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Responsiveness to oral corticosteroids in recurrent wheeze of early childhood


Project Description

We are offering a PhD opportunity, based within the The Asthma UK Centre for Applied Research (AUKCAR), in applied asthma research for the academic year 2019/20.

Recurrent wheeze of early childhood (RWEC) is very common. Significant wheeze episodes require a hospital stay, and deaths occur but are uncommon. Some children develop asthma. Oral corticosteroids are frequently prescribed for acute attacks (of all severities), but appear to have no benefit and potential side effects. Clinical trials in the recent past have had contrasting results, reinforcing the clinical uncertainty when managing acute wheeze in this population [1,2]. Another recent trial failed as clinicians prescribed oral corticosteroids even in placebo randomised groups [3].
We wish to explore whether current trial data can provide better structured evidence to support more confident clinical decision making in RWEC to identify those children with RWEC who may respond or not respond to oral corticosteroids in subsequent episodes.
The PhD will focus:
(1) To perform meta-analyses of available data for the use of oral corticosteroids for children with acute wheeze age inclusive 2-6 years, and to investigate whether it is possible to draw conclusions on which subgroups of children respond to treatment.
(2) To investigate how data from routine clinical data sources can enrich and support the meta-analysis in (1).

Requirements
This PhD will require high levels of statistical learning within a clinical context. We would welcome applicants with a strong academic achievement who could engage with clinical teams to understand the context and requirements of the outputs. Given the nature of the studies, the appropriate candidate is likely to hold a 2:1 or higher relevant undergraduate degree with desirable skills.

The student would be expected to undertake meta-analysis of individual participant data, understand the pitfalls around responder analysis [4], and the underlying biological evidence for each predictor in the clinical studies. The appropriate student will need appropriate statistical experience/qualifications and a willingness to learn further skills.

Following interview, the selected candidate will need to apply and be accepted for a place on the Usher Institute Population Health Sciences PhD programme. Details about the PhD programme can be found here: https://www.ed.ac.uk/studying/postgraduate/degrees/index.php?r=site/view&id=213

Application procedure
Please provide a CV, a personal statement detailing your research interests and reasons for applying, degree certificate(s), marks for your degree(s) and the names of two academic references (we will only contact references for successful applicants).
All documents should be in electronic format and sent via e-mail to: Lauren Blake ()

The closing date for applications is: 4th October 2019

Interview date to be confirmed.



Funding Notes

The award is available for three years’ full-time study, providing tuition fees (Home/EU rate), stipend and a small amount of consumables.
For overseas fee-paying students, the fee waived would be at the home/EU rate and successful applicants will need to pay the difference in the tuition fee if assessed as overseas.

References

References:
1. Panickar NEJM 2009
2. Foster Lancet Resp Med 2018
3. Guilbert JACI 2019
4. http://www.rkstatistics.com/news-views/2012/04/23/What_is_a_Responder_Analysis_and_what_are_the_issues/

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