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 a number of clinical groups in UEMS and beyond to support evaluation. Pre-eminent among these is Prof Hattersley’s team. Chris, Jaime Peters and Rob Anderson are using economic modelling alongside a series of clinical studies to assess the effectiveness and cost-effectiveness of systematically testing for genetically determined diabetes (the UNITED project). A similar approach is being used to evaluate the effectiveness and cost-effectiveness of school entry hearing screening working with Prof Fortnum’s audiology group in Nottingham.

Traditional economic modelling and systematic reviewing, independent of new data collection, remains the mainstay of our evaluative approach. I am closely involved with the Cochrane Collaboration Dementia and Cognitive Improvement Group’s work to systematically review accuracy studies on the wide range of tests which have been suggested for dementia. Working with Harriet Hunt I am contributing to an NIHR programme grant on coagulopathy in trauma through systematic reviews on the value of TEG and ROTEM. Our Technology Appraisal Group have recently completed health technology assessments on OSNA for sentinel lymph node biopsy in breast cancer and testing strategies for Lynch syndrome.

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 in Birmingham. Chris and colleagues at UEMS are currently considering whether our existing classifications and descriptions of different research designs for test evaluation are adequate. He contributed to NICE’s methods guidance on the appraisal of tests.

Chris and colleagues are also working directly to translate research into practice through the Peninsula CLAHRC. We have been fostering skill development in systematic reviews of test accuracy using CT coronary angiography and high sensitivity troponin in acute MI as exemplars. Chris helps direct a team exploring the reasons for variation of thyroid function test ordering in primary care as a prelude to an evidence based approach to reducing variation in test use (the UNTEST project). Led by Chris, Zhivko Zhelev undertook an innovative application of cognitive interviewing to the investigation of what readers understand when reading the newly introduced Cochrane reviews of test accuracy.

Chris remains committed to policy making. He leads the Technology Appraisal Report team providing 4 to 6 health technology assessments or appraisals of manufacturer submissions to NICE annually. He also sits on NICE’s Diagnostics Appraisal Committee.

Chris describes his research into the impact of tests on patients as part of the Exeter Test Group and PenTAG (the Peninsula Technology Assesment Group), in the video below.

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Qualifications:

• MB BS (St Thomas’s Hospital, London)
• MRCP
• FFPH