News Archive

Published: Wednesday 17 January 2018

The figure is the culmination of a decade-long series of ‘What’s it Worth?’ studies – backed by a consortium of high-profile funders including the Medical Research Council, the Wellcome Trust, and the Academy of Medical Sciences – which set out to understand the economic return of public and charity-funded medical research. The final paper in the series, published in the journal Health Research Policy and Systems, investigated the return on investment from musculoskeletal disease research, and supported the findings of similar studies into cancer and cardiovascular research. http://www.brunel.ac.uk/news-and-events/news/articles/Every-1-invested-in-medical-research-returns-25p-per-year-forever

Published: Wednesday 17 January 2018

A new supplement to the Addiction journal will describe the development of EQUIPTMOD, a decision-support tool made available to European stakeholders by a research consortium led by Dr Subhash Pokhrel at HERG. EQUIPTMOD allows users to analyse the health and wider returns that investing in evidence-based tobacco control could generate and thus supports decision making in this area. The tool and supporting documents are available from the EQUIPT website. The supplement will include four methods articles and five policy analyses covering specific decision contexts of England, Germany, Hungary, Spain and the Netherlands. All articles can be downloaded freely from the journal website.

Published: Wednesday 17 January 2018

Why is uptake of health technology assessment (HTA) by decision makers sub-optimal? HERG researchers Dr Subhash Pokhrel and Teresa Jones, in collaboration with European partners, have published a paper to identify the most important facilitators of and barriers to HTA use in the Expert Review of Pharmacoeconomics and Outcomes Research.

Published: Tuesday 19 September 2017

Over 2000 people from central New Zealand who smoke will be invited to join a community-based clinical trial to compared two types of quit smoking medicine. The trial will determine whether the two medicines are at least as effective and safe as each other, and which is the best value for money.

The RAUORA study, run by the researchers at the University of Auckland, in conjunction with the Health Economics Research Group (HERG) at Brunel University London and Lakes District Health Board, aims to see whether two similar medicines, Tabex and Champix, can help people quit smoking. The study focuses on a population with higher than average smoking rates (and consequently higher than average smoking related illness), namely indigenous New Zealanders (Māori) and members of their family. Currently, 3 in 10 Māori smoke – three times more than non-Māori- and so supporting them to quit smoking is a priority of the New Zealand government.

The launch of the trial, and a recruitment promotional video, received high profile coverage in a New Zealand newspaper: http://www.nzherald.co.nz/health/news/article.cfm?c_id=204&objectid=11919646

New Zealand is one of only a handful of countries with a smokefree goal. Associate Professor Natalie Walker, the Lead Investigator from the University of Auckland said, “Our country’s smokefree 2025 goal means that less than 5% of the adult population will be smoking by 2025. No-one should be left behind in our journey to reach this goal, which is why we need to provide extra support for those populations that still have very high rates of smoking."

Both Tabex and Champix help people quit smoking by blocking the effects of nicotine on the brain, which means smoking is less rewarding. Champix (varenicline) is currently the most effective stop smoking medication available, but is very expensive. Tabex has been available in Eastern and Central Europe for at least 40 years, but is not yet approved for use in New Zealand. Tabex contains a chemical called cytisine, which is from a plant called the Golden Rain. Cytisine is found in many plants around the world, including plants in New Zealand.

“Cytisine as a smoking cessation medication, is cheaper than varenicline,” said HERG’s Dr Subhash Pokhrel. “But we don’t know whether one medicine is better than the other, or whether they are equally good at helping people to give up smoking. This study will also help us establish whether cytisine is as cost-effective as varenicline at improving the health of this priority population”.

Results from the trial are expected in May 2019

Published: Thursday 6 July 2017

Drs Anokye, Stewart and Pokhrel from Brunel’s Health Economics Theme contributed a key chapter to a major new report, Health & Wellbeing Benefits of Swimming, commissioned by the Swimming and Health Commission on behalf of Swim England. It is supported by the Chief Medical Officer, Professor Dame Sally Davies. http://www.swimming.org/swimengland/new-report-shows-health-benefits-swimming/

The HERG team’s chapter, Swimming for health and wellbeing: the economic case, partly drew on their previous research on physical activity (PA) and concluded: 

‘Applying the same methodology as Stewart et al. (2015) and following Chief Medical Officer guidance that vigorous PA ‘counts double’ towards meeting PA guidelines (Department of Health, 2011), we estimate that those who swim for recreational or competitive purposes are eight times more likely to meet PA guidelines’.

In launching the report, Swim England also published a report setting out how it had  already begun to address some of the recommendations in the Swimming and Health Commission report, alongside some of the key activities it would like to develop in the future.

In a further example of the impact it’s already making, few days after its publication, Duncan Selbie, Chief Executive of Public Health England, highlighted the report  in his weekly blog: https://publichealthmatters.blog.gov.uk/2017/06/23/duncan-selbies-friday-message-23-june-2017/?utm_source=Stake16&utm_medium=Email&utm_campaign=DSF

Published: Tuesday 17 January 2017

Please join us at the HERG external seminar taking place on 1st March in Mary Seacole Building, Room 113, Brunel University London, 12.30 - 2.00 pm. 

Presenter: Annette Boaz is a Professor of Health Care Research in the Faculty of Health, Social Care and Education at Kingston University and St George’s University of London. Her research focuses on the relationship between research evidence, policy and practice, implementation, improvement and patient engagement. 

Title: Will research active NHS organisations see improvements in the healthcare they deliver?

 Summary: In the UK the National Institute for Health Research (NIHR) has a budget of more than £1000 million each year, with more than £200 million allocated to research programmes and more than £600m spent on infrastructure (including Collaborations for Leadership in Applied Health Research and Care (CLAHRCs) and Networks). As a result, there are growing numbers of systems level interventions such as CLAHRCs, Academic Health Science Networks (AHSNs) and Academic Health Science Centres (AHSCs) designed to enhance the relationship between academic and health systems in the UK.  In addition to these initiatives that boost the level of research activity in healthcare organisations, there are individual level interventions to increase the capacity of healthcare staff to use research in their work and research programmes conducted with the aim of improving services for patients and their families. 

 These different but complementary initiatives further raise the profile of the role of conducting research in enhancing healthcare performance.  For those of us interested in understanding the role of research in policy and practice these are interesting times.  This presentation will partly draw on work conducted jointly by Brunel and Kingston/St George’s and consider the international evidence base for claims that research engagement improves healthcare performance. It will also provide an overview of some of the current initiatives designed to promote improvement and present new research on the role of engagement of different actors (health care staff, patients and policy makers) as a mechanism for improving research use in the healthcare system. 

A sandwich lunch will be available for all attending from 12.30pm and the presentation will start at 1.00pm.

To give us an indication of numbers, and for details about parking, please reply to Abbie Hill (Abbie.Hill@brunel.ac.uk) if you wish to attend.

Published: Thursday 21 April 2016

At the European Network for Smoking and Tobacco Prevention Conference held from 5th to 7th April 2016 in Brussels, the Outstanding European Health Research Award was presented to EQUIPT. This award is given to projects which have shown an extraordinary degree of dedication to promoting tobacco control activities on the basis of sound scientific evidence.

EQUIPT was awarded the prize because of its efforts in providing health care policy makers with bespoke information about the economic and wider returns that investing in evidence-based tobacco control including smoking cessation agendas can generate. EQUIPT has the potential to improve investment in effective tobacco control and cessation services resulting in large cost-savings across the EU. 

Led by Health Economics Research Group (HERG) at Brunel University, London, EQUIPT is a partnership of 11 consortium members from 7 member states – Belgium, Croatia, Germany, Hungary, the Netherlands, Spain and the UK.

Published: Monday 29 February 2016

Professor Julia Fox-Rushby, Institute of Environment, Health and Societies, will deliver her Inaugural Lecture entitled 'Can Economic Evaluations Help Make Smarter Decisions on Public Health' on Tuesday 8 March, 17.30 - 19.30 at the Eastern Gateway Building Auditorium, Brunel University London.

Deciding how best to spend an annual budget of £4.7billion on public health is a hard task. Our aim is to improve such decisions and to help increase population health and wellbeing.

In 2005, the National Institute of Health and Care Excellence (NICE) began to provide guidance on how to prevent ill health and promote healthier lifestyles. The provision and use of economic evaluation in public health policy has since increased. In this lecture Prof Fox-Rushby shows how an economic evaluation of a screening programme for abdominal aortic aneurysm has helped changed policy, improve health and shift research.

The lecture uses economic evaluations from the last 10 years to show which public health interventions are 'good buys'. Despite this evidence, funding for public health interventions has changed little and Prof Fox-Rushby will consider why. The processes, needs and focus of decision-making and research all raise challenges. In the future, economic evaluations need to consider broader points of view, re-consider the outcomes measured, and encourage improvement in the quality of effectiveness data. Evaluators, decision-makers and the public should collaborate more closely too.

The lecture draws on the Health Economics Research Group's research on health technologies, public health, methods of measuring healthcare outcomes and the value of research itself.

To reserve your place at the lecture please book here. Please also indicate if you have special dietary or access requirements we should be aware of.

Published: Wednesday 6 January 2016

People who use their bikes as transport are four times more likely to meet the recommended 150 minutes of physical activity than those who don’t cycle, says a report by Brunel University London.

The Evening Standard's interview with Glenn Stewart on his cycle commuting fitness research.

Published: Tuesday 22 December 2015

A team from the Health Economics Research Group conducted an innovative three-stage ‘hourglass’ review and found that when clinicians and healthcare organisation engage in conducting research as well as delivering care there is a likelihood there will be improved healthcare performance.

A new paper has been published in BMJ Open that builds on, and updates, the full evidence synthesis originally published in 2013. The study was conducted by Steve Hanney, Bryony Soper and Teri Jones from HERG along with Annette Boaz, now Professor of Health Care Research, St. George's, University of London & Kingston University. The research team carried out an innovative three-stage ‘hourglass’ review consisting of: a wide-ranging planning and mapping stage; a focused review of whether research engagement was associated with healthcare improvement; and a wider review of papers identified during the two earlier stages that considered the mechanisms through which improvements in healthcare might result from engaging in research.

Thirty-three papers were included in the focused review, 28 identified improvements in health services performance. Seven of these papers reported some improvement in health outcomes, with others reporting improved processes of care. A diverse range of mechanisms were identified, and particular attention was given to the role of research networks and organisational attempts to more fully integrate research into the healthcare system. The new paper (Boaz et al., 2015) also includes newer evidence from the UK that research-active UK NHS trusts have lower risk-adjusted mortality for acute admissions.

Brunel's Health Economics Research Group (HERG) played a crucial role in providing evidence to help save the UK science budget in the Government’s recent Spending Review.

Just as for the Spending Review in 2010, a range of leading scientific organisations used HERG’s work demonstrating the value of research as key evidence to support their submissions to George Osborne and HM Treasury.

Medical research funders, in particular, used HERG’s work as key evidence. The Association of Medical Research Charities, which is the umbrella organisation for a range of charities such as Cancer Research UK, British Heart Foundation and Arthritis Research UK, started its submission with a list of key points.

The first one drew entirely on HERG’s work and the submission by the AMRC said: "There is compelling evidence, accepted by government, that investment in R&D drives productivity. Every £1 of public or charity investment in medical research generates annual monetised health benefits of 10p in perpetuity and additional spill over benefits." AMRC submission to spending review 2015

In the build up to the 2010 Spending Review many organisations in their evidence advocating continued Government support for science funding highlighted the HERG study, Medical Research: What’s it Worth (HERG et al., 2008).

This study estimated the value of UK cardiovascular and mental health research, and it was used in submissions to support science funding by the relevant government department, Business, Innovation and Skills, as well as many science funding organisations and groups of scientists. Often it was the only evidence cited as having calculated the value of UK research, including in the letter to the Chancellor of the Exchequer from the Chair of the Commons Science and Technology Committee.

In 2013 the Chair of the AMRC, Lord Willis, said about the 2008 HERG report: "In the run up to the 2010 Comprehensive Spending Review, AMRC and many other groups used the report’s findings to demonstrate the value of investing in medical research when arguing for continued government spending and protection of the Charity Research Support Fund (CRSF)….It is my believe that this contributed to the Treasury’s decision to ring-fence the Science Budget, which includes the CRSF, for the 2010-15 financial period, a cut in which would have been hugely detrimental to the UK science base, charity investment and the wider economy."

By the time of the 2015 Spending Review there was a wider range of evidence on which organisations drew. But there was also another key Medical Research: What’s it Worth study from HERG (Glover et al., 2014).

This study, showing the value of UK cancer research, is featured on Brunel campus as one of the banners highlighting 50 Amazing Facts about Brunel. This one is number 45, called The Power of the Pound. It captures HERG’s 2014 calculation that every pound spent on cancer research leads to benefits worth 40 pence each year thereafter, taking into account the value of the health improvements and the contribution to the economy. See also: https://twitter.com/hergbrunel

Published: Thursday 3 December 2015

How likely are stakeholders to use economic evaluations of tobacco control interventions in their decision making? Using the I-Change framework, 93 stakeholders from five European member states (Germany, Hungary, the Netherlands, Spain and the UK) were interviewed to seek an answer to this question. The findings showed that demographics, pre-motivational, and motivational factors explained 69% of the variation in intention to use. Stakeholders were defined as decision-makers, purchasers of services/pharma products, professionals/service providers, evidence generators and advocates of health promotion. Significant differences in beliefs (risk perception, attitude, social support, and self-efficacy towards using the tool) were found between non-intenders and intenders. The study results improves our understanding of the facilitators and barriers to the uptake of economic evaluations in decision making.

Published: Thursday 13 August 2015

Led by Queen Mary University of London, the study reveals how music, on average, reduces postoperative pain by 77 per cent, postoperative anxiety by 68 per cent and the need for postoperative pain relief medication is reduced by 37 per cent.

The team analysed the results of 73 randomised controlled trials, which studied nearly 7,000 patients in total, to produce one systematic review. This findings confirmed, for the first time, the link between music in the operating theatre and a reduction in anxiety.

Researchers analysed data on adult patients undergoing a variety of surgical procedures, with or without anaesthesia, to any part of the body. The only exclusions were surgery on the central nervous system, head and neck (because of potential hearing impairment).

Choice of music, timing and duration varied in all the studies analysed, and evidence showed these factors made little difference to the outcome. Music was effective even when patients were under general anaesthetic.

Dr Catherine Meads, who led the study at Queen Mary University of London but is now based at Brunel University London, comments: <spanarial",sans-serif;>“At the moment, music is not used routinely during surgery to help patients. The lack of uptake is often down to the scepticism of professionals as to whether it genuinely works, and of course issues of budget and the integration into daily practice. We hope this study will now shift misperceptions and highlight the positive impact music can have.”

Dr Martin Hirsch, Co-Study Author at Queen Mary University of London and Barts Health NHS Trust, comments: “We have known since the time of Florence Nightingale that listening to music has a positive impact on patients during surgery, by making them feel calmer and reducing pain. However, it’s taken pulling together all the small studies on this subject into one robust meta-analysis to really prove it works.”

Most people undergo a surgical procedure at some point in their lives. Around 4.6 million hospital admissions lead to surgical care in England, and over 51 million operations are performed annually in the USA. Feelings of pain and anxiety before and after, as well as a need for ongoing pain relief are very common. Music is one of the easiest, safest, cheapest and least invasive interventions that healthcare workers can deliver, and at great benefit to patients.

The researchers now hope to get advice on preparing for surgery into hospitals, so patients know to take their smart phones or iPods etc with them and listen to it before, during and after the procedure, as directed by hospital staff.

Jenny Hole, Co-Author and Medical Student at Queen Mary University of London, Barts and The London School of Medicine and Dentistry, comments:“There is now sufficient evidence to demonstrate music should be available to all patients undergoing surgery. Patients should be able to choose the type of music, and timing and delivery may be adapted to different settings depending on the medical requirements and teams involved.”

The team are following up this research with a pilot scheme of introducing music into operative settings at The Royal London Hospital. The two areas piloted will be women having caesarean sections and women having hysteroscopy. Patients will submit their music playlist on a device of their choice, and this will be connected to a pillow with inbuilt loudspeakers. The researchers will then analyse the effectiveness of rolling this out in practice, and will deepen their understanding of why some evidence-based innovations are difficult to put into practice.

Published: Tuesday 4 August 2015

Dr Louise Longworth from HERG, with researchers from University of Warwick, University of Oxford and the EuroQol Research Foundation in Rotterdam, has developed a reporting statement aimed to improve the quality of studies that report estimates of health-related utility derived through a process known as ‘mapping’. The MAPS statement is a checklist created using well-established methods including a Delphi panel of experts, journal editors and policy makers. 

The MAPs statement has been published simultaneously by seven leading health economics and health outcomes journals including Medical Decision Making, Quality of Life Research and Health and Quality of Life Outcomes (HQLO). In welcoming the MAPS statement, Chris Carswell, editor of HQLO states “Given the MAPS reporting statement is published open access and in a number of well-known journals there really is no excuse for an improvement not to be observed.” 

For more information see:

http://blogs.biomedcentral.com/on-health/2015/08/03/maps-reporting-statement-improving-quality-healthcare-interventions/ 

http://link.springer.com/article/10.1007%2Fs11136-015-1082-8

Published: Wednesday 18 February 2015

Gemma Derrick’s ESRC funded project investigates the process of societal impact evaluation, using the REF2014 impact criterion. Gemma interviewed the evaluator’s from Main Panel A (health and biomedical sciences) about how health research impact is assessed formally.

http://www.nature.com/news/telling-stories-1.16890

The Health Economics Research Group (HERG) is delighted to see its ratings reflecting increases in quality, growth and impact. The REF results were announced today, setting paths for university research funding in the UK for the next few years.

HERG was judged to have a 33% increase in its ‘world-leading’ research (up from 15 to 20% since 2008), with a further 49% judged as ‘internationally excellent’. This was achieved in addition to a doubling of the size of HERG and securing a 100% rating of its research impact rated as ‘internationally excellent or world-leading’ (3/4*), testament to the importance HERG places on high-quality, applied, policy-relevant research.

Published: Friday 5 December 2014

An article published in today’s Archives of Disease in Childhood shows that by doubling the number of mothers who breastfeed for 7-18 months in their lifetime and helping others to

continue for at least four months could save the NHS more than £40 million every year.

Dr Subhash Pokhrel and Professor Julia Fox-Rushby from HERG co-authored the study.

Published: Thursday 4 December 2014

In a major new Lancet Commission, led by Professor Roger Williams, Director of the Institute of Hepatology, London, UK, doctors and scientists from across the UK, including HERG, call for a radical scale up of liver disease treatment and detection facilities in the country, which has one of the worst rates of death from liver disease in Europe.

The UK is the only country in western Europe (except Finland) where the prevalence of liver disease has increased in the past three decades, and the rate of death from the disease for those under the age of 65 years has increased by almost 500% since 1970.

According to Dr Louise Longworth, from the Health Economics Research Group at Brunel University London, one of the report’s authors, “Liver disease is the third commonest cause of premature mortality in the UK. In addition to the significant health impact, the economic cost of liver disease for the NHS and wider cost to society is substantial.”

The Commission provides a cost-effective and achievable blueprint for improving hospital care for people with severe liver disease, by recommending that Liver Units providing acute services are established in every District General Hospital in the UK, linked with 30 Specialist Centres – for more complicated cases - distributed equitably around the country. Screening of high risk individuals using new diagnostic techniques are part of proposed improvements at GP and community level. The authors also recommend a review of the transplant services to ensure better access for patients in some areas of the country, and to ensure sufficient capacity for an anticipated 50% increase in availability of donor organs by 2020.

Details of the commission are available from the Lancet website

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61838-9/fulltext

Published: Thursday 4 December 2014

Health economists, including academics from HERG, call for urgent reform of the Cancer Drug Fund. Originally conceived as a temporary measure, spending on drugs by The Cancer Drug Fund has spiralled from the £50m budgeted for the first year in 2010-11 to well over £200m in 2013-14. In an editorial in this week's BMJ health economists, including Prof Martin Buxton and Dr Louise Longworth from HERG, propose reform of the fund to identify potentially cost-effective treatments and get best value for the NHS.

http://www.bmj.com/content/349/bmj.g7276

Published: Wednesday 29 October 2014

Patients diagnosed with high blood pressure are given better control of their condition from a physician-pharmacist collaborative intervention than physician management alone, according to new research.

Pharmacists can play a key role in communicating with physicians to address suboptimal therapy, helping physicians to provide counselling on lifestyle change and performing patient follow-up.

The research was carried out to evaluate the individual care processes of the physician-pharmacist collaborative intervention in treating hypertension, a major cause of heart disease, strokes and aneurysms of the arteries.

In a study combining two randomised controlled clinical trials, the team of researchers led by Brunel University London found that, resulting from the physician-pharmacist team, each antihypertensive medication alone led to systolic blood pressure (SBP) reduction of 7.19mm Hg, and each session of counselling about lifestyle change alone resulted in a SBP reduction of 5.30mm Hg.

The six-month data was taken from two US studies in 2008 and 2009, in which a total of 496 patients were treated.

Puttarin Kulchaitanaroaj, Research Fellow at Brunel University London’s Health Economics Research Group and co-author of the study, said: “By combining data from two trials and using instrumental variable regression we wanted to address unmeasured confounders and isolate the individual actions from the intervention package that led to a successful outcome – in this case, a reduction in hypertension in patients. We hope that researchers can further and better investigate links between care processes and outcomes.

“The results suggest that both medication and lifestyle change are effective in bringing down a patient’s blood pressure. The study will be useful for health providers to not undermine the benefit of counselling and for policy makers to consider team-based care.”

Published: Monday 29 September 2014

Martin Buxton and Claire Donovan both made substantial contributions to the Second International School on Research Impact Assessment that was held in September in Banff, Alberta.  This school involved almost 100 people from Canada and many other countries who wanted to develop their knowledge and skills relating to research impact assessment, either as researchers demonstrating the value of their work or as research funders analysing the impact of their programmes.  The school made extensive use of the of the Buxton/Hanney payback framework and the various case studies in this area that have been undertaken in recent years in HERG.

Published: Monday 29 September 2014

Martin Buxton was invited to give a key note presentation to the 36th Meeting of the Australian Health Economics Society in Adelaide, which was hosted by Professor Julie Ratcliffe now at Flinders University, who, with her partner Professor Jon Karnon (University of Adelaide), both worked and gained PhDs in HERG.  Martin presented the recent HERG/RAND Study of the net health gain from publicly funded cancer research in the UK, which includes some important advances on methodology that has previously been used to address the issue in Australia.  He additionally took part in an Australian Health Economics Doctoral Workshop including a session of ‘Speed Mentoring’!

Published: Monday 30 June 2014

A presentation on “Modelling prioritisation strategies for CVD risk assessment: using a DES and accounting for uncertainty using a combination of bootstrapping and probabilistic sensitivity analysis” will be given by Catriona Crossan from HERG at the forthcoming 10th World Congress Health Economics in the Age of Longevity, a Joint iHEA & ECHE Congress in Dublin, Ireland. Primary prevention of cardiovascular disease requires that people at risk are identified, assessed and treated with statins and/or anti-hypertensives if needed. However, population wide CVD assessment may not be cost-effective, especially if only a few individuals are eligible for treatment. Instead, it may be more cost-effective to use existing data to identify and assess those at risk of CVD. The findings of a study which evaluated the cost-effectiveness of two prioritisation strategies for inviting people for cardiovascular risk (CVD) assessment in primary care: inviting people for assessment based on age alone or inviting people based on an estimate of their prior CVD risk (using information available in GP clinical records), will be presented at the conference at 8.30am on Monday, 14th July.

A presentation on the cost-effectiveness of non-invasive diagnostic tests for use in the assessment of fibrosis and cirrhosis in patients in Hepatitis C will be given by Dr. Louise Longworth from HERG at the forthcoming 10th World Congress Health Economics in the Age of Longevity, a Joint iHEA & ECHE Congress in Dublin, Ireland. Hepatitis C is a virus which can infect and damage the liver leading to fibrosis and cirrhosis of the liver, where the healthy liver tissue is replaced with scar tissue. Treatment with anti-viral agents can be used successfully in patients who have developed fibrosis or cirrhosis to halt the progression of the disease. Diagnostic tests can be used to detect the presence of fibrosis or cirrhosis in patients with Hepatitis C and treatment can be initiated if required. Such tests include liver biopsy which is an invasive test which carries with it morbidity and mortality risks. Alternatively, all patients could be treated regardless of the degree of fibrosis or cirrhosis, however, this may not be cost-effective. A number of non-invasive diagnostic tests, such as Fibrotest and Fibroscan have been developed for use in patients with Hepatitis C. The findings of a study which evaluated the cost-effectiveness of a number of NITs for use in patients with Hepatitis C compared to treating all without a prior test or using liver biopsy will be presented at the conference at 8.30am on Tuesday, 15th July.

Published: Friday 20 June 2014

Atrial Fibrillation (AF) is a common heart condition, affecting about 800,000 people in the UK. With AF, the heart beats irregularly and too fast. This can cause blood clots, leading to strokes and other serious health problems. Anticoagulant drugs (such as Warfarin) can prevent these problems, but carry a risk of potentially serious side effects. 

The National Institute for Health and Care Excellence (NICE) has updated its clinical guideline on AF. This changes recommendations to patients and NHS clinicians about the use of anticoagulant drugs.

The new guideline was developed for NICE by an independent committee of experts and a team of researchers at the National Clinical Guidelines Centre. Brunel researchers contributed by providing a computer model that was used to estimate the cost-effectiveness of anticoagulants, and by advising on its use. 

The 'MAPGuide AF model' was a collaborative effort between health economists from HERG (Joanne Lord and Marta Trapero-Bertran) and simulation modellers from Department of Computer Science (Julie Eatock, Simon Taylor and Anastasia Anagnostou). It was developed as part of a wider project, funded by the Medical Research Council, to investigate methods for economic evaluation in clinical guidelines.

Published: Monday 16 June 2014

HERG researchers show the considerable value of UK public and charitably funded cancer research. HERG’s Matt Glover is first author on a new paper conducted with RAND Europe that estimates the net value of the improved health outcomes resulting from UK cancer research to be equivalent to an annual rate of return of 10%. http://www.biomedcentral.com/1741-7015/12/99

This new paper builds on the 2008 study led by HERG’s Prof Martin Buxton, Medical Research: What’s it Worth, that was extensively used in the 2010 Spending Review in successful lobbying to protect the UK medical research budget. That study showed the internal rate of return of the improved health outcomes resulting from UK cardiovascular disease (CVD) research was 9%, and in addition the best estimate for the GDP gains from that research was 30%. Together that gave an internal rate of return for UK CVD research of 39%, well above the 3.5% figure usually required by the Treasury for public investment.

In the new study for the returns from cancer research there was no further research undertaken on the GDP figure, so the 30% figure remains the best estimate but further analysis is currently being conducted in a separate research study. The new paper concludes by observing that the 10% met monetary benefit (NMB) for UK cancer-related research is very similar to that of 9% for CVD research: ‘The results suggest that, despite the uncertainties around the methods and estimates, the historical returns in terms of the NMB of the health gains derived in the UK from public and charitably funded biomedical and health research are substantial, and could by themselves justify the investment made.’

Published: Friday 6 June 2014

Matthew Glover, Martin Buxton and colleagues from LSHTM and the University of Cambridge published a paper in the British Journal of Surgery showing the NHS abdominal aortic aneurysm (AAA) screening programme in England is still cost-effective: http://onlinelibrary.wiley.com/doi/10.1002/bjs.9528/abstract

The research underpinning this paper is the most recent element in a long-standing stream focussing on the effectiveness and cost-effectiveness of AAA screening. In this paper modelling developed and published earlier was updated to reflect best current evidence and modern clinical practice. Although the updated parameters, particularly the increased costs and lower AAA prevalence, have increased the cost per QALY, the latest modelling provides evidence that AAA screening as now being implemented in England is still highly cost-effective.

Glover MJ, Kim LG, Sweeting MJ, Thompson SG, Buxton MJ. Cost-effectiveness of the National Health Service abdominal aortic aneurysm screening programme in England. Brit J Surg 2014; DOI: 10.1002/bjs.9528

In April 2014 Matt Glover had also presented the key findings at the Charing Cross International Symposium that attracts thousands of vascular specialists each year.

Published: Friday 28 March 2014

HERG-led research around transferability of health economic concepts and tools is featured in the recent issue of Pan European Networks’ publication Science and Technology. Talking about the European Commission funded €2 million EQUIPT project, the lead investigator Dr Subhash Pokhrel explains how return on investment (ROI) tools can help European Countries assess the costs and benefits of their investment in tobacco control.

Published: Friday 14 March 2014

Doug has a chair in health economics at the Department of Epidemiology and Community Medicine at the University of Ottawa, and obtained his PhD from Brunel with Martin Buxton as his supervisor. As Professor of Health Economics at HERG he contributes to a range of activities at HERG, including providing advice based on his experience of decision making processes through his membership of the Committee to Evaluate Drugs in Ontario.

Doug and Kathryn Coyle are specifically bringing their expertise in economic modelling to the EQUIPT project, a large EU-funded study led by Subhash Pokhrel that is quantifying the utility of investment in protection from tobacco. They had both previously worked with Subhash on the earlier HERG-led study to develop the NICE Return on Investment (ROI) tool in the UK.

Gemma Derrick is recipient of a prestigious ESRC Future Research Leaders Fellowship. Gemma’s research profile combines expertise in public health and research policy; she has PhD in Science Communication and Research Evaluation from the Australian National University. In her fellowship she is investigating the evaluation process surrounding societal impact of health research through a series of in depth, semi structured interviews with the REF2014 evaluators, bibliometric and network analysis and text analysis of EU and UK research policies. Claire Donovan will be providing mentoring support during Gemma’s project.

Published: Tuesday 4 March 2014

A new HERG publication is described by the Medical Journal of Australia as a “Timely study with pressure on funders to provide evidence of wider impacts of research”. The paper reports the findings of a HERG evaluation of the impact of research funded by Australia’s National Breast Cancer Foundation between 1995-2012. The Payback Framework was used to measure research impact on knowledge production, the research system, informing policy, product development and broader health and economic benefits. download

Published: Friday 14 February 2014

The NICEQoL project was funded by the MRC and NIHR under a call for methodological research to underpin decision-making at the National Institute for Health and Care Excellence (NICE). 

The aims of the project were to determine whether commonly used generic-preference based measures (GPBMs) of health are appropriate for key conditions and to explore alternative methods of capturing changes in health-related quality of life for economic evaluations when data from GPBMs are unavailable or inappropriate. Led by Dr Louise Longworth, the research was a collaboration between researchers from Brunel University and the University of Sheffield.

A series of comprehensive systematic reviews established that the most commonly used GPBM, EQ-5D, performs well in studies of cancer and skin conditions; however is likely to be inappropriate for studies of hearing disorders and some visual impairment. Mapping algorithms were estimated to predict EQ-5D values from alternative cancer-specific measures of health. Methodology to develop ‘bolt-on’ items to EQ-5D was explored for conditions where EQ-5D may currently benefit from improvements (hearing, vision and tiredness). A full valuation was conducted for a Vision bolt-on to EQ-5D. 

Longworth L, Yang Y, Young T et al. Use of generic and condition-specific measures of health-related quality of life in NICE decision-making: systematic review, statistical modelling and survey. Health Technology Assessment (2014) volume 18, number 9 

Published: Friday 24 January 2014

People in the UK are becoming less physically active.  This change in our lifestyle this is building up to a huge health problem, with estimates that physical inactivity is responsible for 16.9% of all premature deaths and costs the NHS over £940m.
 
The Health Economics Research Group (HERG) has been awarded £426,702 by the Department of Health to identify which interventions have been successful in getting people more active and which offer best value for money across England.
 
HERG will be taking a unique approach by considering characteristics which affect why and how people take up physical activity as well as the full range interventions.  Director of HERG and project lead, Professor Julia Fox-Rushby explains “We will be looking at projects around schools and sports but also town planning, bike trails, use of signs such as suggestions to take the lift rather than the stairs and social aspects of people’s lives such as going to the GP or activities at the workplace.”
 
The scope of the research is huge, and the team are looking for details of interventions which encourage people in England to be more physically active.  But for interventions to be considered by this research, they must be able to show evidence of their success.  Please contact Dr Nana Anokye if you could have this evidence.
 
As one of the leading research groups in health economics, HERG has considerable experience in the economics of physical activity.  Dr Nana Anokye, Dr Catherine Meads and Dr Joanne Lord from HERG will join Professor Fox-Rushby on this interdisciplinary project which also includes Dr Simon Taylor from Brunel’s School Of Information Systems Computers and Maths.  Dr Taylor will ensure the team produces a ‘fast and friendly’ computer model for comparing the costs and benefits of all physical activity interventions.
 
The team will be collaborating with Professor Peter Whincup from St George’s, University of London, Dr Charlie Foster from University of Oxford and Dr Barbara Jefferis from University College London.  
 
The results of this research will be used to inform how money could be best spent in encouraging people to be more active in England and identify which programmes are most effective for different groups of people at different stages of their lives.  Professor Fox-Rushby continues:  “We hope our model opens up an understanding of how best to encourage people to be more active over their lifetime.”

Published: Friday 17 January 2014

January marked the launch of IMPACT-EV, a four-year project to develop a permanent system of selection, monitoring, evaluation, and comparison of the impact and outcomes of European social sciences and humanities (SSH) research. The IMPACT-EV project team will apply state of the art quantitative and qualitative evaluation techniques, and project results will directly define the European Commission’s approach to evaluating the social impacts of its €50 billion investment in the 7th Framework Programme (2007-13) and €80 billion investment in Horizon 2020 (2014-20).

The research is funded by a €2.3 million grant under the European Union’s 7th Framework Programme. HERG’s Dr Claire Donovan is Co-investigator in a consortium spanning eight European countries.
[more…]

Published: Monday 6 January 2014

'Is brief advice in primary care a cost-effective way to promote physical activity?' by Nana Anokye, Joanne Lord and Julia Fox-Rushby has just been published by British Journal of Sports Medicine.

This study models the cost-effectiveness of brief advice (BA) in primary care for physical activity (PA) addressing the limitations in the current limited economic literature through the use of a time-based modelling approach. Compared with usual care, BA is found to be a cost-effective way to improve PA among adults. BA incurs additional costs of £806 809 but it is more effective leading to 466 QALYs gained in the total cohort, a QALY gain of 0.0047/person. The incremental cost per QALY of BA is £1730 (including mental health gains) and thus can be considered cost-effective at a threshold of £20 000/QALY. Further research is, however, required to provide more accurate evidence on factors contributing to the cost-effectiveness of BA. 

Published: Wednesday 30 October 2013

A new paper HERG describes the benefits from the locality-based Collaborations for Leadership in Applied Health Research and Care (CLAHRCs), and another paper synthesises the evidence and shows that there is a likelihood that clinicians and healthcare organisations who engage in and conduct research provide an improved performance.

In the evaluation of the CLAHRCs a team from HERG worked with RAND Europe and show the benefits of local universities and healthcare providers working together to identify research topics of relevance to the local healthcare system and increase the opportunities for translating appropriate findings into practice.

HERG also led an evidence synthesis on the question of whether those clinicians and healthcare organisations that are active in research provide improved healthcare. The review collected evidence to suggest that where there is such research engagement there is a likelihood of an improved healthcare performance. The team also developed a matrix to help identify and explore the diverse mechanisms at work in such healthcare improvement.

Published: Tuesday 17 September 2013

A HERG-led project to develop a decision-support tool comparing the cost of anti-smoking interventions with savings to the local economy and the wider health sector will be rolled out in countries across Europe following a funding grant of over €2 million. Led by Dr Subhash Pokhrel at HERG, this project will test the Tobacco Return on Investment (ROI) concepts and tools in several European countries, including Germany, the Netherlands, Spain and Hungary.

Published: Monday 19 August 2013

HERG’s payback research features in The World Health Report 2013 published on 15 August. This is WHO’s main annual publication and this year focuses on research systems for the first time. The section on the value of health research (pp46/7) states: ‘there is mounting quantitative proof of the benefits of research to health, society and the economy.’ The citation used to support this statement is Buxton et al (2008) ‘Medical Research: What’s it Worth.’ The section also describes HERG’s Payback Framework as the way to capture the diversity of benefits from research.

Published: Tuesday 6 August 2013

Prof Julia Fox-Rushby and Dr Nana Anokye receive funding from Sport England to conduct the evaluation of a Health and Sport Engagement project in London Borough of Hounslow.

Published: Monday 22 July 2013

Dr Louise Longworth recently attended the biannual congress of the International Health Economics Association (iHEA) in Sydney, Australia. She presented results of her research on ‘mapping’ between alternative measures of quality of life. 'Mapping' is an analytical technique that can be used to predict responses to preference-based quality of life measures when they have not been collected directly as part of a planned clinical research programme. It can facilitate the calculation of quality adjusted life years; a metric commonly used by healthcare decision-makers such as the National Institute for Health and Care Excellence in their assessments of health technologies.

The presentation was part of an organised session and Dr Longworth was joined by contributors from the Universities of Oxford and Sheffield, and from Erasmus University in the Netherlands.

Download publication: (2013) Longworth, L. and Rowen, D., Mapping to Obtain EQ-5D Utility Values for Use in NICE Health Technology Assessments, VALUE IN HEALTH 16 (1) : 202- 210.

Published: Thursday 30 May 2013

Dr Claire Donovan has been elected a Fellow of the Royal Society of Arts. The RSA was founded in 1754, and is today "an enlightenment organisation committed to finding innovative practical solutions to today’s social challenges". Notable past and present members include Charles Dickens, Adam Smith, Benjamin Franklin, Karl Marx, William Hogarth, and Stephen Hawking. Being elected an RSA Fellow depends on having achieved a contribution to society in a cultural or arts-related sphere. Claire was invited to become an RSA Fellow on the basis of her work for a recent report ‘A Holistic Approach to Valuing Our Culture: A Report to the Department of Culture, Media and Sport.’

RSA Website: http://www.thersa.org/

Download ‘A Holistic Approach to Valuing Our Culture: A Report to the Department of Culture, Media and Sport’ from the gov.uk website.

Published: Friday 10 May 2013

A report to the Department for Culture Media and Sport written by Dr Claire Donovan, was launched today on the DCMS website. The report is based on research carried out during a 6-month fellowship that was jointly-funded by the Arts and Humanities Research Council, the Economic and Social Research Council and DCMS. It focuses on the part of this research that engaged directly with representatives of the cultural sector, and with their views on the idea of measuring the value of culture.

Download ‘A Holistic Approach to Valuing Our Culture: A Report to the Department of Culture, Media and Sport’ from the gov.uk website.

Published: Friday 12 April 2013

Invited speakers: Dr Paula Adam and Maite Solans

From: Social Impact of Research Project at the Catalan Agency for Health Information, Assessment and Quality (CAHIAQ)

Provisional title: Assessing the Payback from Spanish Health Research, especially the impact of Spanish mental health research on clinical guidelines

Abstract of the presentation will be circulated closer to the time.

Published: Thursday 11 April 2013

A HERG report evaluating the returns of the $100 million research investment of Australia's National Breast Cancer Research was launched in Sydney on 9 April 2013. The report, written by Claire Donovan, Teresa Jones and Stephen Hanney, uses HERG's Payback Framework across eight different measures of impact across the research continuum. Carole Renouf, NBCF's Chief Executive Officer, described HERG as 'the world leader in evaluating the impact of health and medical research', and NBCF patron, Sarah Murdoch, said that 'based in what is considered to be the most comprehensive evaluation methodology of research impact in the world, we are proud of this first report card and intend it to be the basis of more in the future. With our hands on our hearts, we can now demonstrate that community funds invested in research through NBCF have been well spent.'

Download the report from the National Breast Cancer Foundation website.

Coverage on Sky News 

Coverage on ABC radio

Published: Tuesday 9 April 2013

Invited Speaker - Professor Lou Garrison, Pharmaceutical Outcomes Research & Policy Program, Department of Pharmacy, University of Washington. Currently Visiting Senior Research Fellow 2012-3, Office of Health Economics, London, UK

Title - Extending the QALY framework for HTA: Exploring the linkages among benefit-risk assessments, stratified medicines, and comparative effectiveness research

Published: Wednesday 16 January 2013

Invited speaker - Zoe Garrett

Zoe is currently completing a part-time PhD at Health Economic Research Group, Brunel University looking at the inclusion of caregiver outcomes in health technology assessment of treatments for rheumatoid arthritis. She has worked at the National Institute of Health and Clinical Excellence (NICE) as part of the technology appraisals work programme since October 2005. Prior to working at NICE she worked as a researcher specialising in systematic review at the Social Science Research Unit, Institute of Education, University of London and City University, London.

Title - Factors influencing the outcomes of caregivers of people with arthritis: a systematic review

Published: Thursday 7 June 2012

This is the question put to an Expert Panel of economists - including four Nobel laureates – as part of the Copenhagen Consensus Conference 2012 this week. They are considering evidence on the costs and benefits of solutions to ten different global challenges (from infectious and chronic diseases, climate change, education, population growth, armed conflict, natural disasters, water and sanitation, and biodiversity, hunger & malnutrition).

Evidence for each global is presented in a 'Challenge Papers' with two 'Perspective Papers' designed to question the methods and conclusions of each challenge paper. After deliberations, the Expert Panel's task is to create a prioritized list of solutions to the ten challenges, showing the most cost-effective investments. As in the past, this list will be utilized as an input by donors, governments and philanthropists.

Professor Julia Fox-Rushby has contributed one of the ‘perspective papers’ on chronic disease to this debate. All papers can be downloaded on the Copenhagen Consensus Center website.

Published: Friday 1 April 2011

In March, Brunel’s Health Economics Research Group (HERG) hosted an international two-day workshop on ‘State of the Art in Assessing Research Impact’. The workshop built on HERG’s leadership in assessing research impact, especially the ‘Payback’ Framework pioneered by Professor Martin Buxton and Professor Stephen Hanney in the 1990s to assess the outcomes of healthcare research. This approach gauges the contribution of research to knowledge production, capacity building, informing policy or product development, and broader social and economic benefits.

Participants included leading researchers from the USA, The Netherlands, Spain, and the UK, policymakers from the UK research councils and the Higher Education Funding Council for England, Brunel’s Research Support and Development Office, and Brunel’s Research Excellence Framework (REF) implementation team. The event was designed to draw on diverse disciplinary perspectives including healthcare research, science and technology studies, sociology, social policy, political science, philosophy, and research evaluation.

The workshop began by exploring recent ‘Payback’ studies of the impact of healthcare research in Ireland and in the US National Institutes of Health, and the application of the ‘Payback’ approach to assessing the impact of social science research.

Following that a new ‘productive interactions’ concept was discussed, focusing on reciprocal engagement between researchers and key stakeholders. Other papers dealt with approaches to assessing the impact of environmental research on policy, the use of ex ante peer review of grant proposals to assess potential research impact, and perspectives on assessing impact in the forthcoming REF.

Assessing research impact is a hot topic, and so lively discussion ensued. The role of impact assessment in the REF dominated the final discussion, with Professor John Brewer (Aberdeen University and President of the British Sociological Association) viewing this as ‘a sheep in wolves clothing’ while Professor Ben Martin (Science and Technology Policy Research University, University of Sussex) was concerned that ‘Payback’ assessments are a craft skill and assessing impact for REF will shift to ‘mass production’ and so lose sophistication. The key workshop outcome was that HERG’s ‘Payback’ approach was endorsed as state of the art, but with scope to continue evolving.

The workshop papers will be published as a special edition of the journal Research Evaluation in September 2011, which Dr Claire Donovan (HERG) will guest edit.

Published: Monday 7 March 2011

Clinical research has greater societal impact over a 15–20 year timescale, while basic research has greater academic impact, according to a new study from the Health Economics Research Group (HERG) and RAND Europe.

Project Retrosight was a multinational, four-year study that investigated the translation of basic biomedical and clinical cardiovascular and stroke research, and its impact on future work, policy, products and healthcare. The study was based on a rich source of material taken from 29 carefully selected case studies of grants for research conducted in these areas that were awarded 15-20 years ago.