Weight loss among patients with Head and Neck Cancer at St Vincent's Hospital...Cancer Institute NSW
Patients with Squamous cell carcinoma (SCC) of the Head and Neck (H&N) are often treated with curative intent using treatment protocols placing them at high risk of nutritional decline. Recently released COSA guidelines recommend that prophylactic enteral feeding should be considered for T4 upper aerodigestive tract tumours undergoing concurrent chemoradiotherapy. Evidence is yet to identify optimal method of nutrition intervention and timing across all tumour stages in this population.
New methods for reviewing mechanistic evidence
Systematic review guidelines for integrating evidence from human, animal and other mechanistic studies which link diet, nutrition and physical activity to cancer
By Richard Martin, School of Social and Community Medicine, University of Bristol
Mapping lung cancer diagnostic pathways: a qualitative study of interviews wi...Cancer Institute NSW
Lung cancer remains the leading cause of cancer death in developed countries. There is growing evidence that earlier diagnosis of lung cancer is an important factor in improving outcomes. Despite this, there is surprisingly little qualitative research that documents lung cancer patients' diagnostic pathway and beyond.
ISCaHN Treatment Dashboard: Providing clinician decision support with data ge...Cancer Institute NSW
Illawarra Shoalhaven Cancer and Haematology Network (ISCaHN) has been using an oncology information system (OIS) as a complete electronic record for over 4 years. There has been both considerable and valuable treatment data generated at the point of care. Are we able to rapidly assess the outcomes of our own treatment data, and use this outcome data to help inform the delivery of care to our patients?
Optimising the Model of Care for Patient Management at The Tweed Cancer Care ...Cancer Institute NSW
The commonly understood model of shift to shift nursing handover does not apply to most ambulatory day treatment units. Nonetheless, ‘handover’ of patient clinical information remains quintessential to safe clinical practice. Of considerable interest is how EMR may aid the transfer of patient clinical information in these circumstances and address the question: does this facilitate improved patient care?
Professor Martin Wiseman presentation on The Continuous Update Project: Introduction to the Project at FENS European Nutrition Conference, 20-23 October 2015 Berlin (Germany).
Weight loss among patients with Head and Neck Cancer at St Vincent's Hospital...Cancer Institute NSW
Patients with Squamous cell carcinoma (SCC) of the Head and Neck (H&N) are often treated with curative intent using treatment protocols placing them at high risk of nutritional decline. Recently released COSA guidelines recommend that prophylactic enteral feeding should be considered for T4 upper aerodigestive tract tumours undergoing concurrent chemoradiotherapy. Evidence is yet to identify optimal method of nutrition intervention and timing across all tumour stages in this population.
New methods for reviewing mechanistic evidence
Systematic review guidelines for integrating evidence from human, animal and other mechanistic studies which link diet, nutrition and physical activity to cancer
By Richard Martin, School of Social and Community Medicine, University of Bristol
Mapping lung cancer diagnostic pathways: a qualitative study of interviews wi...Cancer Institute NSW
Lung cancer remains the leading cause of cancer death in developed countries. There is growing evidence that earlier diagnosis of lung cancer is an important factor in improving outcomes. Despite this, there is surprisingly little qualitative research that documents lung cancer patients' diagnostic pathway and beyond.
ISCaHN Treatment Dashboard: Providing clinician decision support with data ge...Cancer Institute NSW
Illawarra Shoalhaven Cancer and Haematology Network (ISCaHN) has been using an oncology information system (OIS) as a complete electronic record for over 4 years. There has been both considerable and valuable treatment data generated at the point of care. Are we able to rapidly assess the outcomes of our own treatment data, and use this outcome data to help inform the delivery of care to our patients?
Optimising the Model of Care for Patient Management at The Tweed Cancer Care ...Cancer Institute NSW
The commonly understood model of shift to shift nursing handover does not apply to most ambulatory day treatment units. Nonetheless, ‘handover’ of patient clinical information remains quintessential to safe clinical practice. Of considerable interest is how EMR may aid the transfer of patient clinical information in these circumstances and address the question: does this facilitate improved patient care?
Professor Martin Wiseman presentation on The Continuous Update Project: Introduction to the Project at FENS European Nutrition Conference, 20-23 October 2015 Berlin (Germany).
One example of how Clinical Cancer Registry level data can review practice va...Cancer Institute NSW
We examined the possible utility of using Cancer Institute NSW Clinical Cancer Registry data by examining one contentious issue in radiation oncology as an example. Increasing evidence has been published about the safety and efficacy of hypofractionated radiotherapy, in comparison with standard fractionation, in early, node-negative breast cancer.
A distributed data mining network infrastructure for Australian radiotherapy ...Cancer Institute NSW
Routine electronic storage of medical records and imaging is becoming standard practice in radiotherapy. There is immense potential to utilise this increasingly diverse data resource as an evidence base for decision support systems for cancer prognosis and subsequent personalised treatment decisions.
Introduction to the WCRF International Continuous Update Project
By Dr Rachel Thompson, Head of Research Interpretation/ Head CUP Secretariat
6 December 2014, UICC World Cancer Congress, Melbourne
Pathways to smoking care for cancer patients (P-SCIP): Stage 1Cancer Institute NSW
As survival from cancer has improved over time, the potential impact of cigarette smoking on cancer patients and survivors is of increasing relevance. In addition to increased risk of chronic disease such as cardiovascular and respiratory disease, continued smoking after a cancer diagnosis increases the risk of second primary cancer, cancer recurrence and is a cause of treatment complications. As well the profound adverse impact of continued smoking on health outcomes in cancer patients, continued smoking among people with cancer incurs significant cost to the health system.
Given the prevalence and adverse effects of psychological distress on treatment outcomes, particularly the influence of depression on nutritional outcomes, evidence based clinical practice guidelines recommend dietitian screening and referral of head and neck cancer patients for psychosocial distress. However, research suggests that the provision of this care is sub-optimal.
The 20th International Congress of Nutrition (ICN) hosted by the International Union of Nutritional Science (IUNS) took place on the 15th-20th September 2013, Granada, Spain. WCRF International held a 2-hour symposium on the Continuous Update Project (CUP) entitled ‘Food, Nutrition, Physical Activity and Cancer – Keeping the Evidence Current: WCRF/AICR Continuous Update Project (CUP).’ It included four presentations exploring the latest updates from the CUP.
Research suggests that chemotherapy may be related to a decline in cognitive
functions such as memory and attention in some solid tumor cancer patients.
However, the presence, extent and course of any cognitive decline and whether or not
it causes observable difficulties for patients remain unclear. The majority of research studies to date have explored cognitive function in cancer patients after treatment has been completed. Few studies have measured patients’ cognitive function prior to the commencement of chemotherapy treatment and hence these studies do not have any baseline. Measuring cognitive function both before and after chemotherapy would make it possible to identify changes occurring during treatment and the duration of such treatment related changes. An additional limitation of existing studies is that they have often lacked a
comparison group (e.g. cancer patients who have not required chemotherapy) against
which to compare cognitive function scores. Furthermore, the majority of cognitive
research to date has focussed on female breast cancer patients. This has precluded an exploration of gender differences in relation to cognitive decline.
Predictors of MDT review and the impact on lung cancer survival for HNELHD re...Cancer Institute NSW
Review by a Multidisciplinary Team (MDT) has been shown to lead to increased rates of surgical resection, radiotherapy, chemotherapy and timeliness of care. Most recently, the Victorian lung cancer patterns of care study have found that MDT review is an independent predictor of lung cancer survival.
Professor Martin Wiseman presentation on The Continuous Update Project: Novel approach to reviewing mechanistic evidence on diet, nutrition, physical activity and cancer at FENS European Nutrition Conference, 20-23 October 2015 Berlin (Germany).
The Efficacy of Pocket Elimination/Reduction Compared to Access Flap Surgery: A Systematic Review and Meta-analysis
To assess the efficacy and adverse effects of resective
surgery compared to access flap in patients with
periodontitis.
Anti-cancer therapy is big business. In Australia alone between 2000 and 2009, cancer-related pharmaceutical expenditure has risen over 200% to over half a billion dollars per annum.
The impact of National Bowel Cancer Screening Program in AustraliaCancer Institute NSW
The full rollout of the National Bowel Cancer Screening Program (NBCSP), offering free biennial screening using immunochemical Fecal Occult Blood Test (iFOBT) for 50-74 years is targeted for 2020. In 2013-14, the overall participation rate among Australians who were invited to participate was 36%.
Providing coordinated cancer care: a population-based survey of patients' exp...Cancer Institute NSW
Improving cancer care coordination is a key priority for health services. Understanding the patient experience and who is at risk of receiving poorly coordinated care is crucial to underpin service improvement. However, there is little understanding of the adequacy of care coordination within Australia.
Building the bridge from discovery-to-delivery: A Community of Practice in Ca...Cancer Institute NSW
A research breakthrough is said to take approximately 17 years to translate into clinical practice. This time lag can have considerable implications for patients, their carers, health services, and public funds. To address this time lag, the Cancer Institute NSW and the Translational Cancer Research Centres (TCRCs) across the state developed a community of practice (CoP) to increase knowledge, skills, and capacity in implementation science.
Impact of Different Surgical Protocols on Dimensional Changes of Free Soft Ti...Dr. B.V.Parvathy
To determine if there is a difference in the amount of shrinkage during
healing of free soft tissue autografts (FSTA) using different surgical
techniques—suturing the vestibular flap margin apically to the base of
the recipient bed versus leaving the flap margin free and unsutured.
The cancer cup challenge—running an international program in safety and quali...Cancer Institute NSW
Adverse events are a significant quality and safety issue in the hospital setting due to their direct impact on patients. Additionally, such events are often handled by junior doctors due to their direct involvement with patients. As such, it is important for health care organisations to prioritise education and training for junior doctors on identifying adverse events and handling them when they occur. How we make this education relevant and engaging remains a key challenge.
One example of how Clinical Cancer Registry level data can review practice va...Cancer Institute NSW
We examined the possible utility of using Cancer Institute NSW Clinical Cancer Registry data by examining one contentious issue in radiation oncology as an example. Increasing evidence has been published about the safety and efficacy of hypofractionated radiotherapy, in comparison with standard fractionation, in early, node-negative breast cancer.
A distributed data mining network infrastructure for Australian radiotherapy ...Cancer Institute NSW
Routine electronic storage of medical records and imaging is becoming standard practice in radiotherapy. There is immense potential to utilise this increasingly diverse data resource as an evidence base for decision support systems for cancer prognosis and subsequent personalised treatment decisions.
Introduction to the WCRF International Continuous Update Project
By Dr Rachel Thompson, Head of Research Interpretation/ Head CUP Secretariat
6 December 2014, UICC World Cancer Congress, Melbourne
Pathways to smoking care for cancer patients (P-SCIP): Stage 1Cancer Institute NSW
As survival from cancer has improved over time, the potential impact of cigarette smoking on cancer patients and survivors is of increasing relevance. In addition to increased risk of chronic disease such as cardiovascular and respiratory disease, continued smoking after a cancer diagnosis increases the risk of second primary cancer, cancer recurrence and is a cause of treatment complications. As well the profound adverse impact of continued smoking on health outcomes in cancer patients, continued smoking among people with cancer incurs significant cost to the health system.
Given the prevalence and adverse effects of psychological distress on treatment outcomes, particularly the influence of depression on nutritional outcomes, evidence based clinical practice guidelines recommend dietitian screening and referral of head and neck cancer patients for psychosocial distress. However, research suggests that the provision of this care is sub-optimal.
The 20th International Congress of Nutrition (ICN) hosted by the International Union of Nutritional Science (IUNS) took place on the 15th-20th September 2013, Granada, Spain. WCRF International held a 2-hour symposium on the Continuous Update Project (CUP) entitled ‘Food, Nutrition, Physical Activity and Cancer – Keeping the Evidence Current: WCRF/AICR Continuous Update Project (CUP).’ It included four presentations exploring the latest updates from the CUP.
Research suggests that chemotherapy may be related to a decline in cognitive
functions such as memory and attention in some solid tumor cancer patients.
However, the presence, extent and course of any cognitive decline and whether or not
it causes observable difficulties for patients remain unclear. The majority of research studies to date have explored cognitive function in cancer patients after treatment has been completed. Few studies have measured patients’ cognitive function prior to the commencement of chemotherapy treatment and hence these studies do not have any baseline. Measuring cognitive function both before and after chemotherapy would make it possible to identify changes occurring during treatment and the duration of such treatment related changes. An additional limitation of existing studies is that they have often lacked a
comparison group (e.g. cancer patients who have not required chemotherapy) against
which to compare cognitive function scores. Furthermore, the majority of cognitive
research to date has focussed on female breast cancer patients. This has precluded an exploration of gender differences in relation to cognitive decline.
Predictors of MDT review and the impact on lung cancer survival for HNELHD re...Cancer Institute NSW
Review by a Multidisciplinary Team (MDT) has been shown to lead to increased rates of surgical resection, radiotherapy, chemotherapy and timeliness of care. Most recently, the Victorian lung cancer patterns of care study have found that MDT review is an independent predictor of lung cancer survival.
Professor Martin Wiseman presentation on The Continuous Update Project: Novel approach to reviewing mechanistic evidence on diet, nutrition, physical activity and cancer at FENS European Nutrition Conference, 20-23 October 2015 Berlin (Germany).
The Efficacy of Pocket Elimination/Reduction Compared to Access Flap Surgery: A Systematic Review and Meta-analysis
To assess the efficacy and adverse effects of resective
surgery compared to access flap in patients with
periodontitis.
Anti-cancer therapy is big business. In Australia alone between 2000 and 2009, cancer-related pharmaceutical expenditure has risen over 200% to over half a billion dollars per annum.
The impact of National Bowel Cancer Screening Program in AustraliaCancer Institute NSW
The full rollout of the National Bowel Cancer Screening Program (NBCSP), offering free biennial screening using immunochemical Fecal Occult Blood Test (iFOBT) for 50-74 years is targeted for 2020. In 2013-14, the overall participation rate among Australians who were invited to participate was 36%.
Providing coordinated cancer care: a population-based survey of patients' exp...Cancer Institute NSW
Improving cancer care coordination is a key priority for health services. Understanding the patient experience and who is at risk of receiving poorly coordinated care is crucial to underpin service improvement. However, there is little understanding of the adequacy of care coordination within Australia.
Building the bridge from discovery-to-delivery: A Community of Practice in Ca...Cancer Institute NSW
A research breakthrough is said to take approximately 17 years to translate into clinical practice. This time lag can have considerable implications for patients, their carers, health services, and public funds. To address this time lag, the Cancer Institute NSW and the Translational Cancer Research Centres (TCRCs) across the state developed a community of practice (CoP) to increase knowledge, skills, and capacity in implementation science.
Impact of Different Surgical Protocols on Dimensional Changes of Free Soft Ti...Dr. B.V.Parvathy
To determine if there is a difference in the amount of shrinkage during
healing of free soft tissue autografts (FSTA) using different surgical
techniques—suturing the vestibular flap margin apically to the base of
the recipient bed versus leaving the flap margin free and unsutured.
The cancer cup challenge—running an international program in safety and quali...Cancer Institute NSW
Adverse events are a significant quality and safety issue in the hospital setting due to their direct impact on patients. Additionally, such events are often handled by junior doctors due to their direct involvement with patients. As such, it is important for health care organisations to prioritise education and training for junior doctors on identifying adverse events and handling them when they occur. How we make this education relevant and engaging remains a key challenge.
Professor Martin Wiseman’s presentation, The Continuous Update Project: Introduction to the Project, at the African Organisation for Research & Training in Cancer (AORTIC) conference, 18-22 November 2015, Marrakech, Morocco.
Improving Care: More Method, Less Uncertainty, Impact summit 30 October 2013NHS Improving Quality
Improving Care: More Method, Less Uncertainty, Impact summit
30 October 2013
Improving Care: More Method, Less Uncertainty – Impact Summit, the second full day event in the Measurement Masterclass series, took place at the Central Hall Westminster in London on 30 October. The event was opened by Professor Sir Bruce Keogh and NHS IQ’s own Professor Moira Livingston, and included contributions from experts from across England and a virtual appearance by Dr Bob Lloyd.
This series for senior clinical leaders was developed to help increase the understanding of the principles of measurement for improvement. Designed to stimulate and challenge, it is supporting clinical leads in holding influential discussions with policy makers and data collectors.
To take the series forward and promote measurement for improvement more widely, NHS Improving Quality is setting up an advisory group to design and develop more learning resources for senior clinicians and their teams
More information: http://www.nhsiq.nhs.uk/capacity-capability/measurement-masterclass.aspx
Cracking the Workplace Discipline Code Main.pptxWorkforce Group
Cultivating and maintaining discipline within teams is a critical differentiator for successful organisations.
Forward-thinking leaders and business managers understand the impact that discipline has on organisational success. A disciplined workforce operates with clarity, focus, and a shared understanding of expectations, ultimately driving better results, optimising productivity, and facilitating seamless collaboration.
Although discipline is not a one-size-fits-all approach, it can help create a work environment that encourages personal growth and accountability rather than solely relying on punitive measures.
In this deck, you will learn the significance of workplace discipline for organisational success. You’ll also learn
• Four (4) workplace discipline methods you should consider
• The best and most practical approach to implementing workplace discipline.
• Three (3) key tips to maintain a disciplined workplace.
What are the main advantages of using HR recruiter services.pdfHumanResourceDimensi1
HR recruiter services offer top talents to companies according to their specific needs. They handle all recruitment tasks from job posting to onboarding and help companies concentrate on their business growth. With their expertise and years of experience, they streamline the hiring process and save time and resources for the company.
RMD24 | Debunking the non-endemic revenue myth Marvin Vacquier Droop | First ...BBPMedia1
Marvin neemt je in deze presentatie mee in de voordelen van non-endemic advertising op retail media netwerken. Hij brengt ook de uitdagingen in beeld die de markt op dit moment heeft op het gebied van retail media voor niet-leveranciers.
Retail media wordt gezien als het nieuwe advertising-medium en ook mediabureaus richten massaal retail media-afdelingen op. Merken die niet in de betreffende winkel liggen staan ook nog niet in de rij om op de retail media netwerken te adverteren. Marvin belicht de uitdagingen die er zijn om echt aansluiting te vinden op die markt van non-endemic advertising.
Improving profitability for small businessBen Wann
In this comprehensive presentation, we will explore strategies and practical tips for enhancing profitability in small businesses. Tailored to meet the unique challenges faced by small enterprises, this session covers various aspects that directly impact the bottom line. Attendees will learn how to optimize operational efficiency, manage expenses, and increase revenue through innovative marketing and customer engagement techniques.
The world of search engine optimization (SEO) is buzzing with discussions after Google confirmed that around 2,500 leaked internal documents related to its Search feature are indeed authentic. The revelation has sparked significant concerns within the SEO community. The leaked documents were initially reported by SEO experts Rand Fishkin and Mike King, igniting widespread analysis and discourse. For More Info:- https://news.arihantwebtech.com/search-disrupted-googles-leaked-documents-rock-the-seo-world/
Affordable Stationery Printing Services in Jaipur | Navpack n PrintNavpack & Print
Looking for professional printing services in Jaipur? Navpack n Print offers high-quality and affordable stationery printing for all your business needs. Stand out with custom stationery designs and fast turnaround times. Contact us today for a quote!
Explore our most comprehensive guide on lookback analysis at SafePaaS, covering access governance and how it can transform modern ERP audits. Browse now!
Remote sensing and monitoring are changing the mining industry for the better. These are providing innovative solutions to long-standing challenges. Those related to exploration, extraction, and overall environmental management by mining technology companies Odisha. These technologies make use of satellite imaging, aerial photography and sensors to collect data that might be inaccessible or from hazardous locations. With the use of this technology, mining operations are becoming increasingly efficient. Let us gain more insight into the key aspects associated with remote sensing and monitoring when it comes to mining.
RMD24 | Retail media: hoe zet je dit in als je geen AH of Unilever bent? Heid...BBPMedia1
Grote partijen zijn al een tijdje onderweg met retail media. Ondertussen worden in dit domein ook de kansen zichtbaar voor andere spelers in de markt. Maar met die kansen ontstaan ook vragen: Zelf retail media worden of erop adverteren? In welke fase van de funnel past het en hoe integreer je het in een mediaplan? Wat is nu precies het verschil met marketplaces en Programmatic ads? In dit half uur beslechten we de dilemma's en krijg je antwoorden op wanneer het voor jou tijd is om de volgende stap te zetten.
Business Valuation Principles for EntrepreneursBen Wann
This insightful presentation is designed to equip entrepreneurs with the essential knowledge and tools needed to accurately value their businesses. Understanding business valuation is crucial for making informed decisions, whether you're seeking investment, planning to sell, or simply want to gauge your company's worth.
"𝑩𝑬𝑮𝑼𝑵 𝑾𝑰𝑻𝑯 𝑻𝑱 𝑰𝑺 𝑯𝑨𝑳𝑭 𝑫𝑶𝑵𝑬"
𝐓𝐉 𝐂𝐨𝐦𝐬 (𝐓𝐉 𝐂𝐨𝐦𝐦𝐮𝐧𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬) is a professional event agency that includes experts in the event-organizing market in Vietnam, Korea, and ASEAN countries. We provide unlimited types of events from Music concerts, Fan meetings, and Culture festivals to Corporate events, Internal company events, Golf tournaments, MICE events, and Exhibitions.
𝐓𝐉 𝐂𝐨𝐦𝐬 provides unlimited package services including such as Event organizing, Event planning, Event production, Manpower, PR marketing, Design 2D/3D, VIP protocols, Interpreter agency, etc.
Sports events - Golf competitions/billiards competitions/company sports events: dynamic and challenging
⭐ 𝐅𝐞𝐚𝐭𝐮𝐫𝐞𝐝 𝐩𝐫𝐨𝐣𝐞𝐜𝐭𝐬:
➢ 2024 BAEKHYUN [Lonsdaleite] IN HO CHI MINH
➢ SUPER JUNIOR-L.S.S. THE SHOW : Th3ee Guys in HO CHI MINH
➢FreenBecky 1st Fan Meeting in Vietnam
➢CHILDREN ART EXHIBITION 2024: BEYOND BARRIERS
➢ WOW K-Music Festival 2023
➢ Winner [CROSS] Tour in HCM
➢ Super Show 9 in HCM with Super Junior
➢ HCMC - Gyeongsangbuk-do Culture and Tourism Festival
➢ Korean Vietnam Partnership - Fair with LG
➢ Korean President visits Samsung Electronics R&D Center
➢ Vietnam Food Expo with Lotte Wellfood
"𝐄𝐯𝐞𝐫𝐲 𝐞𝐯𝐞𝐧𝐭 𝐢𝐬 𝐚 𝐬𝐭𝐨𝐫𝐲, 𝐚 𝐬𝐩𝐞𝐜𝐢𝐚𝐥 𝐣𝐨𝐮𝐫𝐧𝐞𝐲. 𝐖𝐞 𝐚𝐥𝐰𝐚𝐲𝐬 𝐛𝐞𝐥𝐢𝐞𝐯𝐞 𝐭𝐡𝐚𝐭 𝐬𝐡𝐨𝐫𝐭𝐥𝐲 𝐲𝐨𝐮 𝐰𝐢𝐥𝐥 𝐛𝐞 𝐚 𝐩𝐚𝐫𝐭 𝐨𝐟 𝐨𝐮𝐫 𝐬𝐭𝐨𝐫𝐢𝐞𝐬."
Putting the SPARK into Virtual Training.pptxCynthia Clay
This 60-minute webinar, sponsored by Adobe, was delivered for the Training Mag Network. It explored the five elements of SPARK: Storytelling, Purpose, Action, Relationships, and Kudos. Knowing how to tell a well-structured story is key to building long-term memory. Stating a clear purpose that doesn't take away from the discovery learning process is critical. Ensuring that people move from theory to practical application is imperative. Creating strong social learning is the key to commitment and engagement. Validating and affirming participants' comments is the way to create a positive learning environment.
chapter 10 - excise tax of transfer and business taxation
BCCT Showcase - Trials Methodology Research
1. Trials Methodology Research at
University of Birmingham
Professor Lucinda (Cindy) Billingham
Professor of Biostatistics
Director, MRC Midland Hub for Trials Methodology Research
Director of Statistics, Cancer Research UK Clinical Trials Unit
University of Birmingham
BCCT Showcase, University of Birmingham
November 27th 2013
2. The Need for Trials
Methodology Research
Users
Change
Clinical
Practice
Evidence
Synthesis
Pre-trial
Development
Add-on
translational
studies
Established
expertise
New areas
Trial Analysis
Change
Clinical
Practice
Trial
Conduct
Phase I, II, III
Trial Set-Up
and Design
3. MRC Network of Hubs for Trials
Methodology Research (HTMR)
All-Ireland Hub
led by Professor Mike Clarke
Dr Adrian Mander
www.methodologyhubs.mrc.ac.uk
4. Structure of the Midland Hub
University of Birmingham
College of Medical and Dental Sciences
School of Cancer Sciences
Cancer Research
UK Clinical Trials
Unit (CRCTU)
Birmingham
Clinical Trials
Unit (BCTU)
School of Health and Population Sciences
Primary Care
Clinical Sciences
Unit
Public Health,
Epidemiology &
Biostatistics Unit
Health
Economics Unit
Birmingham Centre for Clinical Trials (BCCT)
Billingham
Wheatley
Johnson
[Stocken]
Gray
[Ives]
Calvert
Delaney
Freemantle
Hobbs
Wilson
(Draper)
Deeks
Lilford
Zeegers
[Girling]
[Riley]
[Hemming]
Bryan
[Barton]
[Coast]
(Al-Janabi)
Billingham
Wheatley
Deeks
[Ives]
Calvert
Draper
Lilford
Deeks
Girling
Hemming
Lilford
Riley
Coast
[Barton]
Director: Professor Lucinda Billingham
Deputy Director: Dr Richard Riley
[Key collaborators who are active MHTMR researchers & MHTMR Management Group members]
(Key collaborators who are supervisors for MHTMR PhD projects)
5. Midland Hub Resources (2009-2014)
Director (60%)
Day-to-day management; support and mentorship
to RFs and PhD students; ensure successful
delivery Hub programme; networking
12 Hub Investigators
Supervision and development of research projects
and contributions to training and advisory service
3 Research Fellows
Methodological research projects
Project grant applications
Provision and coordination of advice facility
Training and support to PhD students
1 Senior
Administrator
Support Director, Investigators, Research Fellows
Support training programme and PhD students
Organise Hub meetings and events
5 PhD Students
Methodological development
Plus other affiliated RFs and PhD students
6. Mission Statement of the Midland Hub
‘The mission of the MRC Midland Hub for
Trials Methodology Research is to be a
centre of excellence for trials methodology
research, providing researchers
undertaking trials with appropriate and
innovative methodology for design,
conduct, analysis and reporting, thereby
improving the quality of trials and
ultimately patient care.’
Research Programme
Training Programme
Advice, Support and Dissemination Function
7. Qualitative research methods
Decision modelling
Economic evaluation
Evaluations of Service Delivery and
Policy Interventions
(Lilford, Girling, Hemming)
Cluster trials and stepped-wedge designs
Improving the Quality of Consent
to Trials
(Draper)
Joint modelling of longitudinal and event data
Trials in Rare Diseases
(Wheatley, Billingham)
Statistical modelling of time-to-event data
Early Phase Clinical Trials
(Billingham in collaboration
with O’Quigley)
Systematic reviews and meta-analysis methods
Stratified Medicine and Test Evaluation
(Riley, Deeks)
Bayesian methods
Outcome Measures for Trials
(Calvert, Coast, Billingham)
General clinical trial design, conduct and analysis
Key Research Themes in Midland Hub
8. Some Highlights
• Patient-reported outcomes (PRO): international collaboration to develop
the CONSORT PRO and improve standards of reporting
– Calvert M, Blazeby J, Altman D et al; Reporting of patient-reported outcomes in
randomised trials: the CONSORT PRO extension; JAMA 2013
• Stratified medicine: review to establish methodological standards for
evaluating predictive biomarkers
– Malottki K, Biswas M, Deeks J, Riley R, Craddock C, Johnson P, Billingham L;
Stratified medicine in European Medicines Agency licensing: a systematic review of
predictive biomarkers; on review with BMJ Open
– Billingham L, Deeks J, Riley R, Malottki K, Middleton G, Morton D, Craddock C;
Stratified medicine: methods for evaluating predictive biomarkers for treatment of
cancer; Grant submission to Cancer Research UK Population Research Committee
Nov 2013
• Implementing improved methodology for early phase trials in cancer in
CRCTU
– Craddock C, Yap C et al; A phase I/II trial of combined 5-azacitidine and lenalidomide
salvage therapy in patients with acute myeloid leukaemia who relapse after allogenic
stem cell transplantation; funded by Leukaemia and Lymphoma Research
9. Some Highlights (cont)
• Implementing novel designs to enable practice-changing trials in rare
cancers
– Funding for trials with novel designs in paediatric oncology run by Childrens Cancer
Trials Team in CRCTU (led by Wheatley)
– Funding from CRUK for phase III trial in penile cancer (Billingham in collaboration with
International Rare Cancers Initiative and ICR Trials Unit)
• Enhancing results of an NIHR funded trial run at BCTU that failed to
recruit using Bayesian methods
– Morris RK, Malin GL, Quinlan-Jones E, Middleton LJ, Hemming K, Burke D, Daniels JP,
Khan K, Deeks J, Kilby MD; Percutaneous vesicoamniotic shunting versus conservative
management for fetal lower urinary tract obstruction (PLUTO): a randomised trial;
Lancet 2013
• Influencing decisions of the National Research Ethics Service regarding
patient information for trials
– Kirkby HM, Calvert M, McManus RJ, Draper H; Informing potential participants about
research; observational study with an embedded randomised controlled trial; PloS one
2013
10. Looking to the Future
• Funding for the Midland Hub will cease on May 31st 2014
• The development of the Midland Hub established a
team of researchers involved in trials methodology and
– facilitated some important research projects that
should benefit trials practitioners in the future
– established an infrastructure from which to continue
as a centre of excellence for trials methodology
research into the future within BCCT
