First publication from the NEAT project on consent in ambulance trials

Got-Consent-Logo-2CaHRU are pleased to announce the first publication from the Wellcome Trust funded project, NEAT: Network exploring Ethics in Ambulance Trials. The article, entitled ‘Assessment of consent models as an ethical consideration in the conduct of prehospital ambulance randomised controlled clinical trials: a systematic review‘, sought to understand the main ethical considerations when conducting clinical trials involving ambulance services.

NThe review found  issues with consent were the most significant ethical issue for ambulance trials. The type of consent gained differed depending on the condition or intervention being studied, but the country in which the research took place had less influence on the type of consent. The terminology used to describe consent varied widely with multiple terms used to describe the same processes. This, coupled with the the wide range of consent types used led to the conclusion that standardisation of consent models and terminology used to describe them was warranted.

The systematic review  was published in BMC Medical Research Methodology and is available open access at the following link:

By Stephanie Armstrong.

Viet-Hai Phung attends KCL social science research summer school

Viet-Hai Phung, research assistant and doctoral student at CaHRU recently attended the summer school, ‘Doing social science research in healthcare settings’ at King’s College, London, 13-14 July 2017. This is his account of the course.

vhp2“It was a pleasure to attend this two-day summer school that was run by King’s College, London aimed at Early Career Researchers and PhD students. The five sessions spread over two days covered a range of topics of particular interest and relevance to me. First up, we looked at using theory in applied health research. This started off with the basics of comparing positivism, with its emphasis on objective reality, and interpretivism’s accommodation of multiple realities. The session continued by linking micro, meso and macro-theory. A key focus was Bourdieu’s logic of practice which explores how context and structures affect decisions.

The afternoon session examined how reflexivity can be used at different stages of the research process. Reflexivity also has its place within positivism and interpretivism. There then followed a discussion of the merits of ethics committees. Do they ensure that research is conducted to the highest standards or are they too risk averse? The session concluded by examining the role of the researcher in data collection.

sunflowerThe final day’s morning session continued to discuss the role of ethics committees. It discussed the way research governance has evolved within the healthcare sector and universities. In particular, we discussed the research governance process, particularly, the role of the Health Research Authority. The way they operated was compared (unfavourably) with university ethics committees, which from personal experience, I would agree with. The second morning session discussed the types of social science research that is likely to attract funding. Researchers are encouraged to publish to benefit their institutions in the Research Excellence Framework (REF). Increasingly, PhD students are encouraged to publish papers from their thesis. Deductive projects are particularly attractive to funders because they start with a clear research question, while the initial lack of clarity inherent in inductive research is less persuasive to potential funders.

The final session of the summer school examined the process from an initial idea to it becoming implemented. Apparently, this process normally takes around 17 years, with many pitfalls that can potentially slow the process down.

As a healthcare researcher and a PhD student, I found the summer school to be highly useful and relevant. The sessions were delivered clearly, in an engaging manner and with great enthusiasm. I would definitely recommend it to others in similar career situations.”

By Viet-Hai Phung



CaHRU study on CFRs presented to National Ambulance Forum

vhp2Viet-Hai Phung presented the findings of a University of Lincoln study on Community First Responders at a meeting of the National Ambulance Service First Responder Managers Forum at East Midlands Ambulance Service NHS Trust at Beechdale, Nottingham on 25th April 2017. The presentation set out the aims and objectives of the research, which were to explore the role of CFRs in a rural location, using a systematic scoping review followed up by qualitative interviews.

This study team of Viet-Hai Phung, Fiona Togher, Ian Trueman, Prof Roderick Ørner and Prof Niro Siriwardena, began the research in April 2016 with a systematic scoping review of CFR schemes in the UK which was published recently. CFRWordItOut-word-cloud-2426149Then followed a qualitative study involving 16 interviews of CFRs, conducted from June-July 2016. After describing the progress of the study, Viet-Hai Phung outlined the key findings of the scoping review. These included that: volunteers became CFRs mainly for altruistic reasons; they wanted more training and feedback on incidents they had attended; there were concerns about the possible emotional impact on CFRs responding to incidents; there was low public recognition of CFR schemes and sometimes confusion with ambulance staff; relationships with the ambulance staff were sometimes affected by confusion over roles; CFRs wanted local autonomy for CFR schemes but with greater sharing of best practice. Some of the findings from the scoping review were reinforced by the interview study. These findings, alongside others, were reinforced by the interview study.

The broad consensus among the regional ambulance managers was that further research was needed on CFRs and CFR schemes building on the work so far, and CaHRU is committed to working with ambulance trusts to further develop the work on CFRs. Professor Niro Siriwardena, who was also present at the event, said there were plans to discuss this further with ambulance service research leads at the next meeting of the National Ambulance Research Steering Group.

By Viet-Hai Phung

New CaHRU publication on biosimilars in British local formularies

murraysmith1A new article entitled ‘Biosimilar uptake by British local formularies: a cross sectional study‘, authored by CaHRU member Dr Murray Smith together with colleagues at the universities of Nottingham and Manchester, was published online on September 5, 2017, in the International Journal of Clinical Pharmacy – the link to the open access article is here. The article reported research examining the uptake throughout Britain of biosimilar medicines, where these are inexact copies of biological medicines no longer protected by legal patent from copying.

medication_pillsIncreasing numbers of biosimilars are being manufactured, licensed and becoming available for use in healthcare in Britain predominantly because the biologics they seek to replace are themselves generally quite expensive for the NHS to buy. By interrogating the prescribing recommendations made in 146 local pharmaceutical formularies from NHS trusts and health boards across Britain we were able to contrast the willingness of clinicians towards prescribing a patient to a biosimilar versus that of remaining with the original biologic.

The main finding of this work is that the uptake of biosimilar medicines in Britain is generally less than would be expected especially given that its market for pharmaceuticals has typically had such a strong focus on the use of generics.

By Dr Murray Smith

CaHRU Newsletter (Spring 2017)

CaHRU_logotypeThe latest edition of the CaHRU Newsletter (Spring 2017) was published in June 2017. The newsletter presents the work of the research centre over the previous three months and includes articles from the CaHRU blog covering publications, conferences and funding. The newsletter is written by members of the CaHRU team and produced by Sue Bowler, CaHRU administrator.

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