King’s College London, Press Release: Translational research and patient safety in Europe

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PR 36/10

King’s will lead a consortium of 15 European universities and two private partners to develop methods, standards and systems for the integration of healthcare computer systems for clinical care and research.

Clinical research is often costly and slow. It is difficult to find suitable subjects and time consuming to follow them up. TRANSFoRm will facilitate both these activities using routine healthcare data.

Robert Lechler, Vice-Principal (Health) and Executive Director King’s Health Partners comments: ‘TRANSFoRm is an informatics project that helps achieve the aims of King’s Health Partners to increase the amount of clinical research taking place in South East London, particularly in general practices‘.

Professor Brendan Delaney, the Guy’s and St Thomas’ Charity Chair in Primary Care Research, is the project lead as well as a practising GP in London. Professor Delaney says: ‘TRANSFoRm will demonstrate the use of routine healthcare data in clinical research using two exemplar problems, one in the management of Gastroesophageal Reflux Disease, the other in Diabetes.’

Supporting diagnosis in General Practice

The project will aid General Practitioners in diagnosis by integrating decision support directly into their electronic records systems. Dr Olga Kostopoulou, Senior Lecturer at King’s, will be studying how different types of diagnostic prompts and alerts might influence the diagnostic performance of GPs. King’s and Birmingham University will be developing a generic interface to allow GPs using different record systems to use TRANSFoRm, seamlessly integrated into their existing system.

Dr Kostopoulou says: ‘Prompt diagnosis is a fundamental task for GPs, as they are in many countries the gatekeepers to specialist care and see patients with early disease. The challenge is to identify patients with serious disease such as cancer or heart disease without over-investigating the much larger numbers of patients without serious disease. The symptoms and signs of serious disease are often non-specific and can be attributed to more common and less serious conditions.’

Peter Hewitt, Chief Executive of Guy’s and St Thomas’ Charity said: ‘We are delighted that the Charity’s support is enabling Professor Delaney and his team to spearhead such significant work in the field of health informatics. These two initiatives will not only improve the level of care provided to patients, but will also drive the scale and quality of primary care research across Europe.’

Notes to editors

Project details

TRANSFoRm has been funded by the European Union Framework Programme 7 (Project No 247787), Information Society and Media Directorate, ICT Health Unit, to a total EU contribution of €6.95Million over 5 years, commencing 1. March 2010: www.transform-project.org

European Collaboration involving TRANSFoRM

The Royal College of Surgeons of Dublin will develop a means for piping new clinical prediction rules into the system using a ‘web service’ and computer ‘middleware’. The system will be studied in the UK, Ireland and Greece (by the University of Crete) using a multi-channel recording tool (the Alpha Toolkit) developed at St Georges’ Hospital Medical School.

The University of Antwerp, representing the European General Practice Research Network and Primary Care Diabetes Europe, and the University of Dundee will develop predictors of risk of complications of Type 2 Diabetes using a very large phenotype-genotype association study. The Karolinska Institute, representing the European Primary Care Gastroenterology Society, will study the long-term effectiveness of on-demand vs. continuous use of acid suppression in gastro-oesophageal reflux in a very large randomised trial. The TRANSFoRm system will be developed by Trinity College Dublin, the University of Birmingham, the University of Limerick, Imperial College London and King’s College London using an open source model.

The Mediterranean Institute of Primary Care (Malta), the Medicines and Healthcare Regulatory Authority, General Practice Research Database (UK), NIVEL (Netherlands) and Language and Computing (Belgium) will assist in these areas. The University of Dusseldorf will manage project ethics and also dissemination activities via the European Clinical Research Infrastructures Network. Quintiles UK and Ireland will explore and demonstrate the role of TRANSFoRm in commercial clinical trials.

King’s College London

King’s College London is one of the top 25 universities in the world (Times Higher Education 2009) and the fourth oldest in England. A research-led university based in the heart of London, King’s has more than 21,000 students from nearly 140 countries, and more than 5,700 employees. King’s is in the second phase of a £1 billion redevelopment programme which is transforming its estate.

King’s has an outstanding reputation for providing world-class teaching and cutting-edge research. In the 2008 Research Assessment Exercise for British universities, 23 departments were ranked in the top quartile of British universities; over half of our academic staff work in departments that are in the top 10 per cent in the UK in their field and can thus be classed as world leading. The College is in the top seven UK universities for research earnings and has an overall annual income of nearly £450 million.

King’s has a particularly distinguished reputation in the humanities, law, the sciences (including a wide range of health areas such as psychiatry, medicine and dentistry) and social sciences including international affairs. It has played a major role in many of the advances that have shaped modern life, such as the discovery of the structure of DNA and research that led to the development of radio, television, mobile phones and radar. It is the largest centre for the education of healthcare professionals in Europe; no university has more Medical Research Council Centres.

King’s College London and Guy’s and St Thomas’, King’s College Hospital and South London and Maudsley NHS Foundation Trusts are part of King’s Health Partners. King’s Health Partners Academic Health Sciences Centre (AHSC) is a pioneering global collaboration between one of the world’s leading research-led universities and three of London’s most successful NHS Foundation Trusts, including leading teaching hospitals and comprehensive mental health services. For more information, visit: www.kingshealthpartners.org.

Guy’s and St Thomas’ Charity

Guy’s and St Thomas’ Charity is one of the UK’s largest and most innovative NHS charities. The Charity’s aim is to ensure patients get the very best care possible in the best environment by funding new services and approaches to healthcare at Guy’s and St Thomas’ NHS Foundation Trust, NHS Lambeth, NHS Southwark, South London and Maudsley NHS Foundation Trust.  For further information contact Kate Mensah, Head of Communications on Tel: 0207188 1218 or mob: 077 22 119157 or email: [email protected] or visit www.gsttcharity.org.uk

Further information

Kate Moore, Public Relations Officer (Health)

Public Relations Department

Tel: 0207 848 4334

Email: [email protected]

King’s College London News Archive – http://www.kcl.ac.uk/news/news_details.php?year=2010&news_id=1290

Job Vacancy: King’s College London, Research Assistant OR Associate (30 months) WP2

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Job Description

The post holder will work as part of the Medical Decision Making and Informatics Research Group at Kings

to carry out project tasks, including experimental design, recruitment of participants, data collection, statistical analyses, presentation of findings at conferences and preparation of papers for publication in peer-reviewed journals.

The post is suitable for applicants with a good first degree in Psychology and interest in decision making, who wish to acquire further research experience before starting a PhD. During the project, applicants will have the opportunity (and be strongly encouraged) to develop a PhD proposal, potentially related to the project, to be submitted for further funding.

For the position of Research Assistant, you should have a good first degree in Psychology (at least 2:1) and, preferably, a Masters. You should have good knowledge of experimental design and statistics, demonstrable through your final-year or Masters project.

The post is also suitable for psychology graduates with the type of experience outlined above and with a PhD in a related area (applied cognitive psychology, judgment and decision making) who wish to do postdoctoral research in decision making applied to healthcare.

See http://www.kcl.ac.uk/depsta/pertra/vacancy/external/pers_detail.php?jobindex=8650

Job Vacancy: Research Fellow in Information and Communication Technology (ICT)

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Job Description

EU FP7 ICT Translational Research and Patient Safety in Europe (TRANSFoRm) Project – Information and Communication Technology (ICT) in Primary Care

The HRB Centre for Primary Care Research ( http://www.hrbcentreprimarycare.ie/) is a five-year programme funded by the Health Research Board (HRB) in Ireland. The Programme consists of 3 work packages (WPs): WP1 is on management and co-ordination of care in vulnerable patient groups in the community. WP2 encompasses evidence-based diagnosis in primary care and is directed to a development of an International Register of Clinical Prediction Rules (CPRs), systematic reviews of diagnostic accuracy studies and primary research in the development, validation and impact analysis of CPRs in primary care. WP3 on information and communication technology (ICT) in primary care is designed to develop and implement clinical knowledge sources-computerised clinical decision support systems (CDSSs), decision aids for patients and electronic clinical prediction rules (eCPRs) and generate comparative clinical data for quality improvement.

As part of the above WP3, the HRB Centre at RCSI is a partner in the EU FP7 ICT TRANSFoRm Project ( www.transform-project.org) leading the project’s Work Package 4 “Decision Rules and Evidence” [TP-WP4] and participating in Work Package 2 “Patient Safety Use Case” [TP-WP2] and Work Package 9 “Dissemination and Exploitation” [TP-WP9] as well as contributing to Work Package 5 “User and Software Services” [TP-WP5] and Work Package 7 “Core Tools and Services for Interoperability” [TP-WP7]. The overall aim of TP-WP4 is to develop ICT tools in the form of agents or web-services that utilize a knowledge-based system to drive a decision support system (DSS) via dynamic user interfaces in TP-WP5 and TP-WP7. The DSS will provide patient-specific advice to be provided at the moment of consultation so that clinicians are able to access and quantify likely differential diagnoses framed in terms of diagnostic probability and alternative diagnostic possibilities. Use of these ICT tools for common clinical scenarios will be measured and judged in terms of diagnostic error – chest pain, dyspnoea and abdominal pain, all of which are common diagnostic scenarios in primary/community care settings.

We wish to appoint a Research Fellow in ICT / health informatics and programming for the TRANSFoRm Project. The following conditions apply:

Level: Postgraduate (payscale on Levels 1-2 depending on qualifications and experience)

Type: Full-time

Affiliation: HRB Centre for Primary Care Research (TRANSFoRm Project)

Duration: 5 years

Based in: Department of General Practice, PHS Division, RCSI Medical School, Dublin, Ireland.

Reporting To: Professor Tom Fahey , Head of Department and Principal Investigator of HRB Centre and TRANSFoRm Project and Dr Borislav D Dimitrov, Senior Research Fellow of HRB Centre and Co-Principal Investigator of TRANSFoRm Project

Background:  The HRB Centre for Primary Care Research is a multidisciplinary collaborative Programme between the Royal College of Surgeons in Ireland, Trinity College Dublin and Queen’s University Belfast (see at http://www.hrbcentreprimarycare.ie/ as well as the other enclosed document on the HRB Centre). This 5-year Programme aims to examine the quality of care across the primary/secondary care interface in vulnerable patient groups and to develop Information and Communication Technology (ICT) interventions to improve the care they receive. This Programme will also develop an International Register of Clinical Prediction Rules (CPRs) for use in Primary Care that will be disseminated worldwide as well as channelled through the Cochrane Primary Health Care field.

The Royal College of Surgeons in Ireland Division of Population Health Sciences, incorporating the Departments of General Practice, Psychology, Epidemiology and Public health, brings together a critical mass of academic and research professionals working in the area of primary care, population health, and health services research. RCSI Population Health Sciences (please click this link for info).

Population health, including primary care is one of three main research themes of Trinity College Dublin Medical School. Particular expertise has been developed in the areas of chronic disease including drug misuse involving a regional GP network and inequalities in health, and in the primary care of children through the National Longitudinal Study of Children- Growing Up in Ireland (GUI). TCD Public Health & Primary Care (please click this link for info).

The School of Pharmacy of Queen’s University Belfast is committed to high quality multidisciplinary primary care research and has been a lead partner in a recently funded initiative, the Centre for Health Improvement (CHI) which will carry out highly innovative research that will change public health and healthcare practice and policy, and will have a significant focus on chronic disease in primary care. QUB School of Pharmacy (please click this link for info).

In particular, the HRB Centre (RCSI) will lead TP-WP4 of the TRANSFoRm Project. This incorporates the development of a repository of evidence and rules in selected primary care settings as well as development and integration into an agent-based or a web service-based decision logic framework. The framework will employ the rules to help health professionals with their clinical decision making and improve patient outcome in relation to avoidance of diagnostic error, so enhancing patient safety. In addition to TP-WP4, RCSI will support the adaptive dynamic user interface being developed in TP-WP5 and TP-WP7 based on the use case requirements developed in WP2 as well as the dissemination strategy in WP9.

Objective: The objective of this 5-year post (as funded by the EU FP7 Programme through the TRANSFoRm Project) is the work on TP-WP4 and contributions to TP-WP2 and TP-WP9. While providing support to the Principal Investigator and Senior Research Fellow, helping the coordination within the TRANSFoRm Project Consortium and being the main point of reference for TP-WP4 on behalf of the HRB Centre (RCSI), the post-holder will be also flexible in working across the other two work packages and ensuring all deliverables are met on schedule.

He/she will also proactively engage with the development of requirements and specifications for, and the design and implementation of suitable software packages, modeling and programme tools (mostly web-based) as well as, semantics, interoperability criteria, databases, repositories and libraries that provide clinical decision and diagnosis support, e.g., computerized clinical decision support systems (CDSS), multi-agent distributed decision support systems (i.e., agent-based modeling), decision aids and electronic clinical prediction rules (eCPRs) among others, as part of TP-WP4 of the TRANSFoRm Project. He/she will advise and support the Principal Investigator to develop TP-WP4 and contribute to TP-WP2 and TP-WP9 through appropriate mechanisms in accordance with the TRANSFoRm Project arrangements and governance protocols.

Specifically the duties will include:

  • Development of requirements specifications and design and implementation of software programs, databases, repositories, e-CDSSs, electronic CPRs, according to TP-WP4.
  • Developing ICT, decision support and evidence inputs as well as web-based / abent-based decision logic for the TRANSFoRm Project as well as coordinating those in and across the other two TP-WPs (no.2 and no.9)
  • Academic supervision of postgraduate students, preparing presentations and writing of peer-review publications
  • Preparation of analyses and scientific reports as required
  • Preparation of scientific aspects of Meetings between partners and collaborators within the TRANSFoRm Project consortium as required
  • Supporting and liaison with the Senior Research Fellow to prepare the Progress and Annual Reports as well as the Final Reports to EU with exemplars of tools, databases,, repositories, decision systems and software programs that have been developed as part of the HRB Centre’s participation in the TRANSFoRm Project
  • Other such duties as may be assigned from time to time

Person Specification

The successful candidate will be expected to have relevant postgraduate qualifications and expertise such as ICT, computer sciences, programming, computer languages, health informatics or health-related/medical ICT research.

In particular, candidates should possess:

  • An informatics, health/medical informatics or computer sciences related Master (essential) or PhD (desirable) qualifications
  • A minimum of 2 years experience in research
  • Experience in the design and implementation of web-based systems and programming (essential), ideally in a healthcare setting and/or by agent-based modelling (desirable)

Other desirable attributes include:

  • Previous experience in working with health care users, health professionals and patients
  • Previous experience of contributing to a program of research
  • Excellent interpersonal, communication and presentation skills
  • An ability to win the confidence of stakeholders, researchers and research partner representatives
  • An ability to foster and sustain academic relationships
  • Evidence of peer review publications
  • Attention to detail and thoroughness in work practices and an ability to work to deadlines
  • A capacity to work collaboratively as part of a team and independently

Closing date for receipt of applications is: Friday, 26 February, 5pm.

Please forward a covering letter along with copy of your curriculum vitae quoting reference number: Ref. RES 1005

For Ref. RES1005, please contact Niall Doherty , Project Officer, Division of Population Health Sciences, RCSI, Beaux Lane House, Mercer St. Lower, Dublin 2. Tel: 00 353 1 4022473. Email: [email protected].

Informal enquiries about the posts may be made to Professor Tom Fahey, Email: [email protected]

Please note that interviews will be held in early March

TRANSFoRm project agreement signed by European Commission

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Translational Research and Patient Safety in Europe: TRANSFoRm

King’s College London are leading a consortium of 15 European Universities and two private partners to develop methods, standards and systems for the integration of healthcare computer systems for clinical care and research. The project has two aims:

  1. To aid General Practitioners in diagnosis by integrating decision support directly into their electronic records systems
  2. To speed up the recruitment, management and follow up of patients for research studies by enabling routine electronic health record systems to link to research databases.

Aim 1) Prompt diagnosis is a fundamental task for GPs, as they are in many countries the ‘gatekeepers’ to specialist care and see patients with initial symptoms. The difficulty is to identify patients with symptoms of serious disease such as cancer or heart disease without over-investigating the much larger numbers of patients without serious disease. The symptoms and signs of serious disease are often non-specific and can be attributed to more common and less serious conditions. Clinical prediction rules are combinations of symptoms and signs, sometimes using a mathematical weighting, that have higher predictive value than symptoms and signs in isolation. They are, however, hard to remember and are rarely used in daily practice. King’s College London will be studying how early diagnostic prompts and late ‘alerts’, based on clinical prediction rules, might aid diagnostic performance. King’s and Birmingham University will be developing a ‘generic’ interface to allow GPs using different record systems to use TRANSFoRm, seamlessly integrated into their existing system. The Royal College of Surgeons of Dublin will develop a means for piping new clinical prediction rules into the system using a ‘web service’ and computer ‘middleware’. The system will be studied in the UK, Ireland and Greece using a multi-channel recording tool (the Alpha Toolkit) developed at St Georges’ Hospital Medical School.

Aim 2) Translational Research is a term that refers both to the exploration of basic science discoveries in clinical work and the application of research in clinical settings. Clinical research is often costly and slow, as it is difficult to find suitable subjects and time consuming to follow them up and obtain outcome data. TRANSFoRm will enable both these activities to be achieved using routine healthcare data. Two ‘example problems’ will be tackled. The University of Antwerp, representing the European General Practice Research Network and Primary Care Diabetes Europe, and the University of Dundee will develop predictors of risk of complications of Type 2 Diabetes using a very large phenotype-genotype association study. The Karolinska Institute, representing the European Primary Care Gastroenterology Society, will study the long-term effectiveness of on-demand vs. continuous use of acid suppression in gastro-oesophageal reflux in a very large randomised trial. The TRANSFoRm system will be developed by Trinity College Dublin, the University of Birmingham, the University of Limerick, Imperial College London and King’s College London using an open source model.

There are considerable challenges to be overcome in the legal and ethical domains in relation to access of data, legal frameworks for research, models for interoperability between systems and the development of standards and sustainable models for deploying and using the work of the project. The Mediterranean Institute of Primary Care (Malta), the Medicines and Healthcare Regulatory Authority, General Practice Research Database (UK), NIVEL (Netherlands) and Language and Computing (Belgium) will assist in these areas. The University of Dusseldorf will manage project ethics and also dissemination activities via the European Clinical Research Infrastructures Network. Quintiles UK and Ireland will explore and demonstrate the role of TRANSFoRm in commercial clinical trials.

TRANSFoRm has been funded by the European Union Framework Programme 7 (Project No 247787), Information Society and Media Directorate, ICT Health Unit, to a total EU contribution of €6.95Million over 5 years, commencing 1. March 2010.