NUH Researchers are improving patients' lives with new projects
NUH Consultants have been reaching for the stars with epoch-making research projects, benefiting patients who live with life-threatening heart conditions, lung disease, Alzheimer’s disease and Multiple Sclerosis and those who require kidney transplants.
Since 2019, five doctors at the Trust have received prestigious CARP (Clinical Academic Research Partnership) Awards, with NUH ranking fifth overall in the NIHR league tables as the Trust with the highest number of CARPs.
This means patients who attend the QMC and City Hospital benefit from cutting-edge research and innovation, which involves close partnership with academic leaders and scientists based both locally and nationally.
As the search is underway for the next CARP candidates who will apply for new MRC funding in 2023, we spoke to some of our previous winners at NUH about their research.
Dr Sherif Gonem
Consultant Respiratory Physician based at City Hospital and joint Divisional R&I Lead for the Medicine Division. In 2019, Dr Gonem was one of three CARP successes for NUH, and used his award time to develop an early warning system to monitor patients on respiratory wards, using AI and machine learning.
What did your CARP award win enable you to do?
Sherif Gonem (SG):
“CARP gave me time to undertake the project which I would not otherwise have had. Research is very time-intensive, it takes a lot of time to set a study up, and to do the work itself.”
How has your research project progressed?
SG: “It has gone really well, we’ve developed a ‘DEWS’ (Dynamic Early Warning score) with machine learning techniques and our first paper has been published in the journal Respiratory Research.
“We hope this will make patients safer by having a scoring system that is more sensitive and likely to pick up patient deterioration earlier. It will also make healthcare more efficient by reducing the number of medical reviews needed by doctors due to false alarms.”
What is your advice to others on making a CARP application?
SG: “Firstly, have a good research idea. This should be an important clinical question from your area of clinical expertise.
“Then seek advice early from the NUH R&I teams. I received help from Karen Asher (Head of the R&I Grants Team) and Kate Frost (Head of Patient and Public Involvement & Engagement) early on.
“Ultimately, the panel is investing in you as a person. Make sure you get letters of recommendation from NUH. You also need to let the panel know why NUH is the best place to do the research in terms of support infrastructure, expertise and data sources you can draw on.”
How has CARP benefitted your career?
SG: “It has helped a lot. CARP enabled me to take on other research roles and I am currently joint Research Lead for Medicine.
“It’s allowed me to increase my profile; I have written a journal article that has been viewed more than 1,000 times.
“CARP is a great opportunity. It gives you dedicated research time to develop and implement your idea. It is a very prestigious award and it can be a springboard to other grants applications and, fellowship applications. CARP has been a really positive experience, I’m glad I went for it.”
Dr Akram A. Hosseini
A Consultant Neurologist at NUH, Dr Hosseini won a CARP ward in 2019. Her project used powerful (Ultrahigh Field at 7T) Magnetic Resonance Imaging to study the sub-millimetre and molecular changes of small structures in patients’ brains at the early stages of early onset Alzheimer’s disease, to find novel ways of making the diagnosis.
Since then, she has used 7-Tesla MRI in an international study investigating possible links between COVID-19 and dementia.
How has your career developed since winning CARP?
Akram Hosseini (AH): “CARP provided me with the protected research time to enhance my research skills and experience. It allowed me to integrate research into my clinical practice in dementia and Alzheimer’s disease.
“Most patients in my Young Age Dementia Clinics want to know early if they have Alzheimer’s disease. Since there are new promising treatments for mild Alzheimer’s that appear to slow down the progression of the disease, it has become more important than ever to be able to making the diagnosis early.
“By using the 7T MRI at the Sir Peter Mansfield Imaging Centre, we study the changes on the brain scans of patients with Alzheimer’s disease that has the capability to help make the diagnosis early.
“During the pandemic, I joined an international research consortium investigating the consequences of COVID-19 on brain functioning. In an international effort, we successfully applied for additional funding to study the precursors of Alzheimer’s disease following COVID-19 both the UK and the United States.
“Other than the funding for the clinical research, CARP gave me protected time for academic activities, helped me to build up collaborations with the university colleagues, enhanced networking opportunities and led to translate the scientific knowledge for clinical studies in dementia.”
Do you have any tips for CARP applicants?
AH: “If you have previous research experience, try to take it to the next level. Think about how your research can translate into clinical practice – how would it be useful for your patients?”
Dr Shahnaz Jamil-Copley
A consultant Cardiologist based at City Hospital, Dr Jamil-Copley was a winner of CARP in 2021. Since then, her project using AI (Artificial Intelligence) to develop a ventricular scar model of patients’ hearts has moved forward and brought in new collaborative partners.
The project will eventually have 1,000 or more MRI scans of patients’ hearts, to train AI software to produce a 3D model of a patient’s heart, displaying the complexity of scarring not appreciable to the human eye.
This will be used guide operators to the critical areas inside the heart, which require treatment in Cardiac Electrophysiology laboratories.
What did your CARP win enable you to do?
Shahnaz Jamil-Copley (SJC):
“The advantages are limitless. For me personally, it provided access to academic mentorship whilst giving me the opportunity to concentrate on leading and developing the research and supervising my first PhD fellow. All of this has allowed the project to progress relatively rapidly over the past year.
“The MRC grant has allowed protected time for my research. This has also allowed me to engage with university activities, enhance my research knowledge and practice and access to limitless resources available for an early career researcher.”
How has your research project progressed?
SJC: “Our aim is to obtain and curate a minimum of 1,000 heart scans.
“We already have 500 scans and these have been used to develop and train the first version of our AI model, which computer scientist Dr Xi Chen at the University of Nottingham has been helping us with…
“These 500 anonymised MRI Scans will be made available to researchers all over the world through the usual protected information governance channels to further advance research and grow collaborative research partnerships. Our collaboration with the University of Leeds is underway, as is our prospective study to recruit the next 500 patients.”
Patients will enjoy tangible benefits as sudden cardiac death accounts for 100,000 deaths a year with ischaemic heart disease being the most common cause. Three quarters of all cases are due to scarring from a previous heart attack, which can lead to heart rhythm disorders. These are the scans are being used by the team to develop the model, initially. Researcher later aims to expand to other causes of scarring in the heart.
When some elements of the project slowed, Dr Jamil-Copley used the opportunity bring in other experts including computer scientists from both Oxford and Imperial College who joined with the Nottingham team.
“We are aiming to perform some pilot testing using the AI models imported into the mapping system used in the clinical laboratory hopefully within the current CARP timeline. This data will be used to support further grant applications.”
Do you have any tips on applying for a CARP?
SJC: “If you believe in your project and are devoted to it, then go for it…I wouldn’t let possible rejection or failure put anyone off. People who invest time, energy and enthusiasm will see it through. Bear in mind, I applied for this in the first round of CARP and I was (then) unsuccessful.”
She added: “It’s an honour to have this opportunity, which cannot be wasted. I’m so proud to say that there are limitless ideas I have been able to squeeze into this CARP grant which stand to benefit patients in multiple ways.”
Professor Stephen Ryder, Co-Clinical Director of Research & Innovation at Nottingham University Hospitals NHS Trust, is encouraging other consultants who want to start or develop their research careers at NUH to consider a CARP.
“We are a large teaching Trust that has a high calibre of staff. We want to encourage our staff to progress and we will support them, whatever their needs,” he said.
“Our applicants so far have done extremely well; they are relishing their CARP wins. It is allowing them time to develop both as people and researchers and enhance their CARP project as well,” added Professor Ryder.
- To discuss applying for CARP, email the R&I grants team at: researchgrantapplications@nuh.nhs.uk