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Novel methods of measurement developed by Marek Czosnyka, Peter Hutchinson, David Menon and John Pickard have provided new insights into the pathophysiology of brain injury, led to commercial applications, and influenced patient care in terms of improved outcome for clinical trials. Multimodality brain monitoring of intracranial pressure (ICP), brain oxygen and microdialysis; PET/MRI imaging of critically ill patients; and computerised CSF infusion tests for shunt function in hydrocephalus have each impacted on the clinical practice and the ability to evaluate novel treatments and interventions in brain injury. This work has led directly to the establishment of a National Institute for Health Research (NIHR) Health Technology Cooperative for Brain Injury.
Research conducted at Stirling has improved outcome assessment after traumatic brain injury. Innovative tools, the Glasgow Outcome Scale — Extended (GOSE) and Quality of Life after Brain Injury Scale (QOLIBRI), have made measurement of functional outcome more rigorous, and facilitated the assessment of quality of life after brain injury. The GOSE has specifically impacted practice in clinical trials including those conducted by industry. The QOLIBRI captures the patient's view of life satisfaction after brain injury, and is being used to facilitate communication, as an aid to rehabilitation planning, and in evaluation of progress.
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 into primary care insomnia by the Community and Health Research Unit (CaHRU) has led to broad improvements in healthcare provision for insomnia, improved patient quality of life, informed national/international policy and practice in insomnia care and impacted directly on health professional practice and insomnia sufferers, initially in Lincolnshire spreading across the UK and internationally from 2008 to 2011. Direct effects on practice include changes in sleep management and reduced hypnotic prescribing through seminars, workshops, conferences and e-learning developed by the team; inclusion in UK policy, practitioner information, training materials and guidance on hypnotics has led to greater professional and public awareness of sleep management internationally.
King's College London (KCL) researchers have created, refined and validated the Palliative care Outcome Scale (POS), a tool that measures the physical, psychological, spiritual and information needs of patients at the end of their lives and their families. The POS has had an outstanding impact on clinical competencies and knowledge, and has underpinned an international collaboration to develop standards for palliative care outcomes. The POS is embedded increasingly in everyday clinical practice, improving the care of patients affected by advanced conditions and providing support for their families. The POS, widely used regionally and nationally in the UK to evaluate and improve the quality of care, has been culturally adapted for use in 20 European Union countries, and in Africa and other countries around the globe.
Based on his research at the UCL Institute of Cognitive Neuroscience, Professor Paul Burgess invented and co-invented several cognitive tests (known as the Hayling and Brixton Tests, and the BADS and BADS-C assessment batteries) which are used to detect dysfunction of the frontal lobes of the brain. These were developed for commercial production by Burgess and are now produced and marketed by the largest test publisher in the world (Pearson Assessment). There are versions in several different languages, and they are used in clinics worldwide to diagnose problems in a wide variety of patients with neurological, psychiatric and developmental problems. The tests are now administered around the world to around 55,000 patients per year.
In the UK prison system, new management and assessment procedures and training programmes have been developed as a direct response to a research programme, led by Huw Williams, into the high incidence of head injury in young offenders, and its association with repeat offending. To convert research findings into impact, the team was instrumental in setting up the Criminal Justice and Acquired Brain Injury Interest Group and has contributed data and recommendations to a number of networks, including Parliamentary Policy Groups. Research is continuing to influence policy and legislation (e.g. the Children and Family Bill) as a result of the Ministry for Justice and others becoming aware of brain injury as an important factor for repeat offending.
Ensuring that a new medicine improves or maintains a person's quality of life is important. Abbott's longstanding collaborative relationship with health professionals and service users has enabled the development of two patient-reported, quality of life instruments (CFQoL, LupusQoL). Abbott's expertise has contributed to the development of policy/guidelines concerning quality of life measurement in clinical trials for the European Medicines Agency and European Cystic Fibrosis Society. The instruments have been adopted internationally with the LupusQoL providing a global business opportunity for a US translation company. At the request of pharmaceutical companies, the LupusQoL is translated into the numerous languages required for use in their multi-national clinical trials of new medicines.
A decade of research at the University of Southampton has given thousands of people around the world suffering from dizziness and balance disorders access to a self-management resource that can alleviate their symptoms. Professor Lucy Yardley has pioneered the use of a Balance Retraining (BR) booklet to transform the means of delivering cost-effective, life-changing treatment previously offered to less than one in ten UK patients. The booklet, translated into several languages, has been distributed to patients and practitioners as far afield as China and Japan. Yardley's findings have contributed the bulk of good quality evidence to the Cochrane Review on vestibular rehabilitation.
The PCI is a carefully designed Head & Neck (H&N) cancer pre-clinic consultation checklist and comprises aspects of care and outcomes that patients might wish to raise with the multi-professional healthcare team. The PCI is an innovative and effective tool whose development has been optimised for touch screen devices. (Full details on use of the PCI is given at http://www.patient-concerns-inventory.co.uk/PCI/Home.html.) The PCI has improved patient experiences of clinic consultations, helped development of quality indicators and improved professional practice. The impact of the programme of work has led to its wider implementation nationally as exemplified by its adoption by the British Association of Head and Neck Oncologists (BAHNO), its inclusion in the National H&N Cancer dataset, its emerging use internationally, and its development in other chronic conditions.