RESEARCH PROFILE

Summary: my research interests relate to how, whether and why health evidence can be used at the policy, organisational, population and individual levels, including attention to:

• the relationship between research evidence and health policy
• optimal population levels of interventions to maximise evidence based care and appropriateness in health care
• getting research evidence into individual clinical decisions including the use of information, guidelines, shared decision making, decision analytic methods and the role of "choice"

BACKGROUND

Current and Recently completed research:

1. An evaluation of measures to introduce enhanced access into COPD services in Newham: The main findings of this work were that locally in Newham, (a deprived borough of East London) early discharge whilst thought of as beneficial by staff was not viewed as at all beneficial by many recipients. Routine data backed this finding, although overall numbers were small, those undergoing early discharge had a significant increase in risk of readmission.

2. The REFER Project: Realistic Effective Facilitation of Elective Referral: an assessment of the current use of referral tools for referral from primary to secondary care for elective surgical assessment and design of new tools. Phase 1 has been completed and writing up of research findings is currently being undertaken. Findings here for the three parts of Phase 1 indicate that:

• GPs and PCTs are having problems in containing referrals and new Clinical Assessment Services or Referral Management Centres (RMCs) have been set up to try and deal with this.
• A national survey of GPs showed that they find using referral guidelines troublesome. Many admit to using them in a background educational way rather than directly in their day to day practice and many are critical of their value
• A systematic review of guidelines for elective surgical referral showed very little evidence in favour of guidelines per se in this context - many have been evaluated as part of a more complex intervention intervention so that findings are not generalisable. There are very few RCTs in this area.

In Phase 2 of the project we are using an innovative approach to guideline development in incorporating patient choice (desire for referral) relative to symptom severity and perceived need.

3. Patient based assessment of quality of care in General Practice: a comparison of patient assessment of quality of technical care with objective clinical measures of quality. This was a PhD Supervision and the PhD has been completed. In this project we established that there is no correlation for elderly people between their own assessment of the technical quality of GP care and the actual quality of GP care. The is paper was published in the BMJ and was nominated independently for the Royal College of General Practitioners "Research paper of the year award."

4. An assessment of the information needs of the users of health care ? will the Internet help? This was a PhD Supervision and the PhD completed. In this project conducted jointly with Dr John Powell also from the HSRI, we found that patients with mental health problems find important benefits from the use of the Internet and that Internet use for patients with mental health problems is relatively high compared to use by other sectors of the population.

5. SPHERE Strengthening Public Health Research in Europe: An assessment of the scope and scale of Public Health research in the European Economic Area. In this work undertaken jointly with Prof Margaret Thorogood in the HSRI, we have undertaken the first series of bibliometric overviews of Public Health research, investigating, in collaboration with colleagues from several EU countries (including Hungary, Poland, Italy, France Netherlands, and Portugal), research outputs by all European countries compared tot eh rest of the world. The main findings from this work are that the EU is a major producer of Public Health publications worldwide ? second only to the US; that PH research production (as with much other research production) is strongly linked to GDP and that there appears to be an "inverse research law" in Europe - countries with most need of research in terms of poor health are least likely to be publishing such research.

6. WAVES: In this project funded by NHS Health Scotland, we are validating a scale of mental wellbeing (WEMWBS) developed at Warwick and Edinburgh for use in adolescents. Work is underway with piloting in Birmingham before the full validation in 1,200 students in Coventry and Edinburgh secondary schools. fac/med/research/hsri/research/mental/pubmen/waves

7. WARWICK EVIDENCE We have recently been awarded a grant to undertake technology appraisals for NICE - funded by the Department of Health NETSCC HTA programme. I am in the process of setting up the team to be known as Warwick Evidence and we are currently undertaking some preliminary systematic reviews e.g of nutritional factors (Vitamin D and Vitamin K) and and cardio-metabolic disease. Warwick Evidence is having its first meeting in March 2010 and will be fully operational from the summer of 2011.

EDUCATION PROFILE

Courses Taught

• Health and Disease in Populations [details]
• Isues in Public Health [details]

CURRENT RESEARCH PROJECTS

• Cross Cultural Validation of WEMWEBS Among English Speaking Memebers of Minority Ethnic Popoulations in the UK - continuing development 09/10 , with Prof Sarah L Stewart-Brown, Health Sciences Research Institute, Dr Aileen Clarke - Health Sciences Research Institute - Prof Scott R Weich - Health Sciences Research Institute, National Institute for Mental Health in England, Project Start Date: 01/06/2009 Project End Date: 31/05/2010
• Evidence in Management Decisions (EMD) - Advancing Knowledge Utilization in Healthcare Management, with Prof Jacqueline A Swan, Warwick Business School, Dr Aileen Clarke - Health Sciences Research Institute Dr Davide Nicolini - Warwick Business School Prof Harry Scarbrough - Warwick Business School Dr John Powell - Health Sciences Research Institute, NCCSDO R&D, Project Start Date: 01/01/2009 Project End Date: 31/12/2010
• West Midlands Research Design Service Unit (RDSU), with Professor Nigel Stallard, Health Sciences Research Institute, Dr Nicholas R Parsons - Clinical Sciences Research Institute Dr Aileen Clarke - Health Sciences Research Institute Dr Tim Friede - Health Sciences Research Institute Dr Frances E Griffiths - Health Sciences Research Institute Mrs Gulnaz Iqbal - Health Sciences Research Institute Prof Sarah L Stewart-Brown - Health Sciences Research Institute, National Institute for Health Research (DoH), Project Start Date: 01/10/2008 Project End Date: 30/09/2013
• TAR team tender, with Prof Wiji W Arulampalam - Economics, National Institute for Health Research (DoH), Project Start Date: 01/04/2011 Project End Date: 31/03/2016
• TAR team tender, with - - - - Dr Chris Bridle CPsychol - Health Sciences Research Institute Mrs Samantha A Johnson - Library Dr Paul A Sutcliffe - Health Sciences Research Institute - - - Dr John A Powell - Health Sciences Research Institute Dr Simon Gates - Health Sciences Research Institute, National Institute for Health Research (DoH), Project Start Date: 01/04/2011 Project End Date: 31/03/2016
• TAR team tender, with Professor Ruth M Davies - Warwick Business School, National Institute for Health Research (DoH), Project Start Date: 01/04/2011 Project End Date: 31/03/2016
  
  

  Further Research Projects

SELECTED PUBLICATIONS

• A Clarke, R Sohanpal, G Wilson, S Taylor (2010) 'Patients' perceptions of early supported discharge for chronic obstructive pulmonary disease: a qualitative study' Quality And Safety In Healthcare Qualityand Safety in Healthcare doi:10.1136/qshc.2007.025668 (1475-3898) [article]
• Johanna Parker, Omar Hashmi, David Dutton, Angelique Mavrodaris, Saverio Stranges, Ngianga-Bakwin Kandala, Aileen Clarke, Oscar H. Franco (2010) 'Levels of vitamin D and cardiometabolic disorders: Systematic review and meta-analysis' Maturitas published online (Maturitas xxx (2009) xxx?xxx), (0378-5122) [article]
• Clarke A. Le Maistre N. Forde I. Musila N. Spitzer D Naqvi S. Browne J. (2009) 'What is the effect of guidelines for referral for elective surgical procedures on appropriateness, health outcomes and costs? A systematic review.' Quality And Safety In Healthcare Quality and Safety in Health Care (accepted for publication) (1475-3898)
• Le Maistre N. Clarke A. Mays N. (2009) 'Interpretations of referral appropriateness by senior health managers in five PCT areas in England: a qualitative investigation' Quality And Safety In Healthcare Quality and Safety in Health Care (in press) (1475-3898)
• Clarke A, Nnoaham K, (2008) 'Low serum vitamin D levels and tuberculosis: a systematic review and meta-analysis' International Journal Of Epidemiology 37 (1), 113 - 119 (0300-5771)

Further Publications

Conference Papers