Author: Adam Martin

ISSUE

22

https://medicinehealth.leeds.ac.uk/health-economics

Newsletter of the
Academic Unit of Health Economics
University of Leeds

AUHE News

January 2022

In this issue
Message from Chris Bojke (p.1)
We’re Recruiting! (p.1)
#LeedsHESG Winter 2022 (p.2)
MEED Research Forum 2021 (p.2)
AUHE Talks & Conferences (p.2)
AUHE Webinar series (p.2)
Welcome to: Paola Cocco (p.3)
Welcome to: Richard Mattock (p.3)
Welcome to: Zahid Hasan (p.3)
PhD success for Daliya (p.3)
Growing portfolio on Global Health (p.4)
Funding success (p.4)
COVID projects (p.4)
AUHE teaching (p.4)
Christmas get together (p.5)
Welcome lunch (p.5)
Recent publications (p.5)
About
the Unit
AUHE was established in 2007 to create a health economics research and education centre with a portfolio of applied and methodological research.
The research includes:
economic evaluations alongside clinical trials
value of information studies
valuation of health, health care and wellbeing
priority setting in health care
health care policy
early stage efficiency in research and development
applied health econometrics

Welcome… from Chris Bojke
Welcome to the AUHE winter newsletter. Although the pandemic is still very much with us I think that there are clear signs that we all want life to return to some sort of normality. Nowhere was that more obvious than in our hosting in Leeds of the first face to face HESG meeting since the crisis began. We were completely overwhelmed by the response from health economists in academia, the public sector and industry in their desire to participate in person - something that not even the emergence of Omicron could scupper! As always, the standard of papers was high and discussions were insightful and constructive. Of course, there was a stream of research presented on Covid, and it was great to see the work that Health Economists are contributing in that area - research proving to be useful in policy decisions here and now, in an evolving situation with considerable uncertainty.
I have also noticed an uptake in interest in our discipline on many fronts. The number of economics undergraduates at Leeds taking optional health economics modules has sky-rocketed, and we will also be adding additional content to the medical undergraduate curriculum this year. As Leeds is one of the biggest medical schools in Europe it gives us a unique opportunity to promote the value and insight our discipline can offer to the next generation of clinicians. In addition, we are increasingly being recognised as a vital component at the heart of research projects, especially in those areas in which we are increasingly specialising, such as diagnostics, mental health and digital pathology. It definitely feels like the unit and the discipline as a whole are in good health at the moment and our biggest concerns may be finding sufficient numbers of talented and enthusiastic health economists to meet increasing demand!
Chris Bojke
Professor, Head of AUHE

We’re Recruiting!

We are currently advertising three health economics posts for research assistants/fellows to work on a range of test, digital, preference and economic evaluation projects. Come and join our team!
Closing date 30th January.
For more information please visit our website or see the adverts on jobs.ac.uk at the link below:
https://www.jobs.ac.uk/job/CMG304/research-assistants-fellows-in-health-economics-x-3

#LeedsHESG Winter 2022

From the 5th to the 7th of January, AUHE welcomed fellow health economists to the 99th HESG meeting held at the DoubleTree by Hilton Hotel in Leeds City Centre. This was the first meeting to be held in-person since Newcastle hosted in January 2020. Covid made planning and organisation extremely complex(!) and Christmas involved checking Government guidance and Covid testing policies on a regular basis in order to determine whether we would still be able to go ahead.
Thankfully all the hard work paid off as well over 100 delegates attended (complete with face masks and LFTs for daily testing) with more than 15 early career researchers attending the pre-HESG workshop run by Bethany Shinkins on diagnostics. Having received over 140 abstracts for presentation, 48 were selected as full papers with a further 20 as poster presentations with strong representation from early career researchers and PhD students. Despite a few Covid-related dropouts and the loss of 7 papers from the full programme a successful meeting was held with lots of positive feedback, lots of smiles on faces and a wonderful guest lecture delivered by Professor Gillian Leng, Chief Executive of NICE, followed by a lovely meal.
Special thanks to National Organisers Paula Lorgelly and Bruce Hollingsworth, HESG webmaster Chris Sampson, the Health Foundation, and of course the supporting crew from AUHE which included Bryony Dawkins, Chris Bojke, Daliya Kaskirbayeva, Daniel Howdon, Denise Womersley, Edward Webb, Gurdeep Sagoo, Katie Spencer, Natalie King, Samuel Frempong and Silviya Nikolova. With the Winter nights starting to lighten, we very much look forward to Summer and the 100th HESG meeting in Sheffield.

MEED Research Forum 2021

The 3rd annual Methods for the Economic Evaluation of Diagnostics (MEED) Research Forum took place on Friday, September 24th over Zoom. This year's forum focused on the topic of COVID-19, with a series of empirical talks followed by a panellist discussion session on "The role of health economics in a global pandemic - lessons learnt from COVID-19". The event was a huge success, attracting over 120 attendees from across the world including Europe, Asia, Africa, Australia and North America. The organisation committee (including Dr Alison Smith, AUHE) have written a meeting round-up of the event, which is available on The Academic Health Economists' Blog and includes links to video recordings of the empirical talks from the forum which can be watched free of charge:
https://aheblog.com/2021/12/06/meeting-round-up-meed-forum-2021/

AUHE Talks &
Conferences
David Meads delivered a webinar with the newly-formed Scottish Health Technology Group, NHS Healthcare Improvement Scotland, entitled ‘Health Technology Assessment for new medical technologies – the benefits of early preparation’. The workshop was planned by the Medical Device Manufacturing Centre (MDMC) at Heriot-Watt University and 59 external delegates from academic, clinical and industry backgrounds heard talks and discussion about HTA requirements for MedTech. The webinar was recorded and is available here: https://youtu.be/KASVs78ZyeQ.
Edward Webb and Paul Kind presented the work “Tracking the evolution of EQ-5D values due to demographic change over a 50-year period” at the EuHEA Seminar Series Autumn 2021 on November 17th.
Daliya Kaskirbayeva presented the results of a systematic review titled “Progression of frailty as measured by a cumulative deficit index: a systematic review” at the special interest group in frailty on November 29th.
Armando Vargas-Palacios and David Meads took part in a roundtable discussion at the North-South MedTech Summit on November 26th. The round table (‘How the NIHR can support you’) discussions were based on their role and experience leading the health economic workstream of the NIHR Surgical MedTech co-operative. The event was widely attended by representatives from industry, academia and the NHS aiming to foster collaborations and remove barriers to innovation.
Daniel Howdon had his paper titled “Nonmarginal budgetary impacts and economic evaluation: is mortgaging a solution?” discussed at the HESG Winter 2022, which took place between January 5th and 7th.
Edward Webb, Paul Kind, David Meads and Adam Martin presented their work titled “COVID-19 and EQ-5D-5L health state valuation” at the HESG Winter Workshop 2022, which took place between January 5th and 7th.
Edward Webb and Paul Kind presented the poster “Tracking the evolution of EQ-5D values due to demographic change over a 50-year period” at the HESG Winter Workshop 2022 (January 5th - 7th).

AUHE Webinars Series
26th January 2022
Oliver Kaonga
University of York
The effects of road development on cost of travel and health care utilisation in Malawi
9th March 2022
Anna-Maria Giacomello
Environmental Agency
AUHE Webinars are open to all.

Welcome to: Paola Cocco

Paola started working as a Research Fellow at AUHE in January 2022. She is now working on projects related to test evaluation, specifically projects from the NIHR Leeds In Vitro Diagnostics Co-operative: MAMMO-50, Domino-FU and ARIEL.
Paola had previously joined AUHE in 2018 as a Postgraduate Researcher in Health Economics. Her PhD project focuses on integrating early economic evaluation (EEE) into the development process of Target Product Profiles for diagnostic tests. This project is supervised by Bethany Shinkins, Alison Smith, Kerrie Davies and Robert West. Paola applied the EEE methodology to back-calculate necessary performance requirements new rapid tests for Clostridium difficile infection should possess based on cost-effectiveness considerations. Paola has published two articles from her PhD to date, and she is currently working on two manuscripts. She is part of the Medical Research Foundation National PhD Training Programme in Antimicrobial Resistance Research (wider cohort).
Before her PhD, Paola completed the European Master Health Economics and Management (Eu-HEM) during which she studied at Erasmus University Rotterdam and University of Oslo.

Welcome to: Richard Mattock

Richard joined AUHE in October 2021 as a Research Fellow. His research focus is on the economic evaluation of mental health interventions. He will be working on the FReSH START and SAFE-PIT randomised controlled trials, which evaluate the cost-effectiveness of psychological therapies to prevent self-harm.
Richard previously worked as a research consultant and has experience in developing decision analytic models in a variety of disease areas including liver cirrhosis, influenza, atrial fibrillation, and tobacco cessation.
He holds a BSc in Neuroscience from the University of Leeds, an MSc in Health Economics from the University of York, and a PhD in Health Sciences from the University of York.

Welcome to: Zahid Hasan

Zahid joined the Leeds Institute of Health Science in October 2021. He is being supervised by Tim Ensor, Silviya Nikolova, and Zahidul Quayyum.
His research is linked to the CHORUS project and will explore various urban primary healthcare (PHC) models in low- and middle-income countries in terms of functionality, aspects, and approaches of health service delivery, leading to the development of a model of streamlined urban PHC in Bangladesh.
He holds a Bachelor and a Master of Social Science degree in Health Economics from the Institute of Health Economics, University of Dhaka, Bangladesh. He previously worked as a Research Investigator at the International Center for Diarrhoeal Disease Research, Bangladesh.

PhD Success: Daliya Kaskirbayeva

Congratulations to Daliya who recently successfully defended her PhD thesis titled ‘Impact of provider payment reforms on hospital productivity in Kazakhstan’.
The aim of the project was to provide a comprehensive understanding of intended and unintended consequences of hospital payment systems, review and address any limitations of their evaluation methods by conducting two quasi-experimental studies. These studies aimed to evaluate immediate and delayed impacts of the provider payment policy changes: diagnostic related groups (DRG) and global budgets (GB). The studies suggest that the two hospital payment systems that were consequently introduced in Kazakhstan had a limited effect on hospital productivity. The amount of healthcare services is likely to increase as a result of the change of payment system from fee-for-services to DRG. On the other hand, a switch from DRG to GB is likely to bring some reverse effects where the amount as well as complexity of healthcare provision are decreased.

Growing Portfolio on Global Health

Global Health Research Group in Surgical Technologies (GHRG-ST)
GHRG-ST aims to address unmet surgical needs in low and middle income countries (LMICs), and has developed projects to address unmet surgical needs in North East India and Sierra Leone. Health economics within GHRG-ST is led by Bethany Shinkins and supported by Bryony Dawkins.
Research undertaken by the GHRG-ST has recently featured in an NIHR impact case studies which highlight 1) the use of gasless laparoscopic surgery as a cost-effective and sustainable way to increase access to minimally invasive abdominal surgery in rural North East India; and 2) research in Sierra Leone to improve treatment of broken legs (tibial fractures), along with a project to improve training for surgeons through the use of virtual reality. Watch the videos at the links below:
https://www.nihr.ac.uk/documents/case-studies/frugal-innovations-in-surgical-technology-in-rural-india/28938
https://www.nihr.ac.uk/documents/case-studies/nihr-research-projects-improving-health-in-sierra-leone/29542
Community-led Responsive and Effective Urban Health Systems (CHORUS)
As rapid and uncontrolled urbanisation continues across low- and middle-income countries, health systems are struggling to keep up, and the needs of poor urban communities are often not met. This is especially true for those experiencing exclusion due to intersections with gender, caste, ethnicity, religion and disability. CHORUS is a 6-year research programme consortium focused on urban health systems with funding from Department for International Development (DFID) of £7.9 million. The consortium aims to undertake research that responds to the practical challenges of delivering equitable health in urban areas in 4 partner countries: Bangladesh, Ghana, Nepal and Nigeria. Bryony Dawkins is a co-applicant and Health economics mentor for partners and projects within the consortium.
For further details see:
https://chorusurbanhealth.org/

Funding Success!

Dr Alison Smith has successfully secured funding as a joint-Principal Investigator under the NIHR Research for Patient Benefit (RfPB) programme. Together with Dr Patrick Hamilton (NIHR Clinical Lecturer at the University of Manchester), Alison will lead the project which aims to assess the clinical utility and cost-effectiveness of the anti-PLA2R test for diagnosing patients with membranous nephropathy - a debilitating disease of the kidneys - in clinical practice. The project includes a systematic review of the literature and development of a de novo decision-analytic model, and is due to commence in February 2022 for 15 months. This project was supported by the NIHR Leeds MIC Patient and Public Involvement (PPI) Group, led by Stephanie Roberts (NIHR Leeds MIC Centre Manager).
Dr Daliya Kaskirbayeva has also been successful in securing funding for a White Rose Collaboration project titled “Infectious illness presenteeism in the age of COVID-19” in collaboration with colleagues at the Universities of Leeds, Sheffield and York. This study aims to investigate infectious illness presenteeism (IIP) behaviour in the current climate (particularly focusing on Yorkshire businesses), and develop understanding of why employees engage in IIP in order to inform the design of a potential intervention. More information on the project can be found here:
https://whiterose.ac.uk/collaborationfunds/infectious-illness-presenteeism-in-the-age-of-covid-19/

COVID Projects

Edward Webb, Paul Kind, David Meads and Adam Martin have been investigating whether and how the COVID-19 pandemic has affected how people think about health, and specifically how people value EQ-5D health states. The work uses survey data collected in the first half of 2020.
They have already published an article in Health Economics (vol. 30, issue 10) showing that people's values shifted between 2018 and 2020. Now thanks to a grant from the EuroQol Research Foundation they are seeking to provide evidence that COVID-19 was the cause of people's values changing, and examining if different experiences of the pandemic affected people's values in different ways. The results could have broad implications for healthcare resource allocation in a post-COVID world, as well as furthering research on the life-cycles of national EQ-5D value sets.

Undergraduate Health Economics
Despite seeing our 2nd and 3rd year undergraduate modules (Introduction to Health Economics and Introduction to Economic Evaluation of Health, respectively) taught in back-to-back semesters across two academic years, the first semester of the 2021/22 academic year has still seen approximately 150 students sit the two modules. Teaching has been delivered both online (lectures) and in person (seminars), led by Adam Martin and Dan Howdon and supported by Armando Vargas-Palacios, Bryony Dawkins, Edward Webb, and John O'Dwyer.
Good luck to all students now sitting their exams!
Global and local literature search skills training
Information Specialists Natalie King and Judy Wright have embraced online teaching, running their highly successful ‘Leeds Mixed Methods Systematic Review’ courses for the second time in 2021 during September. Across the two courses, 38 attendees from Europe, S. Asia, Africa and S. America watched pre-recorded videos and zoomed in for live interactive sessions.
Their favourite feedback quote was “I loved the interactive parts. It was very comforting to meet others struggling with the same type of questions, and great to see how together we know a lot more.’”
Natalie and Judy also welcomed a return of face-to-face on campus teaching for DClin students and LIHS Masters modules.
For more information on literature search courses please visit the website where future courses will also be advertised:
http://bit.ly/2QbD1DV.

AUHE Teaching

Christmas Get Together

For the first time in a couple of years members of AUHE were able to get together face-to-face ahead of the Christmas break. It was lovely to catch up over a festive meal— even some of the cracker jokes weren’t bad!

Welcome Lunch

Throughout the pandemic we have welcomed a number of new staff and PhD students to the team virtually so it was great to hold a welcome lunch in November in person and get to meet Richard Mattock and Zahid Hasan who had just started with us as well as Ali Alattas who started earlier in the year. Welcome to the team all of you!

Recent Selected Publications

Aggarwal, V.R., Wu, J., Fox, F., Howdon, D., Guthrie, E. and Mighell, A. 2021. Implementation of biopsychosocial supported self-management for chronic primary oro-facial pain including temporomandibular disorders: A theory, person and evidence-based approach. J Oral Rehabil. 48(10), pp.1118-1128.
Aruparayil, N., Bolton, W., Mishra, A., Bains, L., Gnanaraj, J., King, R., Ensor, T., King, N., Jayne, D. and Shinkins, B. 2021. Clinical effectiveness of gasless laparoscopic surgery for abdominal conditions: systematic review and meta-analysis. Surg Endosc. 35(12), pp.6427-6437.
Balogun-Katung, A., Carswell, C., Brown, J.V.E., Coventry, P., Ajjan, R., Alderson, S., Bellass, S., Boehnke, J.R., Holt, R., Jacobs, R., Kellar, I., Kitchen, C., Lister, J., Peckham, E., Shiers, D., Siddiqi, N., Wright, J., Young, B., Taylor, J. and Diamonds Research Team. 2021. Exploring the facilitators, barriers, and strategies for self-management in adults living with severe mental illness, with and without long-term conditions: A qualitative evidence synthesis. PLoS One. 16(10), pe0258937.
Bennett, M.I., Allsop, M.J., Allen, P., Allmark, C., Bewick, B.M., Black, K., Blenkinsopp, A., Brown, J., Closs, S.J., Edwards, Z., Flemming, K., Fletcher, M., Foy, R., Godfrey, M., Hackett, J., Hall, G., Hartley, S., Howdon, D., Hughes, N., Hulme, C., Jones, R., Meads, D., Mulvey, M.R., O’Dwyer, J., Pavitt, S.H., Rainey, P., Robinson, D., Taylor, S., Wray, A., Wright-Hughes, A. and Ziegler, L. 2021. Pain self-management interventions for community-based patients with advanced cancer: a research programme including the IMPACCT RCT. Programme Grants for Applied Research. 9(15), https://doi.org/10.3310/pgfar09150.
Boele, F., Weimer, J., Proudfoot, J., Marsland, A., Armstrong, T., Given, C., Drappatz, J., Donovan, H. and Sherwood, P. 2021. The effects of SmartCare© on neuro-oncology family caregivers’ distress: a randomized controlled trial. Supportive Care in Cancer. Online ahead of print.
Dawkins, B., Renwick, C., Ensor, T., Shinkins, B., Jayne, D. and Meads, D. 2021. What factors affect patients’ ability to access healthcare? An overview of systematic reviews. Tropical Medicine and International Health. 26(10), pp.1177-1188.
Forster, A., Airlie, J., Ellwood, A., Godfrey, M., Green, J., Cundill, B., Dawkins, B., McMaster, N., Hulme, C., Cicero, R., McLellan, V., Graham, L., Gallagher, B., Ellard, D.R., Firth, J., Farrin, A. and Reach Programme Team. 2021. An intervention to increase physical activity in care home residents: results of a cluster-randomised, controlled feasibility trial (the REACH trial). Age Ageing. 50(6), pp.2063-2078.
Frances, S.M., Velikova, G., Klein, M., Short, S.C., Murray, L., Wright, J.M. and Boele, F. 2021. Long-term impact of adult WHO grade II or III gliomas on health-related quality of life: a systematic review. Neuro-Oncology Practice. pp. npab062, https://doi.org/010.1093/nop/npab1062.
Frempong, S.N., King, N. and Sagoo, G.S. 2021. The cost-effectiveness of using rapid diagnostic tests for the diagnosis of typhoid fever in patients with suspected typhoid fever: a systematic review. Expert Rev Pharmacoecon Outcomes Res. Nov 27. doi: 10.1080/14737167.2022.2012453. Epub ahead of print
Frempong, S. N., Shinkins, B., Howdon, D., Messenger, M., Neal, R. D. and Sagoo, G.S. 2021. Early economic evaluation of an intervention to improve uptake of the NHS England Diabetes Prevention Programme. Expert Review of Pharmacoeconomics & Outcomes Research. pp. 1-11, https://doi.org/10.1080/14737167.2021.1895755.
Hall, L.H., King, N.V., Graham, C.D., Green, S.M.C., Barber, A., Neal, R.D., Foy, R., Clark, J., Lloyd, K.E. and Smith, S.G. 2021. Strategies to self-manage side-effects of adjuvant endocrine therapy among breast cancer survivors: an umbrella review of empirical evidence and clinical guidelines. J Cancer Surviv. pp.Oct 18. doi: 10.1007/s11764-11021-01114-11767. Online ahead of print.
Hollinghurst, J., Daniels, H., Fry, R., Akbari, A., Rodgers, S., Watkins, A., Hillcoat-Nalletamby, S., Williams, N., Nikolova, S., Meads, D. and Clegg, A. 2021. Do home adaptation interventions help to reduce emergency fall admissions? A national longitudinal data-linkage study of 657,536 older adults living in Wales (UK) between 2010 and 2017. Age Ageing. afab201, https://doi.org/210.1093/ageing/afab1201.
Jameson, A., Fylan, B., Bristow, G.C., Sagoo, G.S., Dalton, C., Cardno, A., Sohal, J. and McLean, S.L. 2021. What Are the Barriers and Enablers to the Implementation of Pharmacogenetic Testing in Mental Health Care Settings? Front Genet. 12(740216), p740216.
Jones, D., Di Martino, E., Bradley, S.H., Essang, B., Hemphill, S., Wright, J.M., Renzi, C., Surr, C., Clegg, A., De Wit, N. and Neal, R. 2022. Factors affecting the decision to investigate older adults with potential cancer symptoms: a systematic review. British Journal of General Practice. 72(714):e1-0, http://dx.doi.org/10.3399/BJGP.2021.0257.
Kaur, M.N., Skolasky, R.L., Powell, P.A., Xie, F., Huang, I.C., Kuspinar, A., O'Dwyer, J.L., Cizik, A.M. and Rowen, D. 2021. Transforming challenges into opportunities: conducting health preference research during the COVID-19 pandemic and beyond. Qual Life Res. Oct 18:1–8. doi: 10.1007/s11136-021-03012-y. Epub ahead of print.
Lloyd, K.E., Hall, L.H., King, N., Thorneloe, R.J., Rodriguez-Lopez, R., Ziegler, L., Taylor, D.G., MacKenzie, M., Smith, S.G. and AsCaP Group. 2021. Aspirin use for cancer prevention: A systematic review of public, patient and healthcare provider attitudes and adherence behaviours. Prev Med. 154(106872), p106872.
Ping Loh, T., Smith, A., Bell, K., Lord, S., Criotti, F., Jones, G., Bossuyt, P., Sandberg, S. and Andrea, H. 2021. Setting analytical performance specifications using HbA1c as a model measurand. Clinica Chimica Acta. 523, pp.407-414.
Shinkins, B., Harris, M., Lewington, A., Abraham, S. and Snaith, B. 2021. Kidney function testing prior to contrast-enhanced CT: a comparative cost analysis of a personalised risk-stratified pathway versus a test all approach. Clin Radiol. 76(3), pp.202-212.
Ward, T., Mujica-Mota, R.E., Spencer, A.E. and Medina-Lara, A. 2021. Incorporating Equity Concerns in Cost-Effectiveness Analyses: A Systematic Literature Review. Pharmacoeconomics. pp. Oct 29. doi: 10.1007/s40273-40021-01094-40277. Online ahead of print.
Webb, E., Kind, P., Meads, D. and Martin, A. 2021. Does a health crisis change how we value health? Health Economics. 30(10), pp.2547-2560.
Webb, E.J.D. and Hess, S. 2021. Joint modelling of choice and rating data: Theory and examples. Journal of Choice Modelling. 40(100304), pp.100304-100304.
Yaziji, N., Sharma, N., Selfridge, J. and Sagoo, G.S. 2021. Cost analysis of managing B3 breast lesions by vacuum excision at Leeds Breast Unit using a decision model. BMJ Open. 11(12), e054525.