Journal articles
Bailey S, Green H, Merriel S, Oram R, Thirlwell C, Ruth K, Tyrrell J, Weedon M (In Press). Applying a genetic risk score for prostate cancer to men with lower urinary tract symptoms in primary care to predict prostate cancer diagnosis: a cohort study in the UK Biobank. British Journal of Cancer
Merriel S, Martins T, Bailey S (In Press). Exploring the causes of death among patients with metastatic prostate cancer: a changing landscape. Jama Network Open
Hamilton W, Bailey SER (2023). Colorectal cancer in symptomatic patients: How to improve the diagnostic pathway. Best Practice & Research Clinical Gastroenterology, 66, 101842-101842.
Bailey SER, Butler CAM, Katsampouris E, Kessler L, Quaife SL, Saya S, Merriel SWD (2023). Determining the role of genetic risk scores in symptomatic cancer detection. British Journal of General Practice, 73(728), 106-107.
Green HD, Merriel SWD, Oram RA, Ruth KS, Tyrrell J, Jones SE, Thirlwell C, Weedon MN, Bailey SER (2023). Response to: Genetic risk scores may compound rather than solve the issue of prostate cancer overdiagnosis (BJC-LT3342090).
Br J Cancer,
128(4), 487-488.
Author URL.
Bailey SER, Abel GA, Atkins A, Byford R, Davies S-J, Mays J, McDonald TJ, Miller J, Neck C, Renninson J, et al (2021). Diagnostic performance of a faecal immunochemical test for patients with low-risk symptoms of colorectal cancer in primary care: an evaluation in the South West of England.
British Journal of Cancer,
124(7), 1231-1236.
Abstract:
Diagnostic performance of a faecal immunochemical test for patients with low-risk symptoms of colorectal cancer in primary care: an evaluation in the South West of England
Abstract
. Background
. The faecal immunochemical test (FIT) was introduced to triage patients with low-risk symptoms of possible colorectal cancer in English primary care in 2017, underpinned by little primary care evidence.
.
. Methods
. All healthcare providers in the South West of England (population 4 million) participated in this evaluation. 3890 patients aged ≥50 years presenting in primary care with low-risk symptoms of colorectal cancer had a FIT from 01/06/2018 to 31/12/2018. A threshold of 10 μg Hb/g faeces defined a positive test.
.
. Results
. Six hundred and eighteen (15.9%) patients tested positive; 458 (74.1%) had an urgent referral to specialist lower gastrointestinal (GI) services within three months. Forty-three were diagnosed with colorectal cancer within 12 months. 3272 tested negative; 324 (9.9%) had an urgent referral within three months. Eight were diagnosed with colorectal cancer within 12 months. Positive predictive value was 7.0% (95% CI 5.1–9.3%). Negative predictive value was 99.8% (CI 99.5–99.9%). Sensitivity was 84.3% (CI 71.4–93.0%), specificity 85.0% (CI 83.8–86.1%). The area under the ROC curve was 0.92 (CI 0.86–0.96). A threshold of 37 μg Hb/g faeces would identify patients with an individual 3% risk of cancer.
.
. Conclusions
. FIT performs exceptionally well to triage patients with low-risk symptoms of colorectal cancer in primary care; a higher threshold may be appropriate in the wake of the COVID-19 crisis.
.
Abstract.
Farr WJ, Green D, Bremner S, Male I, Gage H, Bailey S, Speller S, Colville V, Jackson M, Memon A, et al (2021). Feasibility of a randomised controlled trial to evaluate home-based virtual reality therapy in children with cerebral palsy.
Disability and Rehabilitation,
43(1), 85-97.
Abstract:
Feasibility of a randomised controlled trial to evaluate home-based virtual reality therapy in children with cerebral palsy
Purpose: Evidence is increasing for effective virtual reality therapy for motor rehabilitation for children with Cerebral Palsy. We assessed the feasibility of a virtual reality therapy mode of intervention, appropriateness of measures, and potential cost-effectiveness. Methods: a 12-week, 2-group, parallel-feasibility trial (ISRCT 17624388) using Nintendo Wii FitTM at home. Children aged 5–16, with ambulatory Cerebral Palsy, who were able to follow simple instructions were randomised to two groups; one supported by physiotherapists (individualised activity programme), the other unsupported with children having free choice (control). Children were assessed in clinic at baseline, week 6, and week 12 by blinded assessors. Feasibility of the intervention was assessed via recruitment, adherence, and usefulness of measurement tools. Results: Forty-four children were eligible (out of 48 approached): 31 consented, 30 were randomised, 21 completed the study; 10 in the supported group and 11 in the unsupported group. Nine children discontinued from tiredness, after-school activities, homework, surgery, technical difficulties or negative system feedback. The supported group completed 19 of 36 (IQR 5-35) possible sessions; the unsupported group 24 of 36 sessions (IQR 8-36). Gross Motor Function Measure scores varied by Cerebral Palsy severity after the intervention. There were no adverse events. Conclusion: Virtual reality therapy offers potential as a therapeutic adjunct for children with Cerebral Palsy, warranting substantive confirmatory study. Gross Motor Function Measure, with modifications to improve sensitivity, appeared appropriate as a primary measure, with Timed up and Go test secondary. The intervention was inexpensive costing £20 per child. An explanatory trial to evaluate the clinical/cost-effectiveness of commercial system virtual reality therapy is feasible with minor methodological adaptation.Implications for rehabilitation Home-based interactive computer gaming was feasible, safe and cost effective as a therapy adjunct. Discontinue if additional pressures are present: imminent surgery, family resilience to technical difficulties, negative system feedback, after-school activities. Change in Gross Motor Function Measurement scores varied by severity of Cerebral Palsy.
Abstract.
Barlow M, Hamilton W, Ukoumunne OC, Bailey SER (2021). The association between thrombocytosis and subtype of lung cancer: a systematic review and meta-analysis.
Translational Cancer Research,
10(3), 1249-1260.
Abstract:
The association between thrombocytosis and subtype of lung cancer: a systematic review and meta-analysis
Background: Thrombocytosis is associated with poor lung cancer prognosis and has recently been identified as having a high positive predictive value in lung cancer detection. Lung cancer has multiple histological and genetic subtypes and it is not known whether platelet levels differ across these subtypes, or whether thrombocytosis is predictive of a particular subtype. Methods: PubMed and Embase were systematically searched for studies that reported pre-treatment platelet count, as either averages or proportion of patients with thrombocytosis, by subtype of lung cancer using a prespecified search strategy. The Newcastle-Ottowa scale was used to assess study quality and risk of bias. Suitable studies were synthesised in meta-analyses and subgroup analyses examined for differences across subtypes. Results: the prevalence of pre-treatment thrombocytosis across all lung cancer patients was 27% (95% CI: 17% to 37%). By subtype, this was 22% (95% CI: 7% to 41%) for adenocarcinoma, 28% (95% CI: 15% to 43%) for squamous cell carcinoma (SCC), 36% (95% CI: 13% to 62%) for large cell carcinoma (LCC), and 30% (95% CI: 8% to 58%) for small cell lung cancer (SCLC). The pooled mean platelet count for lung cancer patients was 289×109/L (95% CI: 268 to 311). By subtype, this was 282×109/L (95% CI: 259 to 306) for adenocarcinoma, 297×109/L (95% CI: 238 to 356) for SCC, 290×109/L (95% CI: 176 to 404) for LCC, and 293×109/L (95% CI: 244 to 342) for SCLC. There was no difference in thrombocytosis prevalence (P=0.76) or mean platelet count (P=0.96) across the subtypes. Conclusions: These findings suggest thrombocytosis is no more indicative of one lung cancer subtype over another. We therefore conclude a high platelet count is likely to be generic across all lung cancer subtypes.
Abstract.
Clarke C, Hamilton W, Price S, Bailey SER (2020). Association of non-malignant diseases with thrombocytosis: a prospective cohort study in general practice.
British Journal of General Practice,
70(701), E852-E857.
Abstract:
Association of non-malignant diseases with thrombocytosis: a prospective cohort study in general practice
Background Thrombocytosis is an excess of platelets, which is diagnosed as a platelet count >400 × 109/l. An association of thrombocytosis with undiagnosed cancer has recently been established, but the association with non-malignant disease has not been studied in primary care. Aim to examine, in English primary care, the 1-year incidence of non-malignant diseases in patients with new thrombocytosis and the incidence of preexisting non-malignant diseases in patients who develop new thrombocytosis. Design and setting Prospective cohort study using English Clinical Practice Research Datalink data from 2000 to 2013. Method Newly incident and pre-existing rates of non-malignant diseases associated with thrombocytosis were compared between patients with thrombocytosis and age- and sex-matched patients with a normal platelet count. Fifteen candidate non-malignant diseases were identified from literature searches. Results in the thrombocytosis cohort of 39 850 patients, 4579 (11.5%) were newly diagnosed with any one of the candidate diseases, compared with 443 out of 9684 patients (4.6%) in the normal platelet count cohort (relative risk [RR] 2.5, 95% confidence intervals [CI] = 2.3 to 2.8); iron-deficiency anaemia was the most common new diagnosis (4.5% of patients with thrombocytosis, RR 4.9, 95% CI = 4.0 to 6.1). A total of 22 612 (57.0%) patients with thrombocytosis had a preexisting non-malignant diagnosis compared with 4846 patients (50%) in the normal platelet count cohort (odds ratio 1.3, 95% CI = 1.2 to 1.4). There was no statistically significant difference in cancer diagnoses between patients with and without preexisting disease in the thrombocytosis cohort. Conclusion Thrombocytosis is associated with several non-malignant diseases. Clinicians can use these findings as part of their holistic diagnostic approach to help guide further investigations and management of patients with thrombocytosis.
Abstract.
Mounce LTA, Hamilton W, Bailey SER (2020). Cancer incidence following a high-normal platelet count: cohort study using electronic healthcare records from English primary care.
British Journal of General Practice,
70(698), E622-E628.
Abstract:
Cancer incidence following a high-normal platelet count: cohort study using electronic healthcare records from English primary care
Background a raised platelet count (thrombocytosis) measuring >400 × 109/l is associated with high cancer incidence. It is uncertain whether platelet counts at the upper end of the normal range (high-normal: 326–400 × 109/l) are also associated with cancer. Aim to investigate cancer incidence following a normal platelet count in primary care. Design and setting a prospective cohort study was undertaken using data from the Clinical Practice Research Datalink and National Cancer Registration and Analysis Service, dating from 1 May 2005 to 30 April 2014. Method One-year cancer incidence was estimated for 295 312 patients with normal platelet counts (150–400 × 109/l). Patients with platelet counts >325 × 109/l were oversampled to maximise precision of estimates of cancer incidence. All patients were aged ≥40 years with no prior cancer diagnoses. The effects of age, sex, and smoking were explored. Non-melanoma skin cancers were omitted from exclusions and incidence. Results One-year cancer incidence increased greatly with age, male sex, and higher platelet count. Males aged ≥60 years with a high-normal count had an incidence of 4.2% (95% confidence interval [CI] = 4.0 to 4.4). The highest incidence of 6.7% (95% CI = 5.3 to 8.4) was found in males aged ≥80 years, who had platelets in the range of 376–400 × 109/l; this was 3.1 percentage points higher than the incidence for patients in the same age group with lower-normal counts of 150–325 × 109/l. Risks for all female subgroups were
Abstract.
Bailey SER, Abel GA, Atkins A, Byford R, Davies S-J, Mays J, McDonald TJ, Miller J, Neck C, Renninson J, et al (2020). Diagnostic performance of the faecal immunochemical test for patients with low-risk symptoms of colorectal cancer in primary care: a service evaluation in the South West of England.
Abstract:
Diagnostic performance of the faecal immunochemical test for patients with low-risk symptoms of colorectal cancer in primary care: a service evaluation in the South West of England
AbstractObjectivesTo evaluate the faecal immunochemical test (FIT) for primary care clinicians to triage patients with low-risk symptoms of possible colorectal cancer, and to estimate its diagnostic performance.DesignService delivery evaluation.SettingAll primary and secondary care providers in the South West of England, approximate population 4 million.Participants3890 patients aged ≥50 years presenting in primary care with low-risk symptoms of colorectal cancer, following NICE NG12 and DG30, with a FIT (HM-JACKarc assay) analysed from 01/06/2018 to 31/12/2018.Main outcome measuresDiagnosis of colorectal cancer.Results618 (15.9%) patients tested positive at a threshold of 10μg Hb/g faeces (median 36μg Hb/g faeces (IQR 17 to 149)); 458 (74.1%) of these had an urgent referral to specialist lower gastrointestinal (GI) services within three months. 43 were diagnosed with colorectal cancer within 12 months. 3272 patients tested negative; 324 (9.9%) were referred on an urgent lower GI pathway in secondary care within three months. 8 were diagnosed with colorectal cancer within 12 months. The positive predictive value of FIT for colorectal cancer in the low-risk symptomatic population was 7.0% (95% CI 5.1% to 9.3%) and the negative predictive value was 99.8% (CI 99.5% to 99.9%). Sensitivity was 84.3% (CI 71.4% to 93.0%),and specificity 85.0% (CI 83.8% to 86.1%). The area under the ROC curve was 0.92 (CI 0.86 to 0.96). A threshold of 37μg Hb/g faeces would identify patients with an individual 3% risk of cancer.ConclusionsFIT performs exceptionally well to triage patients with low-risk symptoms of colorectal cancer in primary care. The threshold value of 10μg Hb/g faeces represents a risk of cancer below 3% used in current NICE guidance; however, this lower value may be appropriate to meet the national aspiration of improving cancer diagnostics.
Abstract.
van Melle M, Yep Manzano SIS, Wilson H, Hamilton W, Walter FM, Bailey SER (2020). Faecal immunochemical test to triage patients with abdominal symptoms for suspected colorectal cancer in primary care: Review of international use and guidelines.
Family Practice,
37(5), 606-615.
Abstract:
Faecal immunochemical test to triage patients with abdominal symptoms for suspected colorectal cancer in primary care: Review of international use and guidelines
Background: Recently, faecal immunochemical tests (FITs) have been introduced for investigation of primary care patients with low-risk symptoms of colorectal cancer (CRC), but recommendations vary across the world. This systematic review of clinical practice guidelines aimed to determine how FITs are used in symptomatic primary care patients and the underpinning evidence for these guidelines. Methods: MEDLINE, Embase andTRIP databases were systematically searched, from 1 November 2008 to 1 November 2018 for guidelines on the assessment of patients with symptoms suggestive of CRC. Known guideline databases, websites and references of related literature were searched. The following questions were addressed: (i) which countries use FIT for symptomatic primary care patients; (ii) in which populations is FIT used; (iii) what is the cut-off level used for haemoglobin in the faeces (FIT) and (iv) on what evidence are FIT recommendations based. Results: the search yielded 2433 publications; 25 covered initial diagnostic assessment of patients with symptoms of CRC in 15 countries (Asia, n = 1; Europe, n = 13; Oceania, n = 4; North America, n = 5; and South America, n = 2). In three countries (Australia, Spain and the UK), FIT was recommended for patients with abdominal symptoms, unexplained weight loss, change in bowel habit or anaemia despite a low level of evidence in the symptomatic primary care patient population. Conclusions: Few countries recommend FITs in symptomatic patients in primary care either because of limited evidence or because symptomatic patients are directly referred to secondary care without triage.These results demonstrate a clear need for research on FIT in the symptomatic primary care population.
Abstract.
Hopkins R, Bailey SER, Hamilton WT, Shephard EA (2020). Microcytosis as a risk marker of cancer in primary care: a cohort study using electronic patient records.
British Journal of General Practice,
70(696), E457-E462.
Abstract:
Microcytosis as a risk marker of cancer in primary care: a cohort study using electronic patient records
Background Microcytosis (smaller than normal red blood cells) has previously been identified as a possible early risk marker for some cancers. However, the role of microcytosis across all cancers has not been fully investigated. Aim to examine cancer incidence in a cohort of patients with microcytosis, with and without accompanying anaemia. Design and setting Cohort study of patients aged ≥40 years using UK primary care electronic patient records. Method the 1-year cancer incidence was compared between cohorts of patients with a mean red cell volume of
Abstract.
Barlow M, Hamilton W, Ukoumunne OC, Bailey SER (2020). The association between thrombocytosis and subtype of lung cancer: a systematic review and meta-analysis.
Abstract:
The association between thrombocytosis and subtype of lung cancer: a systematic review and meta-analysis
ABSTRACTBackgroundThrombocytosis is associated with poor lung cancer prognosis and has recently been identified as having a high predictive value in lung cancer detection. Lung cancer has multiple histological and genetic subtypes and it is not known whether platelet levels differ across subtypes.MethodsPubMed and Embase were systematically searched for studies that reported pre-treatment platelet count, as either averages or proportion of patients with thrombocytosis, by histological subtype of lung cancer. Suitable studies were synthesised in meta-analyses; subgroup analyses examined for differences across subtypes.ResultsThe prevalence of pre-treatment thrombocytosis across all lung cancer patients was 27% (95% CI: 17 to 37%). By subtype, this was 22% (95% CI: 7 to 41%) for adenocarcinoma (ADC), 28% (95% CI: 15 to 43%) for squamous cell carcinoma (SCC), 36% (95% CI: 13 to 62%) for large cell carcinoma, and 30% (95% CI: 8 to 58%) for small cell lung cancer (SCLC). The pooled mean platelet count for lung cancer patients was 289×109 /L (95% CI: 268 to 311). By subtype, this was 282×109 /L (95% CI: 259 to 306) for ADC, 297×109 /L (95% CI: 238 to 356) for SCC, 290×109 /L (95% CI: 176 to 404) for LCC, and 293×109 /L (95% CI: 244 to 342) for SCLC. There was no difference in thrombocytosis prevalence (p=0.76) or mean platelet count (p=0.96) across the subtypes.ConclusionWe report no evidence of differences in platelet levels across the major subtypes of lung cancer. A high platelet level is likely to be generic across all lung cancer subtypes.KEY MESSAGESWhat is the key question?Which (if any) subtype(s) of lung cancer are more associated with thrombocytosis?What is the bottom line?This can facilitate lung cancer diagnostics and provide insights into the biological mechanism between lung cancer and thrombocytosis.Why read on?This is the first systematic review to compare platelet count across different subtypes of lung cancer, combining data from 9,891 patients across 38 studies.
Abstract.
Watson J, Mounce L, Bailey SER, Cooper SL, Hamilton W (2019). Blood markers for cancer. BMJ, l5774-l5774.
Watson J, Hamilton F, Bailey S, Mounce L, Hamilton W (2019). Clinical implications of increased testing in primary care. BMJ (Online), 364
Bailey SER, van Melle MA, Nicholson BD (2019). Faecal immunochemical (rule-in) testing in general practice. British Journal of General Practice, 69(681).
Ankus E, Price S, Ukoumunne O, Hamilton W, Bailey S (2018). Cancer incidence in patients with a high normal platelet count: a cohort study using primary care data. Family Practice
Bailey SE, Ankus EJ, Hamilton W (2017). Authors' response.
Br J Gen Pract,
67(662), 396-397.
Author URL.
Bailey SER, Ukoumunne OC, Shephard EA, Hamilton W (2017). Clinical relevance of thrombocytosis in primary care: a prospective cohort study of cancer incidence using English electronic medical records and cancer registry data.
British Journal of General Practice,
67(659), e405-e413.
Abstract:
Clinical relevance of thrombocytosis in primary care: a prospective cohort study of cancer incidence using English electronic medical records and cancer registry data
BackgroundThrombocytosis (raised platelet count) is an emerging risk marker of cancer, but the association has not been fully explored in a primary care context.AimTo examine the incidence of cancer in a cohort of patients with thrombocytosis, to determine how clinically useful this risk marker could be in predicting an underlying malignancy.Design and settingA prospective cohort study using Clinical Practice Research Datalink data from 2000 to 2013.MethodThe 1-year incidence of cancer was compared between two cohorts: 40 000 patients aged ≥40 years with a platelet count of >400 × 109/L (thrombocytosis) and 10 000 matched patients with a normal platelet count. Sub-analyses examined the risk with change in platelet count, sex, age, and different cancer sites.ResultsA total of 1098 out of 9435 males with thrombocytosis were diagnosed with cancer (11.6%; 95% confidence interval [CI] = 11.0 to 12.3), compared with 106 of 2599 males without thrombocytosis (4.1%; 95% CI = 3.4 to 4.9). A total of 1355 out of 21 826 females with thrombocytosis developed cancer (6.2%; 95% CI = 5.9 to 6.5), compared with 119 of 5370 females without (2.2%; 95% CI = 1.8 to 2.6). The risk of cancer increased to 18.1% (95% CI = 15.9 to 20.5) for males and 10.1% (95% CI = 9.0 to 11.3) for females, when a second raised platelet count was recorded within 6 months. Lung and colorectal cancer were more commonly diagnosed with thrombocytosis. One-third of patients with thrombocytosis and lung or colorectal cancer had no other symptoms indicative of malignancy.ConclusionThrombocytosis is a risk marker of cancer in adults; 11.6% and 6.2% cancer incidence in males and females, respectively, is worthy of further investigation for underlying malignancy. These figures well exceed the National Institute for Health and Care Excellence-mandated risk threshold of 3% risk to warrant referral for suspected cancer.
Abstract.
Farr W, Green D, Male I, Morris C, Bailey S, Gage H, Speller S, Colville V, Jackson M, Bremner S, et al (2017). Therapeutic potential and ownership of commercially available consoles in children with cerebral palsy.
British Journal of Occupational Therapy,
80(2), 108-116.
Abstract:
Therapeutic potential and ownership of commercially available consoles in children with cerebral palsy
Introduction We conducted a survey amongst families of children with cerebral palsy to ascertain the ownership and therapeutic use and potential of commercial games consoles to improve motor function. Method Three hundred families in South East England were identified through clinical records, and were requested to complete an anonymised questionnaire. Results a total of 61 families (20% response) returned a completed questionnaire with 41 (68%) identified males and 19 (32%) identified females with cerebral palsy, with a mean age of 11 years 5 months (SD 3Y 7M). The large majority of families, 59 (97%), owned a commercial console and the child used this for 50-300 minutes a week. Returns by severity of motor impairment were: Gross Motor Function Classification System I (22%), II (32%), III (13%), IV (15%), V (18%). Consoles were used regularly for play across all Gross Motor Function Classification System categories. Conclusion the potential of games consoles, as home-based virtual reality therapy, in improving the motor function of children with cerebral palsy should be appropriately tested in a randomised controlled trial. Wide ownership, and the relative ease with which children engage in the use of commercially-based virtual reality therapy systems, suggests potential as a means of augmenting therapy protocols, taking advantage of interest and participation patterns of families.
Abstract.
Bailey S, Boddy K, Briscoe S, Morris C (2015). Involving disabled children and young people as partners in research: a systematic review.
Child Care Health Dev,
41(4), 505-514.
Abstract:
Involving disabled children and young people as partners in research: a systematic review.
Children and young people can be valuable partners in research, giving their unique perspectives on what and how research should be done. However, disabled children are less commonly involved in research than their non-disabled peers. This review investigated how disabled children have been involved as research partners; specifically how they have been recruited, the practicalities and challenges of involvement and how these have been overcome, and impacts of involvement for research, and disabled children and young people. The INVOLVE definition of involvement and the Equality and Human Rights Commission definition of disability were used. Relevant bibliographic databases were searched. Websites were searched for grey literature. Included studies had involved disabled children and young people aged 5-25 years in any study design. Reviews, guidelines, reports and other documents from the grey literature were eligible for inclusion. Twenty-two papers were included: seven reviews, eight original research papers, three reports, three guidelines and one webpage. Nine examples of involvement were identified. Recommendations included developing effective communication techniques, using flexible methods that can be adapted to needs and preferences, and ensuring that sufficient support and funding is available for researchers undertaking involvement. Positive impacts of involvement for disabled children included increased confidence, self-esteem and independence. Positive impacts for research were identified. Involving disabled children in research can present challenges; many of these can be overcome with sufficient time, planning and resources. More needs to be done to find ways to involve those with non-verbal communication. Generally, few details were reported about disabled children and young people's involvement in studies, and the quality of evidence was low. Although a range of positive impacts were identified, the majority of these were authors' opinions rather than data. There remains scope for methodological research to inform appropriate approaches to public and patient involvement in childhood disability research.
Abstract.
Author URL.
Shilling V, Bailey S, Logan S, Morris C (2015). Peer support for parents of disabled children part 1: Perceived outcomes of a one-to-one service, a qualitative study.
Child: Care, Health and Development,
41(4), 524-536.
Abstract:
Peer support for parents of disabled children part 1: Perceived outcomes of a one-to-one service, a qualitative study
Background: Parents of disabled children are encouraged to seek peer support. Delivering one-to-one support requires resources; therefore, investigating how these services may impact on families and those providing the service is important when evaluating such services. Methods: We carried out a qualitative study involving semi-structured interviews and focus groups. Participants were 12 parents and 23 befrienders who had contact with the Face2Face one-to-one befriending service in Devon and Cornwall during a 12-month period, and 10 professionals from health, social care and education services. Findings: Shared experience was perceived central to successful peer support and was a catalyst for other elements of support, enabling parents to (i) learn from the experience of others; (ii) speak freely in a safe and non-judgemental environment; and (iii) receive support and encouragement from their befriender. These elements underpinned perceived outcomes for both parents providing and receiving support. Outcomes for parents receiving support centred on emotional stability, personal growth and reduced isolation. Supporting parents experienced positive outcomes through their training, mutual support and the feeling that they were helping others. Parents and befrienders appeared to benefit through expanding their social network. Nevertheless providing support was reported to create emotional burden and concerns for befrienders around their performance, and also required a substantial time commitment. Conclusions: Befrienders as well as parents perceived positive outcomes from their involvement in peer support although there is also potential for less positive impact on those offering support.
Abstract.
Shilling V, Bailey S, Logan S, Morris C (2015). Peer support for parents of disabled children part 1: perceived outcomes of a one-to-one service, a qualitative study.
Child Care Health Dev,
41(4), 524-536.
Abstract:
Peer support for parents of disabled children part 1: perceived outcomes of a one-to-one service, a qualitative study.
BACKGROUND: Parents of disabled children are encouraged to seek peer support. Delivering one-to-one support requires resources; therefore, investigating how these services may impact on families and those providing the service is important when evaluating such services. METHODS: We carried out a qualitative study involving semi-structured interviews and focus groups. Participants were 12 parents and 23 befrienders who had contact with the Face2Face one-to-one befriending service in Devon and Cornwall during a 12-month period, and 10 professionals from health, social care and education services. FINDINGS: Shared experience was perceived central to successful peer support and was a catalyst for other elements of support, enabling parents to (i) learn from the experience of others; (ii) speak freely in a safe and non-judgemental environment; and (iii) receive support and encouragement from their befriender. These elements underpinned perceived outcomes for both parents providing and receiving support. Outcomes for parents receiving support centred on emotional stability, personal growth and reduced isolation. Supporting parents experienced positive outcomes through their training, mutual support and the feeling that they were helping others. Parents and befrienders appeared to benefit through expanding their social network. Nevertheless providing support was reported to create emotional burden and concerns for befrienders around their performance, and also required a substantial time commitment. CONCLUSIONS: Befrienders as well as parents perceived positive outcomes from their involvement in peer support although there is also potential for less positive impact on those offering support.
Abstract.
Author URL.
Shilling V, Bailey S, Logan S, Morris C (2015). Peer support for parents of disabled children part 2: How organizational and process factors influenced shared experience in a one-to-one service, a qualitative study.
Child: Care, Health and Development,
41(4), 537-546.
Abstract:
Peer support for parents of disabled children part 2: How organizational and process factors influenced shared experience in a one-to-one service, a qualitative study
Background: Parents of disabled children often seek support from their peers. The shared experience between parents appears to be a crucial mediating factor. Understanding how a sense of shared experience is fostered can help to design and evaluate services that seek to provide peer support. Methods: We carried out a qualitative study involving semi-structured interviews and focus groups. Participants were 12 parents and 23 befrienders who had contact with the Face2Face one-to-one befriending service in Devon and Cornwall during a 12-month period, and 10 professionals from health, social care and education. Findings: Formal structures and processes in place such as training and ongoing supervision and support were highly valued as was the highly personalized, confidential, flexible, one-to-one at-home nature of the service. Crucial to establishing rapport was putting the right people together and ensuring a good match between befrienders and parents. Clearly, the befriending parent has to be emotionally prepared to provide help. However, if the parent being offered support was not ready to accept help at the time it was offered or the type of support was not right for them, they are less likely to engage with the service. Conclusion: Organizational and process factors as well as characteristics of the parents offering and receiving support contribute to the sense of shared experience in one-to-one peer support. These factors interact to influence whether peer support is effective and should be explicitly considered when designing and evaluating services.
Abstract.
Shilling V, Bailey S, Logan S, Morris C (2015). Peer support for parents of disabled children part 2: how organizational and process factors influenced shared experience in a one-to-one service, a qualitative study.
Child Care Health Dev,
41(4), 537-546.
Abstract:
Peer support for parents of disabled children part 2: how organizational and process factors influenced shared experience in a one-to-one service, a qualitative study.
BACKGROUND: Parents of disabled children often seek support from their peers. The shared experience between parents appears to be a crucial mediating factor. Understanding how a sense of shared experience is fostered can help to design and evaluate services that seek to provide peer support. METHODS: We carried out a qualitative study involving semi-structured interviews and focus groups. Participants were 12 parents and 23 befrienders who had contact with the Face2Face one-to-one befriending service in Devon and Cornwall during a 12-month period, and 10 professionals from health, social care and education. FINDINGS: Formal structures and processes in place such as training and ongoing supervision and support were highly valued as was the highly personalized, confidential, flexible, one-to-one at-home nature of the service. Crucial to establishing rapport was putting the right people together and ensuring a good match between befrienders and parents. Clearly, the befriending parent has to be emotionally prepared to provide help. However, if the parent being offered support was not ready to accept help at the time it was offered or the type of support was not right for them, they are less likely to engage with the service. CONCLUSION: Organizational and process factors as well as characteristics of the parents offering and receiving support contribute to the sense of shared experience in one-to-one peer support. These factors interact to influence whether peer support is effective and should be explicitly considered when designing and evaluating services.
Abstract.
Author URL.
Bailey S, Ukoumunne O, Shephard E, Hamilton W (2015). Thrombocytosis: an underused risk marker of cancer in primary care?.
EUROPEAN JOURNAL OF CANCER CARE,
24, 11-11.
Author URL.
Bailey S, Ukoumunne O, Shephard E, Hamilton W (2014). Thrombocytosis: an underused risk marker of cancer in primary care?.
EUROPEAN JOURNAL OF CANCER CARE,
23, 5-5.
Author URL.
Barnes E, Bullock AD, Bailey SER, Cowpe JG, Karaharju-Suvanto T (2013). A review of continuing professional development for dentists in Europe.
European Journal of Dental Education,
17(SUPPL. 1), 5-17.
Abstract:
A review of continuing professional development for dentists in Europe
Aim: to summarise findings from a literature review of dentists' engagement in continuing professional development (CPD) and its effects on improving oral health care for patients. Method: the search strategy used key terms in a range of databases and an academic literature search engine, complemented by hand searching and citation follow-up. Results: One hundred and fourteen papers were reviewed. The majority of dentists engaged in CPD. Factors affecting participation included time since graduation, costs, work and home commitments, postgraduate qualification, interest and convenience. Learning needs identification and reflection on practice were rarely evidenced. Common modes of CPD were courses and journal reading; no one delivery method proved more effective. Few papers directly explored recommendations for topics although suggestions related to common areas of error and gaps in knowledge or skill. Studies of CPD effectiveness and impact-on-practice suggested that courses can result in widespread new learning and considerable self-reported change in practice. However, significant barriers to implementing change in workplace practice were noted and included availability of materials, resources and support from colleagues. Conclusion: to ensure high standards of care, alongside recommending core or mandatory topics, more attention should be given to reflection on learning needs, the learner's readiness to engage with education and training and the influence of the workplace environment. © 2013 John Wiley & Sons A/S.
Abstract.
Bailey SER, Bullock AD, Cowpe JG, Thomas HS, Yuen-Lee F, Wood M, Newcombe RG (2013). An evaluation of CPD activity of dentists in Wales.
European Journal of Dental Education,
17(1).
Abstract:
An evaluation of CPD activity of dentists in Wales
Introduction: Ongoing professional education is essential for dental professionals to maintain and update their clinical skills and knowledge. There is a current trend towards mandatory Continuing Professional Development (CPD) for dentists within Europe and beyond. Mandatory CPD will ensure high professional standards and enable mobilisation of the dental workforce within Europe. In 2002, the UK General Dental Council (GDC) implemented a system of mandatory CPD for dentists practicing in the UK. The Wales Deanery is situated in the School of Postgraduate Medical and Dental Education, Cardiff University. It provides verifiable CPD courses for dentists and dental care professionals (DCPs) currently practicing in Wales and has recorded professionals' attendance on these courses since 2001. The project aimed to investigate the CPD activity of dentists in Wales, using these data. Methods: the Wales Deanery database holds data on the CPD courses undertaken by 1178 dentists working in Wales since 2001. A number of hypotheses were investigated using a variety of statistical methods. Results: Dentists were undertaking significantly fewer hours of CPD in Mid and West Wales compared to the North and South of the principality. Sole practitioners were found to engage in less CPD than those in group practices, but these differences did not reach statistical significance. Dentists who employed a hygienist or therapist completed more hours of CPD than those who didn't employ either. There were no gender differences in engagement in CPD. CPD participation was consistently and significantly higher in mid and late career than in early career. Conclusions: This study provides a greater understanding of the CPD habits of the dental workforce in Wales. Practice staffing levels, location of practice and time since graduation were found to have the greatest impact on engagement in CPD activity. These findings will be used by the Deanery to inform future education provision for dental professionals in Wales. © 2012 John Wiley & Sons A/S.
Abstract.
Bullock A, Bailey S, Cowpe J, Barnes E, Thomas H, Thomas R, Phillips S, Kavadella A, Kossioni A, Tsiklakis K, et al (2013). Continuing professional development systems and requirements for graduate dentists in the EU: survey results from the DentCPD project.
Eur J Dent Educ,
17(1), e77-e81.
Abstract:
Continuing professional development systems and requirements for graduate dentists in the EU: survey results from the DentCPD project.
INTRODUCTION: By maintaining skills and keeping dentists up-to-date, continuing professional development (CPD) supports safe clinical practice. However, CPD for dentists across Europe is not harmonised. AIM: One aim of the 'DentCPD' project (www.dentcpd.org) was to identify and agree essential CPD requirements for EU dentists. As part of the process, data were collected on existing approaches to CPD for EU dentists. This paper reports those findings. METHODS: Informed by a review of the literature and internet search, the CPD for Graduate Dentists questionnaire gathered data from dental educators on CPD systems, requirements, provision and accreditation in Europe. It sought opinion on mandatory CPD and e-learning. RESULTS: Responses were received from 143 individuals from 30 EU countries. About half the countries had a compulsory CPD system which typically included mandatory core topics. Elsewhere CPD was optional or based on recommended hours. University dental schools and professional dental associations were the most common CPD providers. National regulatory bodies were the most common accrediting body. Only 41% of respondents thought they knew the criteria for successful accreditation of CPD. Eighty-one percent agreed that 'CPD should be obligatory for all dentists'. CONCLUSION: These results present an overview of the status of CPD for EU dentists. Despite a notable trend towards regulated CPD systems, current requirements for dentists to engage in CPD show variation. The harmonisation of requirements would enhance both dentist mobility and safe clinical practice.
Abstract.
Author URL.
Bullock A, Bailey S, Cowpe J, Barnes E, Thomas H, Thomas R, Phillips S, Kavadella A, Kossioni A, Tsiklakis K, et al (2013). Continuing professional development systems and requirements for graduate dentists in the EU: survey results from the DentCPD project.
Eur J Dent Educ,
17 Suppl 1, 18-22.
Abstract:
Continuing professional development systems and requirements for graduate dentists in the EU: survey results from the DentCPD project.
INTRODUCTION: By maintaining skills and keeping dentists up-to-date, continuing professional development (CPD) supports safe clinical practice. However, CPD for dentists across Europe is not harmonised. AIM: One aim of the 'DentCPD' project (www.dentcpd.org) was to identify and agree essential CPD requirements for EU dentists. As part of the process, data were collected on existing approaches to CPD for EU dentists. This paper reports those findings. METHODS: Informed by a review of the literature and internet search, the CPD for Graduate Dentists questionnaire gathered data from dental educators on CPD systems, requirements, provision and accreditation in Europe. It sought opinion on mandatory CPD and e-learning. RESULTS: Responses were received from 143 individuals from 30 EU countries. About half the countries had a compulsory CPD system which typically included mandatory core topics. Elsewhere CPD was optional or based on recommended hours. University dental schools and professional dental associations were the most common CPD providers. National regulatory bodies were the most common accrediting body. Only 41% of respondents thought they knew the criteria for successful accreditation of CPD. Eighty-one percent agreed that 'CPD should be obligatory for all dentists'. CONCLUSION: These results present an overview of the status of CPD for EU dentists. Despite a notable trend towards regulated CPD systems, current requirements for dentists to engage in CPD show variation. The harmonisation of requirements would enhance both dentist mobility and safe clinical practice.
Abstract.
Author URL.
Bailey S, Bullock A, Cowpe J, Barnes E, Thomas H, Thomas R, Kavadella A, Kossioni A, Karaharju-Suvanto T, Suomalainen K, et al (2013). Core continuing professional development (CPD) topics for the European dentist.
Eur J Dent Educ,
17(1), e82-e87.
Abstract:
Core continuing professional development (CPD) topics for the European dentist.
INTRODUCTION: in the context of free movement, EU-citizens need assurance that dental practitioners providing their care have a degree/license to practice that meets EU-standards and that they maintain their knowledge and skills through ongoing education. AIM: One aim of the 'DentCPD' project (HYPERLINK 'http://www.dentcpd.org' www.dentcpd.org) was to identify and agree essential CPD requirements for EU dentists. This paper reports the consensus process and outcomes. METHODS: Agreement on core components of CPD was achieved through a three stage process: an online survey of dental educators' (n = 143) views on compulsory topics; a paper-based questionnaire to practitioners (n = 411); leading to a proposal discussed at the Association for Dental Education (ADEE) 2011 Lifelong Learning special interest group (SIG). RESULTS: from the online survey and practitioner questionnaire, high levels of agreement were achieved for medical emergencies (89%), infection control (79%) and the medically compromised patient (71%). The SIG (34 attendees from 16 countries) concluded that these three CPD topics plus radiation protection should be core-compulsory and three CPD topics should be core-recommended (health and safety, pain management, and safeguarding children & vulnerable adults). They also agreed that the teaching of all topics should be underpinned by evidence-based dentistry. CONCLUSION: Building four core topics into CPD requirements and making quality-approved education and training available will ensure that all dentists have up-to-date knowledge and skills in topic areas of direct relevance to patient safety. In turn, this will contribute to patients having access to comparably high standards of oral health care across Europe.
Abstract.
Author URL.
Bailey S, Bullock A, Cowpe J, Barnes E, Thomas H, Thomas R, Kavadella A, Kossioni A, Karaharju-Suvanto T, Suomalainen K, et al (2013). Core continuing professional development (CPD) topics for the European dentist.
Eur J Dent Educ,
17 Suppl 1, 23-28.
Abstract:
Core continuing professional development (CPD) topics for the European dentist.
INTRODUCTION: in the context of free movement, EU-citizens need assurance that dental practitioners providing their care have a degree/license to practice that meets EU-standards and that they maintain their knowledge and skills through ongoing education. AIM: One aim of the 'DentCPD' project (HYPERLINK 'http://www.dentcpd.org' www.dentcpd.org) was to identify and agree essential CPD requirements for EU dentists. This paper reports the consensus process and outcomes. METHODS: Agreement on core components of CPD was achieved through a three stage process: an online survey of dental educators' (n = 143) views on compulsory topics; a paper-based questionnaire to practitioners (n = 411); leading to a proposal discussed at the Association for Dental Education (ADEE) 2011 Lifelong Learning special interest group (SIG). RESULTS: from the online survey and practitioner questionnaire, high levels of agreement were achieved for medical emergencies (89%), infection control (79%) and the medically compromised patient (71%). The SIG (34 attendees from 16 countries) concluded that these three CPD topics plus radiation protection should be core-compulsory and three CPD topics should be core-recommended (health and safety, pain management, and safeguarding children & vulnerable adults). They also agreed that the teaching of all topics should be underpinned by evidence-based dentistry. CONCLUSION: Building four core topics into CPD requirements and making quality-approved education and training available will ensure that all dentists have up-to-date knowledge and skills in topic areas of direct relevance to patient safety. In turn, this will contribute to patients having access to comparably high standards of oral health care across Europe.
Abstract.
Author URL.
Suomalainen K, Karaharju-Suvanto T, Bailey S, Bullock A, Cowpe J, Barnes E, Thomas H, Thomas R, Kavadella A, Kossioni A, et al (2013). Guidelines for the organisation of continuing professional development activities for the European dentist.
European Journal of Dental Education,
17(SUPPL. 1), 29-37.
Abstract:
Guidelines for the organisation of continuing professional development activities for the European dentist
Aim: Free movement of dental professionals across the European Union calls for more uniform continuing education in dentistry to ensure up-to-date, high-quality patient care and patient safety. This article provides guidelines for the management and delivery of high-quality continuing professional development (CPD) by European dental schools and other CPD providers. Method: the guidelines are based on an extensive literature inventory, a survey of existing practices (both available as separate publications), discussions during meetings of the Association for Dental Education in Europe in 2011 and 2012 and debate amongst the members of the DentCPD project team representing six dental schools. Results: on the basis of the literature review, survey and discussions, we recommend that (i) every dentist should be given the opportunity for CPD, (ii) providers should be quality-approved and impartial, (iii) educators should be approved, impartial, suitably trained, and with educational expertise, (iv) the mode of CPD delivery should suit the educational activity, with clear learning objectives or outcomes, (v) effort should be made to assess the learning, (vi) participant feedback should be collected and analysed to inform future developments and (vii) uniform use of the pan-European system of learning credit points (ECTS) should be implemented. Conclusion: Implementation of these guidelines should make dental CPD more transparent to all relevant parties and facilitate the transferability of earned credits across the European Union. It will also enable better quality control within dentistry, resulting in enhanced dental care and ultimately the improvement in patient safety. © 2013 John Wiley & Sons A/S.
Abstract.
McHugh C, Bailey S, Shilling V, Morris C (2013). Meeting the information needs of families of children with chronic health conditions.
Phys Occup Ther Pediatr,
33(3), 265-270.
Author URL.
Kavadella A, Kossioni AE, Tsiklakis K, Cowpe J, Bullock A, Barnes E, Bailey S, Thomas H, Thomas R, Karaharju-Suvanto T, et al (2013). Recommendations for the development of e-modules for the continuing professional development of European dentists.
European Journal of Dental Education,
17(SUPPL. 1), 45-54.
Abstract:
Recommendations for the development of e-modules for the continuing professional development of European dentists
Aims: to provide evidence-based and peer-reviewed recommendations for the development of dental continuing professional development (CPD) learning e-modules. Methods: the present recommendations are consensus recommendations of the DentCPD project team and were informed by a literature research, consultations from e-learning and IT expert, discussions amongst the participants attending a special interest group during the 2012 ADEE meeting, and feedback from the evaluation procedures of the exemplar e-module (as described in a companion paper within this Supplement). The main focus of these recommendations is on the courses and modules organised and offered by dental schools. Results and discussion: E-modules for dental CPD, as well as for other health professionals' continuing education, have been implemented and evaluated for a number of years. Research shows that the development of e-modules is a team process, undertaken by academics, subject experts, pedagogists, IT and web designers, learning technologists and librarians. The e-module must have clear learning objectives (outcomes), addressing the learners' individual needs, and must be visually attractive, relevant, interactive, promoting critical thinking and providing feedback. The text, graphics and animations must support the objectives and enable the learning process by creating an attractive, easy to navigate and interactive electronic environment. Technology is usually a concern for learners and tutors; therefore, it must be kept simple and interoperable within different systems and software. The pedagogical and technological proficiency of educators is of paramount importance, yet remains a challenge in many instances. Conclusions: the development of e-courses and modules for dental CPD is an endeavour undertaken by a group of professionals. It must be underpinned by sound pedagogical and e-learning principles and must incorporate elements for effective visual learning and visual design and a simple, consistent technology. © 2013 John Wiley & Sons A/S.
Abstract.
Kossioni AE, Kavadella A, Tzoutzas I, Bakas A, Tsiklakis K, Bailey S, Bullock A, Cowpe J, Barnes E, Thomas H, et al (2013). The development of an exemplar e-module for the continuing professional development of European dentists.
European Journal of Dental Education,
17(SUPPL. 1), 38-44.
Abstract:
The development of an exemplar e-module for the continuing professional development of European dentists
Aim: to present the development of an exemplar e-module for dental continuing professional development (CPD) provided by dental schools and other dental educational providers. Materials and methods: the exemplar e-module covered the topic of 'Sterilisation and cross-infection control in the dental practice' as this is one of the most recommended topics for dental CPD in Europe. It was developed by a group of topic experts, adult learning and distance learning experts and a technical developer. Major concerns were pedagogy, interoperability, usability and cost reduction. Open-source material was used to reduce the cost of development. Results: the e-module was pre-piloted in dental practitioners for usability and then evaluated by experts in the field and dental academics through an electronic questionnaire and an online presentation and discussion at the ADEE 2012 Special Interest Group on DentCPD-Lifelong learning. This facilitated refinement before final production. A Creative Commons License was implemented to ensure the developers' rights and facilitate wider distribution and access to CPD providers. Discussion and conclusions: the e-module was developed according to well-defined pedagogical and technical guidelines for developing e-learning material for adult learners. It was structured to promote self-study by directing learners through their study, promoting interaction with the material, offering explanation and providing feedback. Content validity was ensured by extensive review by experts. The next step would be to expand the evaluation to practising dentists in various countries after relevant translations, and adaptations to local policies have been made. © 2013 John Wiley & Sons A/S.
Abstract.
Barnes E, Bullock AD, Bailey SER, Cowpe JG, Karaharju-Suvanto T (2012). A review of continuing professional development for dentists in Europe.
European Journal of Dental Education,
16(3), 166-178.
Abstract:
A review of continuing professional development for dentists in Europe
Aim: to summarise findings from a literature review of dentists' engagement in continuing professional development (CPD) and its effects on improving oral health care for patients. Method: the search strategy used key terms in a range of databases and an academic literature search engine, complemented by hand searching and citation follow-up. Results: One hundred and fourteen papers were reviewed. The majority of dentists engaged in CPD. Factors affecting participation included time since graduation, costs, work and home commitments, postgraduate qualification, interest and convenience. Learning needs identification and reflection on practice were rarely evidenced. Common modes of CPD were courses and journal reading; no one delivery method proved more effective. Few papers directly explored recommendations for topics although suggestions related to common areas of error and gaps in knowledge or skill. Studies of CPD effectiveness and impact-on-practice suggested that courses can result in widespread new learning and considerable self-reported change in practice. However, significant barriers to implementing change in workplace practice were noted and included availability of materials, resources and support from colleagues. Conclusion: to ensure high standards of care, alongside recommending core or mandatory topics, more attention should be given to reflection on learning needs, the learner's readiness to engage with education and training and the influence of the workplace environment. © 2012 John Wiley & Sons A/S.
Abstract.
Bailey SER, Wilson MJ, Griffiths R, Bullock AD, Cowpe JG, Newcombe RG, Lewis MAO (2012). Continuing dental education: Evaluation of the effectiveness of a disinfection and decontamination course.
European Journal of Dental Education,
16(1), 59-64.
Abstract:
Continuing dental education: Evaluation of the effectiveness of a disinfection and decontamination course
Aim: to evaluate a disinfection and decontamination dental postgraduate course run by the Wales Dental Postgraduate Deanery between 2008 and 2010. Methods: Pre- and post-course multiple choice questionnaires were completed by 1177 course attendees. Mean scores before and after participation on the training course were compared and analysed. Results: Mean pre-course score was 45.3%, rising to 87.0% in the post-course assessment, reflecting an improvement of 41.8%. Prior to training, 30.7% achieved a satisfactory score of 13/20 (65%) compared to 98.3% on completion of training. Dental technicians were found to score significantly lower than other occupation groups both before and after course attendance. Decade of graduation had no effect on results. Theoretical microbiology was the question area which showed least improvement. Conclusion: Attending the disinfection and decontamination course significantly improved participants' knowledge. Theoretical microbiology, as a topic area, may be targeted for improvements in future courses to improve results further. © 2011 John Wiley & Sons A/S.
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