9 February 2012 NIHR-funded Surgical Research: NIHR RfPB Award Holder Matt Costa

Research for Patient Benefit Its main purpose is to realise, through evidence, the huge potential for improving, expanding and strengthening the way that healthcare is delivered for patients, the public and the NHS.... Very broad remit: –Mental Health –Hospital Medicine –Primary Care But, all of the research is about direct benefit to the patient...

Warwick Arthroplasty Trial A Randomised Controlled Trial of Total Hip Arthroplasty Versus Resurfacing Arthroplasty in the Treatment of Young Patients with Arthritis of the Hip Joint Design A single-centre, two-arm, parallel group, assessor-blind randomised controlled trial with 1:1 treatment allocation Participants 126 adult patients with severe arthritis of the hip joint suitable for a resurfacing arthroplasty of the hip Interventions Total hip arthroplasty – replacement of femoral head and neck. Hip resurfacing arthroplasty – replacement of the articular surface of femoral head only i.e. the neck remains intact. Main outcome measures Hip function at 12 months post-operation, assessed using the Oxford hip score (OHS) and the Harris hip score (HHS).

Why was this application successful? A research question that was obviously relevant to patient care A multidisciplinary team – methodology as well as clinical expertise Heavy patient involvement Simple, pragmatic study design Realistic (and limited) goals, within the timescale and budget of RfPB

Warwick Arthroplasty Trial Results –The hip function of patients following Resurfacing Arthroplasty was not shown to be better than Total Hip Arthroplasty12 months after operation. –Overall complications rates did not differ between the two groups –Resurfacing may be cost effective in some patients but this depends upon the long-term survival of the implants Conclusions Resurfacing Arthroplasty was not shown to be better than Total Hip Arthroplasty in the 12 months after surgery. Trial registration. Current controlled Trials ISRCTN UKCRN 4093.

What have we learnt? Dont be too clever – simple research questions and straightforward study designs Clinical engagement is key – all of your surgeons and allied health professionals must be on board No substitute for dedicated research staff – surgeons are rubbish at recruiting! Take your expected rate of recruitment, halve it and then halve it again...

What we would do differently next time Patients as co-investigators – really important Research Design Service input What can you afford? Qualitative/Mixed Methods, Health Economics etc – may add to the application but within the budget? Talk to someone who has successfully delivered an RfPB project.....

NIHR springboard.... Track record is important NIHR remarkably supportive and willing to give feedback – take their advice! HTA funding: –Distal Radius Acute Fracture Fixation Trial (DRAFFT) –Wound Management of Open Fractures of the Lower Limb (WOLLF) Programme Grants for Applied Research: –Improving the outcome for patients with fracture of the proximal femur

9 February 2012 Thank you