scholarly journals Features of successful bids for funding of applied health research: a cohort study

2014 ◽  
Vol 12 (1) ◽  
Author(s):  
Sheila Turner ◽  
Peter Davidson ◽  
Louise Stanton ◽  
Victoria Cawdeary
Keyword(s):  
Cohort Study ◽  
Health Research ◽  
Applied Health Research

scholarly journals Early diagnosis of mortality using admission CT perfusion in severe traumatic brain injury patients (ACT-TBI): protocol for a prospective cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e047305
Author(s):  
Susan Alcock ◽  
Divjeet Batoo ◽  
Sudharsana Rao Ande ◽  
Rob Grierson ◽  
Marco Essig ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Cohort Study ◽  
Brain Injury ◽  
Early Diagnosis ◽  
Hospital Mortality ◽  
Brain Death ◽  
Severe Traumatic Brain Injury ◽  
Health Research ◽  
Ct Perfusion ◽  
Severe Tbi

IntroductionSevere traumatic brain injury (TBI) is a catastrophic neurological condition with significant economic burden. Early in-hospital mortality (<48 hours) with severe TBI is estimated at 50%. Several clinical examinations exist to determine brain death; however, most are difficult to elicit in the acute setting in patients with severe TBI. Having a definitive assessment tool would help predict early in-hospital mortality in this population. CT perfusion (CTP) has shown promise diagnosing early in-hospital mortality in patients with severe TBI and other populations. The purpose of this study is to validate admission CTP features of brain death relative to the clinical examination outcome for characterizing early in-hospital mortality in patients with severe TBI.Methods and analysisThe Early Diagnosis of Mortality using Admission CT Perfusion in Severe Traumatic Brain Injury Patients study, is a prospective cohort study in patients with severe TBI funded by a grant from the Canadian Institute of Health Research. Adults aged 18 or older, with evidence of a severe TBI (Glasgow Coma Scale score ≤8 before initial resuscitation) and, on mechanical ventilation at the time of imaging are eligible. Patients will undergo CTP at the time of first imaging on their hospital admission. Admission CTP compares with the reference standard of an accepted bedside clinical assessment for brainstem function. Deferred consent will be used. The primary outcome is a binary outcome of mortality (dead) or survival (not dead) in the first 48 hours of admission. The planned sample size for achieving a sensitivity of 75% and a specificity of 95% with a CI of ±5% is 200 patients.Ethics and disseminationThis study has been approved by the University of Manitoba Health Research Ethics Board. The findings from our study will be disseminated through peer-reviewed journals and presentations at local rounds, national and international conferences. The public will be informed through forums at the end of the study.Trial registration numberNCT04318665

scholarly journals From fringe to centre-stage: experiences of mainstreaming health equity in a health research collaboration

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Ana Porroche-Escudero ◽  
Jennie Popay ◽  
Fiona Ward ◽  
Saiqa Ahmed ◽  
Dorkas Akeju ◽  
...  
Keyword(s):  
Health Equity ◽  
Health Inequalities ◽  
National Health ◽  
Health Research ◽  
Research Collaboration ◽  
Determinants Of Health ◽  
Gender Mainstreaming ◽  
Health Improvement ◽  
Structural Determinants ◽  
Applied Health Research

Abstract Background Action to address the structural determinants of health inequalities is prioritized in high-level initiatives such as the United Nations Sustainable Development Goals and many national health strategies. Yet, the focus of much local policy and practice is on behaviour change. Research shows that whilst lifestyle approaches can improve population health, at best they fail to reduce health inequalities because they fail to address upstream structural determinants of behaviour and health outcomes. In health research, most efforts have been directed at three streams of work: understanding causal pathways; evaluating the equity impact of national policy; and developing and evaluating lifestyle/behavioural approaches to health improvement. As a result, there is a dearth of research on effective interventions to reduce health inequalities that can be developed and implemented at a local level. Objective To describe an initiative that aimed to mainstream a focus on health equity in a large-scale research collaboration in the United Kingdom and to assess the impact on organizational culture, research processes and individual research practice. Methods The study used multiple qualitative methods including semi-structured interviews, focus groups and workshops (n = 131 respondents including Public Advisers, university, National Health Service (NHS), and local and document review. Results utilizing Extended Normalization Process Theory (ENPT) and gender mainstreaming theory, the evaluation illuminated (i) the processes developed by Collaboration for Leadership in Applied Health Research and Care North West Coast to integrate ways of thinking and acting to tackle the upstream social determinants of health inequities (i.e. to mainstream a health equity focus) and (ii) the factors that promoted or frustrated these efforts. Conclusions Findings highlight the role of contextual factors and processes aimed at developing and implementing a robust strategy for mainstreaming health equity as building blocks for transformative change in applied health research.

Interpretative Phenomenological Analysis in Applied Health Research

2014 ◽  
Author(s):  
Rachel Shaw ◽  
Amy Burton ◽  
Christian Borg Xuereb ◽  
Jonathan Gibson ◽  
Deirdre Lane
Keyword(s):  
Health Research ◽  
Interpretative Phenomenological Analysis ◽  
Phenomenological Analysis ◽  
Applied Health Research

scholarly journals Prognostic factors for outcomes of idiopathic sudden sensorineural hearing loss: protocol for the SeaSHeL national prospective cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e038552
Author(s):  
Rishi Mandavia ◽  
Gerjon Hannink ◽  
Muhammad Nayeem Ahmed ◽  
Yaami Premakumar ◽  
Timothy Shun Man Chu ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cohort Study ◽  
Sensorineural Hearing Loss ◽  
Prospective Cohort Study ◽  
Health Research ◽  
Prospective Cohort ◽  
Prognostic Model ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Adult Patients

IntroductionThe mainstay of treatment for idiopathic sudden sensorineural hearing loss (SSNHL) includes oral steroids, intratympanic steroid injections or a combination of both. The National Institute for Health and Care Excellence, in their recent hearing loss guidelines, highlighted the paucity of evidence assessing the comparative effectiveness of these treatments; and the National Institute for Health Research (NIHR) Health Technology Assessment Programme has since released a commissioned call for a trial to identify the most effective route of administration of steroids as a first-line treatment for idiopathic SSNHL. For such trials to be run effectively, reliable information is needed on patients with SSNHL: where they present, numbers, demographics, treatment pathways, as well as outcomes. This study will collect these data in a nationwide cohort study of patients presenting with SSNHL across 97 National Health Service (NHS) trusts. The study will be delivered through ear, nose and throat (ENT) trainee networks, the NIHR Clinical Research Network (CRN) Audiology Champions and the NIHR CRN. Importantly, this study will also provide a dataset to develop a prognostic model to predict recovery for patients with idiopathic SSNHL. The study objectives are to: (1) map the patient pathway and identify the characteristics of adult patients presenting to NHS ENT and hearing services with SSNHL, (2) develop a prognostic model to predict recovery for patients with idiopathic SSNHL and (3) establish the impact of idiopathic SSNHL on patients’ quality of life (QoL).Methods and analysisStudy design: national multicentre prospective cohort study across 97 NHS trusts.Inclusion criteria: adult patients presenting to NHS ENT and hearing services with SSNHL.Outcomes: change in auditory function; change in QoL score.Analysis: multivariable prognostic model, using prespecified candidate predictors. Mean change in QoL scores will be calculated from initial presentation to follow-up.Ethics and disseminationHealth Research Authority and NHS Research Ethics Committee approved the study. Publication will be on behalf of study sites and collaborators.Trial registration numberClinicalTrials.gov Registry (NCT04108598).

scholarly journals The Health Inequalities Assessment Toolkit: supporting integration of equity into applied health research

2020 ◽  
Author(s):  
Ana Porroche-Escudero ◽  
Jennie Popay
Keyword(s):  
Health Inequalities ◽  
Health Research ◽  
Public Involvement ◽  
Routine Data ◽  
Positive Contribution ◽  
Political Commitment ◽  
Structured Interviews ◽  
North West ◽  
The North ◽  
Applied Health Research

Abstract Background Despite insistent calls for more and better evidence to inform action to reduce health inequities, applied health research sensitive to these inequalities is rare. Recognising this problem, the Collaboration for Leadership in Applied Research and Care in the North West Coast (England) developed the Health Inequalities Assessment Toolkit (HIAT) to support those involved in health research to integrate equity into their work. Objective This paper reports on an evaluation of the extent to which HIAT enhances the equity focus of the work of users. Methods The evaluation used semi-structured interviews, focus groups and workshops (n = 131 respondents including Public Advisers, university, NHS and local government partners). Routine data included HIAT feedback forms. Findings HIAT can help to strengthen the equity focus of applied health research by: increasing understanding of how socioeconomic inequities impact on health; building capacity for integrating equity into all aspects of research, implementation and capacity building; stimulating thinking on action to address local structural drivers of health inequalities; and increasing understanding of the positive contribution public involvement can make to research. Conclusion If we are to advance health equity goals delivering research and training needs to be combined with political commitment to create more equal societies.

scholarly journals Working together to co-produce better health: The experience of the Collaboration for Leadership in Applied Health Research and Care for Northwest London

2020 ◽  
Vol 26 (1) ◽  
pp. 28-36
Author(s):  
Cicely A Marston ◽  
Rachel Matthews ◽  
Alicia Renedo ◽  
Julie E Reed
Keyword(s):  
Health Care ◽  
Social Science ◽  
Health Research ◽  
Research Collaboration ◽  
Social Science Research ◽  
Science Research ◽  
Good Evidence ◽  
Care Practice ◽  
New Ways Of Working ◽  
Applied Health Research

Objectives To improve the provision of health care, academics can be asked to collaborate with clinicians, and clinicians with patients. Generating good evidence on health care practice depends on these collaborations working well. Yet such relationships are not the norm. We examine how social science research and health care improvement practice were linked through a programme designed to broker collaborations between clinicians, academics, and patients to improve health care – the UK National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care for Northwest London. We discuss the successes and challenges of the collaboration and make suggestions on how to develop synergistic relationships that facilitate co-production of social science knowledge and its translation into practice. Methods A qualitative approach was used, including ethnographic elements and critical, reflexive dialogue between members of the two collaborating teams. Results Key challenges and remedies were connected with the risks associated with new ways of working. These risks included differing ideas between collaborators about the purpose, value, and expectations of research, and institutional opposition. Dialogue between collaborators did not mean absence of tensions or clashes. Risk-taking was unpopular – institutions, funders, and partners did not always support it, despite simultaneously demanding ‘innovation’ in producing research that influenced practice. Conclusions Our path was made smoother because we had funding to support the creation of a ‘potential space’ to experiment with different ways of working. Other factors that can enhance collaboration include a shared commitment to dialogical practice, a recognition of the legitimacy of different partners’ knowledge, a long timeframe to identify and resolve problems, the maintenance of an enabling environment for collaboration, a willingness to work iteratively and reflexively, and a shared end goal.

scholarly journals Use of directed acyclic graphs (DAGs) to identify confounders in applied health research: review and recommendations

2020 ◽  
Author(s):  
Peter W G Tennant ◽  
Eleanor J Murray ◽  
Kellyn F Arnold ◽  
Laurie Berrie ◽  
Matthew P Fox ◽  
...  
Keyword(s):  
Health Research ◽  
Web Of Science ◽  
Directed Acyclic Graphs ◽  
Causal Effects ◽  
Research Review ◽  
Future Research ◽  
Substantial Variation ◽  
Acyclic Graphs ◽  
Confounding Variables ◽  
Applied Health Research

Abstract Background Directed acyclic graphs (DAGs) are an increasingly popular approach for identifying confounding variables that require conditioning when estimating causal effects. This review examined the use of DAGs in applied health research to inform recommendations for improving their transparency and utility in future research. Methods Original health research articles published during 1999–2017 mentioning ‘directed acyclic graphs’ (or similar) or citing DAGitty were identified from Scopus, Web of Science, Medline and Embase. Data were extracted on the reporting of: estimands, DAGs and adjustment sets, alongside the characteristics of each article’s largest DAG. Results A total of 234 articles were identified that reported using DAGs. A fifth (n = 48, 21%) reported their target estimand(s) and half (n = 115, 48%) reported the adjustment set(s) implied by their DAG(s). Two-thirds of the articles (n = 144, 62%) made at least one DAG available. DAGs varied in size but averaged 12 nodes [interquartile range (IQR): 9–16, range: 3–28] and 29 arcs (IQR: 19–42, range: 3–99). The median saturation (i.e. percentage of total possible arcs) was 46% (IQR: 31–67, range: 12–100). 37% (n = 53) of the DAGs included unobserved variables, 17% (n = 25) included ‘super-nodes’ (i.e. nodes containing more than one variable) and 34% (n = 49) were visually arranged so that the constituent arcs flowed in the same direction (e.g. top-to-bottom). Conclusion There is substantial variation in the use and reporting of DAGs in applied health research. Although this partly reflects their flexibility, it also highlights some potential areas for improvement. This review hence offers several recommendations to improve the reporting and use of DAGs in future research.

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