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Drinkwater J, Farr M, Hickey G, Van Vliet E, Söderholm Werkö S, Klingmann I, Blackburn S. Series: Public engagement with research. Part 3: Sharing power and building trust through partnering with communities in primary care research. Eur J Gen Pract 2024; 30:2328707. [PMID: 38546448 PMCID: PMC10984225 DOI: 10.1080/13814788.2024.2328707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 03/05/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND This article focuses on potential strategies to support primary care researchers in working in partnership with the public and healthcare professionals. Partnership working can potentially to improve the relevance and usefulness of research and ensure better research and health outcomes. DISCUSSION We describe what we mean by partnership working and the importance of reflecting on power and building trusting relationships. To share power in partnership working, it is essential to critically reflect on the multiple dimensions of power, their manifestations, and your own power. Power can influence relationships and therefore, it is essential to build trust with partners. Next, we outline how the context of primary care research and decisions about who you work with and how to work together, are vital considerations that are imbued with power. Lastly, we suggest different ways of working in partnership to address different dimensions of power. We provide examples from primary care research across Europe regarding how to recognise, tackle, and challenge, invisible, hidden and visible power. CONCLUSION We conclude by proposing three calls to actions to encourage researchers working in primary care to consider the multiple dimensions of power and move towards partnership working. First is to use participatory methods to improve the inclusivity of your research. Second is to include patients and the public in decisions about the design, delivery and development of research and its outcomes. Third is to address various systemic and institutional barriers which hinder partnership working.
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Affiliation(s)
- Jessica Drinkwater
- Centre for Primary Care and Health Services Research, University of Manchester, United Kingdom
| | - Michelle Farr
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom
| | - Gary Hickey
- Agora Digital Centre, School of Healthcare Enterprise and Innovation, University of Southampton, United Kingdom
| | | | - Sophie Söderholm Werkö
- The Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden
| | - Ingrid Klingmann
- European Forum for Good Clinical Practice (EFGCP), Brussels, Belgium
| | - Steven Blackburn
- Institute of Applied Health Research, University of Birmingham, United Kingdom
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Masood Y, Alvarez Nishio A, Starling B, Dawson S, Salsberg J, Blackburn S, van Vliet E, Pittens CA. Series: Public engagement with research. Part 2: GPs and primary care researchers working inclusively with minoritised communities in health research to help address inequalities. Eur J Gen Pract 2024; 30:2322996. [PMID: 38477291 PMCID: PMC10939099 DOI: 10.1080/13814788.2024.2322996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/20/2024] [Indexed: 03/14/2024] Open
Abstract
Public engagement in health research is vital for addressing health disparities and promoting inclusivity among minoritised communities who often face barriers to accessing healthcare. Minoritised communities are groups, which have been made minorities by a dominant culture, race, ethnic group and/or social class and may experience health inequalities as a result. By incorporating diverse perspectives and lived experiences of minoritised communities, this approach aims to achieve contextually relevant research outcomes that reduce health inequalities and improve overall well-being. However, underrepresentation and lack of inclusivity challenges persist, necessitating the establishment of inclusive partnerships and grassroots participatory methodologies. To foster inclusive public engagement, it is important to overcome structural and cultural barriers, address socioeconomic challenges, and build trust with minoritised communities. This can be achieved by promoting a cultural shift that values inclusivity, providing comprehensive training to researchers, and collecting rigorous data on engagement demographics for transparency and accountability. Involving minoritised communities in decision-making through participatory research approaches enhances trust and yields successful outcomes. Additionally, allocating sufficient resources, collaborating in co-production, and prioritising the diverse needs and perspectives of stakeholders contribute to fostering inclusive public engagement in research. Overall, inclusive engagement practices particularly in primary care research have the potential to reduce health inequalities and cater to the unique requirements of minoritised communities, thereby creating more impactful outcomes and promoting equitable healthcare access.
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Affiliation(s)
- Yumna Masood
- Centre for Evidence Based Medicine | Nuffield Department of Primary Care Health Sciences |, University of Oxford Radcliffe Primary Care Building, University of Oxford, Oxford, UK
| | | | - Bella Starling
- Manchester University NHS Foundation Trust, Manchester, UK
| | - Shoba Dawson
- Centre for Academic Primary Care, University of Bristol, Bristol, UK
| | - Jon Salsberg
- University of Limerick, Family Medicine Limerick, Limerick, Ireland
| | - Steven Blackburn
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Esther van Vliet
- Academic Collaborative Centers, Knowledge Transfer Office, Tilburg University, Tilburg, The Netherlands
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Swaithes L, Campbell L, Anthierens S, Skrybant M, Schiphof D, French H, de Wit M, Blackburn S, Dziedzic K. Series: Public engagement with research. Part 4: Maximising the benefits of involving the public in research implementation. Eur J Gen Pract 2023; 29:2243037. [PMID: 37609798 PMCID: PMC10448833 DOI: 10.1080/13814788.2023.2243037] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 07/03/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023] Open
Abstract
This final article in the four-part series focuses on the often neglected yet important role of the public in implementing research in General Practice and Primary Care more broadly. Experience in implementation of findings from research with public engagement in Primary Care has highlighted how partnership working with patients and the public is important in transitioning from 'what we know' from the evidence-base to 'what we do' in practice. Factors related to Primary Care research that make public engagement important are highlighted e.g. implementing complex interventions, implementing interventions that increase health equity, implementing interventions in countries with different primary healthcare system strengths. Involvement of patients and public can enhance the development of modelling and simulation included in studies on systems modelling for improving health services. We draw on the emerging evidence base to describe public engagement in implementation and offer some guiding principles for engaging with the public in the implementation in General Practice and Primary Care in general. Illustrative case studies are included to support others wishing to offer meaningful engagement in implementing research evidence.
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Affiliation(s)
- Laura Swaithes
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, United Kingdom
| | - Laura Campbell
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, United Kingdom
| | - Sibyl Anthierens
- Department of Family Medicine and Population Health, University of Antwerpen, Antwerpen, Belgium
| | - Magdalena Skrybant
- National Institute of Applied Health Research Applied Research Collaboration West Midlands, Institute of Applied Health, University of Birmingham, Edgbaston, United Kingdom
| | - Dieuwke Schiphof
- Department of General Practice, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Helen French
- School of Physiotherapy, Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland
| | - Maarten de Wit
- Patient Research Partner, Stichting Tools, The Netherlands
| | - Steven Blackburn
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Krysia Dziedzic
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, School of Medicine, Keele University, Staffordshire, United Kingdom
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Blackburn S, Clinch M, de Wit M, Moser A, Primdahl J, van Vliet E, Walker C, Stevenson F. Series: Public engagement with research. Part 1: The fundamentals of public engagement with research. Eur J Gen Pract 2023; 29:2232111. [PMID: 37578421 PMCID: PMC10431741 DOI: 10.1080/13814788.2023.2232111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 05/30/2023] [Accepted: 06/27/2023] [Indexed: 08/15/2023] Open
Abstract
BACKGROUND In the first of a four-part series, we describe the fundamentals of public engagement in primary care research. OBJECTIVES The article's purpose is to encourage, inform and improve the researcher's awareness about public engagement in research. For a growing number of researchers, funders and patient organisations in Europe, public engagement is a moral and ethical imperative for conducting high-quality research. DISCUSSION Starting with an explanation of the role of public engagement in research, we highlight its diversity and benefits to research, researchers and the public members involved. We summarise principles of good practice and provide valuable resources for researchers to use in their public engagement activities. Finally, we discuss some of the issues encountered when researchers collaborate with members of the public and provide practical steps to address them. Case studies of real-life situations are used to illustrate and aid understanding. CONCLUSION We hope this article and the other papers in this series will encourage researchers to better consider the role and practice of public engagement and the potential added value to research that collaborating with the public could provide.
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Affiliation(s)
- Steven Blackburn
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Megan Clinch
- Centre for Public Health & Policy, Queen Mary University of London, London, UK
| | - Maarten de Wit
- Patient Research Partner Stichting Tools, Amsterdam, the Netherlands
| | - Albine Moser
- Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Jette Primdahl
- Department of Regional Health Research, University of Southern Denmark, Denmark
| | - Esther van Vliet
- Academic Collaborative Centers, Knowledge Transfer Office, Tilburg University, Tilburg, the Netherlands
| | - Christine Walker
- Research User Group, Primary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK
| | - Fiona Stevenson
- Primary Care and Population Health, University College London, London, UK
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Moult A, Baker D, Aries A, Bailey P, Blackburn S, Kingstone T, Lwembe S, Paskins Z. Using the UK standards for public involvement to evaluate the public involvement sections of annual reports from NIHR managed research centres. Res Involv Engagem 2023; 9:109. [PMID: 38037160 PMCID: PMC10688454 DOI: 10.1186/s40900-023-00517-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 11/20/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Within the United Kingdom (UK), the National Institute for Health and Care Research is the largest funder of health and social care research, and additionally funds research centres that support the development and delivery of research. Each year, award-holders of these research centres are required to write a report about their activities, including a summary of Patient and Public Involvement and Engagement (PPIE) activities. This study aimed to evaluate the PPIE sections of annual reports to identify best practice and challenges; this could inform future delivery of PPIE activities. METHODS A framework documentary analysis informed by the six UK Standards for Public Involvement ('Inclusive opportunities', 'Working together', 'Support and learning', 'Communications', 'Impact' and 'Governance') was conducted on 112 reports. A quality improvement framework ('Insights') was used to evaluate quality as one of: 'Welcoming', 'Listening', 'Learning' and 'Leading'. Recommendations from this review were co-developed with stakeholders and public contributors. RESULTS Reports documented varying levels of quality in PPIE activities which spanned across all six UK Standards. Award-holders either intended to, or were actively working towards, increasing access and inclusivity of public involvement opportunities. Methods of working with public contributors were varied, including virtual and in-person meetings. Most award-holders offered PPIE support and learning opportunities for both public contributors and staff. Some award-holders invited public contributors to co-produce communication plans relating to study materials and research findings. The impact of public involvement was described in terms of benefits to public contributors themselves, and on an organisation and project level. Many award-holders reported inviting public contributors to share decision-making within and about governance structures. CONCLUSIONS This evaluation identified that most annual reports contained evidence of good quality PPIE practice with learning from public contributors. Using the UK Standards and Insights framework enabled exploration of the breadth and quality of PPIE activities. Recommendations include the need for a platform for centres to access and share PPIE best practice and for centres to collaborate with local and national partners to build relationships with the public through inclusive community engagement.
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Affiliation(s)
- Alice Moult
- Impact Accelerator Unit, Keele University, Newcastle-under-Lyme, ST5 5BG, UK.
| | - Dereth Baker
- School of Medicine, Keele University, Newcastle-under-Lyme, ST5 5BG, UK
| | - Ali Aries
- School of Allied Health, Keele University, Newcastle-under-Lyme, ST5 5BG, UK
| | - Paul Bailey
- School of Allied Health, Keele University, Newcastle-under-Lyme, ST5 5BG, UK
| | - Steven Blackburn
- Patient and Public Involvement and Engagement, Institute of Applied Health Research, University of Birmingham, Edgbaston, Stoke on Trent, B15 2TT, UK
| | - Tom Kingstone
- School of Medicine, Keele University, Newcastle-under-Lyme, ST5 5BG, UK
| | - Saumu Lwembe
- National Institute for Health and Care Research, LGC Ltd, Grange House, 15 Church St, Twickenham, TW1 3NL, UK
| | - Zoe Paskins
- School of Medicine, Keele University, Newcastle-under-Lyme, ST5 5BG, UK
- Haywood Academic Rheumatology Centre, Haywood Hospital, Midland Partnership University NHS Foundation Trust, Stoke on Trent, ST5 5BG, UK
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6
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Blackburn S, Hine R, Fairbanks S, Parkes P, Murinas D, Meakin A, Taylor R, Parton L, Jones M, Tunmore J, Lench J, Evans N, Lewney K, O'Mara L, Fryer AA. The INSIGHT project: reflections on the co-production of a quality recognition programme to showcase excellence in public involvement in health and care research. Res Involv Engagem 2023; 9:99. [PMID: 37880805 PMCID: PMC10601214 DOI: 10.1186/s40900-023-00508-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/20/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND The quality of Patient and Public Involvement (PPI) in healthcare research varies considerably and is frequently tokenistic. We aimed to co-produce the Insight | Public Involvement Quality Recognition and Awards programme, based on the UK Standards for Public Involvement (UKSPI) alongside an incremental scale designed by Expert Citizens (a lived experience-led community group), to incentivise and celebrate continuous improvement in PPI. METHODS We used Task and Finish Groups (19/44 [43%] public contributor membership) to co-produce the programme which we piloted in three organisations with different healthcare research models. We used surveys and review sessions to capture learning and reflections. RESULTS We co-created: (1) A Quality descriptor matrix comprising four incremental quality levels (Welcoming, Listening, Learning, Leading) for each UKSPI standard. (2) An assessment framework including guidance materials, self-assessment form and final report template. (3) An assessor training package. (4) The quality awards event format and nomination form. These materials were modified based on pilot-site feedback. Of survey respondents: 94.4% felt they had made at least 'Some' personal contribution (half said 'Quite a lot'/'A great deal'), 88.9% said they were 'Always'/'Often' able to express their views freely and, 100% stated the programme would have 'A lot of impact'/'Quite a bit of impact'. During the project, we identified the importance of taking time to explain project aims and contributor roles, adapting to the needs of individual contributors and, using smaller bespoke sessions outside the main Task and Finish Groups. CONCLUSIONS We co-produced and piloted a quality recognition programme to incentivise and celebrate continuous quality improvement in PPI. One public contributor stated, "I feel strongly that the Insight framework and awards will raise awareness of the [public involvement] work going on in many community settings. [It] is likely to result in better sharing of positive practice, incentivising research groups of any size to start work or to improve the quality of [PPI] could be one of the main benefits. I'm excited that if this initiative takes off, regionally and then in the longer term nationally, it could be a significant step in advancing the [public] voice."
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Affiliation(s)
- Steven Blackburn
- Institute for Applied Health Research, University of Birmingham, Birmingham, UK
| | - Rachele Hine
- Expert Citizens CIC, The Dudson Centre, Hanley, Staffordshire, UK
| | | | - Phillip Parkes
- Expert Citizens CIC, The Dudson Centre, Hanley, Staffordshire, UK
| | - Darren Murinas
- Expert Citizens CIC, The Dudson Centre, Hanley, Staffordshire, UK
| | - Andrew Meakin
- Expert Citizens CIC, The Dudson Centre, Hanley, Staffordshire, UK
| | - Robert Taylor
- Research User Group, Keele University, Keele, Staffordshire, UK
| | - Linda Parton
- Research User Group, Keele University, Keele, Staffordshire, UK
| | | | - Jessica Tunmore
- Research and Innovation Department, Midlands Partnership University NHS Foundation Trust, St George's Hospital, Stafford, UK
| | - Jennifer Lench
- Research and Innovation Department, Midlands Partnership University NHS Foundation Trust, St George's Hospital, Stafford, UK
| | - Nicola Evans
- Impact Accelerator Unit, School of Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Katharine Lewney
- Directorate of Research and Innovation and Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands, Staffordshire, UK
| | - Lucy O'Mara
- Directorate of Research and Innovation and Centre for NMAHP Research and Education Excellence (CeNREE), University Hospitals of North Midlands, Staffordshire, UK
| | - Anthony A Fryer
- Impact Accelerator Unit, School of Medicine, Keele University, Keele, Staffordshire, ST5 5BG, UK.
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Burton C, Rathod-Mistry T, Blackburn S, Blagojevic-Bucknall M, Chesterton L, Davenport G, Dziedzic K, Higginbottom A, Jowett S, Myers H, Oppong R, van der Windt D, Hay E, Roddy E. The effectiveness of corticosteroid injection versus night splints for carpal tunnel syndrome: 24-month follow-up of a randomized trial. Rheumatology (Oxford) 2023; 62:546-554. [PMID: 35394019 PMCID: PMC9891401 DOI: 10.1093/rheumatology/keac219] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/04/2022] [Accepted: 04/04/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES This follow-up study of the INSTinCTS (INjection vs SplinTing in Carpal Tunnel Syndrome) trial compared the effects of corticosteroid injection (CSI) and night splinting (NS) for the initial management of mild-to-moderate CTS on symptoms, resource use and carpal tunnel surgery, over 24 months. METHODS Adults with mild-to-moderate CTS were randomized 1:1 to a local corticosteroid injection or a night splint worn for 6 weeks. Outcomes at 12 and 24 months included the Boston Carpal Tunnel Questionnaire (BCTQ), hand/wrist pain intensity numeric rating scale (NRS), the number of patients referred for and undergoing CTS surgery, and healthcare utilization. A cost-utility analysis was conducted. RESULTS One hundred and sixteen participants received a CSI and 118 a NS. The response rate at 24 months was 73% in the CSI arm and 71% in the NS arm. By 24 months, a greater proportion of the CSI group had been referred for (28% vs 20%) and undergone (22% vs 16%) CTS surgery compared with the NS group. There were no statistically significant between-group differences in BCTQ score or pain NRS at 12 or 24 months. CSI was more costly [mean difference £68.59 (95% CI: -120.84, 291.24)] with fewer quality-adjusted life-years than NS over 24 months [mean difference -0.022 (95% CI: -0.093, 0.045)]. CONCLUSION Over 24 months, surgical intervention rates were low in both groups, but less frequent in the NS group. While there were no differences in the clinical effectiveness of CSI and NS, initial treatment with CSI may not be cost-effective in the long-term compared with NS.
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Affiliation(s)
- Claire Burton
- School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK
| | - Trishna Rathod-Mistry
- School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK
| | - Steven Blackburn
- School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK
| | | | - Linda Chesterton
- School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK
| | - Graham Davenport
- School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK
| | - Krysia Dziedzic
- School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK
| | - Adele Higginbottom
- School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.,Patient and Public Involvement and Engagement Coordinator
| | - Sue Jowett
- Institute of Applied Health Research, University of Birmingham, Birmingham
| | - Helen Myers
- School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK
| | - Raymond Oppong
- Institute of Applied Health Research, University of Birmingham, Birmingham
| | - Danielle van der Windt
- School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK
| | - Elaine Hay
- School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK
| | - Edward Roddy
- School of Medicine and Primary Care Centre Versus Arthritis, Keele University, Staffordshire, UK.,Haywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, UK
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Yu D, Peat G, Jordan KP, Bailey J, Prieto-Alhambra D, Robinson DE, Strauss VY, Walker-Bone K, Silman A, Mamas M, Blackburn S, Dent S, Dunn K, Judge A, Protheroe J, Wilkie R. Estimating the population health burden of musculoskeletal conditions using primary care electronic health records. Rheumatology (Oxford) 2021; 60:4832-4843. [PMID: 33560340 PMCID: PMC8487274 DOI: 10.1093/rheumatology/keab109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 01/18/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Better indicators from affordable, sustainable data sources are needed to monitor population burden of musculoskeletal conditions. We propose five indicators of musculoskeletal health and assessed if routinely available primary care electronic health records (EHR) can estimate population levels in musculoskeletal consulters. METHODS We collected validated patient-reported measures of pain experience, function and health status through a local survey of adults (≥35 years) presenting to English general practices over 12 months for low back pain, shoulder pain, osteoarthritis and other regional musculoskeletal disorders. Using EHR data we derived and validated models for estimating population levels of five self-reported indicators: prevalence of high impact chronic pain, overall musculoskeletal health (based on Musculoskeletal Health Questionnaire), quality of life (based on EuroQoL health utility measure), and prevalence of moderate-to-severe low back pain and moderate-to-severe shoulder pain. We applied models to a national EHR database (Clinical Practice Research Datalink) to obtain national estimates of each indicator for three successive years. RESULTS The optimal models included recorded demographics, deprivation, consultation frequency, analgesic and antidepressant prescriptions, and multimorbidity. Applying models to national EHR, we estimated that 31.9% of adults (≥35 years) presenting with non-inflammatory musculoskeletal disorders in England in 2016/17 experienced high impact chronic pain. Estimated population health levels were worse in women, older aged and those in the most deprived neighbourhoods, and changed little over 3 years. CONCLUSION National and subnational estimates for a range of subjective indicators of non-inflammatory musculoskeletal health conditions can be obtained using information from routine electronic health records.
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Affiliation(s)
- Dahai Yu
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University
| | - George Peat
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University.,MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton
| | - Kelvin P Jordan
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University.,Centre for Prognostic Research, Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Keele
| | - James Bailey
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University
| | - Daniel Prieto-Alhambra
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford
| | - Danielle E Robinson
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford
| | - Victoria Y Strauss
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford
| | - Karen Walker-Bone
- MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton
| | - Alan Silman
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford
| | - Mamas Mamas
- Keele Cardiovascular Research Group, Centre for Prognosis Research, School of Medicine, Keele University, Keele
| | - Steven Blackburn
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University
| | | | - Kate Dunn
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University
| | - Andrew Judge
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford.,Musculoskeletal Research Unit, University of Bristol, Bristol, UK
| | - Joanne Protheroe
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University
| | - Ross Wilkie
- Primary Care Centre Versus Arthritis, School of Medicine, Keele University.,MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton
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Thakkar H, Mullassery DM, Giuliani S, Blackburn S, Cross K, Curry J, De Coppi P. Thoracoscopic oesophageal atresia/tracheo-oesophageal fistula (OA/TOF) repair is associated with a higher stricture rate: a single institution’s experience. Pediatr Surg Int 2021; 37:397-401. [PMID: 33550454 PMCID: PMC7900027 DOI: 10.1007/s00383-020-04829-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/30/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE Thoracoscopic OA/TOF repair was first described in 1999. Currently, less than 10% of surgeons routinely employ minimally access surgery. Our primary aim was to review our immediate-, early- and long-term outcomes with this technique compared with the open approach. METHODS A retrospective review of all patients undergoing primary OA/TOF (Type C) repair at our institution from 2009 was conducted. Outcome measures included length of surgery, conversion rate from thoracoscopy, early complications such as anastomotic leak and post-operative complications such as anastomotic strictures needing dilatations. Fisher's exact and Kruskal-Wallis tests were used for statistical analysis. RESULTS 95 patients in total underwent OA/TOF repair during the study period of which 61 (64%) were completed via an open approach. 34 were attempted thoracoscopically of which 11 (33%) were converted. There was only one clinically significant anastomotic leak in our series that took place in the thoracoscopic group. We identified a significantly higher stricture rate in our thoracoscopic cohort (72%) versus open surgery (43%, P < 0.05). However, the median number of dilations (3) performed was not significantly different between the groups. There was one recurrent fistula in the thoracoscopic converted to open group. Our median follow-up was 60 months across the groups. CONCLUSION In our experience, the clinically significant leak rate for both open and thoracoscopic repair as well as recurrent fistula is much lower than has been reported in the literature. We do not routinely perform contrast studies and are, thus, reporting clinically significant leaks only. The use of post-operative neck flexion, ventilation and paralysis is likely to be protective towards a leak. Thoracoscopic OA/TOF repair is associated with a higher stricture rate compared with open surgery; however, these strictures respond to a similar number of dilatations and are no more refractory. Larger, multicentre studies may be useful to investigate these finding further.
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Affiliation(s)
- H Thakkar
- Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK
| | - D M Mullassery
- Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK
| | - S Giuliani
- Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK
| | - S Blackburn
- Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK
| | - K Cross
- Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK
| | - J Curry
- Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK
| | - Paolo De Coppi
- Department of Specialist Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK.
- Stem Cells and Regenerative Medicine Section, Department of Paediatric Surgery, UCL Great Ormond Street Institute of Child Health, 30 Guilford Street, Holborn, London, WC1N 1EH, UK.
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Østerås N, Blaker IB, Hjortland T, Cottrell E, Quicke JG, Dziedzic KS, Blackburn S, Paulsen A. Improving osteoarthritis management in primary healthcare: results from a quasi-experimental study. BMC Musculoskelet Disord 2021; 22:79. [PMID: 33446167 PMCID: PMC7807869 DOI: 10.1186/s12891-021-03959-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/05/2021] [Indexed: 12/27/2022] Open
Abstract
Background To improve quality of care for patients with hip and knee osteoarthritis (OA), general practitioners (GPs) and physiotherapists (PTs) in a Norwegian municipality initiated an intervention. The intervention aimed to increase provision of core OA treatment (information, exercise, and weight control) prior to referral for surgery, rational use of imaging for assessing OA and improve communication between healthcare professionals. This study assessed the effectiveness of this intervention. Methods Forty-eight PTs and one hundred one GPs were invited to the intervention that included two interactive workshops outlining best practice and an accompanying template for PT discharge reports. Using interrupted time series research design, the study period was divided into three: pre-implementation, transition (implementation) and post-implementation. Comparing the change between pre- and post-implementation, the primary outcome was patient-reported quality of OA care measured with the OsteoArthritis Quality Indicator questionnaire. Secondary outcomes were number of PT discharge reports, information included in GP referral letters to orthopaedic surgeon, the proportion of GP referral letters indicating use of core treatment, and the use of imaging within OA assessment. Analyses involved linear mixed and logistic regression models. Results The PT workshop had 30 attendees, and 31 PTs and 33 GPs attended the multidisciplinary workshop. Two hundred eight and one hundred twenty-five patients completed the questionnaire during pre- and post-implementation, respectively. The adjusted model showed a small, statistically non-significant, increase in mean total score for quality of OA care (mean change = 4.96, 95% CI -0.18, 10.12, p:0.057), which was mainly related to items on OA core treatment. Patients had higher odds of reporting receipt of information on treatment alternatives (odds ratio (OR) 1.9, 95% CI 1.08, 3.24) and on self-management (OR 2.4, 95% CI 1.33, 4.32) in the post-implementation phase. There was a small, statistically non-significant, increase in the proportion of GP referral letters indicating prior use of core treatment modalities. There were negligible changes in the number of PT discharge reports, in the information included in the GP referral letters, and in the use of imaging for OA assessment. Conclusion This study suggests that a primary care intervention including two inter-active workshops can shift the quality of care towards best practice recommendations. Trial registration ClinicalTrials.gov: NCT02876120. Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-03959-6.
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Affiliation(s)
- Nina Østerås
- Division of Rheumatology and Research, National Advisory Unit on Rehabilitation in Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.
| | | | | | - Elizabeth Cottrell
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, Keele University, Staffordshire, ST5 5BG, UK
| | - Jonathan G Quicke
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, Keele University, Staffordshire, ST5 5BG, UK
| | - Krysia S Dziedzic
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, Keele University, Staffordshire, ST5 5BG, UK
| | - Steven Blackburn
- Impact Accelerator Unit, Versus Arthritis Primary Care Centre, Keele University, Staffordshire, ST5 5BG, UK
| | - Aksel Paulsen
- Department of Orthopaedics, Division of Surgery, Stavanger University Hospital, Stavanger, Norway.,Department of Public Health, The Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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Paskins Z, Torres Roldan VD, Hawarden AW, Bullock L, Meritxell Urtecho S, Torres GF, Morera L, Espinoza Suarez NR, Worrall A, Blackburn S, Chapman S, Jinks C, Brito JP. Quality and effectiveness of osteoporosis treatment decision aids: a systematic review and environmental scan. Osteoporos Int 2020; 31:1837-1851. [PMID: 32500301 DOI: 10.1007/s00198-020-05479-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 05/25/2020] [Indexed: 10/24/2022]
Abstract
Decision aids (DAs) are evidence-based tools that support shared decision-making (SDM) implementation in practice; this study aimed to identify existing osteoporosis DAs and assess their quality and efficacy; and to gain feedback from a patient advisory group on findings and implications for further research. We searched multiple bibliographic databases to identify research studies from 2000 to 2019 and undertook an environmental scan (search conducted February 2019, repeated in March 2020). A pair of reviewers, working independently selected studies for inclusion, extracted data, evaluated each trial's risk of bias, and conducted DA quality assessment using the International Patient Decision Aid Standards (IPDAS). Public contributors (patients and caregivers with experience of osteoporosis and fragility fractures) participated in discussion groups to review a sample of DAs, express preferences for a new DA, and discuss plans for development of a new DA. We identified 6 studies, with high or unclear risk of bias. Across included studies, use of an osteoporosis DA was reported to result in reduced decisional conflict compared with baseline, increased SDM, and increased accuracy of patients' perceived fracture risk compared with controls. Eleven DAs were identified, of which none met the full set of IPDAS criteria for certification for minimization of bias. Public contributors expressed preferences for encounter DAs that are individualized to patients' own needs and risk. Using a systematic review and environmental scan, we identified 11 decision aids to inform patient decisions about osteoporosis treatment and 6 studies evaluating their effectiveness. Use of decision aids increased accuracy of risk perception and shared decision-making but the decision aids themselves fail to comprehensively meet international quality standards and patient needs, underpinning the need for new DA development.
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Affiliation(s)
- Z Paskins
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK.
- Haywood Academic Rheumatology Centre, Staffordshire and Stoke-on-Trent Partnership Trust, Stoke-on-Trent, ST6 7AG, UK.
| | - V D Torres Roldan
- Knowledge and Evaluation Research Unit, Endocrinology Department, Mayo Clinic, Rochester, MN, USA
| | - A W Hawarden
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
- Haywood Academic Rheumatology Centre, Staffordshire and Stoke-on-Trent Partnership Trust, Stoke-on-Trent, ST6 7AG, UK
| | - L Bullock
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - S Meritxell Urtecho
- Knowledge and Evaluation Research Unit, Endocrinology Department, Mayo Clinic, Rochester, MN, USA
| | - G F Torres
- Universidad Peruana Cayetano Heredia, Lima, Peru
| | - L Morera
- Knowledge and Evaluation Research Unit, Endocrinology Department, Mayo Clinic, Rochester, MN, USA
| | - N R Espinoza Suarez
- Knowledge and Evaluation Research Unit, Endocrinology Department, Mayo Clinic, Rochester, MN, USA
| | - A Worrall
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - S Blackburn
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - S Chapman
- School of Pharmacy and Bioengineering, Keele University, Staffordshire, ST5 5BG, UK
| | - C Jinks
- Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, ST5 5BG, UK
| | - J P Brito
- Knowledge and Evaluation Research Unit, Endocrinology Department, Mayo Clinic, Rochester, MN, USA
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Schultz L, O'Palka J, Blackburn S, Bigatti S. Evaluating the Burmese Population and Their Use of the WIC Program. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hinrichs R, O'Palka J, Blackburn S. Measuring the Impact of Curriculum-Integrated Librarian Instruction on Dietetic Interns’ Evidence-Based Nutrition Practice Knowledge and Behaviors. J Acad Nutr Diet 2020. [DOI: 10.1016/j.jand.2020.06.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Higginbottom A, Rhodes C, Campbell L, Blackburn S. PARE0030 PEER SUPPORT OF PATIENT AND PUBLIC INVOLVEMENT AND ENGAGEMENT IN RESEARCH: THE ‘RUG-BUDDY’. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Since 2006, The School of Primary, Community and Social Care, Keele University has a long standing commitment to Patient and Public Involvement and Engagement (PPIE) in research. The School’s Research User Group (RUG) has 133 members in January 2020, compared to 80 members in September 2016. Supporting the practical and emotional needs of a growing number of RUG members to support their long-term involvement is of prime importance.Arising from Keele’s role as a test bed site for the new UK Public Involvement Standards, a new peer support role (the ‘RUG-Buddy’) was co-produced to facilitate the support of RUG members.Objectives:The RUG-Buddy is a peer support and mentoring scheme. More experienced RUG members attend research meetings with less experienced members to provide support and reassurance. The scheme aims to provide:•A welcoming and friendly environment for RUG members•Extra support for all RUG members before, during and after research meetings•Help new RUG members ease into public involvement•Support with discussions between researchers and RUG members, e.g. avoiding research jargon••Reassurance to new members - learning from those with greater experience of public involvement•Someone to talk to and confide in from people who have personal experience of PPIE•Practical advice on completing payment forms, parking issues, etc.Methods:Peer support is provided by a panel of existing RUG members who have substantial experience of PPIE in research. This is anadditionalmethod of supporting the RUG members alongside support provided by the School’s PPIE team. RUG-Buddies will be supported in their role by the PPIE team and provided with an induction and training. RUG-Buddies are offered payment for their time and have their travel expenses reimbursed. The RUG-Buddies scheme will be piloted during an initial 6-month period, after which it will be reviewed, with feedback from RUG-Buddies and RUG members.Results:A role description for the RUG-Buddy role has been coproduced by Keele’s PPIE team and its RUG Steering Group (Table 1). A panel of 10 RUG members have been recruited for the RUG-Buddy role and have received an induction and training (e.g. Health and Safety, Information Governance). RUG-Buddies have provided support to and attended research meetings with other RUG members. The RUG-Buddy role will be reviewed in September 2020.Table 1.Summary of the RUG-Buddy role descriptionQualities of a RUG-BuddyRUG-Buddy responsibilitiesPPIE team responsibilitiesWilling to share personal experienceTo attend up to the first three PPIE meetings of a research projectTo provide a training session for all RUG-BuddiesFriendly and approachableTo introduce new member to RUG members and research teamTo meet RUG-Buddies every two months to provide review/feedback of the roleEnthusiastic and knowledgeable about PPIE in researchTo encourage contribution to the meetingTo have a named PPIE lead for any questions/queries that may ariseBe reliable and punctualTo provide support and respond to RUG members’ questionsTo work alongside RUG-Buddy to meet and greet public membersConclusion:The RUG-Buddy is an innovative peer support scheme to support the involvement of patients and the public in research. The support provided by RUG-Buddies offers a different perspective from people with real-life experience of involvement in research. It is anticipated that this additional support will enrich the experience of RUG members and facilitate a more welcoming and conducive environment for active and meaningful public involvement. Furthermore, it has also provided an opportunity for the RUG-Buddies to gain valuable new skills and also give something back to the PPIE team and researchers who have supported their own involvement for many years.Acknowledgments:This project is funded by the National Institute for Health Research (NIHR) School for Primary Care Research (project reference 440). Thank you to the Keele Research User Group for all their great workDisclosure of Interests:None declared
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Deodhar A, Strand V, Conaghan PG, Sullivan E, Blackburn S, Tian H, Gandhi K, Jugl SM, Alten R. Unmet needs in ankylosing spondylitis patients receiving tumour necrosis factor inhibitor therapy; results from a large multinational real-world study. BMC Rheumatol 2020; 4:19. [PMID: 32159075 PMCID: PMC7050131 DOI: 10.1186/s41927-020-0118-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 02/05/2020] [Indexed: 01/13/2023] Open
Abstract
Background Symptoms and comorbidities of ankylosing spondylitis (AS) considerably reduce health-related quality of life (HRQoL) and ability to work. This real-world study assessed rates of tumour necrosis factor inhibitor (TNFi) use and switching, treatment failure, and associations between failing TNFi and HRQoL, work productivity and activity impairment (WPAI). Methods AS patients and their treating physicians completed questionnaires capturing patient demographics, clinical status, TNFi treatment history, reasons for switching TNFi, HRQoL and WPAI. Current TNFi was determined as “failing” if, after ≥3 months, physician-rated disease severity had worsened, remained severe, was “unstable/deteriorating”, physicians were dissatisfied with disease control and/or did not consider treatment a “success”. Results The analysis included 2866 AS patients from 18 countries. Of 2795 patients with complete treatment data, 916 (32.8%) patients had never received TNFi therapy, 1623 (58.1%) patients were receiving their 1st TNFi and 200 (7.2%) patients had ever received ≥2 TNFi (treatment switch). Primary or secondary lack of efficacy were the commonest reasons for switching, and the mean delay in switching after primary lack of efficacy was 11.1 months. 232 (15.4%) patients on TNFi were currently “failing” who, compared to those with treatment success, reported poorer HRQoL: 5-dimension EuroQoL (EQ-5D-3 L): 0.63 vs. 0.78; Medical Outcomes Study Short-Form Health Survey version 2 (SF-36v2) mental component summary (MCS): 41.8 vs. 46.3; physical component summary (PCS): 40.2 vs. 45.1; impaired work productivity: 46.4% vs. 25.0%; and activity: 44.5% vs. 29.6%; all P < 0.001. Conclusions Among AS patients, switching TNFi is uncommon and delayed by nearly 1 year despite primary lack of efficacy. Patients currently failing TNFi experience worse physical function, HRQoL and work productivity.
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Affiliation(s)
- A Deodhar
- 1Oregon Health and Science University, Portland, OR USA
| | - V Strand
- Biopharmaceutical Consultant, Portola Valley, CA USA
| | - P G Conaghan
- 3Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds & NIHR Leeds Biomedical Research Centre, Leeds, UK
| | | | | | - H Tian
- 5Novartis Pharmaceuticals Corporation, East Hanover, NJ USA
| | - K Gandhi
- 5Novartis Pharmaceuticals Corporation, East Hanover, NJ USA
| | - S M Jugl
- 6Novartis Pharma AG, Basel, Switzerland
| | - R Alten
- 7Schlosspark-Klinik, University Medicine, Berlin, Germany
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Hawarden A, Jinks C, Mahmood W, Bullock L, Blackburn S, Gwilym S, Paskins Z. Public priorities for osteoporosis and fracture research: results from a focus group study. Arch Osteoporos 2020; 15:89. [PMID: 32548718 PMCID: PMC7297850 DOI: 10.1007/s11657-020-00766-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 06/03/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED Four focus groups were conducted with members of the public to identify important areas for future osteoporosis research. Participants identified priorities to increase public awareness of osteoporosis, reduce delays in diagnosis, improve communication between healthcare providers and to improve follow-up and information provision about causes of osteoporosis, medication harms and prognosis. PURPOSE Patients and the public must be involved in setting research agendas to ensure relevant and impactful questions are prioritised. This study aimed to understand what people living with osteoporosis and fragility fractures felt was important to research, to inform the content of a national survey on research priorities in this area. METHODS Focus groups were conducted with members of the public with experience of osteoporosis or fragility fractures. The topic guide was co-developed with a patient and public involvement research user group, and explored participants' experiences of osteoporosis including diagnosis, management and effect upon their lives, what aspects of their ongoing care was most important to them and what about their care or condition could be improved. Focus groups were audio-recorded, transcribed and analysed thematically. RESULTS A total of twenty-three participants were recruited to four focus groups. Analysis identified two main themes: challenges in living with osteoporosis and healthcare services for osteoporosis. Information needs was a further cross-cutting theme. Participants called for increased public awareness of osteoporosis and wanted healthcare services to address conflicting messages about diet, exercise and medication. Participants described long delays in diagnosis, poor communication between primary and secondary care and the need for structured follow-up as important areas for future research to address. CONCLUSION The findings from this study provide an understanding of research priorities from the perspective of patients and the public, have informed the content of a national survey and have implications for patient education, health services research and policy.
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Affiliation(s)
- Ashley Hawarden
- grid.9757.c0000 0004 0415 6205Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, ST5 5BG UK ,grid.500956.fHaywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, ST6 7AG UK
| | - Clare Jinks
- grid.9757.c0000 0004 0415 6205Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, ST5 5BG UK
| | - Waheed Mahmood
- grid.9757.c0000 0004 0415 6205Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, ST5 5BG UK
| | - Laurna Bullock
- grid.9757.c0000 0004 0415 6205Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, ST5 5BG UK
| | - Steven Blackburn
- grid.9757.c0000 0004 0415 6205Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, ST5 5BG UK
| | - Stephen Gwilym
- grid.4991.50000 0004 1936 8948Oxford Trauma, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Zoe Paskins
- grid.9757.c0000 0004 0415 6205Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, ST5 5BG UK ,grid.500956.fHaywood Academic Rheumatology Centre, Midlands Partnership NHS Foundation Trust, Stoke-on-Trent, ST6 7AG UK
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Leahy A, Smith J, Eather N, Morgan P, Lonsdale C, Noetel M, Plotnikoff R, Duncan M, Blackburn S, Lubans D. Utility and feasibility of a smartphone app to support school-based high-intensity interval training (HIIT): Findings from the Burn 2 Learn cluster RCT. J Sci Med Sport 2019. [DOI: 10.1016/j.jsams.2019.08.219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Alten R, Conaghan PG, Strand V, Sullivan E, Blackburn S, Tian H, Gandhi K, Jugl SM, Deodhar A. Unmet needs in psoriatic arthritis patients receiving immunomodulatory therapy: results from a large multinational real-world study. Clin Rheumatol 2019; 38:1615-1626. [DOI: 10.1007/s10067-019-04446-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 01/15/2019] [Accepted: 01/21/2019] [Indexed: 01/01/2023]
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Thakkar HS, Hewitt R, Cross K, Hannon E, De Bie F, Blackburn S, Eaton S, McLaren CA, Roebuck DJ, Elliott MJ, Curry JI, Muthialu N, De Coppi P. The multi-disciplinary management of complex congenital and acquired tracheo-oesophageal fistulae. Pediatr Surg Int 2019; 35:97-105. [PMID: 30392126 PMCID: PMC6325990 DOI: 10.1007/s00383-018-4380-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/18/2018] [Indexed: 12/02/2022]
Abstract
AIM OF THE STUDY Complex tracheo-oesophageal fistulae (TOF) are rare congenital or acquired conditions in children. We discuss here a multidisciplinary (MDT) approach adopted over the past 5 years. METHODS We retrospectively collected data on all patients with recurrent or acquired TOF managed at a single institution. All cases were investigated with neck and thorax CT scan. Other investigations included flexible bronchoscopy and bronchogram (B&B), microlaryngobronchoscopy (MLB) and oesophagoscopy. All cases were subsequently discussed in an MDT meeting on an emergent basis if necessary. MAIN RESULTS 14 patients were referred during this study period of which half had a congenital aetiology and the other half were acquired. The latter included button battery ingestions (5/7) and iatrogenic injuries during oesophageal atresia (OA) repair. Surgical repair was performed on cardiac bypass in 3/7 cases of recurrent congenital fistulae and all cases of acquired fistulae. Post-operatively, 9/14 (64%) patients suffered complications including anastomotic leak (1), bilateral vocal cord paresis (1), further recurrence (1), and mortality (1). Ten patients continue to receive surgical input encompassing tracheal/oesophageal stents and dilatations. CONCLUSIONS MDT approach to complex cases is becoming increasingly common across all specialties and is important in making decisions in these difficult cases. The benefits include shared experience of rare cases and full access to multidisciplinary expertise.
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Affiliation(s)
- H. S. Thakkar
- Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK
| | - R. Hewitt
- Department of Otolaryngology, Great Ormond Street Hospital, London, UK ,Tracheal Team, Great Ormond Street Hospital, London, UK
| | - K. Cross
- Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK
| | - E. Hannon
- Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK
| | - F. De Bie
- Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK ,General Surgery Resident, KU Leuven, Leuven, Belgium
| | - S. Blackburn
- Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK
| | - S. Eaton
- Stem Cells and Regenerative Medicine Section, DBC, University College London, London, UK ,Department of Radiology, Great Ormond Street Children’s Hospital, London, UK
| | - C. A. McLaren
- Tracheal Team, Great Ormond Street Hospital, London, UK ,Stem Cells and Regenerative Medicine Section, DBC, University College London, London, UK ,Department of Radiology, Great Ormond Street Children’s Hospital, London, UK
| | - D. J. Roebuck
- Tracheal Team, Great Ormond Street Hospital, London, UK ,Stem Cells and Regenerative Medicine Section, DBC, University College London, London, UK ,Department of Radiology, Great Ormond Street Children’s Hospital, London, UK
| | - M. J. Elliott
- Tracheal Team, Great Ormond Street Hospital, London, UK ,Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - J. I. Curry
- Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK
| | - N. Muthialu
- Tracheal Team, Great Ormond Street Hospital, London, UK ,Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, UK
| | - P. De Coppi
- Neonatal and Paediatric Surgery, Great Ormond Street Hospital, London, UK ,Tracheal Team, Great Ormond Street Hospital, London, UK ,Stem Cells and Regenerative Medicine Section, DBC, University College London, London, UK
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Blackburn S, McLachlan S, Jowett S, Kinghorn P, Gill P, Higginbottom A, Rhodes C, Stevenson F, Jinks C. The extent, quality and impact of patient and public involvement in primary care research: a mixed methods study. Res Involv Engagem 2018; 4:16. [PMID: 29850029 PMCID: PMC5966874 DOI: 10.1186/s40900-018-0100-8] [Citation(s) in RCA: 66] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Accepted: 04/10/2018] [Indexed: 05/06/2023]
Abstract
PLAIN ENGLISH SUMMARY In the UK, more patients go to primary care than other parts of the health service. Therefore it is important for research into primary care to include the insights and views of people who receive these services. To explore the extent, quality and impact of patient and public involvement (PPI) in primary care research, we examined documents of 200 projects and surveyed 191 researchers.We found that about half of studies included PPI to develop research ideas and during the study itself. Common activities included designing study materials, advising on methods, and managing the research. Some studies did not undertake the PPI activities initially planned and funded for. PPI varied by study design, health condition and study population. We found pockets of good practice: having a PPI budget, supporting PPI contributors, and PPI informing recruitment issues. However, good practice was lacking in other areas. Few projects offered PPI contributors training, used PPI to develop information for participants about study progress and included PPI to advise on publishing findings.Researchers reported beneficial impacts of PPI. Most impact was reported when the approach to PPI included more indicators of good practice. The main cost of PPI for researchers was their time. Many reported difficulties providing information about PPI.In partnership with PPI contributors, we have used these findings to develop:a new Cost and Consequences Framework for PPI highlighting financial and non-financial costs, benefits and harms of PPIFifteen co-produced recommendations to improve the practice and delivery of PPI. ABSTRACT Background: To improve the lives of patients in primary care requires the involvement of service users in primary care research. We aimed to explore the extent, quality and impact of patient and public involvement (PPI) in primary care research.Methods: We extracted information about PPI from grant applications, reports and an electronic survey of researchers of studies funded by the NIHR School for Primary Care Research (SPCR). We applied recognised quality indicators to assess the quality of PPI and assessed its impact on research.Results: We examined 200 grant applications and reports of 181 projects. PPI was evident in the development of 47 (24%) grant applications. 113 (57%) grant applications included plans for PPI during the study, mostly in study design, oversight, and dissemination. PPI during projects was reported for 83 (46%) projects, including designing study materials and managing the research. We identified inconsistencies between planned and reported PPI. PPI varied by study design, health condition and study population.Of 46 (24%) of 191 questionnaires completed, 15 reported PPI activity. Several projects showed best practice according to guidelines, in terms of having a PPI budget, supporting PPI contributors, and PPI informing recruitment issues. However few projects offered PPI contributors training, used PPI to develop information for participants about study progress, and had PPI in advising on dissemination.Beneficial impacts of PPI in designing studies and writing participant information was frequently reported. Less impact was reported on developing funding applications, managing or carrying out the research. The main cost of PPI for researchers was their time. Many researchers found it difficult to provide information about PPI activities.Our findings informed:a new Cost and Consequences Framework for PPI in primary care research highlighting financial and non-financial costs, plus the benefits and harms of PPIFifteen co-produced recommendations to improve PPI in research and within the SPCR.Conclusions: The extent, quality and impact of PPI in primary care research is inconsistent across research design and topics. Pockets of good practice were identified making a positive impact on research. The new Cost and Consequences Framework may help others assess the impact of PPI.
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Affiliation(s)
- Steven Blackburn
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
| | - Sarah McLachlan
- Department of Physiotherapy, Division of Health and Social Care Research, King’s College London, London, UK
| | - Sue Jowett
- Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Birmingham, UK
| | - Philip Kinghorn
- Health Economics Unit, School of Health and Population Sciences, University of Birmingham, Birmingham, UK
| | - Paramjit Gill
- Social Science and Systems in Health, Warwick Medical School, University of Warwick, Coventry, UK
| | - Adele Higginbottom
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
- PPI Contributor, Keele, UK
| | - Carol Rhodes
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
- PPI Contributor, Keele, UK
| | - Fiona Stevenson
- The Research Department of Primary Care and Population Health, University College London, London, UK
| | - Clare Jinks
- Research Institute for Primary Care & Health Sciences, Keele University, Keele, Staffordshire ST5 5BG UK
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Muir D, Vat LE, Keller M, Bell T, Jørgensen CR, Eskildsen NB, Johnsen AT, Pandya-Wood R, Blackburn S, Day R, Ingram C, Hapeshi J, Khan S, Muir D, Baird W, Pavitt SH, Boards R, Briggs J, Loughhead E, Patel M, Khalil R, Cooper D, Day P, Boards J, Wu J, Zoltie T, Barber S, Thompson W, Kenny K, Owen J, Ramsdale M, Grey-Borrows K, Townsend N, Johnston J, Maddison K, Duff-Walker H, Mahon K, Craig L, Collins R, O’Grady A, Wadd S, Kelly A, Dutton M, McCann M, Jones R, Mathie E, Wythe H, Munday D, Millac P, Rhodes G, Roberts N, Simpson J, Barden N, Vicary P, Wellings A, Poland F, Jones J, Miah J, Bamforth H, Charalambous A, Dawes P, Edwards S, Leroi I, Manera V, Parsons S, Sayers R, Pinfold V, Dawson P, Gibbons B, Gibson J, Hobson-Merrett C, McCabe C, Rawcliffe T, Frith L, Gudgin B, Wellings A, Horobin A, Ewart C, Higton F, Vanhegan S, Pandya-Wood R, Stewart J, Wragg A, Wray P, Widdowson K, Brighton LJ, Pask S, Benalia H, Bailey S, Sumerfield M, Etkind S, Murtagh FEM, Koffman J, Evans CJ, Hrisos S, Marshall J, Yarde L, Riley B, Whitlock P, Jobson J, Ahmed S, Rankin J, Michie L, Scott J, Barker CR, Barlow-Pay M, Kekere-Ekun A, Mazumder A, Nishat A, Petley R, Brady LM, Templeton L, Walker E, Moore D, Shaw L, Nunns M, Thompson Coon J, Blomquist P, Cochrane S, Edelman N, Calliste J, Cassell J, Mader LB, Kläger S, Wilkinson IB, Hiemstra TF, Hughes M, Warren A, Atkins P, Eaton H, Keenan J, Poland F, Wythe H, Wellings A, Vicary P, Rhodes C, Skrybrant M, Blackburn S, Chatwin L, Darby MA, Entwistle A, Hull D, Quann N, Hickey G, Dziedzic K, Eltringham SA, Gordon J, Franklin S, Jackson J, Leggett N, Davies P, Nugawela M, Scott L, Leach V, Richards A, Blacker A, Abrams P, Sharma J, Donovan J, Whiting P, Stones SR, Wright C, Boddy K, Irvine J, Harris J, Joseph N, Kok M, Gibson A, Evans D, Grier S, MacGowan A, Matthews R, Papoulias C, Augustine C, Hoffman M, Doughty M, Surridge H, Tembo D, Roberts A, Chambers E, Beever D, Wildman M, Davies RL, Staniszewska S, Stephens R, Schroter S, Price A, Richards T, Demaine A, Harmston R, Elliot J, Flemyng E, Sproson L, Pryde L, Reed H, Squire G, Stanton A, Langley J, Briggs M, Brindle P, Sanders R, McDermott C, David C, Nicola H, Simon D, Martin W, Coldham T, Ballinger C, Kerridge L, Mullee M, Eyles C, Barlow-Pay M, Hickey G, Johns T, Paylor J, Turner K, Whiting L, Roberts S, Petty J, Meager G, Grinbergs-Saull A, Morgan N, Turner K, Collins F, Gibson S, Passmore S, Evans L, Green SA, Trite J, Matthews R, Hrisos S, Thomson R, Green D, Atkinson H, Mitchell A, Corner L, AM AMK, Nguyen R, Frank B, McNeil N, Harrison H. Abstracts from the NIHR INVOLVE Conference 2017. Res Involv Engagem 2017; 3:27. [PMCID: PMC5773864 DOI: 10.1186/s40900-017-0075-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Delia Muir
- Leeds Institute of Clinical Trials Research, University of Leeds, Leeds, UK
| | - Lidewij Eva Vat
- Newfoundland and Labrador’s Support for People and Patient-Oriented Research and Trials Unit, Memorial University Newfoundland, St. Johns, Newfoundland and Labrador Canada
| | - Malori Keller
- Saskatchewan Centre for Patient-Oriented Research, Health Quality Council, Saskatoon, Saskatchewan Canada
| | - Tim Bell
- Canadian Institutes of Health Research, Ottawa, Ontario Canada
| | - Clara R. Jørgensen
- Department of Disability, Inclusion and Special Needs, School of Education, University of Birmingham, Birmingham, UK
| | - Nanna B. Eskildsen
- Department of Palliative Medicine, Bispebjerg Hospital, DK-2400 Copenhagen, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Anna T. Johnsen
- Department of Palliative Medicine, Bispebjerg Hospital, DK-2400 Copenhagen, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Raksha Pandya-Wood
- National Institute for Health Research, Research Design Service East Midlands, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Steven Blackburn
- National Institute for Health Research, Research Design Service West Midlands, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Ruth Day
- National Institute for Health Research, Research Design Service East Midlands, Department of Health Sciences, University of Leicester, Leicester, UK
- Public contributor involved with the National Institute for Health Research, Research Design Service Public Involvement Community, Derby, UK
| | - Carol Ingram
- National Institute for Health Research, Research Design Service West Midlands, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
- Public contributor involved with the National Institute for Health Research, Research Design Service Public Involvement Community, Derby, UK
| | - Julie Hapeshi
- National Institute for Health Research, Research Design Service South West, Gloucestershire Royal Hospital, Gloucester, UK
| | - Samaira Khan
- National Institute for Health Research, Research Design Service Yorkshire and Humber, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Delia Muir
- National Institute for Health Research, Research Design Service Yorkshire and Humber, Leeds Institute for Clinical Trials Research, University of Leeds, Leeds, UK
| | - Wendy Baird
- National Institute for Health Research, Research Design Service Yorkshire and Humber, School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Sue H. Pavitt
- School of Dentistry, University of Leeds, Leeds, UK
- The SMILE AIDERS Patient Public Involvement & Engagement Forum School of Dentistry, University of Leeds, Leeds, UK
| | - Richard Boards
- The SMILE AIDERS Patient Public Involvement & Engagement Forum School of Dentistry, University of Leeds, Leeds, UK
| | - Janet Briggs
- The SMILE AIDERS Patient Public Involvement & Engagement Forum School of Dentistry, University of Leeds, Leeds, UK
| | - Ellen Loughhead
- The SMILE AIDERS Patient Public Involvement & Engagement Forum School of Dentistry, University of Leeds, Leeds, UK
- Batley Girls High School, Batley, UK
| | - Mariya Patel
- The SMILE AIDERS Patient Public Involvement & Engagement Forum School of Dentistry, University of Leeds, Leeds, UK
- Batley Girls High School, Batley, UK
| | - Rameesa Khalil
- The SMILE AIDERS Patient Public Involvement & Engagement Forum School of Dentistry, University of Leeds, Leeds, UK
- Batley Girls High School, Batley, UK
| | | | - Peter Day
- School of Dentistry, University of Leeds, Leeds, UK
| | - Jenny Boards
- School of Dentistry, University of Leeds, Leeds, UK
- The SMILE AIDERS Patient Public Involvement & Engagement Forum School of Dentistry, University of Leeds, Leeds, UK
| | - Jianhua Wu
- School of Dentistry, University of Leeds, Leeds, UK
| | | | - Sophy Barber
- School of Dentistry, University of Leeds, Leeds, UK
| | | | - Kate Kenny
- School of Dentistry, University of Leeds, Leeds, UK
| | - Jenny Owen
- School of Dentistry, University of Leeds, Leeds, UK
| | | | | | | | | | - Katie Maddison
- School of Performance & Cultural Industries, University of Leeds, Leeds, UK
| | - Harry Duff-Walker
- School of Performance & Cultural Industries, University of Leeds, Leeds, UK
| | - Katie Mahon
- School of Performance & Cultural Industries, University of Leeds, Leeds, UK
| | - Lily Craig
- School of Performance & Cultural Industries, University of Leeds, Leeds, UK
| | - Rebecca Collins
- School of Performance & Cultural Industries, University of Leeds, Leeds, UK
| | - Alice O’Grady
- School of Performance & Cultural Industries, University of Leeds, Leeds, UK
| | - Sarah Wadd
- Substance Misuse and Ageing Research Team (SMART), Institute of Applied Social Research, University of Bedfordshire, Luton, UK
| | - Adrian Kelly
- Substance Misuse and Ageing Research Team (SMART), Institute of Applied Social Research, University of Bedfordshire, Luton, UK
| | - Maureen Dutton
- Substance Misuse and Ageing Research Team (SMART), Institute of Applied Social Research, University of Bedfordshire, Luton, UK
| | - Michelle McCann
- Substance Misuse and Ageing Research Team (SMART), Institute of Applied Social Research, University of Bedfordshire, Luton, UK
| | - Rebecca Jones
- Substance Misuse and Ageing Research Team (SMART), Institute of Applied Social Research, University of Bedfordshire, Luton, UK
| | - Elspeth Mathie
- CRIPACC, University of Hertfordshire, Hatfield, Hertfordshire, UK
| | - Helena Wythe
- CRIPACC, University of Hertfordshire, Hatfield, Hertfordshire, UK
| | - Diane Munday
- Public Involvement in Research Group, University of Hertfordshire, Hatfield, Hertfordshire, UK
| | - Paul Millac
- Public Involvement in Research Group, University of Hertfordshire, Hatfield, Hertfordshire, UK
| | - Graham Rhodes
- INsPIRE PPI Group, Cambridgeshire Community Services NHS Trust, Ely, Cambridgeshire, UK
| | - Nick Roberts
- INsPIRE PPI Group, Cambridgeshire Community Services NHS Trust, Ely, Cambridgeshire, UK
| | - Jean Simpson
- Cambridge University Hospital (CUH) Patient and Public Involvement Panel, Cambridgeshire, UK
| | - Nat Barden
- Service User and Research Group, Cambridge and Peterborough Foundation Trust, Cambridgeshire, UK
| | - Penny Vicary
- Public & Patient Involvement in Research (PPIRes), Norfolk and Suffolk, UK
| | - Amander Wellings
- Public & Patient Involvement in Research (PPIRes), Norfolk and Suffolk, UK
| | | | - Julia Jones
- CRIPACC, University of Hertfordshire, Hatfield, Hertfordshire, UK
| | - Jahanara Miah
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
- Public Programmes Team, Research and Innovation Division, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Howard Bamforth
- SENSE-Cog Research User Group, Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Anna Charalambous
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Piers Dawes
- Manchester Centre for Audiology and Deafness (ManCAD), Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - Steven Edwards
- Public Programmes Team, Research and Innovation Division, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Iracema Leroi
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Valeria Manera
- CoBTeK COgnition Behaviour Technology, Universite de Nice Sophia Antipolis, Nice, France
| | - Suzanne Parsons
- Public Programmes Team, Research and Innovation Division, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | | | | | - Paul Dawson
- Lancashire Care NHS Foundation Trust, Preston, UK
| | | | | | | | | | | | - Lucy Frith
- National Institute for Health Research (NIHR), Research Design Service North West, University of Liverpool, Liverpool, UK
| | | | | | - Adele Horobin
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK
- Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, UK
| | | | | | | | - Raksha Pandya-Wood
- National Institute for Health Research (NIHR) East Midlands Research Design Service, Department of Health Sciences, University of Leicester, Leicester, UK
| | - Jane Stewart
- National Institute for Health Research (NIHR) East Midlands Research Design Service, School of Medicine, University of Nottingham, Nottingham Health Science Partners, Queen’s Medical Centre, Nottingham, UK
| | - Andy Wragg
- Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, UK
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Queen’s Medical Centre, Nottingham, UK
| | - Paula Wray
- INVOLVE Coordinating Centre, University of Southampton, Southampton, UK
| | - Kirsty Widdowson
- Nottingham University Hospitals NHS Trust, Queens Medical Centre, Nottingham, UK
| | - Lisa Jane Brighton
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King’s College London, London, UK
| | - Sophie Pask
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King’s College London, London, UK
| | - Hamid Benalia
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King’s College London, London, UK
| | - Sylvia Bailey
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King’s College London, London, UK
| | - Marion Sumerfield
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King’s College London, London, UK
| | - Simon Etkind
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King’s College London, London, UK
| | - Fliss E. M. Murtagh
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King’s College London, London, UK
- Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK
| | - Jonathan Koffman
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King’s College London, London, UK
| | - Catherine J. Evans
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King’s College London, London, UK
- Department of Palliative Medicine, Sussex Community NHS Foundation Trust, Brighton, UK
| | - Susan Hrisos
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | | | | | - Bren Riley
- Riverside Project, Newcastle upon Tyne, UK
| | | | | | - Safia Ahmed
- Health and Race Equality Forum, Newcastle upon Tyne, UK
| | - Judith Rankin
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Lydia Michie
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Jason Scott
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Caroline R. Barker
- National Institute for Health Research Southampton Clinical Research Facility and Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK
| | - Megan Barlow-Pay
- National Institute for Health Research Design Service South Central, University of Southampton, Southampton, Hampshire, UK
| | - Aisha Kekere-Ekun
- Young Adult Patient and Public Involvement Group member, Southampton, Hampshire, UK
| | - Aniqa Mazumder
- Young Adult Patient and Public Involvement Group member, Southampton, Hampshire, UK
| | - Aniqa Nishat
- Young Adult Patient and Public Involvement Group member, Southampton, Hampshire, UK
| | - Rebecca Petley
- Young Adult Patient and Public Involvement Group member, Southampton, Hampshire, UK
| | - Louca-Mai Brady
- Kingston and St George’s Joint Faculty and Independent Research Consultant, London, UK
| | | | - Erin Walker
- Centre for Outcomes and Experiences Research in Child Health, Illness and Disease, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Darren Moore
- National Institute of Health Research Peninsula Collaboration for Leadership in Applied Health Research & Care, University of Exeter Medical School, Exeter, UK
| | - Liz Shaw
- National Institute of Health Research Peninsula Collaboration for Leadership in Applied Health Research & Care, University of Exeter Medical School, Exeter, UK
| | - Michael Nunns
- National Institute of Health Research Peninsula Collaboration for Leadership in Applied Health Research & Care, University of Exeter Medical School, Exeter, UK
| | - Jo Thompson Coon
- National Institute of Health Research Peninsula Collaboration for Leadership in Applied Health Research & Care, University of Exeter Medical School, Exeter, UK
| | - Paula Blomquist
- Public Health England, London, UK
- National Institute for Health Research (NIHR) Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at UCL, London, UK
| | - Sarah Cochrane
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Natalie Edelman
- Brighton & Sussex Medical School, Brighton, UK
- University of Brighton, Brighton, UK
| | - Josina Calliste
- National Institute for Health Research (NIHR) Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at UCL, London, UK
| | - Jackie Cassell
- National Institute for Health Research (NIHR) Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at UCL, London, UK
- Brighton & Sussex Medical School, Brighton, UK
| | - Laura B. Mader
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Sabine Kläger
- Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Ian B. Wilkinson
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Thomas F. Hiemstra
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Cambridge Clinical Trials Unit, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Mel Hughes
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Angela Warren
- PIER (Public Involvement in Education and Research) partnership, Bournemouth University, Bournemouth, UK
| | - Peter Atkins
- PIER (Public Involvement in Education and Research) partnership, Bournemouth University, Bournemouth, UK
| | - Hazel Eaton
- Research and Development, Dorset Healthcare University NHS Foundation Trust, Dorset, UK
| | | | | | - Helena Wythe
- University of Hertfordshire, Hatfield, Hertfordshire, UK
| | - Amander Wellings
- Members of the Patient and Public in Research Group (PPIRes), NHS South Norfolk Clinical Commissioning Group, Norwich, Norfolk, UK
| | - Penny Vicary
- Members of the Patient and Public in Research Group (PPIRes), NHS South Norfolk Clinical Commissioning Group, Norwich, Norfolk, UK
| | - Carol Rhodes
- NIHR Research Design Service West Midlands, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, UK
| | - Magdalena Skrybrant
- NIHR Collaboration for Leadership in Health Research and Care West Midlands, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Steven Blackburn
- NIHR Research Design Service West Midlands, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, UK
| | - Lucy Chatwin
- Academic Health Science Network West Midlands, Institute of Translational Medicine, Queen Elizabeth Hospital, Birmingham, UK
| | - Mary-Anne Darby
- NIHR Clinical Research Network West Midlands, Greyfriars Business Park, Stafford, UK
| | - Andrew Entwistle
- NIHR Clinical Research Network West Midlands, Greyfriars Business Park, Stafford, UK
| | - Diana Hull
- NIHR/Wellcome Trust Birmingham Clinical Research Facility, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Naimh Quann
- NIHR/Wellcome Trust Birmingham Clinical Research Facility, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Gary Hickey
- INVOLVE, University of Southampton Science Park, Southampton, UK
| | - Krysia Dziedzic
- NIHR Research Design Service West Midlands, Research Institute for Primary Care & Health Sciences, Keele University, Staffordshire, UK
| | - Sabrina A. Eltringham
- Directorate of Therapeutics and Palliative, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Jim Gordon
- Directorate of Therapeutics and Palliative, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Sue Franklin
- Directorate of Therapeutics and Palliative, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Joni Jackson
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Nick Leggett
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Philippa Davies
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Manjula Nugawela
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Lauren Scott
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Verity Leach
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Alison Richards
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Anthony Blacker
- University Hospitals Coventry and Warwickshire, Coventry, UK
| | | | - Jitin Sharma
- University Hospitals Coventry and Warwickshire, Coventry, UK
| | - Jenny Donovan
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Penny Whiting
- The National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Simon R. Stones
- NIHR: CRN Children/Arthritis Research UK Paediatric Rheumatology Clinical Studies Group, Liverpool, UK
| | - Catherine Wright
- NIHR: CRN Children/Arthritis Research UK Paediatric Rheumatology Clinical Studies Group, Liverpool, UK
| | - Kate Boddy
- NIHR CLAHRC South West Peninsula (PenCLAHRC), University of Exeter Medical School, Exeter, UK
| | - Jenny Irvine
- NIHR CLAHRC North West Coast (CLAHRC NWC), Based at Division of Health Research, Lancaster University, Lancaster, UK
| | - Jim Harris
- Peninsula Public Involvement Group (PenPIG), PenCLAHRC, South West Peninsula, Exeter, UK
| | - Neil Joseph
- Public Reference Panel (PRP), CLAHRC NWC, North West Coast area, Liverpool, UK
| | - Michele Kok
- Department of Health and Social Sciences, University of the West of England, Bristol, UK
| | - Andy Gibson
- Department of Health and Social Sciences, University of the West of England, Bristol, UK
| | - David Evans
- Department of Health and Social Sciences, University of the West of England, Bristol, UK
| | - Sally Grier
- Department of Medical Microbiology, North Bristol NHS Trust, Bristol, UK
| | - Alasdair MacGowan
- Department of Medical Microbiology, North Bristol NHS Trust, Bristol, UK
| | - Rachel Matthews
- NIHR CLAHRC Northwest London, Imperial College London/Chelsea and Westminster NHS Foundation Trust, London, UK
| | | | - Cherelle Augustine
- NIHR CLAHRC Northwest London, Imperial College London/Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Maurice Hoffman
- NIHR CLAHRC Northwest London, Imperial College London/Chelsea and Westminster NHS Foundation Trust, London, UK
| | | | - Heidi Surridge
- NIHR Evaluation Trials and Studies Coordinating Centre (NETSCC), Southampton, UK
| | - Doreen Tembo
- NIHR Evaluation Trials and Studies Coordinating Centre (NETSCC), Southampton, UK
| | - Amanda Roberts
- Public member, NETSCC Public Involvement Virtual Network and Public member of a Trial Steering Committee, Southampton, UK
| | - Eleni Chambers
- Public member, NETSCC PPI Reference Group, Southampton, UK
| | - Daniel Beever
- Clinical Trials Research Unit, School of Health and Related Research, University of Sheffield, Sheffield, South Yorkshire UK
| | - Martin Wildman
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire UK
| | - Rosemary L. Davies
- Department of Health and Social Sciences, University of the West of England, Bristol, UK
- National Institute for Health Research, Collaborations for Leadership in Applied Health Research and Care West (NIHR CLAHRC West), University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Sophie Staniszewska
- Warwick Research in Nursing, Warwick Medical School, University of Warwick, Warwick, UK
| | | | | | - Amy Price
- The BMJ, London, UK
- Department of Continuing Education, University of Oxford, Oxford, UK
| | | | | | | | | | | | - Lise Sproson
- NIHR Devices for Dignity Health Technology Co-operative, Sheffield, UK
| | - Liz Pryde
- NIHR Devices for Dignity Health Technology Co-operative, Sheffield, UK
| | - Heath Reed
- Lab4Living, Art and Design Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Gill Squire
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Andy Stanton
- Lab4Living, Art and Design Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Joe Langley
- Lab4Living, Art and Design Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Moya Briggs
- NIHR Devices for Dignity Health Technology Co-operative, Sheffield, UK
| | - Philip Brindle
- NIHR Devices for Dignity Health Technology Co-operative, Sheffield, UK
| | - Rod Sanders
- NIHR Devices for Dignity Health Technology Co-operative, Sheffield, UK
| | - Christopher McDermott
- Sheffield Institute for Translational Neuroscience, University of Sheffield, Sheffield, UK
| | - Coyle David
- NIHR Devices for Dignity Healthcare Technology Co-operative at Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF UK
- Renal Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Heron Nicola
- NIHR Devices for Dignity Healthcare Technology Co-operative at Sheffield Teaching Hospitals NHS Foundation Trust, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF UK
| | - Davies Simon
- Institute for Applied Clinical Sciences, Keele University, Keele, Staffordshire UK
- University Hospital of North Midlands, Newcastle Rd, Stoke-on-Trent, Staffordshire, ST46QG UK
| | - Wilkie Martin
- University Hospital of North Midlands, Newcastle Rd, Stoke-on-Trent, Staffordshire, ST46QG UK
| | | | | | | | - Mark Mullee
- Research Design Service South Central, Southampton General Hospital, Southampton, UK
| | - Caroline Eyles
- Research Design Service South Central, Southampton General Hospital, Southampton, UK
| | - Megan Barlow-Pay
- Research Design Service South Central, Southampton General Hospital, Southampton, UK
| | - Gary Hickey
- NIHR INVOLVE, University of Southampton, Southampton, UK
| | - Tracey Johns
- NIHR Research Design Service East of England, University of Essex, Essex, UK
| | - Jon Paylor
- NIHR Research Design Service London, Kings College London, London, UK
| | - Katie Turner
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Lisa Whiting
- Department of Nursing and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, England
| | - Sheila Roberts
- Department of Nursing and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, England
| | - Julia Petty
- Department of Nursing and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, England
| | - Gary Meager
- Department of Nursing and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, England
| | | | | | - Kati Turner
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Flavia Collins
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Sarah Gibson
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Siobhan Passmore
- Population Health Research Institute, St George’s, University of London, London, UK
| | - Liz Evans
- NIHR CLAHRC Northwest London, Imperial College London/Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Stuart A. Green
- NIHR CLAHRC Northwest London, Imperial College London/Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Jenny Trite
- Central and Northwest London NHS Foundation Trust, London, UK
| | - Rachel Matthews
- NIHR CLAHRC Northwest London, Imperial College London/Chelsea and Westminster NHS Foundation Trust, London, UK
| | - Susan Hrisos
- Institute of Health & Society, Newcastle University, Newcastle, UK
| | - Richard Thomson
- Institute of Health & Society, Newcastle University, Newcastle, UK
| | - Dave Green
- Institute of Health & Society, Newcastle University, Newcastle, UK
| | - Helen Atkinson
- Faculty of Medical Sciences Engage, Newcastle University, Newcastle, UK
| | - Alex Mitchell
- Faculty of Medical Sciences Engage, Newcastle University, Newcastle, UK
| | - Lynne Corner
- Faculty of Medical Sciences Engage, Newcastle University, Newcastle, UK
| | | | - Rebecca Nguyen
- Consumer and Community Health Research Network, Perth, Australia
- Telethon Kids Institute, Perth, Australia
| | - Belinda Frank
- Consumer and Community Health Research Network, Perth, Australia
| | - Ngaire McNeil
- Consumer and Community Health Research Network, Perth, Australia
| | - Hayley Harrison
- Consumer and Community Health Research Network, Perth, Australia
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Hill JC, Kang S, Benedetto E, Myers H, Blackburn S, Smith S, Dunn KM, Hay E, Rees J, Beard D, Glyn-Jones S, Barker K, Ellis B, Fitzpatrick R, Price A. Development and initial cohort validation of the Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ) for use across musculoskeletal care pathways. BMJ Open 2016; 6:e012331. [PMID: 27496243 PMCID: PMC4985936 DOI: 10.1136/bmjopen-2016-012331] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Current musculoskeletal outcome tools are fragmented across different healthcare settings and conditions. Our objectives were to develop and validate a single musculoskeletal outcome measure for use throughout the pathway and patients with different musculoskeletal conditions: the Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ). SETTING A consensus workshop with stakeholders from across the musculoskeletal community, workshops and individual interviews with a broad mix of musculoskeletal patients identified and prioritised outcomes for MSK-HQ inclusion. Initial psychometric validation was conducted in four cohorts from community physiotherapy, and secondary care orthopaedic hip, knee and shoulder clinics. PARTICIPANTS Stakeholders (n=29) included primary care, physiotherapy, orthopaedic and rheumatology patients (n=8); general practitioners, physiotherapists, orthopaedists, rheumatologists and pain specialists (n=7), patient and professional national body representatives (n=10), and researchers (n=4). The four validation cohorts included 570 participants (n=210 physiotherapy, n=150 hip, n=150 knee, n=60 shoulder patients). OUTCOME MEASURES Outcomes included the MSK-HQ's acceptability, feasibility, comprehension, readability and responder burden. The validation cohort outcomes were the MSK-HQ's completion rate, test-retest reliability and convergent validity with reference standards (EQ-5D-5L, Oxford Hip, Knee, Shoulder Scores, and the Keele MSK-PROM). RESULTS Musculoskeletal domains prioritised were pain severity, physical function, work interference, social interference, sleep, fatigue, emotional health, physical activity, independence, understanding, confidence to self-manage and overall impact. Patients reported MSK-HQ items to be 'highly relevant' and 'easy to understand'. Completion rates were high (94.2%), with scores normally distributed, and no floor/ceiling effects. Test-retest reliability was excellent, and convergent validity was strong (correlations 0.81-0.88). CONCLUSIONS A new musculoskeletal outcome measure has been developed through a coproduction process with patients to capture prioritised outcomes for use throughout the pathway and with different musculoskeletal conditions. Four validation cohorts found that the MSK-HQ had high completion rates, excellent test-retest reliability and strong convergent validity with reference standards. Further validation studies are ongoing, including a cohort with rheumatoid/inflammatory arthritis.
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Affiliation(s)
- Jonathan C Hill
- Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK
| | - Sujin Kang
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, Oxfordshire, UK
| | - Elena Benedetto
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, Oxfordshire, UK
| | - Helen Myers
- Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK
| | - Steven Blackburn
- Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK
| | - Stephanie Smith
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, Oxfordshire, UK
| | - Kate M Dunn
- Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK
| | - Elaine Hay
- Arthritis Research UK Primary Care Centre, Keele University, Keele, Staffordshire, UK
| | - Jonathan Rees
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, Oxfordshire, UK
| | - David Beard
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, Oxfordshire, UK
| | - Sion Glyn-Jones
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, Oxfordshire, UK
| | - Karen Barker
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, Oxfordshire, UK
| | | | - Ray Fitzpatrick
- Nuffield Department of Population Health, University of Oxford, Oxford, Oxfordshire, UK
| | - Andrew Price
- Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, Botnar Research Centre, University of Oxford, Oxford, Oxfordshire, UK
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Abstract
Cue theory has had a resurgence in recent years as part of modular approaches to vision. Cues often seem to combine according to a weighted linear sum, although interactions may also occur. Conflict studies show that linear perspective and stereo combine to influence slant perception, with perspective weighted surprisingly heavily. We investigated the effect of conflicting linear perspective in reducing stereo slant when perspective is present as a purely cyclopean outline shape, compared with conditions when the shape is also monocularly present. In experiment 1, random line stereograms were generated with cyclopean trapezoids standing out from a background. Their outline convergence either conflicted with or supported a stereo gradient across the surface of the trapezoid. Two stereo slants and two standing disparities were used. In experiment 2, an aperture condition was included with the cyclopean trapezoids behind the surround. There was strong influence of trapezoid direction on perceived slant. This influence was only marginally increased by outlining the trapezoid. These findings demonstrate the effectiveness of cyclopean shape as perspective information. As expected, when the trapezoid was an area seen through an aperture, its direction did not significantly affect stereo slant. We conclude that stereo and perspective cannot be considered as separate modules. In binocular vision, perspective is conveyed stereoscopically.
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Jinks C, Mahmood W, Jayakumar P, Gwilym S, Blackburn S, Worrall A, Paskins Z. OP0251-PARE Patient and Public Involvement in Design, Analysis and Reporting of A Public Priority Setting Exercise for Research in Osteoporosis. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3302] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Peterson S, Li N, Blackburn S, Kielar D. SAT0089 Anxiety and Depression among Rheumatoid Arthritis Patients, and Association with Clinical Measurements and Patient Reported Disability and Treatment Satisfaction: Table 1. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Alten R, Strand V, Conaghan P, Deodhar A, Sullivan E, Blackburn S, Tian H, Gandhi K, Jugl S. THU0630 Treatment Failure, Treatment Switching and Health-Related Quality of Life in Patients with Ankylosing Spondylitis or Psoriatic Arthritis: Results from A Large Multinational Real-World Sample in Europe and The USA. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Conaghan P, Deodhar A, Strand V, Alten R, Sullivan E, Blackburn S, Tian H, Gandhi K, Jugl S. THU0411 Fatigue in Patients with Ankylosing Spondylitis and Low Vitality in Those with Psoriatic Arthritis: Results from A Large Real-World Survey in Europe and The USA. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.2125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wei W, Anderson P, Gadkari A, Blackburn S, Moon R, Piercy J, Shinde S, Gomez J, Ghorayeb E. 125 Disagreement between physician- and patient-reported disease severity in adults with a history of moderate-to-severe atopic dermatitis. J Invest Dermatol 2016. [DOI: 10.1016/j.jid.2016.02.152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Blackburn S, Higginbottom A, Taylor R, Bird J, Østerås N, Hagen KB, Edwards JJ, Jordan KP, Jinks C, Dziedzic K. Patient-reported quality indicators for osteoarthritis: a patient and public generated self-report measure for primary care. Res Involv Engagem 2016; 2:5. [PMID: 29062506 PMCID: PMC5611660 DOI: 10.1186/s40900-016-0019-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 02/09/2016] [Indexed: 06/07/2023]
Abstract
PLAIN ENGLISH SUMMARY People with osteoarthritis desire high quality care, support and information. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators can be used to benefit patients by measuring whether minimum standards of quality care are being met from a patient perspective. The aim of this study was to describe how a Research User Group (RUG) worked alongside researchers to co-produce a set of self-reported quality indicators for people with osteoarthritis when visiting their general practitioner or practice nurse (primary care). These were required in the MOSAICS study, which developed and evaluated a new model of supported self-management of OA to implement the NICE quality standards for OA. This article describes the public involvement in the MOSAICS study. This was 1) the co-development by RUG members and researchers of an Osteoarthritis Quality Indicators United Kingdom (OA QI (UK)) questionnaire for use in primary care, and 2) the comparison of the OA QI (UK) with a similar questionnaire developed in Norway. This study shows how important and effective a research user group can be in working with researchers in developing quality care indicators for osteoarthritis for use in a research study and, potentially, routine use in primary care. The questionnaire is intended to benefit patients by enabling the assessment of the quality of primary care for osteoarthritis from a patient's perspective. The OA QI (UK) has been used to examine differences in the quality of osteoarthritis care in four European countries. ABSTRACT Background People with osteoarthritis (OA) desire high quality care, support and information about OA. However, the quality of care for people with OA in general practice is not routinely collected. Quality Indicators (QI) can be used to benefit patients by measuring whether minimum standards of quality care (e.g. NICE quality standards) are being met from a patient perspective. A Research User Group (RUG) worked with researchers to co-produce a set of self-report, patient-generated QIs for OA. The QIs were intended for use in the MOSAICS study, which developed and evaluated a new model of supported self-management of OA to implement the NICE guidelines. We report on 1) the co-development of the OA QI (UK) questionnaire for primary care; and 2) the comparison of the content of the OA QI (UK) questionnaire with a parallel questionnaire developed in Norway for the Musculoskeletal Pain in Ullensaker (MUST) study. Methods Researchers were invited to OA RUG meetings. Firstly, RUG members were asked to consider factors important to patients consulting their general practitioner (GP) for OA and then each person rated their five most important. RUG members then discussed these in relation to a systematic review of OA QIs in order to form a list of OA QIs from a patient perspective. RUG members suggested wording and response options for a draft OA QI (UK) questionnaire to assess the QIs. Finally RUG members commented on draft and final versions of the questionnaire and how it compared with a translated Norwegian OA-QI questionnaire. Results RUG members (5 males, 5 females; aged 52-80 years) attended up to four meetings. RUG members ranked 20 factors considered most important to patients consulting their GP for joint pain. Following discussion, a list of eleven patient-reported QIs for OA consultations were formed. RUG members then suggested the wording and response options of 16 draft items - four QIs were split into two or more questionnaire items to avoid multiple dimensions of care quality within a single item. On comparison of this to the Norwegian OA-QI questionnaire, RUG members commented that both questionnaires contained seven similar QIs. The RUG members and researchers agreed to adopt the Norwegian OA-QI wording for four of these items. RUG members also recommended adopting an additional seven items from the Norwegian OA-QI with some minor word changes to improve their suitability for patients in the UK. One other item from the draft OA QI (UK) questionnaire was retained and eight items were excluded, resulting in a 15-item final version. Conclusions This study describes the development of patient-reported quality indicators for OA primary care derived by members of a RUG group, working in partnership with the research team throughout the study. The OA QI (UK) supports the NICE quality standards for OA and they have been successfully used to assess the quality of OA consultations in primary care in the MOSAICS study. The OA QI (UK) has the potential for routine use in primary care to assess the quality of OA care provided to patients. Ongoing research using both the UK and Norwegian OA-QI questionnaires is assessing the self-reported quality of OA care in different European populations.
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Affiliation(s)
- Steven Blackburn
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Adele Higginbottom
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Robert Taylor
- Lay Member of the Osteoarthritis Research User Group, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Jo Bird
- Lay Member of the Osteoarthritis Research User Group, Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | | | | | - John J. Edwards
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Kelvin P. Jordan
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Clare Jinks
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
| | - Krysia Dziedzic
- Arthritis Research UK Primary Care Centre, Research Institute for Primary Care & Health Sciences, Keele University, Keele, UK
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Jinks C, Carter P, Rhodes C, Taylor R, Beech R, Dziedzic K, Blackburn S, Hughes R, Ong BN. Patient and public involvement in primary care research - an example of ensuring its sustainability. Res Involv Engagem 2016; 2:1. [PMID: 29062502 PMCID: PMC5611572 DOI: 10.1186/s40900-016-0015-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 01/07/2016] [Indexed: 05/23/2023]
Abstract
BACKGROUND The international literature on patient and public involvement (PPI) in research covers a wide range of issues, including active lay involvement throughout the research cycle; roles that patients/public can play; assessing impact of PPI and recommendations for good PPI practice. One area of investigation that is less developed is the sustainability and impact of PPI beyond involvement in time-limited research projects. METHODS This paper focuses on the issues of sustainability, the importance of institutional leadership and the creation of a robust infrastructure in order to achieve long-term and wide-ranging PPI in research strategy and programmes. RESULTS We use the case of a Primary Care Research Centre to provide a historical account of the evolution of PPI in the Centre and identified a number of key conceptual issues regarding infrastructure, resource allocation, working methods, roles and relationships. CONCLUSIONS The paper concludes about the more general applicability of the Centre's model for the long-term sustainability of PPI in research.
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Affiliation(s)
- Clare Jinks
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, ST5 5BG England
| | - Pam Carter
- Department of Health Sciences, College of Medicine, Biological Sciences and Psychology, University of Leicester, 22-28 Princess Road West, Leicester, LE1 6TP England
| | - Carol Rhodes
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, ST5 5BG England
- Patient and Public Involvement Coordinator, Research User Group (RUG), Research Institute for Primary Care and Health Sciences, Keele University, Keele, ST5 5BG England
| | - Robert Taylor
- Lay Representative, Research User Group (RUG), Research Institute for Primary Care and Health Sciences, Keele University, Keele, ST5 5BG England
| | - Roger Beech
- Keele University School of Nursing and Midwifery Clinical Education Centre, University Hospitals of North Midlands NHS Trust, Royal Stoke University Hospital, Newcastle Road, Stoke-on-Trent, ST4 6QG England
| | - Krysia Dziedzic
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, ST5 5BG England
| | - Steven Blackburn
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, ST5 5BG England
| | - Rhian Hughes
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, ST5 5BG England
| | - Bie Nio Ong
- Research Institute for Primary Care and Health Sciences, Keele University, Keele, ST5 5BG England
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Sabnis D, Storer L, Simmonds L, Blackburn S, Kilday JP, Lowe J, Grundy G, Kerr I, Coyle B. OP20DRUGGABLE PROGNOSTIC MARKERS IN PAEDIATRIC EPENDYMOMA; IS BLBP THE SOLUTION? Neuro Oncol 2015. [DOI: 10.1093/neuonc/nov283.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Wheeler R, Blackburn S, Biggs H. When might an operative complication be regarded as acceptable? Part 2: Judicial factors that influence the finding of fault during surgical litigation. Ann R Coll Surg Engl 2015; 97:180-3. [PMID: 26263800 DOI: 10.1308/003588414x14055925060992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In cases where surgeons face litigation over operative misadventure, the result of a trial is uncertain. In order to identify factors in cases of surgical litigation that have influenced the final decision of the courts, we have previously reviewed reported cases where the outcome turned on actions taken by surgeons. We now turn our attention to judicial attitudes to evidence that play a role in the determination of the case.
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Affiliation(s)
- R Wheeler
- University Hospital Southampton NHS Foundation Trust , UK
| | | | - H Biggs
- University of Southampton , UK
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Taylor R, Blackburn S, Higginbottom A, Rhodes C, Dziedzic K. PARE0013 Demystifying Research Jargon: A Volunteer Led Glossary. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Blackburn S, Stevenson K, Somerville S, Duffy H, Hughes R, Dziedzic K. OP0142-PARE Improving the Routine Care of Patients with Back Pain: The Role of Public Involvement in Taking Successful Research into Clinical Practice. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Higginbottom A, Jinks C, Bird J, Rhodes C, Blackburn S, Dziedzic K. OP0014-PARE From Design to Implementation – Patient and Public Involvement in an Nihr Research Programme in Osteoarthritis in Primary Care. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.2944] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wei W, Chen C, Sullivan E, Blackburn S, Curtis J. OP0133 Differences in Physician-Reported and DAS28-Based Assessment of Disease Remission Among Patients with Rheumatoid Arthritis (RA) in Clinical Practices. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.4207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Wheeler R, Blackburn S, Biggs H. When might an operative complication be regarded as acceptable? Part 1: Surgical factors that influence courts when finding fault during litigation. Ann R Coll Surg Engl 2015; 97:98-101. [PMID: 25723684 PMCID: PMC4473417 DOI: 10.1308/003588414x14055925060956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In cases where surgeons face litigation over operative misadventure, the result of a trial is uncertain. In order to identify factors in cases of surgical litigation that have influenced the final decision of the courts, we have reviewed recent reported cases, noting both surgical and evidential influences on outcome. Taken together, these reveal that among other influential factors, the acceptability of more than one reasonable operative approach, the court's approach to inappropriate delegation and the uncertainties of expert evidence all play a role in the determination of the case.
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Affiliation(s)
- R Wheeler
- University Hospital Southampton NHS Foundation Trust, UK
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Jinks C, Carter P, Rhodes C, Beech R, Dziedzic K, Hughes R, Blackburn S, Ong BN. Sustaining patient and public involvement in research: A case study of a research centre. ACTA ACUST UNITED AC 2015; 7:146-154. [PMID: 26705412 PMCID: PMC4362802 DOI: 10.1179/1750168715y.0000000003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
The literature on patient and public involvement (PPI) in research covers a wide range of topics. However, one area of investigation that appears under developed is the sustainability and impact of PPI beyond involvement in time-limited research projects. This paper presents a case study of PPI development in one primary care research centre in England, and its approach to making this sustainable using documentary sources and material from a formal evaluation. We provide narrative accounts of the set-up, operation and main processes of PPI, and its perceived impact. PPI requires a long-term perspective with participation and trust growing over time, and both users and researchers learning what approaches work best. PPI is a complex interplay of clarity of purpose, defined roles and relationships, organised support (paid PPI staff) and a well-funded infrastructure. ‘Soft systems’ are equally important such as flexible and informal approaches to meetings, adapting timetables and environments to meet the needs of lay members and to create spaces for relationships to develop between researchers and lay members that are based on mutual trust and respect. This case study highlights that the right combination of ethos, flexible working practices, leadership, and secure funding goes a long way to embedding PPI beyond ad hoc involvement. This allows PPI in research to be integrated in the infrastructure and sustainable.
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Affiliation(s)
- Clare Jinks
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, UK
| | - Pam Carter
- Social Science Applied to Healthcare Improvement Research (SAPPHIRE) Group and East Midlands Research Design Service, Department of Health Sciences, University of Leicester, UK
| | - Carol Rhodes
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, UK
| | - Roger Beech
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, UK
| | - Krysia Dziedzic
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, UK
| | - Rhian Hughes
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, UK
| | - Steven Blackburn
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, UK
| | - Bie Nio Ong
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, UK
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Cheng X, Yuan C, Blackburn S, Withey P. The study of the influence of binder systems in an Y2O3–ZrO2 facecoat material on the investment casting slurries and shells properties. Ann Ital Chir 2014. [DOI: 10.1016/j.jeurceramsoc.2014.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Ward AB, Chen C, Norrving B, Gillard P, Walker MF, Blackburn S, Holloway L, Brainin M, Philp I. Evaluation of the Post Stroke Checklist: A Pilot Study in the United Kingdom and Singapore. Int J Stroke 2014; 9 Suppl A100:76-84. [DOI: 10.1111/ijs.12291] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 03/31/2014] [Indexed: 11/29/2022]
Abstract
Background There is currently no standardized process for long-term follow-up care. As a result, management of post-stroke care varies greatly, and the needs of stroke survivors are not fully addressed. The Post Stroke Checklist was developed by the Global Stroke Community Advisory Panel as a means of standardizing long-term stroke care. Since its development, the Post Stroke Checklist has gained international recognition from various stroke networks and is endorsed by the World Stroke Organization to support improved stroke survivor follow-up and care. Aims The aim of this study was to evaluate the feasibility and usefulness of the Post Stroke Checklist in clinical practice and assess its relevance to stroke survivors in pilot studies in the United Kingdom and Singapore. Methods The Post Stroke Checklist was administered to stroke survivors in the United Kingdom ( n = 42) and Singapore ( n = 100) by clinicians. To assess the feasibility of the Post Stroke Checklist in clinical practice, an independent researcher observed the assessment and made notes relating to the patient–clinician interaction and their interpretations of the Post Stroke Checklist items. Patient and clinician satisfaction with the Post Stroke Checklist was assessed by three questions, responded to on a 0–10 numerical rating scale. Clinicians also completed a Pragmatic Face and Content Validity test to evaluate their overall impressions of the Post Stroke Checklist. In the United Kingdom, a subset of patients ( n = 14) took part in a concept elicitation interview prior to being administered the Post Stroke Checklist, followed by a cognitive debriefing interview to assess relevance and comprehension of the Post Stroke Checklist. Results The Post Stroke Checklist identified frequently reported problems for stroke survivors including cognition (reported by 47·2% of patients), mood (43·7%), and life after stroke (38%). An average of 3·2 problems per patient was identified across both countries (range 0–10). An average of 5 and 2·6 problems per patient were identified in the United Kingdom and Singapore, respectively. The average time taken to administer the Post Stroke Checklist was 17 mins (standard deviation 7·5) in Singapore and 13 mins (standard deviation 7·6) in the United Kingdom. Satisfaction ratings were high for patients (8·6/10) and clinicians (7·7/10), and clinician feedback via the Pragmatic Face and Content Validity test indicated that the Post Stroke Checklist is ‘useful’, ‘informative’, and ‘exhaustive’. All concepts measured by the Post Stroke Checklist were spontaneously discussed by patients during the concept elicitation interviews, suggesting that the Post Stroke Checklist is relevant to stroke survivors. Cognitive debriefing data indicated that the items were generally well understood and relevant to stroke. Minor revisions were made to the Post Stroke Checklist based on patient feedback. Conclusions The findings suggest that the Post Stroke Checklist is a feasible and useful measure for identifying long term stroke care needs in a clinical practice setting. Pilot testing indicated that the Post Stroke Checklist is able to identify a wide range of unmet needs, and patient and clinician feedback indicated a high level of satisfaction with the Post Stroke Checklist assessment. The items were generally well understood and considered relevant to stroke survivors, indicating the Post Stroke Checklist is a feasible, useful, and relevant measure of poststroke care.
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Affiliation(s)
- Anthony B. Ward
- Rehabilitation Medicine Department, University Hospital of North Staffordshire, Stoke on Trent, UK
| | - Christopher Chen
- Department of Pharmacology, National University of Singapore, Singapore
| | - Bo Norrving
- Department of Clinical Sciences, Section of Neurology, Lund University, Lund, Sweden
| | - Patrick Gillard
- Global Health Outcomes Strategy and Research, Allergan Inc, Irvine, CA, USA
| | - Marion F. Walker
- Division of Rehabilitation and Ageing, University of Nottingham, Nottingham, UK
| | - Steven Blackburn
- Endpoint Development and Outcomes Assessment, Adelphi Values Ltd, Macclesfield, UK
| | - Laura Holloway
- Endpoint Development and Outcomes Assessment, Adelphi Values Ltd, Macclesfield, UK
| | - Michael Brainin
- Department of Clinical Neurosciences and Preventive Medicine, Danube University Krems, Krems, Austria
| | - Ian Philp
- Health Sciences Department, University of Warwick, Warwick, UK
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Ashton JJ, Blackburn S, Burge D, Beattie RM. An unlikely cause of severe malnutrition in a 3-year-old girl with previous gastroschisis. BMJ Case Rep 2014; 2014:bcr-2014-204530. [PMID: 25183805 DOI: 10.1136/bcr-2014-204530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 3-year-old girl with previous gastroschisis associated with jejunal and colonic atresia presented with severe oedema, abdominal pain and diarrhoea. Clinically she was malnourished. Serum albumin and concentrations of micronutrients were low. A barium meal examination showed jejunal dilation. A stricture was suspected and the patient was taken to theatre where an 8 cm length of bowel was resected including a jejunal stricture at the point of previous atresia repair. Inside the proximal dilated jejunum was a large trichobezoar (hairball), thought to be acting as a ball valve inside the bowel. This girl made a rapid recovery after surgery. Her nutritional state improved, symptoms resolved and serum biochemistry normalised. She remains well at follow-up with normal blood results, normal albumin and no diarrhoea.
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Affiliation(s)
- J J Ashton
- Department of Paediatric Gastroenterology, University Hospital Southampton, Southampton, UK
| | - S Blackburn
- Department of Paediatric Surgery, University Hospital Southampton, Southampton, UK
| | - D Burge
- Department of Paediatric Surgery, University Hospital Southampton, Southampton, UK
| | - R M Beattie
- Department of Paediatric Gastroenterology, University Hospital Southampton, Southampton, UK
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Hoffman LM, Donson AM, Nakachi I, Griesinger AM, Birks DK, Amani V, Hemenway MS, Liu AK, Wang M, Hankinson TC, Handler MH, Foreman NK, Zakrzewska M, Zakrzewski K, Fendler W, Stefanczyk L, Liberski PP, Massimino M, Gandola L, Ferroli P, Valentini L, Biassoni V, Garre ML, Sardi I, Genitori L, Giussani C, Massimi L, Bertin D, Mussano A, Viscardi E, Modena P, Mastronuzzi A, Barra S, Scarzello G, Cinalli G, Peretta P, Giangaspero F, Massimino M, Boschetti L, Biassoni V, Garre ML, Schiavello E, Sardi I, Genitori L, Bertin D, Modena P, Calareso G, Barra S, Scarzello G, Cinalli G, Peretta P, Mastronuzzi A, Giussani C, Giangaspero F, Antonelli M, Pecori E, Gandola L, Massimino M, Biassoni V, Di Meco F, Garre ML, Schiavello E, Sardi I, Genitori L, Bertin D, Viscardi E, Modena P, Barra S, Scarzello G, Cinalli G, Peretta P, Migliorati R, Taborelli A, Giangaspero F, Antonelli M, Pecori E, Gandola L, Witt H, Sill M, Wani K, Mack SC, Capper D, Pajtler K, Lambert S, Tzaridis T, Milde T, Northcott PA, Kulozik AE, Witt O, Collins VP, Ellison DW, Taylor MD, Kool M, Jones DTW, Korshunov A, Ken A, Pfister SM, Makino K, Nakamura H, Kuroda JI, Kuratsu JI, Toledano H, Margolin Y, Ohali A, Michowiz S, Witt H, Johann P, Tzaridis T, Tabori U, Walker E, Hawkins C, Taylor M, Yaniv I, Avigad S, Hoffman L, Plimpton SR, Foreman NK, Stence NV, Hankinson TC, Handler MH, Hemenway MS, Vibhakar R, Liu AK, Lourdusamy A, Rahman R, Ward J, Rogers H, Grundy R, Punchihewa C, Lee R, Lin T, Orisme W, Dalton J, Aronica E, Smith A, Gajjar A, Onar A, Pounds S, Tatevossian R, Merchant T, Ellison D, Parker M, Mohankumar K, Punchihewa C, Weinlich R, Dalton J, Tatevossian R, Phoenix T, Thiruvenkatam R, White E, Gupta K, Gajjar A, Merchant T, Boop F, Smith A, Ding L, Mardis E, Wilson R, Downing J, Ellison D, Gilbertson R, Ward J, Lourdusamy A, Speed D, Gould T, Grundy R, Rahman R, Mack SC, Witt H, Pfister SM, Korshunov A, Taylor MD, Consortium TIE, Hoffman LM, Griesinger A, Donson A, Birks D, Amani V, Foreman NK, Ohe N, Yano H, Nakayama N, Iwama T, Wright K, Hassall T, Bowers DC, Crawford J, Bendel A, Fisher PG, Merchant T, Ellison D, Klimo P, Boop F, Armstrong G, Qaddoumi I, Robinson G, Wetmore C, Broniscer A, Gajjar A, Rogers H, Chapman R, Mayne C, Duane H, Kilday JP, Coyle B, Grundy R, Graul-Conroy A, Hartsell W, Bragg T, Goldman S, Rebsamen S, Puccetti D, Salamat S, Patel NJ, Gomi A, Oguma H, Hayase T, Kawahara Y, Yagi M, Morimoto A, Wilbur C, Dunham C, Hawkins C, Tabori U, Mabbott D, Carret AS, Lafay-Cousin L, McNeely PD, Eisenstat D, Wilson B, Johnston D, Hukin J, Mynarek M, Kortmann RD, Kaatsch P, Pietsch T, Timmermann B, Fleischhack G, Benesch M, Friedrich C, von Bueren AO, Gerber NU, Muller K, Tippelt S, Warmuth-Metz M, Rutkowski S, von Hoff K, Murugesan MK, White E, Poppleton H, Thiruvenkatam R, Gupta K, Currle S, Kranenburg T, Eden C, Wright K, Ellison D, Gilbertson R, Boulos N, Dapper J, Patel Y, Wright K, Mohankumar K, Freeman B, Gajjar A, Shelat A, Stewart C, Guy R, Gilbertson R, Adamski J, Taylor M, Tabori U, Huang A, Bartels U, Ramaswamy V, Krishnatry R, Laperriere N, Hawkins C, Bouffet E, Araki A, Chocholous M, Gojo J, Dorfer C, Czech T, Dieckmann K, Slavc I, Haberler C, Pietsch T, Mynarek M, Doerner E, Muehlen AZ, Warmuth-Metz M, Kortmann R, von Buehren A, Friedrich C, von Hoff K, Rutkowski S, von Hoff K, Kortmann RD, Gerber NU, Mynarek M, Muller K, Friedrich C, von Bueren AO, Benesch M, Warmuth-Metz M, Ottensmeier H, Resch A, Kwiecien R, Faldum A, Kuehl J, Pietsch T, Rutkowski S, Sabnis D, Storer L, Simmonds L, Blackburn S, Lowe J, Grundy R, Kerr I, Coyle B, Pietsch T, Wohlers I, Goschzik T, Dreschmann V, Denkhaus D, Doerner E, Rahmann S, Klein-Hitpass L, Iglesias MJL, Riet FG, Dhermain FD, Canale S, Dufour C, Rose CS, Puget S, Grill J, Bolle S, Parkes J, Davidson A, Figaji A, Pillay K, Kilborn T, Padayachy L, Hendricks M, Van Eyssen A, Piccinin E, Lorenzetto E, Brenca M, Massimino M, Modena P, Taylor M, Ramaswamy V, Bouffet E, Aldape K, Cho YJ, Weiss W, Phillips J, Jabado N, Mora J, Fan X, Jung S, Lee JY, Zitterbart K, French P, Kros JM, Hauser P, Faria C, Korshunov A, Pfister S, Mack SC. EPENDYMOMA. Neuro Oncol 2014; 16:i17-i25. [PMCID: PMC4046284 DOI: 10.1093/neuonc/nou068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2023] Open
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Abstract
This article explores the possibility that the surgeon's control over his or her environment is not complete and that, in certain circumstances, the final swab count can be distinguished from the 'normal course of events'. We readily accept that most swabs and instruments are left inside patients simply as a result of substandard care but we cannot accept that this is invariably the case, and lessons from the common law are cited to illustrate the reasons why. We hope to persuade defendant lawyers that it might be worthwhile to tease out from surgeons under scrutiny how these factors may have influenced their practice on the day that a swab was retained.
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Affiliation(s)
- R Wheeler
- University Hospital Southampton NHS Foundation Trust, UK.
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Humphrey L, Kulich K, Deschaseaux C, Blackburn S, Maguire L, Strömberg A. The Caregiver Burden Questionnaire for Heart Failure (CBQ-HF): face and content validity. Health Qual Life Outcomes 2013; 11:84. [PMID: 23706131 PMCID: PMC3673843 DOI: 10.1186/1477-7525-11-84] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Accepted: 05/03/2013] [Indexed: 11/10/2022] Open
Abstract
Background A new caregiver burden questionnaire for heart failure (CBQ-HF v1.0) was developed based on previously conducted qualitative interviews with HF caregivers and with input from HF clinical experts. Version 1.0 of the CBQ-HF included 41 items measuring the burden associated with caregiving in the following domains: physical, emotional/psychological, social, and impact on caregiver’s life. Following initial development, the next stage was to evaluate caregivers’ understanding of the questionnaire items and their conceptual relevance. Methods To evaluate the face and content validity of the new questionnaire, cognitive interviews were conducted with caregivers of heart failure patients. The cognitive interviews included a “think aloud” exercise as the patient completed the CBQ-HF, followed by more specific probing questions to better understand caregivers’ understanding, interpretation and the relevance of the instructions, items, response scales and recall period. Results Eighteen caregivers of heart failure patients were recruited. The mean age of the caregivers was 50 years (SD = 10.2). Eighty-three percent of caregivers were female and most commonly the patient was either a spouse (44%) or a parent (28%). Among the patients 55% were NYHA Class 2 and 45% were NYHA Class 3 or 4. The caregiver cognitive interviews demonstrated that the CBQ-HF was well understood, relevant and consistently interpreted. From the initial 41 item questionnaire, fifteen items were deleted due to conceptual overlap and/or item redundancy. The final 26-item CBQ-HF (v3.0) uses a 5-point Likert severity scale, assessing 4 domains of physical, emotional/psychological, social and lifestyle burdens using a 4-week recall period. Conclusions The CBQ-HF (v3.0) is a comprehensive and relevant measure of subjective caregiver burden with strong content validity. This study has established that the CBQ-HF (v3.0) has strong face and content validity and should be valuable as an outcomes measure to help understand and monitor the relationship between patient heart failure severity and caregiver burden. A Translatability AssessmentSM of the measure has since been performed confirming the cultural appropriateness of the measure and psychometric validation is planned for the future to further explore the reliability, and validity of the new questionnaire in a larger caregiver sample.
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Metz W, Abbruzzese B, Blackburn S, Potter B, Shuping J, Cope F, King D, Christman L. PD-0288 CORRELATION OF LYMPHOSCINTIGRAPHY W/ILM IN PIII STUDIES W/TC99M-TILMANOCEPT IN BREAST CANCER & MELANOMA. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70627-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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