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Past projects

Introduction

We have particular expertise in design and analysis of occupational and environmental epidemiological surveys

In addition to our specific research projects, we provide assistance with:

  • statistical design
  • data management
  • analysis
  • presentation of results
  • dissemination of findings

We also have a well-established, highly thought of teaching programme.


Past Projects

 

Quality improvement in cystic fibrosis (CF): What can we learn from each other?

  • Stephanie MacNeill, Janet Allen (CF Trust), Diana Bilton (Royal Brompton and Harefield NHS Trust), Jonathan Boote (University of Sheffield), Siobhan Carr (Royal Brompton and Harefield NHS Trust), Paul Cullinan, Caroline Elston (King’s College Hospital NHS Trust), Steve Harrison (Sheffield Teaching Hospitals NHS Trust), Mohammed Mohammed (University of Bradford), Livia Pierotti and Martin Wildman (Sheffield Teaching Hospitals NHS Trust)

Patients with CF are treated at specialist centres offering dedicated paediatric or adult care. The CF Trust – the national UK charity for CF - maintains a national registry database of detailed clinical and demographic information on all patients attending these specialist centres. Patients are invited to attend annual reviews and based on these data the Trust produces annual reports describing the health of patients. The reports are available on the CF Trust website to be accessed by patients and clinicians alike (http://www.cysticfibrosis.org.uk/about-cf/publications/cf-registry-reports).  Since 2008 these reports have included comparisons between centres in terms of key clinical outcomes using simple rankings. While these comparisons give a sense of the distribution of outcomes between centres, they encourage the reader to assume that centres with the highest lung function measures are “better” than those with lower values. This is misleading on two grounds:

1)  The rankings make no allowances for the differences in the intake of patients.

2)  The rankings include no formal tests comparing centres. Without formal comparisons we cannot say that there is evidence that outcomes are better at one centre than another let alone conclude that any observed differences are related to the process of care.

Our aim in this study is to avoid the inappropriate interpretation of league tables and to adopt a more systematic and scientific method based on "statistical process control" (SPC) to identify exceptional CF care services in the UK in terms of clinically meaningful outcomes.

Study funded by the NIHR HSDR programme.


Post-marketing surveillance in CF

  • Stephanie MacNeill, Diana Bilton (Royal Brompton and Harefield NHS Trust), Martin Wildman (Sheffield Teaching Hospitals NHS Trust) and the CF Trust

In collaboration with the CF Trust and a number of pharmaceutical companies, we are involved in post-marketing safety studies of new treatments for patients with CF.  These observational studies are designed to assess and monitor long-term safety outcomes of new treatments in everyday use. The studies we are involved in have the unique feature of making use of routinely collected clinical data on both treated and untreated patients from the UK CF Registry patient database. Using the rich data available on the CF Registry allows us to collect a range of clinical outcomes on both patients who are receiving the treatment under study as well as comparable groups of untreated patients with CF. As these are observational studies, selection of an appropriate comparator group is important to ensure that safety events are not due to disease severity. As such, we are using specialised statistical techniques to ensure that our comparator groups are similarly likely to receive the study treatments.

Our work at Imperial College London is funded by the CF Trust.


Habitual gait speed: A novel prognostic marker in COPD?

This MRC-funded research study aims to assess whether usual walking speed is a useful marker of disease severity and whether it has prognostic value in COPD.

The reliability of the gait speed and the association between gait speed and existing measures of exercise capacity will be assessed in stable COPD patients. The ability of gait speed to predict early hospital readmission in hospitalized patients at discharge following acute exacerbation of COPD will be prospectively evaluated. Furthermore, the ability of gait speed to predict mortality will be prospectively assessed in a cohort of stable COPD patients followed up for a minimum of two years.