Research and Development ASPH

More research, greater benefit. Across 129 NHS trusts, risk-adjusted survival rose step-by-step from the lowest to the highest third for research funding & recruitment (Ozdemir et al., PLoS ONE 2015) — a "dose effect" echoed by Boaz et al. 2024. #Research #NHS #ASPH

Research-active NHS trusts had more doctors, nurses, critical-care beds & operating theatres — and lower risk-adjusted mortality (Ozdemir et al., PLoS ONE 2015). Research grows alongside clinical capacity, not apart from it. #Research #NHS #ASPH

What turns single studies into system-wide gains? Research networks. A 2024 review of 95 studies found network-level investment central to linking research to better care & outcomes (Boaz et al.). Our R&D connects into the NIHR network. #NIHR #NHS #Research

Cancer is the most-studied field in the research-and-outcomes literature — and the evidence is largely positive, linking research engagement to better care & outcomes (Boaz et al., 2024). A reason we prioritise oncology research at ASPH. #CancerResearch #NHS #ASPH

Research improves more than survival. Greater interventional research activity is linked to better CQC ratings across 129 NHS trusts (Jonker & Fisher 2018), and reviews report better care processes too (Boaz et al. 2024). Better care, day to day. #NHS #QualityOfCare

Research-active teams deliver safer, higher-quality care (Ozdemir 2015; Boaz 2015, 2024) — and it depends on people. Colleagues: open or join a study. Patients: ask your team about research you could take part in. #ClinicalResearch #NHS #ASPH

A cheap steroid. An NHS trial. Lives saved worldwide. The RECOVERY trial showed dexamethasone cut 28-day deaths in ventilated Covid-19 patients from 41.4% to 29.3% (RECOVERY Collaborative Group, NEJM 2021). Why hospital research matters. #RECOVERY #NHS #ClinicalTrials

What happens in a clinical trial? Phase 1: safety & dose (small group) Phase 2: does it work? (larger) Phase 3: vs standard care (large) Phase 4: monitoring after approval Voluntary, fully explained, withdraw anytime. Ask your team. #ClinicalTrials #NHS #ASPH

Research should represent everyone it aims to help. A 2024 review found the evidence is still dominated by the Global North, and flagged equity (Boaz et al.). Inclusive recruitment — across age, sex & ethnicity — makes research fairer & stronger. #HealthEquity #NHS

Sometimes the key finding is that an operation doesn't help. CSAW — a UK trial in 32 NHS hospitals — found a common shoulder decompression op was no better than placebo surgery (Beard et al., Lancet 2018). #ShoulderSurgery #NHS

For many proximal humerus (shoulder) fractures, surgery is not the answer. The NHS PROFHER trial found surgery gave no better outcomes than non-surgical care & wasn't cost-effective (BJJ 2016). #Orthopaedics #NHS

'Negative' trials are among the most valuable research we do. UK shoulder trials (CSAW, PROFHER) found some operations work no better than simpler care — fewer unnecessary surgeries. Knowing what to stop matters. #EvidenceBasedMedicine #NHS

Example of a sensitivity and specificity table evaluating a new test (culture swab) for diagnosis of a disease (tibia infection).

Pathogenesis of the Biofilm.

Brilliant research deserves to be read. Every year, outstanding research goes unnoticed Read, Heard, Believed is the practical guide every researcher wishes they had before writing their first paper.

Injury (lateral clavicle fractures) Classification (Neer)

A Flow diagram showing the requirements for the design of an outcome measure.

A target analogy for reliability and validity. The 'bull's eye' represents the true outcome to be measured, and each arrow represents a single application of the outcome instrument.

The cost-effectiveness plane. Adapted from Anderson et al. (1986); Black (1990) and Maniadakis and Gray (2000).