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Research carried out at the University of Southampton has led to the development of a new tool for detecting and managing malnutrition. The Malnutrition Universal Screening Tool (MUST) has been rolled out to more than 80% of hospitals and care homes in England and 98% in Scotland, is part of national health policy in Finland and the Netherlands, and has attracted interest internationally. The National Institute for Health and Clinical Excellence bases its current quality standard for nutritional support in adults on the MUST framework; only two NICE guidelines have saved the NHS more money. MUST has become an integral part of the UK's health policy framework, embedded in routine clinical care and supported by bodies responsible for clinical and care excellence. It is central to learning programmes on managing malnutrition.
The Leicester Cilia Group (LCG) established methods to study ciliary damage and dysfunction, transforming the diagnosis and management of Primary Ciliary Dyskinesia (PCD), a genetic disorder that causes severe permanent lung damage in children. The group developed diagnostic methods, adopted in the UK and internationally, that increased the accuracy and speed of diagnosis, uncovering a number of previously unrecognised phenotypes. The group was instrumental in the establishment of the first nationally funded diagnostic service (three centres, including Leicester) in the world. This has resulted in the group jointly leading a successful bid (2012) to set up the first nationally funded management service for children with PCD.
A Cardiff researcher has led an International 15 year programme resulting in multiple novel findings which have led to changes in the recommended diagnosis and treatment of acquired haemophilia A (AHA). The research has, for the first time, allowed the comparison of immunosuppressive regimens for inhibitor eradication and comparison of the efficacy of treatment strategies to control bleeds. Studies led directly to the production of UK and International guidelines on the management of AHA with 14 of the 18 specific recommendations in the UK guideline being underpinned by Cardiff-led research.
Measurement of hormones is essential to the understanding and diagnosis of endocrine diseases. White and her research group have developed unique antibodies that are widely used in diagnostic assays for adrenocorticotrophic hormone (ACTH) and related peptides, including the first and only kit for measuring pro-opiomelanocortin (POMC), the precursor of ACTH. These assays are used worldwide for diagnosis, decisions on treatment, monitoring for recurrence of tumours and prognosis in a number of patient groups with life-threatening endocrine disorders. Global sales of the ACTH Elecsys tests by Roche exceeded 6 million kits since 2008. AstraZeneca has used the POMC and ACTH assays in its drug discovery programmes in the cardiovascular and metabolic diseases therapy area. The antibodies therefore have had health impact in relieving suffering and in improving patient care, as well as commercial impact in worldwide sales of assays and influencing drug development strategies.
Impact: Health and welfare, policy and services. By quantifying the high lifetime prevalence of allergy, high costs and sub-optimal NHS care, UoE researchers catalysed international policy change and UK service developments.
Significance: Investment in expanded allergy services and improved standards of care, resulting in a significant drop in global allergy-related mortality rates.
Beneficiaries: People with allergies; GPs and emergency care clinicians; policymakers and professional bodies.
Attribution: The work was led by Sheikh (UoE) with collaborators for national surveys.
Reach: International. 1 in 3 people in the UK have an allergy; World Allergy Organization anaphylaxis guidelines are used in 89 countries.
The work of Cardiff University's Wound Healing Research Unit revealed a need for, and led the development of, a disease-specific Health-related Quality of Life (QoL) instrument; the Cardiff Wound Impact Schedule (CWIS). CWIS is able to quantify in a psychometrically sound manner the impact of chronic non-healing wounds upon a patient's QoL. The tool, a first of its type, is accurate and sensitive to changes in the healing status of chronic wounds, particularly those of the lower limb. CWIS has been adopted internationally advantaging QoL assessments in both commercial and practice settings to yield economic and practice impacts as well as direct patient benefits.
Research at Hull into hypersensitivity of the airways has provided novel insights into the epidemiology and causes of cough, and its burden on patients. This was achieved by the development of novel methodologies that allow the rigorous and objective testing of new and existing drugs. Patients benefit through the online provision of a diagnostic tool, and Proctor & Gamble have successfully exploited the cloned cell receptors in their drug development programme resulting in a new range of pharmaceuticals for cough. The work has underpinned the standardisation of cough challenge methodology through incorporation in national and international healthcare guidelines leading to a widespread improvement in patient treatment.
Between 1996 and 2013 researchers at Swansea University evaluated service initiatives and changing professional roles associated with the management of patients with debilitating gastrointestinal disorders. This work showed the clinical and cost effectiveness of two main innovations: open access to hospital services for patients with inflammatory bowel disease; and increased responsibility for nurses, particularly as endoscopists. Our evidence has had a broad, significant impact on: national policy through incorporation in NHS strategies, professional service standards and commissioning guides; service delivery through the provision of increasing numbers of nurse endoscopists and the wide introduction of nurse-led open access to follow-up; and patient care, as documented in sequential national audits in 2006, 2008 and 2010.
Age Related Macular Degeneration (AMD) is by far the leading cause of blindness in older people in the developed world, affecting 30% of those aged over 65, and is set to increase. The naturally-occurring carotenoids lutein (L) and zeaxanthin (Z) are located in the central retina (macula) and are collectively called the macular pigment (MP). High MP levels confer protection from AMD. Murray and colleagues have developed a new instrument, the Macular Pigment Screener (MPS), which allows regular, non-invasive monitoring of MP in ophthalmic practice. This means that, for the first time, the MPS can show the effect of intervention on the MP, providing a management strategy for AMD patients, and allowing early identification of those at risk of developing AMD. Over 750 instruments have been sold to date, with more than 1M patients in the US alone estimated to be benefiting from routine MP testing.
The Rylands Cairo Genizah Project has had impact through its conservation, presentation, and interpretation of an internationally important archive of manuscripts which illuminate all aspects of the history, and the religious, social, and commercial life of the Jews in the Levant from the 9th to the 19th centuries. This collection is of deep interest to the Jewish community in the UK and abroad, and forms part of the cultural capital of this country, where the vast bulk of it is now housed. The project has also had an impact on heritage experts, by developing methods which have been applied to recording and disseminating other cultural assets.