Author Archives: Niroshan Siriwardena

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CaHRU Research Forum November 2016

CaHRU_logotypeCaHRU, in conjunction with NHS partners including East Midlands Ambulance Service and Lincolnshire Community Health Services NHS Trusts, held its latest Research Forum of 2016 on 16th November. The forum followed its usual two-hour format with three speakers giving detailed presentations about a study they have been working on and then responding to questions.

brayford_arc1The first presentation was from Dr Murray Smith, CaHRU’s health economist and econometrician, who talked about ‘An Economic Feasibility Study on the Fluoridation of Drinking Water in the East Midlands’. This study is being led by NHS Nottingham City on behalf of all nine primary care trusts in the East Midlands. It examined the cost of setting up fluoridation plants, where they would be and the cost of ongoing maintenance. Ultimately, the feasibility study will produce a report for each of the areas covered by the nine participating primary care trusts.

Next was Professor Niro Siriwardena who presented on behalf of Dr Zahid Asghar on their study examining the performance of candidates with dyslexia in the Applied Knowledge Test (ATK) for Membership of the Royal College of Desk1General Practitioners (RCGP). A key finding of the study was that there was no evidence of differential attainment in candidates declaring dyslexia compared with those who did not once other candidate attributes such as age, gender, ethnicity and country of primary medical qualification had been accounted for.

Dr Stephanie Armstrong concluded the Research Forum by presenting findings from the Network exploring the Ethics of Ambulance Trials (NEAT) study. This is a Wellcome funded study led by the University of Lincoln and involving a number of other UK, as well as Dutch and Swiss, universities. The study has been running for less than a year but has already achieved an impressive set of outcomes. These include: a systematic review of published randomised controlled trials; a review of global and national regulations; and preliminary results of interviews with expert informants, paramedics and patients who have been involved in ambulance trials.

By Viet-Hai Phung

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Julie Pattinson successfully defends PhD thesis on gambling behaviour in British older adults

Julie Pattinson who recently joined CaHRU as a research assistant, recently successfully defended her doctoral thesis evaluating psychological and physical health as predictors for problem gambling in British older adults.

The aim of the doctorate was to build knowledge and understanding of British older adult gambling behaviour to PHOTO - Copyunderstand psychological and age-related physical health differences as predictive risk factors for problem gambling. The study used a mixed methods approach. A qualitative study using grounded theory suggested that British older adults gambled to alleviate distress experienced from psychological, lifestyle and physical changes associated with ageing. A cross-sectional survey investigating risk factors for problem gambling behaviour found the strongest predictor was use of slot machines. The third study used Interpretative Phenomenological Analysis found that British older adult women gambled to fill voids, for emotional escape, and in doing so risked overspending.

Overall the thesis provided a detailed analysis of how psychological and physical health factors affect British older adult gambling behaviour. This will inform future research on gambling behaviour, with a long-term goal of informing development of gambling interventions for this population.

By Julie Pattinson

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Ana Godoy successfully gains international doctorate

Ana Godoy, Lecturer in Health Economics at the University of Extremadura, Spain and visiting research fellow at CaHRU, presented her thesis “Four essays about quality in the delivery of healthcare” last week to obtain her Ana_PhDinternational doctorate.

Ana’s thesis considered the importance of quality indicators in primary healthcare, and included the development of a weighted measurement scale of patient satisfaction with healthcare (the w-HEALTHQUAL), a multi-level analysis of patients’ satisfaction with primary healthcare in the Extremadura region of Spain, and an investigation into the use of various patient reported outcome measures (PROMs) in the analysis of hospital performance in the UK.

After giving a detailed presentation of her work and responding to questions from the international panel, which included Drs. Coral Sirdifield and Zahid Asghar from CaHRU, Ana was successfully awarded her international doctorate. She now plans to build on her studies through future research at the University of Extremadura.

By Dr Coral Sirdifield

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Experts convene for Wellcome funded Network Exploring Ethics in Ambulance Trials (NEAT) project meeting

NOn 4th November 2016, CaHRU played host to an eminent group of researchers, ethicists and patient representatives in a meeting to discuss ethics in ambulance based trials. The group was formed as part of the Network Exploring Ethics in Ambulance Trials (NEAT) project, funded by the Wellcome Trust, which is seeking to understand the issues related to ethics in ambulance trials. The meeting had two main objectives, firstly to update the network on the findings of the NEAT project to date and secondly to discuss potential recommendations and future funding opportunities.

neat_ws1In the morning presentations by Dr Adele Langlois and Dr Stephanie Armstrong, outlined the findings of the project to date. These included a systematic review of published randomised controlled trials, a review of global and national regulations and the preliminary results of interview studies with expert informants, paramedics and patients who have been involved in ambulance trials. The morning sessions generated a lot of lively debate centring on both consent models and regulations, and in fact where there was agreement and conflict between these areas.

NAfter a pleasant lunch the discussion continued with possible recommendations of the project being that more work need to be done to clarify the guidance and regulations ultimately leading to a code of practice for ambulance trials and accompanying common ethics framework. Funding opportunities were discussed and the day ended with an agreement that there should be a commitment to continue the work of the network through collaborative research opportunities.

By Dr Stephanie Armstrong

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Implementation science and research methods seminar: statistical modelling of time series data

Dr Murray SmithThe latest CaHRU Implementation Science and Research Methods seminar was presented by Dr Murray Smith on 25th October 2016, on the topic of statistical modelling of time series data. Dr Smith, research fellow at the Community and Health Research Unit (CaHRU), is an econometrician with a wide range of experience and research interests in micro-econometric modelling, health informatics, health economic modelling, mathematical statistics and computer algebra. Murray has previously worked as an Associate Professor in the Department of Econometrics and Business Statistics at the University of Sydney, Australia, and as an Associate Professor at the School of Pharmacy, University of Nottingham before coming to the University of Lincoln. His research has focuses on the quality of use of pharmaceutical medicines in chronic disease, with analyses that utilise prescribing data drawn from a large database of general practice patient records.

segmentedregressionHe introduced his topic by defining (and giving examples) of data, and related these to how researchers can statistically model time series data in different ways. Murray described four fundamental components of times series including: time (Tt); Cycle (Ct); Seasonal (St) and Irregular (It). He also gave examples of Time Series Analysis Curves such as survival data, Engle’s AutoRegressive Conditional Heteroscedasticity (ARCH) and segmented regression. He showed how modelling time series data can be useful for quality improvement research, as this can facilitate the measurement of outcomes or impact over time and extrapolate or estimate future values or outcomes. A time series method (using segmented regression) is being used in a paper currently being prepared by Dr Murray Smith and Professor Niro Siriwardena for publication.

QIlogoDr Smith concluded his interesting presentation by recommending three key books for further reading on Statistical Modelling of Time Series Data: Time Series Analysis by Jame D Hamilton, Time Series Analysis: Forecasting and Control by George E. P. Box et al. and Introduction to Time Series and Forecasting by Peter J. Brockwell & Richard A. Davis. He made the session so interesting that participants asked for further presentations on time series analysis. For his next seminar, Murray will focus more on use of the method for current research at CaHRU to enable more researchers to apply this method to their research.

By Joseph Akanuwe