A5025610333- Health Systems, Economic Evaluations, Quality of Life
- Child Abuse and Trauma
- Digital Mental Health Interventions
- Acute Ischemic Stroke Management
- Employment and Welfare Studies
- Renal cell carcinoma treatment
- Gestational Diabetes Research and Management
- Colorectal Cancer Screening and Detection
- Substance Abuse Treatment and Outcomes
- Geriatric Care and Nursing Homes
- Mobile Health and mHealth Applications
- Bariatric Surgery and Outcomes
- Intraperitoneal and Appendiceal Malignancies
- Renal and related cancers
- Behavioral Health and Interventions
- Lung Cancer Treatments and Mutations
- Maternal and Perinatal Health Interventions
- Cancer Immunotherapy and Biomarkers
- Ovarian cancer diagnosis and treatment
- Appendicitis Diagnosis and Management
- Pregnancy and preeclampsia studies
- Healthcare Systems and Practices
- Cerebrovascular and Carotid Artery Diseases
- Global Health Care Issues
- Clinical practice guidelines implementation
University College London
2015-2024
National Institute for Health Research
2021-2022
UCL Australia
2018
University of London
2018
Universidad de Londres
2018
Imperial College London
2011-2015
Charing Cross Hospital
2015
Boehringer Ingelheim (United Kingdom)
2015
Imperial College Healthcare NHS Trust
2015
London Business School
2011
Background and Purpose— Recently, 5 randomized controlled trials demonstrated the benefit of endovascular therapy compared with intravenous tissue-type plasminogen activator in acute stroke. Economic evidence evaluating stent retrievers is limited. We cost-effectiveness alone versus mechanical thrombectomy as a bridging eligible patients UK National Health Service. Methods— A model-based cost-utility analysis was performed using lifetime horizon. Markov model constructed populated...
There is little strong evidence relating to the impact of single-room accommodation on healthcare quality and safety. We explore all single rooms staff patient experience; safety outcomes; costs.Mixed methods pre/post 'move' comparison within four nested case study wards in a acute hospital with 100% rooms; quasi-experimental before-and-after two control hospitals; analysis capital operational costs associated rooms.Two-thirds patients expressed preference for comfort outweighing any...
The identification of patients with advanced liver fibrosis secondary to non-alcoholic fatty disease (NAFLD) remains challenging. Using non-invasive tests (NILT) in primary care may permit earlier detection clinically significant for specialist review, and reduce unnecessary referral mild disease. We constructed an analytical model assess the clinical cost differentials such strategies. A probabilistic decisional simulated a cohort 1000 NAFLD over 1 year from healthcare payer perspective....
Importance The diagnosis of rare diseases and other genetic conditions can be daunting due to vague or poorly defined clinical features that are not recognized even by experienced clinicians. Next-generation sequencing technologies, such as whole-genome (WGS) whole-exome (WES), have greatly enhanced the expanding ability sequence a large part genome, rendering cost-effectiveness comparison between them necessary. Objective To assess WGS compared with WES conventional testing in children...
There is a paucity of high-level evidence on small renal mass (SRM) management, as previous classical randomised controlled trials (RCTs) failed to meet accrual targets. Our objective was assess the feasibility recruitment cohort-embedded RCT comparing cryoablation (CRA) robotic partial nephrectomy (RPN). A total 200 participants were recruited cohort, whom 50 enrolled in RCT. In RCA intervention arm, 84% consented (95% confidence interval [CI] 64–95%) and 76% CI 55–91%) received CRA; 100%...
Digital interventions, including apps and websites, can be effective for reducing alcohol consumption. However, many are not evidence- or theory-informed have been evaluated. We tested the effectiveness of Drink Less app consumption compared with usual digital care in UK.
Background New hospital design includes more single room accommodation but there is scant and ambiguous evidence relating to the impact on patient safety staff experiences. Objectives To explore of move a newly built acute with all rooms care delivery, working practices, experience, outcomes costs. Design (1) Mixed-methods study inform pre-/post-‘move’ comparison within hospital, (2) quasi-experimental in two control hospitals (3) analysis capital operational costs associated rooms. Setting...
Abstract Child maltreatment is a major public health problem with significant consequences for individual victims and society. In this paper, we quantify the first time economic costs of fatal nonfatal child in UK relation to several short‐, medium‐, long‐term outcomes ranging from physical mental problems labor market welfare use. We combine novel regression analysis rich data National Development Study English Longitudinal Aging secondary evidence produce an incidence‐based estimate...
Objective To determine if use of point care testing (POCT) is less costly than laboratory to the National Health Service (NHS) in delivering NHS Check (NHSHC) programme primary setting. Design Observational study and theoretical mathematical model with microcosting approach. Setting We collected data on NHSHC delivered at nine general practices (seven using POCT; two not POCT). Participants recruited offering a pathology services same area. Methods conducted modelling permutations following...
Orthopaedic procedures, such as total hip replacement and knee replacement, are among the commonest surgical procedures in England. The Getting it Right First Time project (GIRFT) aims to deliver improvements quality reductions cost of NHS orthopaedic care across country. We will examine whether planned changes have delivered patient outcomes. also study processes involved developing implementing care, professional organisational factors influencing these processes. In doing so, we identify...
Background Recently, two randomized controlled trials demonstrated the benefit of mechanical thrombectomy performed between 6 and 24 h in acute ischemic stroke. The current economic evidence is supporting intervention only within h, but extended treatment times may result better long-term outcomes for a larger cohort patients. Aims We compared cost-utility addition to medical versus alone beyond from stroke onset UK National Health Service (NHS). Methods A analysis was using Markov model...
We aimed to estimate the clinical effectiveness of Community Occupational Therapy for people with dementia and family carers-UK version (Community in Dementia-UK [COTiD-UK]) relative treatment as usual (TAU). hypothesised that COTiD-UK would improve ability perform activities daily living (ADL), carers' sense competence, compared TAU.The study design was a multicentre, 2-arm, parallel-group, assessor-masked, individually randomised controlled trial (RCT) internal pilot. It conducted 15 sites...
The extent to which interventions are perceived as acceptable users impacts engagement and efficacy.
It is unknown whether endovascular thrombectomy (EVT) cost effective in large ischemic core infarcts.In the prospective, multicenter, cohort study of imaging selection (SELECT), was defined as computed tomography (CT) ASPECTS<6 or perfusion (CTP) volume (rCBF<30%) ≥50 cc. A Markov model estimated costs, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratio (ICER) EVT compared with medical management (MM) over lifetime. The willingness to pay (WTP) per QALY set at $50...
BackgroundSickle cell disease (SCD) is an inherited blood disorder which may result in a broad range of complications including recurring and severe episodes pain—sickle 'crises'—which require frequent hospitalizations. We assessed the cost hospitalizations associated with SCD crisis England.
The preoperative diagnosis of gallstone ileus is challenging due to the variability its presentation, often resulting in late diagnosis. Controversy remains regarding management ileus; surgery standard treatment, but also less invasive approaches have proven be successful. We present an unusual case and conservative treatment. describe a 49-year-old Caucasian woman with bowel sub-occlusion, treated conservatively. imaging technique (plain abdominal X-ray computed tomography scan) led...
We aim to outline the annual cost of setting up and running a standard, local, multi-professional obstetric emergencies training course, PROMPT (PRactical Obstetric Multi-Professional Training), at Southmead Hospital, Bristol, UK - unit caring for approximately 6500 births per year.A retrospective, micro-costing analysis was performed. Start-up costs included purchasing mannequins teaching props, printing materials assembly emergency boxes (real training). The variable administration time,...
Introduction Small renal masses (SRMs; ≤4 cm) account for two-thirds of new diagnoses kidney cancer, the majority which are incidental findings. The natural history SRM seems largely indolent. There is an increasing concern regarding surgical overtreatment and associated health burden in terms morbidity economy. Observational data support safety efficacy percutaneous cryoablation but there unmet need high-quality evidence on non-surgical management options a head-to-head comparison with...
National Health Service (NHS) 111 helpline was set up to improve access urgent care in England, efficiency and cost-effectiveness of first-contact health services. Following trusted, authoritative advice is crucial for improved clinical outcomes. We examine patient call-related characteristics associated with compliance given NHS calls. The importance interactions that are not face-to-face has recently been highlighted by COVID-19 pandemic. In this retrospective cohort study, call records...