Mrs Harriet Hunt
Research Fellow in Evidence Synthesis and Test Evaluation
South Cloisters 309
I am a Research Fellow in Evidence Synthesis and Test Evaluation within the Evidence Synthesis and Modelling for Health Improvement team (ESMI) in the Institute of Health Research. My main interest is in evaluating medical tests and how they are used in diagnosis and prognosis of a condition or state. I am currently investigating the diagnosis of dementia in primary care with support from the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC). My principal supervisor is Professor Chris Hyde, and I’m also supported by Dr Mark Pearson and Dr David Llewellyn as co-supervisors.
I joined the Medical School in 2009 as part of the Public Health Evidence research group conducting public health reviews for the Centre for Public Health Excellence at NICE on topics such as injury in childhood and smoking cessation. As part of these activities we developed integrative systematic review methods applying theoretical approaches to obesity prevention. I developed further in using theory-led approaches through work with Mark Pearson carrying out a realist synthesis to investigate avoiding acute hospital admissions, funded by the NIHR Service and Delivery Organisation (now Health Services and Delivery Research).
I am involved in two systematic reviews as part of a NIHR Programme Grant looking at coagulation problems in bleeding associated with major trauma (trauma-induced coagulopathy). One of these reviews is a diagnostic test accuracy review, produced with the Cochrane Injuries Group and published in the Cochrane Library. The other is a review of prognostic factors (protocol CRD42014009060 published on PROSPERO). In addition to the coagulopathy work, I am also working with Professor Chris Hyde on a diagnostic test accuracy review of tests of haemoglobin levels in blood donors, alongside colleagues at the Universities of Oxford and Cambridge and NHS Blood and Transplant at The John Radcliffe Hospital, Oxford. This work complements the work of the INTERVAL trial, a randomised controlled trial looking at the well-being of blood donors. I also carry out peer reviewing for the Cochrane Diagnostic Test Accuracy Review Unit within the Cochrane Collaboration.
Broad research specialisms:
- the evaluation of medical tests
- systematic reviews and meta-analysis
- testing for dementia
- realist synthesis
MSc (Open University, 2009) Psychological Research Methods
BSc Dual Hons (Keele, 2001) Psychology and Criminology
I’m particularly interested in how test information is understood; working alongside Professor Chris Hyde has provided an education in test evaluation and associated knotty issues. At Exeter we have a broad range of highly expert researchers taking collaborative and cross-disciplinary approaches which allows test research to cut across the traditional topical and methods boundaries, working with groups including the Exeter Collaboration for Primary Care (APEx), Clinical Epidemiology, the Cancer Diagnosis group (DISCO), and the NIHR Collaboration for Leadership in Applied Health Research and Care in the South West Peninsula (PenCLAHRC).
Dementia is a topical area with particular challenges for diagnostic testing in an environment where people often initially present to their general practitioner with concerns about their memory or cognitive performance. Investigating how to improve the current situation is the focus of my PhD research, with support from and collaboration with a range of other University of Exeter researchers. My principal supervisor is Professor Chris Hyde, and my co-supervisors are Dr Mark Pearson and Dr David Llewellyn.
I am also interested by the practical application of diagnostic test data. I teach part of the Clinical Decision Making course for our undergraduate medical students, and am keen to explore how ‘useable’ diagnostic information is for medics and non-medics, and how this usefulness might be improved. I am interested in the impact of false positive and false negative test results on the people who use this data, e.g. medical practitioners, patients and carers. Tests are used for various reasons such as screening, guiding therapy and predicting how a disease might progress. Prognosis is a developing area, and with Chris Hyde our investigations are also looking at the possible added prognostic value of some diagnostic tests.
Currently the reporting of diagnostic test accuracy data is under scrutiny, and along with Zhivko Zhelev and colleagues from the University of Birmingham Medical School and the University of Amsterdam Medical Centre we are looking at how study designs might be better reported in the research literature.
Another research method that I am interested in is realist synthesis. This is a theory-led approach to research which moves beyond describing whether something works, to explaining who it works for, in what circumstances, in what respects and why. Further details are available from the the Rameses Project. I'm interested in the potential for realist approaches to test evaluation, as this more inductive method may help to unearth many of the more complex and hidden aspects of test evaluation that are not addressed with standard accuracy assessments.
I am carrying out a doctoral research programme looking at optimizing cognitive assessment in primary care to support a more effective route to dementia diagnosis and supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC).
I have just completed a diagnostic test accuracy review Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) for trauma-induced coagulopathy in adult trauma patients with bleeding with the Cochrane Injuries Group, published in the Cochrane Library and working with colleagues at the University of Exeter , National Institute for Health Research (NIHR) Oxford Biomedical Research Centre, Oxford, John Radcliffe Hospital, NHS Blood & Transplant, Oxford, Churchill Hospital, Oxford Haemophilia & Thrombosis Centre, Oxford and the Royal Centre for Defence Medicine ICT Centre, Department of Military Anaesthesia and Critical Care, Birmingham.
I am currently working with colleagues at John Radcliffe Hospital, NHS Blood & Transplant, Oxford, and the Department of Public Health and Primary Care, University of Cambridge on a diagnostic test accuracy review of tests of haemoglobin levels in blood donors (protocol CRD42014005179 published on PROSPERO).
GW4 Network (Bristol, Bath, Exeter and Cardiff Universities); Alzheimer's Research UK South West Hub; Sociology of Diagnosis network
- 2016 University of Exeter Doctoral College
The University of Exeter Doctoral College Professional Development Awards support postgraduate research across the University. The awards support a well-defined activity or combination of activities for research purposes that take place and are paid for between 25 January and 29 July 2016.
- 2014 University of Exeter
Researcher-led Initiative - Developing research capacity by increasing the knowledge and skills of researchers involved in diagnostic accuracy research
- 2014 RCUK Newton Fund
The Department for Business, Innovation & Skills (BIS South Central & West) Newton Fund - £49, 531: to delivery health technology assessment teaching at the National Institute of Infectious Diseases Evandro Chagas, Rio de Janeiro, Brazil
- 2013 University of Exeter Medical School
Translational Medicine Discretionary Fund - Initiative to support and develop ideas for systematic reviews of dementia for University of Exeter researchers
Publications by category
Publications by year
I teach Yr 1 and Yr2 sessions as part of the Clinical Decision Making modules for University of Exeter Medical School medical students.