Sheffield Teaching Hospitals Trust projects

Can longitudinal data from patients with cutaneous lymphomas provide insights into earlier diagnostic certainty? 

This project is based on descriptive analytics and serves to summarise a retrospective sample detailing patient demographics from a cohort of patients with suspected cutaneous lymphoma.

Learn more about this project

Supervisors

• Professor Ruth Murphy (ruth.murphy8@nhs.net)
• Professor John Snowden (john.snowden1@nhs.net)
• Dr Nicholas Lawrance

Objectives

• To identify a retrospective cohort of patients referred to an SSMDT from 2015 to 2023 with a suspected diagnosis of cutaneous lymphoma.
• To provide longitudinal data about the diagnostic determinants and whether this changed with time.

Methodology

The student will identify all the patients presented and captured on the SSMDT database from 2015-2023. These are patients with a possible diagnosis of cutaneous lymphoma from South Yorkshire, Bassetlaw and North Derbyshire.

The student will extract longitudinal data from these patients to provide a narrative of clinical, histological and immunophenotypes of the disease from the initial presentation of the disease to diagnostic certainty. This will map time to diagnosis, criteria leading to a definitive diagnosis and any changes in the disease phenotypes, and treatments given as the disease evolves.

Expected outcome

This retrospective analysis provides longitudinal data to map the clinical, histological and immunological phenotypic evolution of cases referred with suspected cutaneous lymphoma to a regional specialised skin cancer MDT, which then may be tested in future work in larger super-regional/national datasets to generate hypotheses for possible markers for earlier disease diagnosis.

This is important as treatment paradigms are evolving from symptomatic relief and disease control to disease modification and regression in both inflammatory skin diseases and lymphomas.

Type of Project

Qualitative project/non-lab based - primarily using qualitative methods

Additional training

SPSS should provide the necessary training for relevant analyses. Histopathology colleagues will help to improve the basic understanding of histopathological diagnoses and disease immunophenotypes.

---

 DECONSTRCKT (Deconditioning and sarcopaenia after stroke study)

Twenty-four patients with acute stroke will be recruited from the stroke units at Sheffield. Socio-demographic and clinical details will be recorded.

Learn more about this project

Main Supervisor

• Dr Ali Ali (ali.ali@sheffield.ac.uk)
• Dr Liz Williams (e.a.williams@sheffield.ac.uk)
• Dr Simon Nichols

Objective

To characterise the time course of the development of sarcopaenia after acute stroke and its determinants (stroke severity, disability, physical activity, systemic inflammation and nutritional status).

Research Methodology

Twenty-four patients with acute stroke will be recruited from the stroke units at Sheffield. Socio-demographic and clinical details will be recorded. Baseline blood tests for inflammatory markers and muscle markers (IL-6, IL-1, TNFa, IL-10, myostatin, irisin, IGF-1) will be drawn. Participants will undergo a weekly assessment (except ultrasound which will be undertaken every 3 days) of the following characteristics until discharge from hospital:

• Strength and function: grip strength, 5 x chair stand, timed up and go (TUG), gait speed, Barthel Index.
• Systemic inflammation: modified Glasgow prognostic score [Yoshimura 2018] – serum CRP and albumin.
• Nutrition: 24-hour food recall, review of nutritional charts for tube-fed patients, Malnutrition Universal Screening Tool (MUST).
• Structural: Bioelectrical impedance analysis (BIA), thigh and humeral circumference, quadriceps thickness (muscle ultrasound).

Expected outcomes

The feasibility of undertaking the longitudinal analysis will be confirmed if > 80% of the intended measurements are completed. Longitudinal analysis of changes to muscle strength and function, structure, nutrition and systemic inflammation will be undertaken.

Outcomes will be reported descriptively with statistical analysis using repeated measures along a time course (ANOVA) and comparisons from baseline assessment (students paired T-test).

Multiple regression analysis will be undertaken to elucidate factors associated with the largest declines in muscle mass and strength.

Type of project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional training

Students will receive training on the following:

• Use of muscle ultrasound (Advanced Wellbeing Research Centre)
• Use of bioelectrical impedance analysers
• Blood letting and spinning in preparation for freezing
• Performing ELISA tests on serum
• Use of nutritional software analysis systems (myfood24)
• Various statistical analyses

---

Unmet needs of people with multiple sclerosis

People with multiple sclerosis (MS) experience a variety of biopsychosocial problems, many of which remain unmet by the current MS services. Currently, there is no tool that can reliably identify patients’ unmet needs. We developed and evaluated the psychometric properties of a 29-item questionnaire, Long-term Unmet Needs in MS (LUN-MS), to identify the unmet needs of people with multiple sclerosis (pwMS).

Launched in 2011, the UK MS Register (UKMSR) was created by the Population Data Science team at Swansea University Medical School and was funded by the MS Society. The UKMSR collects data directly from the NHS clinical record following informed consent and from pwMS via an online portal.

Learn more about this project

Supervisors

• Professor K. P. Sivaraman Nair (siva.nair@nhs.net)
• Dr Esther Hobson (e.hobson@sheffield.ac.uk)

Objectives

• To identify the unmet needs of people with MS
• To study the impact of unmet needs on the quality of life of people with MS
• To identify geographical differences in nature and frequency of unmet needs

Methodology

The student will be liaising with the UKMR. The student will get access to the UKMSR and post the questionnaire through the website. The student will collate the responses and collect data such as

• MS type
• number of relapses
• date of conversion to secondary progressive MS
• past and current disease-modifying medications
• Hospital Anxiety and Depression scale
• MS walking scale
• European Quality of Life scale
• MS Impact scale

The student will receive support for analysing the data

Expected outcome

A nationwide study using LUN-MS on platforms such as the UK MS register could facilitate the identification of unmet needs in pwMS in the UK. The student will also assess the impact of unmet needs on the quality of life of people with MS.

Type of project

Medical Humanities

Additional training

• Training in accessing and getting data from a nationwide database
• Statistical analysis on techniques like correlation and multiple logistic regression
• Modelling of data to predict future needs

---

 Improving foot outcomes in people with diabetes

Diabetic foot ulceration is the most common cause of hospitalisation in people with diabetes and also the most common reason for lower limb amputation in the UK. Although there is now strong evidence regarding interventions to reduce ulceration and amputations, the incidence remains stubbornly high.

A key part of the project will be to try and determine factors that result in people with diabetes presenting with recurrent foot ulceration or progressing to amputation. Many also die prematurely. This is still a poorly understood area and a better understanding of these factors could lead to the deployment of strategies to improve outcomes.

Learn more about this project

Supervisors

• Dr Rajiv Gandhi (rajiv.gandhi1@nhs.net)
• Dr Greig Marni (marni.greig@nhs.net)

Aim and Objectives

This study will involve prospectively following up with people who have presented with ulcers and determining what factors at baseline predict how they are likely to progress. In particular, it will examine how illness beliefs and psychological barriers contribute to poor concordance and outcomes.

This is an ongoing study and the student will have access to a large database of cases collected by previous students.

Another project will involve looking at how the redesign of foot care services post-COVID has impacted the delivery of care and key foot outcomes.

Methodology

This study will use both qualitative and quantitative data from a variety of sources including primary and secondary care medical databases, as well as patient interviews.

The study examining factors affecting outcomes of foot ulceration will incorporate factors such as screening practices in primary care, referral patterns, management of risk factors, vascular interventions etc. The impact of interventions on these processes will also be assessed. It will also involve surveying patient attitudes, illness beliefs and other psycho-social factors and the impact these have on clinical outcomes.

Expected outcomes

• Insights into research practices within the NHS including governance
• Understanding the role and value of Clinical Networks
• Understanding the value of medical databases in conducting research
• Recruiting, collecting and analysing data for a clinical study (patient contact). Previous students have commented on the tremendous confidence they have gained in how they interact with both patients and other HCPs
• Results of this study have and will continue to be used to improve national guidelines and policy and the successful BMedSci will gain substantial insight into how clinical research can be used to influence national strategies to improve patient care.
• An understanding of how to achieve service improvement and the challenges faced when the service bridges primary and secondary care
• It is expected that the work will result in at least 3-4 first-author abstracts and 1-2 publications

Type of Project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional Training

The successful BMedSci student will join a vibrant diabetes team with an active research arm and will be jointly supervised by two consultants with specialist expertise in the diabetic foot. Training will be provided on all research techniques and on how clinical research can be applied to directly improve patient care. Students will have weekly meetings with their supervisor to ensure close mentoring and support.

---

Service evaluation of the predictive performance of a Digital Decision Support tool for risk assessment and mitigation of preterm birth and stillbirth at the Jessop Wing Maternity Hospital

How well does the Tommy's Digital Decision Support Tool (TDDST) perform in providing and triaging women at booking to care to mitigate preterm birth and stillbirth?

Learn more about this project

Supervisors

• Professor Dilly Anumba (d.o.c.anumba@sheffield.ac.uk)
• Dr Brenda Narice (b.n.narice@sheffield.ac.uk)
• Dr Victoria Stern

Objectives

• To determine the uptake of the TDDST at the Jessop Wing since adoption - between 2022 and 2024.
• To determine the extent to which TDDST informed the care pathways followed by the women after the initial risk assessment at booking, thereby identifying gaps in the use of the tool and gaps in service provision.
• To assess the prevalence of the various categories of preterm birth and small for gestational age/stillbirth outcomes by the risk predicted at initial pregnancy registration and risk assessment .
• To explore trends in preterm birth and placental dysfunction interventions (such as progesterone use, cervical cerclage, ultrasound scans) during the study period as the TDDST becomes embdedded in routine care.
• Determine potential best practice approaches for the TDDST to reduce preterm birth and stillbirth.

Methodology

Retrospective review of digital hsopital records on the Tommy's app, Viewpoint database, JMIS, CRIS, and electronic patient records.

Expected outcomes

• Understanding of the frequency of utilisation of the TDDST between 2022 and 2024.
• Better appreciation of the impact of the decision support tool on the provision of antenatal care as well as decisions regarding the birth.
• Identification of the barriers and enablers of optimum utilisation of the TDDST in providing obstetric care.

Type of project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional training

• Training in service evaluation
• Hospital informatics use
• Evidence synthesis
• Data acquisition
• Data filtering and cleaning
• Software use (including SPSS and other statistical packages)
• Data analysis and write-up

---

Surgery for Blunt Thoracic Trauma - where does it lie in the hierarchy of other procedures, and why?

Does the timing of surgery matter in patients with lung thoracic trauma?

Learn more about this project

Supervisors

• Mr John Edwards (john.edwards3@nhs.net)
• Mr Ashok Kar (Ashok.Kar@nhs.net)

Objectives

• Characterise the thoracic and other surgical procedures performed in patients with blunt thoracic trauma
• Assess outcomes according to the nature of surgical procedures undertaken
• Determine whether recommendations can be made regarding the order and timing of procedures, and whether there are further research questions on this topic.

Methodology

• Analysis of large existing databases
• Characterisation of the nature of thoracic trauma according to established methods
• Interrogation of HES and HRG data to determine outcomes

Expected outcomes

• Presentation of findings at departmental, national and international meetings
• Publication of findings in peer-reviewed journals (depending on merit)

Type of project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional training

Training and support in the appropriate research methodology will be provided. Exposure to relevant clinical settings will also be possible.

---

Development of a patient decision aid for overactive bladder (OAB PDA)

To develop and implement a patient decision aid for women with overactive bladder

Learn more about this project

Supervisors

Professor Swati Jha (swati.jha1@nhs.net)

Objectives

The first aim of this project is to establish patient and clinician requirements on information required and decision support needs. Once this is established, a patient decision aid for overactive bladder will be drawn up in conjunction with patient and clinician steering groups. Quantitative analysis will be performed to assess utility and qualitative analysis will be performed to assess acceptability and usability

Methodology

A multi-disciplinary steering group comprised of Urogynaecology specialist consultants, urogynaecology specialist nurses, patients and members of the Trust management board will be assembled and individual views and preferences as to decisional needs collated. An initial draft of the patient decision aid will be collated, based on NICE guidelines and incorporating initial discussions from the steering group.

The first draft will then undergo alpha testing with both patients and clinicians to assess for comprehensibility, usability and acceptability. A second draft will then undergo beta testing and qualitative analysis with a select number of patients and clinicians in the field. Quantitative analysis of Ottawa Decision Conflict Scales will inform utility.

Expected outcomes

The outcome is a PDA that is used nationally for women considering treatment for OAB.

Type of project

Clinical project - based in the clinical environment with patients/including service evaluation.

Additional training

Introduction to qualitative methodology and statistical analysis.

---

Quantitative assessment of human MOvement, muscle STRength and muscle ACTivation in patients with Neurological Disorders (MoStrAct)

Can quantitative phenotyping of balance, movement, and force expression, provide fundamental biomarkers for neurological disorders such as motor neuron disease, Parkinson’s disease, multiple sclerosis, stroke, ataxia, gluten-related neurological disorders, hereditary spastic paraparesis and adults with cerebral palsy?

Learn more about this project

Supervisors

• Professor Krishnan Padmakumari Sivaraman Nair (k.nair@sheffield.ac.uk)
• Dr Ellen Buckley (e.e.buckley@sheffiled.ac.uk)

Objectives

This research proposal aims to identify quantitative biomarkers (eg spatiotemporal gait parameters; muscle activation; force generation in multiple conditions; power and endurance in different muscle groups) for objective assessment of clinical and neurophysiological changes in adults with cerebral palsy.

Methodology

The student will help with patient recruitment from the clinic, collecting the clinical data from records, and performing clinical evaluations. The student will be trained to perform clinical and biomechanical assessments:

• Gross motor function (5 minutes in duration)
• Modified Ashworth scale (10 minutes in duration)
• 10-meter walk test in conjunction with Borg’s Rate Of Perceived Exertion Test (60 minutes in duration)
• Fatigue severity scale (5 minutes in duration)
• EQoL-5D-5L (5 minutes in duration)
• Surveillance for cerebral palsy in Europe classification (SCE) (10 minutes in duration)
• Collect report of neuroimaging (MRI) (60 minutes in duration)
• Accompanying impairments (10 minutes in duration)
• Aetiology (causes of cerebral palsy) (10 minutes in duration)

We will train the student to do movement assessment using wearable sensors (about the size of a wristwatch) attached to arms, body and/or legs using Velcro or double-sided adhesive patches. These will measure upper and lower limb motion during the exercises. The student will collect the data while the patient is walking on a walkway for five metres.

As part of this study, we will gather data on how people walk and move in their natural, home environment. The student will give patients a wearable sensor to wear for seven days. The sensor is worn on a strap around the lower back and is comfortable to wear and should be removed while bathing or swimming. The student will help in collecting the data and doing the analysis under Dr Ellen Buckley.

Expected outcomes

The study will give objective information on gait and activity of the adults with cerebral palsy using non-invasive wearable sensors to measure motion, balance and muscle functions . The output from the digital technology devices will be correlated with the results of clinical and radiological assessments.

Type of project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional training

We will train the student

• to use digital mobility devices in a clinical setting
• to administer clinical evaluations in the protocol including quality-of-life assessments
• to do statical tests to correlate data from digital

---

Validity and acceptability of SoundSleep

Validity and acceptability of SoundSleep, a novel system for assessing sleep-disordered breathing in people living with multiple sclerosis (MS).

Learn more about this project

Supervisors

• Professor Krishnan Padmakumari Sivaraman Nair (k.nair@sheffield.ac.uk)
• Dr Ning Ma (n.ma@sheffield.ac.uk)
• Anna Weighall (anna.weighall@sheffield.ac.uk)

Objectives

• To validate the Sleep monitoring system SoundSleep, developed by Dr Ning Ma for people living with MS.
• To collect raw data for developing machine learning models.
• To Investigate the feasibility of performing a study on the impact of sleep and sleep disorders on fatigue in people living with MS.

Methodology

Consultants will identify and consent 20 people living with MS. The student will collect clinical data from hospital records. The student will administer the Epworth sleepiness scale and MS Fatigue Impact scale. They will issue participants with a SomnoTouchREST sleep sensor and a smartphone with a bespoke app, Home Sleep Study, for recording breathing sounds during sleep. After seven days, the devices will be returned.

The student will analyse the breathing sounds recorded by the smartphone app using the sleep monitoring system developed by Dr Ning Ma (SoundSleep) and compare the results with the results obtained from SomnoTouchREST.

Expected outcomes

The study will inform us whether the SoundSleep system can be used to identify the sleep disordered breathing among people living with MS. The feedback from the participants about experience with sleep monitoring will be used for designing a larger study.

The study will give us the rate of recruitment (number consented\number approached) in a definitive study on impact of sleep disorders in people with MS. We will explore trends on correlation between sleep and fatigue, quality of life and MS impact. We will use the raw data for developing machine learning models to analyse sleep disordered breathing in MS.

Type of project

Clinical project - based in the clinical environment with patients/including service evaluation.

Additional training

We will train the student

• to do a patient facing clinical study along the Good Clinical Practice ( GCP) guidelines
• to administer patient reported outcome measures- Multiple sclerosis fatigue impact scale, Multiple sclerosis Impact scale, European quality of life questionnaire and sleep questionnaires
• to obtain feedback from participants
• to use the SoundSleep and The SomnoTouch RESP sleep sensor and data extraction
• to analyse the data on sleep from sleep system and correlate with patient reported and clinical outcomes

---

Bedside-focused transthoracic echocardiography in suspected myocardial infarction in acute and urgent settings

A systematic review and meta-analysis of diagnostic accuracy.

What is the diagnostic accuracy of bedside focused echocardiography in suspected acute myocardial infarction in acute, urgent and critical care settings?

Learn more about this project

Supervisors

• Dr Nick Mani (nickmani@nhs.net)
• Dr Amir Tahvili (amir.tahvili@nhs.net)

Objectives

The overall aim is to completed a systematic review and met-analysis in diagnostic accuracy

Objectives are to devise a literature search protocol based on the research question (see PICO below), complete the search, screen and identify the appropriate paper to include, critically analyse and extract data as per protocol, complete bias analysis, synthesises the results, and if deemed appropriate undertake meta-analysis (quantitative). This will be all based on the PRISMA-DTA standard guideline with the protocol registered on PROSPERO.

• Patient: Adults presenting to urgent/Acute/Emergency/Critical Care health care settings with acute cardiovascular and/or respiratory presenting complaints
• Intervention: Bedside focused transthoracic echocardiography
• Comparison: Any reference standard (final chart review, combination of tests, coronary angiogram or cardiac enzymes)

Methodology

Systematic review and meta-analysis in diagnostic accuracy

Expected outcomes

The primary outcome will be TTE findings suggesting a diagnosis of acute myocardial infarction (as defined by the study authors).

Additional outcomes are time to definitive diagnosis, time to definitive management and patient disposition, and impact on morbidity and mortality

Type of project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional training

Introduction to systematic review and meta-analysis in diagnostic accuracy

---

Deferiprone treatment in patients with infratentorial superficial siderosis

Is deferiprone an effective and safe treatment in patients with progressive ataxia caused by infratentorial superficial siderosis (iSS)?

Learn more about the project

Supervisors

• Dr Priya Shanmugarajah (p.d.shanmugarajah@sheffield.ac.uk)
• Dr Andrew Martin (andrew.martin29@nhs.net)

Objectives

• Identify aetiology and diagnostic criteria of infratentorial superficial siderosis
• Set up Sheffield Ataxia Centre Registry of patients with infratentorial superficial siderosis
• Determine objective outcome measures for deferiprone treatment and monitoring pathway
• Recognise safety monitoring profile of deferiprone
• Compare outcome measures between those on treatment with deferiprone with those not on treatment

Methodology

• Literature review on infratentorial superficial siderosis in patients with progressive ataxia plus disorders and treatment options
• Design database for data recording and monitoring
• Measure clinical outcomes (stability and progression) by:
  • Clinical assessments - ataxia rating scale
  • MRI radiological regression and progression - radiology rating scales
• Perform quality of life survey and patient-reported outcome measures

Expected outcomes

• Enhance understanding of the natural history of infratentorial superficial siderosis
• Data from this study will be used to support NHS England Preliminary Policy Proposal (already in progress) for the deferiprone treatment pathway in infratentorial superficial siderosis

Type of project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional training

• OPD clinic experience at Sheffield Ataxia Centre, one of 3 national ataxia centres in the UK
• How to perform ataxia, radiology and QoL rating scales
• Participation in neurology teaching sessions and academic meeting CPD sessions

---

External validation of the Frailty-adjusted Prognosis tool for mortality in older Emergency Department patients (FaP-ED)

Does adjustment of vital signs with clinical frailty scores improve mortality prediction in older people using the emergency department?

Learn more about this project

Supervisors

• Dr James van Oppen (j.vanoppen@sheffield.ac.uk)
• Dr Gordon Fuller (gordon.fuller2@nhs.net)

Objectives

To externally validate the Frailty-adjusted Prognosis tool for mortality in older emergency department patients (FaP-ED)

Methodology

FaP-ED was developed in Basel, Switzerland, and combined physiological vital signs with the Clinical Frailty Scale in risk predictive models to create an improved tool for mortality prediction. The FaP-ED has not yet been externally validated.

This project will first require a dataset, so the student will first spend around two months in the Northern General Hospital's Emergency Department, both collecting data themselves and encouraging staff members to document Clinical Frailty Scale scores correctly.

Analyses will be performed in statistics software such as R, which the student will next need to spend around one month learning to programme their choice of package.

Development of adjusted risk prediction models will be led by the student and will take around three months.

The remaining time will be spent producing the dissertation and drafting a report.

Expected outcomes

External validation of the FaP-ED will generate important evidence for or against its use as a predictor of mortality. There is certainly potential for the student to present their results at a conference and/or prepare a manuscript for journal submission.

Type of project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional training

We will support data collection with induction and scheduled sessions in the emergency department.

Statistical programming in software such as R has an initial steep learning curve and then becomes easy to self-teach. Initial training, direction to resources, and regular support will be provided.

---

Effect of direct oral anticoagulants on hip fracture surgery

What is the effect of direct oral anticoagulants on hip fracture surgery?

Learn more about this project

Supervisors

Dr Matt Wiles (matthew.wiles1@nhs.net)

Dr Paul Bramley (paul.bramley2@nhs.net)

Objectives

To determine if direct oral anticoagulants (DOACs) impact on hip fracture surgery in the following areas:

• Time to surgery
• Anaesthetic technique
• Blood loss and transfusion requirements
• Incidence of complications (including mortality)

Methodology

Database/notes review of all patients who underwent hip fracture surgery at Sheffield Teaching Hospitals (2021-2024) and who were on a DOAC on admission. The following data will be collected:

• Baseline demographics (age/sex/ethnicity/renal function)
• Haemoglobin on admission, day 1 and day 2 postoperatively
• Mode of anaesthesia
• Number of units of RBCs transfused
• Time to surgery
• Intra-operative blood loss
• Duration of stay
• Incidence of complications (including death)
• Nottingham Hip Fracture Score

Expected outcomes

To determine the effect of surgical delay on mode of anaesthesia and outcomes. Sheffield has a protocol for deferral of surgery for 24 in patients on DOACs (which is not present in other centres). There is a paucity of data on the correct time for delay (especially in patients with low eGFR) and the results of this study will be of interest nationally.

Type of project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional training

Students will be trained to access all relevant databases and in data analysis (including statistical tests)

---

Communication in dementia: shared decision-making in three-party consultations

This is a qualitative study looking at communication in naturally-occurring medical interactions involving healthcare professionals, people with dementia, and their carers/partners. The study will investigate the way that shared decision making is affected by the choice of words, who speaks when, and who directs talk to whom.

Learn more about this project

Supervisors

Dr Isabel Windeatt-Harrison (i.windeatt@sheffield.ac.uk)

Dr Traci Walker (traci.walker@sheffield.ac.uk)

Prof Markus Reuber

Objectives

• Better understand how people with dementia and their companions are involved in shared decision-making (SDM) at different stages of decline.
• Observe and analyse already-recorded interactions involving patients with mild, moderate and severe dementia, their companions, and doctors to build collections of SDM sequences
• Qualitatively assess the quality of SDM practices and the contributions of the doctors and/or companions

Methodology

The project employs Conversation Analysis (CA), a qualitative, micro-analytic method for studying real-life interaction. CA is widely recognised as the leading methodology for investigating doctor-patient communication in practice.

The student will receive comprehensive training in this methodology, and will access existing transcripts and video recordings to identify and build collections of the communicative practices used in instances of SDM. An example of this would be to compare the details of the way that medications are discussed, how the benefits of cognitive stimulation therapy are presented, and how patients and companions respond to this.

Expected outcomes

As this is a qualitative study, there are no hypotheses being tested. The student will be carefully guided to explore the data by the supervisory team. Some areas identified for analysis are: how all three parties orient to deferred decisions; the use of offers, requests, and/or option-listing; the use of gaze and pronouns to pick out a respondent; how information about the patient is supplied by the companion, and how this affects and informs SDM.

Ultimately, the findings of this project will contribute to communication training interventions, but measuring their outcomes is beyond the scope of this project.

Type of project

Qualitative Project/non-lab based - primarily using qualitative methods

Additional training

The student will receive all necessary training in CA techniques. Although the data to be used has already been collected and transcribed, the student will have the opportunity to learn about transcription practices in CA. Training in the use of Nvivo software, which will be used to build collections of these instances, will also be provided.

Additionally, the student will be taught how to present and work on data collaboratively in data sessions, with the option to attend a meeting of DemCAN, an online international dementia and interaction research group .

---

Frailty assessment in lung cancer

Lung cancer is the most common cancer in Yorkshire & the Humber and is associated with the worst mortality rate. Complex multi-modality treatment options are increasingly used, involving combinations of surgery, radiotherapy, cytotoxic chemotherapy, immunotherapy and/or targeted therapy. These options improve outcomes but are associated with increased treatment-related adverse effects which can be serious.

Frailty is the loss of physiological reserve resulting in a state of vulnerability to external stresses. Frailty is commoner in older patients, but chronological age and performance status are poor estimates of physiological age and functional reserve. Frailty assessment scales have been developed, which incorporate measures from multiple domains, including functional status, cognitive status and emotional well-being, to more accurately evaluate patient frailty. Frailty assessments have been shown to predict treatment-related toxicity from cytotoxic chemotherapy but to date, there is little evidence to demonstrate their use with the newer systemic anticancer treatments or with multi-modality treatment regimens.

This project will correlate pre-treatment well-being and frailty assessment scores with short-term outcomes including treatment-related toxicity in newly diagnosed lung cancer patients, to evaluate their utility in routine clinical practice.

Depending upon the interests of the research student, the project could be tailored to focus more on oncology patients or surgical patients, with the scope to create two parallel projects for two students each covering one of the patient settings, if there was sufficient interest.

Learn more about this project

Supervisors

• Dr Robin Young (robin.young@nhs.net)
• Mr John Edwards (john.edwards3@nhs.net)

Objectives

To measure well-being and frailty in a cohort of newly diagnosed lung cancer patients planned for multi-modality treatment and to correlate these assessments with short-term outcomes including treatment-related toxicities.

Methodology

This is a prospective observational study in patients with newly diagnosed lung cancer.

Potential research participants will be identified by the supervisor from the weekly Lung Cancer MDT. The research student will attend clinics to undertake the frailty assessments in consenting patients and will collect data from clinical records on subsequent short-term treatment-related outcomes for correlation.

The student will receive appropriate training for undertaking the planned frailty assessments and will be supported in clinic by the supervisors to assess the participating patients.

Expected outcomes

The student would gain experience in clinical research methods as well as in oncology/surgical clinics. It is expected that 75-100 patients will be recruited to the study during the active phase of the research project (November to April).

It is expected that the student would subsequently write up and submit the data as an abstract for presentation at the British Thoracic Oncology Group annual meeting the following year (March 2027).

Type of project

Clinical project - based in the clinical environment with patients/including service evaluation

Additional training

The student will receive appropriate training for undertaking the planned frailty assessments and will be supported in clinic by the supervisors to assess the participating patients.