Funded research

funded research

These are just some of the ways in which questions highlighted as important by James Lind Alliance Priority Setting Partnerships (PSPs) are being, or have been, addressed. This is research that we know has come about as a direct result of a PSP. We know that other research will be taking place that answers PSP questions, perhaps having been suggested already for other reasons. We’re keen to hear from you if you know of studies that we haven’t mentioned that directly result from a PSP. Please get in touch.

Interventions for acne scars

Addressing priority 3:  A Cochrane Review was published in April 2016.  The team reviewed 24 previous trials to pull together the evidence that already exists about interventions for acne scars, and to highlight where further research is needed.

Persistent Acne in Adult Women

Addressing priority 7:  Commissioning brief advertised to researchers by the NIHR HTA Programme.

A controlled study of the effectiveness of breathing training exercises taught by a physiotherapist by either instructional videos/DVDs/internet download or by face-to-face sessions in the management of asthma in adults

Addressing priority 7:  NIHR research in progress. Many people with asthma are interested in non-drug treatments, particularly in breathing exercises.  Teaching these breathing exercises face to face works well, but this study based at the University of Southampton is finding out whether breathing exercises can be taught as effectively by using a DVD or the internet.

Intensive behavioural interventions based on applied behavioural analysis for young children with autism

Addressing priority 24:  Commissioning brief advertised to researchers by the NIHR HTA programme.

Pharmacological and non-pharmacological interventions for non-respiratory sleep disturbances in children with neurodevelopmental disorders: a systematic review

Addressing priority 10:  NIHR research in progress.

Bryony Beresford and her team are bringing together the evidence which already exists from lots of previous studies about sleep disturbance, to determine how well different treatments work.  They will publish and promote their conclusions so that parents and health professionals are better informed about how to manage sleep disturbance.  Their work will also identify where further research is needed.

Therapy interventions for children with neurodisability: a scoping study of current practice and perceived research needs

Addressing priority 1:  Scoping study underway, funded by the NIHR HTA Programme and jointly commissioned with the NIHR HS&DR Programme.

This research looks at current approaches to therapy, how and why they vary and what influences decision-making.  The team aims to find out what the evidence gaps are and to get the views of health professionals, parents and children on how future research might be designed to answer these gaps.

A pragmatic Randomised Controlled Trial of Sensory Integration Therapy versus usual care for sensory processing difficulties in Autism Spectrum Disorder in children: impact on behavioural difficulties, adaptive skills and socialisation (SenITA)

Addressing priority 13:  NIHR research in progress.

Autism Spectrum Disorder is a common lifelong condition affecting 1 in 100 people.  A team based at Cardiff University is investigating whether Sensory Integration Therapy, provided by trained occupational therapists, improves a child’s behaviour, socialisation and daily functioning, compared with the usual care they’d receive.

Interventions to improve eating ability in children with neurodisability

Addressing priority 20:  NIHR research in progress.

Young children with developmental difficulties may also have eating, drinking and swallowing problems. Eating and drinking difficulties may lead to a restricted diet, poor growth, and impact on development, in addition to general physical health risks such as choking or chest infections. This research team wants to find out what treatments are currently recommended by health professionals. They will then decide which of these potentially useful treatments should be tested in a future study.

Identifying appropriate symbol communication aids for children who are non-speaking: enhancing clinical decision making

Addressing priority 2:  NIHR research in progress.

It’s a challenge to identify suitable communication aids and language representation systems for each child, and getting it right means that long-term successful use is much more likely.  This team of researchers is exploring current provision of symbol communication aids.  They aim to provide guidance to support clinicians, parents and others in their selection of the most appropriate aids.

Are behavioural and sensory interventions (e.g. early intensive behavioural intervention, EarlyBird, encouraging socialisation with peers etc.) effective in managing symptoms of Autistic Spectrum Disorder?

Addressing priority 14:  Commissioning brief advertised to researchers by the NIHR HTA Programme.

Does appropriate provision of wheelchairs to enable independent mobility for very young children improve their self-efficacy?

Addressing priority 4:  NIHR Technology Assessment Report in progress. 

Optimising acute care for people with dementia - a mixed-methods study

This research was informed by a number of service uncertainties throughout the whole list of questions identified by this PSP: NIHR research in progress.

Numbers of people with dementia who are admitted to general hospitals are increasing.  This research team aims to help us understand what works best in hospitals when providing quality care for people with dementia. 

Evaluation of specialist nursing support for carers of people with dementia

This research was informed by a number of service uncertainties throughout the whole list of questions identified by this PSP : NIHR research in progress. 

We need to know more about how to provide specialist nursing support to carers of people with dementia, effectively and efficiently. Gillian Parker and her team are looking at the costs and benefits, what kinds of help leads to the best outcomes for carers and what the outcomes are that carers want?

Surgical interventions for Meniere’s Disease

Addressing priority 5:   A Cochrane Review was updated in February 2013.  The review looks at existing studies about surgical treatments to see what the reported benefits are.

Getting it right: the continuing support and service needs of ICU survivors

Addressing priority 2:  In 2015 the Intensive Care Foundation gave a £50,000 ‘JLA Award’ to Dr Brenda O’Neill and Dr Bronagh Blackwood of Queen’s University Belfast, who led a UK-wide collaborative project proposal aiming to improve the assessment of ICU survivor’s support needs across the continuum of care.

What is the best treatment for controlling diarrhoea and/or incontinence symptoms in people with IBD, including novel pharmacological and non-pharmacological options? Is high-dose Loperamide safe and effective in the treatment of diarrhoea in IBD?

Addressing priority 6:  Commissioning brief advertised to researchers by the NIHR HTA Programme.

Optimal treatment strategies for fistulising perianal Crohn's disease

Addressing priority 5:  Commissioning brief advertised to researchers by the NIHR HTA Programme.

Exercise therapy for fatigue in Multiple Sclerosis

Addressing priority 3:  A Cochrane Review published in September 2015 brought together the best available evidence looking at whether exercise therapy is an effective and safe way of reducing fatigue in MS.

Read more from Evidently Cochrane.

CARer-ADministration of as-needed sub-cutaneous medication for breakthrough symptoms in home-based dying patients: a UK study (CARiAD)

Addressing priority 1 and 4:  NIHR research in progress  Most people want to be cared for and die at home. As people get weaker in the last weeks or days of life, they usually can’t swallow. In the UK, when this happens, it is standard practice for medicines to be given by a drip under the skin to relieve symptoms. If, despite a drip being in place, distressing symptoms still occur, a family member is advised to call a healthcare professional to give the patient an injection under the skin. This can take time. In Australia, family members are trained to give such an injection. This feasibility study aims to find out more about how acceptable and effective this would be in the UK and how feasible a large-scale trial would be. 

Taking positive steps to prevent falls

Addressing priority 1:  Katherine Baker hopes her Parkinson's UK-funded study will shed new light on the complex relationship between physical activity and falls in Parkinson’s. And that the new knowledge this study produces will empower people with the condition to manage their condition more effectively and reduce their risk of falling. 

Mindfulness to tackle anxiety and depression

Addressing priority 2:  In this Parkinson’s UK-funded study Angeliki Bogosian and her team have tested a mindfulness course to assess how helpful it is.

Exploring anxiety in Parkinson’s

Addressing priority 2:  Researchers are investigating whether anxiety in Parkinson’s is similar to anxiety in people without the condition and then test whether this anxiety can be reduced with a simply computer training task in this Parkinson’s UK-funded study.

A combined therapy for dyskinesia

Addressing priority 3:  In another Parkinson’s UK-funded study, a team led by Riccardo Brambilla has been looking at what makes nerve cells become overactive when taking Levodopa, resulting in uncontrollable movements..

Towards treatments for Parkinson’s dementia

Addressing priority 5:  In this Parkinson’s UK-funded study Roger Barker and his team are working to further understand the changes that happen in the brain if people with Parkinson’s go on to develop dementia so that new treatments may be developed in future.

Developing a simple test for Parkinson’s dementia

Addressing priority 5:  Michele Hu wants to develop a simple blood test which could help diagnose and predict the risk of a person with Parkinson’s developing dementia. This Parkinson’s UK-funded study aims to find biomarkers that predict the risk.

Understanding how genes are involved in dementia with Lewy bodies

Addressing priority 5:  Researchers are looking at the gene activity in different parts of the brain in people affected by dementia with Lewy bodies and with Parkinson’s. They will then compare gene activity levels to those found in healthy people to understand the differences in this Parkinson’s UK-funded study

Learning new movements with rewards

Addressing priority 6:  This Parkinson’s UK-funded project could find ways to improve the long term benefits of therapies where people with Parkinson’s learn new movements.

The New Monument Discovery Award

Addressing priority 7:  This largest ever research grant given by Parkinson’s UK brings together a world-class team of researchers to betters understand Parkinson’s.

Understanding the causes of pain in Parkinson’s

Addressing priority 23:  More than half of all people with Parkinson’s experience chronic pain. This Parkinson’s UK-funded study aims to increase our understanding of this symptom.

Solution for swallowing problems in Parkinson’s

Addressing priority 24:  Shaheen Hamdy and his team are looking at three different techniques for treating swallowing problems in this Parkinson’s UK-funded study

Get it on time: What’s the evidence

Addressing priority 25:  This Parkinson’s UK-funded research aims to find out if people with Parkinson’s will recover more quickly and spend less time in hospital if they are given their medication on time.

Read more about what Parkinson’s UK is doing to address the priority areas for research from its PSP in this 2016 Unmet needs report.

Surgical treatment of pressure ulcers

Addressing priority 11:  Commissioning brief advertised to researchers by the NIHR HTA Programme.  

Patient and lay carer education for preventing pressure ulceration in at-risk populations

Addressing priority 2:  Cochrane Review protocol published in December 2015.  This review will look at how well patient and carer education about preventing pressure ulcers works.

STEPWISE: Structured lifestyle Education for People WIth Schizophrenia

Addressing priority 10:  NIHR research in progress.

Obesity and problems with weight are two to three times more common in people with schizophrenia.  This project creates a lifestyle education programme (based on an existing one for Diabetes around diet and physical activity) and evaluates how it can support weight loss in around 5,000 adults, within 10 mental health trusts across the UK.

EMPOWER: Early Signs Monitoring to Prevent Relapse and PrOmote Wellbeing, Engagement and Recovery

Addressing priority 2:  Joint research through NIHR and the Australian National Health and Medical Research Council in progress

Relapse in schizophrenia is a major cause of distress and disability among patients and their families.  Teams based in the UK and Australia are working together to build an intervention that refines existing smartphone technology for the monitoring of early warning signs.  They will assess the acceptability of this to service users, carers and health professionals and look at the feasibility of a larger scale trial of its acceptability and safety.

Training to recognise the early signs of recurrence in schizophrenia

Addressing priority 2:

A Cochrane Review was published in February 2013.  It looked at all previous evaluations of how effective early warning signs interventions are and what kind of future research we need in this area.

Management of sexual dysfunction due to antipsychotic drug therapy

Addressing priority 4:  Commissioning brief advertised to researchers by the NIHR HTA Programme.

Strategies for managing sexual dysfunction induced by antidepressant medication

Addressing priority 4:  A Cochrane Review was published in May 2013.  It looked at the results of previous studies around this relatively common side effect of antidepressant medication to find out what management strategies are effective and what the adverse effects and acceptability of them are.

Management of sexual dysfunction due to antipsychotic drug therapy

Addressing priority 4:  A Cochrane Review was published in November 2012.  It pulled together the results of previous studies looking at the effects of different treatment options.

Prevention of recurrent Symptomatic Urinary Tract Infections in Patients with Chronic Neurogenic Bladder Dysfunction: PReSUTINeB study

Addressing priority 4:  NIHR research in progress.  There is no clear agreement among experts on how to detect urinary tract infection in people who have loss of bladder control.  Also many scientific studies disagree on the correct definition of a urinary tract infection.  Stoke Mandeville National Spinal Injuries Centre is seeking to answer these questions by working with patients and reviewing the current evidence.  The results will help doctors better understand how to treat these infections.

In patients with 3 and 4 part proximal humeral fractures what is the long term outcome of reverse total shoulder replacement compared to hemiarthoplasty (half shoulder replacement)?

Addressing priority 5:  Commissioning brief advertised to researchers by the NIHR HTA Programme. 

A Randomised, single masked, non-inferiority trial of Femtosecond Laser Assisted vs Manual Phacoemulsification Cataract Surgery for Adults with Visually Significant Cataract: The FACT trial

Addressing Priority 7 in the Cataract Top 10: NIHR Research in progress. 

Read more information about this study. 

Mark Wilkins, consultant ophthalmologist at Moorfields Eye Hospital, is leading a team comparing two forms of cataract surgery. The trial will include more than 800 people, from Moorfields Eye Unit at St Ann’s Hospital in North London, and Wolverhampton Infirmary. They’re looking at the benefits of making some of the steps of surgery more robotic.

KERALINK: Efficacy and safety of cross-linking in children with Keratoconus

Addressing priority 6 in Corneal and External eye conditions: NIHR Research in progress. 

Read more information about this study. Keratoconus is a long term eye disorder that impairs the ability of the eye to focus and reduces vision.  Frank Larkin, a consultant at Moorfields Eye Hospital, and his co-investigators will test a treatment known as ‘collagen cross-linking to find out if it’s safe and whether it works in children and young people.

Summary of work funded by Fight for Sight, the NIHR and the Macular Society

The Sight Loss and Vision PSP report of funded research in the priority areas.

Horizon scanning review

Addressing priority 1 in Inherited Retinal Disease:  

In June 2014, the NIHR published the results of its 'horizon scanning review', which looked for any new and emerging technologies for inherited retinal disease.  The review found 40 new and emerging technologies.   

Horizon scanning review

Addressing priority 1 in Corneal and external eye conditions:  

In September 2016, the NIHR published the results of its horizon scanning review, which looked for any new and emerging technologies for the treatment of corneal disorders. The review identified 130 new and emerging technologies and procedures.  

The effect of light therapy on birdshot uveitis

Addressing ocular inflammatory priority 1:   

Participants in this study will be given a course of experimental light therapy in one eye only, in addition to their existing treatment, to see if this can reduce inflammation in the eye caused by auto-immune activity.

The world’s first birdshot uveitis database

Addressing ocular inflammatory priority 5:   

This biobank of samples from patients with birdshot will ultimately enable a great variety of statistically-valid studies to be performed on large numbers of patient samples.

Can we develop a fast, reliable and cheap way to monitor Birdshot’s progress?

Addressing ocular inflammatory priority 7:   

Omar Mahroo and colleagues tested a portable device that measures electroretinogram activity to find out whether it can reliably monitor Birdshot’s progress.

Can supercell analysis diagnose Birdshot uveitis

Addressing ocular inflammatory priority 3 and 5:   

In this project, a research team from Birmingham explores a machine learning method known as ‘supercell analysis’ to see if it can help speed up diagnosis and ultimately lead to a reliable diagnostic test.

Are there any early signs or symptoms that can predict Birdshot’s course?

Addressing ocular inflammatory priority 3:   

In this project, Mark Westcott and team at Moorfields Eye Hospital are looking for which clinical signs that appear early in the condition are good predictors of poor prognosis later on.

A patient-friendly way to measure flare-ups of birdshot uveitis

Addressing ocular inflammatory priority 3 and 5:   

This team based at Queen Elizabeth Hospital Birmingham is testing a light-based imaging device to see how good it is at detecting ‘flare-ups’.

How many new cases of birdshot are there each year?

Addressing ocular inflammatory priority 7:   

This project is a 2-year national survey of the demographics, signs and symptoms of each new case of birdshot in the UK.

Studying birdshot using stem cells from patients

Addressing ocular inflammatory priority 1 and 5:   

It would help our understanding of birdshot to study cells and tissue from patients, but donor tissue is in short supply. This team aims to develop a suitable layer of tissue from certain stem cells that come from patients.

Are the genetics of birdshot related to iron overload in the eye?

Addressing ocular inflammatory priority 5:   

This research team is studying genes to find out whether iron overload is related to birdshot and can therefore be helped by standard therapy for iron overload.

Does ultrasound assessment of fetal growth in the third trimester reduce stillbirth?

Addressing priority 2:  NIHR Research in progress. 

Care and support for bereaved parents

Addressing priority 7:  Commissioning brief advertised to researchers by the NIHR HTA Programme.

Why do people with tinnitus use apps?

Addressing priority 1:  Research in progress, supported by The British Tinnitus Association Head of Research.

Currently available tinnitus apps suggest a range of ways in which they might be effective for managing and treating tinnitus, including masking, neuromodulation, relaxation etc. Many allow customisation and personalisation of sounds used. Despite increasing popularity of apps it is unclear what proportion of people use apps for tinnitus management and which apps are the most popular. Also deeper and independent assessment of tinnitus apps that would assess quality of apps (including accuracy of content and usability) and mechanisms of action is lacking. In this ‘horizon scanning’ study, Magdalena Sereda at the NIHR Nottingham Hearing Biomedical Research Unit will identify apps that people use for tinnitus management, evaluate their content, and assess their potential strengths and limitations through an online survey.

Manualisation and feasibility study of audiologist-delivered counselling for tinnitus

Addressing priority 2:  NIHR research in progress funded by the NIHR RfPB Programme.

In the UK, emphasis is placed on audiologists meeting tinnitus patient needs but few receive the necessary training to provide patient counselling and few audiology departments have counselling-trained audiologists. In this feasibility study, NIHR Nottingham Hearing Biomedical Research Unit staff led by Derek Hoare will develop a manual for audiologists which defines standard care and counselling. Feasibility study objectives include evaluating acceptability of the counselling intervention, compliance, and whether there is sufficient interest and need for a randomised controlled trial.

Cognitive Behaviour Therapy for tinnitus-related insomnia

Addressing priority 3:  Research in progress commissioned by the The Tinnitus Association.

Sleep disturbance is one of the most common complaints from people with tinnitus affecting between 50-70% of people attending tinnitus clinics. Cognitive Behavioural Therapy (CBT) is a psychological talking therapy which has been shown to help manage insomnia. CBTi is now part of the NICE guidelines for the management of long term insomnia (NICE 2014). This study, led by Dr Laurence McKenna and Dr Liz Marks, University College London, will investigate the effectiveness of CBTi as a treatment of tinnitus-related insomnia. Sleep Hygiene (an approach commonly used in the tinnitus clinics) will be used as a control.

Evaluating the Tinnitus E-Programme, an internet-based self-help programme for tinnitus

Addressing priority 4:  NIHR research in progress. Funded through the NIHR Nottingham Hearing Biomedical Research Unit PhD studentship.

Until a cure for tinnitus is found, people need support to manage their tinnitus and reduce its impact on their everyday lives. Self-help programmes provide one way of achieving this. A systematic review was published in May 2016 which identified the self-help techniques used in self-help interventions for adults with chronic tinnitus and assessed their effectiveness. From 5 previous studies 15 behaviour change techniques and eight self-management components were identified but confident conclusions could not be drawn regarding efficacy. The PhD project has also evaluated the Tinnitus E-Programme (www.tinnituseprogramme.org), an internet-based self-help programme for people with tinnitus.

Amplification with hearing aids for patients with tinnitus and co-existing hearing loss

Addressing priority 5:  A Cochrane Review was published in January 2014. The team reviewed one previous trial to pull together the evidence that already exists about hearing aid interventions for tinnitus and co-existing hearing loss, and to highlight where further research is needed.

The British Tinnitus Association is funding a Head of Research fellowship that addresses priorities 1, 4, 5 and 9. Research is in progress. Dr Magdalena Sereda hopes her funded research will shed new light on the clinical efficacy and cost-effectiveness of NHS contracted sound therapy options for tinnitus including hearing aids and combination hearing aids.

Combined amplification and sound generation devices for tinnitus: towards creating clinical guidance and recommended procedure

Addressing priority 5:  Research in progress. Supported by the British Society of Audiology Tinnitus and Hyperacusis Special Interest Group Part-funded by a BSA Applied Research Grant.

Combination hearing aids are devices which amplify sounds in the same way as hearing aids, but also can create sounds such as white noise. They are used to manage tinnitus and are a fairly new addition to use in the UK. Many audiology clinics can offer combination aids. However, there is no standard guide to help audiologists decide on who to offer the devices to or how to fit them to best meet the needs of each patient with hearing loss and tinnitus. Ongoing research led by Dr Magdalena Sereda is conducting a series of surveys to 1) identify where there is and is not clinical consensus on who should be recommended combination hearing aids (candidacy) and how those devices should be fitted; 2) explore expectations and experiences of people with tinnitus who have used combination hearing aids.

Tinnitus in children practice guidance

Addressing priority 6:  In March 2015, the Paediatric Audiology Interest Group (PAIG) of the British Society of Audiology published practice guidance – a project that was undertaken by a working party of national specialists in paediatric tinnitus. The guidance offers child-friendly, practical advice for those wanting to develop their skills in the management of children with tinnitus. It is intended for a multidisciplinary audience including audiologists, medical professionals, school nurses, teachers of the deaf, and psychologists. This project was supported by the British Tinnitus Association.

People's experiences with different degrees of hearing loss and tinnitus

Addressing priority 7:   People who are deaf or have profound hearing loss are often marginalised by both their tinnitus and hearing loss. The British Tinnitus Association commissioned The Ear Foundation to investigate people's experiences with different degrees of hearing loss and tinnitus (supported by the James Tudor Foundation). The report was launched in September 2015 and presents the views of 1432 participants on the treatment they have received, what helped, what didn't and their hopes for the future.

The QUest In Eliminating Tinnitus (QUIET-1): testing a novel drug for tinnitus

Addressing priority 10:  In 2015, Autifony Therapeutics Ltd sponsored a Phase IIa tinnitus clinical trial in the UK, funded by Innovate UK. Professor Jaydip Ray, Consultant Ear, Nose and Throat (ENT) surgeon at Sheffield Teaching Hospitals NHS Foundation Trust and Sheffield Children’s Hospital NHS Foundation Trust was the national Coordinating Investigator and Professor Deborah Hall, University of Nottingham and NIHR Nottingham Hearing Biomedical Research Unit (BRU), was the academic partner. See BRU project page. The main aim was to try to demonstrate an improvement in the severity of tinnitus symptoms and impact after 28 days of treatment with the study medicine compared to placebo. Findings from the planned interim analysis of completed participants led to the closure of recruitment due to lack of efficacy. On a statistical basis, it would not be possible to reach the magnitude of change needed to show improvement over the placebo. Nevertheless, the team gained many valuable insights about trial design and patient recruitment.

Multicentre randomised trial of the effectiveness and cost-effectiveness of basic versus biofeedback-mediated intensive pelvic floor muscle training for female stress or mixed urinary incontinence (OPAL – Optimal PFMT for Adherence Long-term)

Addressing priority 1 and 3:  NIHR Research in progress Accidental leakage of urine is a distressing problem that affects about one in three women and the NHS spends considerable amounts of money treating it. Biofeedback equipment allows women to see their pelvic floor muscles working as they exercise. This study compares exercise with this equipment with standard exercises in around 600 women.

UVB light combined with topical corticosteroid for treatment of vitiligo

Addressing priority 4:  NIHR Research in progress. Read more information about this study. Vitiligo can have a devastating effect on the quality of life of those who have it, particularly where it is easily seen by others, for example on the face or hands. Over 440 people with vitiligo are involved in this study which looks at combinations of light therapy delivered at home, with steroid ointment.

Identifying High-Risk Women for Endometrial Cancer Prevention Strategies: Proposal of an Endometrial Cancer Risk Prediction Model

Addressing priority 1: This review published in December 2016 discusses a prediction model for identifying women at high risk of endometrial cancer who may therefore benefit from prevention strategies.

Interventions for weight reduction in obesity to improve survival in women with endometrial cancer

Addressing priority 10: Cochrane Review review protocol published in January 2017. This review will look at the impact of weight loss interventions, in addition to the standard management of womb cancer, on overall survival and frequency of adverse events.