Maternal Mortality
Network Analysis
Selection Bias


PRAiS2 work published in the Annals of Thoracic Surgery

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The PRAiS2 project, led by Principal Investigator Christina Pagel, built on the earlier PRAiS project, which developed a risk-adjustment model equation for mortality after paediatric cardiac surgery. The PRAiS (Partial Risk Adjustment in Surgery) model, and computer software that implements it, uses risk factors to estimate the chance of death within 30 days of surgery. This helps clinical teams to take account of the types of patient they have operated upon when studying their recent survival data.

Dr Sonya Crowe Appointed Lecturer in Operational Research

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We are delighted to announce that Dr Sonya Crowe has been appointed to a new permanent position at UCL CORU as Lecturer in Operational Research.

New parent-led website that opens up NHS children's heart surgery data to families launches

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CORU’s Christina Pagel has led an NIHR funded project to develop a new webtool that launches today that makes published NHS survival statistics accessible to everyone.  

Christina Pagel wins prestigious Harkness Fellowship

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Dr Christina Pagel, Reader in UCL’s Clinical Operational Research Unit (CORU) and the UCL Department of Applied Health Research (DAHR), has been awarded a Harkness Fellowship in Health Care Policy and Practice by The Commonwealth Fund. Considered one of the most prestigious in health policy, up to sixteen Harkness Fellowships are awarded each year, of which four are to candidates from the U.K. In the U.K., the Harkness Fellowships are co-sponsored by the National Institute for Health Research (NIHR) and The Health Foundation

Martin Utley and Sonya Crowe win OR Society Goodeve Medal

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Goodeve 2014

Alongside co-authors Peter Bennett and Maren Daraktchiev of the Department of Health (DH), Martin Utley and Sonya Crowe of CORU were presented with the OR Society’s Goodeve Medal on 26 November.

The award was made in recognition of the most outstanding contribution to the philosophy, theory or practice of OR published in the Journal of the OR Society (JORS) in 2014. The winning paper “Use of modelling to inform public health policy: a case study on the blood-borne transmission of variant-CJD” was based on one of the research projects CORU has taken on as part of the responsive facility we provide to DH to support Health Protection policy.  

The citation for the award read:

“Since the identification of variant Creutzfeldt–Jacob (mad cow) disease in the late 1980s, the possibility that this disease might be passed on via blood transfusion in humans has presented challenging policy questions for Government and blood services in the UK. This study is an excellent example of effective collaboration between Operational Researchers, expert clinicians and decision makers in predicting the future impact of vCJD infections and to evaluate the likely impact of counter measures to alleviate the spread. The challenge to OR was to develop (relatively simple) models using realistic assumptions to predict future infections from very few observations, when the transmission rate is low and the development of the disease is long term – in fact this study could be labelled ‘OR with Small Data’! The model’s predictions conformed to the observed data and enabled certain assumed rates of infection to be dismissed as unrealistic. The model was endorsed by the clinicians and the likely future scenarios generated were then used by the decision makers to inform government policy.”

For further information, please contact a.wilshere@ucl.ac.uk or 020 76794509.

Improving risk adjustment in the PRAiS model - PRAiS2

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Improving risk adjustment in the PRAiS model for mortality after paediatric cardiac surgery and improving public understanding of its use in monitoring outcomes (PRAiS2)

Prof. Steve Gallivan

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We deeply regret to announce the death of Professor Steve Gallivan after a period of illness. Steve joined CORU in 1985 and served as our Director between 1995 and 2007. He made an immense contribution to the life and work of the unit, and to the application of operational research to health care internationally. His contribution to OR was recognised by the Canadian Operational Research Society in 2009 when it awarded Steve the prestigious Harold Larnder Prize. His influence on the work we do remains.

UK death rates for children’s heart surgery have almost halved over past decade

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Deaths within 30 days of children’s heart surgery have almost halved in the UK over the past decade, despite a rise in the number and complexity of cases during that period, reveals an analysis of national data, published in the online journal Open Heart.

CORU's Tom Treasure discusses colorectal cancer in the BMJ

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Professor Tom Treasure discusses in the BMJ this month the story behind a 20 year old trial on colorectal cancer that has just been published.

Health research partnership launches to tackle major health challenges

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A new collaboration of health researchers across the NHS, world-leading universities, local authorities, clinical commissioning groups, industry and charities is launching today to lead and join up innovative research that will tackle some of the major health challenges in the north Thames region. 

Editorial published in Heart discussing the benefits and risks of monitoring mortality

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We have written an editorial on the importance of monitoring mortality following heart surgery in children, but also on the limitations on making inferences based on the comparison of risk-adjusted outcomes between hospitals. The editorial has been published this week as an open access article in the journal Heart.

CORU's work with the Department of Health's health protection team continues

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CORU has been providing the UK Department of Health’s (DH) health protection team with academic advice and operational research responsive to DH policy priorities. The contract to provide this work has now been extended for another two years so that CORU analysts will continue to provide an external perspective to pressing policy questions. The responsive nature of the work means that our work will address policies of relevance to current policy and feed into decisions making. We are delighted to continue our long standing association with the UK Department of Health. 

Funding bid to understand complications following children's heart surgery successful!

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CORU is a co-applicant on a successful bid to the National Institute of Health Research's Health Services & Delivery Research Programme (NIHR HS&DR) to select, define and evaluate important complications following heart surgery in children. The project is led by Great Ormond Street Hospital for Children and will also involve clinical teams from University Hospitals Bristol, Royal Hospital For Sick Children in Glasgow, Birmingham Children’s Hospital and Evelina Children’s Hospital in London. The Children's Heart Federation is also a co-applicant on the bid and will help facilitate planned work with patients and their families.

UCL Partners successful in bid to host a new £9 million CLAHRC!

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Professor Rosalind Raine, director of the UCL Department of Applied Health Research has led a successful nine million pound bid to launch a new London CLAHRC (Collaboration for Leadership in Applied Health Research and Care) funded by the National Institute for Health Research (NIHR). The CLAHRC will be hosted at Barts Health NHS Trust, to start in January 2014 for five years.

CORU work helps child heart teams get clearer picture of their results

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For the first time, teams that care for children needing heart surgery have been able to review their short-term results across all the different operations they perform.

Is surgery to remove secondary cancer always a good thing?

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In this week’s BMJ (1), Tom Treasure and Martin Utley of UCL’s Clinical Operational Research Unit challenge the utility of repeated surgery for sarcoma which became accepted practice 40 years ago. Sarcoma is the name given to cancers of the structural tissues of the body (bone, muscle, fat) as opposed to organs (breast, lung, prostate). Sarcoma, particularly of bone, tends to affect younger people and if it spreads it tends to be by blood borne seeding in the lungs where the nodules of secondary cancer are called metastases. They can be removed by surgery - an operation called metastasectomy.

Sonya Crowe awarded Improvement Science Fellowship by the Health Foundation!

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Dr Sonya Crowe of CORU has been awarded an Improvement Science Fellowship by the Health Foundation, one of five appointments to develop and champion a rigorous, scientific approach to improving the quality of healthcare in the emerging field of improvement science. Sonya will be mentored by Martin Utley and by Professor Naomi Fulop of the UCL Department of Applied Health Research and is funded for three years from March 2013, one of several collaborative endeavours between these groups.

Health financing website receives positive feedback!

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Last year, Save the Children launched a health financing website (equitablehealthfinancing.org) designed with the help of Christina Pagel and Martin Utley of CORU and colleagues at the UCL Institute of Global Health. We initially reported on this last year, but now early reviews are in! Preliminary feedback has proven very positive and we are hopeful that this methodology could become a new way to bridge the gap between academic evidence and policy.

CORU article highlights challenges in implementing modelling toolkits

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CORU’s work on the NIHR funded project “Developing evidence based and acceptable stepped care systems in mental health care: an operational research project” has highlighted some of the challenges in implementing modelling software and distributing it effectively to healthcare managers. Our work on this has just been published in the Journal of Operational Research.

Number of people living with cancer set to increase significantly

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Martin Utley of CORU contributed to work at Thames Cancer Registry, Kings College London to project the number of people living with or beyond cancer in the coming decades. The work has generated a lot of interest and is described in recent articles in The Guardian and The Independent newspapers and BBC News Online.

CORU's visual outcome monitoring tool (VLAD) goes global!

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Over fifteen years ago, researchers at CORU collaborated with heart surgeons to produce charts that could be used to monitor risk-adjusted outcomes following surgery in a routine manner. These charts are called Variable Life-Adjusted Displays (VLAD) Charts and are now routinely used in cardiac units across the UK and internationally. VLAD Charts have also started to be used to monitor other outcomes, almost always in hospital settings, and almost always in high income contexts. They are most useful for allowing users to quickly spot trends in outcomes that might warrant further investigation or aid understanding of a dataset.

CORU's Skilled Birth Attendance paper is a BMC Highly Accessed paper!

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Our paper on the scale of unattended births over the next five years in sub-Saharan Africa and South Asia has become a BMC Highly Accessed paper just over two weeks after its publication!  

CORU projections of skilled birth attendance rates in world's poorest regions published

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Sonya Crowe, Christina Pagel and Martin Utley have been working with Anthony Costello, director of the UCL Insitute of Global Health, to assess the extent to which women in two of the world's poorest regions (South Asia and sub-Saharan Africa) will continue to give birth without a skilled birth attendant (SBA).

Marfan aortic aneurysm: Golesworthy wins Healthcare Award

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The project team

CORU partner Tal Golesworthy (left in the project team photo below) was awarded The Engineer's Medical & Healthcare Award at The Royal Society.  Golesworthy in 2004 became the first person fitted with the External Aortic Root Support (EARS) implant which he had himself devised. A process engineer, Golesworthy worked with MRI scans, CAD and rapid prototyping technology to design and manufacture the textile external support which has NICE Technology Appraisal in the UK.

Save the Children launch website designed with CORU's help

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Health financing summary

Save the Children have just launched a health financing website (equitablehealthfinancing.org) designed with the help of Christina Pagel and Martin Utley of CORU and colleagues at the Centre for International Health and Development. The website aims to help policy makers in low and middle income countries navigate the complex evidence around different ways of financing a health system, especially given the gradual phasing out of fees at point of use. The website uses a variety of methods to summarise the evidence of a rapid literature review, fully exploiting web architecture by including cross-referencing and searchable and sortable tables. Most innovative are new ‘scattar plots' (a combination of scatter and radar) showing a graphical summary of the evidence of impact for different tools (see also figure) where the distance of each study (dot) from the centre depends on how closely the context of that study matches the country of the user.

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