HEDS is part of the School of Health and Related Research (ScHARR) at the University of Sheffield. We undertake research, teaching, training and consultancy on all aspects of health related decision science, with a particular emphasis on health economics, HTA and evidence synthesis.

Thursday, 22 March 2018

February’s CEAs.....

Our quick search for CEA’s published in February uncovered 51 articles.   In the right-hand column of this blog is a CEA Archive, which includes our CEA search results by month.  Below are those in our areas of interest.
  • Alemao E, Johal S, Al MJ, Rutten-van Molken M. Cost-Effectiveness Analysis of Abatacept Compared with Adalimumab on Background Methotrexate in Biologic-Naive Adult Patients with Rheumatoid Arthritis and Poor Prognosis. Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research. 2018;21(2):193-202.
  • Hernandez L, Lanitis T, Cele C, Toro-Diaz H, Gibson A, Kuznik A. Intravitreal Aflibercept Versus Ranibizumab for Wet Age-Related Macular Degeneration: A Cost-effectiveness Analysis. Journal of managed care & specialty pharmacy. 2018:1-9.
  • Kumar V, Cohen JT, van Klaveren D, Soeteman DI, Wong JB, Neumann PJ, et al. Risk-Targeted Lung Cancer Screening: A Cost-Effectiveness Analysis. Annals of internal medicine. 2018;168(3):161-9.
  • Laiteerapong N, Cooper JM, Skandari MR, Clarke PM, Winn AN, Naylor RN, et al. Individualized Glycemic Control for U.S. Adults With Type 2 Diabetes: A Cost-Effectiveness Analysis. Annals of internal medicine. 2018;168(3):170-8.
  • Russell LB, Bhanot G, Kim SY, Sinha A. Using Cluster Analysis to Group Countries for Cost-effectiveness Analysis: An Application to Sub-Saharan Africa. Medical decision making : an international journal of the Society for Medical Decision Making. 2018;38(2):139-49.

Wednesday, 21 March 2018

Our University ranked in the top 50 most international universities in the world

We have been named as one of the 'most international' universities by The Times Higher Education.

The 2018 league table of the world’s most international universities celebrates institutions that have an outstanding international reputation, in turn helping to attract the very highest calibre of staff and students. The University of Sheffield is ranked 42nd out of the 800 leading universities worldwide. The rankings consider the "international outlook" of institutions, including levels of international staff, students and research co-authors, as well as universities' international reputations.

A place in the highly-regarded top 50 - which also includes Oxford, Cambridge and the leading universities in the U.S and Asia - marks a significant increase in Sheffield’s international reputation ranking in 2018. A key factor in this success has been the concerted effort at building overseas partnerships with the world's top universities and industry, efforts which open opportunities for staff and student exchange, research collaboration and inward investment in the local economy.

Image of students outside The Diamond Building in Sheffield
Vice-Chancellor Professor Sir Keith Burnett – who has personally led the University's focus on global reputation and strategic partnerships, in particular in China – said: "The University of Sheffield has always been internationally minded but recently we have focused even more on the partnerships we know are crucial not only to our research but which will also create opportunities for our students and our region. As a result, the university is now working with four of the top five universities in China and our industrial partnerships are highly regarded around the world, with the AMRC also active in the U.S., China and South Korea.

"I am also deeply proud that The University of Sheffield is a global university with over 140 nationalities represented on campus and that our city has always made clear that staff and students from around the world are welcome. We know these students and staff make a huge contribution to academic life, knowledge and our economic growth as a nation as well as working in our local hospitals as trainee doctors, carrying out invaluable research into diseases like cancer and motor neurone disease, and also volunteering for charities."
Phil Baty, Editor at Times Higher Education, said: “The best universities in the world live or die by their ability to attract the brightest talent from all across the world - students, academics, researchers and managers. I believe that a university simply cannot be world class without a global outlook, a global network and a global pool of talent.”

Wednesday, 14 March 2018

Website of the Month - ISPOR International Digest of Databases

This month's website is the ISPOR International Digest of Databases. 

Image of ISPOR International Digest of Databases website

Taken from the site:
"The International Society for Pharmacoeconomics and Outcomes Research (ISPOR) has developed an electronic index (digest) of 400 databases from 45 countries.  The Digest consists of key attributes of health care databases. It is grouped by country and allows both key word searches and searches by type of database.

The Digest is an invaluable source of information for health care outcomes researchers around the world.  This information is also very useful to health care decision makers, clinicians, and ultimately, patients.

If your organization has a health care database that could be included in the ISPOR International Digest of Databases, please complete the questionnaire at: Health Care Database Key Attributes Questionnaire."

Wednesday, 7 March 2018

Short Course - Evidence Synthesis of Qualitative Research in Europe (ESQUIRE)

The ScHARR short Course Unit are running a three day course on Evidence Synthesis of Qualitative Research in Europe (ESQUIRE)
Tue 11th - Thu 13th September 2018

Course overview: The course will follow the systematic review process as it applies, and is adapted to, qualitative evidence synthesis. The Programme Faculty will take participants through the stages of defining and exploring scope, conducting the literature searches, quality assessing studies for inclusion, synthesising data and writing up and presenting the product of the synthesis. Participants will be provided with practical experience of key stages in the review process.The course will be led by members of the Cochrane Qualitative Research Methods Group.

Who will benefit from this course? No formal experience is required, working knowledge of standard systematic review methods or a background in qualitative research methods will be an advantage, but not essential.Qualitative Researchers who want to learn how to synthesise qualitative researchSystematic Reviewers who want to learn how to translate synthesis methods to qualitative data.
Image of Halifax Hall - Sheffield
Halifax Hall
PhD Students in topic areas that require substantive review of qualitative research
New researchers who want to develop evidence synthesis/systematic reviewQualitative systematic reviewers who want to update and extend their skills and knowledgePlease note there is a discounted fee for bookings confirmed before 2nd July 2018.

Link to further course informationhttps://www.sheffield.ac.uk/scharr/shortcourseunit/esquire2018

Link to our online booking storehttps://onlineshop.shef.ac.uk/conferences-events/faculty-of-medicine-dentistry-and-health/school-of-health-and-related-research-scharr

Course leaders
Members of the Cochrane Qualitative Research Methods Group and Experienced ScHARR Staff.
Dr Andrew Booth, Reader in Evidence Based Information Practice and Director of Information, ScHARR, University of Sheffield and Course Leader of this popular course.
Fiona Campbell, Research Fellow, ScHARR, University of Sheffield.
Helen Buckley-Woods, Information Specialist, ScHARR, University of Sheffield.
Megan Wainwright, is a member of the core international CERQual team

Tuesday, 6 March 2018

New Short Course - The Application of Psychometrics for Measuring Health Outcomes and Quality of Life

The Application of Psychometrics for Measuring Health Outcomes and Quality of Life - 2 part course (can be done together or individually)

Part 1: 2 day course - Mon 14th - Tues 15th May 2018

Part 2: 3 day course - Weds 16th - Fri 18th May 2018

Part 1: The aim of this 2 day course is to provide participants with an introduction to psychometrics as applied to health. It will cover the core psychometric and statistical methods used in scale construction and the development of multi-item patient-reported outcome measures (PROMs). Sessions will be delivered by external staff Professor Jakob Bue Bjorner - Optum Patient Insights and Georgina Jones - Leeds becket University, who have an international reputation in psychometric methods and questionnaire development, analysis and interpretation and ScHARR Staff Anju Keetharuth. The course will be interactive and practical. Sessions will be delivered using lectures and individual and small group practical exercises using real world examples.

Image of The Edge Sheffield
The Edge Sheffield
By the end of this course participants should be able to:

  • Identify the key stages involved in scale construction and development
  • Understand the qualitative process involved in the development of a PROM and item generation
  • Describe the different ways of scoring and scaling a PROM and the theory underpinning these
  • Understand exploratory (EFA) and confirmatory (CFA) factor analysis and be able to carry out EFA using SPSS
  • Understand what is meant by reliability, validity, and responsiveness and be able to analyse and interpret these using SPSS
  • Explore the above concepts using datasets from a range of existing disease-specific and generic PROMs
  • Be aware of the use of different software other than SPSS where applicable.
Part 2: The aim of this 3 day course is to provide participants with an introduction to advanced psychometric models in analysis of multi-item patient-reported outcome measures (PROMs). The course will cover confirmatory factor analytic methods for categorical data, Rasch models, and other items response theory (IRT) models. Sessions will be delivered by external staff Jakob Bue Bjorner - Optum Patient Insights, who has an international reputation in advanced psychometric methods and ScHARR Staff Anju Kaeetharuth. The course will be interactive and practical. Sessions will be delivered using lectures and individual and small group practical exercises using real world examples.

By the end of this course participants should be able to:
  • Perform item-level confirmatory factor analysis (CFA) of PROMs using Mplus software
  • Understand the assumptions of CFA models, evaluate model fit, and revise the model
  • Understand the similarities and differences between CFA models, Rasch models and other IRT models
  • Perform IRT analyses using the Mplus software
  • Understand the assumptions of Rasch and IRT models and the principles for testing the models
  • Use results from IRT analyses to develop or select the optimal PROM for a particular research purpose
  • Be aware of the use of other software for CFA, Rasch and IRT analyses.

Link to further information on Part 1 of the course https://www.sheffield.ac.uk/scharr/shortcourseunit/psychometricspart1-2018
Link to further information on Part 2 of the course https://www.sheffield.ac.uk/scharr/shortcourseunit/psychometricspart2-2018

Link to our Online Store, where all of our ScHARR short course bookings are initially processed:

Monday, 5 March 2018

Update on Minimum Alcohol Pricing

Colin Angus from HEDS gives an update on recent developments around Minimum Unit Pricing for alcohol, how research that has been going on in ScHARR has fed into these and their potential implications for Public Health policy.

On the 15th November 2017, the UK Supreme Court ruled that a Minimum Unit Price for alcohol was legal in Scotland. This ended a bitter court battle between the Scottish Government and the alcohol industry over this flagship Public Health policy which had been running since 2012, when the policy was first passed into law. ScHARR’s Sheffield Alcohol Research Group, including several modellers from HEDS, have played an integral part in this legal dispute, publishing a series of reports which addressed key questions at each stage of the legal process. These included: was Minimum Pricing effective; was it well targeted at the population at greatest risk of harm; and how would it impact on socioeconomic inequalities in health. For the Supreme Court the critical question was whether the introduction of Minimum Pricing, which had previously been adjudged to contravene EU laws on the free movement of goods, was a more proportionate means of addressing the Public Health burden of alcohol than more conventional approaches such as increasing alcohol taxes, in which case it would still be legal. 

CC BY 2.0 Karen http://bit.ly/2HRb6m4
ScHARR’s research (which you can read here) showed that this was indeed the case, with substantial tax rises of at least 28% being required to achieve the same impact as a 50p Minimum Unit Price, and with such a tax rise having a much greater effect on people drinking at moderate levels while failing to effectively target the heaviest drinkers, who disproportionately purchase the cheapest alcohol most affected by a Minimum Price. The Supreme Court’s ruling makes it clear that they found this modelling work extremely persuasive and it formed a key part of their decision making process.

With the policy scheduled to finally come into force on the 1st May this year, the Alcohol Research Group's most recent research suggests that Scotland is likely to see a significant fall in alcohol consumption (3.5%) and associated reductions in hospital admissions (6.8%) and deaths (7.4%) caused by alcohol, with the vast majority of these benefits accruing to heavy drinkers, particularly those on low incomes. The Supreme Court decision also has wider implications for Public Health policy in the UK beyond alcohol. As well as demonstrating that it is possible to implement strong Public Health approaches, even in the face of staunch opposition, the Supreme Court also made very clear the decision on whether a health policy is proportionate relative to its impact on free trade lies with politicians and not with the courts. This may open the way, where there is political will, for bold new policies in areas such as tobacco control and sugar taxes. Perhaps emboldened by Scotland's success, Wales, Ireland and, somewhat further afield, Australia's Northern Territory are already in the process of introducing their own Minimum Unit Price legislation

Friday, 2 March 2018

PhD Opportunity at HEDS - Conducting indirect comparisons between treatments using disconnected evidence

ScHARR is currently advertising a project with the Healthcare Gateway scheme in collaboration with Amgen, supervised by HEDS academics Dr John Stevens and Dr Kate Ren:

If you are aware of any Home/EU students who may be eligible, please do encourage them to apply. 

Project Description
Image of Regent Court - ScHARR
Regent Court - ScHARR
The decision to recommend interventions for use by the National Health Service in England is typically based on a health technology assessment that considers the relative costs and benefits associated with new and existing interventions. Health benefits are quantified using quality-adjusted life years, which involves estimation of the population mean survival for competing interventions. 

When evidence is available about interventions evaluated in randomised controlled trials that share at least one treatment in common, relative effects can be estimated using network meta-analysis methodology. In some circumstances the evidence base may comprise patient-level data from singlearm or randomised controlled trials of a company’s intervention, and aggregate data from single-arm or randomised controlled trials of one or more comparator interventions but in which the trials do not share any interventions in 

The aim of the research is to better understand statistical methods for assessing relative intervention effects on time-to- event outcomes associated with disconnected networks of evidence and to explore the assumptions behind the statistical methods. The intention is 
to build on the review by Stevens et al (2018) and NICE DSU Technical Support Document 18: Methods for Population-Adjusted Indirect Comparisons in Submissions to NICE. 

The research questions will include: 
  • How should indirect comparisons between interventions be made using disconnected evidence? 
  • What is the extent of the systematic error arising from unaccounted for covariates when making unanchored comparisons using disconnected evidence? 
  • How should the systematic error arising from unaccounted for covariates be adjusted for using disconnected evidence? 
The research will focus primarily on statistical methods applicable to drug development in oncology in which interest is in estimating mean lifetime benefit i.e. involving the extrapolation of survival functions beyond the duration of an RCT and allowing for time- varying intervention effects. 

It is envisaged that in the first year, the student would familiarise themselves with the design, analysis and reporting of oncology studies for drug registration and reimbursement purposes; the standard statistical literature on NMAs; the statistical literature on analysing 
patient-level observational data; and methods for populationadjusted indirect comparisons. In addition, the student would conduct a review of applications in the scientific literature and to reimbursement agencies of indirect comparisons using disconnected evidence. 

In the second year, the student will develop and propose a method(s) for conducting indirect comparisons between interventions using disconnected evidence in the context of products for the treatment of cancer; the focus will be on the appropriate estimation of mean overall survival. The research will involve quantifying the extent of the systematic error arising from unaccounted for covariates when making unanchored comparisons using disconnected evidence and assessing the frequentist properties of the model using simulation methods. In addition, the use of Bayesian methods that allow the incorporation of external information to reflect parameter and structural uncertainty in addition to sampling variation will also be investigated. 

In the third year, the student will complete the simulations, finalise recommendations, write manuscripts for publication in scientific journals, present the research at scientific conferences and complete the thesis. 

Entry Requirements: 
Candidates must have a first or upper second class honours degree in Mathematics or Statistics, and a master’s degree in biostatistics or medical statistics, or significant research experience.

Thursday, 1 March 2018

Latest Publications from HEDS in February

Once again we explore what new publications have been produced by HEDS in collaboration with colleagues in ScHARR. Many of these are currently in press, so you can find much of our work in its open access form via our institutional repository. Tuck in here.

Image of Eye Journal   
© Royal College of Ophthalmologists
       Carlton, J. & Kaltenthaler, E. (n.d.) Amblyopia and quality of life: a systematic review. Eye.

       Pandor, A. et al. (2018) Ponatinib for Treating Chronic Myeloid Leukaemia: An Evidence Review Group Perspective of a NICE Single Technology Appraisal. Pharmacoeconomics. [online]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29480454.

       Pollard, D. J. et al. (n.d.) The cost-effectiveness of insulin pumps compared to multiple daily injections, both provided with structured education, for adults with type 1 diabetes: a health economic analysis of the relative effectiveness of pumps over structured education (REPOSE) randomised controlled trial. BMJ Open.
Image of PharmacoEconomics Journal
© Adis

Thokala, P. et al. (2018) Cost-Effectiveness Thresholds: the Past, the Present and the Future. Pharmacoeconomics. [online]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29427072.

Wong, C. K. H. et al. (2018) Direct medical costs of diabetes mellitus      in the year of mortality and year before mortality. Diabetes Obes Metab. [online]. Available from: https://www.ncbi.nlm.nih.gov/pubmed/29430799.

Tuesday, 27 February 2018

HEDS Short Course - An introduction to using Social Media to Communicate Research

HEDS are running a one day course An introduction to using Social Media to Communicate Research on Tuesday 15th May at Halifax Hall in Sheffield.

Background: The treadmill of academia is a relentless one: proposal, research, write, present and then hopefully publish before starting all over again, all in the hope that the research is recognised as being of good quality, worthy and valuable. There's one problem though - journals are not geared up for the modern online world of instant sharing and communication. Tools and ways of communicating research such as Twitter, YouTube, ResearchGate, Slideshare, blogging, infographics, animation and many others will be covered. The good news is they are mostly free and can work together to help research to reach a wider audience. That audience is not just academic peers, but publishers, editors, fund holders and the general public.
Image of Halifax Hall - Sheffield
Halifax Hall - Sheffield
Course Overview: The aim of the workshop is to offer an introduction to the many tools you can use to help you communicate research and work smarter. The purpose of the day is to help attendees come away with a variety of tools and artefacts they can use to help communicate and share their work. We will teach you basics of social media in an academic setting and demystify some of the barriers that may have put you off from using these tools in your work.
We will show you how to make the most from these technologies and show you how to find out alternative ways of discussing and communicating research. Attention will be paid to the various ethical issues to working more on the web from copyright and Creative Commons to making more use of your mobile device, from safety and security to how you conduct yourself online and netiquette.
This short course will benefit a wide range of people including (but not exhaustive of):
  • Researchers,
  • Masters and PhD students,
  • Research Support Staff and Managers,
  • Library and Information Professionals,
  • Communications and Marketing Professionals.
Course leaders:
Andy Tattersall
Claire Beecroft

Link to further course information:

Link to our online booking store:

Monday, 26 February 2018

More than 200 million medication errors occur in NHS per year

A new study has revealed an estimated 237 million medication errors occur in the NHS in England every year, and avoidable adverse drug reactions (ADRs) cause hundreds of deaths. Researchers from HEDS alongside colleagues from the Universities of York and Manchester report that an estimated 712 per year deaths result from avoidable ADRs. However, researchers say that ADRs could be a contributory factor to between 1,700 and 22,303 deaths a year.
Of the total estimated 237 million medication errors that occur, researchers found that almost three in four are unlikely to result in harm to patients, but there is very little information on the harm that actually happens due to medication errors.
This led researchers to review studies related to the harm caused to patients from ADRs. As well as the number of deaths reported, they also showed that avoidable ADRs had significant cost implications, at £98.5 million per year, but this could be significantly higher.
Fiona Campbell, Research Fellow from HEDS, said: “Measuring harm to patients from medication errors is difficult for several reasons, one being that harm can sometimes occur, when medicines are used correctly, but now that we have more understanding of the number of errors that occur we have an opportunity to do more to improve NHS systems.”
Image of medications
CC BY 2.0 e-Magine Art http://bit.ly/2EVwvc3
The economic impact of medication errors varied widely, from £60 per error for inhaler medication, for example, to more than £6 million in litigation claims associated with anaesthetic errors. The team is calling for more work to be done on finding cost-effective ways of preventing medication errors and their potential harm to patients.
The report, which reflects on 36 studies that detail medication error rates in primary care, care homes and secondary care, showed that the most errors with potential to cause harm happen in primary care (71 per cent), which is where most medicines in the NHS are prescribed and dispensed.
Errors were more likely to occur in older people and in patients with multiple conditions and using many medicines. 
Professor of Health Economics at the University of York, Mark Sculpher, said: “Although these error rates may look high, there is no evidence suggesting they differ markedly from those in other high-income countries. Almost three in four errors would never harm patients and some may be picked up before they reach the patients, but more research is needed to understand just how many that is.”
Rachel Elliott, Professor of Health Economics from the University of Manchester said “The NHS is a world-leader in this area of research, and this is why we have a good idea about error rates. There is still a lot to do in finding cost-effective ways to prevent medication errors. What this report is showing us is that we need better linking of information across the NHS to help find more ways of preventing medication errors.”
The report, funded by the UK Department of Health Policy Research Programme, will be unveiled at the World Patient Safety Science and Technology Summit and is published by the Policy Research Unit in Economics Evaluation of Health and Care Interventions (EEPRU).
Staff and students in the University of Sheffield‘s School of Health and Related Research (ScHARR) work together to tackle some of the world’s biggest health challenges to improve the health and care of people in the UK and around the world.

You can read the report here