Professor Christopher Hyde

About me:

Chris Hyde was recruited to Exeter in 2009. He is a lead for research on test evaluation including systematic reviews, economic models and primary research. He directs the Exeter Test Group. He directed PenTAG the team delivering health technology assessments for national policy-making bodies, particularly NICE, from 2009 until 2015. He is a member of the National Screening Committee and was previously a member of NICE's Diagnostic Advisory Committee.

Chris qualified in medicine in 1986 and worked in general medicine until 1990. He then undertook specialist training in Public Health, completing this in 1996. In 1994 he did a placement at the UK Cochrane Centre as part of his specialist training and became interested in using research to inform decisions about health. In 1996 he set up and directed a unit based in the University of Birmingham to support commissioners of health care use research (ARIF) which continued until 2012. He became progressively more active in doing research as well as disseminating it and became Director of the West Midlands Health Technology Assessment Collaboration (WMHTAC) in 2007. He was also closely involved in setting up the NHS Blood & Transplant Systematic Reviews Initiative and has contributed to the work of the Cochrane Collaboration since its inception.

Throughout his career Chris has been variously intrigued and frustrated by research on tests and their interpretation. He has done many systematic reviews and health economic models on a wide variety tests including near patient tests in primary care, novel methods of processing cervical smears, hysteroscopy, tests for predicting preeclampsia and preterm birth, PET/CT scanning for breast cancer and OSNA for sentinel lymph node biopsy in breast cancer. A recurring theme is that test evaluations are often not fit for purpose and provide only indirect evidence about whether a new test will benefit patients and society if introduced. Helping to improve this situation is the main purpose of Chris’s research at UEMS.

Broad research specialisms:

Systematic reviews and meta-analysis

Health economic modelling

Health technology assessment

Test evaluation

Research dissemination

Health policy making

Interests:

Test evaluation is Chris’s main area of interest. He works closely with clinical groups to support their evaluations of new approaches to clinical care. Pre-eminent among these in Exeter is Prof Hattersley’s team. Chris from Jaime Peters from the Exeter Test Group used economic modelling alongside a series of clinical studies performed by the Diabetes group to assess the effectiveness and cost-effectiveness of systematically testing for genetically determined diabetes (the UNITED project). A similar approach was subsequently used to evaluate the effectiveness and cost-effectiveness of school entry hearing screening working with the audiology group in Nottingham.

Traditional economic modelling and systematic reviewing, independent of new data collection, remains the mainstay of our evaluative approach. This is often referred to as health technology assessment (HTA). A recent example would be our joint work with Tristan Snowsill of the Health Economic Group in Exeter and ourselves assessing the cost-effectiveness of low dose CT scanning for the targeted screening of lung cancer. The ENaBL model (Exeter Natural history based model of Lung cancer screening) was central to the UK National Screening Committee’s recent decision to recommend screening for lung cancer be introduced.

Chris is committed to methodological development. He was closely involved with the development of a new evaluation framework for tests by Lavinia Ferrante di Ruffano during her PhD in Birmingham funded by the MRC. The MRC has supported recent further development of the work in the MRC TEST project resulting in a recent critique of international HTA methods for evaluating tests which won the Egon Jonsson prize in 2024. He also has a long association with the QUADAS group which is the main quality assessment tool for diagnostic test accuracy studies. The group has recently published QUADAS-3, the third iteration of the tool. Chris is closely associated concepts like the importance of considering value proposition in the evaluation of tests and the need to assess comparative accuracy.

Chris remains committed to policy making. He led PenTAG the Technology Appraisal Report team providing 4 to 6 health technology assessments or appraisals of manufacturer submissions to NICE annually from 2009 until 2015. He was a member of NICE’s Diagnostics Appraisal Committee for 10 years and was its vice-Chair. He then became a member of the UK National Screening Committee where he is a source of expertise on public health and cost-effectiveness, including the recent recommendation on prostate cancer screening.

Chris and colleagues have also worked directly to translate research into practice working through the South West CLAHRC before its evolution into the ARC. The Exeter Test Group fostered skill development in systematic reviews of test accuracy using CT coronary angiography and high sensitivity troponin in acute MI as exemplars. Chris helped direct a team exploring the reasons for variation of thyroid function test ordering in primary care as a way of exploring an evidence based approach to reducing variation in test use (the UNTEST project). Zhivko Zhelev, another member of the ETG undertook an innovative application of cognitive interviewing to the investigation of what readers understand when reading the newly introduced Cochrane reviews of test accuracy.

Continuing work in translational research, Chris was recently part of the successful application for Exeter to become a HealthTech Research Centre (NIHR HRC Sustainable Innovation). He is the co-lead for the Commercialisation and Capacity theme, with particular responsibility enhancing the NHS’s capacity to do health technology assessment through training and methodological development. He works closely on this with Bogdan Grigore.

Finally Chris and the ETG have been active in working with developers of new tests evaluate their technology. A good example of this is his work with Skin Analytics demonstrating the effectiveness and cost-effectiveness of their AIaMD, DERM, to improve the diagnosis of skin cancer. This includes evaluation of the implementation of DERM to assist in the triage of patients presenting to primary care with lesions they are worried could be skin cancer.

Qualifications:

MB BS (St Thomas’s Hospital, London)

MRCP

FFPH