHS, usually this evidence will come from a previous small RCT that shows an efficacy signal under ideal circumstances with a health outcome, strong surrogate or meta analysis of an RCT. It's recognised that efficacy for complex interventions can be challenging but the panel still needs a convincing explanation of how the intervention is likely to result in the proposed effect.
It is helpful to have feasibility studies showing that the intervention is acceptable to the population being studied and that randomisation into the study is possible but feasibility is not enough by itself and an efficacy signal will be needed.
HTA evaluates interventions in typical NHS or social care settings with typical NHS or social care users and the panel will need to be convinced that the intervention is ready for such pragmatic evaluation.
The only exception where efficacy signal isn't needed is where an intervention is already widely used in the NHS but evidence of value or harm is lacking. These are usually picked up by the commissioning brief but you can bring one to the researcher-led stream as long as you can demonstrate that decision makers will be responsive to your results.
More information about remit and efficacy can be found on the NIHR website guide
Created on Tuesday, 11 Feb 2020. Posted in Design Tips
1. A traffic light system of green (go), amber (amend) and red (stop) might be preferable to a simple stop/go approach when specifying progression criteria for internal pilot studies;
2. Pre-specified progression criteria agreed with funders need to strike a careful balance between being firm enough to promote ambition in the trial team yet being flexible enough to allow opportunities to remedy early problems;
3. Recruitment progression criteria should be based on rates per centre per unit time (eg, per month) that can be easily extrapolated, rather than specifying that an absolute number should be reached by a specific date, due to the unpredictability of opening sites;
4. When recruitment falls behind, it is essential to explore screening logs to determine whether insufficient participants were approached, insufficient participants passed eligibility criteria or insufficient eligible participants agreed to randomisation;
5. The assessment of intervention adherence, cross-over and outcome event rates should take into account the duration from randomisation to timing of primary outcomes if sufficient data are to be gleaned in time to inform progression;
6. When assessing missing data, it is important to explore the degree of missing data within key outcomes as well as the percentage of participants with missing data;
7. Trial teams should involve both their funders and their Trial Steering Committee in assessing their progression criteria;
8. Pilot study recruitment sites should be representative of sites that recruit into the main study;
9. Triallists may be able to take the opportunity to assess whether changes to existing technologies have occurred since the original study was planned, so that new technologies can be considered with funders, such as using an adaptive design;
10. Pilot studies need to be reported fully. An extension to CONSORT guidelines for pilot and feasibility studies is now available.
Over the past three years, Healthwatch England has heard from over 20,000 young people about their experiences of mental health support. To gain a deeper understanding of this issues, they brought together 47 young people, aged 16-25, to talk about what affects their mental health, their current experiences of care, and what services can do to better support them. The key findings are below but the full report is online.
What do young people want their mental health support to look like?
More options for treatment and personalised care, such as more flexible appointment times and access to different types of therapies.
Created on Monday, 10 Feb 2020. Posted in Literature
This review brings together NIHR-funded research for and about health and social care services for people with learning disabilities. Work is needed to improve care for these people, who experience poorer health and die earlier than the general population. Many of these deaths could be prevented by public health interventions or better access to high quality care. This review features 23 recent studies with important findings for those who commission, deliver, work in and use these services. These range from qualitative research on user experience to randomised trials of complex new services. Many of these studies involved people with learning disability and family carers in the research and in delivering some of the interventions.
This review looks primarily at studies of health and social care services targeted at people with lived experience of learning disabilities and their families. It excludes studies specifically concerned with autism because these may relate to separate pathways and services. Although there is a small number of studies on services for children, most are on services for adults. The NIHR has funded many studies on the effectiveness of individual interventions, from drugs to psychological therapies, but the focus of this review is on services for people with learning disabilities. These interventions are only included where the study is also about how this works in the context of health and social care services.
Created on Monday, 03 Feb 2020. Posted in Toolkit/Database
This online toolkit looks at when and how in the research process participatory data gathering can be used, and explores key issues to consider when designing your research. Participatory data gathering can be a mutual learning experience, increasing the value to participants, as well as generating rich data. As well as core principles, the video introduces Ketso, a hands-on and visual toolkit, which makes participatory data gathering easier.
Created on Monday, 03 Feb 2020. Posted in Toolkit/Database
The new Cambridge Multimorbidity Score is a transparent, simple measure of multimorbidity that can predict different outcomes in people with multiple conditions. The score which includes 20 conditions could help people planning clinical services or allocating healthcare resources to respond to the needs of patients with multiple health conditions.
In this guide you will find links to tools and reports that can help you:
These evidence resources are relevant for local decision makers as well as national policymakers.
The cost-effectiveness of specific topic areas
PHE’s Health Economics team has produced a number of resources which can be used to estimate the value of investing in prevention and early diagnosis in your area. They pull together the best available evidence on costs, savings, and health benefits for specific topic areas in a single place, thus simplifying the process of commissioning cost-effective services.
Created on Tuesday, 28 Jan 2020. Posted in Literature
Health and Care of People with Learning Disabilities, 2018-191 summarises data relating to 54% of patients in England on key health issues for people recorded by their GP as having a learning disability. It also includes comparative data about patients recorded by their GP as not having a learning disability, to show differences in health and care between the two groups.
For the first time, this publication contains a standardised mortality ratio, comparing mortality for those with a learning disability against those without.
Statistics about the prevalence of various health conditions, such as epilepsy and heart disease, are also included.