Stephen Senn inaugural lecture….

…titled "Numbers needed to mislead, meta-analysis and muddled thinking".  Stephen is an Honorary Professor in the Design, Trials and Statistics section of ScHARR.

The lecture is on Wednesday 26 October 2016, 17.15-18.00 and followed by a wine reception.  The lecture is in Lecture Theatre 4, The Diamond. All are welcome to attend.  Please confirm your attendance, using the on-line booking form here.

The abstract to his lecture is below:

'The ardent espousal by the evidence based medicine movement of numbers needed to treat (NNT) as a way of making difficult statistical concepts simple and concrete, has has the unintended consequence of sowing confusion. Many users, including many in the evidence based movement themselves, have interpreted these statistics as indicating what proportion of patients benefit from treatment. However, they cannot deliver this information.

I shall explain this, with the example of a recent Cochrane Collaboration meta-analysis of paracetamol against placebo in trials of tension headache for which the plain language summary claimed:

'The outcome of being pain free or having only mild pain at two hours was reported by 59 in 100 people taking paracetamol 1000 mg, and in 49 out of 100 people taking placebo (high quality evidence), meaning that only 10 in 100 people benefited because of paracetamol 1000 mg.'

With the aid of a simple model also illustrated (just for fun) by a simulation, I shall show that the plain language conclusion is plain wrong. The observed facts do not necessarily mean that only 10 in 100 people benefited.

I conclude that the combination of arbitrary dichotomies and NNTs has a dangerous ability to deceive and may be leading us to expect much more of personalised medicine than it can deliver'

Image: The Diamond by Kyle Emmerson

Proceedings of Sheffield PROMs Conference 2016

Abstract from the Conference held on 9th June 2016 are now available in Health and Quality of Life Outcomes via here.  The papers are listed below.

• Using computerized adaptive testing
• Well-being: what is it, how does it compare to health and what are the implications of using it to inform health policy?
• “Am I going to get better?” - Using PROMs to inform patients about the likely benefit of surgery
• Identifying Patient Reported Outcome Measures for an electronic Personal Health Record
• Examining the change process over time qualitatively: transformative learning and response shift
• Developing a PROM to evaluate self-management in diabetes (HASMID): giving patients a voice
• Development of the Primary Care Outcomes Questionnaire (PCOQ)
• Developing the PKEX score- a multimodal assessment tool for patients with shoulder problems
• Applying multiple imputation to multi-item patient reported outcome measures: advantages and disadvantages of imputing at the item, sub-scale or score level
• Integrating Patient Reported Outcome Measures (PROMs) into routine primary care for patients with multimorbidity: a feasibility study
• eRAPID: electronic self-report and management of adverse-events for pelvic radiotherapy (RT) patients
• Patient reported outcomes (PROMs) based recommendation in clinical guidance for the management of chronic conditions in the United Kingdom
• Cross-sectional and longitudinal parameter shifts in epidemiological data: measurement invariance and response shifts in cohort and survey data describing the UK’s Quality of Life
• Patient-reported outcomes within health technology decision making: current status and implications for future policy
• Can social care needs and well-being be explained by the EQ-5D? Analysis of Health Survey for England dataset
• Where patients and policy meet: exploring individual-level use of the Long-Term Conditions Questionnaire (LTCQ)

ScHARR Pemberton Lecture

"Alcohol: evidence-based policies and practical implementation – mind the gap" given by Professor Sir Ian Gilmore

Image: brew bottles by frankieloen

Monday 3 October 2016 at 17.30 followed by a wine reception, The University of Sheffield Students' Union Auditorium, Western Bank, Sheffield.

Alcohol has been part of human culture for more than five thousand years and remains a topic of continuing interest - everyone is an expert on why we drink and how much. There is now a wealth of scientific analysis of consumption and harm in populations that differ in ethnicity, gender, age, equity and other variables, and this has allowed a clear picture of what works and doesn’t work in optimising our troubled relationship with alcohol. However there are so many vested interests in our favourite drug that putting this evidence into practice has met with challenges that remain unresolved but infinitely fascinating.

Professor Sir Ian Gilmore is an honorary consultant physician at the Royal Liverpool University Hospital and holds an honorary chair at the University of Liverpool. He is a past-president of the Royal College of Physicians (RCP) and the British Society of Gastroenterology. He is chairman of Liverpool Health Partners, created to promote an Academic Health Science System in the city and he chairs the UK Alcohol Health Alliance. He is also President of Alcohol Concern and is a member of the Climate and Health Council.

Free admission, by ticket only....but available here.

HEDS Spring Seminars

Celebrate the arrival of Spring by attending one of our seminars...

Image: Daffodils by Chris Waits

Thursday 24th March

Caroline Clarke, University College London (UCL)

“Modelling the cost-effectiveness of preventing hazardous drinking: is what’s good for the goose also good for the gander?”

Pemberton Room, 12pm

Thursday 21st April

Chris Sampson, University of Nottingham

“Risk-based screening for diabetic retinopathy: A model for individualisation”

Pemberton Room (B side only), 12pm

Thursday 19th May

Bogdan Grigore, University of Exeter

“Methodological trade-offs in the use of expert elicitation in Health Technology Appraisal (HTA)”

Pemberton Room (B side only), 12pm

Thursday 16th June

Beth Woods, University of York

“Partitioned survival analysis: a critical review of the approach and application to decision modelling in health care”

Pemberton Room, 12:00pm

Thursday 28th July

Jamie Kirkham, University  of Liverpool

“A random walk through outcomes based research for healthcare”

Pemberton Room (B side only), 12:30pm

All seminars are within Regent Court, 30 Regent Street. All University staff and students are welcome at the seminars. There is no need to book - just come along. Tea and coffee will be provided, and you're welcome to bring your lunch to all events.

ISPOR details

We can now give all our ISPOR details.  Click the images below for presentation information.  If you want to talk to us, you can also come to stand number 308 where you can discuss all aspects of ScHARR's work (not just HEDS).

Just as a reminder....ScHARR is an International Centre of Excellence for Health Technology Assessment (HTA), Health Economics and Decision Modelling, Health Services Research, and Public Health. We have over 20 years’ experience of providing worldwide knowledge transfer activities in the health.  Innovation and Knowledge Transfer (IKT) allows us to utilise the impact of ScHARR’s research by applying our expert knowledge and skills in the real world of health and social care. Our support covers private industry, public and third sectors as well as other policy, decision-making and academic collaborations in health. Innovation and Knowledge Transfer (IKT) allows us to utilise the impact of ScHARR’s research by applying our expert knowledge and skills in the real world of health and social care.

ISPOR, Milan, HEDS.....

While we put together the details of what we are doing at the forthcoming ISPOR conference, here's a quick outline..... 2 short courses, 1 plenary presentation, 3 workshops, 2 podium presentations, 1 forum, 1 issue panel and four posters.  Plus a stand to discuss future work, collaborations, teaching and training.

HEDS Autumn Seminars

Broaden your horizons….all are welcome!!!

Wed. 21st Oct. – Dr Katherine Stevens, ScHARR – Pemberton room
The ScHARR MOOC on Measuring and Valuing Health – come and learn about PROMS and QALYs

Thur. 19th Nov. – Carmen Casas, visiting fellow, ScHARR – Eric Wilkes room
HTA in Brazil: The process for Appraisal, Decision Making and Reimbursement

Thur. 17th Dec. – Dr Jamie Kirkham, University of Liverpool – Trent room
A random walk through outcomes based research for healthcare

Thur. 21st Jan. – Stuart Campbell, University of Sheffield – Pemberton room
Parental ethnic identity and child development

Thur 18th Feb. – Paul Revill, University of York – Trent room
Cost effectiveness thresholds in low and middle income countries

You can be alerted to the HEDS seminars as they are booked by adding the HEDS seminars calendar to your Google calendar by visiting here and clicking on the + image link that says *Google calendar* (at the bottom right hand corner of the calendar - look closely, it is there but kinda small).

ScHARR Autumn Seminar Series

Seminars  run every other week on Tuesdays at 12.30 to 1.30 and are usually in the Pemberton Lecture Theatre in Regent Court (unless mentioned otherwise).

6th Oct - Flavia Fernandes, Universidade de Sao Paulo ~ Brazilian pre-hospital care: a case study of Sao Paulo City.

13th Oct - Anju Keetharuth, ScHARR ~ Recovering Quality of Life (ReQoL): development of a generic PROM for mental health populations.

3rd Nov - Mike Kelly, University of Cambridge ~ TBC.

10th Nov - Rosie McEachan, Born in Bradford team, NHS ~ Born in Bradford - from epidemiology to intervention.

17th Nov - Max Moullin, Director of Public Sector Scorecard Research Centre and Visiting Fellow of Sheffield Business School ~ Using the Public Sector Scorecard in health and social care.

1st Dec -  Kalipso Chalkidou, NICE (Director of NICE International) ~ Setting priorities for health soending: who lives, who decides?

8th Dec - Mystery Speaker

15th Dec (Eric Wilkes) - Matthew Sperrin, University of Manchester ~ TBC.

All staff and students are welcomed and there will be refreshments. There is no need to book.

Short Courses at HEDS and ScHARR

Evidence Synthesis of Qualitative Research in Europe (ESQUIRE) 2015
2.5 day course: Monday 24th - Wednesday 26th, August 2015

Remixing Research - Methods for Increasing and Measuring your Scholarly Output on the Web
1 day course: Thursday, 15th October 2015

Rapid Review Methods
1 day course: Wednesday, 11th November 2015

The Application of Psychometrics for Health Measurement
Monday 23rd - Friday 27th, November 2015

Cluster Randomised Trials Design and Analysis
1 day course: Wednesday, 2nd December 2015

A Guide to Doing Mixed Methods Studies in the Health Sciences Short Course
1 day course: Tuesday, 9th February 2016

The Identification and Review of Evidence to Inform Cost Effectiveness Models
1 day course: Thursday, 25th February 2016

Utility Data for Health Technology Assessment
2 day course: Monday 7th and Tuesday 8th March 2016

Systematic Reviews and Meta-analysis Short Course
3 day course: Tuesday, 12th - Thursday, 14th April 2016

Online Open Days

The School of Health and Related Research (ScHARR) run various online open days aimed at people who are considering applying for postgraduate study at ScHARR. Online open days are an opportunity for you to learn more about our courses and how they are taught. They also allow students to talk with members of teaching staff and ask questions directly.

Online open days at ScHARR

You can book onto these here.

The next two open days are:

20 April 2015 (12pm) ~ MSc Health Economics and Decision Modelling
14 May 2015 (12.30pm) - MSc International Health Technology Assessment

European Health Economics Association PhD Student-Supervisor Conference

After a successful inaugural conference last year, the 2nd conference has been confirmed for 2 – 4 September 2015 in Paris.  The conference provides a unique opportunity for PhD students and early career researchers to receive detailed feedback on their research. Each paper will be allocated one hour, for presentation and detailed discussion led by another student’s supervisor.

Deadline for submission of abstracts is 23 March 2015.  Further details are available here.

If you want to have a look at what is required, the abstracts from last year’s conference are still available here.

HERG Virtual Research Seminars

The HERG virtual research seminar is a web-based meeting for PhD students and early career researchers in health economics based at universities and research institutes. It provides the opportunity to share knowledge and ideas with colleagues with no travel time or costs, and to extend a research network and develop new collaborations. The meetings encourage high quality, constructive academic feedback supporting and promoting health economics research.

Oral presentations are invited from PhD students and early career researchers who would like to discuss work-in-progress with a focus on health economics. Please contact us if you would like to present your work: herg.vrs@brunel.ac.uk

The next webinar is on Wednesday, February 25th at 1pm

The presenter is Dr. Paul Mitchell, King's College London

Title: The relative impacts of major disease on health status and capability wellbeing: would priorities change under a different evaluative space?

Summary: Evaluations of the outcomes of disease and health services commonly focus exclusively on health status. There is, however, also concern about broader impacts on wellbeing and, increasingly, on a person's capability. In this presentation, Paul will discuss a recent study that compares the impact on health status and capability of seven major health conditions, utilising data from four countries, and assess differences in priorities when outcomes are measured by (i) health status (using the EQ-5D-5L) and (ii) capability (using the ICECAP-A).

You can register here.

HEDS Seminars

After Rachel kicked off the Spring Programme last month, the rest of the programme is now confirmed as:

Thur. 12th February – Sabine Grimm, ScHARR
Estimating the impact of health technology implementation on cost-effectiveness and value of information analysis

Tues. 3rd March – Dr Paul Mitchell, King College of London (KCL)
Years of Sufficient Capability (YSC) as an outcome measure for economic evaluation

Thur. 23rd April – Chris Marshall, Keele University
Automated Tool Support for Systematic Reviews

HEDS Seminar Series…

…is kicking off again on Friday the 23rd January with Rachael Hunter from UCL, who will be speaking about "The economics of providing health care in prisons – a fiscal fugitive".

Rachael is the senior health economist for PRIMENT Clinical Trials Unit at UCL focusing on economic evaluations alongside trials of complex interventions, particularly in mental health, primary care and criminal justice settings. She previously worked for Prison Health in the Department of Health and was involved with a number of projects providing expertise on the health economics of substance misuse treatment in prisons.

The seminar is at 11.30-12.30 in the Pemberton Room, Regent Court.

The rest of the programme is currently being finalised, but will be announced in the next week or two.  The HEDS seminars can be added to your Google calendar by visiting
http://www.google.com/calendar/embed?src=sheffield.ac.uk_6vuim90bl3nedg89v5agarija0%40group.calendar.google.com&ctz=Europe/London
and clicking on the + image link that says *Google calendar* (at the bottom right hand corner of the calendar).

ScHARR Seminar Series

The spring series has been confirmed, and includes 2 HEDS-y topics, although all seminars are open to everyone.   Seminars will run almost weekly on Tuesdays at 12.30 to 1.30 and are usually in the Pemberton Lecture Theatre in Regent Court (unless mentioned otherwise).  Here is the list:

13th Jan - Ed Wilson, University of Cambridge ~ How detailed does a piggybacked economic evaluation alongside an RCT need to be?  A comparison of relative value of information from different resource use data collection processes in an economic evaluation alongside a clinical trial

20th Jan - Laura Di Bona, ScHARR ~ Adopt a Care Home: A collaboration between school children and people with dementia

27th Jan - Paul Aylin, Imperial College London ~ Understanding weekend mortality rates in hospitals

3rd Feb - Matt Dexter, Sheffield Hallam ~ Open Design and medication products - enabling participation in design and manufacture

10th Feb - Shirley Thomas, University of Nottingham ~ TBC

24th Feb -  Lukasz Tanajewski, University of Nottingham ~ Economic evaluation of a general hospital unit for older people with delirium and dementia (TEAM trial): clinical outcomes versus cost-effectiveness

10th Mar - Pablo Monsovais, University of Oxford ~ TBC

17th Mar (Eric Wilkes) - Alicia O'Cathain, ScHARR ~ Quality of mixed methods studies

24th Mar (Venue TBA) - Wandi Bruine de Bruin, University of Leeds ~ The mental models approach to developing risk communication

Treatment switching workshop

In October HEDS travelled to Adelaide, Australia, acting as the Scientific Secretariat for a workshop on the "Challenges of Early Crossover in Clinical Trial Design for Oncology", organised by the Australian ethics company, Bellberry.  The purpose of the workshop was to bring together representatives of key stakeholders from around the world to discuss the issues around treatment switching with a view to identifying where there is agreement on appropriate approaches to address treatment switching in the design and analysis of oncology trials, and where further discussion or work is needed.


The workshop included a diverse group of international participants, with stakeholders represented including regulators (EMA, FDA, TGA), HTA agencies (NICE, IQWiG, PBAC, CADTH and US payers), patients and carers, ethicists, oncologists, academics and industry. HEDS' role was to provide background papers for participants, to present research undertaken on treatment switching, and to lead the development of outputs from the workshop - which will be forthcoming soon.

The HEDS team were Nick Latimer and Helen Bell

HERG Virtual Research Seminars

The HERG virtual research seminar is a web-based meeting for PhD students and researchers in health economics based at universities and research institutes. It provides the opportunity to share knowledge and ideas with colleagues with no travel time or costs, and to extend a research network and develop new collaborations. The meetings will encourage high quality, constructive academic feedback supporting and promoting health economics research.

We invite oral presentations from PhD students and early career researchers who would like to discuss work-in-progress with a focus on health economics.  Please contact us if you would like to present your work: herg.vrs@brunel.ac.uk

The next seminar is on Wednesday, November 19th at 1pm.  The presenter is David Mott, PhD Student, Newcastle University.  The title is "Whose preferences matter in discrete choice experiments?"

Register here.

Subgroup analysis in CEA

The Pharmaceutical Statistics journal club is discussing the paper "Subgroup analyses in cost-effectiveness analyses to support health technology assessments" on 28th October. Author and
publication details are: Christy Chuang-Stein, Marie-Ange Paget, Carol Reid and Neil Hawkins;
Pharmaceutical Statistics, Volume 13, Issue 4, Pages 265-274, July/August 2014.

Details on how to join in are available here.  For those in ScHARR interested, please contact Steve Julious, who is booking a room to dial in.

ScHARR Autumn Seminars

The ScHARR Seminar Series for the Autumn Semester 2014/15 is back on the 30th September, with a new look team and format! You can expect the usual excellent external speakers every fortnight, however new to the series is the presence of internal speakers once a month in-between these slots to display the world class research that takes place on our very own doorstep. Seminars are held on Tuesday lunchtimes (12.30-13.30) in the Pemberton Room, Regent Court (please note exceptions to this in the list below). Our programme has been confirmed as:

30th Sept – Lorna Fraser, University of York

Image by mattgarber via Flickr CC BY 2.0

Life-limiting conditions in children: the use of routine data

7th Oct (Trent Rm) – Duncan Gillespie, ScHARR
The health equity and effectiveness of future policy options to reduce dietary salt in England: policy forecast

14th Oct – Matt Dexter, Sheffield Hallam University
Open Design and medical products – enabling participation in design and manufacture

4th Nov (LT 1&2) – Jack Parker, ScHARR
Stroke patients’ utilisation of extrinsic feedback from computer-based technology in the home: a multiple case study realistic evaluation

11th Nov – Tom Phillips, Kings College London
Title TBC

25th Nov – Louisa Ells, Teeside University
Measuring up obesity from policy to research

2nd Dec (LT 1&2) – Penny Buykx, ScHARR
Australian alcohol and drug treatment system – patient pathways

9th Dec – Rachel Elliot, University of Nottingham
Title TBC

ScHARR's 4th Annual Pemberton Lecture

Image by booleansplit via Flickr CC BY 2.0 

We are fortunate to have Professor Trish Greenhalgh, Professor of Primary Health Care and Dean for Research Impact at Barts and the London School of Medicine and Dentistry, to deliver ScHARR's fourth Pemberton Lecture at 17:00 on Tuesday, 9 September 2014. Professor Greenhalgh will speak on the topic: ''Research impact: defining it, measuring it, maximising it, questioning it'.

Professor Greenhalgh says:

"Both in the UK and more widely, the higher education sector is under pressure from government to demonstrate that it makes a difference. That aside, few of us want to be the kind of academic that sits in an ivory tower thinking clever thoughts while Rome burns below. As Karl Marx said, many academics only interpret the world, but the true purpose of scholarship is to change it. The 'impact agenda' thus contains two goals that may occasionally be in tension with one another. The first is to demonstrate impact as defined by a relatively narrow set of government-driven criteria and metrics (most notably in the UK, the 'Impact' section of the Research Excellence Framework). There is much emphasis in policy circles, for example, on the need for medical schools to build links with industry with a view to generating 'health and wealth' (that is, improving survival or quality of life while also saving money and boosting business for our national industries). The second goal, more in line with the vision of engaged scholarship articulated by Marx, is to align the research agenda with such things as community-campus partnerships and a commitment to social justice.

Whilst it is easy to be cynical about the colonisation of academia by commercial interests, many universities now boast fruitful industry collaborations that have not only supported the development of new drugs, devices and technologies (and, in a few cases, led to measurable economic benefit for the university) but which have also accelerated the uptake and use of innovations for societal benefit. Nevertheless, much of the impact from biomedical research to date has been through a wide range of non-commercial partnerships with clinical provider organisations, national policymakers, councils, schools, faith groups, third-sector organisations and citizens. In short, 'impact' is much more than commercial spin-offs.”

As the first 'Dean for Research Impact' appointed by a UK higher education institution, Professor Greenhalgh will summarise prevailing national and international debates about what research impact is; how it should be measured; how to balance the potentially conflicting agendas of 'economic' and 'societal' impact; and how to build capacity at all levels for delivering on both these agendas." 

You are invited to attend what should be a stimulating lecture on impact and to stay for the following wine reception. Admission to the lecture is free by ticket only. Please would you confirm your attendance by 1 September 2014 at the latest using the on-line registration form.