Evaluation, Trials and Studies Coordinating Centre Developing Sight Loss and Vision research questions: a funder’s perspective Anna Tallant Scientific Advisor, HTA programme 23 September 2015

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NETSCC: Established: 2008 Public Health Research Established: 2008 Health Technology Assessment Established: 1993 Health Services and Delivery Research Established: 2012 Efficacy and Mechanism Evaluation Researcher-led Funded by the MRC Managed by NIHR Commissioned Funded and managed by NIHR Established: 2008 & 2011 NIHR Evaluation, Trials and Studies (NETS) programmes

NETS Programme remits EME programme funds research into the clinical efficacy of treatments and tests that have existing proof-of-concept HTA programme funds research on the clinical and cost effectiveness of healthcare treatments and tests HS&DR programme funds research on the quality, accessibility and organisation of health services PHR programme funds research on non-NHS interventions to improve the health of the public and reduce health inequalities

Funding streams Researcher-led work stream Open calls for researchers to apply for funding for their own topics and questions. Commissioned work stream Designed to met the needs of decision makers within the NHS. Topics refined and prioritised by experts and commissioning briefs advertised.

Examples of funded research What are the most effective treatments for glaucoma and how can treatment be improved? (No 1 in Glaucoma top 10) HTA 12/35/38: Treatment of Advanced Glaucoma Study (TAGS): A multicentre randomised controlled trial comparing primary medical treatment with primary trabeculectomy for people with newly diagnosed advanced glaucoma (Prof A King, Jan 2014 – Aug 2020, £1.76 million) How safe and effective is laser assisted cataract surgery? (No 7 in Cataract top 10) HTA 13/04/46: A Randomised Comparison of Femtosecond Laser Assisted vs Manual Phacoemulsification Cataract Surgery for Adults with Visually Significant Cataract: The FACT trial (Mr M Wilkins, Sep 2014 – Sep 2018, £1.37 million)

Topic identification External Engagement (Royal colleges, clinical networks, speciality groups, charities) Stakeholder engagement (e.g. DH, NICE) Panel members/ Chairs (suggestions and ID activities at panels) James Lind Alliance Priority Setting Partnerships Website suggestions Literature and data base scanning (Cochrane, DARE, NIHR Journals Library final reports) Capture of NICE research priorities

What makes a good research question? Important to the NHS and its patients Supported by current evidence High scientific quality Feasible Timely, i.e. research will continue to be relevant following completion of study Clear and well-defined Represents value for money

Burden of disease Health services Need = frequency x severity x impact of technology x evidence deficit (Discounted for time to produce evidence) Important question on an important topic Evidence gap Prioritising research

Issues commonly discussed by the funding boards (1) Research question – the question needs to be in remit and clearly defined in simple terms, ideally in one sentence Importance – of this project needs to be explained Justification – needs references or preliminary data Patient and public involvement is expected from the design stage through to delivery and dissemination of research Multi-disciplinary team – including clinical staff, researchers, statisticians and experts in study design Research Design Service/ Clinical Trials Unit – consult early !

Issues commonly discussed by the funding boards (2) Study design – needs to be optimised to answer the question Outcome measures –justify your choice of primary outcome and any secondary outcomes Sample size/power calculation – provide enough data to allow the calculation to be repeated Recruitment plan – make sure this is credible by including eligible number of patients, drop-out rates and recruitment targets Drug dose/side effects – need to be clearly explained for drug studies Costs – clearly justified, especially for % high-cost staff, e.g. clinicians

Key points for success Make an early approach to local RDS or a CTU for advice on application and proposed methodology Ensure the team has relevant scientific and project management skills, including strong statistical support Ensure good patient and public involvement from the start Check fit with remit of relevant programmes (use FAQs) If unsure, discuss your proposed study with relevant programme before submitting an application

Resources for applicants NIHR Clinical Research Network Research Design Service (RDS) INVOLVE Browse NETS website for study protocols, guidance notes and FAQs Become a reviewer for NETS programmes Become a panel member

For further information, to apply for funding or to submit suggestions for our commissioned workstreams: