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 Harriet Hunt

Harriet Hunt

Research Fellow in Evidence Synthesis and Test Evaluation

6074

South Cloisters 309

I am a Research Fellow in Evidence Synthesis and Test Evaluation within the Exeter Test Group (web pages and further information here) at the Institute of Health Research.

I'm intrigued by how medical tests are used in the real world, and my specialism is in how we evaluate medical tests for identifying diseases or conditions (diagnosis) and predicting how those diseases or conditions might develop (prognosis). At present I am investigating the accuracy of using brief cognitive assessments (or 'pen and paper' tests) when used to identify dementia in general practice 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 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 have been 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.

Research specialisms:

  • evaluating medical tests
  • systematic reviews and meta-analysis 
  • testing for dementia
  • realist synthesis

Qualifications

  • MSc (Open University, 2009) Psychological Research Methods

  • BSc Dual Hons (Keele, 2001) Psychology and Criminology

 

Links

Research

Research interests

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 number of highly expert researchers within the Exeter Test Group, 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.

Research projects

I am conducting PhD research looking at the accuracy of using brief cognitive assessments (or 'pen and paper' tests) when used to identify dementia in general practice supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care South West Peninsula (PenCLAHRC).

I was lead researcher of 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 and the Royal Centre for Defence Medicine ICT Centre, Department of Military Anaesthesia and Critical Care in Birmingham, UK.

I am also 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).

Research networks

GW4 Network (Bristol, Bath, Exeter and Cardiff Universities); Alzheimer's Research UK South West Hub; Sociology of Diagnosis network, PRISMA-DTA network group.

Research grants

  • 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

Links


Key publications | Publications by category | Publications by year

Key publications


Hunt HA, Van Kampen S, Takwoingi Y, Llewellyn DJ, Pearson M, Hyde CJ (2017). The comparative diagnostic accuracy of the Mini Mental State Examination (MMSE) and the General Practitioner assessment of Cognition (GPCOG) for identifying dementia in primary care: a systematic review protocol. Diagnostic and Prognostic Research, 1, 1-6. Full text.
Pearson M, Hunt HA, Cooper C, Shepperd S, Pawson R, Anderson R (2015). Providing effective and preferred care closer to home: a realist review of intermediate care. Health and Social Care in the Community, 2(23). Full text.
Hunt HA, Stanworth S, Curry N, Wolley T, Cooper C, Ukoumunne O, Zhelev Z, Hyde C (2015). Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) for trauma-induced coagulopathy in adult trauma patients with bleeding. Cochrane Database of Systematic Reviews 2015(2). Full text.
Hunt HA, Hardwick RJ (2013). An analysis of theory building in realist synthesis: perspectives from the literature. 21st Cochrane Colloquium 2013.
Hunt HA, Hyde CJ, Pearson M (2013). Realist synthesis – what is it and how could it add value to the diagnosis of dementia in primary care?. Methods for Evaluating Medical Tests and Biomarkers Symposium 2013.
Zhelev Z, Hunt HA, Hyde CJ (2013). The reporting of research design of diagnostic test accuracy (DTA) studies in the abstracts in major medical journals. Methods for Evaluating Medical Tests and Biomarkers Symposium 15th – 16th July 2013; Birmingham, UK.

Publications by category


Journal articles

Hunt HA, Van Kampen S, Takwoingi Y, Llewellyn DJ, Pearson M, Hyde CJ (2017). The comparative diagnostic accuracy of the Mini Mental State Examination (MMSE) and the General Practitioner assessment of Cognition (GPCOG) for identifying dementia in primary care: a systematic review protocol. Diagnostic and Prognostic Research, 1, 1-6. Full text.
Pearson M, Hunt HA, Cooper C, Shepperd S, Pawson R, Anderson R (2015). Providing effective and preferred care closer to home: a realist review of intermediate care. Health and Social Care in the Community, 2(23). Full text.
Hunt HA, Stanworth S, Curry N, Wolley T, Cooper C, Ukoumunne O, Zhelev Z, Hyde C (2015). Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) for trauma-induced coagulopathy in adult trauma patients with bleeding. Cochrane Database of Systematic Reviews 2015(2). Full text.
Hunt HA, Hyde CJ, Stanworth S, Curry N, Perel P, Woolley T, Cooper C, Ukoumunne O (2013). Thromboelastography (TEG) and thromboelastometry (ROTEM) for trauma-induced coagulopathy in adult trauma patients with bleeding [Protocol]. Cochrane Database of Systematic Reviews 2013 Full text.
Pearson M, Hunt H, Garside R, Moxham T, Peters J, Anderson R (2012). Preventing unintentional injuries to children under 15 years in the outdoors: a systematic review of the effectiveness of educational programs. Inj Prev, 18(2), 113-123. Abstract.  Author URL.  Full text.

Conferences

Hunt HA, Hyde CJ (2017). An overview of systematic reviews summarising the accuracy of brief cognitive assessments for identifying dementia in primary care. Methods for Evaluating Medical Tests and Biomarkers. 19th - 20th Jul 2016. Abstract.  Full text.
Hunt HA, Hardwick RJ (2013). An analysis of theory building in realist synthesis: perspectives from the literature. 21st Cochrane Colloquium 2013.
Hunt HA, Hyde CJ, Ukoumunne O, Cooper C (2013). Identifying uncontrolled haemorrhage after trauma. University of Exeter Medical School Medical and Health Research Showcase 2013.
Hunt HA, Hyde CJ, Pearson M (2013). Realist synthesis – what is it and how could it add value to the diagnosis of dementia in primary care?. Methods for Evaluating Medical Tests and Biomarkers Symposium 2013.
Zhelev Z, Hunt HA, Hyde CJ (2013). The reporting of research design of diagnostic test accuracy (DTA) studies in the abstracts in major medical journals. Methods for Evaluating Medical Tests and Biomarkers Symposium 15th – 16th July 2013; Birmingham, UK.
Zhelev Z, Hunt H, Hyde CJ (2013). Using QUADAS-2 in systematic reviews of Diagnostic Test Accuracy (DTA) studies: Survey of users’ experience. 21st Cochrane Colloquium 2013.
Pearson MN, Hunt HA, Anderson R (2012). Assessing the quality of sources in a systematic review of implementation: Reflections from a realist review. 12th Annual Colloquium of the Campbell Collaboration 2012 29th – 31st May; Copenhagen, Denmark.
Pearson MN, Hunt HA, Cooper C, Shepherd S, Pawson R, Anderson R (2012). Moving care closer to home through intermediate care: a realist review of what works for whom and why. Delivering better health services: Health Services Research Network Symposium 2012; 19th & 20th June; Manchester, UK.
Hunt H, Pearson M, Cooper C, Shepperd S, Pawson R, Anderson R (2012). Moving care closer to home through intermediate care: developing a conceptual framework. Health Services Research Network Symposium 2012.

Reports

Garside R, Pearson M, Hunt HA, Moxham T, Anderson R (In Press). Identifying the key elements and interactions of a whole system approach to obesity prevention. NICE Centre for Public Health Excellence, NICE. Abstract.  Author URL.
Hunt HA, Anderson R, Coelho HF, Garside R, Bayliss S, Fry-Smith A (2012). Preventing obesity: the effectiveness of whole system approaches. NICE Programme Development Group, NICE. Author URL.
Pearson M, Hunt H, Cooper C, Shepperd S, Pawson R, Anderson R (2012). The effective and cost-effective use of intermediate, step-down, hospital at home and other forms of community care as an alternative to acute inpatient care: a realist review., NIHR. Author URL.
Hunt H, Anderson R (2011). Whole system approaches to obesity prevention case studies: Analysis of documentary evidence from three localities – Sheffield, Newcastle-upon-Tyne, and Barking & Dagenham.
Garside R, Pearson M, Hunt H, Moxham T, R A (2010). Preventing obesity using a ‘whole system’ at local and community level: Identifying the key elements and interactions of a whole system approach to obesity prevention. Author URL.
Pearson M, Hunt H, Garside R, Moxham T, Peters J, R A (2010). Preventing unintentional injuries among under-15s: outdoor play and leisure – systematic review of effectiveness of educational interventions. Author URL.

Publications by year


In Press

Garside R, Pearson M, Hunt HA, Moxham T, Anderson R (In Press). Identifying the key elements and interactions of a whole system approach to obesity prevention. NICE Centre for Public Health Excellence, NICE. Abstract.  Author URL.

2017

Hunt HA, Hyde CJ (2017). An overview of systematic reviews summarising the accuracy of brief cognitive assessments for identifying dementia in primary care. Methods for Evaluating Medical Tests and Biomarkers. 19th - 20th Jul 2016. Abstract.  Full text.
Hunt HA, Van Kampen S, Takwoingi Y, Llewellyn DJ, Pearson M, Hyde CJ (2017). The comparative diagnostic accuracy of the Mini Mental State Examination (MMSE) and the General Practitioner assessment of Cognition (GPCOG) for identifying dementia in primary care: a systematic review protocol. Diagnostic and Prognostic Research, 1, 1-6. Full text.

2015

Pearson M, Hunt HA, Cooper C, Shepperd S, Pawson R, Anderson R (2015). Providing effective and preferred care closer to home: a realist review of intermediate care. Health and Social Care in the Community, 2(23). Full text.
Hunt HA, Stanworth S, Curry N, Wolley T, Cooper C, Ukoumunne O, Zhelev Z, Hyde C (2015). Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) for trauma-induced coagulopathy in adult trauma patients with bleeding. Cochrane Database of Systematic Reviews 2015(2). Full text.

2013

Hunt HA, Hardwick RJ (2013). An analysis of theory building in realist synthesis: perspectives from the literature. 21st Cochrane Colloquium 2013.
Hunt HA, Hyde CJ, Ukoumunne O, Cooper C (2013). Identifying uncontrolled haemorrhage after trauma. University of Exeter Medical School Medical and Health Research Showcase 2013.
Hunt HA, Hyde CJ, Pearson M (2013). Realist synthesis – what is it and how could it add value to the diagnosis of dementia in primary care?. Methods for Evaluating Medical Tests and Biomarkers Symposium 2013.
Zhelev Z, Hunt HA, Hyde CJ (2013). The reporting of research design of diagnostic test accuracy (DTA) studies in the abstracts in major medical journals. Methods for Evaluating Medical Tests and Biomarkers Symposium 15th – 16th July 2013; Birmingham, UK.
Hunt HA, Hyde CJ, Stanworth S, Curry N, Perel P, Woolley T, Cooper C, Ukoumunne O (2013). Thromboelastography (TEG) and thromboelastometry (ROTEM) for trauma-induced coagulopathy in adult trauma patients with bleeding [Protocol]. Cochrane Database of Systematic Reviews 2013 Full text.
Zhelev Z, Hunt H, Hyde CJ (2013). Using QUADAS-2 in systematic reviews of Diagnostic Test Accuracy (DTA) studies: Survey of users’ experience. 21st Cochrane Colloquium 2013.

2012

Pearson MN, Hunt HA, Anderson R (2012). Assessing the quality of sources in a systematic review of implementation: Reflections from a realist review. 12th Annual Colloquium of the Campbell Collaboration 2012 29th – 31st May; Copenhagen, Denmark.
Pearson M, Hunt HA, Anderson R (2012). Assessing the quality of sources in a systematic review of implementation: Reflections from a realist review.
Pearson MN, Hunt HA, Cooper C, Shepherd S, Pawson R, Anderson R (2012). Moving care closer to home through intermediate care: a realist review of what works for whom and why. Delivering better health services: Health Services Research Network Symposium 2012; 19th & 20th June; Manchester, UK.
Pearson P, Hunt HA, Cooper C, Shepperd S, Pawson R, Anderson R (2012). Moving care closer to home through intermediate care: a realist review of what works for whom and why.
Hunt H, Pearson M, Cooper C, Shepperd S, Pawson R, Anderson R (2012). Moving care closer to home through intermediate care: developing a conceptual framework. Health Services Research Network Symposium 2012.
Hunt HA, Pearson P, Cooper C, Shepperd S, Pawson R, Anderson R (2012). Moving care closer to home through intermediate care: developing a conceptual framework.
Hunt HA, Anderson R, Coelho HF, Garside R, Bayliss S, Fry-Smith A (2012). Preventing obesity: the effectiveness of whole system approaches. NICE Programme Development Group, NICE. Author URL.
Pearson M, Hunt H, Garside R, Moxham T, Peters J, Anderson R (2012). Preventing unintentional injuries to children under 15 years in the outdoors: a systematic review of the effectiveness of educational programs. Inj Prev, 18(2), 113-123. Abstract.  Author URL.  Full text.
Pearson M, Hunt H, Cooper C, Shepperd S, Pawson R, Anderson R (2012). The effective and cost-effective use of intermediate, step-down, hospital at home and other forms of community care as an alternative to acute inpatient care: a realist review., NIHR. Author URL.

2011

Hunt H, Anderson R (2011). Whole system approaches to obesity prevention case studies: Analysis of documentary evidence from three localities – Sheffield, Newcastle-upon-Tyne, and Barking & Dagenham.

2010

Garside R, Pearson M, Hunt H, Moxham T, R A (2010). Preventing obesity using a ‘whole system’ at local and community level: Identifying the key elements and interactions of a whole system approach to obesity prevention. Author URL.
Pearson M, Hunt H, Garside R, Moxham T, Peters J, R A (2010). Preventing unintentional injuries among under-15s: outdoor play and leisure – systematic review of effectiveness of educational interventions. Author URL.

I teach Yr 1 and Yr2 sessions as part of the Clinical Decision Making and Using Evidence Based Medicine modules for University of Exeter Medical School BMBS medical students.

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