Systematic review of the clinical effectiveness and cost-effectiveness, and economic evaluation, of denosumab for the treatment of bone metastases from solid tumours

Peer reviewedPublisher PD

Twelve-year follow-up of conservative management of postnatal urinary and faecal incontinence and prolapse outcomes : randomised controlled trial

© 2013 Royal College of Obstetricians and Gynaecologists. Funded by Royal College of Obstetricians and Gynaecologists, London, UK; Health Research Council of New Zealand. Grant Number: RG 819/06 New Zealand Lottery Grant Board Health Services Research Unit, University of Aberdeen Chief Scientist Office of the Scottish Government Health DirectoratesPeer reviewedPostprin

Assessment of highly distributed power systems using an integrated simulation approach

In a highly distributed power system (HDPS), micro renewable and low carbon technologies would make a significant contribution to the electricity supply. Further, controllable devices such as micro combined heat and power (CHP) could be used to assist in maintaining stability in addition to simply providing heat and power to dwellings. To analyse the behaviour of such a system requires the modelling of both the electrical distribution system and the coupled microgeneration devices in a realistic context. In this paper a pragmatic approach to HDPS modelling is presented: microgeneration devices are simulated using a building simulation tool to generate time-varying power output profiles, which are then replicated and processed statistically so that they can be used as boundary conditions for a load flow simulation; this is used to explore security issues such as under and over voltage, branch thermal overloading, and reverse power flow. Simulations of a section of real network are presented, featuring different penetrations of micro-renewables and micro-CHP within the ranges that are believed to be realistically possible by 2050. This analysis indicates that well-designed suburban networks are likely to be able to accommodate such levels of domestic-scale generation without problems emerging such as overloads or degradation to the quality of supply

Clinical effectiveness and cost-effectiveness of imatinib dose escalation for the treatment of unresectable and/or metastatic gastrointestinal stromal tumours that have progressed on treatment at a dose of 400 mg/day : a systematic review and economic evaluation

Peer reviewedPublisher PD

Design of a DSO-TSO balancing market coordination scheme for decentralised energy

The proliferation of distributed generation and the electrification of heat and transport pose significant challenges to distribution system operators (DSOs) and transmission system operators (TSOs). These challenges include the choice between network upgrades or operating increasingly constrained networks, with a reliance on the flexibility of distributed energy resources (DERs). This study presents a novel market-based coordination scheme, which allows both the DSO and TSO to access DER flexibility, while respecting distribution system limits. The DSO's objective in this work is to minimise the cost incurred by DSO adjustments to DERs, required to ensure stable distribution network operation. The methodology presented has the advantages of being compatible with existing TSO balancing market operation, and scalable enough to include multiple DSO markets coordinating with the TSO. The approach is demonstrated on a section of Great Britain distribution network, using high DER growth scenario data for the year 2030. The case studies demonstrate the proposed DSO market mechanism to maintain thermal and voltage limits during periods of peak demand and DER output. The DSO is given priority in using DERs to solve distribution network constraints, however, significant flexibility remains for the TSO even during periods of peak demand and maximum export

Mesh inlay, mesh kit or native tissue repair for women having repeat anterior or posterior prolapse surgery: randomised controlled trial (PROSPECT)

Funding The project was funded by the National Institute for Health Research Health Technology Assessment Programme (Project Number 07/60/18). The Health Services Research Unit and the Health Economics Research Unit are funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. Acknowledgements The authors wish to thank the women who participated in the PROSPECT study. We also thank Margaret MacNeil for her secretarial support and data management; Dawn McRae and Lynda Constable for their trial management support; the programming team in CHaRT, led by Gladys McPherson; members of the Project Management Group for their ongoing advice and support of the study; and the staff at the recruitment sites who facilitated the recruitment, treatment and follow up of study participants.Peer reviewedPublisher PD

A systematic review of the use of an expertise-based randomised controlled trial design

Acknowledgements JAC held a Medical Research Council UK methodology (G1002292) fellowship, which supported this research. The Health Services Research Unit, Institute of Applied Health Sciences (University of Aberdeen), is core-funded by the Chief Scientist Office of the Scottish Government Health and Social Care Directorates. Views express are those of the authors and do not necessarily reflect the views of the funders.Peer reviewedPublisher PD

The TOPSY pessary self-management intervention for pelvic organ prolapse: a study protocol for the process evaluation.

BACKGROUND: Process evaluations have become a valued component, alongside clinical trials, of the wider evaluation of complex health interventions. They support understanding of implementation, and fidelity, related to the intervention and provide valuable insights into what is effective in a practical setting by examining the context in which interventions are implemented. The TOPSY study consists of a large multi-centre randomised controlled trial comparing the effectiveness of pessary self-management with clinic-based care in improving women's condition-specific quality of life, and a nested process evaluation. The process evaluation aims to examine and maximise recruitment to the trial, describe intervention fidelity and explore participants' and healthcare professionals' experiences. METHODS: The trial will recruit 330 women from approximately 17 UK centres. The process evaluation uses a mixed-methods approach. Semi-structured interviews will be conducted with randomised women (18 per randomised group/n = 36), women who declined trial participation but agreed to interview (non-randomised women) (n = 20) and healthcare professionals recruiting to the trial (n ~ 17) and delivering self-management and clinic-based care (n ~ 17). The six internal pilot centres will be asked to record two to three recruitment discussions each (total n = 12-18). All participating centres will be asked to record one or two self-management teaching appointments (n = 30) and self-management 2-week follow-up telephone calls (n = 30). Process data (quantitative and qualitative) will be gathered in participant completed trial questionnaires. Interviews will be analysed thematically and recordings using an analytic grid to identify fidelity to the intervention. Quantitative analysis will be predefined within the process evaluation analysis plan. DISCUSSION: The wide variety of pessary care delivered across the UK for women with pelvic organ prolapse presents specific localised contexts in which the TOPSY interventions will be implemented. Understanding this contextual variance is central to understanding how and in what circumstances pessary self-management can be implemented (should it be effective). The inclusion of non-randomised women provides an innovative way of collecting indispensable information about eligible women who decline trial participation, allowing broader contextualisation and considerations of generalisability of trial findings. Methodological insights from examination of recruitment processes and mechanisms have the potential to inform recruitment mechanisms and future recruitment strategies and study designs. TRIAL REGISTRATION: ISRCTN62510577 . Registered on 6 October 2017