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The ultimate goal of in-vitro fertilisation (IVF) therapy is the live birth of a single, healthy child. However, issues of treatment failure, complications and multiple births (twins or triplets) continue to persist and have a major impact on patient quality of life. Pioneering research at the University of Glasgow has driven the concept of personalised IVF therapy and outcome prediction, reforming clinical guidelines and defining criteria for access to funded IVF therapy. This research has stimulated revision of UK regulatory policy on the number of embryos transferred during IVF. These strategies underpin the recommended practice for the 48,000 women undergoing IVF in the UK each year. In addition, the Glasgow team's online, personalised `IVFpredict' calculator, which women can use to predict their success of a live birth, has been completed by more than 5 million users worldwide.
The IOE's Evidence for Policy and Practice Information and Co-ordinating (EPPI) Centre has helped UK and overseas governments to make better-informed decisions on education, public health and health education, social welfare and international development, through the use of systematic reviews. The internationally-respected research team has done this by developing and improving methods and tools that produce a broader range of high quality, reliable studies better able to answer policy-makers' questions. EPPI trains civil servants to formulate effective research questions, supports NICE and WHO in ensuring the validity of their guidelines, and works with governments across the EU to build capacity in evidence-informed policy and practice in education.
The World Health Organization (WHO) estimate 3.3 billion people are at risk of malaria, with 219 million cases and over half a million deaths annually. The Liverpool School of Tropical Medicine (LSTM) has applied new methods of research synthesis to malaria, and the results of this work have directly influenced important global decisions on malaria policies, including the adoption of new antimalarial drugs. In this case study, we report on the influence of the LSTM on malaria control over the last 15 years by preparing rigorous, up-to-date, timely systematic reviews on malaria. This work has also contributed to substantive improvements in the methodological rigor and transparency of the WHO malaria policy group in evidence-based policy formulation and guideline development.
Impact: Health and welfare; public policy; the work led to UK and international guidelines advising against progesterone use to prevent preterm birth in twin pregnancy.
Significance: Thousands of women now avoid this unpleasant procedure annually, with a saving to the NHS of £25M.
Beneficiaries: Pregnant women, policy-makers, the NHS and healthcare-providers.
Attribution: The work was initiated by a five-centre UK collaborative group including UoE. Data analysis, interpretation and translation into practice were led by Jane Norman, UoE.
Reach: The data are cited in guidelines and have changed clinical practice on three continents: Europe (NICE), North America and Australasia. Applies to 11,000 women annually in UK alone.
Prof Tanner's research on surgical site infections (SSIs) has had a direct impact on both patient care and policy at local, national and international levels. It has resulted in a reduction in the number of SSIs, thus improving patients' quality of life, shortening lengths of stay in hospital and making substantial cost savings for the NHS. The research has led directly to the development of policy and guidelines for various bodies including the World Health Organisation, the Department of Health, NICE and the Joint Commission Accreditation Healthcare Organisations (USA), as well as locally in a number of NHS trusts. The post discharge SSI surveillance programme pioneered by Prof Tanner has led to an increase in the number of trusts in the UK undertaking post discharge surveillance.
The Scottish Longitudinal Study (SLS) is a pioneering study, combining census, civil registration, health and education data (administrative data). It has established an approach that allows the legal and ethical use of personal, sensitive information by maintaining anonymity within the data system. This approach has become a model for the national data linkage systems that are now being established across the UK. The SLS has also enabled policy analysts to monitor key characteristics of the Scottish population in particular health inequalities (alerting policy makers to Scotland's poor position within Europe), migration (aiding economic planning) and changing tenure patterns (informing house building decisions). Finally, the study has become fully embedded in Scotland's National Statistical agency, allowing it to produce new informative statistical series.
(1) Enhancing the awareness of (i) women of childbearing age suffering from epilepsy and prescribed new and/or older generation AEDs, and (ii) their healthcare professionals. Empowering both to make informed decisions through evidence-based practice that will reduce/prevent the risk of harm to unborn children potentially exposed to AEDs in early pregnancy.
(2) A change in the process by which GlaxoSmithKline (GSK) practices post-marketing epidemiological surveillance of the new generation AED `lamotrigine' in pregnancy.
(3) Benefit to the methodological practice of other researchers in Europe involved with AEDs and epidemiological surveillance
(4) Contribution to building European system for reproductive safety evaluation
Middlesex University's Applied Health Psychology research on Medically Assisted Reproduction (MAR) has impacted in three areas. First, all Parental Order Reporters and accredited Infertility Counsellors in the UK are exposed to the research through standard professional training and practice materials. Secondly, research has informed Human Fertility and Embryology Authority (HFEA) policy on surrogacy and gamete donation. Thirdly, HFEA-commissioned research on elective Single Embryo Transfer (eSET) and stakeholder group membership has contributed to national guidelines, resulting in decreased numbers of embryos transferred in UK clinical practice, dramatically reducing multiple births and associated maternal and infant morbidity and mortality.
Clinical research is heavily dependent on individuals providing tissues for experimentation and therapeutic developments. Since the Declaration of Helsinki (1964) the ethical protection of tissue providers has been a central concern. However, tissue providers have rarely been included in designing those protections. Research at Newcastle (2001-2011) has contributed to changing this, since 2008 it has brought providers' perspectives to the attention of key audiences: clinical research funders, policy advisers, and practising scientists. In terms of significance and reach this research has:
The University of Brighton's sustained musculoskeletal research programme has, through the development of novel standardised data collection tools, improved data capture, communication, policy and business planning at local practitioner level and at organisational/regulatory body levels (e.g. Physio First, the private physiotherapy practitioner group of the Chartered Society of Physiotherapy (CSP) UK and the General Osteopathic Council (GOsC)). Secondly, research findings from a study exploring patients' expectations have significantly informed the recent revision of the GOsC's osteopathic practice standards and a new revalidation scheme for osteopaths. Thirdly, as a result of studies identifying research priorities for the physiotherapy profession, changes have occurred in the direction and focus of research funding applied by the CSP's charitable trust.