A5070248257- Health Systems, Economic Evaluations, Quality of Life
- Attention Deficit Hyperactivity Disorder
- Schizophrenia research and treatment
- Digital Mental Health Interventions
- Retinal Diseases and Treatments
- Acute Ischemic Stroke Management
- Healthcare Policy and Management
- Child and Adolescent Psychosocial and Emotional Development
- Mental Health Treatment and Access
- Personality Disorders and Psychopathology
- Musculoskeletal pain and rehabilitation
- Global Health Care Issues
- Antiplatelet Therapy and Cardiovascular Diseases
- Primary Care and Health Outcomes
- Retinal Imaging and Analysis
- Healthcare cost, quality, practices
- Infant Development and Preterm Care
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Stroke Rehabilitation and Recovery
- Pharmaceutical studies and practices
- Health disparities and outcomes
- Delphi Technique in Research
- Behavioral and Psychological Studies
- Emergency and Acute Care Studies
- Bone fractures and treatments
University of Nottingham
2016-2025
Queen's Medical Centre
2014-2023
University of Wales Institute Cardiff
2023
Collaborative Group (United States)
2021
Florey Institute of Neuroscience and Mental Health
2020
The University of Melbourne
2020
Austin Health
2020
Peninsula Health
2020
Eastern Health
2020
Monash Health
2020
<h3>Background</h3> Iron deficiency anaemia (IDA) occurs in 2–5% of adult men and postmenopausal women the developed world is a common cause referral to gastroenterologists. Gastrointestinal (GI) blood loss from colonic cancer or gastric cancer, malabsorption coeliac disease are most important causes that need be sought. <h3>Defining iron anaemia</h3> The lower limit normal range for laboratory performing test should used define (B). Any level investigated presence haemoglobin more likely...
Postoperative oral nutritional supplementation has been shown to be of clinical benefit. This study examined the effects and cost administration supplements both before after surgery.This was a randomized trial conducted in three centres. Patients undergoing lower gastrointestinal tract surgery were one four groups: group CC received no supplements, SS took surgery, CS postoperative only, SC given only surgery. Preoperative from time it decided operate 1 day started when patient able take...
BackgroundIntensive antiplatelet therapy with three agents might be more effective than guideline treatment for preventing recurrent events in patients acute cerebral ischaemia. We aimed to compare the safety and efficacy of intensive (combined aspirin, clopidogrel, dipyridamole) that guideline-based therapy.MethodsWe did an international, prospective, randomised, open-label, blinded-endpoint trial adult participants ischaemic stroke or transient attack (TIA) within 48 h onset. Participants...
Background Standardised Diagnostic Assessment tools, such as the Development and Well‐Being (DAWBA), may aid detection diagnosis of emotional disorders but there is limited real‐world evidence their clinical or cost effectiveness. Methods We conducted a multicentre, two‐arm parallel group randomised controlled trial in eight large National Health Service Trusts England providing multidisciplinary specialist Child Adolescent Mental Services (CAMHS). Participants (5–17 year‐olds with...
<h3>Objectives</h3> Data on costs associated with acute upper gastrointestinal bleeding (AUGIB) are scarce. We provide estimates of UK healthcare costs, indirect and health-related quality life (HRQoL) for patients presenting to hospital AUGIB. <h3>Setting</h3> Six university hospitals >20 AUGIB admissions per month, >400 adult beds, 24 h endoscopy, on-site access intensive care surgery. <h3>Participants</h3> 936 aged ≥18 years, admitted AUGIB, enrolled between August 2012 March 2013...
It is challenging to engage repeat users of unscheduled healthcare with severe health anxiety in psychological help and high service costs are incurred. We investigated whether clinical economic outcomes were improved by offering remote cognitive behaviour therapy (RCBT) using videoconferencing or telephone compared treatment as usual (TAU). A single-blind, parallel group, multicentre randomised controlled trial was undertaken primary general hospital care. Participants aged ≥18 years ≥2...
Diagnosis of attention deficit hyperactivity disorder (ADHD) relies on subjective methods which can lead to diagnostic uncertainty and delay. This trial evaluated the impact providing a computerised test activity (QbTest) report speed accuracy decision-making in children with suspected ADHD.Randomised, parallel, single-blind controlled mental health community paediatric clinics England. Participants were 6-17 years-old referred for ADHD assessment; all underwent assessment-as-usual, plus...
The top 3% of frequent attendance in primary care is associated with 15% all appointments care, a fivefold increase hospital expenditure, and more mental disorder functional somatic symptoms compared to normal attendance. Although often temporary if these rates last than two years, they may become persistent (persistent or regular attendance). However, there no long-term study the economic impact clinical characteristics care. Cognitive behaviour formulation treatment (CBT) for as motivated...
Most frequent attendance in primary care is temporary, but persistent expensive and may be suitable for psychological intervention. To plan appropriate intervention service delivery, there a need research involving standardized psychiatric interviews with assessment of physical health status. compare the mental characteristics status attenders (FAs) care, currently over preceding 2 years, normal (NAs) matched by age, gender general practice. Case–control study 71 FAs (30 or more GP practice...
Aims It is unclear if a supportive bandage, removable splint, or walking cast offers the best outcome following low-risk ankle fractures in children. The aim of this study was to evaluate feasibility randomized controlled trial compare these treatments. Methods Children aged five 15 years with were recruited from 1 February 2020 30 March 2023. for two weeks. Follow-up at two, six, and 12 weeks undertaken determine definitive trial. Outcomes collected included complications, Patient-Reported...
Abstract Aims/hypothesis Using variable diabetic retinopathy screening intervals, informed by personal risk levels, offers improved engagement of people with diabetes and reallocation resources to high-risk groups, while addressing the increasing prevalence diabetes. However, safety data on extending intervals are minimal. The aim this study was evaluate cost-effectiveness individualised, variable-interval, risk-based population compared usual care, wide-ranging input from individuals...
Introduction Currently, all people with diabetes (PWD) aged 12 years and over in the UK are invited for screening diabetic retinopathy (DR) annually. Resources not increasing despite a 5% increase numbers of PWD nationwide each year. We describe rationale, design methodology randomised controlled trial (RCT) evaluating safety, acceptability cost-effectiveness personalised variable-interval risk-based DR. This is first DR largest ophthalmic RCT UK. Methods analysis attending seven clinics...
Chondral defects of the knee cartilage are prevalent. Autologous chondrocyte implantation (ACI) and mosaicplasty increasingly used to treat symptomatic defects. This study assessed costs health status outcomes after ACI mosaicplasty.Patients were eligible participate in this cross-sectional if they received or at Royal National Orthopaedic Hospital between 1997 2001 on a waiting list for ACI. Secondary-care resource use was collected 2 years postoperatively using collection proforma....
Objective. Local steroid injections and community-based physiotherapy have been shown to be of similar benefit for treating shoulder pain presenting primary care. This paper presents a cost consequences analysis prospective economic evaluation, conducted alongside randomized clinical trial (RCT) corticosteroid versus new episodes unilateral pain, determine the implications injection physiotherapy.
Asthma affects one in eight children the UK. National management guidelines have been available for many years but, unlike adults, studies few, with their methodologies often based on inappropriate adult models. Sound medical evidence support of national asthma is lacking. The MASCOT study has developed to address this need.To determine whether adding salmeterol or montelukast low-dose inhaled corticosteroids (ICSs) can reduce number exacerbations requiring treatment oral uncontrolled...
Introduction The National Institute for Health and Care Excellence (NICE) guidelines attention deficit/hyperactivity disorder (ADHD) state that young people need to have access the best evidence-based care improve outcome. current ‘gold standard’ ADHD diagnostic assessment combines clinical observation with subjective parent, teacher self-reports. In routine practice, reports from multiple informants may be unavailable or contradictory, leading uncertainty delay. addition of objective tests...
The aim of this study is to develop a core set outcome domains that should be considered and reported in all future trials childhood limb fractures.A four-phase was conducted agree domains. Identification candidate were identified through systematic review trials, relevant families semi-structured interviews with 20 (parent-child pairing or group). Outcome prioritized using an international three-round Delphi survey 205 panellists then condensed into consensus workshop 30 stakeholders.The 85...
To produce a priority list for purchasers to use when purchasing elective care in the speciality of orthopaedics so that efficiency health (that is, maximising benefit per unit resource available resident population) can be achieved.The study used cost utility analysis orthopaedics. The diagnostic groups were chosen on basis those conditions constituted greatest proportion orthopaedic waiting list, and consequently activity within speciality. Costs derived by two methods: extra contractual...
Cost-effectiveness and cost-utility analyses were conducted to compare advice exercise plus manual therapy (MT) pulsed shortwave diathermy (PSWD) with alone (A&E) in the treatment of non-specific neck disorders by experienced physiotherapists.Between July 2000 June 2002, 350 participants from 15 physiotherapy departments randomized to: A&E (n = 115); MT 114) PSWD 121). Outcome resource-use data collected using physiotherapist case report forms participant self-complete questionnaires....
Most frequent attendance in primary care is temporary. Long-term may be suitable for psychological intervention to address health management and service use.To explore the feasibility acceptability of cognitive behaviour therapy (CBT) long-term obtain preliminary evidence regarding clinical cost effectiveness.A CBT case series was carried out five GP practices East Midlands.Frequent attenders (FAs) were identified from notes invited by their practice assessment, then offered CBT. Feasibility...
The Covid-19 pandemic and mitigation approaches, including lockdowns school closures, are thought to have negatively impacted children young people's (CYP) mental health. However, the impact for clinically referred CYP is less clear. We investigated differences in health of specialist Child Adolescent Mental Health Services (CAMHS) before since onset pandemic. Using baseline data (self- parent- completed Mood Feelings Questionnaire Strengths Difficulties Questionnaire) from an ongoing RCT...