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Informing national policy to increase prescribing of statins for the prevention of heart disease

Summary of the impact

University of Sheffield research which evaluated the clinical and cost-effectiveness of statins for the primary and secondary prevention of cardiovascular events has directly led to an additional 3.3 million people in England and Wales becoming eligible for this treatment. Statins have been shown to reduce the risk of future cardiovascular events, such as heart attacks and stroke.

Guidance on statin prescribing in England and Wales, issued by the National Institute for Health and Care Excellence (NICE) Appraisal Committee in January 2006 was informed by our research report. Following this guidance the number of patients receiving statins has increased year on year with the number of prescriptions increasing by 29% between 2007 and 2011, enabling these patients to benefit from reduced risk of heart attacks and stroke and CVD related deaths.

Submitting Institution

University of Sheffield

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

FRAX, an international tool for the assessment of fracture risk

Summary of the impact

Research at the University of Sheffield has resulted in FRAX, the first internationally-applicable fracture risk calculator that provides individualised 10-year probabilities of major osteoporotic fractures from readily available clinical risk factors. It has replaced bone mineral density (BMD) as the sole quantitative measure of fracture risk, thus increasing global access to risk assessment and improving targeting of treatment to patients at highest risk. FRAX is incorporated widely into national and international guidelines for osteoporosis management. Launched in 2008, it now provides country-specific calculations for 53 nations, in 28 languages. The online tool alone recently processed its 6.6 millionth calculation.

Submitting Institution

University of Sheffield

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Informing guidance for treatment of women with osteoporosis

Summary of the impact

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.

Submitting Institution

University of Sheffield

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Improved diagnosis of Clostridium difficile infection through two-stage testing

Summary of the impact

Clostridium difficile infection (CDI) is a frequent and often fatal hospital-acquired infection. In the past, the diagnosis of CDI has been inadequate. This has had serious consequences for the management and control of infection in healthcare settings. Planche and colleagues at St George's have developed and validated a new diagnostic algorithm for CDI. This has led to policy changes in the UK Department of Health, and amongst European and US authorities, and to practical changes in the way CDI is diagnosed. Its implications for the successful understanding and management of this infection have been profound.

Submitting Institution

St George's, University of London

Unit of Assessment

Clinical Medicine

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Neurosciences, Public Health and Health Services

The Management of Deep Vein Thrombosis (DVT) using the AUTAR Scale

Summary of the impact

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.

Submitting Institution

De Montfort University

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Spatiotemporal Undersampling for Highly Accelerated MRI

Summary of the impact

Imaging speed is of critical importance in most Magnetic Resonance (MR) imaging applications. King's College London (KCL) researchers have developed spatiotemporal undersamplings, or "k-t" methods, for three-dimensional (3D) imaging and corresponding image reconstruction methods that have increased the speed of imaging significantly, so that particular scans are now 5-7 fold faster. This has directly impacted the experience of the patient whose overall examination time has been reduced from more than 1 hour to less than 30 minutes depending on the application. The technology has been patented and has been implemented by Philips Healthcare, one of the three major manufacturers of MR equipment. A clinical solution platform for 3D MR cardiac perfusion and quantitative flow imaging, based on the technology developed at KCL, has also been launched by the Swiss company, GyroTools LLC.

Submitting Institution

King's College London

Unit of Assessment

General Engineering

Summary Impact Type

Technological

Research Subject Area(s)

Physical Sciences: Other Physical Sciences
Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Neurosciences

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