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.
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.
Background Acne is very common and, although thought of as a teenage condition, it often continues into adulthood where impact on quality of life can be significant. The most commonly used treatment for acne is long courses of antibiotics but concerns about antibiotic resistance mean we need to find alternatives. Spironolactone reduces hormones called androgens that are implicated in acne as these increase grease production and cause changes in follicles in the skin making them prone to acne. This study will measure whether spironolactone helps adult women with persistent moderate-severe facial acne.
Surgery through the side of the chest (thoracotomy), usually to treat lung cancer, can cause pain post-operatively that can last months or years in up to half of patients. This Chronic Post-Thoracotomy Pain (CPTP) can be severe and debilitating to patients, leading to more frequent GP visits, anxiety, depression, time off sick and unemployment. This study is trying to find out which of two common pain relief techniques results in less incidence of chronic pain at six months after surgery.
Addressing priority 7: NIHR research published. Many people with asthma are interested in non-drug treatments, particularly in breathing exercises. Teaching these breathing exercises face to face works well. This study showed that breathing retraining exercises improve quality of life in adults with asthma and at lower cost than usual care, with delivery by DVD having equivalent outcomes with lower cost than face-to-face training.
“It has been a great privilege to be involved in a research project like BREATHE, which had its roots firmly embedded in the wishes and priorities of patients with asthma and their families. We knew from the work of the James Lind Alliance, and our own clinical experience, that breathing techniques were of great interest to people with asthma.
We also knew that there were not enough NHS physiotherapists with the specialist skills needed to teach these techniques. BREATHE was developed out of these two key facts – and has resulted in a trial assessing the effect of physiotherapy breathing retraining learned through two different delivery methods – a) face to face with a physio, and b) digitally using a DVD plus booklet at home. We have found that both delivery methods were equally effective for our participants.
The interventions were developed iteratively with feedback from patients and clinicians, and this has helped to make sure they are not only effective, but also acceptable, and therefore more likely to be used in practice. We can honestly say that without the input of clinicians, patients and their families, we would not have been able to design, develop, test, and now implement, our new digital intervention.”
Anne Bruton, Co-investigator of the BREATHE study
Commissioning brief advertised to researchers by the NIHR HTA programme.
Commissioning brief advertised. The UK’s NIHR and the Australian National Health and Medical Research Council (NHMRC) are collaborating on this research priority and will consider joint funding for any collaborative research proposals submitted.
Autism is a complex life-long condition that impacts on development in different areas including intellectual, communication, social, emotional, and adaptive skills for daily living. The proportion of children diagnosed with autism has increased considerably over the last two decades, and it now affects approximately 3 in 200 children born in the UK. This study aims to find out whether or not intensive early interventions based on applied behaviour analysis (ABA) can help young children with autism, and whether it represents good value for money.
Addressing priority 6: Commissioning brief advertised to researchers by the NIHR HTA Programme.
Challenging restricted repetitive behaviours (RRB) such as repetitive movements, routines, restricted interests, and resistance to change can interfere with an autistic child's ability to engage in everyday living activities, reduce social opportunities and prevent learning new skills. Parents report they need strategies and advice on how to manage their child's challenging RRB. This study will assess the effectiveness of a Managing Repetitive Behaviours intervention.
Addressing priority 1: Commissioning brief advertised to researchers by the NIHR HTA Programme.
Bryony Beresford and her team brought together the evidence which already exists from lots of previous studies about sleep disturbance, to determine how well different treatments work. The review showed that it was not possible to draw conclusions about the effectiveness of non-pharmacological interventions for managing sleep disturbance and although there was some benefit with melatonin, the degree of benefit is uncertain.
Families and professionals agree that there needs to be more research on therapy interventions (physiotherapy, occupational therapy and speech and language therapy) for children with neurodisabilities. To aid decisions about what, or whether, to fund research on this topic, the National Institute for Health Research commissioned a small scoping study.
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.
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.
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.
Addressing priority 4: Commissioning brief advertised to researchers by the NIHR HTA Programme
Addressing priority 7: Commissioning brief advertised to researchers by the NIHR HTA Programme
Addressing a broad range of the priorities: Commissioning brief advertised to researchers by the NIHR HTA Programme.
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.
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?
Research has given us a growing list of things that can be done to improve dementia care, but there is a gap between what we know and what actually happens. This project looks at how we can best communicate the practices that have been shown to improve care.
Addressing priority 10: Commissioning brief advertised to researchers by the NIHR HTA Programme.
Addressing priority 18: Commissioning brief advertised to researchers by the NIHR HTA Programme.
Addressing priority 1: Commissioning brief advertised to researchers by the NIHR HTA Programme.
1 in 5 children in the UK have eczema There are many different emollients (moisturising treatments applied directly to the skin) to relieve skin dryness and hardly any research comparing them. This research team wants to do a fair test of the four most commonly used types of emollients.
Addressing any of the priorities in the Surgical Top 10: Evidence synthesis commissioning brief advertised to researchers by the NIHR HTA Programme
Addressing priority 5: Commissioning brief advertised to researchers by the NIHR HTA Programme
We want to find out whether treatments used for diarrhoea in people with irritable bowel syndrome (IBS) can help people with stable ulcerative colitis (UC) and diarrhoea, with no sign of active bowel inflammation. In IBS, a low FODMAP diet improves diarrhoea, because some poorly absorbed sugars (FODMAPs) increase small intestinal water content. Drugs like ondansetron (an anti-sickness drug), amitriptyline (an old-fashioned anti-depressant drug), or loperamide (an anti-diarrhoeal drug) can also be effective in IBS with diarrhoea. This is because they change bowel activity, and can relieve tummy pain. These treatments may therefore help people with UC with diarrhoea who have no active bowel inflammation, but we are unsure as there are no large studies. This project is due to commence April 2019 and end December 2022
Addressing priority 5: Commissioning brief advertised to researchers by the NIHR HTA Programme.
Addressing any of the relevant priorities in the Top 10: forCrohns and Core announced a joint call for research projects on Crohn’s Disease, which should reflect at least one of the Top 10 from the PSP in IBD
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.
In the UK, over 2,000 patients are diagnosed yearly with pleural mesothelioma, a cancer of the lining of the chest wall and lung mainly due to previous (40 to 60 years ago) exposure to asbestos. This trial compares surgery (extended pleurectomy decortication) versus no surgery with respect to overall survival in patients with pleural mesothelioma.
In March 2017, the NIHR published the results of its horizon scanning review, which looked for new and emerging technologies for hearing loss. The review identified 55 new technologies. Patients, clinicians and researchers highlighted the technologies of interest to them which, if successful, would have the potential to change the cochlear implant landscape for patients, improve patient experience and use of hearing aids, and would affect service delivery and provision.
Commissioning brief advertised to researchers by the NIHR HTA Programme
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.
In 2014, the MS-STAT1 clinical trial of 140 people with secondary progressive multiple sclerosis followed for 2 years showed promising results in those taking simvastatin (dose-80mg/day) compared to placebo (a dummy drug). This MS-STAT2 trial is based on the original MS-STAT1 trial, but is a larger clinical trial. Patients will be followed for 3 years to investigate whether there is confirmed slowing of disability progression or not.
Addressing priority 1: Research grant awarded to Professor Scott Murray, University of Edinburgh, in March 2017, by Marie Curie and the Chief Scientist Office Scotland.
Addressing priority 1: Research grant awarded to Dr Felicity Hasson, Ulster University, by Marie Curie.
Addressing priority 1: Research grant awarded to Professor Richard Harding, Kings College London, and Dr Fliss Murtagh, Hull York Medical School, by Marie Curie.
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.
Addressing priority 4: Research grant awarded to Dr Nathan Davies, University College London, by Marie Curie
Addressing PSP priorities 6 and 8 from the Top 10: Research grant awarded to Dr Christopher McDermott, University of Sheffield, in March 2017, by Marie Curie and the Motor Neurone Disease Association.
Addressing PSP priority 6 from the Top 10 and number 33 from the long list of questions identified: Research grant awarded to Dr Kate Flemming, University of York, in March 2017, by Marie Curie and the Motor Neurone Disease Association.
Addressing PSP priorities 4, 8, and 10 from the Top 10 and numbers 36, 37, 42 and 45 from the long list of questions identified: Research grant awarded to Professor Gunn Grande, University of Manchester and Dr Gail Ewing, University of Cambridge, in March 2017, by Marie Curie and the Motor Neurone Disease Association.
Addressing PSP numbers 18, 21, and 73 from the long list of questions identified: Research grant awarded to Professor Marie Fallon and Dr Barry Laird, University of Edinburgh, in March 2017, by Marie Curie and the Chief Scientist Office Scotland.
Addressing priority 19: Research grant awarded to Professor Marie Fallon, University of Edinburgh, by Marie Curie
Addressing priority 19: Research grant awarded to Professor Simon Noble, Cardiff University and Dr Jason Boland, Hull York Medical School, by Marie Curie
Addressing numbers 47, 48, 49 and 50 from the long list of questions identified: Research grant awarded to Dr Richard Harding and Dr Katherine Bristowe, King’s College London, in March 2017, by Marie Curie.
Addressing priority 26: Research grant awarded to Professor Richard Harding and Dr Steve Marshall, Kings College London, by Marie Curie
Addressing priority 28: Research grant awarded to Dr Sally Wheelwright, University of Southampton, by Marie Curie.
Addressing number 80 from the long list of questions identified: Research grant awarded to Dr Bridget Candy, University College London, in March 2017, by Marie Curie.
Addressing PSP priorities 2 and 6 from the Top 10 and number 64 from the long list of questions identified: Research grant awarded to Dr Morag Farquhar, University of East Anglia, in March 2017, by Marie Curie.
Addressing PSP priorities 3 and 4 from the Top 10: Research grant awarded to Dr Karen Shaw, University of Birmingham, in March 2017, by Marie Curie.
Addressing priority 1 NIHR research in progress to determine whether a drug, known as a cholinesterase inhibitor, can prevent falls in Parkinson's. The effect of these drugs on falls in Parkinson's has been tested in 3 small trials showing that treatment has the potential to reduce the number of falls and this study will provide better evidence for this.
Addressing priority 1: This Parkinson's UK-funded study aimed to shed new light on the complex relationship between physical activity and falls in Parkinson’s, hoping that this new knowledge will empower people with the condition to manage their condition more effectively and reduce their risk of falling.
Addressing priority 2: In this Parkinson’s UK-funded study, the team has tested a mindfulness course to assess how helpful it is.
Addressing priority 2: In this project, the team hopes to test the reason behind anxiety in Parkinson’s and a technique to reduce anxiety using simple online exercises.
Addressing priority 2: Researchers investigated whether anxiety in Parkinson’s is similar to anxiety in people without the condition and then tested whether this anxiety could be reduced with a simple computer training task in this Parkinson’s UK-funded study.
Addressing priority 3: In another Parkinson’s UK-funded study, a team looked at what makes nerve cells become overactive when taking Levodopa, resulting in uncontrollable movements.
Addressing priorities 4 and 7: At the end of the project, this research team hopes to be able to accurately calculate risk based on a number of factors and be able to predict people who will develop Parkinson’s in the future.
Addressing priority 4 and 7: This research team is interested in finding out how people’s genetic makeup may influence the progression of Parkinson’s.
Addressing priority 5: In this Parkinson’s UK-funded study the team worked 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.
Addressing priority 5: This Parkinson’s UK-funded study aimed to find biomarkers that predict the risk of a person with Parkinson’s developing dementia.
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.
Addressing priorities 5 and 6: The main goal of this is to better understand the early signs of dementia in people with Parkinson’s.
Addressing priority 6: This Parkinson’s UK-funded project looked for ways to improve the long term benefits of therapies where people with Parkinson’s learn new movements.
Addressing priority 6: The team is studying people with REM sleep behaviour disorder, who are at high risk of developing Parkinson’s, to identify areas of the brain affected early on.
Addressing priority 7: This research grant given by Parkinson’s UK brings together a world-class team of researchers to better understand Parkinson’s.
Addressing priority 9: Symprove is an oral probiotic that can reach the lower gut and has been seen to improve symptoms in conditions such as irritable bowel syndrome. The research team has some evidence that Symprove may be able to reduce motor and non-motor symptoms in people with Parkinson’s. Now they want to test its potential.
Addressing priority 10: Urinary problems are one of the top research priorities for improving quality of life for people with Parkinson’s. This project is looking to test a new bladder training programme for people with Parkinson’s in a pilot study.
Addressing priority 10: Transcutaneous electrical stimulation involves using a device to deliver small electrical impulses to the skin. This approach is sometimes used to address pain but has not been used to treat bladder problems before. This project will test if the treatment can improve bladder symptoms in people with Parkinson’s.
Addressing priority 20: Delirium is difficult to diagnose in people with Parkinson’s. This is because it has similar symptoms to Parkinson’s and dementia – such as confusion, hallucinations and sleep disturbances. But people will often make a full recovery from delirium if it is recognised and treated early enough. The findings from this study will be used to help develop and evaluate a new tool to identify delirium in people with Parkinson’s, so that it can be treated better.
Addressing priority 20: This project will investigate delirium in people with Parkinson’s admitted to hospital, which could help better identify and treat the condition.
Addressing priority 23: More than half of all people with Parkinson’s experience chronic pain. This Parkinson’s UK-funded study aimed to increase our understanding of this symptom.
Addressing priority 24: This project looked at three different techniques for treating swallowing problems in this Parkinson’s UK-funded study.
Addressing priority 25: This Parkinson’s UK-funded research aimed 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.
Addressing priority 11: Commissioning brief advertised to researchers by the NIHR HTA Programme.
Addressing priority 8: A Cochrane Review published in June 2017 brought together the best available evidence to help health professionals and people with pressure ulcers make decisions about the use of dressings or topical agents as treatments.
Addressing priority 1: Commissioning brief advertised to researchers by the NIHR HTA Programme.
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.
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.
A number of drugs improve the mental health of people with psychosis; these are called 'antipsychotic' drugs. Up to a half of people who take them experience sexual side effects including reduced desire for and pleasure from sex. These side effects lead some to stop taking their medication making a relapse more likely. This study will compare the effects of switching a person's medication to an equivalent dose of an alternative antipsychotic drug that is believed to result in fewer sexual side effects. This study started in May 2018 and is due to end in January 2021.
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.
Obesity and problems with weight are two to three times more common in people with schizophrenia. This project created a lifestyle education programme (based on an existing one for Diabetes around diet and physical activity) and evaluated how it could support weight loss in around 5,000 adults, within 10 mental health trusts across the UK. Despite the challenges of undertaking clinical research in this population, the trial successfully recruited and retained participants, indicating a high level of interest in weight management interventions; however, the STEPWISE intervention was neither clinically effective nor cost-effective. Further research will be required to define how overweight and obesity in people with schizophrenia should be managed. The trial results suggest that lifestyle programmes for people with schizophrenia may need greater resourcing than for other populations, and interventions that have been shown to be effective in other populations, such as people with diabetes mellitus, are not necessarily effective in people with schizophrenia.
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.
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.
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.
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.
Participants in this study are 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.
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.
Omar Mahroo and colleagues test a portable device that measures electroretinogram activity to find out whether it can reliably monitor Birdshot’s progress.
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.
In this project, Mark Westcott and team at Moorfields Eye Hospital look for which clinical signs that appear early in the condition are good predictors of poor prognosis later on.
This team based at Queen Elizabeth Hospital Birmingham tests a light-based imaging device to see how good it is at detecting ‘flare-ups’.
This project is a 2-year national survey of the demographics, signs and symptoms of each new case of birdshot in the UK.
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.
This research team studies genes to find out whether iron overload is related to birdshot and can therefore be helped by standard therapy for iron overload.
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.
This trial tests whether planned delivery at 38 weeks is better than monitoring women and babies until at least 40 weeks. The WILL trial will run for 3 years in about 30 UK hospitals. We will ask women to take part if they have reached 36 or 37 weeks of pregnancy and have high blood pressure and no other current problems. This trial started in June 2018
Addressing priority 7: Commissioning brief advertised to researchers by the NIHR HTA Programme.
Currently, women are offered a scan at 20 weeks, but are not offered any scans after that unless a problem is identified. It is currently known that some babies with problems are not picked up by the usual abdominal examinations during antenatal check-ups. As babies that are small, large or not head first prior at birth are more likely to be sick at birth or not survive, it is thought an extra scan in late pregnancy may be helpful and improve outcomes for babies. The trial will evaluate existing evidence, consider and determine the level of appropriate support for women for whom a late scan identifies a problem, evaluate financial costs vs benefit of a screening programme and finally, taking into account all the evidence, design a study of scanning in late pregnancy. HTA will then be able to judge whether or a not a trial of scanning in late pregnancy for all women should go ahead.
Addressing one of the Top 10 priorities: Commissioning brief advertised to researchers by the NIHR HTA Programme.
Breaking (fracturing) the upper part of the arm at the shoulder (proximal humerus) most commonly occurs in people over 65 years old after a simple fall. Fractures are considered more serious & complex when the bone is broken into more than 2 parts or are widely separated This study will assess which is the most effective treatment for these more severe fractures.
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.
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.
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.
Addressing priority 4: NIHR research was 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.
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.
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.
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.
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.
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. 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.
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.
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.
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.
Addressing priority 10: Cochrane Review published in February 2018. This review looked at the impact of weight loss interventions, in addition to the standard management of womb cancer, on overall survival and frequency of adverse events.