January 2019 Research & Development Taighde & Forbairt Research Activity in the HSE and its Funded Organisations AM Terrés, MC O’Hara, P Fleming, N Cole, D O’Hanlon, P Manning A report of staff engaged in research, research studies undertaken, publication output and research networks
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January 2019
Research & DevelopmentTaighde & Forbairt
Research Activity in the HSE and its Funded Organisations
AM Terrés, MC O’Hara, P Fleming, N Cole, D O’Hanlon, P Manning
A report of staff engaged in research, research studies undertaken, publication output and research networks
Executive Summary 4
1. Introduction and Context 12
2. Methodology 14 2.1. Research Activity Indicators and Associated Datasets 15 2.2. Time periods 16 2.3. ClassificationMethodology 17
ThisreportpresentstheresultsofsuchastudyasthefirstattempttobenchmarktheresearchactivitywithinthepublichealthandsocialcareservicesinIreland.Avarietyofdifferentaccessibledatasetswereusedasanindicationofresearchactivityandoutput.Theresultsaredescribedaroundfourmaincategories:staffinvolvedinresearch,researchstudiesundertaken,publicationoutputsandClinicalResearchNetworks.Theseindicatorsshowthatthevolumeofon-goingresearchissignificantandthatbroad experience and capability across a variety of domains currently exists.
2) Assessment of numbersanddistributionofconsultantswithacademicappointments,hence formally linked to the university sector and whose contract generally includes time for research:
• Fromatotalof2,700medicalconsultantsintheHSEandfundedhospitals,189hadaformaljointuniversityacademicappointmentin2018.Thisrepresents7%ofthetotalnumberofconsultantpostsemployed by model 4 and speciality hospitals.
• Ofthetotal13,466articlespublishedbetween2013and2017withintheIrishpublichealthsystem,4,964(37%)werepublishedbyconsultantswithaformalacademicappointment.Thisindicatesthatthepublicationoutputofthiscohortisveryprolificastheyrepresentonly7%ofthetotalnumberofexistingconsultants.Italsoindicatesthat63%ofthepublicationoutputisproducedbystaffwithouta formal university appointment.
Research Activity in the HSE and its Funded Organisations
In summary this study showsAsignificantpercentageofstaffintheHSEanditsfundedorganisationsareresearchactive,andtheoutputscannotbeunderestimated.Despitethefactthatresearchisbyandlargenotformallyembeddedwithintheprocessofservicedelivery,itisverymuchapartoftheon-goingactivityinthehealthandsocialcareservice,anditcannotbeignored.Thedatainthisstudyshowsthehugepotentialforimpactthatcouldbeleveragedbyaligningtheresearchactivitytoserviceneeds,inordertoobtainthemaximumbenefitforourhealthserviceandthehealthandwellbeingofourpatientsandthegeneralpopulation.
11
Exe
cutive
Sum
mary
1,904 Valid Survey responses
1,829 REC
approvals
51 Grant Awards
45 HRB
6 EU 2,975 Publications
34 HPRA Regulated studies
27 new clinical trials
7 new medical
device trials
Research Activity in the HSE and its Funded Organisations
Research Activity 2017
1. Introduction and Context
Healthresearchcontributestotheadvancementofscientificknowledgeandtheevidencebase.Theutilisationofthisevidenceisessentialtoimprovethehealthandwellbeingofpatients,toimprovehealthservicedeliveryandtheequityofhealthcareprovision.Evidencehasshownthatresearch-activeorganisationsdeliverbetterpatientoutcomes,includingreducedmortalityrates6andagrowingbodyofevidenceindicatesthathealthcareorganisationswithastrongresearchculturedeliverbettercare.Suchacultureisassociatedwithbetterorganisationalperformance,reducedstaffturnover,improvedpatientsatisfactionandimprovedorganisationalefficiency,andthesebenefitsgobeyondthoseexperienceddirectly by research participants.7Furthermore,theeconomicbenefitsofhealthresearchcannotbeunderestimated;abriefingdocumentpublishedin2014bytheWellcomeTrust8 in the UK indicates that eachpoundinvestedincancer-relatedresearchbythetaxpayerandcharitiesreturnsaround40pencetothe UK every year thereafter.
Forthepurposeofthisreport,researchisdefinedinaccordancewiththeUKResearchGovernancePolicyFrameworkas“theattempttoderivegeneralisableortransferablenewknowledgetoanswerorrefinerelevantquestionswithscientificallysoundmethods”. It refers to research that takes place intheHSEanditsfundedorganisations,andthatinvolvestheirpatients,data,stafforinfrastructure.Thisincludes:
Projectsthatarenotstrictlyresearchaccordingtothedefinition(e.g.standardserviceevaluations)areoftenreviewedandapprovedbyresearchethicscommitteesandpublished.Itwasthereforenotpossibletoexcludetheserelatedactivitiesfromsomeofthedatasetsandconsequentlysomeofthisactivityisincluded in the analysis presented in this report.
7 HardingK,LynchL,PorterJ,TaylorNF.Organisationalbenefitsofastrongresearchcultureinahealthservice:asystematicreview.Australian Health Review2016,41(1)45-53.https://doi.org/10.1071/AH15180.
Thelackofcomprehensivedatasetsanddifficultiesaccessingexistingdatasetsweresignificantimpedimentsforthisstudy.However,whiletheinformationavailablewaslimitedandimperfect,ithasenabledustopaintthefirstpictureofthiskindandhashighlightedthegapsininformationmanagementthatneedtobeaddressedtorepeatthisexerciseinthefutureinamoresubstantialway.Theproblemsencountered and alternative approaches used are outlined in Table 1.
•Thehealthserviceisdeliveryfocused;researchactivityisnotmeasured,thereforeit is not systematically recorded: there are no national or local research information systems or protocols to record research activity.
•MostResearchEthicsCommitteesinthe health service provided information onresearchstudiesreviewed.
•TheHealthResearchBoardwasapproached for information on funded research studies that involved health servicestaffinaPrincipalor Co-principalInvestigatorcapacity.
•InformationonEUfundedstudiesinwhichtheHSEwasaparticipantwasobtained from the EU participant portal.
Research Activity in the HSE and its Funded Organisations
KeyActivityIndicator
Impediments Approach
Publication Output
•Somehealthprofessionalslinkedtouniversities publish their research outputs usingonlytheiruniversityaffiliation.
•Muchoftheresearchactivitydoesnotgetformallypublishedinpeer-reviewedpublications but rather in the form of reports published at local level. While some of these outputs are published in the LenusOpenAccessrepositoryoftheHSENationalHealthLibraryandKnowledgeService,itwasnotpossibletodetermineiftheseweretheresultofresearchactivityornot,andthereforecouldnotbeincludedinthis study.
•PublicationsindexedinScopuswereanalysedusingtheSciValanalysistool.These included all indexed publications (journalarticles,books,bookchapters,etc.).
• Thedataavailablefromthedifferentdatasourceswasoriginallyavailablefordifferenttimeperiods.Inorder to simplify the information for this report and to use a consistent approach across the datasets toenablecomparisons,onlydatafor2017hasbeenincludedinthisstudy.
16
2. M
eth
odolo
gy
Research Activity in the HSE and its Funded Organisations
c) Publicationoutput:2013-2017
• Publicationoutputwasanalysedforafiveyearperiod,from2013to2017.Thereisgenerallyatime-lapsebetweentheresearchbeingperformedandtheoutputbeingpublished;thereforeitisnotpossible to relate this dataset to any of the above.
Inordertoanalysethedatasetsassociatedwithresearchstudiesandpublicationoutputs,thedata wascategorisedusingtheUKHealthResearchClassificationSystem(HRCS)9 developed in 2005. Twodimensionsoftheframeworkwereusedforthisstudy:
Atotalof1,920respondentscompletedthesurvey,but16indicatedthattheyworkedintheprivatehealthcaresector,sotheirresponseswereremovedfromthedataset.Theresultsbelowrepresentananalysis of the information provided by the 1,904respondents. It should be noted that the results must beinterpretedinthecontextofresponsestothesurvey,ratherthanasabsolutenumbers.
3.1.1. SurveyAnalysisbyPlaceofWork
The responses indicated that staffwereengagedinresearchinallareasoftheservice,includingtheacuteandcommunitysectors,aswellasnationalservicesandHSEcorporate,andmanywerealsolinkedtoacademia(Figure1).Respondentswereabletoselectmorethanoneplaceofwork,withsomeselectinguptosix.Intotal,11%indicatedmorethanoneplaceofwork.
Figure 6: Number (including percentage) of staff in research by profession and health service area (or location)
Health& Social Care
(655)
Nursing&Midwifery (431)
MedicalDoctor (343)
HealthcareProfessionalCategories
Researcher (184)
Management (106)
Administration (168)
300
250
200
150
100
50
0
No.ofR
espo
nden
ts
AcuteHospital National ServiceCommunity Academia Other
33%
51%
11%
13%26%
57%
43%
7%
23%
38%13%
30%
8%
18%
42%
33%10%19%
6%
13%
57%
13%3%
9%
3% 7% 8%1%
1%
3%
3.1.3. SurveyAnalysisofEducationalQualifications
Surveyrespondentswereaskedabouttheirhighestacademicqualification.Clinicalstaffcategories(medicaldoctor,HSCP,nursing/midwifery)hadhigherqualificationsthannon-clinicalstaff(Figure7).Thehighestmostcommonlyoccurringqualificationlevel,acrossthethreemainclinicalprofessionalgroupswasamaster’sdegree(Figure8),withthepercentageslistedrepresentingtheproportionofeachqualificationwithineachprofessionalgroup:48%ofallnursingandmidwiferyrespondentshadamaster’sdegree, and medicaldoctorsandHSCPsrespondentshadthehighestproportionofPhDs(23%and22%respectively).
22
3. A
ctivity Indica
tor 1
Research Activity in the HSE and its Funded Organisations
23
3. A
ctivity Indica
tor 1
Figure 7: Number (including percentage which represents the proportion within the Clinical and Non-Clinical grouping) of respondents by highest qualification level
Masters Degree PhD Higher Diploma
MD Diploma Other Advanced /Higher
Cert
Leaving Cert
600
500
400
300
200
100
0
No.ofR
espo
nden
ts
29.1%
13.2%
11.7%
7.2%
3% 1.5%
1.3%
0.7%
0.3%
8.7%
4.3%
10%
1.7% 0%
2.4% 0.8%
1.6%
2.4%
HealthcareQualificationLevel
Clinical Non-Clinical
Figure 8: Percentage (including number) of clinical staff by highest qualification level
ResponseRates(%)
Highe
stQua
lifica
tionLe
velb
yHea
lthca
re
Professiona
lCateg
ory
4
17
0
56
51
50
20
1
8
1
1
0
99
20
190
73
24
64
Nursing&Midwifery
(396)
Medical Doctor (280)
6
0
14712
66
18281
134
Health& Social Care
(611)
Other
Degree Diploma
MD
LeavingCert
PhD
Advanced/HigherCert
Masters HigherDiploma
0% 5% 10% 15% 25% 40%35%20% 30% 45% 50%
Research Activity in the HSE and its Funded Organisations
24
3. A
ctivity Indica
tor 1
3.1.4. SurveyAnalysisofResearcherCompetencies
Respondentswereaskedtopickthedescriptionthatbestdescribedtheirresearchcompetenciesortheirinvolvement in research as indicated in Table 2.
•Ipublishandpresentinfluentialpapersandbooks,serveonconferenceorganisingcommittees and deliver invited talks
Thecategoriesofindependentresearcher,researchleaderandinternationalresearchleaderdescribestaffcapableofcarryingonresearchactivitywithoutsupervision(i.e.independentresearchactivity)and these three representedatotalof15%oftherespondents(Figure9).
Figure 9: Number (including percentage) of respondents by research competencies
Research Enabler
Research Assistant
EarlyStageResearcher
Experienced Research Team
Member
Research Leader
Independent Researcher
International Research Leader
400
350
300
250
200
150
100
50
0
No.ofR
espo
nden
ts
14%
12%
18%17%
6%
4%5%
TypeofResearchers
Research Activity in the HSE and its Funded Organisations
26
3. A
ctivity Indica
tor 1
RespondentsfromtheHSCPgrouparerepresentedacrossallcategories(Figure10),butarepredominantlyintheearlystageandexperiencedresearchteammembercategories,whilea total of11%ofHSCPrespondentsdescribethemselvesasbeingengagedinindependentresearchactivity (independentresearcher,researchleaderandinternationalresearchleader).Medicaldoctorswerealsorepresentedacrossallcategories,butwithmorerespondentsclassifyingthemselvesashavingthecompetenciesofaninternationalresearchleadercomparedwithHSCPsornurses.Intotal,42%ofmedicaldoctorrespondentsdescribedthemselvesasbeingengagedinindependentresearch. The response of nursesandmidwiferyprofessionalsindicatedthattheyweremorepredominantlyinvolved in enablingandassistingresearchactivity,andasearlystageresearchers.HSCPrespondentsweremorecommonlyintheearlystageresearcherandexperiencedresearchteammembercategories.
Figure 10: Number (including percentage which represents a proportion within the HSCP, Medical and Nursing groups) of respondents by type of researcher and profession (clinical types)
Respondentswereaskediftheyheldapositionwithacademicinstitutions:60%indicatedthattheywerenotassociatedwithathirdlevelacademicinstitution,while40%indicatedanassociationwiththethirdlevelsector,eithercontractuallyboundornot. The types of activities carried out in the HigherEducationInstitutions(HEIs)aredescribedinFigure11.
Figure 11: Percentage (including numbers) of respondents by their academic activities in HEIs
0% 5% 10% 15% 25% 35% 40% 45% 50%20%
Percentage
Acad
emicActivity
of
Respo
nden
tsin
Universities
30%
Tutor
Advisory
Board/Committee
Adjunct
Research
Teaching
16
53
83
164
359
376
Figure 12: Hours spent on research during the working week by the number of respondents (percentages represent proportion within the clinical or non-clinical grouping)
Figure 13: Hours spent on research outside of working hours by the number of respondents (percentages represent proportion within the clinical or non-clinical grouping)
Figure 14: Hours spent on research inside and outside of working hours (percentages represent the proportion of respondents with and without an academic post)
Zero 1 to 10 11to20+
900
800
700
600
500
400
300
200
100
0
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
No.ofR
espo
nden
tsRespo
nseRate(%
)
HoursSpentConductingResearchOutsideWork(perweek)
Hours(perweek)
Clinical Non-Clinical
Hourswithinworkingday Hoursoutsideworkingday
Academic Post No Academic Post
19%32%
Zero
92
369
1 to 10
464559
11to20+
194
70
Zero
63
292
1 to 10
555
498
11to20+
7948
71%
10% 5%
63%
Research Activity in the HSE and its Funded Organisations
29
3. A
ctivity Indica
tor 1
3.2. Medical Consultants with a Formal Academic Appointment
Healthprofessionalsinvolvedinresearchoftenhavecloselinkswiththeuniversitysector.Someofthoselinkagesinvolveaformalcontractualacademicappointmentgenerallyforthepurposeofeducationand/orresearch(Section3.1.5).Ingeneral,staffmemberswithformalacademicappointmentshaveprotectedacademictime,fullaccesstosupportandresourcesofferedbythethirdlevelinstitution,andfurtheropportunities to establish academic collaborations.
Theacademicaffiliation/sandkeydisciplineofmedicalconsultantswithacademicappointments(CFAA)asper2018wereanalysedinordertodeterminehowthesestaffaredistributedacrossclinicalsitesandhowthisvariesbyspeciality.Manymedicalconsultantswithaformalacademicappointmenthadappointmentswithmorethanonehospital.Forthepurposeofthereport,theanalysiswasbasedonthe principal clinical site and does not include vacant posts.
Atotalof32committeesservingthehealthservicenationallywereidentified.TheseincludehospitalandHSEregionalRECsinadditiontoRECsinsection38/39organisations.All32RECswerecontactedtorequestinformationrelatedtotheprojecttitlesofresearchstudiesapprovedbythecommitteesduring2017.Thevastmajorityofcommitteesrespondedwithinformation(n=30,94%),althoughthreereportedinformationfrom2016(orearlier)ratherthan2017(Table5).BeaumontHospitalandDaughtersofCharityRECsdidnotsubmittitleinformation(Table5andTable6),thereforetheEastRegiondatasetisslightlyincomplete. The time period of the datasets used for the analysis is indicated in Table 5.
National #IrishCollegeofGeneralPractitionersREC 2017 57TOTALnumberofRECreviews(Note:someproposalsarereviewedbymorethanoneREC,hencethetotalnumberofprojectsis,therefore,lessthanthetotalnumberofreviews)
1,829
^Submittedtotalnumberofstudiesbutnofurtherdata,hencetheseprojectsarenotincludedinfurtheranalysis.* No data supplied. #NationalRECforapprovalofIMPclinicaltrials.16 SomeRECssubmitteddataindifferentyearperiodduetoadministrativecapacityconstraints.17 RegionalResearchEthicsCommittees:ReviewsHospitalandCHObasedresearch.18 UniversitybasedRECwhichreviewsHospitalsandCHObasedresearch.19 HospitalbasedRECswhichalsoreviewCHObasedresearch.20 HospitalbasedRECwhichreviewsHospitalbasedresearchonly(somereviewcommunityresearchoccasionally.21 CommunityServices(Section39)OrganisationREC.
Research Activity in the HSE and its Funded Organisations
GenericHealthRelevance accounted for almostaquarterofallstudiesapproved(Figure18).Thisreferstoresearchapplicabletoalldiseasesandconditionsortothegeneralhealthandwellbeingofindividuals,publichealthresearch,epidemiologyandhealthservicesresearchthatisnotfocusedonspecificconditionsorunderpinningbiological,psychosocial,economicormethodologicalelementsspecifictoindividualdiseases.
Cancer,MentalHealth,ReproductiveHealthandChildbirth,CardiovascularandNeurologicalwerethenextmostprevalentresearchactivitycategories(Figure18).AnalysisbyregionshowsasimilaremphasisonGenericHealthRelevancealthoughtheSouthEastshowedhigherratesofMental Health research,closelyfollowedbyMidlandsandNorthEastregions(Figure19,andAppendix2).
Figure 17: Number of proposals approved per region in 2017 or nearest year as indicated in Table 5
Researchactivityanalysisbyregionindicatesthatnationaldistributionisalignedwithregionaldistributionin the South/South-West,West/North-WestandEast,withtreatmentevaluation,healthservicesresearchandaetiologyaccountingforthelargestproportionofresearchactivity(Figure21).In the remainingregions(Figure22),healthservicesresearchaccountsforthemajorityofapprovedstudies,i.e.Mid-Western(50%),South-East(37%),Midlands(31%)andNorth-East(38%).
42
Figure 20: Percentage and number of studies classified by research activity in the overall sample
0% 5% 10% 15% 25% 40%35%20% 30%
Percentage
UKHRCSResea
rchAc
tivity
Cod
es Other
Detection and Diagnosis
Aetiology
HealthServices
Treatment Evaluation
179
163
356
438
636
Figure 21: Percentage and number of studies classified by type of research activity for the regions with more annual project throughput
HSERegion
300
250
200
150
100
50
0
No.ofS
tudies
42%
East
22%17%
9% 4% 2% 1%3% 1%
35%
S/SW
22%25%
8%5%
1%
2%1% 1%
37%
W/NW
18%26%
8%2%4% 1%2% 1%
Treatment Evaluation
Treatment Development Underpinning
Aetiology
Prevention
HealthServices
NA
DetectionandDiagnosis DiseaseManagement
Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
43
Figure 22: Percentage and number of studies classified by type of research activity for the regions with less annual project throughput
Figure 23: Percentage and number of studies by health categories from the ICGP and PCRC at national level
*NotethatthePCRCisnotaREC,butagovernancebodythatapprovesresearchprojectsforPrimaryCareintheCHOswhichhavepriorRECapproval.HencethestudiesinthePCRCsample(n=18)arealsoincludedintheanalysis of section 4.1.1.
Research Activity in the HSE and its Funded Organisations
InformationrelatedtoEUfundedstudiesinvolvingtheHSEwasobtainedfromtheEUparticipantportal.In2017thereweresixEUfundedstudiesinwhichtheHSEwasaprojectpartner.TheseincludedthreeHorizon2020awardsandthreefromtheThirdHealthProgramme.TheHSEparticipatedasapartner rather than as the coordinator in all studies.
EUfundedstudiesusuallyinvolveparticipantsfromseveralEUcountries,withthenumberofpartnersperstudyinthisdatasetrangingfrom13to109.Thetotalawardvalueofthesestudies(forallpartners)in2017was€102,317,219.Ofthis,€695,245wasawardedtotheHSEin2017.The total value of EU researchfundingreceivedbytheHSEinthelast10years(from2009to2019)is€2,019,069.56.
HealthProductsRegulatoryAuthority(HPRA)regulatedclinicalresearchfallsintotwocategories:clinicaltrialsofinvestigationalmedicinalproducts(CT-IMP)andclinicalinvestigationsofmedicaldevices.22 In Ireland,theHPRAisdesignatedastheCompetentAuthorityfortheirregulationandensurescompliancewiththeEUlegislation[EuropeanCommunities(ClinicalTrialsonMedicinalProductsforHumanUse)Regulations,2004,transposedintoIrishlawthroughSINo190of2004].23
TheothermaintypeofregulatedstudyisaClinicalInvestigationofaMedicalDevice. These are alsoregulatedbyEUlawwhichwasenactedinApril2017.25TheseareregulatedbytheHPRAandtheNationalStandardsAuthorityofIreland(NSAI)Regulations,andalsorequireethicalapproval.Themedicaldevicesregulationoverlapsinmanyareaswiththeclinicaltrialsregulations,butunlikethose,thereisnoprovisionforasinglenationalethicsopinionformulti-siteregulatedClinicalInvestigations.
Studiesareregisteredbythestudysponsor,andthedatabaseisusedbytheHPRAfordatarelatedtoclinicaltrialprotocols.TheHPRAaddstheauthorisationonlywhenafavourableethicscommitteeopinionis provided by the sponsor. Whilethesponsorsare,inmanycases,pharmaceuticalcompanies,organisationssuchasCancerTrialsIreland(CTI),HRBClinicalResearchCoordinatorIreland(HRB-CRCI)haveakeyroleincoordinatingandsupportingthesetrials.Inaddition,someuniversitiescanalsotaketheroleofsponsor.
One important measure of research activity is publication output. Research outputs can bedisseminatedinmanydifferentways,butforthepurposeofthisreport,wefocusedtheanalysisonresearcharticlespublishedinjournalsindexedinScopus.Thistypeofpublicationoutputwaschosenbecause:
5.1. Analysis of Publication Number per year from 2013-2017
ThetotalnumberofpublicationsfromHSEorganisationsandsection38hospitalsnationally indexed in Scopus inthefiveyearperiodfrom2013to2017was13,466(thisincludestotalHSEHospitals,n=4,050;totalVoluntaryHospitals,n=8,934;andtotalCommunityandNon-Hospital,n=482,whereatleastoneoftheauthorshasknownHSEaffiliation).Thefiguresincludethepublicationoutputofmedicalconsultantswithanacademicappointment.Therehasbeenaslightsteadyincreasesince2013inthetotalnumberofpublicationsfromthehealthservice(Figure35),althoughcommunity andnon-hospitalresearchonlyaccountforbetween3to4%ofthetotaloutputeachyear. This may indicatethatmuchresearchisnotpublishedorispublishedinother(non-peerreviewed)outlets.
57
5. A
ctivity Indica
tor 3
Figure 35: Total number of publications between 2013 and 2017 by HSE Hospitals, Voluntary Hospitals, Community & Non-Hospital and Total
2013
Total Total Voluntary Hospitals
TotalHSEHospitals
Community and Non-Hospital
2014 2015 2016 2017PublicationYear
Num
bero
fSco
pus-Inde
xedPu
blications
(2013-2017)
3,500
3,000
2,500
2,000
1,500
1,000
500
080 87 102 102 111
727 815 764 855 889
1,742 1,758 1,698 1,7611,975
2,549 2,660 2,5642,718
2,975
Research Activity in the HSE and its Funded Organisations
5. A
ctivity Indica
tor 3
58
Figure 36: Comparison of 2017 Scopus indexed publications between the health services nationally and the university sector.
Figure 42: Percentage and number of Scopus indexed publications in 2017 classified using the UK HRCS research activity codes for community and non-hospital areas
%ofScopus-IndexedPublications
0 10 20 30 5040 60
Treatment Development
Detection&Diagnosis
NA
HealthServices
Aetiology
Treatment Evaluation
4
5
7
13
22
60
UKHRCSResea
rchAc
tivity
Cod
es
Research Activity in the HSE and its Funded Organisations
5. A
ctivity Indica
tor 3
62
Figure 44: Percentage and number of Scopus indexed publications in 2017 by research activity codes for total hospitals
Figure 43: Percentage and number of Scopus indexed publications in 2017 classified by the top six health categories for total hospitals
CTIs vision is to be able to provide everypatientwithcancer,accesstopotentiallyhigh-qualityandlife-alteringcancertrialsandmakeIrelandahighlyattractivelocationto open cancer trials.
NUIGalway/UHG,UCC/CUH,TCD/SJH,The National Cancer RegistryIreland,BeaumontHospitalandTheMaterHospital
SFIandICS TheaimofBCNIistoprovideIrishbloodcancerpatientswithaccessto novel and innovative cancer treatmentsthroughtheprovisionofearlyphaseclinicaltrials,offeringtheopportunitytotestnew,potentiallylife-savingtreatmentsanddrugs.Thenetworkalsocollects information and samples from blood cancer patients in Ireland in order to improve their understandingandtouncovernewwaystocombatthisdisease.
Critical Care HRBCriticalCare Clinical TrialsNetworkIreland(HRBCCTNI)
2015
Thenetworkencompasses more than75%ofalltheICUcapacity in Ireland.
HRB TheHRBCCTNIbringstogetherdoctors,nursesandresearcherstotestnewtreatmentsthatcanimprove outcomes for critically ill patients in intensive care units.
Perinatal health HRBMother&BabyClinicalTrialsNetworkIreland(CTNI)
2015
The members includeresearchers,consultants,obstetricians,neonatologists,midwivesandrelatedprofessionals from sevenofthelargestmaternity hospitals in Ireland.
HRB The aim of the CTNI is to addressproblemsinwomenandchildren’shealththatwillhaveaglobalimpact.CTNIhasawell-established record in collaborative researchandinconductinglarge-scale,multicentre,randomisedcontrolled trials.
Primary Care HRBPrimaryCare Clinical TrialNetworkIreland (PrimaryCareCTNI)
2015
NUIGalway,RCSI&QUBandICGPwithmanyGPsandotherprimary care health professionals.
HRB Itsaimsarethedesign,conductanddisseminationofhighquality,internationallyrecognised,randomised trials in Irish primary care,whichaddressimportantandcommon problems.
Research Activity in the HSE and its Funded Organisations
ClinicalandscientificinvestigatorswithaninterestinCrohn’sDisease and Ulcerative Colitisthroughouttheisland of Ireland
Not available It aims to foster collaboration andencouragemulti-centreinvestigator-initiatedstudiesinCrohn'sDiseaseandUlcerativeColitis in Ireland.
HepatitisC IrishHepatitisC Outcomes Research Network/ICORN
2012
CollaborationbetweenClinicians from BeaumontHospital,CUH,GUH,theMaterHospital,St.Luke’sHospital,Kilkenny,SJHandSVUH,patientadvocacygroupsandhealthcare service providersincludingISGE,IDSI,andtheNCPE.
AbbVie Ireland and BristolMyersSquibb
TheinitialgoalofthiscollaborationwastooptimisethequalityofcareofpatientswithHepatitisC(HCV)undergoingtreatmentwithdirect-actingantiviraltherapy(DAAs).Othernetworkresearchthemesdeveloped since 2012 include innovative research studies on modelsofcareandscreeningforHCVinfection.
Thenetworkiscomprisedofdedicatedmulti-disciplinarycentresthatprovideacoordinatedcare-pathforpatientswithprimarysystemic small vessel vasculitis (PSV),fromdiagnosistorelapseandontolongtermremission.Itprovides access to clinical trials for patientswithPSV.
Respiratory Respiratory and Asthma Research Network/INCA Studies
2011
A collaborative researchprogrammedelivered from the RCSI Research Centre and TCD Bioengineering.
SFI The focus is on clinical investigationsforrespiratorydevices,particularlydevelopinganoveltechnologywhichcanbe used in clinical practice as an objectiveassessmentofpatientadherence to inhaled therapy.
Neurology NeurologyResearch GroupinSVUH
2003
UCDandSVUH SFI,HRBand industry
Their areas of excellence are in neuroinflammatorydisorders,inparticular,multiplesclerosis,movementdisordersandcognitiveneurology.Thefocusisonrunningnumerous clinical pharmaceutical trials,academicresearchstudies–bothclinicalandbasicscience,andinterventionalstudieswithallied health professionals. Several nationalneurologyregistriesandresearch databases are also coordinatedfromtheSVUHsite.
Research Activity in the HSE and its Funded Organisations
CancerTrialsIreland(CTI)30 CTIprovidessupportsforoncologyclinicaltrialswithintheOncologyClinicalTrialunitsacross14publicandthreeprivatehospitalsitesinCork,Limerick,Offaly,Galway,Sligo,Donegal,WaterfordandDublin.Itisanot-for-profitorganisationwithcharitablestatus.Servicesprovidedincludeplanning,opening,co-coordinating,supporting,monitoringandauditingcancertrialsinIreland.Inaddition,theorganisationprovidestrainingfacilitates,co-operationbetweenallprofessionalsworkinginthearea,andsupportsthedevelopment of cancer trials research units around the country.
Healthcareprofessionals and scientists,withexpertise in pain management.
Irish Pain Society and other funders.
Thisnetworkaimstobringtogetherallactive pain researchers on the island of Ireland(NorthandSouth)forthepurposesofsharingresearchresultsandideasandfacilitatingcross-institutionalcollaborationin the area of pain research.
Thenetworkaimstosharecurrentknowledgeandnewdiscoveriesaboutthecausesof,andtreatmentfor,psychoticdisorders. Research areas include disordersthataffectperception,cognitionandmoodinwaysthatarechallengingand,attimes,disablingforthoseaffected.
Diabetes GalwayDiabetes Research Centre (GDRC)
2012
NUIGalwayandSaolta University HealthCareGroup.
SFIandHRBs.
The centre is a hub for collaborative effortofresearchersandclinicians,withapassionforthiswork,toprovideagreaterunderstandingofhowdiabetesdevelopsandtheunderlyingmechanisms,thedevelopmentofnewandbettertherapiesforpatients,andassessinghealthcareinterventions and delivery for patients.
The primary aim of the biobank is to recruitpatientswithcommonrheumaticdiseases,andtoobtainbio-samplesthatwillunderpinclinicalresearch.Asecondary aim is to increase national involvement in clinical trials of novel therapeuticagents.
Research Activity in the HSE and its Funded Organisations
AsimplecomparisonofthenumberofclinicaltrialsinothercountriesofsimilarsizetoIreland,suchasDenmarkandFinland,indicatesthatthereissignificantroomforimprovementinIreland.Overthelast10yearsasignificantamountofinvestmentinthedevelopmentofclinicalresearchnetworksandclinicalresearchinfrastructurehastakenplace,andmuchofthisinvestmenthastakenplaceviatheacademicsector.Asshowninchapter6,asignificantamountofnetworksandinfrastructurecurrentlyexisttosupportclinicalresearch,butyetthehealthserviceisunderperforminginthisregardwhencomparedtoother EU countries.
Research Activity in the HSE and its Funded Organisations
2 Cancer Alltypesofneoplasms,includingbenign-malignantcancers(includesleukaemia)
3 Cardiovascular Coronaryheartdisease,diseasesofthevasculatureandcirculationincludingthelymphaticsystem,andnormaldevelopmentandfunctionofthecardiovascular system
13 Neurological Dementias,transmissiblespongiformencephalopathies,Parkinson’sdisease,neurodegenerativediseases,Alzheimer’sdisease,epilepsy,multiplesclerosisand studies of the normal brain and nervous system
Institution(s) Established Director Coverage Core Team
Studies
1 HRBClinicalResearch FacilityCork(HRBCRF-C)
HRB/UCC
UCC and MUH,Cork
2011 Professor Joseph Eustace
SouthandSouth-WesternregionsofIrelandwithapopulation of over 1million(greaterMunsterregion)
69 108ActiveStudies
2 HRBClinicalResearch Facility,Galway(HRBCRFG)
HRB
NUIGalway,GUHSaoltaUniversity HealthCareGroup
2008 Professor MartinO’Donnell
West and North regionofIrelandwithapopulationofjustunder1million
58inCRFG
9inCancer Clinical Trials Unit (CCTU)
Non-Oncology:48active studies
CRFGDataManagementand Statistics: 16 active studies
CCTU: Unknown
3 Wellcome TrustHRBClinical Research FacilityatSJH(WellcomeTrustHRBCRFSJH)
Wellcome Trust and the HRB
TCDandSJH 2013 Professor MartinaHennessy
GreaterDublinMidlandsareagenerally.Forsome specialist areasSt.James’sis the National Centre for many specialist services (e.g.Haemophilia,Burns,BoneMarrowTransplant,OesophagealCancer)
23 41 studies currently open to patient recruitment.
53 studies completed and closed since 2013
4 RCSI Clinical Research Centre(RCSICRC)
RCSI
RCSI and BeaumontHospital
2000 Professor Dermot Kenny
GreaterDublin/North East area
30 MajorSupport=40
Research Activity in the HSE and its Funded Organisations
Appendix 3
80
No. Facility/Centre Funder
Institution(s) Established Director Coverage Core Team
Studies
5 UCD Clinical Research Centre(UCDCRC)
HEAinvestment for the initial three years,NowUCD School ofMedicine&LeveragedFunding
UCD,MaterMisericordiaeandSVUH,
National MaternityHospital&Ireland East HospitalGroup
2006 Professor Peter Doran
Dublin/Leinsterand other national tertiary referrals
18Core
22ProjectSpecific
225
6 Children’sClinical Research Unit,NationalChildren’sResearch Centre(NCRC)
Children’sMedicalResearch Foundation(CMRF)
OLCHC(Children’sHealthIrelandfrom January 2019)
NCRC is over 50 years but theChildren’sClinical Research Unit (CCRU)wasestablished in 2010
Professor Colm O'Donnell
OurLady’sChildren’sHospital,Crumlin,withspecificstudies also supported by NCRCstaffatTemple Street Children’sUniversity Hospital,TallaghtUniversity Hospital,UniversityHospitalLimerickandUniversityCollegeHospitalGalway.Centralised clinical research support service is available to all paediatric centres. Per the national paediatric modelofcare,themajorityofquaternaryandtertiary paediatric healthcare services are delivered by OLCHCandTSCUH(Children’sHospitalGroup).
26 131
OLCHC:110(46Haematology/OncologyTrialsUnit)
TSCUH:6
TUH:6
UCHG:1
UHL:8
Research Activity in the HSE and its Funded Organisations
81
Appendix 3
No. Facility/Centre Funder
Institution(s) Established Director Coverage Core Team
Studies
7 HealthResearch Institute Clinical Research Support Unit Limerick(HRICRSU)