A5001597281- Esophageal and GI Pathology
- COVID-19 and healthcare impacts
- Esophageal Cancer Research and Treatment
- Gastric Cancer Management and Outcomes
- Healthcare cost, quality, practices
- Gastroesophageal reflux and treatments
- Meta-analysis and systematic reviews
- Clinical Nutrition and Gastroenterology
- Cardiac, Anesthesia and Surgical Outcomes
- Colorectal Cancer Screening and Detection
- Pancreatic and Hepatic Oncology Research
- Abdominal Surgery and Complications
- Surgical Simulation and Training
- Gastrointestinal disorders and treatments
- Clinical practice guidelines implementation
- Health Systems, Economic Evaluations, Quality of Life
- Ethics in Clinical Research
- Surgical site infection prevention
- Data-Driven Disease Surveillance
- Health Policy Implementation Science
- Bariatric Surgery and Outcomes
- Body Contouring and Surgery
- Patient Safety and Medication Errors
- HIV/AIDS Research and Interventions
- Thermal Regulation in Medicine
Frimley Health NHS Foundation Trust
2022
Frimley Park Hospital
2020-2021
Imperial College London
2015-2021
Royal Marsden Hospital
2016-2020
Royal Surrey County Hospital
2008-2020
St Mary's Hospital
2018
St. Mary's Hospital
2018
National Institute for Health Research
2015-2017
NIHR Leeds In Vitro Diagnostics Co-operative
2017
St Mary's Hospital
2016-2017
Objectives Point-of-care (POC) C reactive protein (CRP) is incorporated in National Institute of Health and Care Excellence (NICE) guidelines for the diagnosis pneumonia, reduces antibiotic prescribing cost effective. Aim To determine barriers facilitators to adoption POC CRP testing Service (NHS) primary care lower respiratory tract infection. Design The study followed a qualitative methodology based on grounded theory. was undertaken 2 stages. Stage 1 consisted semistructured interviews...
Objective: To identify the most prevalent symptoms and those with greatest impact upon health-related quality of life (HRQOL) among esophageal cancer survivors. Background: Long-term symptom burden after esophagectomy, associations HRQOL, are poorly understood. Patients Methods: Between 2010 2016, patients from 20 European Centers who underwent surgery, were disease-free at least 1 year postoperatively asked to complete LASER, EORTC-QLQ-C30, QLQ-OG25 questionnaires. Specific questionnaire...
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...
The existing British National Patient Safety Agency (NPSA) safety guideline recommends testing the pH of nasogastric (NG) tube aspirates. Feeding is considered safe if a 5.5 or lower has been observed; otherwise chest X-rays are recommended. Our previous research found that at 5.5, test lacks sensitivity towards oesophageal placements, major risk identified by feeding experts. aim this to use decision analytic modelling approach systematically assess under cut-offs 1-9.We mapped out care...
Objective Endoscopic mucosal resection (EMR) is established for the management of benign and early malignant upper GI disease. The aim this observational study was to establish effect endoscopist procedural volume on mortality. Design Patients undergoing EMR between 1997 2012 were identified from Hospital Episode Statistics database. primary outcome 30-day mortality secondary outcomes 90-day mortality, requirement emergency intervention elective cancer re-intervention. Risk-adjusted...
(i) To establish at a national level clinical outcomes from patients presenting with acute para-esophageal hernia (PEH); and (ii) to determine if hospital volume-outcome relationship exists for the management of PEH.Currently, no clear guidelines exist regarding PEH, practice patterns are based upon relatively small case series.Patients admitted as an emergency treatment PEH between 1997 2012 were included Hospital Episode Statistics database. The influence volume was analyzed in unmatched...
The recent COVID-19 pandemic led to the cancellation of elective surgery across United Kingdom. Re-establishing in a manner that ensures patient and staff safety has been priority. We report our experience outcomes from setting up "COVID protected" robotic unit for colorectal renal housed both da Vinci Si (Intuitive, Sunnyvale, CA, USA) Versius (CMR Surgical, Cambridge, UK) systems. was undertaken day-surgical attached main hospital. A standard operating procedure developed collaboration...
Abstract Background This study aimed to develop the Point-of-Care Key Evidence Tool (POCKET); a multi-dimensional checklist guide evaluation of point-of-care tests (POCTs) incorporating validity, utility, usability, cost-effectiveness and patient experience. The motivation for this was improve efficiency evidence generation in POCTs reduce lead-time adoption novel POCTs. Methods A mixed qualitative quantitative approach applied. Following literature search, three round Delphi process...
Aims (1) To model the process of use and usability pH strips (2) to identify, through simulation studies, likelihood misreading strips, assess professional's acceptance, trust perceived strips. Methods This study was undertaken in four phases used a mixed method approach (an audit, semi-structured interview, survey study). The three months audit 24 patients, interview performed with 19 health professionals informed A 134 novices explored misinterpreting Standardised questionnaires were...
To develop and provide validity feasibility evidence for the QUality of Information Transfer (QUIT) tool.Prompt escalation care in setting patient deterioration can prevent further harm. Escalation information transfer skills are not currently measured surgery.This study comprised 3 phases: development (phase 1), validation 2), analysis 3) QUIT tool. Phase 1 involved identification core needed successful through literature review 33 semistructured interviews with stakeholders. 2 generation...
Objectives Public and patient engagement (PPE) is fundamental to healthcare research. To facilitate effective in novel point-of-care tests (POCTs), the test downstream consequences of result need be considered. Sequential simulation (SqS) a tool represent journeys effects intervention at each subsequent stages. This case study presents process evaluation SqS as for PPE development volatile organic compound-based breath POCT diagnosis oesophagogastric (OG) cancer. Setting Three 3-hour...
Objectives This study investigated the barriers and facilitators to adoption of point-of-care tests (POCTs). Design Qualitative incorporating a constant comparative analysis stakeholder responses series interviews undertaken design Point-of-Care Key Evidence Tool. Setting The was conducted in relation POCTs used all aspects healthcare. Participants Forty-three stakeholders were interviewed including clinicians (incorporating laboratory staff members trust POCT committees), commissioners,...
Introduction Point-of-care in vitro diagnostics (POC-IVD) are increasingly becoming widespread as an acceptable means of providing rapid diagnostic results to facilitate decision-making many clinical pathways. Evidence utility, usability and cost-effectiveness is currently provided a fragmented detached manner that fraught with methodological challenges given the disruptive nature these tests have on pathway. The Key Tool (POCKET) checklist aims provide integrated evidence-based framework...
Data on the long-term symptom burden in patients surviving oesophageal cancer surgery are scarce. The aim of this study was to identify most prevalent symptoms and their interactions with health-related quality life.This a cross-sectional cohort who underwent 20 European centres between 2010 2016. Patients had be disease-free for at least 1 year. They were asked complete 28-symptom questionnaire single time point, year after surgery. Principal component analysis used assess clustering...
Robotic surgery for colorectal cancer has become established more slowly than in other specialities. The aim of this study was to assess the risks and benefits use robotic rectal comparison with laparoscopic within confines a subspecialist service district general hospital.Outcomes from consecutive patients undergoing minimal access between July 2008 January 2020 were analysed. Comparisons made short-term outcomes including conversion rates, anastomotic leakage pathological as well long-term...
Sarcomas are rare and heterogeneous solid tumours of mesenchymal origin frequently have an aggressive course. The mainstay management for localized disease is surgical excision. Following excision there approximately 30-50% risk developing distant metastases. role pancreatic resection metastatic sarcoma unclear. Therefore, the aim this study was to asses outcome patients with metastases treated resection.A retrospective analysis a prospectively maintained single-surgeon, single-centre...
NG (nasogastric) tubes are used worldwide as a means to provide enteral nutrition. Testing the pH of tube aspirates prior feeding is commonly verify location before or medication. A at lower than 5.5 was taken evidence for stomach intubation. However, existing standard strips lack sensitivity, especially in patients receiving and antacids We developed validated first-generation ester-impregnated strip test improve accuracy towards gastric placements adult population routine NG-tube feeding....