Danny J N Wong

My PhD Title: Critical Care Provision After Surgery

Supervisors: S. Ramani Moonesinghe (Primary), Steve K. Harris (Secondary)

Lay summary: Surgery is a treatmemt for many medical disorders, but it has associated risks as well as benefits. Critical care (a term including both intensive care and high dependency care) is thought to reduce mortality and morbidity arising from surgery. However, previous evidence suggests that high-risk patients are not consistently admitted to critical care units after their operations. My research looks to answer these following questions: 1. How do clinicians estimate postoperative risk? 2. How accurate are currently available risk prediction tools? 3. How do clinicians decide which patients to admit for postoperative critical care? 4. What factors influence patient admission to postoperative critical care? 5. Does immediate critical care admission reduce postoperative complications?

My Background I am a medical doctor specialising in Anaesthesia and have been caring for patients since 2008. I was interested in how we as clinicians deploy our treatments and make decisions about the management of patients given the knowledge we have about the risks and benefits of our interventions, and given the resource constraints we work under. I am a 2017 Fellow of the Software Sustainability Institute, a national facility for cultivating and improving research software to support world-class research. I contribute to the Data Science for Docs course, which aims to teach medical professionals basic concepts, skills, and tools for working more effectively with data. I am also a Fellow of the Royal College of Anaesthetists and Member of the Royal College of Physicians (UK).

Qualifications

Awards

Publications Peer Reviewed Articles

E. Palmer, S. Ciechanowicz, A. Reeve, S. Harris, D. Wong, Sultan P. Operating room-to-incision interval and neonatal outcome in emergency caesarean section: a retrospective 5-year cohort study. Anaesthesia. 2018 Apr 6. doi: 10.1111/anae.14296

SR. Moonesinghe, D. Wong, L. Farmer, et al for the SNAP-2 Project team and Steering Group. SNAP-2 EPICCS: the second Sprint National Anaesthesia Project-EPIdemiology of Critical Care after Surgery: protocol for an international observational cohort study BMJ Open 2017;7:e017690. doi: 10.1136/bmjopen-2017-017690

HW. Gan, D. Wong, B. Dean, AS. Hall. Do expanded seven-day NHS services improve clinical outcomes? Analysis of comparative institutional performance from the "NHS Services, Seven Days a Week" project 2013-2016. BMC Health Services Research. 2017 Aug 10;17:552. doi: 10.1186/s12913-017-2505-8

D. Wong, CM. Oliver, SR. Moonesinghe. Predicting Postoperative Morbidity in Adult Elective Surgical Patients using the Surgical Outcome Risk Tool (SORT). British Journal of Anaesthesia. 2017, Jul;119(1):95-105. doi: 10.1093/bja/aex117

D. Wong, J. Bedford, S. Luck, R. Bloomer. Evaluating Services at a Major Trauma Centre Before Helipad Construction. Air Medical Journal. 2017, Jan;36(1):34-6. doi: http://dx.doi.org/10.1016/j.amj.2016.11.007

D. Wong, A. Wickham. A Survey of Intensive Care Unit Discharge Communication Practices in the United Kingdom. J Intensive Care Soc. 2013, Oct; Vol 14(4):330-333. doi: 10.1177/175114371301400411

M.L. Starkey, M. Davies, P.K. Yip, L.M. Carter, D. Wong, S.B. McMahon, E.J. Bradbury. Expression of the regeneration-associated protein SPRR1A in primary sensory neurons and spinal cord of the adult mouse following peripheral and central injury. J Comp Neurol. 2009. 513(1):p. 51-68. doi: 10.1002/cne.21944

Publications - Books and Book Chapters

H. Montgomery, L. Camporota, O. Orhan, D. Wong, Z. Puthucheary, D. Antcliffe, A. Joy, S. B. Luks, M. Smith, T. Joy, J. Bichard, V. Nangalia, K. Zadrazilova, I. Stone, P. Dlouhy. The Intensive Care Foundation Handbook of Mechanical Ventilation: A User's Guide. London, UK: The Intensive Care Foundation. 2015. ISBN: 978-0-9555897-1-3. (e-book available free from: http://members.ics.ac.uk/ICS/handbooks.aspx)

Publications - Conference Abstracts

D. Wong, J. Bedford, M. Chazapis, L. Farmer, D. Saunders, S. Harris, S. Moonesinghe. Postoperative critical care facilities in the UK: not as simple as 1-2-3. Anaesthesia 2018, 73, (Suppl. 2), 125. doi: 10.1111/anae.14190

S. Hashim, D. Wong, L. Farmer, S. Harris, S. Moonesinghe. The perceptions of UK clinicians towards postoperative critical care. Anaesthesia 2018, 73, (Suppl. 2), 131. doi: 10.1111/anae.14190

D. Wong, C. Oliver, S. Moonesinghe. The postoperative morbidity survey as a tool to predict postoperative length of stay. Anaesthesia 2017, 72, (Suppl. 2), 75. doi: 10.1111/anae.13789

D. Wong, S. Harris. Interhospital critical care transfer delays result from organisational not geographical factors: secondary analysis of deteriorating ward patients in 49 UK hospitals. Critical Care. 2015, 19(Suppl 1):P510. doi: 10.1186/cc14590

D. Wong, A. Wickham. A Survey of Intensive Care Unit Discharge Communication Practices in the United Kingdom. Supplement October 2012: Abstracts ESICM LIVES 2012 25th Annual Congress Lisbon, Portugal 13-17 October 2012. Intensive Care Med. 2012 Oct; 38 Suppl 1:S69-70.

K. Zadrazilova, D. Wong, A. Lewis, N. Richard, R. Jennings, T. Wu, S. Gillis, M. Kuper. Can A Hospital 'Intranet' Guideline Improve Management Of Severe Sepsis? Supplement October 2009: Abstracts 22nd ESICM Annual Congress Vienna, Austria 11-14 October 2009. Intensive Care Med. 2009 Sep; 35 Suppl 1:S33.

Publications - Letters and Correspondence

D. Wong. Cox Regression Models for Frailty in Vascular Surgery Patients. Anaesthesia. 2016 Sep;71(9): 1117-18. doi:10.1111/anae.13580

D. Wong. Training in the Ethics of Audit, Quality Improvement and Research. Anaesthesia. 2016 Sep;71(9): 1113-14. doi:10.1111/anae.13586

D. Wong. Seven day services: how relevant is the junior doctors' contract? BMJ. 2016; 352:i1576. doi: 10.1136/bmj.i1576

D. Wong. Conflating odds ratio with "risk." BMJ. 2014; 349:g6291-g6291. doi: 10.1136/bmj.g6291

D. Wong, A. Wickham. The UK needs more critical care investment in order to improve peri-operative outcomes. Anaesthesia. 2012 May;67(5):541. doi: 10.1111/j.1365-2044.2012.07162.x.

D. Wong. Public and private providers coexist in Singapore. BMJ. 2012, Jan 24;344:e561. doi: 10.1136/bmj.e561.

D. Wong. Correspondence regarding: Putting a price on life. J Intensive Care Soc. 2011, Oct; Vol 12(4):344. doi: 10.1177/175114371101200427

D. Wong. Measure for measure. BMA News. 2011, July 16.

Publications - Others

D. Wong. PreopDrugs: Preop Medication Advice. Web application and Software source code. https://dannyjnwong.shinyapps.io/PreopDrugs/

D. Wong. SORTMorbidityWebCalc: a web implementation of the SORT-morbidity tool to calculate risk of postoperative morbidity in adult elective surgical patients. Web application and Software source code. https://dannyjnwong.shinyapps.io/SORTMorbidityWebCalc/

S. Harris, A. Al-Hindawi, F. Catling, E. Palmer, D. Wong. Data Science for Docs. Bulletin 104 of The Royal College of Anaesthetists. July 2017 p. 12-13

D. Wong, S. R. Moonesinghe. SNAP-2: Epidemiology of Critical Care provision after Surgery (EPICCS) Coming to Your Hospital Soon! Bulletin 102 of The Royal College of Anaesthetists. Mar 2017 p. 20-22

D. Wong. JDPayCalc: Junior Doctors' Pay Calculator. Software source code (Github repository). https://github.com/dannyjnwong/JDPayCalc/tree/0.5. doi: 10.5281/zenodo.56805

D. Wong, S. R. Moonesinghe. The 2nd Sprint National Anaesthesia Project:

Epidemiology of Critical Care provision after Surgery. Bulletin 95 of The Royal College of Anaesthetists. Jan 2016 p. 18-19

NELA project team. First patient report of the National Emergency Laparotomy Audit. RCoA London. 30 June 2015 (Produced the Thematic Map on the cover of the report).

Appointments

Research Fellow, National Institute of Academic Anaesthesia, Health Services Research Centre

Intensive Care Fellow, The London Clinic

ST5 Anaesthetic Specialty Registrar, South London School of Anaesthesia

Contact details  Email: danny.wong@ucl.ac.uk; dwong@rcoa.ac.uk

Twitter: @dannyjnwong

Personal website: http://dannyjnwong.github.io