scholarly journals Using the West Midlands CONCERT to characterise regional incidence of acute-onset post cataract surgery endophthalmitis

Eye ◽  
2020 ◽  
Author(s):  
George Moussa ◽  
◽  
Hetvi Bhatt ◽  
Ian Reekie ◽  
Gibran Butt ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Positive Culture ◽  
Clinical Effectiveness ◽  
Acute Onset ◽  
The West ◽  
Research And Innovation ◽  
West Midlands ◽  
Collaborative Working ◽  
Improving Patient Care

Abstract Background Whilst research and innovation is embedded within the UK’s National Health Service (NHS) constitution, Doctors-in-training have little opportunity to contribute to designing, leading and recruiting into clinical trials or cohort studies. We formed the West MidlandsCollaborativeOphthalmologyNetwork forClinicalEffectiveness &Research byTrainees (The West Midlands CONCERT) and undertook a characterisation of post cataract surgery endophthalmitis as a proof-of-concept study to test the feasibility of the CONCERT model. Methods Doctors-in-training formed a collaborative working group to test the concept of delivering a pan-regional clinical effectiveness study across multiple hospital sites by performing retrospective analyses of post cataract endophthalmitis over a 6-year period. Results Overall, 157,653 cataract surgeries were performed by participating centres accredited to deliver the Royal College of Ophthalmologists training curriculum. Thirty-eight cases of post cataract endophthalmitis were identified, giving an incidence of 2.41 per 10,000 cases (0.0241%). A further 15 endophthalmitis cases presented who had surgery in non-training centres, giving a total of 53 cases. The most common organisms were S. epidermidis (14 (51.9%)) and P. aeruginosa (5 (18.5%)). Anterior-chamber and vitreous sampling yielded positive culture in 33.3% (6/18) and 50.9% (27/53), respectively. At 6 months follow-up, 19 (51.4%) patients achieved visual acuities of ≤0.5 LogMAR. Repeat intravitreal injections (11 (20.8%)) and vitrectomy (n = 22 (41.5%)) were not associated with better outcomes. Conclusions Using post cataract endophthalmitis as a pilot cohort, this study highlights the feasibility of using the CONCERT model for studies across multiple sites. A UK-CONCERT could provide a powerful infrastructure enabling characterisation of patient cohorts and a platform for high-quality interventional studies, improving patient care.

scholarly journals Correction: Using the West Midlands CONCERT to characterise regional incidence of acute-onset post cataract surgery endophthalmitis

Eye ◽  
2020 ◽  
Author(s):  
George Moussa ◽  
◽  
Hetvi Bhatt ◽  
Ian Reekie ◽  
Gibran Butt ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Acute Onset ◽  
The West ◽  
West Midlands

An audit on the management of pelvic inflammatory disease in the West Midlands, UK

2007 ◽  
Vol 18 (10) ◽  
pp. 717-719 ◽  
Author(s):  
M Walzman ◽  
A Tariq ◽  
S Bhaduri ◽  
J D C Ross
Keyword(s):  
Data Collection ◽  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
National Standards ◽  
National Standard ◽  
Standards Of Care ◽  
National Guidelines ◽  
The West ◽  
West Midlands

The potential complications of pelvic inflammatory disease (PID) make optimizing its management a high priority. A clinical audit of PID against current national management guidelines was conducted in 14 departments of genitourinary medicine in the West Midlands for women presenting with PID between January and December 2005. There were a total of 810 diagnoses of PID made from a total of 49,390 female attendees for that year, giving an incidence of 164 cases per 10,000 attendees. Of these 810 cases, data collection and analysis for this audit were performed on 139. An ofloxacin 400 mg twice daily (b.i.d.) based regimen was prescribed in 91 (65%, 95% confidence interval [CI] 57–73%) cases. Doxycycline 100 mg b. i. d. for 14 days plus metronidazole 400 mg b. i. d. for 5–14 days was prescribed in 44 (32%, 95% CI 25–40%) cases, but a third-generation cephalosporin was only given with this regimen in three cases. Partner notification was performed in 101 (73%, 95% CI 65–79%) cases. A total of 130 male contacts were recorded on the data collection forms, and of these 58 (45%) were traced and 51 (39%), treated. A follow-up appointment was given to 133 (96%, 95% CI 91–98%) women, although in most cases this was for seven days or more, and 104 (78%, 95% CI 67–81%) women attended for follow-up. Adherence to the national guidelines in this cohort of patients did not reach the national standard for choice of treatment regimen nor did it attain the target for proportion of male partners traced. Barriers preventing adherence to the national guidelines need to be explored and appropriate assistance given to physicians to help meet national standards of care.

RCS surgical clinical trial centres; and have you used your vote for Council?

2013 ◽  
Vol 95 (4) ◽  
pp. 123-123
Keyword(s):  
Clinical Trial ◽  
Patient Care ◽  
Surgical Techniques ◽  
The West ◽  
Regional Variations ◽  
West Midlands ◽  
Improving Patient Care

The College has recently launched a nationwide network of surgical clinical trial centres. These will enable surgeons to assess new surgical techniques and increase their understanding of a range of conditions, thus improving patient care. Successful trials work in the West Midlands, led by Professor Dion Morton, is now to be replicated nationwide. This will enable new surgical innovations to be introduced quickly, while simultaneously reducing regional variations and driving up standards.

scholarly journals Ante-natal screening and post-natal follow-up of hepatitis B in the West Midlands of England

QJM ◽  
2008 ◽  
Vol 101 (4) ◽  
pp. 307-312 ◽  
Author(s):  
S. Bhattacharya ◽  
K. O'Donnell ◽  
T. Dudley ◽  
A. Kennefick ◽  
H. Osman ◽  
...  
Keyword(s):  
Hepatitis B ◽  
The West ◽  
West Midlands

Partnerships from the seeds of collaboration

2016 ◽  
Vol 30 (6) ◽  
pp. 4-6
Keyword(s):  
Leadership Education ◽  
The West ◽  
Content Type ◽  
The People ◽  
Health And Social Care ◽  
West Midlands ◽  
Collaborative Working ◽  
Pertinent Information ◽  
The Uk ◽  
Practical Implications

Purpose This paper aims to review the latest management developments across the globe and pinpoint practical implications from cutting-edge research and case studies. Design/methodology/approach This briefing is prepared by an independent writer who adds their own impartial comments and places the articles in context. Findings In 2007, Birmingham City University (UK) and the West Midlands National Health Service (NHS) Strategic Health Authority developed and implemented the leadership, education and partnership project. The project aimed to develop genuine partnership and collaborative working among health and social care education providers from a range of higher education and NHS organizations in the West Midlands region of the UK. Neither the partnership label nor the most robust of partnership contracts will make a partnership succeed. That is something only the people within the partnership can do. This project demonstrated that partners who are already collaborating, or are predisposed to do so, are more likely to build and sustain a partnership that really delivers. Practical implications The paper provides strategic insights and practical thinking that have influenced some of the world’s leading organizations. Originality/value The briefing saves busy executives and researchers hours of reading time by selecting only the very best, most pertinent information and presenting it in a condensed and easy-to-digest format.

scholarly journals The West Midlands ActiVe lifestyle and healthy Eating in School children (WAVES) study: a cluster randomised controlled trial testing the clinical effectiveness and cost-effectiveness of a multifaceted obesity prevention intervention programme targeted at children aged 6–7 years

2018 ◽  
Vol 22 (8) ◽  
pp. 1-608 ◽  
Author(s):  
Peymane Adab ◽  
Timothy Barrett ◽  
Raj Bhopal ◽  
Janet E Cade ◽  
Alastair Canaway ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Healthy Eating ◽  
School Children ◽  
Controlled Trial ◽  
Clinical Effectiveness ◽  
Cluster Randomised Controlled Trial ◽  
Post Intervention ◽  
School Based ◽  
West Midlands

BackgroundSystematic reviews suggest that school-based interventions can be effective in preventing childhood obesity, but better-designed trials are needed that consider costs, process, equity, potential harms and longer-term outcomes.ObjectiveTo assess the clinical effectiveness and cost-effectiveness of the WAVES (West Midlands ActiVe lifestyle and healthy Eating in School children) study intervention, compared with usual practice, in preventing obesity among primary school children.DesignA cluster randomised controlled trial, split across two groups, which were randomised using a blocked balancing algorithm. Schools/participants could not be blinded to trial arm. Measurement staff were blind to allocation arm as far as possible.SettingPrimary schools, West Midlands, UK.ParticipantsSchools within a 35-mile radius of the study centre and all year 1 pupils (aged 5–6 years) were eligible. Schools with a higher proportion of pupils from minority ethnic populations were oversampled to enable subgroup analyses.InterventionsThe 12-month intervention encouraged healthy eating/physical activity (PA) by (1) helping teachers to provide 30 minutes of additional daily PA, (2) promoting ‘Villa Vitality’ (interactive healthy lifestyles learning, in an inspirational setting), (3) running school-based healthy cooking skills/education workshops for parents and children and (4) highlighting information to families with regard to local PA opportunities.Main outcome measuresThe primary outcomes were the difference in body mass index z-scores (BMI-zs) between arms (adjusted for baseline body mass index) at 3 and 18 months post intervention (clinical outcome), and cost per quality-adjusted life-year (QALY) (cost-effectiveness outcome). The secondary outcomes were further anthropometric, dietary, PA and psychological measurements, and the difference in BMI-z between arms at 27 months post intervention in a subset of schools.ResultsTwo groups of schools were randomised: 27 in 2011 (n = 650 pupils) [group 1 (G1)] and another 27 in 2012 (n = 817 pupils) [group 2 (G2)]. Primary outcome data were available at first follow-up (n = 1249 pupils) and second follow-up (n = 1145 pupils) from 53 schools. The mean difference (MD) in BMI-z between the control and intervention arms was –0.075 [95% confidence interval (CI) –0.183 to 0.033] and –0.027 (95% CI –0.137 to 0.083) at 3 and 18 months post intervention, respectively. The main analyses showed no evidence of between-arm differences for any secondary outcomes. Third follow-up included data on 467 pupils from 27 G1 schools, and showed a statistically significant difference in BMI-z (MD –0.20, 95% CI –0.40 to –0.01). The mean cost of the intervention was £266.35 per consented child (£155.53 per child receiving the intervention). The incremental cost-effectiveness ratio associated with the base case was £46,083 per QALY (best case £26,804 per QALY), suggesting that the intervention was not cost-effective.LimitationsThe presence of baseline primary outcome imbalance between the arms, and interschool variation in fidelity of intervention delivery.ConclusionsThe primary analyses show no evidence of clinical effectiveness or cost-effectiveness of the WAVES study intervention. A post hoc analysis, driven by findings at third follow-up, suggests a possible intervention effect, which could have been attenuated by baseline imbalances. There was no evidence of an intervention effect on measures of diet or PA and no evidence of harm.Future workA realist evidence synthesis could provide insights into contextual factors and strategies for future interventions. School-based interventions need to be integrated within a wider societal framework and supported by upstream interventions.Trial registrationCurrent Controlled Trials ISRCTN97000586.FundingThis project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full inHealth Technology Assessment; Vol. 22, No. 8. See the NIHR Journals Library website for further project information.

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