Examples of impacts for patients include:
New systems for patient self-reporting improve care and quality of life for cancer patients
In collaboration with Professor Galina Velikova and colleagues, Professor Julia Brown has played a key role in the design and development of new approaches and technologies for cancer patients to self-assess their symptoms and quality of life. The work has focused on electronic methods for collecting patient-reported outcome measures (PROMs), developing PROMs for neglected areas of patient care, and running trials of these techniques. These approaches produced sizeable patient benefits including improved symptom control and better quality-of-life. These findings have influenced clinical guidelines in the UK and Canada, NHS policy and the endorsement of PROMs in the Health and Social Care Act (2012). Electronic PROMs systems based on the Leeds research have been implemented locally, nationally and internationally, making measurable improvements to patient welfare and health, such as a reported significant increase in completion of chemotherapy treatment.
In collaboration with Professors David Jayne and Pierre Guillou, Professor Julia Brown has played a key role in the design and delivery of colorectal surgery trials. Work includes the RObotic versus LAparoscopic Resection for Rectal cancer (ROLARR), a large international trial and the MRC funded Conventional versus Laparoscopic-Assisted Surgery In Colorectal Cancer trial (CLASICC), the largest and most successful UK trial of a technology applied to general surgery. It addressed an area of huge clinical uncertainty, providing a rigorous evaluation of a new technology and enabling its safe and widespread implementation. The impact of CLASICC has been global, confirming the advantages for patients (quicker recovery) and healthcare providers (cost-effectiveness) and so influencing national and international policy in favour of the laparoscopic technique. It informed NICE guidance and led to a major DH initiative that has seen the UK become one of the largest providers in the world of laparoscopic colorectal cancer surgery. CLASICC is regarded as a benchmark surgical trial, combining high quality trial design with rigorous quality assurance, which has informed the design of many subsequent colorectal cancer studies.
Pressure Ulcer Prevention
Professor Jane Nixon has led research which has identified independent risk factors associated with pressure ulcer development and made a significant contribution to the evidence base for choosing the most cost-effective mattress to prevent pressure ulcers. Through publication and subsequent integration into systematic reviews/ practice guidelines the research has been disseminated to policy makers and practitioners. Leeds evidence is now included in international guidelines translated into at least 17 languages.
Transforming the treatment of myeloma has produced significant improvement in patient survival: the MRC Myeloma trials
In collaboration with Professors Peter Selby, Gareth Morgan and Anthony Child, Professors Julia Brown and Walter Gregory have played a significant role in the design and delivery of two large multicentre clinical trials resulting in major changes to treatment for patients with multiple myeloma. Myeloma VII clearly established the use of high-dose melphalan supported by autologous stem cell transplant (ASCT) following chemotherapy. Myeloma IX, the largest randomised controlled trial ever in myeloma, showed that zoledronic acid, in addition to reducing skeletal damage, showed an overall survival benefit and introduced the use of thalidomide as an effective yet less toxic therapy. Adoption of these treatment regimens has produced significantly improved outcomes throughout the developed world.