Table 2.
The Oxford Biomedical Research Centre (BRC) projects that Research theme/Working group leads indicated had potential impacts on patient care at Oxford University Hospitals NHS Foundation Trust (OUH), with an indication of whether that impact was perceived by senior clinicians at OUH
| BRC Research theme/Working group | Oxford BRC projects with potential impact on patient care | Potential impact on patient care at OUH | OUH senior clinician mentioned impact unprompted?a | OUH senior clinician confirmed impact after prompting?a |
|---|---|---|---|---|
| Biomedical Informatics and Technology | Gestational diabetes smartphone application | Processes and/or service organisation | YES | n.a. |
| New alerting score based on patients’ vital signs (CALMS-3 Study – Computer Alerting Monitoring System) | Processes and/or service organisation | NO | NO | |
| Maintenance of database of samples and consent management for Oxford Biobank | Processes and/or service organisation | NO | YES | |
| System for Electronic Notes Documentation (SEND) project (electronic track and trigger and patient alerting) | Processes and/or service organisation | YES | n.a. | |
| Blood | Training and hiring staff and improving infrastructure for clinical programme to do stem cell transplants and run more clinical trials in this area | Treatments | NO | NO |
| Cancer | Multi-gene testing service with rapid (1 week) turnaround | Diagnostics, testing, screening | NO | YES |
| BRC-funded clinical research posts specialising in sarcoma, gynaecological cancers and melanoma | Staffing for specialist services | NO | NO | |
| Cardiovascular | MRI diagnostic tools for patients with intermittent angina | Diagnostics, testing, screening | NO | YES |
| Clinical Informatics | Upgrade for cancer informatics in OUH (enabled by Genomic Medicine Centre (GMC) designation) | Diagnostics, testing, screening | NO | NO |
| Molecular diagnostics and genome sequencing services (enabled by GMC designation) | Diagnostics, testing, screening | NO | NO | |
| Development of integrated logical record for each cancer patient (in progress) | Processes and/or service organisation | NO | YES | |
| True colours technology for mental health patients across Oxfordshire to aid self-management | Processes and/or service organisation | NO | YES | |
| Streamlining management of notes/records from multidisciplinary cancer meetings (in progress) | Processes and/or service organisation | NO | YES | |
| Clinical decision support dialogue to make blood orders more efficient | Processes and/or service organisation | NO | NO | |
| Dementia and Cerebrovascular Disease | New screening process for acute confusion in medical admissions | Diagnostics, testing, screening | NO | YES |
| Fast track carotid surgery | Treatments | NO | NO | |
| Telemetric home blood pressure monitoring | Processes and/or service organisation | NO | NO | |
| The first transient ischaemic attack (TIA) and minor stroke clinic in the United Kingdom | Processes and/or service organisation | YES | n.a. | |
| Diabetes | Diagnostic programme to identify patients with a genetic basis for their diabetes | Diagnostics, testing, screening | NO | NO |
| Pancreatic islet extraction unit | Treatments | NO | NO | |
| Pancreatic transplants | Treatments | NO | NO | |
| Functional Neuroscience and Imaging | Imaging protocols (epilepsy) | Diagnostics, testing, screening | NO | NO |
| Functional neurosurgery team (part of the BRC) provides a clinical service, including pain deep brain stimulation | Treatments | NO | NO | |
| Specialist clinic in epilepsy, Parkinson’s disease, motor neurone disease, supported by BRC-funded research fellows | Staffing for specialist services | NO | NO | |
| Genomic Medicine | Targeted next generation sequencing | Diagnostics, testing, screening | NO | NO |
| Whole exome or whole genome sequencing | Diagnostics, testing, screening | NO | NO | |
| Immunology and Inflammation | Non-invasive tests for liver disease | Diagnostics, testing, screening | YES | n.a. |
| Patient stratification for biologic therapies | Diagnostics, testing, screening | NO | YES | |
| Tests to diagnose encephalitis (brain inflammation) | Diagnostics, testing, screening | NO | NO | |
| Trials on treatment of inflammation in eczema | Treatments | NO | NO | |
| Infection | Work linking care to outcomes with big data approaches | Processes and/or service organisation | NO | NO |
| Genomic testing to support infection monitoring (provided informally) | Processes and/or service organisation | NO | NO | |
| Molecular Diagnostics | Oxford designated as GMC for Genomics England’s 100,000 Genomes Project | Diagnostics, testing, screening | YES | n.a. |
| Multi-gene testing for cancer patients | Diagnostics, testing, screening | NO | YES | |
| Diagnostic tests for children with rare blood conditions | Diagnostics, testing, screening | NO | NO | |
| Response prediction in leukaemia | Diagnostics, testing, screening | NO | YES | |
| Prevention and Population Care | The first TIA and minor stroke clinic in the United Kingdom | Processes and/or service organisation | YES | n.a. |
| Surgical Innovation and Evaluation | Chemotherapy (device targeted therapy): liposomes developed to carry the treatment to the organ of interest | Treatments | NO | NO |
| Image-guided surgery using fluorescents | Treatments | YES | n.a. | |
| Organ transplantation/reconditioning | Treatments | NO | NO | |
| Restoring vision through an electronic implant | Treatments | YES | n.a. | |
| Restoring vision through gene therapy | Treatments | YES | n.a. | |
| Training and Education | No projects identified | |||
| Translational Physiology | No projects identified | Diagnostics, testing, screening | YES | n.a. |
| Vaccines | Respiratory syncytial virus, trialling a new vaccineb | Treatments (national) | YES | n.a. |
| Meningitis, looking at trials of schedules for baby vaccines, booster doses, meningitis B vaccine trialsb | Processes and/or service organisation (national) | YES | n.a. | |
| Multiple Research themes/Working groups | Better infrastructure for clinical trials and other studies (e.g. better pharmacovigilance, biobanking) | Processes and/or service organisation | NO | YES |
NO, Either none of the clinicians interviewed recognised the project as described, or if it was recognised it was not confirmed as having an impact on patient care; YES, At least one clinician interviewed recognised the project and confirmed impacts from it; n.a., Not applicable
aThe absence of a YES from both of the last two columns of the table should not be interpreted as evidence of an absence of clinical impact. The approach used to query impacts had limitations. Each interviewee was prompted with a list of 3–6 projects selected by the interviewers before the interview on the basis of the interviewee’s clinical area, so lack of recognition of projects could result from (1) unsuitable choice of prompts by the interviewers, (2) projects not being used as prompts, or (3) the projects may not have been described in terms familiar to the interviewees
bProjects were not among those prompted, because their impact is national rather than specific to OUH, but they were both mentioned by clinicians unprompted
In addition to the projects in the table that were mentioned unprompted, four projects were mentioned unprompted and confirmed to be Oxford BRC projects: digital monitoring of neonates in an intensive care unit, research on radiotherapy for rectal cancer, Tardox project to deliver treatment to specific tumour sites in liver, and metabolic imaging of brain tumours. A further eight projects were mentioned unprompted by the senior clinicians when asked about Oxford BRC projects that might have impacted patient care, but these had not been mentioned by the Oxford BRC RT/WG leads and were not identifiable from Oxford BRC documentation as being projects they had contributed significantly to