Research topic identification & the funding process Gemma Bashevoy Research Fellow, Topic Identification Team NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC) 3/11/2017
Overview National Institute for Health Research Programmes hosted by NETSCC Topic identification for commissioned workstreams Getting proposals funded via researcher-led routes
What is the NIHR? The National Institute for Health Research (NIHR) aims to improve the health and wealth of the nation through research Commissions and funds NHS, social care and public health research to develop the research evidence to support decision making by professionals, policy makers and patients. Large, multi-faceted organisation encompassing faculty, research, infrastructure and systems
The NIHR health research system
NETS Programmes Health Services and Delivery Research HS&DR programme funds research on the quality, accessibility & organisation of health services Health Technology Assessment HTA programme funds research on the clinical and cost effectiveness of healthcare treatments and tests NETSCC HS&DR HTA PHR EME Public Health Research PHR programme funds research on non-nhs interventions to improve the health of the public & reduce health inequalities Efficacy and Mechanism Evaluation EME programme funds research into the clinical efficacy of treatments and tests that have existing proof-of-concept
Project examples HS&DR Gatekeeping in intensive care: Understanding and improving the decision-making process surrounding admission to the intensive care unit Christopher Bassford University Hospitals Coventry & Warwickshire NHS Trust Feb 2012 Jan 2018 703,118 HTA Prehospital Assessment of the Role of Adrenaline: Measuring the Effectiveness of Drug administration In Cardiac arrest (Paramedic 2) Gavin Perkins University of Warwick Mar 2014 Aug 2018 2,751,277
Workstreams Researcher-Led Open calls for researchers to apply for funding for their own topics and questions, within the remit of the relevant programme Commissioned Calls for research in a specific area. Designed to meet the needs of decision makers within the NHS & public health settings. Identify evidence gaps and stimulate market failure research that may not otherwise be funded Themed Calls Cross-NIHR calls on topics of national priority. 1-2 per year. Invite researchers to submit applications within a specific theme, e.g. complex health needs
Commissioned Workstream Where topics come from What makes a good topic How we get topics through the commissioning process
Topic Lifecycle Commissioned workstream Topic suggestions Ideas generated are worked up by the relevant panel secretariat, and compared against other topics received Panel Topics developed Panel Meeting Topics which are prioritised will be developed into commissioning briefs Research briefs developed Methods Group Expert review We may come back to you during the development process Final Research brief Prioritisation Group In 9-12 months successful topics will be advertised to the research community Advertised Commissioning Briefs We will get an answer in anything from 18 months to over a decade.
Topic Sources Panel and Board members NICE & SIGN guidelines Patients and the Public Clinicians and Researchers Charities and patient groups Royal colleges Clinical specialty groups James Lind Alliance PSPs Research Recs from NIHR journals Stakeholder workshops Cochrane and scientific literature
What Makes a Good Topic? Important to the NHS, patients &/or the public Supported by current evidence Feasible Timely, i.e. research will continue to be relevant following completion of study Clear and well-defined Represents value for money
Constructing a research question opulation ntervention omparator Why important? utcomes
Example PICO What is the effectiveness of urinary catheter washout for patients with long term urinary catheters P Patients with long term (> 28 days) urinary catheters (urethral or suprapubic). I Urinary catheter washout (regimen including type of solution, timing, frequency, volume to be determined). C No washout O Important outcomes will be objective measures of catheter-associated urinary tract infections (UTIs) and catheter blockages including, Symptomatic UTIs, number of catheters used, length of time each catheter was in situ, catheter removal rates due to blockage/infection, quality of life, washout acceptability measures (patient discomfort, satisfaction, ease of use), health economics (cost of washouts, resource implications of different washout regimens) Justification Patients with long term urinary catheters suffer a high infection rate through their catheters. We don t know if regular washing out of catheters is beneficial or harmful.
Criteria for assessing importance What are the benefits in terms of reduced uncertainty? (e.g. outcomes for patients and carers, costs effectiveness to the NHS How long before benefits could be realised? Bearing in mind the time needed to perform the study and to bring about change in practice Would the assessment offer value for money? How important is early assessment? Other factors which might have a bearing on importance (e.g. national priorities and policy considerations, prevalence of the disease/conditions, social/ethical considerations)
Challenges of ID&P Obvious/easy questions already answered! Broad vs narrow questions Feasibility of answering the question Remit and definition of a treatment uncertainty Defining standard practice/care Existing, ongoing research Relative importance compared to other disease areas Consideration of existing NETS portfolio
Prompts for devising research questions A recent patient - difficult to treat or to choose the most appropriate treatment? What information would have helped? An intervention that you think doesn't seem to work for your patients? Any new or different approaches/ interventions being used abroad or in other centres? Issues with the most common/least common clinical condition you see? Have you recently had to confer with a colleague about a clinical uncertainty? If you had a magic wand what condition/issue would you most like to treat? If you had 500k to spend on research what area would you invest in to improve patient care?
How you can get involved? Submit your research priorities as suggestions for commissioned calls, and help to shape future research: https:///research-andimpact/research/suggest-an-idea-for-research/ Email me: Gemma.Bashevoy@nihr.ac.uk or netsid@nihr.ac.uk
Applying for funding The application journey What the Panels/Boards are looking for Common pitfalls
The Application Journey Picking the right programme Lots of resources on our website information on remit and our existing project portfolio If unsure talk to the relevant teams for advice and guidance
Designing the right study Research Design Service (RDS) - design and methodological support to health and social care researchers Clinical Trials Units (CTUs) - specialist expert statistical, epidemiological and other advice and coordination to undertake successful clinical trials INVOLVE - national advisory group supporting active public involvement in NHS, public health and social care research Discuss with NHS /decision makers to ensure research will be useful
Key features of a good application Important Research Question Appropriate study design Multidisciplinary team Deliverability Costs/ Value for money Dissemination plan Respond to Feedback
Common Pitfalls Out of remit of the programme/call Insufficient justification of need/importance Lack of awareness of major/related ongoing work Insufficient detail or clarity on intervention, methods etc Incorrect & inconsistent numbers e.g. sample size/power calculations Unrealistic/inaccurate costings (under or over-costed) Gaps in expertise on the research team Insufficient public and patient involvement Acronyms/assumptions use Plain English Poor presentation & typos time for proof reading?
How to apply Links to all the funding programmes: https:///funding-and-support/funding-for-researchstudies/funding-programmes/ Sign up to NIHR newsletters/twitter feed and you'll be informed when new calls are advertised
Any Questions
Prompts for devising research questions A recent patient - difficult to treat or to choose the most appropriate treatment? What information would have helped? An intervention that you think doesn't seem to work for your patients? Any new or different approaches/ interventions being used abroad or in other centres? Issues with the most common/least common clinical condition you see? Have you recently had to confer with a colleague about a clinical uncertainty? If you had a magic wand what condition/issue would you most like to treat? If you had 500k to spend on research what area would you invest in to improve patient care?