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Breast cancer affects 1/9 women accounting for significant healthcare resources. The Centre for Magnetic Resonance Investigations in Hull have demonstrated that the addition of MRI to conventional triple assessment does not reduce the re-operation rate for most patients, but instead exposes them to unnecessary investigations. These studies have underpinned the formulation of British, European and American Guidelines on optimal utilisation of MRI in women with early breast cancer scheduled for local excision. The knowledge is widely available on Cancer Help web-sites, helping patients to understand their treatment better. The resulting changes in clinical practice have reduced delays in surgery improving patient treatment whilst saving healthcare resources.
Research at the University of Manchester (UoM) has changed the landscape of medical care and research in fungal infections internationally. The impacts include: the world's first commercialised molecular diagnostic products for aspergillosis and Pneumocystis pneumonia (£10m investment); pivotal contributions to the preclinical development (£35m investment), clinical developments and registrations of 3 new antifungals with combined market share of ~$2 billion; one (voriconazole, 2012 sales >$750m worldwide) now first line therapy for invasive aspergillosis with improved survival of 15-20%; and internationally validated methods to detect azole resistance in Aspergillus (an emerging problem partly related to environmental spraying of azole fungicides for crop protection).
Early diagnosis of major brain diseases, especially in children, is a crucial yet largely unmet clinical need. Since 1996 Aston University researchers have pioneered the development and clinical application of Magnetoencephalography (MEG). The team's research now supports the UK's first and largest clinical pre-surgical evaluation programme in partnership with leading neurosurgery centres. This work has had the following impacts (2008 — date) on health services, patient welfare and commerce:
Lung cancer is the commonest cause of cancer-related mortality worldwide. The University of Manchester (UoM) Lung Cancer Group has generated insights that underpin new standards of care in the treatment of advanced, metastatic small cell (SCLC) and non-small cell lung cancer (NSCLC), contributed to the results required for licensing of new drugs and secured approval for new treatment regimens now in routine clinical use internationally. Key contributions include an increase in survival of 23% in advanced NSCLC with the use of chemotherapy and doubling one-year survival from 13% to 27% in patients with incurable, extensive stage SCLC by the use of prophylactic cranial irradiation. The Group's research has impacted on outcomes for thousands of patients worldwide.
15m people have a stroke each year worldwide. In England alone, stroke generates direct care costs of £3bn and a wider economic burden of £8bn. Service users report high levels of unmet need in relation to cognitive dysfunction (e.g. concentration). Improving cognition was the number one priority agreed by users and providers (James Lind Alliance, Lancet Neurology 2012). Research led by the University of Manchester (UoM) underpins recommendations in several recent clinical guidelines for stroke management and rehabilitation in the UK and internationally. Our 2012 aphasia trial and qualitative study made key contributions to the recommendations in the recent NICE (2013) and Intercollegiate Stroke Working Party (2012) guidelines. UoM-led Cochrane reviews (e.g., neglect, apraxia, perception) have directly influenced recommendations in guidelines produced by the Scottish Intercollegiate Guidelines Network, the European Stroke Organization and the Australian National Stroke Foundation.
Falls are a common (30-40% >65 year olds fall each year) and important age-related health problem costing the NHS and social care >£5.6m each day. University of Manchester research has contributed to reducing the burden of falls worldwide.
We demonstrated that falls are better predictors of fracture than bone mineral density. We developed an effective intervention, reducing falls amongst older people by 30%; identified barriers to service use, and approaches to increasing uptake and adherence; and developed a fear of falling instrument (FES-I), now translated into 30+ languages and widely used in clinical practice.
By 2012, 54% NHS Trusts used training programmes based on our research. It moulded service provision nationally and internationally, changing the emphasis of how falls prevention services are presented, from "reducing risk" to "improving/maintaining independence".
The FLAIR (Fluid Attenuated Inversion Recovery) MRI sequence developed at Imperial College has transformed the sensitivity of clinical neuroimaging for white matter brain lesions. FLAIR has had significant commercial impact with incorporation as a standard imaging sequence offered by all manufacturers on their MRI scanners. The inclusion of FLAIR in routine diagnostic MRI protocols in radiology centres worldwide provides evidence of the continued extensive reach of impact for better healthcare outcomes through improved diagnosis and management. The use of FLAIR has led to more powerful Phase II trial designs for development of medicine for stroke, neuroinflammatory disorders, epilepsy and neuro-oncology based on imaging outcomes.
New methods to study the biophysical action of the human digestive system were developed in Nottingham using high speed magnetic resonance imaging (MRI) and have been used by: (i) the food and drug industry (Unilever, Proctor & Gamble, Mitsubishi Chemicals, Reckitt Benckiser, Glaxo and McNeil Pharmaceuticals) to develop new products; (ii) Plant Bioscience Limited (PBL) to develop an artificial Dynamic Gut Model (DGM) which is now being applied commercially to characterise drug and food ingestion; (iii) the BBC and other media agencies in programmes related to the promotion of better understanding of nutrition in an effort to combat obesity.
40% of all cancer patients, who are cured of their disease, receive radiotherapy as part of their treatment. The number of cancer cures could be increased if the application of radiotherapy could be improved. Research at the University of Manchester (UoM) has: led the way in identifying, validating and exemplifying the value of predictive/prognostic biomarkers of response to radiotherapy; and demonstrated, in clinical trials, the therapeutic efficacy of combining molecularly targeted agents with radiotherapy. Further, the pharmaceutical industry has incorporated these concepts into drug development programs, accelerating clinical drug development, and thus saving them time and money.
WHO estimates that 600 million school-age children need deworming treatment and preventive intervention.
The University of Manchester (UoM) Immunology Group delivered an educational programme on the immune response and biology of parasitic worm infections in areas where worm infections are most prevalent, including Uganda and Pakistan, and with UK immigrant communities.
International benefits include health worker and educator training, which is critical for improving the understanding of worm infection and distribution of health education messages to endemic communities. Nationwide engagement activities provided immigrant communities and school pupils with improved awareness of global health issues and a greater understanding of immunology, and have inspired some participants to pursue careers in science.