Prof T Jaki
No more applications being accepted
Competition Funded PhD Project (European/UK Students Only)
About the Project
The MRC Hubs for Trials Methodology (HTMR) Network has one non-clinical studentship available for early 2018 entry. Below is a description of one project which can be applied for.
Please contact the named supervisor in advance of submitting your application.
Please see our website for further details, guidance and application form.
https://www.methodologyhubs.mrc.ac.uk/about/phd-studentships/
Location: Lancaster University, Hub: North West
Background
In early 2014 the World Health Organization (WHO) was notified of an outbreak of the Ebola virus and around half a year later the WHO declared the epidemic to be a “public health emergency of international concern” . In the time that followed frantic efforts where undertaken by different groups around the world to evaluate treatments to cure the disease .
With hindsight, it seems strange that no treatments were evaluated prior to the epidemic. Upon closer inspection, however, some of the reasons for this become clear. Firstly, without an epidemic, there are no or hardly any patients who could participate in a formal evaluation of a treatment. Secondly, the large number of pathogens (e.g. Avian flu, Swine flu, MERS-CoV, …) that could potentially lead to an epidemic makes it difficult to choose which disease should be the focus of the research.
The project
The goal of this project is to develop a statistical framework that allows evaluation of treatments for diseases that occur in outbreaks and have the potential for an epidemic. In such a setting learning about a treatment’s effect can happen in two ways: Through a sequence of small (contained) outbreaks and during an epidemic.
In the first instance the project will develop methods that allow learning about the effectiveness of a treatment across several small outbreaks through a sequence of small clinical trials. The primary challenges here is the uncertainty about the number of patients recruited during each outbreak together with the potential of regional and other differences. The project will consider how to incorporate these differences and explore suitable stopping criteria.
The second part will consider adaptive methods that allow the design of these small clinical trials to be altered in the event of an epidemic. The initial challenge is to establish when a change in design should be triggered; i.e. when does an outbreak become an epidemic. We will begin by considering changing the rules for stopping the evaluation of a treatment to ensure that treatments reach patients faster. Due to the markedly increased speed of recruitment, designs that allow adapting the primary endpoint will be considered as long term endpoints are unsuitable during an epidemic. These adaptations will ensure decisions about the suitability of a treatment are made quickly and therefore ensure that suitable treatments are found in a timely manner.
The project will be informed by the experiences during the recent Ebola outbreak for which Prof Horby led one of the groups seeking to find treatments. Open source software for the designs developed will be made available.
Supervision arrangement
TJ will be the main supervisor and meet weekly with the student to provide ideas and to help overcome obstacles. JW will provide input and advice on the statistical aspects and PH, Professor in Emerging Infectious Diseases, University of Oxford, will provide clinical insights to the project and ensure that the project is undertaken within practical constraints and methods are suitable for real world applications. Joint quarterly supervisory meetings are planned with at least one meeting a year in person. In addition, the student will also have to opportunity for a secondment of at least 2 weeks to Prof Horby’s group
Deadline - 8 January 2018 at 4pm (GMT)
General enquiries [Email Address Removed]
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Funding Notes
Stipend of £17,726 per year
Due to funding restrictions only home/EU applicants are eligible for funding through this programme. Eligibility and residence requirements must be met. Candidates are advised to review the RCUK/MRC studentship documentation for full details.
http://www.rcuk.ac.uk/documents/documents/termsconditionstraininggrants-pdf/
References
WHO Ebola Response Team. "Ebola virus disease in West Africa—the first 9 months of the epidemic and forward projections." N Engl J Med 2014.371 (2014): 1481-1495.
LE Dodd “Clinical Trials During the Ebola Crisis: A Series of Articles and Commentaries Describing the Challenges of Conducting Clinical Research During a Lethal Epidemic” Clin Trials 13(1) (2016) 1-111.