Nurturing the lifecycle of research
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1 Nurturing the lifecycle of research Sheetal Bhurke, Ria Osborne and Sally Bailey (Presenter: Amanda Blatch-Jones) Research on Research Programme
2 What is Research on Research? NIHR The National Institute for Health Research (NIHR) is funded through the Department of Health to improve the health and wealth of the nation through research Research Programmes NETS Efficacy & Mechanism Evaluation (EME) Programme Health Service & Delivery (HS&DR) Programme Health Technology Assessment (HTA) Programme Public Health Research (PHR) Programme Systematic Reviews Programme (SRP) Research on Research Research on Research (RoR) is an internal programme to conduct high quality research to help inform, improve and make recommendations on the management of NIHR research Programmes and the projects they fund.
3 Adding Value in Research Developed from Chalmers I, Glasziou P. Avoidable waste in the production and reporting of research evidence. Lancet 2009; 374 (9683):86-89.
4 Purpose and scope Establish how research recommendations from Cochrane Reviews inform the NIHR HTA identification process Review how Cochrane Reviews inform the prioritisation and commissioning process (what gets funded?) Establish how subsequent NIHR HTA studies feed back into updated Cochrane Reviews
5 Methods Retrospective cohort October 1999 to December 2013 Review of NIHR HTA information systems for submitted research recommendations from Cochrane reviews (commissioned work stream) Review of Cochrane Library to assess HTA trials contribution to the updating of future reviews Citation analysis for studies published to December 2012 Used Database of Abstracts of Reviews of Effects (DARE) [ceased in March 2015]
6 Results (1) 4,450 Cochrane review recommendations recorded in NETS system 74 Cochrane review research recommendations prioritised and commissioned by the NIHR HTA programme during Recommendations not taken forward by the Programme were not reviewed (work in progress) 271 applications received against the 74 recommendations 64 studies were funded against the Cochrane review research recommendations
7 Results (2) Of the 64 funded studies, 20 were published before the end of 2012: 10 primary research 10 secondary research A review of the funded secondary research was undertaken NIHR HTA secondary research studies - prioritised through Cochrane - 2 Cochrane recommendations based on further cost-effectiveness research - 8 Cochrane recommendations for primary research but the HTA programme justified the need for an evidence synthesis or an economic modelling study
8 Secondary Research Example The Cochrane review (Gibbs 2003) suggested an urgent need for better quality randomised controlled trial on the routine treatments for common warts, particularly cryotherapy. The HTA funded project - Thomas 2006 (Effectiveness and cost-effectiveness of salicylic acid and cryotherapy for cutaneous warts. An economic decision model, Health Technol Assess, 2006; 10 (25)) The HTA Commissioning Brief stated, There was an uncertainty as to whether cryotherapy is more effective than topical salicylic acid and the HTA Programme is considering commissioning a randomised controlled trial. However, given its higher costs, cryotherapy would have to be substantially more effective to be costeffective. We are seeking analysis using an economic model of whether such a result is plausible enough to justify the trial.
9 NIHR HTA trials informing the updated Cochrane Reviews 7 reviews updated since the publication of the relevant NIHR HTA studies 5 reviews included the NIHR HTA studies in the updated version 1 review changed their conclusions after inclusion of the NIHR HTA study 1 review changed their conclusion based on the NIHR HTA study only
10 Conclusions Appropriateness of research recommendations to inform the development of high priority questions Accessibility of research outputs to help inform and add value to current knowledge Value and importance of completed studies to help inform updated reviews Is the question relevant? What does existing evidence say? Contributing to and updating what?
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