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(MCRC Clinical) Modelling the impact on costs and outcomes on enhancing early detection in lung and colorectal cancers


Project Description

Background
Cancer early detection (ED) and cancer health economics are key MRCR themes and central to the successful CRUK Manchester MERCADO award (includes Renehan & Payne). There is a paucity of individual-patient level models available to allow evaluation of the cost-effectiveness of interventions to enhance ED and its anticipated downstream effects on down-staging and improved outcome. Such a model will greatly facilitate the translation and targeting of, for example, new biomarker tests into clinical practice.

Aims
This 3-year PhD proposal (for a clinical student) will:
1. Use the Clinical Practice Research Dataset (CPRD: 2006 to 2015) to identify [through linkage with the National Cancer Registration and Analysis Service (NCRAS); Office of National Statistics (ONS); Hospital Episode Statistics (HES)] and model patients with lung and colorectal cancer;
2. Through the linked databases, capture individual-level data on confounding factors – patient-related (co-morbidities; smoking) and treatment-related (stage, treatment modality);
3. Using multi-state modelling and Hidden Markov Models, derive estimates of lifetime survival and quality-adjusted life years (QALYs);
4. Build decision analytical models to account for plausible changes in stages at diagnosis brought about by an enhanced ED intervention.

Study design
By PhD commencement (Oct 2020), the Renehan-Payne collaboration will be supervising two projects in cancer health economics. From that platform, there will be four workstreams (WSs): (i) using the CPRD linked with NCRAS, ONS and HES to characterise the natural histories of lung and colorectal cancer patients (WS1); ii) using transition multi-state modelling to estimate lifetime costs accounting for stage, treatment, co-morbidities, lifestyle (e.g. smoking) (WS2); (iii) estimate QALYs (WS3); and (iv) build decision analytical models to account for plausible changes in stages at diagnosis brought about by an enhanced ED intervention, introduced at different ages.

Entry Requirements:
Candidates must be post-registration clinicians and ideally have a specialist post in a related subject, for example, obstetrics and gynaecology, oncology, or primary care. Applicants must have been resident and worked within the EEA (European Economic Area) for at least three years prior to application.

Funding Notes

The clinical fellowships are usually tenable for three years, although in certain circumstances they may be four years duration. We will provide running expenses, an appropriate salary in line with the applicant’s current salary and grade, and full coverage of University PhD fees. Where international student fees are payable, please provide evidence with your application of how the shortfall will be covered (approximately £19,000 per annum).

The length of this project will be THREE YEARS.

Related Subjects

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