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The Institute of Sound and Vibration Research (ISVR) has played an influential role in transforming testing for child deafness in Europe, North America and elsewhere. In England, the NHS drew on its findings in deciding to replace traditional testing methods with universal newborn hearing screening programmes. This form of testing is more accurate, cost-effective and can be conducted at an earlier age. In England alone more than four million babies will be screened between 2008 and 2013, with around 6,000 identified as having hearing impairments. Earlier clinical intervention has benefited children's language development and overall quality of life.
Vitamin A deficiency (VAD) is a major public health problem in low- and middle-income countries with young children and pregnant women particularly at risk. Over the last 20+ years LSHTM researchers have carried out a series of definitive trials in collaboration with the Ghana Health Service to evaluate the impact of different vitamin A supplementation (VAS) strategies on maternal and/or child survival. Findings have had major impacts on national and global VAS programmes and influenced WHO guidelines on VAS in: infants and children 6-59 months of age; infants 1-5 months of age; postpartum women; and pregnant women.
The Millennium Cohort Study (MCS) has influenced health policy and practice at local, national and international levels. Breastfeeding research based on MCS data has made a particularly important contribution to health education, and important insights have been provided on immunisation and obesity. The study has also helped to shape policy thinking and public discussion on issues such as social mobility, family poverty and child development. The MCS has not only created an invaluable resource for researchers in the UK and other countries, it has also served as a model for other cohort studies. Leading researchers around the world say it sets the benchmark against which other child cohort studies will be measured.
Language impairment is common in children and, without effective early intervention, presents a risk for educational, social and emotional disturbance. The team used their considerable experience in child language research to produce a novel assessment of child language development — The Reynell Developmental Language Scales 3 (RDLS3) — the first test of child language development to be standardised in the U.K. to assess both understanding and production of language in young children. Use of the test has improved language assessment and diagnosis for children with language impairments and, as such, has enabled health and education professionals to target therapy and monitor the effectiveness of interventions to improve child language development. The test has been widely used in the U.K. and is now also being used widely internationally. Recent research by the team has informed a revised version of the test — The New Reynell Developmental Language Scales (NRDLS). Sales figures of the RDLS3 and the commissioning of the NRDLS are testament to its outstanding reputation and enduring legacy worldwide.
Impact: By showing the benefits of accurate identification and targeted treatment of chronic fatigue syndrome, UoE research has influenced worldwide medical practice and stimulated public and governmental debate.
Significance: Guidelines and policy debate have resulted in improved patient treatment, with associated economic benefit.
Beneficiaries: Patients with medically unexplained symptoms, policy-makers, clinicians.
Attribution: Work conducted at UoE in a team led by Carson and Sharpe.
Reach: The research affects the more than 25% of all GP presentations who have unexplained symptoms / chronic fatigue syndrome (40% in gastroenterology and neurology). Guidelines have been changed internationally including UK, USA, Australasia.
The results of two major randomised trials and a cohort study based at the University of Manchester (UoM) have had a major impact on cervical screening in the UK and influenced thinking internationally. These trials evaluated two technologies which had the potential to improve cervical screening. As a result HPV primary screening has moved to a large national pilot study. HPV as a test of cure following treatment of cervical precancerous lesions has now been adopted as standard across the National Screening Programme. Automation assisted technology, which was shown to be inferior to manually read cytology, will not be adopted.
Our research on the clinical effectiveness and cost effectiveness of cochlear implantation has had two impacts. First, the research informed the decision by the National Institute for Health and Care Excellence (NICE) to issue guidance to the effect that the National Health Service (NHS) in England and Wales should provide cochlear implants to both ears of deaf children, but to only one ear of deaf adults. Those recommendations are binding on the NHS in England and Wales and have also been adopted in Scotland and Northern Ireland. Second, we translated tests of spatial hearing, which were developed in the course of the research, for use by clinicians. We incorporated the tests in a unique apparatus which is being produced commercially and used in clinics to monitor candidacy for, and outcomes from, cochlear implantation and other treatments.
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.
Professor Gilbert's research identified retinopathy of prematurity (ROP) to be a major cause of blindness in children in middle-income countries and cities in Asia, and delineated those infants most at risk. Since Gilbert joined LSHTM in 2002, her research and advocacy have led to ROP being prioritised for control by the Pan American Health Organization, with regional guidelines developed for Latin America, and national guidelines in many middle-income counties. Programmes for control are expanding and improving. Six Latin American countries have made eye examination mandatory. Although difficult to quantify, these initiatives are preserving the sight of many thousands of infants.
Since 2010, over 60,000 Year 8 students (including over 11,000 trained peer supporters) have been exposed to a new smoking prevention programme which has achieved a projected 1674 fewer teenage smokers. DECIPHer-ASSIST, a theoretically-grounded peer-led, schools-based smoking prevention intervention was developed and evaluated during research studies conducted at Cardiff University. An MRC-funded trial demonstrated that this intervention reduced the prevalence of smoking by 10% and that it is cost-effective. The intervention has been highlighted in numerous national strategy documents and was recommended in NICE guidance. It is being implemented under licence by public health providers in 23 areas across the UK. A new Cardiff University-owned company (DECIPHer Impact Ltd) sells these licences and supports the delivery of ASSIST in secondary schools.