Clinical research is dying in the United Kingdom

BMJ ◽  
2003 ◽  
Vol 327 (7422) ◽  
pp. 0-e-0
Keyword(s):  
United Kingdom ◽  
Clinical Research ◽  
The United Kingdom

scholarly journals The management and outcome for patients with chronic subdural hematoma: a prospective, multicenter, observational cohort study in the United Kingdom

2017 ◽  
Vol 127 (4) ◽  
pp. 732-739 ◽  
Author(s):  
Paul M. Brennan ◽  
Angelos G. Kolias ◽  
Alexis J. Joannides ◽  
Jonathan Shapey ◽  
Hani J. Marcus ◽  
...  
Keyword(s):  
United Kingdom ◽  
Clinical Research ◽  
Functional Outcome ◽  
Subdural Hematoma ◽  
Chronic Subdural Hematoma ◽  
Bed Rest ◽  
Repeat Surgery ◽  
Symptomatic Recurrence ◽  
The United Kingdom ◽  
High Flow Oxygen

OBJECTIVESymptomatic chronic subdural hematoma (CSDH) will become an increasingly common presentation in neurosurgical practice as the population ages, but quality evidence is still lacking to guide the optimal management for these patients. The British Neurosurgical Trainee Research Collaborative (BNTRC) was established by neurosurgical trainees in 2012 to improve research by combining the efforts of trainees in each of the United Kingdom (UK) and Ireland's neurosurgical units (NSUs). The authors present the first study by the BNTRC that describes current management and outcomes for patients with CSDH throughout the UK and Ireland. This provides a resource both for current clinical practice and future clinical research on CSDH.METHODSData on management and outcomes for patients with CSDH referred to UK and Ireland NSUs were collected prospectively over an 8-month period and audited against criteria predefined from the literature: NSU mortality < 5%, NSU morbidity < 10%, symptomatic recurrence within 60 days requiring repeat surgery < 20%, and unfavorable functional status (modified Rankin Scale score of 4–6) at NSU discharge < 30%.RESULTSData from 1205 patients in 26 NSUs were collected. Bur-hole craniostomy was the most common procedure (89%), and symptomatic recurrence requiring repeat surgery within 60 days was observed in 9% of patients. Criteria on mortality (2%), rate of recurrence (9%), and unfavorable functional outcome (22%) were met, but morbidity was greater than expected (14%). Multivariate analysis demonstrated that failure to insert a drain intraoperatively independently predicted recurrence and unfavorable functional outcome (p = 0.011 and p = 0.048, respectively). Increasing patient age (p < 0.00001), postoperative bed rest (p = 0.019), and use of a single bur hole (p = 0.020) independently predicted unfavorable functional outcomes, but prescription of high-flow oxygen or preoperative use of antiplatelet medications did not.CONCLUSIONSThis is the largest prospective CSDH study and helps establish national standards. It has confirmed in a real-world setting the effectiveness of placing a subdural drain. This study identified a number of modifiable prognostic factors but questions the necessity of some common aspects of CSDH management, such as enforced postoperative bed rest. Future studies should seek to establish how practitioners can optimize perioperative care of patients with CSDH to reduce morbidity as well as minimize CSDH recurrence. The BNTRC is unique worldwide, conducting multicenter trainee-led research and audits. This study demonstrates that collaborative research networks are powerful tools to interrogate clinical research questions.

scholarly journals Dumfries

1991 ◽  
Vol 15 (5) ◽  
pp. 292-294
Author(s):  
R. G. McCreadie
Keyword(s):  
United Kingdom ◽  
Clinical Research ◽  
Patient Care ◽  
Management Team ◽  
Unit Management ◽  
The United Kingdom

My work has four main strands – patient care, membership of the unit management team, clinical research and the College. At different times I can, or have to, place greater or lesser emphasis on any one of these areas – the result is a job virtually devoid of routine. Let me tell you about each area. I hope by doing so you will also learn a little about what is going on in psychiatry north of the border. You will know we arrange things rather differently from the rest of the United Kingdom.

scholarly journals Informing National Health Service patients about participation in clinical research: A comparison of opt-in and opt-out approaches across the United Kingdom

2020 ◽  
pp. 000486742097326
Author(s):  
Catherine Henshall ◽  
Jennifer Potts ◽  
Sophie Walker ◽  
Mark Hancock ◽  
Mark Underwood ◽  
...  
Keyword(s):  
Mental Health ◽  
United Kingdom ◽  
National Health Service ◽  
Health Service ◽  
Clinical Research ◽  
National Health ◽  
Research Participation ◽  
Research Opportunities ◽  
The United Kingdom ◽  
Opt Out

Objective: Recruitment to clinical research in the National Health Service remains challenging. One barrier is accessing patients to discuss research participation. Two general approaches are used in the United Kingdom to facilitate this: an ‘opt-in’ approach (when clinicians communicate research opportunities to patients) and an ‘opt-out’ approach (all patients have the right to be informed of relevant research opportunities). No evidence-based data are available, however, to inform the decision about which approach is preferable. This study aimed to collect information from ‘opt-in’ and ‘opt-out’ Trusts and identify which of the two approaches is optimal for ensuring National Health Service patients are given opportunities to discuss research participation. Method: This sequential mixed methods study comprised three phases: (1) an Appreciative Inquiry across UK Trusts, (2) online surveys and (3) focus groups with National Health Service staff and patients at a representative mental health Trust. Results: The study was conducted between June and October 2019. Out of seven National Health Service Mental Health Trusts contacted (three ‘opt-out’ and four ‘opt-in’), only four took part in phase 1 of the study and three of them were ‘opt-out’ Trusts. Benefits of an ‘opt-out’ approach included greater inclusivity of patients and the removal of research gatekeepers, while the involvement of research-active clinicians and established patient–clinician relationships were cited as important to ‘opt-in’ success. Phases 2 and 3 were conducted at a different Trust (Oxford Health NHS Foundation Trust) which was using an ‘opt-in’ approach. Of 333 staff and member survey responders, 267 (80.2%) favoured moving to an ‘opt-out’ approach (phase 2). Nineteen staff and 16 patients and carers participated in focus groups (phase 3). Concern was raised by staff regarding the lack of time for clinical research, with clinical work taking precedence over research; patients were concerned about a lack of research activity; all considered research to be beneficial and were supportive of a move to ‘opt-out’. Conclusion: Findings suggest that ‘opt-out’ is more beneficial than ‘opt-in’, with the potential to vastly increase patient access to research opportunities and to enable greater equality of information provision for currently marginalised groups. This should ensure that healthcare research is more representative of the entire population, including those with a mental health diagnosis.

scholarly journals TRIP Database

2018 ◽  
Vol 39 (3) ◽  
pp. 152-154
Author(s):  
Jackie Phinney
Keyword(s):  
United Kingdom ◽  
Clinical Research ◽  
Research Database ◽  
Sources Of Information ◽  
Multiple Sources ◽  
Single Interface ◽  
The United Kingdom

Based in the United Kingdom, TRIP (Turning Research Into Practice) is a clinical research database that allows users to search across multiple sources of information and publication types using a single interface.

scholarly journals Using the United Kingdom standards for public involvement to evaluate the impact of public involvement in a multinational clinical study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Kathy Seddon ◽  
Jim Elliott ◽  
Miriam Johnson ◽  
Clare White ◽  
Max Watson ◽  
...  
Keyword(s):  
United Kingdom ◽  
Clinical Study ◽  
Clinical Research ◽  
Public Involvement ◽  
Lead Author ◽  
National Study ◽  
The United Kingdom ◽  
Lay Members ◽  
The Uk ◽  
The Impact

Abstract Background The publication of the United Kingdom (UK) Standards for Public Involvement (PI) (UK Standards) in research drew a clear line in the sand regarding the importance of utilising the unique experience, skills and expertise that lay people may offer to the development, conduct and dissemination of clinical research. The UK Standards provide a benchmark which researchers should aim to achieve, yet its implementation continues to be a step wise iterative process of change management. A recent evaluation by a regional research group has suggested that our understanding of PI is enhanced through reflection on the UK Standards. We report on the utility of PI in the design, conduct and dissemination of the HIDDen study, a national, multicentre clinical study based across three UK centres. Methods A retrospective review of PI within the HIDDen study was conducted using field notes taken by the lead author from interactions throughout their involvement as a lay representative on the study. Key members of the HIDDen study were interviewed and data analysed to explore adherence to the UK Standards. Results There was universal support for PI across the study management group with genuine inclusivity of lay members of the committee. All six of the UK Standards were met to varying degrees. The greatest opportunities lay in ‘working together’ and ‘support and learning’. There were challenges meeting ‘governance’ with evidence of participation in decision making but less evidence of opportunities in management, regulation, leadership. Conclusion This study concurs with previous research supporting the utility of the Standards in the conduct and evaluation of PI in clinical research. To our knowledge this is the first multi-national study to be evaluated against the UK Standards.

scholarly journals Resuscitating clinical research in the United Kingdom

BMJ ◽  
2003 ◽  
Vol 327 (7422) ◽  
pp. 1041-1043 ◽  
Author(s):  
J. Bell
Keyword(s):  
United Kingdom ◽  
Clinical Research ◽  
The United Kingdom
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