Warwick Evidence Research Strategy 2011

Introduction

Warwick Evidence is a health services research unit with a primary focus on health technology assessment (HTA). Warwick Evidence undertakes reviews and evidence synthesis on the clinical and cost effectiveness of health care interventions for the NHS R&D Health Technology Assessment (HTA) Programme for and for a range of research funders and policy makers, including the National Institute for Health and Clinical Excellence (NICE). It is one of nine Technology Appraisal Review Teams who have a core contract to deliver reviews for NICE and other NHS policy-making bodies. Our current contract runs from April 2011 to March 2016. Our high-level aim is to carry out research that will lead to improvements in the health care, either directly by facilitating the introduction of cost-effective new treatments, or indirectly by restricting spending on treatments that are not cost effective.

Warwick Evidence’s priority function is to provide NICE with evidence on which to base decisions on whether to recommend technologies (drugs, other treatments, devices and diagnostics) for use within the NHS. Each year Warwick Evidence delivers a mix of long and short Technology Appraisals for the NIHR HTA Programme, NICE and others such as the National Screening Committee.

Based in Warwick Medical School (WMS), Warwick Evidence brings together experts in clinical and cost effectiveness reviewing, epidemiology, health economics, statistics and modelling. The multidisciplinary team undertakes research collaboratively with several groups across WMS and departments at the University of Warwick and is supported by clinical and methodological advisors at both local and national level. We are an academic research group within the Populations, Evidence and Technologies grouping in the Division of Health Sciences. The Warwick Evidence research strategy has themes which match the wider divisional research strategy. Members of staff work together with groups such as the Warwick Preventive Heart Group and Warwick Clinical Trials Unit.

Aims of Warwick Evidence

To fulfil the requirements of our core contract with the NIHR HTA programme, producing high quality technology assessments for NICE and others
To become a centre of research excellence in health technology assessment and to increase local, regional and national awareness of the potential of health technology assessment in health care
To increase capacity in WMS in systematic reviewing, health economic and cost effectiveness modelling and meta-analysis and to increase numbers of future Principal Investigators in line with WMS research strategy
To strengthen links across the University of Warwick related to health evidence, technology appraisal and assessment of cost effectiveness, clinical trials, economic modelling and knowledge diffusion and dissemination
To promote the exchange of knowledge between Warwick Evidence and the NHS through developing close collaboration with the NHS to support the further development of knowledge-based health services
To attract external funding to support related empirical and methodological work of the highest quality
To disseminate research findings via high quality publications and via local, regional NHS and academic networks

Purpose of this strategy document

The purpose of this strategy is to encourage research excellence through:

A focus on key research areas
High quality research outputs
Optimum research impact

The research strategy aims to complement the wider strategies being developed in WMS. Our research strategy encourages us towards significant increases in grant income every year, as well as increased impact by publications and citations in peer reviewed journals. Our research development, training and findings will complement our undergraduate and post graduate teaching in WMS. Our aim is to ensure that Warwick Evidence contributes as highly as possible to the forthcoming REF.

PRIORITIES

1. Delivery on our core contract

We will deliver the requirements of our core contract with the NIHR HTA programme and the Department of Health, to produce technology assessment reports, to support NICE and other policy-making bodies; and similar reports for various clients, including the HTA Programme. We will aim to secure work from the HTA Programme in the following areas which reflect our interest and expertise:

Cancers, particularly with short term survival
Diabetes and macular oedema
Musculoskeletal problems/conditions such as back pain, gout, arthritis
Mental health and psychological interventions
Prognosis

2. Publishing in high impact journals

We aim to:

Publish our research in peer reviewed high impact journals
Secure good citation rates for our publications
Publish technology appraisals where possible in the peer reviewed, high impact factor HTA monograph series
Where appropriate, publish peer-reviewed journal versions of short technology appraisals for example based on work for NICE and aiming at rapid publication when the subject is at its most topical, shortly after the NICE guidance is issued

3. achieving grant funding for SECONDARY RESEARCHT

We aim to achieve additional grant funding for secondary research – systematic reviews and meta-analyses in:

Substantive clinical areas. Current examples include:

- A systematic review of chiropractor interventions

- Joint work with the Warwick Preventive heart group on flavonoid – rich food for the primary prevention of coronary heart disease

Methodology for example, bibliometrics, indirect comparisons, and survival modelling

4. achieving grant funding for Primary research

We also aim to achieve additional grant funding in primary research. Systematic reviews and meta-analyses provide clear evidence of where further research is needed. There have been several examples where technology appraisals have led to collaborations in primary research.

An RCT: The REPOSE trial of insulin pumps and structured education – one of our team helped draft the successful bid (for over £2 million) and is deputy chief investigator in this multi-centre trial

Other examples include:

- A bid currently at outline stage for research into the clinical and cost effectiveness of automated grading in diabetic retinopathy screening

- A recently completed national survey of use of evidence by health commissioning managers

5. Fostering Specialist interests

Members of Warwick Evidence have specialist interests, in topic areas such as diabetes -or methodological areas such geo-spatial modelling or survival analysis. Given our diabetes interests and modelling capacity, we are keen, for example, to develop a diabetes model for use in other research, either from scratch, or by building on an existing model. Other areas of interest and expertise include screening (breast, type II diabetes), child developmental disorders, e-health and uptake and use of evidence in health decision-making.

6. Developing capacity

We need to produce not only research but researchers. We aim to increase capacity by training new researchers, and by developing the careers of our existing ones. We will seek to increase the number of PhD students and post–doc fellowships. We will also provide opportunities for public health and other clinical trainees and colleagues and those doing dissertations for post-graduate degrees to collaborate with us. We have a Training, Development and Conference strategy in preparation and its aim is to ensure that all our staff as highly skilled as possible to undertake their work. We plan in-house training workshops (e.g. on Value-based pricing, NHS costing) and individual programmes of postgraduate training for researchers employed in Warwick Evidence.

RESEARCH EXCELLENCE FRAMEWORK (ref)

The output from Warwick Evidence will be submitted to Panel A2, Public Health, Health Services and Primary Care. Our HTA reports relying on highly skilled technical research and critical appraisal provide the foundation for national policy-making and are likely to achieve high impact scores.

Our process will involve:

Assessing eligibility of staff (ensuring as many people as possible have four good publications [or two in the case of early career researchers])
Assessing the quality of the publications
Surveillance to continue to ensure the strongest possible publications are submitted

The future

Our core programme grant runs until the end of March 2016. We will aim for renewal of the current TAR contract with the Department of Health, when it is released for tender in 2014.

Warwick Evidence warrants a strong succession plan is in place. We are prepared for eventualities such as retirements, promotions, secondments, maternity leave and ill health to ensure the work of the group is maintained at a high standard.

What do we need to do to achieve our Research Strategy And markers of success

Warwick Evidence needs to:

Recognise the importance of developing a critical mass of expertise across many areas that are directly related to Health Technology Assessment and decision making
Establish national and international collaborations across disciplines through developing our profile and promoting and disseminating our research findings
Work closely with our clinical advisory group and others at WMS
Maintain recruitment of excellent clinical and methodological advisors to support our work
Continue working closely as a group, expanding our methodological and topic based understanding of both clinical and cost effectiveness and of evidence synthesis
Establish clear research and publication goals at annual review, during probationary periods and through effective project management

Some specific markers of success will be:

• Publications and citations

• Obtaining research funding

• Developing collaboration and clinical advisory support

• Evidence of creating a supportive research environment and network

• Attracting PhD and post-doc students

• Being recognised as a centre for research excellence

• Building a large and stable research team within our specialist areas

Details of COntacts, grants, and publications

Contacts and details of our grants and publications can be obtained from our website

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