A5080425689- Health Systems, Economic Evaluations, Quality of Life
- Cardiac, Anesthesia and Surgical Outcomes
- Aortic aneurysm repair treatments
- Obstructive Sleep Apnea Research
- Primary Care and Health Outcomes
- Tracheal and airway disorders
- Diabetes Management and Education
- Dysphagia Assessment and Management
- Health Policy Implementation Science
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Geriatric Care and Nursing Homes
- Vascular Procedures and Complications
- Orthopedic Surgery and Rehabilitation
- Musculoskeletal Disorders and Rehabilitation
- Bone fractures and treatments
- Liver Disease Diagnosis and Treatment
- Rheumatoid Arthritis Research and Therapies
- Ultrasound in Clinical Applications
- Frailty in Older Adults
- Healthcare Policy and Management
- Meta-analysis and systematic reviews
- Chronic Disease Management Strategies
- Renal and Vascular Pathologies
- Health and Medical Research Impacts
- Palliative Care and End-of-Life Issues
University of Surrey
2020-2024
Washington University in St. Louis
2023
AstraZeneca (United States)
2022
Brunel University of London
2013-2020
The University of Texas MD Anderson Cancer Center
2018-2019
Environment and Health Group (United States)
2016
Texas Endosurgery Institute
2015
National Hyperbaric Centre
2012
Torbay Hospital
2010
University of Arkansas at Little Rock
2008
Building on an approach applied to cardiovascular and cancer research, we estimated the economic returns from United Kingdom public- charitable-funded musculoskeletal disease (MSD) research that arise net value of improved health outcomes in Kingdom. To calculate MSD-related Kingdom, (1) public charitable expenditure between 1970 2013; (2) monetary benefit (NMB), derived quality adjusted life years (QALYs) valued terms (using a base-case QALY £25,000) minus cost delivering benefit, for...
Building on an approach developed to assess the economic returns cardiovascular research, we estimated from UK public and charitable funded cancer-related research that arise net value of improved health outcomes. To these in estimated: 1) expenditure 1970 2009; 2) monetary benefit (NMB), is, measured quality adjusted life years (QALYs) valued terms (using a base-case QALY GB£25,000) minus cost delivering benefit, for prioritised list interventions 1991 2010; 3) proportion NMB attributable...
Abstract Background Implementation of the National Health Service abdominal aortic aneurysm (AAA) screening programme (NAAASP) for men aged 65 years began in England 2009. An important element evidence base supporting its introduction was economic modelling long-term cost-effectiveness screening, which based mainly on 4-year follow-up data from Multicentre Aneurysm Screening Study (MASS) randomized trial. Concern has been expressed about whether this conclusion still holds, given early...
<h3>Rationale</h3> Mandibular advancement devices (MADs) are used to treat obstructive sleep apnoea-hypopnoea syndrome (OSAHS) but evidence is lacking regarding their clinical and cost-effectiveness in less severe disease. <h3>Objectives</h3> To compare clinical- of a range MADs against no treatment mild moderate OSAHS. <h3>Measurements methods</h3> This open-label, randomised, controlled, crossover trial was undertaken at UK centre. Adults with Apnoea-Hypopnoea Index (AHI) 5–<30/h...
Background The effectiveness of exercise for improving hand and wrist function in people with rheumatoid arthritis (RA) is uncertain. Objectives study aims were (1) to estimate the clinical cost-effectiveness adding an optimised programme hands upper limbs standard care patients RA; (2) qualitatively describe experience participants trial a particular emphasis on acceptability intervention, behaviours reasons adherence/non-adherence. Design A pragmatic, multicentred, individually randomised...
A third of deaths in the UK from ruptured abdominal aortic aneurysm (AAA) are women. In men, national screening programmes reduce AAA and cost-effective. The benefits, harms, cost-effectiveness offering a similar programme to women have not been formally assessed, this was aim study.We developed decision model assess predefined outcomes death caused by AAA, life years, quality-adjusted costs, incremental ratio for population invited versus who were screening. discrete event simulation set up...
Background Obstructive sleep apnoea–hypopnoea (OSAH) causes excessive daytime sleepiness (EDS), impairs quality of life (QoL) and increases cardiovascular disease road traffic accident risks. Continuous positive airway pressure (CPAP) treatment is clinically effective but undermined by intolerance, its cost-effectiveness borderline in milder cases. Mandibular advancement devices (MADs) are another option, evidence lacking regarding their clinical effectiveness disease. Objectives (1) Conduct...
Background Coronavirus disease-2019 was associated with significant mortality and morbidity in care homes 2020–1. Repurposed antiviral drugs might reduce through reducing viral transmission, infection, replication inflammation. We aimed to compare the safety efficacy of potential home residents. Methods designed a cluster-randomised, open-label, blinded end-point platform trial test postexposure prophylaxis paradigm. Participants aged 65+ years from United Kingdom homes, or without nursing,...
In the ASTER study, mediastinal staging was more accurate for patients randomised to combined endobronchial and endoscopic ultrasound, followed by surgical if endoscopy negative, versus alone. Here, we report survival, quality of life cost effectiveness up 6 months, UK, The Netherlands Belgium, separately. Survival in two arms study similar. all three countries, endosonography strategy had slightly higher quality-adjusted years over cheaper. Therefore, based on clinical accuracy...
Quality improvement collaboratives (QICs) bring together multidisciplinary teams in a structured process to improve care quality. How QICs can be used support healthcare homes is not fully understood.A realist evaluation develop and test programme theory of how work homes. A multiple case study design considered implementation across 4 sites 29 Observations, interviews focus groups captured contexts mechanisms operating within QICs. Data analysis classified emerging themes using...
Use of bystander video livestreaming from scene to Emergency Medical Services (EMS) is becoming increasingly common aid decision making about the resources required. Possible benefits include earlier, more appropriate dispatch and clinical financial gains, but evidence sparse.
The Treatment Escalation Plan (TEP) was introduced into our trust in an attempt to improve patient involvement and experience of their treatment hospital embrace clarify a wider remit options than the Do Not Resuscitate (DNR) order currently offers. Our suggests that family are rarely engaged DNR discussions. This is acutely relevant considering Mental Capacity Act (MCA) now obliges these discussions take place. TEP form doctor completes, ideally with competent or close relative, documenting...
Abdominal aortic aneurysm (AAA) screening programmes have been established for men in the UK to reduce deaths from AAA rupture. Whether or not should be extended women is uncertain. To evaluate cost-effectiveness of population AAAs and compare a range options. A discrete event simulation (DES) model was developed provide clinically realistic screening, surveillance, elective emergency repair operations. Input parameters specifically were employed. The run 10 million women, with parameter...
Markov models are often used to evaluate the cost-effectiveness of new healthcare interventions but they sometimes not flexible enough allow accurate modeling or investigation alternative scenarios and policies. A model previously demonstrated that a one-off invitation screening for abdominal aortic aneurysm (AAA) men aged 65 y in UK subsequent follow-up identified AAAs was likely be highly cost-effective at thresholds commonly adopted (£20,000 £30,000 per quality adjusted life-year)....