Health and social care delivery research最新文献

{"title":"Exploring and improving resuscitation decisions in out of hospital cardiac arrest: synopsis of the PROTECTeD mixed-method study.","authors":"Michael A Smyth, Terry P Brown, Rachael Fothergill, Frances Griffiths, Ranjit Lall, John Long, Stavros Petrou, Aloysius Niroshan Siriwardena, Anne-Marie Slowther, Lauren Betteley, Karin Eli, Galina Gardiner, Caroline Huxley, Kamran Khan, Felix Michelet, Gavin Perkins","doi":"10.3310/GJGP0922","DOIUrl":"https://doi.org/10.3310/GJGP0922","url":null,"abstract":"<p><strong>Background: </strong>The PROTECTeD study sought to develop an evidence-based termination of resuscitation guideline for use within United Kingdom ambulance services.</p><p><strong>Methods: </strong>This mixed-methods study comprised several work packages: Work package 1 - diagnostic test accuracy meta-analysis of termination of resuscitation rules Work package 2 - modelling performance of termination of resuscitation rules using data from the Out of Hospital Cardiac Arrest Outcomes registry Work package 3 - review of ambulance service practices Work package 4 - qualitative interviews with ambulance clinicians, emergency department clinicians and relatives of non-survivors Work package 5 - stakeholder consensus conference to develop a new termination of resuscitation guideline.</p><p><strong>Results: </strong>We described the performance of 42 different termination of resuscitation rules. Our meta-analysis suggests the best performing termination of resuscitation rule is the Universal termination of resuscitation. We modelled the performance of 29 termination of resuscitation rules and found that none would be suitable for implementation within a United Kingdom context. We identified significant variation in how the termination of resuscitation guideline was implemented across the United Kingdom (UK) ambulance services. Ambulance clinicians experience conflict between what the guideline permits them to do and being able to act in the patient's best interest. They felt obliged to follow the guideline. Most emergency department staff believed that paramedics should be empowered to stop resuscitation where appropriate. However, some felt that more senior emergency department clinicians should make these decisions. Relatives needed to be informed about the resuscitation attempt and must feel confident that every effort had been made to save their relative. They also believed that they were able to provide useful information to inform paramedic decision-making. We drafted a new termination of resuscitation guideline in conjunction with clinical experts and multiple stakeholders at a consensus conference. We employed nominal group techniques to determine content and formulate treatment recommendations.</p><p><strong>Discussion: </strong>Termination of resuscitation decisions are complex, requiring consideration of several important aspects, including what is in the patient's best interest. Our work suggests that the current ambulance guideline may restrict the paramedics ability to act in the patient's best interest, increasing the potential for moral injury.</p><p><strong>Conclusion: </strong>Paramedic decision-making is informed by both clinical and best interest considerations. Relatives are confident that paramedics do everything possible to save their loved one, and they are able to provide paramedics with information to guide decision-making. We developed a new evidence-based termination of resuscitation guideline, employing nominal gro","PeriodicalId":519880,"journal":{"name":"Health and social care delivery research","volume":"14 27","pages":"1-52"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148709193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meeting social welfare legal needs in end-of-life care: co-creation of a system-wide research partnership.","authors":"Colette Hawkins, Amy Wheatman, David Black, Alexis Pala, Yu Fu, Tomos Robinson, Jonathan Ling, Sarah Gorman, Sarah Beardon, Hazel Genn, Hannah Hesselgreaves","doi":"10.3310/YGRA9852","DOIUrl":"10.3310/YGRA9852","url":null,"abstract":"<p><strong>Background: </strong>Social welfare legal needs (matters of daily life, such as finances, housing and employment with legal rights, entitlements or protections) are prevalent towards end of life, creating significant difficulties for both patients and carers. Most people do not know where to go, although a range of services provide advice and support for addressing social welfare legal problems. Navigating this complex and fragmented system across health, social care and social welfare legal support is very challenging. Healthcare professionals are often the first contact for social welfare legal needs, although these are often overlooked and their impact on health and well-being unrecognised. Interprofessional learning can increase awareness of social welfare legal needs and build connections between service providers, offering a more holistic and cohesive multiagency response to the complex needs around end of life. The aim of the research was to co-create a robust foundation for cross-agency research investigating the impact of interprofessional learning on social welfare legal needs towards end of life in the North East England region.</p><p><strong>Objectives: </strong>Convene a research partnership group across academics, multiagency service providers and members of the public with lived experience. Consider and agree key issues for successful place-based multiagency research in this area. Co-create a complexity-appropriate research proposal with interprofessional learning as an intervention.</p><p><strong>Methods: </strong>A series of research activities was implemented to convene a multiagency partnership group and consider the key issues for successful place-based multiagency research. Data were collected from two online workshops, an optional reflective workbook, and a modified Delphi technique. Initial participants were selectively recruited from our established stakeholder and patient and public involvement groups. Increasing diversity of the partnership continued throughout the project, using contacts provided by group members. Representation of services supporting underserved groups was a priority.</p><p><strong>Results: </strong>All invited participants were recruited to the partnership, although contribution to research activities was variable. The partnership bridged knowledge gaps between services and united diverse perspectives, expertise and experience. A greater understanding of the barriers and opportunities for place-based multiagency working was generated, such as considering the importance of language in facilitating collaboration and responding to concerns around capacity. A non-hierarchical partnership was meaningful, with both personal and professional insights viewed as equally important. Facilitators to engagement with interprofessional learning were identified including the need for leadership endorsement. A non-traditional, mixed-method approach to interprofessional learning evaluation was favoured, with","PeriodicalId":519880,"journal":{"name":"Health and social care delivery research","volume":" ","pages":"149-170"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142305767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory study from an end-of-life research partnership network to improve access for ethnically diverse communities in one region.","authors":"Erica J Cook, Elaine Tolliday, Nasreen Ali, Mehrunisha Suleman, Emma Wilkinson, Gurch Randhawa","doi":"10.3310/MWHY5612","DOIUrl":"10.3310/MWHY5612","url":null,"abstract":"<p><strong>Background: </strong>Minority ethnic patients are less likely to access timely and effective palliative and end-of-life care and, as a consequence, more likely to experience poorer symptom management and receive more intensive treatments at the end of life. Research activity has the potential to address the aforementioned barriers to improve access. However, there is a need to develop capacity and capability, particularly within underserved communities, to provide an infrastructure that can drive research activity informed by the community to benefit the community.</p><p><strong>Objective: </strong>To build and develop a robust, inclusive and representative research partnership to facilitate improved research activity committed to addressing inequity in access to palliative and end-of-life care among ethnically diverse communities.</p><p><strong>Design: </strong>An inclusive and representative KEEch research Partnership NETwork was established, comprised over 80 partner organisations that represent the local diverse and multifaith communities. Interviews (<i>n</i> = 11) with service providers and face-to-face roundtable workshops with community stakeholders, service providers, informal carers and faith leaders were conducted to understand needs, challenges and research priorities.</p><p><strong>Setting: </strong>Bedfordshire, Hertfordshire and Milton Keynes, United Kingdom.</p><p><strong>Results: </strong>Developing KEEch research Partnership NETwork required a flexible and agile approach to engage effectively with institutionalised and non-institutionalised stakeholders. Sharing a joint purpose of learning, managing partners' expectations and providing transparency and accountability within the network were all essential in building trust and equity within the research partnership. The overarching findings revealed a range of sociocultural and structural barriers that negatively impact access and experience among minority ethnic groups. Discussions centred on the disconnect between informal care and support within the community, which many ethnic minority communities rely upon, and 'institutional' medical services. KEEch research Partnership NETwork uncovered that while service providers and communities acknowledge they need to engage with each other more, they remain uncertain of the best way to achieve this. There was also consensus that services need to deliver more effective, culturally competent, person-centric care that promotes compassion and gives weight to non-medical needs to better meet the needs of the diverse population. These findings and priorities have informed the submission of a co-produced research funding proposal. Beyond that, KEEch research Partnership NETwork has also provided a platform for further unplanned spin-off research projects and collaboration, including the implementation of an innovative 'community connector' role to facilitate better integration of community and voluntary services in palliative and ","PeriodicalId":519880,"journal":{"name":"Health and social care delivery research","volume":" ","pages":"171-194"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142825001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing palliative and end-of-life care research partnerships in the North East and North Cumbria: A report on the first year of the RIPEN network.","authors":"Katherine Frew, Joanne Atkinson, Dawn Craig, Sonia Dalkin, Felicity Dewhurst, Yu Fu, Olivia Grant, Kathryn Mannix, Fiona Matthews, Paul Paes, Felicity Shenton, Daniel Stow, Adam Todd, Donna Wakefield, Barbara Hanratty","doi":"10.3310/GJKF1425","DOIUrl":"10.3310/GJKF1425","url":null,"abstract":"<p><strong>Background: </strong>The North East is one of the most disadvantaged areas of England with end-of-life care needs shaped by high levels of disability, physical and mental ill health. This programme of work aimed to set the foundation for the development of a palliative and end-of-life care research community, equipped to meet local and national challenges.</p><p><strong>Objectives: </strong>Develop a self-sustaining research culture in North East palliative and end-of-life care. Build research collaborations around older age, frailty, multiple long-term conditions and inequalities and submit at least one research proposal. Convene a diverse patient and public advisory group.</p><p><strong>Methods and findings: </strong>To establish cross-institutional collaborations, we worked with patient and public partners and key stakeholders from local National Health Service trusts, hospices, social care, our National Institute for Health and Care Research infrastructure (Applied Research Collaboration North East and North Cumbria, Policy Research Unit Older People and Frailty, National Institute for Health and Care Research Innovation Observatory, Comprehensive Research Network, and Research Design Service). A series of events were hosted to foster a research culture, including establishing a monthly seminar programme, research sandpits, bespoke research training and dissemination events. A diverse community of patient and public involvement partners was established to support and shape the developing research. Multiple project and two fellowship applications were supported by the partnership. A qualitative study identified issues pertinent to local access to data that could support research.</p><p><strong>Conclusions: </strong>This work has been a catalyst for palliative and end-of-life care research and practice collaborations to develop. Funding success and ongoing research and training events should provide a platform for sustained research development in this area.</p><p><strong>Funding: </strong>This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR135278.</p>","PeriodicalId":519880,"journal":{"name":"Health and social care delivery research","volume":" ","pages":"135-148"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145688888","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation and use of technology-enabled remote monitoring for chronic obstructive pulmonary disease: a rapid qualitative evaluation.","authors":"Nikki Newhouse, Agne Ulyte, Zuzanna Marciniak-Nuqui, Jackie van Dael, Sonja Marjanovic, Sharon Brennan, Sara Shaw","doi":"10.3310/GJSS1422","DOIUrl":"10.3310/GJSS1422","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic obstructive pulmonary disease affects around 2% United Kingdom population. Timely identification of patients at risk of deterioration is crucial. Technology-enabled remote monitoring may help prevent deterioration, support chronic obstructive pulmonary disease patients at home and appropriate use of National Health Service services. Evidence on the adoption, use and experience of technology-enabled remote monitoring in the chronic obstructive pulmonary disease pathway is currently limited, impeding efforts to inform effective technology-enabled remote monitoring design and implementation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To understand what supports good practice in the implementation and use of technology-enabled remote monitoring in the chronic obstructive pulmonary disease care pathway and draw transferable lessons that can inform spread and scale up.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design and methods: &lt;/strong&gt;Rapid evaluation, combining qualitative interviews, focused case studies and stakeholder workshops. Patient and public voices informed evaluation design, conduct and co-design of resources.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting and participants: &lt;/strong&gt;Scoping interviews with a purposive sample of 29 national and regional stakeholders informed selection of four case study sites involved in delivering technology-enabled remote monitoring for chronic obstructive pulmonary disease. Case studies combined interviews with 19 staff and review of 18 documents. Analysis was informed by the non-adoption, abandonment and challenges to scale-up, spread and sustainability of technology framework. A stakeholder workshop (&lt;i&gt;n&lt;/i&gt; = 23 participants) refined emerging findings. Interviews with respiratory patients and a co-design workshop informed development of patient-facing resources.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Technology-enabled remote monitoring for chronic obstructive pulmonary disease occurs along a continuum of scope and scale. Technology-enabled care pathways have some common overarching features, but variation is seen across contexts and patient cohorts. Technology-enabled remote monitoring services influence care provision on a system level. Effective implementation is underpinned by service characteristics affecting its use, technology functionalities and organisational capabilities and capacities. Technology-enabled remote monitoring success also depends on defining the data-driven purpose and value proposition, ensuring buy-in, organising the workforce and workload in sustainable ways, data and IT platform interoperability, support for patients in using the service safely and appropriately, utilising existing resources, team buy-in, financial resourcing and clear policy incentives, and openness to ongoing learning. Patients value technology-enabled remote monitoring services that help them feel more connected to healthcare providers and provide timely information and support. Healthcare staff value high-quality patient care, s","PeriodicalId":519880,"journal":{"name":"Health and social care delivery research","volume":" ","pages":"17-56"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145574994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Referral pathways into the NHS Digital Weight Management Programme for musculoskeletal and perioperative patients: rapid process evaluation.","authors":"Stephanie Stockwell, Maggie Bradford, Zuzanna Marciniak-Nuqui, Saoirse Moriarty, Justin Waring, Jon Sussex","doi":"10.3310/GJJS9715","DOIUrl":"10.3310/GJJS9715","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The National Health Service in England is piloting an extension of access to its Digital Weight Management Programme, a digital service to support behavioural and lifestyle changes for weight loss. Access is being piloted to include referrals for patients with a body mass index above a threshold level set by the National Health Service England and who either have a diagnosis of osteoarthritis of the knee or hip (musculoskeletal referrals - 11 pilot sites) or are on elective surgical care waiting lists (elective care referrals - 10 pilot sites). There is a marked variation across sites in the number of patients referred.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To understand reasons for variation (local implementation, barriers and facilitators) and experiences of the implementation and functioning of referral pathways for musculoskeletal and elective surgical care patients into the National Health Service Digital Weight Management Programme.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design and methods: &lt;/strong&gt;A comparative case study (&lt;i&gt;n&lt;/i&gt; = 7 sites) methodology was used, employing a mixed-methods approach following a sequential explanatory design: descriptive analysis of quantitative referral data from National Health Service England; staff (&lt;i&gt;n&lt;/i&gt; = 25) and patient (&lt;i&gt;n&lt;/i&gt; = 18) interviews and online workshops. Thematic analysis was conducted.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Osteoarthritis treatment and elective surgery providers in the National Health Service in England.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Participants: &lt;/strong&gt;Interviews: staff and patients at three musculoskeletal and four elective care pilot sites. Workshops: staff at all pilot sites.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Intervention: &lt;/strong&gt;Referral of osteoarthritis and elective surgery patients to the National Health Service Digital Weight Management Programme.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome measures: &lt;/strong&gt;Patients' and staff's views.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Sites that created referral processes that optimised clinical staff time (e.g. automation and use of administrative staff) and involved ways to capture body mass index if missing from patient records were more likely to have a higher number of referrals. Despite generally positive attitudes towards the Programme, many staff felt they had insufficient information to describe it accurately to patients, which may impact both offering and acceptance of referrals. Strong leadership and personal staff motivation are also likely to impact referral offers. Similarly, patients were more likely to accept a referral if it aligned with their attitudes towards weight management and was offered at a time where they felt they could engage with the Programme.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Data were available on numbers of patients referred but not on numbers of eligible patients not referred. All patients interviewed had accepted referral to the Programme: we were unsuccessful in our attempts to recruit patients who had declined referral. No patients f","PeriodicalId":519880,"journal":{"name":"Health and social care delivery research","volume":" ","pages":"99-134"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146101133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Independence and interdependence of non-medical practitioners in the emergency care skill-mix (SKILLMix-ED): a multi-method study to develop a measurement tool.","authors":"Francesca Taylor, Mary Halter, Vari M Drennan, Jonathan Gabe, Heather Gage, Heather Jarman, Celayne Heaton-Shrestha, Catriona Brice","doi":"10.3310/GJMH1818","DOIUrl":"10.3310/GJMH1818","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In addressing the many challenges that face them, some emergency departments are changing their staffing to include new roles, such as nurse practitioners and physician associates. Known collectively as non-medical practitioners, they work with varying levels of independence and supervision, which, evidence suggests, may influence outcomes. As part of a larger study investigating the impact of these staff skill-mix changes, we sought to measure quantitatively how such staff work independently or with supervision.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To develop a prototype-structured observational tool for quantitative measurement of levels of independence and supervision of non-medical practitioners in emergency departments and urgent treatment centres in England.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;A multimethod study using an incremental and iterative process underpinned by theories suggesting autonomy can be measured by practice independence behaviour.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;We undertook three interconnected research activities in March 2021-April 2023: (1) literature review to clarify concepts, and identify classifications and tools associated with independence and supervision; (2) 12 ethnographic observations of non-medical practitioners and resident doctors to describe the enactment of independence and supervision, with data coded and thematically analysed; (3) collaborative prototype tool development incorporating three collaborative sessions with 28 clinicians, non-medical practitioners and patients, and three further stages of stakeholder feedback.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Twenty-six articles were included in the literature review. Nine articles included concepts associated with independence and supervision, the main concepts being clinical decision-making, competence, responsibility and autonomy. These multifaceted concepts were found to be intertwined in complex ways with those of collaboration, teamwork and interdependence. Seventeen articles included classifications or tools to measure levels of independence or supervision. Shared decision-making was the most frequently measured concept. There were no tools or classifications identified for measuring levels of independence or supervision within a skill-mix team. Our clinical observations found that participant clinicians practised with varying levels of independence within an interdependent team. The extent of guidance, education and direction received in discussion with the clinician-in-charge varied widely. In addition to the clinician-in-charge structure, clinical discussion and advice seeking were often with colleagues known and trusted to have specific knowledge. Spatial, temporal and resource constraints also encouraged collaborative working. Patients played an important team role. During collaborative development of the prototype tool, key issues raised by stakeholders and addressed in the prototype included: concerns that an inappropria","PeriodicalId":519880,"journal":{"name":"Health and social care delivery research","volume":" ","pages":"233-262"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147611281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual Participant Data Meta-Analysis (IPDMA) of long-term COVID-19 outcomes in a systematic review-informed, international, multidisciplinary database.","authors":"Myzoon Ali, Marian C Brady, Pauline Campbell, Scott Rooney, Linda Williams, Lorna Paul, Helen Mason, Sarkis Manoukian, Charlie Chung, Mark Barber, Claire McGoldrick, Andrew Smith, Neil Basu, Manish Patel, Kathryn VandenBerg, Aikaterini Papadopoulou, Azza Abdelaal, Samuel Jk Abraham, Alaa Abu Sayf, Jane Agergaard, Motaz Alawna, Sergiu Albu, Laurent Alric, Paulette Andino, Jakub Antczak, Alexander Arutyunov, Aylin Ayyıldız, Ellena Badrick, Pınar Yalcin Bahat, Tala Ballouz, Clara Balsano, Matteo Bassetti, Mariana Bendersky, Danilo Berton, Fausto Biancari, Bjorn Blomberg, Gianluca Em Boari, Silvia Bonetti, Mohammad Bosaeed, Benoit Bouteleux, Salvatore Brugaletta, Mikhail Bychinin, Ina Callebaut, Stephen J Carter, Michal Chudzik, Julien Coelho, Mario Cornejo-Giraldo, Stefania Costi, Gilles Darcis, David R Darley, Antonio Di Baigio, Arianna Di Stadio, Michael Dreher, Dmitry Enikeev, Rachael Evans, Luiz Fábio Magno Falcão, Clara Fehrmann, Stefania Fugazzaro, Lorenzo Gamberini, Fatma Ketenci Gencer, Carlos Alberto Gonzalez, Fergus Hamilton, Chelsea Harrison, Markus C Hayden, Haley Hedlin, Majanka Heijenbrok-Kal, Merel E Hellemons, Brynja Ingadottir, Prasanna Jagannathan, Roman Khokhlov, Leonid Khokhlov, Dacre Knight, Marc Kollum, Henrik Kolstad, Luciane Kopittke, Linda Ashman Kröönström, Nina Langeland, Christian Lawlor, Mark L Levitt, Fabio Santos Lira, Judith Loffler-Ragg, David Tw Lui, Reaz Mahmud, Łukasz Małek, Ili Margalit, Sergi Marti-Beltran, Adrian Martineau, Mar Masia, Paul Mathew, Gisela Mautner, Aurélien Mazeraud, Dominik Menges, Christian S Meyhoff, Alice Milne, Fatemeh Sadat Mirfazeli, Shima T Moein, Aliae Ar Mohamed-Hussein, Giovanni Monteleone, Igor H Murai, Andreas Steenholt Niklassen, Arvind Nune, Maria Natividad Seisdedos Nunez, Luis Ortega-Paz, Daniel Ouellette, Alna Carolina Mendes Paranhos, Esra Pehlivan, Giovanna Pelà, Filipe Alexandre Pereira, Hanna C Persson, Simone Piva, Terry F Plasse, Tamara Platteel, Simone Porcelli, Irene Prediletto, Gilead Raday, Kadalraja Raghavan, Kathrin Reetz, Damiano Rizzoni, Mauricio Salinas, Gillian Santorelli, H N Sarker, Sathyamurthy P, Islam Galal Sayed, Leo Sekine, Susan Shapiro, Samuel Katsuyuki Shinjo, Ventura Simonovich, Gaia Sinatti, Thomas Sonnweber, Vasileios T Stavrou, Björn Stessel, Katharina Stibrant Sunnerhagen, Julio Vallejos, Rita Jg van den Berg-Emons, Lavanya Visvabharathy, Yize I Wan, John Wilkinson, Clarissa Lin Yasuda, Zuobiao Yuan, Alexandre Prehn Zavascki, Maria Del Pilar Brito Zeron, Sigridur Zoëga, Cesar Zoni","doi":"10.3310/GJMA0602","DOIUrl":"10.3310/GJMA0602","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Identifying and addressing long-term health and societal challenges after COVID-19 is a research priority.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To create an international, multidisciplinary COVID-19 database, and synthesise long-term outcomes, predictors and costs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;Systematic identification of COVID-19 data sets and meta-analysis of individual participant data on long-term outcomes after COVID-19.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;Contributed data were collected in clinical, community and research settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interventions: &lt;/strong&gt;Interventions from original studies were included as covariates in models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, PsycInfo&lt;sup&gt;®&lt;/sup&gt; (American Psychological Association, Washington, DC, USA), Cumulative Index to Nursing and Allied Health Literature, World Health Organization Global Index Medicus, Epistemonikos, LitCOVID; World Health Organization International Clinical Trials Registry Platform; ClinicalTrials.gov and supplementary searches for studies (November 2019-November 2021) were searched for studies on &gt; 10 people from cohort, case-control, survey or randomised controlled trial studies, across any setting, describing validated assessment instruments, symptoms, hospitalisation, discharge destination or mortality beyond 28-days after COVID-19 onset. Data were extracted by two independent reviewers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Principal investigators contributed fully anonymised individual participant data. Demography, equity and symptoms were described. Assessment instruments were mapped to the International Classification of Functioning, Disability and Health. Factors associated with outcomes at 3-6 months, 9-12 months and beyond 12 months of index infection, for &lt;i&gt;n&lt;/i&gt; &gt; 500 individual participant data and &gt; 1 data set were described using ratio of difference, point estimates, odds ratio and 95% confidence interval, as appropriate. The Mixed Methods Appraisal Tool described study quality; models were appraised using a Grading of Recommendations Assessment, Development and Evaluation-informed approach; heterogeneity was described using &lt;i&gt;I&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Outcome measures: &lt;/strong&gt;Included overall perception of health, multidomain cognitive function, anxiety, depression, stress, post-traumatic stress disorder, fatigue, strength, walking ability, mobility, coping with daily life, breathlessness, mortality, later hospitalisation and health-related quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;PRECIOUS collated 116 data sets from 40 countries (individual participant data = 62,849), comprising 20 randomised controlled trials, 13 case-control, 60 cohort 2 longitudinal, 1 survey and 20 other study types. Participants' median age was 58 years interquartile range (45-68); 34,185 (54.4%) were female; 158 unique symptoms and 137 unique assessment ","PeriodicalId":519880,"journal":{"name":"Health and social care delivery research","volume":"14 29","pages":"1-160"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formulating outputs from a mixed-methods study of access to general practice: a series of collaborative stakeholder workshops.","authors":"Helen Atherton, Toto Gronlund, Abi Eccles, Carol Bryce, Angela Martin, Catherine Pope","doi":"10.3310/WBWD8844","DOIUrl":"10.3310/WBWD8844","url":null,"abstract":"<p><strong>Background: </strong>Access to general practice is a concern for policy-makers, politicians, service providers and the public. We conducted a study to examine what happens in the long term to general practices that have introduced innovations designed to improve access to appointments. Recognising the importance of ensuring research findings are transferable to those using them, we used collaborative workshops to aid the development of our study outputs.</p><p><strong>Methods: </strong>We held three sequential interactive workshops. These covered (1) early findings of the study, (2) what evidence-based resources attendees use and (3) what resources they would like to see produced. We sought to include 6-12 people from staff from practices participating in the wider research study, from primary care networks, from partnership boards of integrated care systems, clinical commissioners, professional bodies, National Health Service bodies and independent think tanks. The first two workshops were online, the final was in-person. Workshops were facilitated by the research team, including the patient and public involvement lead. A research team member took detailed notes.</p><p><strong>Results: </strong>Workshop 1 had 12 attendees; workshop 2 had 9 attendees, of which 7 were also at the previous workshop; workshop 3 had 7 attendees, of whom 6 had attended a previous workshop. From these workshops, we gained insights that helped us to validate our interpretation of the study data. We observed the competing interests and needs of different groups, who have different perspectives on the value of research evidence. Outputs that are brief, written in lay terms and widely publicised appear to be of especial value.</p><p><strong>Limitations: </strong>The range of stakeholders included was less varied than intended; this was in part due to the commitment involved in attending, and this may limit the inclusivity of the findings.</p><p><strong>Future work: </strong>This approach could be used in future studies to ensure that stakeholder interests are included in study dissemination plans.</p><p><strong>Funding: </strong>This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR133620.</p>","PeriodicalId":519880,"journal":{"name":"Health and social care delivery research","volume":" ","pages":"295-304"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing artificial intelligence in chest diagnostics for lung disease: A mixed-methods evaluation.","authors":"Angus Ig Ramsay, Kevin Herbert, Rachel Lawrence, Chris Sherlaw-Johnson, Stuti Bagri, Nadia Crellin, Emma Dodsworth, Holly Elphinstone, Amanda Halliday, Joanne Lloyd, Efthalia Massou, Raj Mehta, Stephen Morris, Pei Li Ng, Holly Walton, Naomi J Fulop","doi":"10.3310/GJAR2722","DOIUrl":"10.3310/GJAR2722","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Artificial intelligence tools simulate aspects of human intelligence. Policy and research highlight artificial intelligence's potential to support delivery of radiology pathways. In 2023, National Health Service (NHS) England invested £21M to deploy artificial intelligence diagnostic tools for chest X-ray and chest computed tomography in 66 NHS Trusts. Little is known about how artificial intelligence tools are implemented in practice, staff experience of these tools, and their effectiveness and cost.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;Evaluate evidence on artificial intelligence tools within radiology internationally. Evaluate implementation of artificial intelligence for chest diagnostics in England. Investigate how effectiveness and cost-effectiveness of artificial intelligence for chest diagnostics can be measured.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Ten-month mixed-methods study (rapid scoping review and empirical study comprising staff interviews, observations and documentary analysis). Findings were analysed using rapid assessment procedures, drawing on qualitative, quantitative and health economic approaches. Our evaluation was also designed to inform phase 2 of our study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;The review included 114 articles on artificial intelligence use in radiology, internationally. Empirical work included 51 staff interviews, 57 observations and 166 documents from 10/11 of the networks and 6/66 trusts implementing artificial intelligence tools. Our review found evidence gaps, including real-world implementation of artificial intelligence tools; patient and carer experiences; impact on inequalities, sustainability and wider systems; and cost-effectiveness. Artificial intelligence for chest diagnostics was implemented in various ways, with different aims, pathways and approaches. Implementation takes time due to multiple activities related to planning, procurement, preparation for deployment, monitoring and evaluation. These tasks - technical and social - required time and resource, including a wide range of stakeholders and expertise. As of November 2024, 24/66 trusts had implemented artificial intelligence tools in practice. Implementation barriers included time, resources, challenges navigating processes and adapting these to local contexts. Facilitators included stakeholder engagement and support. Network and trust ability to evaluate service impact was influenced by factors such as data availability, data linkage, resources and capacity. Factors varied across implementation stages. Our findings indicated multiple data sources that may support measurement of effectiveness and cost-effectiveness within the English National Health Service. However, limitations to data availability need to be addressed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Limitations: &lt;/strong&gt;Our rapid timeline meant we could not interview patients, carers, and several staff groups at trust and national levels. Delayed deployment meant we could not ","PeriodicalId":519880,"journal":{"name":"Health and social care delivery research","volume":" ","pages":"57-98"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147501058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}