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Dr Luke Mounce

Dr Luke Mounce

Research Fellow

 2900

 +44 (0) 1392 722900

 College House 1.20

 

College House, University of Exeter, St Luke's Campus, Heavitree Road, Exeter, EX1 2LU, UK

I am a Research Fellow with Professor Willie Hamilton's Diagnosis of Symptomatic Cancer Optimally (DISCO) research group.  Since receiving my PhD at the end of 2011, I have been a Health Services Researcher with a particular focus on methodology, database management, and applied statistics.  Previously, I have worked with the Epidemiology and Public Health, Primary Care, Health Services and Policy Research, and Health Statistics research groups at UEMS.

My research has investigated the quality of healthcare provided to older people with chronic health conditions, the causes and consequences of having multiple chronic conditions (multimorbidity), the assessment of instruments for capturing patients' experiences of Primary Care, and the risk of side effects from second-line diabetes medication.

I currently lead the analyses on the NORMA project, which is investigating the risk of cancer in patients with a high-normal platelet count (a successor to Dr Sarah Bailey's PhD work, which found patients with thrombocytosis to be at greatly increased cancer risk).

Broad Research Specialisms

I have expertise in database management (including database linkage), data cleaning, and leading analyses on large observational datasets, notably:

  • The Clinical Practice Research Datalink (CPRD), the largest database of electronic Primary Care records in the world (approximately 60 million records).
  • The English Longitudinal Study of Ageing (ELSA), a national panel study (approximately 11,000 cases and 4,500 variables per wave).
  • The UK General Practice Patient Survey (GPPS), which is the largest survey of patients’ experiences of Primary Care undertaken in the world (2.7 million annual responses). 

He has also worked with primary data, particularly around the development and validation of questionnaires (using both Classical Test Theory, and Item Response Theory) and a feasibilty RCT.

Longitudinal modelling is another area of my expertise.  I undertook a Graduate Certificate in Statistics with the University of Sheffield after senior colleagues recognised my aptitude in health modelling, and have been lead quantitative analyst on projects since obtaining my PhD.  In particular, I have utilised:

  • Linear and logistic regressions
  • Flexible parametric survival models
  • Exploratory and confirmatory factor analyses
  • Structural equation modelling
  • ANOVA and ANCOVA
  • Rasch modelling
  • Psychometrics

Qualifications

BSc (hons) in Psychology (Exeter, UK)

MSc in Psychological Research Methods (Exeter, UK)

PhD in Psychology (focus: clinical neuropsychology) (Exeter, UK)

Graduate Certificate in Statistics (Sheffield, UK)

Research

Research interests

I am a methodologist, and seek to translate clinically important research questions into a scientifically rigorous research protocol, and then to carry that out.

I especially like using large observational databases.  Although experimental studies eliminate more bias, and are as such more sound, I believe use of linked routine data will be increasingly important in health research and monitoring going forward.

My particular interests are:

  • Longitudinal modelling of health outcomes
  • Management of large datasets
  • Latent variable modelling
  • Psychometrics and Item Response Theory
  • Qusasi-experimental approaches for reducing bias in observational data

Research projects

My current role is lead analyst on a project in cancer diagnostics titled "Are patients with high normal platelet counts at increased risk of cancer? The NORMA study."  Previous work has shown that patients with high platelet counts (thrombocytosis) are at much higher risk of cancer than the 3% criterion indicated in NICE referral guidelines for suspected cancer.  The aim of NORMA, therefore, is to investigate the risk of cancer in patients at the high-end of the normal range of platelet count.  This project will involve analysing the anonymised electronic health records of ~300,000 patients, contained in the Clinical Practice Research Datalink, to explore how cancer risk varies by age, gender, and platelet count.  NORMA is funded by the Policy Research Unit.

 


I am involved in projects covering a number of other work-streams:

Patient Safety

  • Developing short-form versions of the Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire.  PREOS-PC is a recently developed patient reported outcome measure (PROM) of experiences safety in Primary Care, consisting of 54 items and 11 scales.  This project is developing a compact version of the instrument, retaining the scales, but using a reduced number of items, as well as a short 6 item screening tool.  This process is being informed by use of both Classical Test Theory and Item Response Theory, and uses data collected for the development of the original measure.
  • An investigation of the impact of multimorbidity on patient safety, using the PREOS-PC questionnaire.

Determinants and Impact of Multimorbidity

  • An investigation into the socio-demographic and lifestyle determinants of multimorbidity (having two or more chronic conditions) in older people, using the English Longitudinal Study of Aging (ELSA).  This is a prospective cohort study, following participants over ten years.
  • The impact of multimorbidity on ease of cancer diagnosis.  Using CPRD, we are exploring how the presence of additional conditions affects the time taken to diagnose lung cancer after presentation of the first sign/symptom.

Key publications | Publications by category | Publications by year

Key publications


Mounce LTA, Price S, Valderas JM, Hamilton W (2017). Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records. Br J Cancer, 116(12), 1536-1543. Abstract.  Author URL.  Full text.
Steel N, Hardcastle AC, Bachmann MO, Richards SH, Mounce LTA, Clark A, Lang I, Melzer D, Campbell JL (2015). Economic inequalities in burden of illness, diagnosis and treatment of five long-term conditions in England: panel study. BMJ Open, 4(10). Abstract.  Full text.
Steel N, Hardcastle AC, Clark A, Mounce LTA, Bachmann MO, Richards SH, Henley WE, Campbell JL, Melzer D (2014). Self-reported quality of care for older adults from 2004 to 2011: a cohort study. Age Ageing, 43(5), 716-720. Abstract.  Author URL.  Full text.
Mounce LTA, Williams WH, Jones JM, Harris A, Haslam SA, Jetten J (2013). Neurogenic and psychogenic acute postconcussion symptoms can be identified after mild traumatic brain injury. J Head Trauma Rehabil, 28(5), 397-405. Abstract.  Author URL.
Davies RC, Williams WH, Hinder D, Burgess CN, Mounce LT (2012). Self-reported traumatic brain injury and postconcussion symptoms in incarcerated youth. J Head Trauma Rehabil, 27(3), E21-E27. Abstract.  Author URL.
Tonks J, Williams WH, Mounce L, Harris D, Frampton I, Yates P, Slater A (2011). 'Trails B or not Trails B?' is attention-switching a useful outcome measure?. Brain Inj, 25(10), 958-964. Abstract.  Author URL.

Publications by category


Journal articles

Mounce LTA, Williams WH, Harris A, Yates PJ, Llewellyn D (In Press). Deprivation increases risk of head versus orthopaedic injury in children and young people.
Mounce LTA, Barry HE, Calitri R, Henley WE, Campbell J, Roland M, Richards S (In Press). Establishing the validity of English GP Patient Survey items evaluating out-of-hours care. BMJ Qual Saf, 25(11), 842-850. Abstract.  Author URL.  Full text.
Mounce LTA, Price S, Valderas JM, Hamilton W (2017). Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records. Br J Cancer, 116(12), 1536-1543. Abstract.  Author URL.  Full text.
Burt J, Campbell J, Abel G, Aboulghate A, Ahmed F, Asprey A, Barry H, Beckwith J, Benson J, Boiko O, et al (2017). Improving patient experience in primary care: a multimethod programme of research on the measurement and improvement of patient experience. Programme Grants for Applied Research, 5(9), 1-452. Full text.
Wright C, Davey A, Elmore N, Carter M, Mounce L, Wilson E, Burt J, Roland M, Campbell J (2017). Patients' use and views of real-time feedback technology in general practice. Health Expect, 20(3), 419-433. Abstract.  Author URL.  Full text.
Davey AF, Roberts MJ, Mounce L, Maramba I, Campbell JL (2016). Test–retest stability of patient experience items derived from the national GP patient survey. SpringerPlus, 5(1). Abstract.  Full text.
Steel N, Hardcastle AC, Bachmann MO, Richards SH, Mounce LTA, Clark A, Lang I, Melzer D, Campbell JL (2015). Economic inequalities in burden of illness, diagnosis and treatment of five long-term conditions in England: panel study. BMJ Open, 4(10). Abstract.  Full text.
Ricci-Cabello I, Violán C, Foguet-Boreu Q, Mounce LTA, Valderas JM (2015). Impact of multi-morbidity on quality of healthcare and its implications for health policy, research and clinical practice. A scoping review. Eur J Gen Pract, 21(3), 192-202. Abstract.  Author URL.  Full text.
Mounce LTA, Steel N, Hardcastle AC, Henley WE, Bachmann MO, Campbell JL, Melzer D, Richards SH (2015). Patient characteristics predicting failure to receive indicated care for type 2 diabetes. Diabetes Research and Clinical Practice, 107(2), 247-258. Abstract.  Full text.
Hardcastle AC, Mounce LT, Richards SH, Bachmann MO, Clark A, Henley WE, Campbell JL, Melzer D, Steel N (2015). The dynamics of quality: a national panel study of evidence-based standards. Health Services and Delivery Research, 3(11), 1-128. Full text.
Hughes N, Williams WH, Chitsabesan P, Walesby RC, Mounce LTA, Clasby B (2015). The prevalence of traumatic brain injury among young offenders in custody: a systematic review. J Head Trauma Rehabil, 30(2), 94-105. Abstract.  Author URL.
Steel N, Hardcastle AC, Clark A, Mounce LTA, Bachmann MO, Richards SH, Henley WE, Campbell JL, Melzer D (2014). Self-reported quality of care for older adults from 2004 to 2011: a cohort study. Age Ageing, 43(5), 716-720. Abstract.  Author URL.  Full text.
Hardcastle A, Mounce LT, Steel N (2013). HAS THE QUALITY OF CARE WORSENED FOR GERIATRIC CONDITIONS?. GERONTOLOGIST, 53, 204-204. Author URL.
Mounce LTA, Williams WH, Jones JM, Harris A, Haslam SA, Jetten J (2013). Neurogenic and psychogenic acute postconcussion symptoms can be identified after mild traumatic brain injury. J Head Trauma Rehabil, 28(5), 397-405. Abstract.  Author URL.
Hardcastle A, Mounce LT, Steel N (2013). WHAT PREDICTS QUALITY OF CARE: RESULTS FROM THE ENGLISH LONGITUDINAL STUDY OF AGEING. GERONTOLOGIST, 53, 205-205. Author URL.
Mounce L, Williams H (2012). Outcome following Mild Traumatic Brain Injury: the interplay of concussion and post-traumatic stress. BRAIN INJURY, 26(4-5), 638-639. Author URL.
Davies RC, Williams WH, Hinder D, Burgess CN, Mounce LT (2012). Self-reported traumatic brain injury and postconcussion symptoms in incarcerated youth. J Head Trauma Rehabil, 27(3), E21-E27. Abstract.  Author URL.
Tonks J, Williams WH, Mounce L, Harris D, Frampton I, Yates P, Slater A (2011). 'Trails B or not Trails B?' is attention-switching a useful outcome measure?. Brain Inj, 25(10), 958-964. Abstract.  Author URL.

Conferences

Mounce LTA (2014). Do Patient’s Characteristics Predict Failure to Receive Care for Type 2 Diabetes?. Society for Academic Primary Care (regional). 6th - 7th Mar 2014.
Mounce LTA (2014). Do Patient’s Characteristics Predict Failure to Receive Care for Type 2 Diabetes?. Society for Academic Primary Care. 9th - 11th Jul 2014. Abstract.
Hardcastle AC, Mounce LTA, Steel N (2014). What predicts quality of care: results from the English Longitudinal Study of Ageing. Gerontological Society of America 66th annual scientific meeting. 14th - 18th Nov 2014.
Hardcastle AC, Mounce LTA, Steel N (2014). What predicts quality of care: results from the English Longitudinal Study of Ageing. Gerontological Society of America 66th annual scientific meeting. 14th - 18th Nov 2014.
Mounce LTA (2012). Outcome following mild traumatic brain injury: the interplay of concussion and post-traumatic stress. 9th World Congress on Brain Injury. 22nd - 25th Mar 2012.
Mounce LTA, Williams WH (2011). The Neurological and Psychological Roots of Post-Concussion Syndrome After MTBI: the Role of Traumatic Re-Experiencing. 4th Pacific Rim Meeting. 6th - 9th Jul 2011.
Mounce LTA, Williams WH (2010). Does acute stress predict mTBI symptoms?. Annual Meeting of Emergency Medicine. 22nd - 25th Mar 2010.
Mounce LTA (2007). Risk of psychiatric disorder in children with congenital versus acquired brain-dysfunction. 4th Satellite Symposium on Neuropsychological Rehabilitation. 9th - 11th Jul 2007.

Reports

Melzer D, Tavakoly B, Winder R, Richards S, Mounce LTA, Gericke C, Lang I (2012). Health Care Quality for an Active Later Life: Improving quality of prevention and treatment through information - England 2005 to 2012. A report from the Peninsula College of Medicine and Dentistry Ageing Research Group for Age UK.

Publications by year


In Press

Mounce LTA, Williams WH, Harris A, Yates PJ, Llewellyn D (In Press). Deprivation increases risk of head versus orthopaedic injury in children and young people.
Mounce LTA, Barry HE, Calitri R, Henley WE, Campbell J, Roland M, Richards S (In Press). Establishing the validity of English GP Patient Survey items evaluating out-of-hours care. BMJ Qual Saf, 25(11), 842-850. Abstract.  Author URL.  Full text.

2017

Mounce LTA, Price S, Valderas JM, Hamilton W (2017). Comorbid conditions delay diagnosis of colorectal cancer: a cohort study using electronic primary care records. Br J Cancer, 116(12), 1536-1543. Abstract.  Author URL.  Full text.
Burt J, Campbell J, Abel G, Aboulghate A, Ahmed F, Asprey A, Barry H, Beckwith J, Benson J, Boiko O, et al (2017). Improving patient experience in primary care: a multimethod programme of research on the measurement and improvement of patient experience. Programme Grants for Applied Research, 5(9), 1-452. Full text.
Wright C, Davey A, Elmore N, Carter M, Mounce L, Wilson E, Burt J, Roland M, Campbell J (2017). Patients' use and views of real-time feedback technology in general practice. Health Expect, 20(3), 419-433. Abstract.  Author URL.  Full text.

2016

Davey AF, Roberts MJ, Mounce L, Maramba I, Campbell JL (2016). Test–retest stability of patient experience items derived from the national GP patient survey. SpringerPlus, 5(1). Abstract.  Full text.

2015

Steel N, Hardcastle AC, Bachmann MO, Richards SH, Mounce LTA, Clark A, Lang I, Melzer D, Campbell JL (2015). Economic inequalities in burden of illness, diagnosis and treatment of five long-term conditions in England: panel study. BMJ Open, 4(10). Abstract.  Full text.
Ricci-Cabello I, Violán C, Foguet-Boreu Q, Mounce LTA, Valderas JM (2015). Impact of multi-morbidity on quality of healthcare and its implications for health policy, research and clinical practice. A scoping review. Eur J Gen Pract, 21(3), 192-202. Abstract.  Author URL.  Full text.
Mounce LTA, Steel N, Hardcastle AC, Henley WE, Bachmann MO, Campbell JL, Melzer D, Richards SH (2015). Patient characteristics predicting failure to receive indicated care for type 2 diabetes. Diabetes Research and Clinical Practice, 107(2), 247-258. Abstract.  Full text.
Hardcastle AC, Mounce LT, Richards SH, Bachmann MO, Clark A, Henley WE, Campbell JL, Melzer D, Steel N (2015). The dynamics of quality: a national panel study of evidence-based standards. Health Services and Delivery Research, 3(11), 1-128. Full text.
Hughes N, Williams WH, Chitsabesan P, Walesby RC, Mounce LTA, Clasby B (2015). The prevalence of traumatic brain injury among young offenders in custody: a systematic review. J Head Trauma Rehabil, 30(2), 94-105. Abstract.  Author URL.

2014

Mounce LTA (2014). Do Patient’s Characteristics Predict Failure to Receive Care for Type 2 Diabetes?. Society for Academic Primary Care (regional). 6th - 7th Mar 2014.
Mounce LTA (2014). Do Patient’s Characteristics Predict Failure to Receive Care for Type 2 Diabetes?. Society for Academic Primary Care. 9th - 11th Jul 2014. Abstract.
Steel N, Hardcastle AC, Clark A, Mounce LTA, Bachmann MO, Richards SH, Henley WE, Campbell JL, Melzer D (2014). Self-reported quality of care for older adults from 2004 to 2011: a cohort study. Age Ageing, 43(5), 716-720. Abstract.  Author URL.  Full text.
Hardcastle AC, Mounce LTA, Steel N (2014). What predicts quality of care: results from the English Longitudinal Study of Ageing. Gerontological Society of America 66th annual scientific meeting. 14th - 18th Nov 2014.
Hardcastle AC, Mounce LTA, Steel N (2014). What predicts quality of care: results from the English Longitudinal Study of Ageing. Gerontological Society of America 66th annual scientific meeting. 14th - 18th Nov 2014.

2013

Hardcastle A, Mounce LT, Steel N (2013). HAS THE QUALITY OF CARE WORSENED FOR GERIATRIC CONDITIONS?. GERONTOLOGIST, 53, 204-204. Author URL.
Mounce LTA, Williams WH, Jones JM, Harris A, Haslam SA, Jetten J (2013). Neurogenic and psychogenic acute postconcussion symptoms can be identified after mild traumatic brain injury. J Head Trauma Rehabil, 28(5), 397-405. Abstract.  Author URL.
Hardcastle A, Mounce LT, Steel N (2013). WHAT PREDICTS QUALITY OF CARE: RESULTS FROM THE ENGLISH LONGITUDINAL STUDY OF AGEING. GERONTOLOGIST, 53, 205-205. Author URL.

2012

Melzer D, Tavakoly B, Winder R, Richards S, Mounce LTA, Gericke C, Lang I (2012). Health Care Quality for an Active Later Life: Improving quality of prevention and treatment through information - England 2005 to 2012. A report from the Peninsula College of Medicine and Dentistry Ageing Research Group for Age UK.
Mounce L, Williams H (2012). Outcome following Mild Traumatic Brain Injury: the interplay of concussion and post-traumatic stress. BRAIN INJURY, 26(4-5), 638-639. Author URL.
Mounce LTA (2012). Outcome following mild traumatic brain injury: the interplay of concussion and post-traumatic stress. 9th World Congress on Brain Injury. 22nd - 25th Mar 2012.
Davies RC, Williams WH, Hinder D, Burgess CN, Mounce LT (2012). Self-reported traumatic brain injury and postconcussion symptoms in incarcerated youth. J Head Trauma Rehabil, 27(3), E21-E27. Abstract.  Author URL.

2011

Tonks J, Williams WH, Mounce L, Harris D, Frampton I, Yates P, Slater A (2011). 'Trails B or not Trails B?' is attention-switching a useful outcome measure?. Brain Inj, 25(10), 958-964. Abstract.  Author URL.
Mounce LTA, Williams WH (2011). The Neurological and Psychological Roots of Post-Concussion Syndrome After MTBI: the Role of Traumatic Re-Experiencing. 4th Pacific Rim Meeting. 6th - 9th Jul 2011.

2010

Mounce LTA, Williams WH (2010). Does acute stress predict mTBI symptoms?. Annual Meeting of Emergency Medicine. 22nd - 25th Mar 2010.

2007

Mounce LTA (2007). Risk of psychiatric disorder in children with congenital versus acquired brain-dysfunction. 4th Satellite Symposium on Neuropsychological Rehabilitation. 9th - 11th Jul 2007.

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Luke was an Associate Teaching Fellow for four years during his PhD in Psychology.  Since joining the Medical School, Luke as been a tutor on the Making Sense of Evidence module for BMBS students, and demonstrated statastics as part of the Fundamental Skills for Medical Scientists module on the Medical Science bachelors degree.

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