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CORU News

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.

Attempts at surgical removal are of no benefit to asbestos cancer sufferers finds trial led by CORU's Tom Treasure

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Patients suffering from cancer of the lung cavity do not survive any longer if surgeons remove the lung and cavity linings, compared with those who do not have this major surgery. That is the conclusion of a ten-year series of studies carried out by a team at UCL and the Institute of Cancer Research led by CORU's Tom Treasure.

Pandemic flu countermeasure work published in Vaccine

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CORU's work with the UK Department of Health last year has resulted in a paper1 published in Vaccine. One of the major complications of flu is pneumonia and it was thought that vaccinating the population against pneumococcal pneumonia at the start of a pandemic might prevent deaths due to complications of flu. We built a mathematical model to investigate the potential effect of such a policy using a variety of estimates over the efficacy of the pneumonia vaccine, the virulence of the flu and the achievable coverage of such a vaccination programme. We found that there were substantial reductions in deaths only under specific circumstances - a virulent flu where most complications were due to pneumococcal pneumonia. 

CORU's work shows effects of selective citation on surgical practice

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Pulmonary Metastasectomy Citation Network

Pulmonary metastasectomy for colorectal cancer is a commonly performed and well-established practice of over 50 years standing. The absence of strong evidence, in the form of controlled studies, to support this practice led three of CORU's researchers to investigate the evidence base that has been used in establishing its status as a standard of care. Using citation network analysis on a total of 344 publications, they found frequent use of historical or landmark papers while, on the other hand, the few papers expressing opposing viewpoints were rarely cited (the four papers outside the main citation network in the figure below). They concluded that this citation pattern tends to escalate belief in clinical practice even when it lacks a high-quality evidence base and helps create an impression of more authority than is warranted.

Editorial praises CORU's simple risk stratification model

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CORU's recent work with Papworth Hospital, developing a simple stratification scheme for identfying patients at risk of excessive post-operative bleeding has been published in the European Journal of Cardio-thoracic Surgery (EJCTS)1. The work was discussed in an editorial for EJCTS2 where we were praised for the effort that went into the score and for its easy-to-use nature, facilitating its potential use across several different hospitals. 

Tom Treasure's talk is ranked among top three presentations

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Tom Treasure's presentation at the 2011 Annual Meeting of the Society of Cardiothoracic Surgery was ranked among the top three at the entire meeting. 

CORU informs national policy on pandemic flu

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CORU has informed UKpolicy on the use of vaccination against pneumonia as a countermeasure to pandemic flu.

CORU developed a mathematical model for estimating the number of deaths and hospitalisations that could be avoided by use of a vaccine against pneumonia in the advent of an influenza pandemic. This work directly informed the policy process within Department of Health and led to the Joint Committee on Vaccination and Immunisation decision that "using PPV23 as a countermeasure against pandemic influenza would not be cost effective and is not advised".

The Ekjut trial in India is selected as Trial of the Year!

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The Ekjut Trial, which Christina Pagel was a co-author on (Lancet 2010;375: 1182-92), has been recognised as Trial of the Year by the Society for Clinical Trials

Christos Vasilakis gives keynote lecture at Young OR 17 conference

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Christos Vasilakis has been invited to give a keynote talk at the biannual Young OR conference in Nottingham this April. 

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