Research
Interventional cardiology; Clinical trials methodology and reporting
I have established a standing at national and international level for practice and research in interventional cardiology. My recognised expertise is in the planning, performance and reporting of clinical trials. I also have substantial achievements in observational research, database application design and application, and outcomes analysis.
I established the Clinical Trials and Evaluation Unit at the Royal Brompton Hospital and led its initial flagship ventures including the landmark Stent or Surgery Trial (SoS). The primary publication from this study remains
in the top 1% of quoted papers in cardiology. More recently I conceived and led the HEAT-PPCI trial (Lancet 2014: 384; 1849 - 1858), a study that resulted in changes in international guidelines for the management of acute myocardial infarction. HEAT-PPCI was the largest ever UK trial in coronary intervention and the largest ever single-centre study in world cardiology. The methodology pioneered new approaches to patient consent and efficient data collection. I have a leading role in a number of ongoing national and international trials.
I am also interested in the evaluation of service development. I have published research on the workforce implications of the provision of primary PCI services and on the development of patient safety checklists for the cardiac catheterisation laboratory. I have helped to develop the performance of high quality trials led by nursing and other health professionals including an examination of neuropsychological outcome after revascularisation.
I have developed clinical database applications that have been successful on three continents. My database application ‘Minerva’ was bought by the Norwegian and Scottish governments for national implementation. The original code, including artificial intelligence systems, was subsequently purchased by the multi-national corporation Philips for integration with their cardiovascular information systems.
My work in outcomes analysis in PCI is recognised as leading in its field and my published work on risk adjustment has been adopted by the UK Central Cardiac Audit Database (CCAD) for national application. I serve on the main board for the National Institute for Cardiovascular Outcomes Research (NICOR), based in London.
I have made a significant contribution to the development of research in my NHS trust and served as the Chair of the Academic Committee. I make regular contributions to a range of educational meetings and have been central to the development of a range of well-received training courses. I have served in leadership roles in my trust, network and in my specialist society and continue to contribute to the development of UK cardiology.
I hold a national Clinical Excellence Award at silver level: the specialist section of my application was in research and development.
I developed the concept of the Institute of Cardiovascular Medicine and Science (ICMS) and worked with Prof Kim Fox to secure its formation in September 2011. This is a collaboration between the Liverpool Heart and Chest Hospital and the Royal Brompton and Harefield hospitals (as leading specialist cardiovascular NHS Foundation Trusts) and the National Heart and Lung Institute at Imperial College.
I hold honorary appointments at both the Institute of Translational Medicine of the University of Liverpool and at the National Heart and Lung Institute, Imperial College London.
In January 2013 I was elected, by the National Society, as the UK Research Lead for Interventional Cardiology and in 2016 was appointed Chair of the Academic and Research Committee of the British Cardiovascular Society.