Dr Zhivko Zhelev

I am a health services researcher with a background in clinical psychology and systemic family therapy, specialising in evidence synthesis across health and social care. My work integrates applied and methodological research, with expertise spanning systematic reviews, qualitative and mixed-methods synthesis, and economic evaluation, including cost-effectiveness modelling.

I am currently based within the Exeter NIHR HSDR Evidence Synthesis Centre, where I contribute to a portfolio of policy-relevant evidence synthesis projects. My work focuses on the synthesis of complex evidence across diverse areas, including remote monitoring, data sharing between health and social care, patient safety, and service delivery models such as extra-care housing. Through this role, I engage closely with decision-makers and evidence users to produce research that is methodologically rigorous, timely and directly relevant to policy and practice.

My current research programme centres on the intersection of artificial intelligence (AI), equity, diversity and inclusion (EDI) and evidence synthesis. I am particularly interested in how AI-supported methods are transforming evidence synthesis workflows and evidence ecosystems, and in developing approaches to ensure that these advances are implemented in ways that are transparent, equitable and inclusive. This includes examining how EDI is conceptualised and operationalised within evidence synthesis, how AI may amplify or mitigate inequities, and how stakeholder perspectives - including public and patient involvement - can be meaningfully integrated into AI-enabled processes. 
I contribute to national initiatives in this area, including involvement in the NIHR Evidence Synthesis Programme’s Best Practice Working Groups on automation and EDI, and methodological research on AI-supported evidence synthesis, such as a Study-Within-A-Review examining AI-assisted data extraction. My work aims to inform the development of frameworks, guidance and infrastructure for responsible, EDI-informed use of AI in evidence synthesis.

Alongside this, I have an established programme of research on the evaluation of medical tests, including diagnostic accuracy and the assessment of emerging AI-based technologies. As a member of the Exeter Test Group, I have led and contributed to systematic reviews of test accuracy across a range of clinical areas, including AI-based screening for diabetic retinopathy, hearing screening in children, pre-hospital stroke assessment, and tests for cow’s milk protein allergy. This work has informed national policy, including recommendations by the UK National Screening Committee.. I have also contributed to methodological research on the design, conduct and reporting of test accuracy studies, and on how such evidence is used in decision-making. 

In addition to my research, I contribute to education and capacity building in evidence-based practice and research methods. I teach on the “Making sense of evidence” programme for undergraduate medical students and healthcare professionals, supervise students across undergraduate to doctoral levels, and contribute to institutional and national initiatives related to research ethics, evidence use, and trustworthy AI. I am a member of the University of Exeter Institute of Data Science and AI and have held a leadership role in the Trustworthy AI theme, reflecting my commitment to advancing responsible and inclusive AI in health research.

Broad research specialisms:

• Systematic reviews and evidence syntheses for policy making
• Primary and secondary research related to the evaluation and use of medical tests
• Health economic modelling, particularly for the evaluation of medical tests
• Assessment of the effectiveness and cost-effectiveness of artificial intelligence based medical tests

Interests:

I have a particular interest in the following research areas:

• AI-supported evidence synthesis 
• Equality, Diversity and Inclusion in evidence synthesis
• philosophy and social theory of evidence-based healthcare
• communication of research evidence, especially related to medical tests, to various audiences
• teaching evidence-based practice
• multidisciplinary research
• the relationship between environment and health

Qualifications:

Learning and Teaching in Higher Education (LTHE) programme (Unit 1 completed, currently enrolled on Units 2-6)

Advanced training in Decision Modelling for Health Economic Evaluation (University of York, 2022)

PhD, Disability Discourses in Modern Bulgarian Society (University of Plymouth, 2009)

Advanced Clinical Training in Systemic Family Therapy (University of London & New Bulgarian University, 2000)

MSc in Clinical Psychology (University of Sofia, 1994)

BSc in Psychology (University of Sofia, 1992)

Career:

I completed the Masters in Clinical Psychology programme (University of Sofia, Bulgaria) in 1994. I worked as a clinical psychologist and lecturer in psychology at the New Bulgarian University and Burgas Free University until 2001. More specifically, I was a cofounder of the New Bulgarian University’s counselling service for students with substance abuse problems and the Bulgarian National Harm Reduction programme; I initiated various projects for families with disabled children, such as family counselling provided in conjunction with horseback riding therapy. I was also part of a team that initiated various collaboration research and leadership development projects with Roma communities in different parts of Bulgaria. I was involved in setting up and running the Social Work programme at the Burgas Free University and worked there as a lecturer until 2001. In 2000 I completed my Advanced Clinical Training in Systemic Family Therapy and contributed to the setting up of the Family Therapy programme at the New Bulgarian University. From 1997 to 2001 I acted as a Clinical Director of a private counselling centre in Sofia, Bulgaria.

I moved to the UK in 2001 and worked as care assistant at residential homes for young people with learning disabilities. In 2004 I joined the Little House Contact Centre team in Exeter. My role there was to prepare assessments for family courts and provide support and safe environment for contact between children and non-resident parents, especially when there are allegations or risk of child abuse or domestic violence. Between 2009 and 2011 I worked as a Research and Development Officer at The Dartington Hall Trust, as part of their Research for Adults team. My role was to prepare evidence syntheses reports commissioned by adult social services teams from different local authorities.

I joined the University of Exeter Medical School in 2011. Initially, I worked as a qualitative researcher looking at the difficulties that clinicians and policy makers experience when interpreting the results from Cochrane diagnostic accuracy reviews. Later I was appointed as a research fellow in diagnostics within the NIHR Applied Research Collaboration South West Peninsula (PenCLAHRC) working mostly on systematic reviews of test accuracy studies. Since 2018 I’ve been working on a string of systematic review projects commissioned by Public Health England.