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Research conducted at the University of Surrey has resulted in a suite of clinically-relevant, multi-scale mathematical models being developed and used within the NHS [1-3].
One of these models, MALTHUS, now funded by the National Cancer Action Team, predicts demand for radiotherapy across England and Wales. MALTHUS is a national metric and NHS commissioners are required to use MALTHUS to justify purchases of new radiotherapy equipment. Ipswich was the first to use Malthus in evidence to justify successfully the purchase of new equipment.
This case study presents the applied research work in systems modelling, control and machine vision led by Dr Haas and its impact on radiotherapy. The research is linked to a series of collaborative projects with industry and the NHS on control systems development for clinical equipment, and the evaluation of state of the art treatments. The main impacts are:
Thyrotoxicosis (over-activity of the thyroid) affects up to 5% of the UK population and causes excess mortality, especially from vascular diseases, even in its mildest form. Thyroid cancer is the commonest endocrine cancer, its treatment being associated with adverse consequences which need to be minimised. A large programme of thyroid research in Birmingham led by Prof Jayne Franklyn has made major contributions to improving the management of thyrotoxicosis, specifically through optimal use of radioiodine treatment. Her group has developed and delivered a national training scheme to allow endocrinologists (hormone specialists) to give this treatment safely and effectively. Radioiodine is also a crucial part of treatment of thyroid cancer; Franklyn helped deliver a major trial showing that lower doses are as effective as higher doses in most cases but with fewer days in hospital and side effects. This research has changed clinical practice regarding more effective and safe use of radioiodine in thyrotoxicosis and thyroid cancer. It has been incorporated in national and international clinical guidance, patient information sources, and has directly affected clinician training and patient care pathways.
SubSafe is a high-fidelity, real-time interactive simulation of a Royal Navy (RN) submarine. The SubSafe programme has improved the delivery of spatial awareness and safety training for RN recruits, over and above legacy practices (such as PowerPoint, "chalk-and-talk" and technical manuals). It has also played a major role in influencing industrial and defence agency uptake of simulation technologies across a range of applications. UK (MoD), Australian and Canadian national strategies relating to future exploitation of simulation in training and concept visualisation have been positively influenced by the success of this programme. SubSafe has also been instrumental in launching a new, innovative games-based simulation company.
Muscle invasive bladder cancer is the sixth most common cancer and remains a major cause of death and suffering worldwide. The standard treatment for advanced bladder cancer has been surgical removal of the bladder (cystectomy) which is associated with considerable morbidity. Many (20%) patients are elderly, with significant co-morbidities and hence are high risk for a major operation. In the past patients who were not able to undergo surgery were offered palliative radiotherapy. Research at the University of Birmingham has shown that the addition of low toxicity chemotherapy to radiotherapy is as effective as cystectomy in controlling disease progression and has minimal impact on bladder function. This new approach is an excellent alternative to cystectomy and has been adopted as a new standard of care thus demonstrating considerable impact on clinical practice and patient outcome.