New papers co-authored by IHI researchers

Novel strategies to promote physical activity (PA) in adolescence are urgently required. The vEngage study ultimately aims to test whether a virtual reality (VR) exergaming intervention can produce sustained increases in PA in adolescents. However, an essential part of intervention development is to conduct formative work with target users. The study shows that use of VR to promote PA in adolescents is very promising, and the appeal to girls is particularly encouraging. However, important concerns and barriers were raised, and key elements that should be incorporated into a VR for health intervention were identified  

Farič N, Yorke E, Varnes L, Newby K, Potts HWW, Smith L, Hon A, Steptoe A, Fisher A. Adolescents' perceptions and attitudes about physical activity, exergaming and virtual reality: A qualitative intervention development study. JMIR Serious Games (in press). doi: 10.2196/11960

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How does gender influence the choice to specialise in general practice, surgery, psychiatry, paediatrics, anaesthetics etc.? And how does gender affect who is successful? In a new paper published in BMJ Open, a team led by Dr Kath Woolf (UCL Research Department of Medical Education) and also including Dr Henry Potts (UCL Institute of Health Informatics), analysed routinely collected data on over 10000 junior doctors. The study found that sex segregation across specialties is largely due to differential application, but female doctors are statistically significantly more likely to be offered places on paediatric and GP training, and more likely to accept places on GP training.

Woolf K, Jayaweera H, Unwin E, Keshwani K, Valerio C, Potts H. Effect of sex on specialty training application outcomes: A longitudinal administrative data study of UK medical graduates. BMJ Open 2018; 9, e025004. doi: 10.1136/bmjopen-2018-025004

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Lukasz Cieply, who now works at Public Health England, did an MSc in Health Informatics at the UCL Institute of Health Informatics. His dissertation project, supervised by Dr Henry Potts, was the basis for a new paper just published in Epidemiology and Infection.

Significant numbers of individuals are living with blood-borne viruses – notably HIV, hepatitis B and hepatitis C – but have not been diagnosed. Traditionally, testing has been targeted in high risk groups, like those attending genitourinary medicine clinics. However, there is now a drive to expand the availability of testing. One testing site that could be effective at reaching more vulnerable and underserved populations is the hospital emergency department, but the question remains whether infection rates are high enough to make this worthwhile. As part of a broader programme of work, this study aimed to estimate the prevalence of HIV, HBV and HCV infections among those attending two London emergency departments. This was done using anonymised, residual blood samples from people where blood was taken as part of their routine care. Rates of infection were found that support offering testing in these contexts. Seroprevalence rates for all three viruses were above those for the general population, providing evidence that higher risk groups for blood-borne viruses may attend urban emergency departments.

Cieply L, Simmons R, Ijaz S, Kara E, Rodger A, Rosenberg W, McGuinness A, Mbisa JL, Ledesma J, Ohemeng-Kumi N, Dicks S, Potts H, Lattimore S, Mandal S. Seroprevalence of HCV, HBV and HIV in two inner-city London Emergency Departments. Epidemiology and Infection 2019; 147, e145.
doi: 10.1017/S0950268819000360

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Male doctors are more likely to be sanctioned by the General Medical Council (GMC), but it has been unclear why. Dr Emily Unwin, a PhD student at UCL with Prof Jane Dacre, Dr Katherine Woolf and Dr Henry Potts, examined sex differences in tests of competence carried out by the GMC on GPs under investigation with performance concerns.

Female doctors did better on the tests of competence than male doctors. Test performance predicted the final decision, whether the GP was sanctioned or not. There was no independent effect of sex on outcome after controlling for test performance.

Unwin E, Woolf K, Dacre J, Potts HWW. Sex differences in fitness to practise test scores: A cohort study of GPs. British Journal of General Practice 2019; online first. doi: 10.3399/bjgp19X701789

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A review of learning health systems concludes that they are inheriting unresolved challenges from the implementation of electronic health records (EHRs). If learning health systems are to deliver their goal of ubiquitous personalised health care, challenges with EHRs need to be solved, which includes patients, clinicians and ethics committees having trust that the EHR will protect privacy. Stakeholder involvement – including patients – in the development and implementation of EHRs and broader health information systems is a key facilitator to realising the promise of these technologies. The work was led by Scott McLachlan of QMUL, with a team including Henry Potts at the UCL Institute of Health Informatics.
 

McLachlan S, Dube K, Johnson O, Buchanan D, Potts HWW, Gallagher T, Fenton N. A framework for analysing learning health systems: Are we removing the most impactful barriers? Learning Health Systems 2019; Early View: e10189. doi: 10.1002/lrh2.10189