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 you are here › Home Impact and achievments

We assess our outputs and performance in terms of the impact of the research we fund. In this section, we showcase the range and depth of our research and highlight why it is important.

By 'impact', we mean the contribution to benefits to society resulting from the research we fund, including patients, populations, the NHS, health services, the economy and academia. Impact involves any change to activity or understanding arising from the research we fund, including:

school  

Improved health and wellbeing

(e.g. through better and more cost-effective treatment and services, informing national guidance and guidelines through NICE and other agencies)

IVAN (in progress)

More information:
HTA project page

News items :
BBC News
The Guardian

IVAN The IVAN trial is a head-to-head trial of Avastin vs. Lucentis to compare their efficacy for treating wet age-related macular degeneration (wet AMD). With Lucentis treatment, eyesight improves in a quarter of cases and in the majority (90% or more) eyesight does not deteriorate; this represents a huge improvement over previous treatments. Another treatment, Avastin, (from which Lucentis was derived), appears to be equally good and is considerably cheaper, but its efficacy and safety have only been studied in case series.

Why this is important: Wet AMD is a condition which causes sight loss in older people. It leads to the severe loss of sight within two years for 70 percent of those diagnosed. Avastin could be a significantly cheaper, but equally good, alternative to Lucentis.

Interim finding: The one-year results show that both drugs work equally well and have similar safety profiles. The study will continue to follow patients for two years.

Potential impact: IVAN could generate annual savings of £84.5m for the NHS

Chief investigator: Professor Usha Chakravarthy
Institution:  Centre for Vision and Vascular Science, The Queens University of Belfast Trust

Birthplace England

Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study.

The Birthplace integrated programme of research was conducted to fill important gaps in the evidence relating to the availability, safety, organisation and costs of maternity services provided for women in labour in four birth settings.

Why is this important: The relative benefits and risks of birth in different settings have been widely debated in recent years. There is a lack of good quality evidence comparing the risk of rare but serious adverse outcomes by birth setting. This remaining uncertainty affects both NHS decision makers planning services and patient care, and expectant parents planning their place of birth.  The study collected data for the mother and baby for over 64,000 births. It achieved exceptionally high participation, coverage quality and completeness of data.

Findings

  • For healthy women with low risk pregnancies, the incidence of adverse perinatal outcomes is low in all birth settings
  • For healthy multiparous women with a low risk pregnancy, there are no differences in adverse perinatal outcomes between planned births at home or in a midwifery unit compared with planned births in an obstetric unit
  • For healthy nulliparous women with a low risk pregnancy, the risk of an adverse perinatal outcome seems to be higher for planned births at home, and the intrapartum transfer rate is high in all settings other than an obstetric unit

Potential impact: Studying planned place of birth results will enable midwives and doctors to give women information that is most relevant to their decision making. The results can also inform the planning and design of maternity services.

Chief Investigator: Professor Peter Brocklehurst
Institution: UCL Institute for Womens Health

Evaluating the impact of urban regeneration on young people and their families.

More information:
PHR project page

News items:
PHR news item

The primary research question is “what is the impact of urban regeneration on the social determinants of health (employment), health behaviours (physical activity) and health outcomes (mental health and wellbeing) of adolescents and their parents”?
In this study, regeneration activities in Stratford, London Borough of Newham, will act as the main intervention being evaluated, primarily the construction of the Olympic Park and Stratford City developments during late 2011 and early 2012.

Why is this important: The Marmot Review of Health Inequalities (Marmot 2010) has the creation of healthy and sustainable places and communities, the creation of fair employment and good work for all and the enabling of children and young people to maximise their capabilities and opportunities as key objectives to improve health and reduce health inequalities. This project will investigate how urban regeneration programmes impact on health and psychological wellbeing, and its wider determinants.

Potential impact: This project will address the impact of urban regeneration on the social determinants, health and health behaviours and health outcomes. This could be important evidence to support the realisation of these benefits in future regeneration projects and therefore increase value for money and reduce inequalities.

Chief Investigator: Dr Steven Cummins
Institution : Queen Mary University of London

Researchers  

Improved contributions to research and use of research findings

(e.g. through publications and other dissemination activities, building research capacity, setting standards for health research, enabling evidence use within health services)
How to spread good ideas (completed)

More information:
HS&DR project page

A systematic review of the literature on diffusion, dissemination and sustainability of innovations in health service delivery and organisation.

Why this is important: There are good ways and bad ways of organising and delivering health services. Innovations in service delivery and organisation are often evaluated positively but not widely implemented. This study performed a comprehensive review of the literature to identify the barriers to adoption of evidence based innovations.

Impact: In addition to its usefulness with the NHS, this theoretical work and evidence review contributed to future research and is cited by 189 articles in Medline (May 2012).

In the NHS Chief Executive’s Review of Innovation in the NHS Summary of the responses to the Call for Evidence and Ideas, which informed Innovation Health and Wealth this study was cited as “a landmark systematic review” NHS Chief Executive Innovation review

Chief investigator: Trisha Greenhalgh
Institution: Barts and the London School of Medicine and Dentistry

Tablets  

Improved wealth of the nation

(e.g. saving money by stopping ineffective or unnecessarily costly treatments and services, supporting innovation, enabling a healthier workforce)

Cystic Fibrosis Gene Therapy Trial

A randomised double-blind placebo controlled Phase 2B clinical trial of repeated application of gene therapy in patients with Cystic Fibrosis.

A treatment that successfully delivers a working copy of the defective gene – known as CFTR (Cystic Fibrosis Transmembrane conductance Regulator) – directly into the lungs of patients has been developed previously by the UK Cystic Fibrosis Gene Therapy Consortium. This phase two clinical trial, funded through the MRC-NIHR Efficacy and Mechanism Evaluation programme and conducted by Imperial College London, and the Universities of Edinburgh and Oxford, will evaluate whether delivering this therapy once a month for a year can improve lung function. They hope to reduce the amount of mucus, inflammation and infection in Cystic Fibrosis patients.

Why this is important: Gene therapy represents one of the most promising treatment avenues for Cystic Fibrosis and many other devastating conditions that currently have no effective cure.

Potential impact: This is a pioneering clinical trial that could lead to a potentially life-changing new treatment for Cystic Fibrosis (CF).

The research, which has been supported by the Cystic Fibrosis Trust for a decade, had faced an uncertain future due to a funding shortfall. This investment by the MRC and NIHR will ensure the next stage of the programme can continue as planned.

Chief investigator: Professor Eric Alton
Institution: Imperial College London

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The NIHR Evaluation, Trials and Studies Coordinating Centre (NETSCC), based at the University of Southampton, manages evaluation research programmes and activities for the NIHR.

 

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