About the Project
Are you interested in helping to promote the collection of data on health outcomes that matter most to patients, clinicians and other decision-makers?
It is increasingly accepted that insufficient attention has been given to the patient-focused health and social care outcomes needed to (i) guide decision-making in healthcare, (ii) undertake research to underpin such decision-making and (iii) inform value-based commissioning of health services (1). The relationship between outcomes used in decision-making and data recorded in electronic health records (EHR) is poorly understood.
The COMET Initiative (2) supports the development and use of ‘core outcome sets’ (COS), representing the minimum set of patient-focused health outcomes that should be measured and reported for a specific health condition. COS are determined by consensus amongst health professionals, researchers, policymakers and patients or their representatives.
Interest is growing in how COS might flow through the healthcare research and delivery ecosystem, and how this might be facilitated. It is proposed that COS be used to inform clinical guidelines, local commissioning, audit quality standards (QS) and quality indicators (QI) (3). Policymakers, including NICE and HQIP, are recognising the relevance of considering COS in their work (4,5).
The potential of EHR to facilitate comparative effectiveness research and value-based commissioning of healthcare by providing a readily available source of data would be greatly enhanced if the outcome data being collected in routine practice align with those outcomes which reflect value and are deemed important for research. This proposal aims to study whether existing COS for research and routine care differ, whether COS are included in clinical guidelines, local commissioning, QS and QI, and to investigate whether existing routine data collection systems contain COS or could be supplemented, to enhance the quality and efficiency of research and care.
The aim of this research is to determine whether it is possible to obtain a single set of core outcomes relevant to decision making in a particular condition, to inform both routine care and research design, which would then flow through to inform clinical guidelines, healthcare commissioning, QS and resulting QI. If so, we seek to explore whether these data can be obtained from readily available EHR or an EHR supplemented by a patient-led data collection system. The objectives are to address the following questions:
1. Do patient-focused core outcomes for comparative effectiveness research and routine care differ? And if so, why?
2. Are patient-focused core outcomes reflected in NICE clinical guidelines, QS and QI? And if not, why?
3. How do patient-focused core outcomes relate to those used to commission local healthcare, and what are the reasons for any discrepancies?
4. How do patient-focused core outcomes and routine data sources (primary and secondary care EHR) compare, and what are the reasons for any discrepancies?
This project aims to establish a methodology for value-based commissioning informed by local stakeholders going forward. The review of current COS for routine care and their alignment with NICE metrics will provide the basis for promoting value-based commissioning based on important patient-focused core outcomes as defined by key stakeholders.
This work will be carried out in collaboration with the Liverpool Clinical Commissioning Group, who are keen to gather evidence about patient-centred outcomes in healthcare services that they commission. This project is also of direct relevance and key importance to NICE, and representatives from the NICE Centre for Guidelines and NICE Quality and Leadership Programme have agreed to collaborate on this project, given the ultimate aim of ensuring that their clinical guidelines, QS and QI are relevant and patient-centred.
It is expected the successful applicant (s) must commence on or before 1st February 2021.
For any enquiries please contact Dr Susanna Dodd on [Email Address Removed]
If you wish to apply, please send a covering letter, full CV together with names and contact details of two academic referees, stating the research proposal/s of interest to you and why you think you are suitable. Please send to Dr S Dodd on [Email Address Removed] and Professor P Williamson on [Email Address Removed]
Funding Notes
The studentships will be for 4 years full-time (subject to satisfactory progress) and will cover the cost of tuition fees at Home/EU rates. A stipend in line with the UK Research Council is payable at £15285 per annum, and an additional allowance of up to £1000 per year will be paid for approved research costs. Please note that funding is only available for the first 3 years but a 4th year is unfunded for writing up. Due to funding restrictions, the studentships are open to Home/EU applicants only.
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