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What We Do

Our ethos is to generate insight and find practical solutions to real problems. We use mathematical modelling, computer simulation and quantitative analysis to tackle a range of problems in health and health care, choosing whatever approach is most suited to the problem at hand. Key to our success is that we work very closely with clinicians and other experts to ensure our work is informed by and relevant to their experience. It is our flexibility in methodological approach, our ability to spot opportunities for cross-fertilisation and our extensive collaborative network that enables CORU to undertake projects across a very broad range of disciplines and problems.

Some of our current and recent projects

LOCAL NATIONAL
GLOBAL
Managing heart transplant programmes Risk modelling in congenital heart surgery Navigating the evidence on health financing
Organisation of hospital pharmacies The role of pneumococcal vaccine in a flu pandemic Maternal health in Africa
Workforce planning in a cardiac intensive care unit Modelling the effectiveness of triage to intensive care The scale of unattended deliveries in Asia and Africa
The monitoring of surgical wound infections
Trends in cancer prevalence International Trials

LOCAL

Modelling concerning the use of bridging technologies in heart transplantation programmes


It is possible to prolong the life of some children awaiting heart transplantation using “bridging” technologies. We are working with surgeons, cardiologists and intensivists at Great Ormond Street Hospital to address a number of questions raised by the availability of this expensive resource. Bridging may increase the chance of an individual patient receiving a transplant and of a donated organ being used. However, these benefits need to be considered alongside the opportunity costs associated with the prolonged use of intensive care beds and the fact that for some patients this burdensome intervention will prove unavailing.

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Organisation of hospital pharmacies

Pharmacy simulation workflow

CORU has an ongoing collaboration with colleagues from the School of Pharmacy and Imperial College Healthcare NHS Trust in work related to the operation of in hospital pharmacy dispensers and the provision of feedback to physicians on prescribing errors.

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Workforce planning in a cardiac intensive care unit

Cardiac workforce planning

In a short exercise working with consultant intensivists, we compared patterns of admission to cardiac intensive care to staffing levels by time of day and day of week. This work informed decisions regarding future staffing of the unit concerned.

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The monitoring and reporting of surgical wound infections

SWIM Tool

Hospital acquired infections such as MRSA are a major concern for clinicians and for the public. As part of our work in the area of improving patient safety, we are working with microbiologists at University College London Hospital to develop practical tools to assist with the monitoring and reporting of surgical wound infections. We aim to provide clinicians with an early-warning system that will help identify, in a timely fashion, trends in infection rates and also to standardise and automate the reporting of the occurrence of surgical wound infections to clinical teams. By alerting clinicians to potential problems, the hope is that this work will result in a reduction in the number of surgical wound infections and, consequently, save many lives and reduce post-operative morbidity. 

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NATIONAL

Risk modelling in congenital heart surgery

Monitoring outcomes of congenital heart surgery

Audit and clinical governance in adult cardiac surgery have benefited greatly from the existence of a widely accepted model for the risk of peri-operative death and tools developed within CORU for monitoring risk-adjusted outcomes. No widely accepted risk model exists for use in congenital heart surgery, partly due to the great diversity in diagnoses, co-morbidities and surgical procedures. CORU is working with surgeons and intensivists at Great Ormond Street Hospital for Children and the Central Cardiac Audit Database to establish whether the routine adjustment of surgical outcomes for case mix is feasible.

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Evaluating the role of pneumococcal vaccine in an influenza pandemic

PPV fig

We 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.

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Modelling the effectiveness of triage to intensive care

Triage Flowchart

Working with consultant intensivists from Great Ormond Street Hospital, we developed simple analytical models to inform thinking concerning processes of triage to determine access to critical care during a pandemic. Our work focussed attention on the need to be clear as to the objectives of triage and explored the nature and scale of differences that would have to exist between different patient groups for triage to have the intended benefits.

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Trends in cancer prevalence

Cancer prevalence

CORU is working with colleagues at the Thames Cancer Registry to build mathematical models for estimating cancer prevalence over the coming decades. Ultimately, our aim is to provide estimates as to the number of people at each of a number of stages of their disease or recovery with a view to informing the provision of health care and other services for this growing section of the population. Image courtesy of King's College London.

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GLOBAL

Navigating the Evidence of Health Financing

Health Financing Options

We have been working with colleagues at the UCL Centre for International Health and Development and Save the Children to review the published evidence on the impact and feasibility of different models of health financing. The second part of the project involved developing a web based tool that will allow policy makers to explore and navigate the evidence generated by the literature review with respect to their own contexts and concerns. This tool is due to be launched in the spring of 2011.

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Maternal health in Africa

Maternal Mortality Interventions

Insufficient progress had been made towards meeting the Millennium Development Goals of reducing maternal mortality rates. We built a mathematical model of the key steps during and after childbirth which can lead to maternal death from haemorrhage or sepsis. We used this model to estimate the potential impact of a range of interventions aimed at increasing women's access to life-saving medicines.

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The scale of unattended deliveries in Asia and Africa

Relationship between mortality and birth attendance

A key step to reducing maternal mortality in Asia and Africa is to increase access to skilled attendance at birth. In 2008, less than half of women gave birth with a skilled attendant in many parts of Asia and Africa. However, access cannot be increased overnight, and many women will continue to give birth without skilled attendance in the years to come. In such contexts, policy makers might choose to implement policies aimed at preventing death in unattended births, alongside policies aimed at increase access to skilled attendance.
We used existing data and simple mathematics to estimate a plausible range for the absolute number of women giving birth without a skilled attendant in each county in South Asia and sub-Saharan Africa over the next five years, to help inform short-term policy. Graphic from WHO. 

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International Trials

Women's Group


We assisted in the analysis of two trials published in the Lancet in 2010 on the effect of community women’s groups on neonatal deaths in India and Bangladesh. Following up on this work, CORU contributed to UCL consultancy work for the Department of International Development to examine the potential for extending community interventions in India to address malnutrition.
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