A5028868688- Breast Cancer Treatment Studies
- Ethics in Clinical Research
- Breast Implant and Reconstruction
- Health Systems, Economic Evaluations, Quality of Life
- Patient-Provider Communication in Healthcare
- Healthcare cost, quality, practices
- Global Cancer Incidence and Screening
- COVID-19 and healthcare impacts
- Breast Lesions and Carcinomas
- BRCA gene mutations in cancer
- Healthcare Policy and Management
- Healthcare Systems and Challenges
- Sex and Gender in Healthcare
- Acute Myocardial Infarction Research
- Health Policy Implementation Science
- Central Venous Catheters and Hemodialysis
- Digital Imaging in Medicine
- Conferences and Exhibitions Management
- Participatory Visual Research Methods
- Cognitive Abilities and Testing
- Interpreting and Communication in Healthcare
- Gambling Behavior and Treatments
- Primary Care and Health Outcomes
- Ethics in medical practice
- Artificial Intelligence in Games
University of Bristol
2015-2025
At Bristol
2021-2024
The Patients Association
2023
Bristol Regional Medical Center
2022
Mount Vernon Cancer Centre
2019
National Institute for Health Research
2018-2019
Cambridge University Hospitals NHS Foundation Trust
2018-2019
University College London
2018-2019
University Hospitals Coventry and Warwickshire NHS Trust
2018
ObjectiveTo evaluate the impact of QuinteT Recruitment Intervention (QRI) on recruitment in challenging randomized controlled trials (RCTs) that have applied intervention. The QRI aims to understand difficulties and then implements "QRI actions" address these as proceeds.Study Design SettingA mixed-methods study, comprising (1) before-and-after comparisons rates numbers patients approached (2) qualitative case studies, including documentary analysis interviews with RCT...
Abstract Introduction The COVID-19 pandemic impacted the operationalisation of non-COVID-19 clinical trials globally, particularly site and participant recruitment trial success/stoppage. Trials which anticipate challenges may embed methods such as QuinteT Recruitment Intervention (QRI) to help identify understand sources challenges. Such interventions can shed light on pandemic-related This paper reports our experience impact conducting with an embedded QRI, highlighting how QRI aided in...
Abstract Background De-adoption of healthcare involves stopping or removing provision an intervention, usually because concerns about harm, effectiveness, and/or cost-effectiveness. is integral to upholding the quality and sustainability systems, but can be challenging achieve. Previous research conducted with decision-makers identified a desire for more national support identify implement de-adoption opportunities. The ‘Evidence-Based Interventions’ (EBI) programme was introduced in English...
<h2>Abstract</h2><h3>Objectives</h3> To explore how the concept of randomization is described by clinicians and understood patients in randomized controlled trials (RCTs) it contributes to patient understanding recruitment. <h3>Study Design Setting</h3> Qualitative analysis 73 audio recordings recruitment consultations from five, multicenter, UK-based RCTs with identified or anticipated difficulties. <h3>Results</h3> One 10 appointments did not include any mention randomization. Most...
Abstract Background Oncoplastic breast-conserving surgery may be a better option than mastectomy, but high-quality comparative evidence is lacking. The aim of the ANTHEM study (ISRCTN18238549) was to explore clinical and patient-reported outcomes in multicentre cohort women offered oncoplastic as an alternative mastectomy with or without immediate breast reconstruction. Methods Women invasive/pre-invasive cancer who were volume replacement displacement techniques avoid recruited...
Abstract Background Oncoplastic breast-conserving surgery may allow women with early breast cancer to avoid a mastectomy, but many undergo more extensive surgery, even when options are offered. The aim of the ANTHEM qualitative study was explore factors influencing women’s surgical decision-making for and against oncoplastic surgery. Methods Semi-structured interviews were conducted purposive sample who had received either or mastectomy without immediate reconstruction their rationale...
AimsDe-escalation trials are challenging and sometimes may fail due to poor recruitment. The OPTIMA Prelim randomised controlled trial (ISRCTN42400492) patients with early stage breast cancer chemotherapy versus 'test-directed' chemotherapy, a possible outcome of no which could confer less treatment relative routine practice. Despite encountering challenges, reached its recruitment target ahead schedule. This study reports the root causes challenges strategies used successfully overcome...
Introduction Approximately 40% of the 55 000 women diagnosed with breast cancer each year in UK undergo mastectomy because they are considered unsuitable for standard breast-conserving surgery (BCS) due to tumour size or multiple foci. Mastectomy can significantly impact women’s quality life, and only one four currently immediate reconstruction (IBR). Level 2 oncoplastic (OPBCS) combines removing a range plastic surgical volume replacement (eg, local perforator flaps) displacement techniques...
Abstract Background Informed consent is an accepted ethical and legal prerequisite for trial participation, yet there no standardised method of assessing patient understanding informed consent. The participatory (PIC) measure was developed application to recruitment discussions evaluate recruiter information provision evidence understanding. Preliminary evaluation the PIC indicated need improve inter-rater intra-rater reliability ratings conduct further psychometric evaluation. This paper...
Health systems are under pressure to maintain services within limited resources. The Evidence-Based Interventions (EBI) programme published a first list of guidelines in 2019, which aimed reduce inappropriate use interventions the NHS England, reducing potential harm and optimising Seventeen procedures were selected round, April 2019.We evaluated changes trends for each procedure after its inclusion EBI's using interrupted time series analysis. We explored whether there was any evidence...
Abstract Background In-centre nocturnal haemodialysis (INHD) offers extended-hours haemodialysis, 6 to 8 h thrice-weekly overnight, with the support of dialysis specialist nurses. There is increasing observational data demonstrating potential benefits INHD on health-related quality life (HRQoL). a lack randomised controlled trial (RCT) confirm these and assess safety. Methods The NightLife study pragmatic, two-arm, multicentre RCT comparing impact months conventional (thrice-weekly daytime...
Abstract Background: Oncoplastic breast conserving surgery (OPBCS) may allow women with cancer to avoid mastectomy, but many continue choose more extensive even when options are offered. Reasons for women’s procedure choices unclear. The UK prospective multicentre ANTHEM study (ISRCTN18238549) aimed explore the feasibility of undertaking a large-scale comparing clinical and patient-reported outcomes OPBCS as an alternative mastectomy in offered both options. qualitative phase use...
Abstract Background: Oncoplastic breast conserving surgery (OPBCS) may allow women with early cancer to avoid mastectomy leading fewer complications and better quality of life. High comparative evidence, however, is lacking. The UK ANTHEM study (ISRCTN18238549) aimed explore the feasibility undertaking a large-scale multicentre comparing clinical patient reported outcomes (PROs) OPBCS as an alternative +/- immediate reconstruction (IBR) in offered both options. Methods: Women aged 18 over...
Abstract Background:Multi-parameter tumour gene expression assays (MPAs) are widely used to estimate individual patient residual risk and guide chemotherapy use in hormone-sensitive, HER2-negative early breast cancer. The TAILORx trial supports MPA a node-negative population. Evidence for node-positive cancer is limited. OPTIMA (Optimal Personalised Treatment of usIng Multi-parameter Analysis) (ISRCTN42400492) aims validate MPAs as predictors sensitivity largely population where prospective...
At the onset of COVID-19 pandemic, elective surgical provision was severely affected by need for hospital reorganization to care critically ill patients. In response, National Health Service (NHS) England issued national guidance proposing acceptable time intervals postponing different types procedure. This study reports healthcare professionals' private accounts strategies adopted manage imbalance demand and resource, using colorectal cancer surgery as a case study.Twenty-seven...
Abstract Background:. Mammographic screening programmes have been shown to reduce breast cancer mortality. However, they detect many small tumours with favourable biological features which may not progress during a woman’s lifetime. These are treated standard surgery and adjuvant therapies, associated morbidities. Thus, there is need overtreatment of good prognosis found by screening. Minimally invasive treatment approaches described but no prospective randomised evidence support their...
TPS614 Background: Mammographic screening programmes reduce breast cancer mortality but detect many small tumours with favourable biology which may not progress. These are treated surgery and adjuvant therapies, associated morbidities mean there is a need to overtreatment. Minimally invasive treatments such as vacuum-assisted excision (VAE) have been described no prospective randomised evidence support their routine use. SMALL (ISRCTN 12240119) designed establish the feasibility of using VAE...