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Dr Kirsten McEwan

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Page 1: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Dr Kirsten McEwan

Page 2: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

RDCSService is based on the successful network of RDS in England which focus in providing consultancy and advice to healthcare professionals who are working up applications to peer‐reviewed funding competitionsCovering Health Boards in SE Wales Cardiff and Vale University Health Board (HB), Cwm Taf HB, Aneurin Bevan HB, Powys Teaching HB and Public Health Wales.

“Supporting health professionals to develop high quality research”

Page 3: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

The service aims to:support the development of a vibrant research culture within partner organisationssupport the development of a research methods strategy for partnersprovide links to experienced researchers for partner organisationswork in partnership with health boards through initiatives like on‐site consultancy and helpdesks

Page 4: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Who we can helpThe RDCS is a free service funded by the NISCHR to 

assist NHS staff based in South East Wales who are 

preparing research proposals for submission to 

national, peer‐reviewed funding competitions for 

applied health or social care research

Page 5: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Who we can’t help Projects for which there is no intention to submit a grant applicationActually doing the research. If required this would need to be costed appropriately into the project grant, and would also depend upon available research capacity and interests of host institutionsFormal supervision or informal support for studentsAny aspect of activities that are not research, e.g. audit, service evaluationConducting unfunded analysis on data already collected

Page 6: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

How we can helpWe offer advice in a number of ways: We offer helpdesks and run workshops   We can arrange face‐to‐face meetings with you and your teamWe can comment on proposals and grant applications over email or phoneAfter submitting your request for support, you can  contact us as many times as you require whilst developing your research proposal. To date we have advised on 105 projects.

Page 7: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

The RDCS can advise on ...Advise on all aspects of grant application development:focusing ideas and refining the research question(s)building an appropriate research team or signposting you to other sources of expertiseinvolving patients and carers in all stages of the research processchoice and application of research methodologies for both qualitative and quantitative approachesidentifying the resources required for a successful project including identifying suitable funding opportunities

Page 8: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Need more ‘hands‐on’ help?Where more “hands‐on” involvement, for example drafting appropriate sections of the application and/or co‐ordinating the overall process of its development is deemed appropriate SEWTU may undertake to adopt a study and in this way share in any future funding or publications.If conducting a clinical trial (e.g. RCT of intervention or drug treatment) a funder will expect you to have support from a trials unit

Page 9: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Feedback from a successful application

“Our research centres on adolescent depression, especially those adolescents at high risk of depression because of parental recurrent depression. We were planning to develop an intervention study to help these adolescents and considered doing some sort of qualitative study to inform the intervention, but we had very little qualitative experience and weren’t sure if this would be possible. 

I first met with RDCS in January 2012. This was very helpful not only as a primer in qualitative research but for encouragement to develop this further.  I was also provided with additional literature and ongoing support. 

This encouraged me to develop a research proposal for this phase of the study and apply for funding.  This funding application was successful. We have now completed 5 focus group interviews (3 with parents, one with adolescents, 1 with health professionals)

Results from these have been very illuminating and provided valuable insights into the   design of the intervention study.  I have had further meetings on qualitative analysis with RDCS and we now also have a medical student doing an intercalated degree on   exploring depression in adolescents using a qualitative approach. I have found RDCS to be an extremely helpful and easily accessible resource for help with particular research needs and for developing proposals”.

Page 10: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

RDCS team

Mirella Longo Health Economist

Dr Claire O’ NeillQualitative research

Vicky RobertsResearch administrator

Dr Kirsten McEwanPROMS/Statistics

Dr Mark KellyStatistics

Page 11: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

How to use the service?Get in touch as early in the design process as possibleInitial contacts will preferably be made via the HB R&D officesYou will be asked to complete the “request for support form”You will receive written feedback and a follow up meeting(s) as appropriate

Email: [email protected]: 029 2068 7518

www.cardiff.ac.uk/rdcs

Page 12: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Upcoming RDCS eventsHELPDESKS :

26 June 2013 Royal Glamorgan Hospital, Llantrisant

24 July 2013 Welshpool Hospital, Powys

WORKSHOPS:17 September 2013 

Workshop, GlamorganBuilding, Cardiff

Page 13: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Writing a quality proposal

Page 14: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Questions to bear in mindHow did your research question arise? Was it from practice?Why do you think it’s important for scarce research resources to be spent on your research?Why should it be funded now?What will the benefits of your research be for patients, practioners and the NHS as a whole?What is the extent of the problem and how might your research reduce NHS burden and costs?Who would you need in your research team to tackle the research?Have you had any patient or public involvement so far?Have you done any pilot research so far?

Page 15: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Importance of the research question

Diverse membership of commissioning panels often mean different ideas of 'importance’Need to explain in background section WHY the study question is important (e.g. High prevalence of disease, chronicity of disease, burden on quality of life and burden on NHS/economic burden)Refer to priority documents from NHS/DH, Cochrane reviews, NICE guidelines, etcYour topic could be one which is currently an NHS priority and has received lots of media attention, if so make reference to this & emphasise the timeliness of the research

Page 16: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Background work

Have you done your homework?  i.e. demonstrated that you are fully up to speed on what is/isn’t known on the topic?Have you demonstrated a need for this study i.e. a gap in knowledge?Have you done any feasibility/pilot work? Are you aware of  on‐going research (to avoid duplication)?To get a large grant you must demonstrate that you have previously done relevant work 

Page 17: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Literature review

Conduct a thorough literature review to check the originality of your idea. Provide background on the research area, what has already been done and how your research is unique?Use previous literature to support your choice of research question and methodological approach.For clinical trials, search registered clinical trials databases as part of the literature review to ensure your work is unique and not currently underway elsewhere. 

Page 18: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Level of detail in the proposalInclude clear objectives and research question(s)Get advice on the most appropriate research designTake time with the “Summary for the non‐expert” and avoid jargon throughout Theoretical issues (conceptual framework, design details, evidence of expected effect, power calculation, statistical analysis, etc.) Practical (recruitment of patients and centres, willingness to co‐operate, burden, ethics, randomisation method, data collection, etc.)Project Management (day to day, steering committee, management group, data monitoring committee).  Suggest using a flow diagram 

Page 19: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Details of study designProviding insufficient detail is a common fault in proposals Add as much detail as possible on design and methodology, using sub‐headings and spacing as appropriate to include justification for:Study designResearch settingTarget populationInclusion and exclusion criteriaMeasurements, sample size, and power calculationsFollow‐upEconomic evaluationDurationPractical arrangements e.g. participant recruitment or accessing with existing data‐sets.

Page 20: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Details of clinical trial design

Proposals to conduct randomised controlled trials (RCTs) should have adequate recruitment and randomisation strategies, appropriate allocation to trial arms, arrangements for blinding and show evidence of being informed by statistical advice and power calculations.Input from clinical trials units is considered very important for randomised controlled trials.Registering your trial with a clinical trials unit can be essential for getting your research published

Page 21: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

The study teamThink very hard about what disciplines you may be accused of having omittedStatistician, health economist, health professionals, librarian,operational researcher, qualitative researcher, administrator support, trial manager etc.Layperson/patient representative involvement   Links to networks/etcDemonstrate you have the expertise/experience in your team to conduct the research. If you don’t have all the expertise, bring it in from collaborations.Provide evidence of communication with relevant collaborators e.g. other Trusts, charitable organisations, research sites, managers, co‐applicants, patient/public representatives. Consider attaching letters of support.

Page 22: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Patient/public Involvement (PPI)

PPI is very important e.g. first section to be completed on someproposal forms.Approach patients and public as early as possible in the research design stage to ask them what they think about the study aims, the design, materials, and whether they would be likely to take part (or would there be any reasons for not taking part that canbe resolved?)Provide specific detail of how patients, public and/or practitioners have had input into your research proposal.E.g. Involving people  [email protected]

Page 23: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

How PPI can help researchersCould be advisory:developing and improving research proposals to have a good design, recruitment & measurement approachpatient insight into methods or processes of research and designimproved lay summariesincreased insight regarding patient understanding e.g. for information sheets, participant questionnaires and interviewsassistance with dissemination of findings to patient groups and healthcare professionalsCould be actively involved as a researcher or steering team/trial management team member:Collect data from marginalised/hard to reach groupsOffer ongoing advice as project progresses

Page 24: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Participant recruitment strategy

Review panels are looking to see if your recruitment strategy is feasible.Provide detail of how you will identify and recruit participants, including realistic timescales. Provide evidence that you have looked into the feasibility of your recruitment strategy (e.g. that you have approached the appropriate organisations or individuals and are aware of  numbers of individuals accessing a service, or that you approached patient/public representatives for their views on the recruitment strategy and assessed whether people will want to participate). The panel will want reassurance that you have minimised the risks associated with recruitment of participants; you know there are enough people out there to recruit from; and they are likely to want to participate.The main reason for requests of extended time and money is overoptimistic researcher assessment of recruitment time.

Page 25: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Data acquisition strategy

If you are accessing existing data‐sets as part of your research (e.g. routinely collected patient data held on a secure database)....Provide detail of how you will access this data Provide evidence that you have sought approval from the database custodian and that you have checked the completeness of the database. Reviewer panels want to see that you have minimised the risks associated with extracting data from existing databases.E.g. Welsh Clinical Portal www.wales.nhs.uk/nwis

Page 26: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Analysis plan

Provide sufficient detail of statistical and/or qualitative analyses. Provide a detailed sample size calculation which compensates for participant drop‐out. When calculating you sample size consider what effects sizes and sample sizes have been used in previous similar studies? What would a clinically significant outcome be and how to stand the best chance of detecting this with your study design? What effect size is clinically significant? i.e. what is the minimum value worth detecting?Clearly outline how the analysis will be carried out, who will carry out the analysis when will the analysis be conducted.Consult a statistician or qualitative researcher early on about your analysis plan and sample size calculation.

Page 27: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Practical issuesProposal must be clear to a layperson, review panels have laypersons and they have considerable influence on the outcome. The layperson summary is very important.Provide realistic timescales for ethics and R&D approval, and for participant recruitment.Contact your local R&D office early for advice and to ask about current turn‐around time on ethics proposals and by discussing with clinicians the numbers of patients they are seeing or amount of data already routinely collected.Make sure ethical considerations have been considered in full. Lack of R&D support prevents a project form starting and could even be considered a design flaw.Presentation is very important so proof read your proposal carefully before submitting.Aim for a submission deadline which is a few days earlier than the actual deadline. Some online proposal forms have faults, proposal processes can become more complicated than expected, these can be resolved with a phone call to the  helpdesk. Don't miss a deadline because of technical faults on the day.

Page 28: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Dissemination plansConference presentations and publication in peer reviewed journals are essential....But more creative dissemination plans will earn more brownie pointsBe specific with your dissemination plan e.g. Mention journal titles you may try to submit to, conferences you may attend, network/charity meetings you may present at, clinical team meetings/patient meetings

Page 29: Dr Kirsten McEwan - Cardiff and Vale University Health Board...yAny aspect of activities that are not research, e.g. audit, service evaluation ... conduct the research. ... yApproach

Value for moneyCosting must be realisticIt is essential not to undercostE.g. can you seriously expect a part time RA to collect all these data?But don’t try to get away with murdere.g. asking for a laptop computer (unless you have a case) If possible give indication of potential cost‐benefits or burden reduction on NHS resources. Seek advice from R&D office and perhaps a health economist early on. 

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Finally...Do seek support from the RDCS early on as we can help advise and support you in developing a proposal which we hope will stand a better chance of being a successful grant application

Email: [email protected]: 029 2068 7518

www.cardiff.ac.uk/rdcs