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Research at the University of Sheffield has demonstrated that zoledronic acid is an effective and safe treatment for osteoporosis. It resulted in a new drug intervention (Aclasta/Reclast) which has been licensed in more than 100 countries and shows increased positive outcomes for patients.
As a result of the licensing of the drug, clinical guidelines have changed globally. For patients, the drug provides a preferred method of treatment, evidenced in surveys which show the majority of patients preferred an annual infusion of zoledronic acid to the alternative, which is the standard treatment of weekly oral alendronate.
Industry has invested in research and development of the drug. Novartis has funded studies into the efficacy and safety profile (up to 2012); in 2011, sales of Aclasta/Reclast were US$0.6 billion.
The Cambridge-led Emerging Risk Factors Collaboration (ERFC) is a global consortium involving individual-participant data on 2.5 million participants from 130 cohort studies. The ERFC has helped optimise approaches to cardiovascular disease (CVD) risk assessment by: 1) quantifying the incremental predictive value provided by assessment of risk factors 2) evaluating the independence of associations between risk factors and CVD and 3) addressing uncertainties related to the implementation of screening. ERFC publications on lipids, lipoproteins, and inflammation biomarkers have been cited by 9 guidelines published since 2010, including those of the European Society of Cardiology and the American Heart Association.
QRISK is a new algorithm which predicts an individual's risk of cardiovascular over 10 years. It was developed using the QResearch database and is in routine use across the NHS. It is included in national guidelines from NICE and the Department of Health and in the GP quality and outcomes framework. It is incorporated into > 90% of GP computer systems as well as pharmacy and secondary care systems. The web calculator has been used >500,000 times worldwide. ClinRisk Ltd was incorporated in 2008 to develop software to ensure the reliable widespread implementation of the QRISK algorithm into clinical practice.
QRisk is a statistical model / score derived from routine general practice (GP) records to calculate an individual's risk of developing cardiovascular disease (CVD). Queen Mary researchers formed the London arm of a multi-centre study and were particularly instrumental in testing the tool in general practice. QRisk targets treatment more effectively than other scores; it is also more equitable for disadvantaged and minority ethnic groups and cheaper per event prevented. QRisk is used in the NHS Health Checks programme covering 20 million people in England and is available at a keystroke in all GP computer systems in England. It has contributed to the identification of an additional 2.8 million people in England at high risk of CVD and their treatment with statins, reducing CVD deaths and events by an estimated 9,000 per year — about 50,000 to date since the NHS Checks programme started in 2009.
Venous Thromboembolism (VTE) is a disease which comprises of Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE). In 2005, VTE typically caused 25,000 - 32,000 deaths a year, at a typical annual cost to the National Health Service of £640 million (House of Commons Health Select Committee, 2005). However, this disease is mostly preventable (NICE, 2007).
The Autar DVT risk assessment scale was developed to enable clinicians to stratify patients by their risk of developing DVT. The scale exceeded expectations, leading to the introduction of the first mandatory VTE risk assessment tool nationally and shifting the focus of VTE management from reactive treatment (which is resource exhaustive) to very cost effective, proactive, prevention.
The scale continues to be used (both nationally and internationally), and to have impacts that are both financial (cost savings for hospitals) and relate to the wellbeing of patients, both through improved quality of life and reduced morbidity.
Research at the University of Sheffield to evaluate the cost-effectiveness of different treatments for women with osteoporosis was used by the National Institute of Health and Care Excellence (NICE) to develop their guidance on the condition. The evaluation model was the first to combine cost-effectiveness of both treatment and screening and to include more detailed categorisation of patients. The model was used by NICE in their 2005, 2008 and 2011 guidance, which is mandatory for the NHS in England and Wales, and, therefore, since 2008 has influenced the treatment of over two million women with osteoporosis.
RVC's Veterinary Epidemiology, Economics and Public Health team (VEEPH) has been at the forefront of applying and evaluating new techniques for modelling disease risk, for policy and decision makers to use in surveillance and control of animal and zoonotic infections. Application of their recommendations, including European `Commission Decision' legislation, is contributing to ensuring that Europe remains free from African swine fever (ASF). The status of FAO Reference Centre in Veterinary Epidemiology, awarded by the United Nations' Food and Agriculture Organisation in 2012, recognises the RVC as a centre of excellence in this field and reinforces its role in guiding policies relating to animal health.
A new method for classifying aircraft accidents and modelling the effectiveness of runway end safety areas was developed by Pitfield and colleagues at Loughborough University (1997-present) to improve global airfield safety. It was adopted by the US Airports Cooperative Research Program in 2008, validated at eight airports, and empirically applied at three, including San Francisco and Toronto (2009-2010). It resulted in: the use of enhanced aircraft accident modelling methodologies by aviation practitioners; improvements to global airport risk assessment and safety management regimes; the utilisation of empirical techniques by a commercial consultancy; and evidence being presented to the 2011 UK Public Inquiry into the proposed expansion of London Ashford Airport.
Approximately 25,000 people in the UK die each year from venous thromboembolism (VTE); furthermore, VTE affects 1 in 100,000 women of childbearing age and causes one-third of all maternal deaths. Thrombophilia, pregnancy and the use of oral oestrogens can all place women at increased risk of VTE when compared with other individuals. University of Glasgow researchers quantified the probability of VTE among at-risk women and analysed the benefits and cost-effectiveness of thrombophilia screening. Their research is cited in the recommendations and evidence bases of leading national and international clinical guidelines. This work also galvanised an overhaul of VTE prevention policy within NHS Scotland by emphasising the need for regional health boards to implement and audit standardised in-house protocols and provide accessible patient information on VTE.
Our research has led to the development of guidelines on the diagnosis of deep vein thrombosis (DVT), reducing the risk of death and saving resources by reducing unnecessary tests and treatments.
Meta-analysis and decision-analysis modelling studies undertaken at the University of Sheffield between 2005 and 2007 formed the basis of the National Institute for Health and Clinical Excellence (NICE) and the American College of Chest Physicians (ACCP) guidelines for diagnosing DVT. These guidelines determine the management of over 140,000 patients each year in the United Kingdom with suspected DVT, and many more in other countries.