The Cluster develops ‘pull through’ capacity; biostatistics, health economics, social sciences and epidemiology that inform effective study design through consultancy and training. Key elements include developing and implementing methods and models of: public and patient involvement (PPI) and engagement in research (recruitment/awareness); implementing a clinical informatics platform for stratified medicine; collaboration with Clusters 1 and 2 to design efficient and effective studies that maximise the chances of ‘pull through’ to the patient.
The Cluster comprises interdisciplinary skills in bioinformatics, clinical informatics, public health, primary care, environmental health, epidemiology, statistics, health economics and social sciences for research and training. The Cluster hosts the Clinical Trials Unit Hub, statistical/database support, BRC training in statistics, study design, social science, health economics, clinical informatics developments including the NIHR Health Informatics Collaborative, PPI/Public engagement in science, links to Guy’s and St Thomas’ and community and links to the NIHR Research Design Service.
We have established a significant infrastructure to support translational research. Our key successes across our programmes include:
- Improving the effectiveness of translational research through social science analyses of different models of translation: We have collaborated with researchers in Cluster Two in preparing the PPI strategy for the successful MRC Stratified Medicine call for Ancestry and Biological Informative Markers for stratification of Hypertension: The ‘AIM HY’ study and continue to support the investigators organising PPI events to identify potential barriers to participation in the trial.
- Development and testing of a digital infrastructure for stratified medicine and translational research: Lambeth DataNet (LDN) is a primary care dataset of all patients registered at general practices in Lambeth and is linked to patients clinical data. The database has become hosted by the Division of Public Health in King’s College London, with the BRC becoming the guardian of the data though Cluster Three and the NIHR HIC Project Manager.
- NIHR Health Informatics Collaborative: The HIC collaboration between five BRCs (Oxford, Cambridge, Guy’s and St Thomas’, Imperial, UCLH) is based around five clinical areas: Guy’s and St Thomas’ leads on renal transplantation. Key progress has been made in relation to information governance to enable data sharing between the collaborating BRCs. The programme wide data sharing agreement (DSA) was signed by the Trust CEOs, providing a legal framework to share data within the themes. A transplantation exemplar study has also begun in 2015 which looks at data usage to demonstrate the use and value in addressing specific translational research questions.
- Making translational studies more effective and efficient: The statistics consultancy within Cluster Three has supported more than 40 research studies to date, including BRC trainees, through consultancy, collaborations and training. These collaborations, particularly within Clusters One and Two have leveraged significant grant income and contributed to over 50 peer-reviewed publications.
- Environmental impact on respiratory and cardiovascular health: A new UK Birth Cohort study ‘The Life Study’ started in October 2014 with our researchers leading the environmental aspect investigating maternal exposure to environmental pollutants throughout pregnancy. 15 women in their third trimester of pregnancy have had environmental monitoring equipment installed into their homes in the pilot phase. An important part of the pilot was the testing the acceptability and use of smart phone apps for gathering personal and environmental exposure data – this system proved a cheap and scalable method for assessing environmental stress during pregnancy for future cohort studies.
- Breathe London: As part of the South East London Air Pollution Community Research Project the Breathe London website has been designed to give advice on air pollution and exposure. The website was launched at a public meeting in March 2015 (http://breathelondon.org) and provides a means of translating research which was undertaken to the local boroughs though straightforward advice outlining the impacts of air pollution on health along with interactive tools for reducing risk of harm through behavioural change. It is also being used for disseminating results of PPI studies and recruitment for future SELAP studies.
- EXHALE project: The final school visits for the sixth year of the EXHALE cross-sectional school study were completed in 2015.Amongst the preliminary findings from analysis of the first three years of data (2008 – 2011) have shown that the introduction of the London Emission Zone has not been associated with year-on-year improvements in urban air quality and that children with high exposures to air pollution report more symptoms of rhinitis and have clinically significant reductions in lung volumes.
The cluster utilises a number of the services on offer across King’s Health Partners. These include regulatory advice and support from the KHP Clinical Trials Office (CTO) and partner R&D departments at Guy’s and St Thomas’ and King’s College Hospital. In addition, clinical trial statistics, databases and management from King’s Clinical Trials Unit are all exploited as necessary.
All of the cluster’s research investigators collaborate with their peers from other academic institutions in the UK and abroad as well as with commercial and non-profit organisations such as charities.
NIHR Health Informatics Collaborative (NHIC)
Our BRC is playing an important role in helping big data to become increasingly valuable in clinical studies through its leadership of the NIHR Health Informatics Collaborative (HIC).
The programme brings together five leading NHS Trusts with large NIHR BRCs with the collective aim of making NHS clinical data more readily available to researchers, industry and the NHS community.
We are the lead BRC in the renal transplantation theme. We have also now taken up our joint-lead role in the theme of breast cancer and prostate cancer. We are actively involved in all other themes covered by the HIC.
The Data Analytics cluster board is led by Professor Charles Wolfe. It comprises senior research clinicians from Guy’s and St Thomas’ and King’s College London.
The board has oversight of the cluster’s research portfolio and acts as a forum to accurately and effectively support and monitor the research activities within the cluster. The board meetings also provide an opportunity for communicating potential opportunities for funding the expansion and future development of activities.