Developing Sight Loss and
Vision research questions:
a funder’s perspective
Anna Tallant
Scientific Advisor, HTA programme
23 September 2015
Evaluation, Trials and Studies Coordinating Centre
The NIHR Health Research System
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Information
Systems
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NIHR Evaluation, Trials and Studies
(NETS) programmes
Health Services
and Delivery Research
Established: 2012
NETSCC: Established: 2008
Public Health
Research
Established: 2008
Health Technology
Assessment
Established: 1993
Efficacy and Mechanism
Evaluation
Researcher-led
Funded by the MRC
Managed by NIHR
Commissioned
Funded and managed
by NIHR
Established: 2008 & 2011
NETS Programme remits
EME programme funds research into the clinical efficacy of
treatments and tests that have existing proof-of-concept
HTA programme funds research on the clinical and cost
effectiveness of healthcare treatments and tests
HS&DR programme funds research on the quality, accessibility
and organisation of health services
PHR programme funds research on non-NHS interventions to
improve the health of the public and reduce health inequalities
Funding streams
Researcher-led work stream
• Open calls for researchers to apply for funding for their
own topics and questions.
Commissioned work stream
• Designed to met the needs of decision makers within the
NHS.
• Topics refined and prioritised by experts and
commissioning briefs advertised.
Examples of funded research
What are the most effective treatments for glaucoma and how can
treatment be improved? (No 1 in Glaucoma top 10)
HTA 12/35/38: Treatment of Advanced Glaucoma Study (TAGS): A
multicentre randomised controlled trial comparing primary medical
treatment with primary trabeculectomy for people with newly diagnosed
advanced glaucoma (Prof A King, Jan 2014 – Aug 2020, £1.76 million)
How safe and effective is laser assisted cataract surgery? (No 7 in
Cataract top 10)
HTA 13/04/46: A Randomised Comparison of Femtosecond Laser
Assisted vs Manual Phacoemulsification Cataract Surgery for Adults
with Visually Significant Cataract: The FACT trial (Mr M Wilkins, Sep
2014 – Sep 2018, £1.37 million)
Topic identification
• External Engagement (Royal colleges, clinical networks,
speciality groups, charities)
• Stakeholder engagement (e.g. DH, NICE)
• Panel members/ Chairs (suggestions and ID activities at
panels)
• James Lind Alliance Priority Setting Partnerships
• Website suggestions
• Literature and data base scanning (Cochrane, DARE,
NIHR Journals Library final reports)
• Capture of NICE research priorities
What makes a good research
question?
•
Important to the NHS and its patients
•
Supported by current evidence
•
High scientific quality
•
Feasible
•
Timely, i.e. research will continue to be relevant
following completion of study
•
Clear and well-defined
•
Represents value for money
Prioritising research
Burden of
disease
Health
services
Evidence
gap
Need = frequency x severity x impact of technology x evidence deficit
(Discounted for time to produce evidence)
Important question on an important topic
Issues commonly discussed by
the funding boards (1)
• Research question – the question needs to be in remit and clearly
defined in simple terms, ideally in one sentence
• Importance – of this project needs to be explained
• Justification – needs references or preliminary data
• Patient and public involvement is expected from the design stage
through to delivery and dissemination of research
• Multi-disciplinary team – including clinical staff, researchers,
statisticians and experts in study design
• Research Design Service/ Clinical Trials Unit – consult early !
Issues commonly discussed by
the funding boards (2)
• Study design – needs to be optimised to answer the question
• Outcome measures –justify your choice of primary outcome and
any secondary outcomes
• Sample size/power calculation – provide enough data to allow the
calculation to be repeated
• Recruitment plan – make sure this is credible by including eligible
number of patients, drop-out rates and recruitment targets
• Drug dose/side effects – need to be clearly explained for drug
studies
• Costs – clearly justified, especially for % high-cost staff, e.g.
clinicians
Key points for success
• Make an early approach to local RDS or a CTU for advice on
application and proposed methodology
• Ensure the team has relevant scientific and project
management skills, including strong statistical support
• Ensure good patient and public involvement from the start
• Check fit with remit of relevant programmes (use FAQs)
• If unsure, discuss your proposed study with relevant
programme before submitting an application
Resources for applicants
•
NIHR Clinical Research Network
•
Research Design Service (RDS)
•
INVOLVE
•
Browse NETS website for study protocols, guidance
notes and FAQs
•
Become a reviewer for NETS programmes
•
Become a panel member
For further information, to apply for funding or to submit
suggestions for our commissioned workstreams:
www.nets.nihr.ac.uk