Leading Healthcare Awards 2022: Research Study of the Year

Ahead of the Leading Healthcare Awards evening, here we explore why each entry has become a finalist, covering some of the highlights from the entries.

In this feature, we focus on the Research Study of the Year category, covering the projects, approaches and results. The finalists include:

ORCHA: The impact of COVID-19 on web-based internet searches for Digital Health Products

ORCHA – the Organisation for the Review of Care and Health Apps – research was published by BMJ Open, highlighting an increase in internet searches for Digital Health Products (DHPs) during the pandemic. The project resulted in the creation of a free COVID-19-support app library for NHS staff and the public, and a free online digital health training academy.

The paper was submitted to the journal in June 2021 by a research team from ORCHA, led by health economist Dr Simon Leigh. 

The research took the form of a retrospective time-series analysis of web-based internet searches for DHPs in the UK, split over two periods, pre-COVID-19 lockdown (31 January 2019–23 March 2020) and post-COVID-19 lockdown (24 March 2020–31 December 2020).

The results showed there were 126,640 searches for DHPs over the study period. Searches for DHPs increased by 343% from 2446 per month prior to COVID-19 lockdown measures being introduced to 8996 per month in the period following the first COVID-19 lockdown in the UK.

Musculoskeletal conditions (2,036%), allergy (1,253%) and healthy living DHPs (1,051%) experienced the greatest increases in searches compared with pre-lockdown. 

Increased search volumes for DHPs were sustained in the 9 months following the introduction of lockdown measures, with 21/25 (84%) of condition areas experiencing monthly search volumes at least 50% greater than pre-lockdown levels.

The team reflected that the rise in the use of DHPs may be attributed to a shift in treatment-seeking behaviour from those experiencing denied or delayed access to routine face-to-face appointments with healthcare professionals. Other reasons for the rise could include a general increasing acceptance of DHPs over time and the promotion of this relatively new medium by health authorities.

This research led to three significant developments from the company:

  • Covid-19 toolkit – a free library of COVID-specific products
  • Elective care toolkit – high-volume, low complexity apps which support the NHS’s key focus areas for 2022 and beyond: ophthalmology, dermatology, cardiology and MSK
  • The Digital Health Academy – education and training for healthcare professionals

University of Westminster, and University College London research study explores use of AI chatbots for health conditions

Researchers from the University of Westminster, with support from University College London (UCL), published research that explored the use of chatbots and virtual assistants for health conditions.

The paper – entitled ‘Health chatbots acceptability moderated by perceived stigma and severity: a cross-sectional survey’ was published 8 December in SAGE Digital Health journal.

Between May and June 2019, the researchers conducted an online study, advertised using Facebook, for UK citizens. A total of 237 participants completed the study with the majority female (73.4%), aged over 45 years old (65.0%), and educated with a degree or higher (54.9%).

Using a factorial simulation experiment, the researchers’ analysis suggests that for “health conditions that are perceived as highly severe such as cancers, people would be less likely to use AI algorithms”, however they suggest “patients were more inclined to discuss highly stigmatising conditions with AI chatbots than a GP”.

The researchers aimed to assess how perceived stigma and severity of various health issues are associated with the acceptability for three sources of health information and consultation: an automatic chatbot, a GP, or a combination of both. They also aimed to further understanding and research into the use and effectiveness of AI symptom checking technology for differing conditions.

One of the conclusions from the researchers, included: “For policymakers and digital service designers to recognise the limitation of health chatbots”, and they called for “future research about the use of AI in healthcare to establish a set of health topics most suitable for chatbot-led interventions and primary healthcare services”.

Dr Tom Nadarzynski, lead author of the study from the University of Westminster, said: “Many AI developers need to assess whether their AI-based healthcare tools such as symptoms checkers or risk calculators are acceptable interventions. Our research finds that patients value the opinion of healthcare professionals, therefore implementation of AI in healthcare may not be suitable in all cases, especially for serious illnesses.”

Read the full paper in the SAGE Digital Health journal. The authors included: Oliver Miles, Robert West and Tom Nadarzynski.

The Greater Manchester Care Record first research paper published

The paper, entitled: ‘Temporal trends in primary care-recorded self-harm during and beyond the first year of the COVID-19 pandemic: Time series analysis of electronic healthcare records for 2.8 million patients in the Greater Manchester Care Record‘, was published on 31 October 2021.

The study used de-identified, primary care health records, analysing clinical codes entered into the health records from 2019, of patients registered with a GP practice in Greater Manchester.

Access to this data helped to provide “findings that are representative of patients across this large and socially diverse conurbation”, said the authors.

Across the study’s observation period, the researchers analysed trends by month, gender, age and deprivation quantile. The researchers also explored changes depending on the lockdown measures during the pandemic. It examined frequencies of monthly primary care recorded self-harm, from March 2020 to May 2021, compared to the same months in 2019.

The researchers highlighted: “Continued monitoring of numbers of recorded self-harm episodes is important in understanding how perceptions of the accessibility of general practice and hospital emergency departments has fluctuated through the course of the pandemic, as well as providing insight into gaps in help-seeking that have arisen and potential increases in clinical need.

“The COVID-19 pandemic and associated national lockdowns and regional restrictions persisting into the second quarter of 2021 appear to have had a marked and prolonged impact on levels of primary care-recorded self-harm. Reductions among those living in more deprived neighbourhoods is evidence that deepening of pre-pandemic health inequalities is persisting. The larger reduction in recorded self-harm among men suggests a potential treatment gap.

“During the ten months leading to May 2021, adolescents aged 10–17 years were more likely to have an episode of self-harm recorded in primary care than in the same months in 2019, suggesting the clinical need among this group has increased. The trends we observed suggest the COVID-19 pandemic has implications for clinicians’ ability to assess the needs and risks of individuals. Some patients may have experienced untreated deterioration in their mental health up to over a year after the first wave of the pandemic. There are also important implications for potential demand experienced by primary care and mental health services.

“Inequalities in access to healthcare remain heightened, with people in the most deprived neighbourhoods less likely to be in contact with health services for self-harm than in pre-pandemic months. The continued impact on men, who are at particularly high risk of subsequent suicide if they have harmed themselves, may suggest ongoing unmet need, while the increase in primary care recorded self-harm among young people aged 10 to 17 could reflect increased prevalence of self-harm. Prioritising capacity of health services to manage changes in demand and potential unidentified need in some groups are important implications.”

The authors and researchers included: Sarah Steeg, Lana Bojanić, George Tilston, Richard Williams, David A. Jenkins, Matthew J. Carr, Niels Peek, Darren M. Ashcroft, Nav Kapur, Jennifer Voorhees and Roger T. Webb.

To read the complete paper, please click here.

University College London results of COVID-19 Social Study

University College London (UCL) released results from its ongoing COVID-19 Social Study – which has been tracking the psychological and social impacts of the pandemic.

The research – funded by the Wellcome Trust and the Nuffield Foundation, with support from UK Research and Innovation – focuses not only on the effects of the virus on adults in the UK, but also on measures such as social distancing.

Participants took part in panels and phone/video interviews across the past year. While datasets from the study are analysed in real-time, with results made regularly available to the public via the dedicated website. 

Each report includes data from panel studies focused on different questions, typically featuring anywhere from 40,000 to over 90,000 participants. The research is presented in an easy-access grid format for simple use, with research available for individual downloads. 

Stretching from one to 56 weeks, the results releases cover psychological responses to a range of different but related topics – beginning with people’s experiences of COVID-19 stressors, exercise and social behaviours, and ethnic and gender disparities in regards to mental health, through to worries about others, vaccine intentions, differences between Brexit and COVID-19 stress, and concerns about unemployment. 

Findings from the most recent report – the 33rd release, for weeks 53 to 56 – focuses on the results of adult experiences in relation to compliance with government guidelines, confidence in the government, mental health, wellbeing, and physical and psychological harm, as well as changes in smoking habits and alcohol use. 

Although the study is not intended to be representative of the entire UK population, from over 70,000 respondents, findings included: 65.6% of adults reported no change in their alcohol consumption compared to last year; more than one in three (39.0%) of adults are currently smoking more per day than a year ago; the vast majority of non-and ex-smokers (98.5%) have not taken up smoking over the year; all demographic groups reported increasing levels of happiness and life satisfaction since the easing of restrictions; however, differences across demographic groups remain, with younger participants, people living alone, women, people from ethnic minority backgrounds, and those with lower household incomes reporting lower levels of happiness and life satisfaction; levels of depression and anxiety symptoms remain similar to autumn. 

Researchers are now asking to speak to more demographics about their experiences of the pandemic – including people experiencing financial difficulties, women who have been pregnant during the last year, young carers, women who have experienced abuse, people with current or recent experiences of ‘problem alcohol’ or drug use, those who have been homeless, and service providers who work with people in these groups. 

UCL says that the results are shared weekly with ‘key decision makers’ such as the NHS, the UK government, Public Health England, and the World Health Organisation.

Download and read the reports online, or register your interest in joining the study here. All information will be anonymised and kept confidential.