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Introduction
Current institution
Additional affiliations
February 1992 - November 1994
The King's Fund
Position
- Information Services Manager
February 1991 - September 1994
The King's Fund
Position
- Information Services Manager
February 1992 - October 1994
The King's Fund
Position
- Information Services Manager
Education
October 1979 - June 1982
Publications
Publications (589)
Background
Over ten years since the first qualitative evidence synthesis (QES) was published in the Cochrane Library, QES and mixed‐methods reviews (MMR) with a qualitative component have become increasingly common and influential in healthcare research and policy development. The quality of such reviews and the completeness with which they are rep...
Background
The prevalence of overweight and obesity among children and adolescents is rising and is a recognized global health problem. This overview of reviews explored the views of children, adolescents, and parents/caregivers regarding behavioral interventions for obesity management.
Methods
Eleven electronic databases were searched to identify...
Background
Population-wide newborn blood spot screening programmes are a successful public health intervention used to detect whether the baby is at risk of certain rare conditions, with the aim of earlier diagnosis and provision of optimal care and treatment. Evaluating candidate conditions to include in newborn blood spot and genetic sequencing r...
Free water protocols (FWP) give patients at risk of aspiration the option to drink water between meals. Evidence is lacking about their use in acute stroke care. This systematic review evaluated the literature about barriers and facilitators to FWP implementation in acute stroke unit settings. Electronic databases and grey literature sources were s...
Background
The COVID-19 pandemic marked a unique period characterised by an extraordinary global virus spread. The collective effort to halt the transmission of the virus led to various public health initiatives, including a variety of COVID-19 vaccine trials. Many of these trials used adaptive methods to address the pandemic’s challenges, such as...
Objectives
The COVID-19 pandemic has led to increased use of digital clinical consultations (phone or video calls) within UK maternity services. This project aimed to review the evidence on digital clinical consultations in maternity systems to illuminate how, for whom and in what contexts, they can be used to support safe, personalised and equitab...
Background
Housing insecurity can be understood as experiencing or being at risk of multiple house moves that are not through choice and related to poverty. Many aspects of housing have all been shown to impact children/young people’s health and wellbeing. However, the pathways linking housing and childhood health and wellbeing are complex and poor...
Background
Winter pressures are a familiar phenomenon within the National Health Service and represent the most extreme of many regular demands placed on health and social care service provision. This review focuses on a part of the pathway that is particularly problematic: the discharge process from hospital to social care and the community. Altho...
Background
Newborn screening (NBS) programmes have been used worldwide to diagnose newborns with rare inherited conditions. They are considered to be a key public health intervention. Opportunities to expand NBS programmes in terms of the conditions tested as well as the introduction of whole genome sequencing (WGS) for diagnostic purposes at postp...
Background
Outdoor air pollution can cause serious illness, death and exacerbation of health inequalities on a wide scale and thus is a serious public health concern in the UK. A comprehensive, up-to-date evidence synthesis of neighbourhood-level outdoor air pollution reduction interventions is needed to aid local authority policy and decision-maki...
Purpose
In the UK signposting services can be developed as enhanced support for people with health and social care needs or service diversion to help primary and urgent care services manage their workload. This review considers these two conflicting purposes.
Design/methodology/approach
The review used a realist approach, initial searches to ident...
Background
Signposting typically refers to an informal process that involves giving information to patients to enable them to access external services and support. It is perceived to reduce demand on primary care and other urgent care services.
Methods
This focused realist review was conducted rapidly within time constraints. Searches to identify...
Introduction
Qualitative evidence is increasingly incorporated into decision‐making processes. Assessing the methodological limitations of primary studies is critical to making an overall assessment of confidence in findings from qualitative evidence syntheses (QES) using GRADE‐CERQual. Current critical appraisal tools were not developed specifical...
Background
Risk assessment is a key process when a child or adolescent presents at risk for self-harm or suicide in a mental health crisis or emergency. Risk assessment by a healthcare professional should be included within a biopsychosocial assessment. However, the predictive value of risk-screening tools for self-harm and suicide in children and...
Background
Housing insecurity can be understood as experiencing or being at risk of multiple house moves that are (1) not through choice and (2) related to poverty. For example, due to short-term private rental tenancies, temporary or emergency housing, and homelessness. Housing insecurity has grown due to recent trends in the cost and availability...
Background
Bariatric surgery and weight loss devices have been considered as a therapeutic option in some settings for adolescents with severe obesity. We conducted a systematic review and qualitative evidence synthesis of factors affecting adolescent and caregiver decision‐making processes around such interventions, as well as post‐surgery demands...
Background:
The World Health Organization declared the COVID-19 pandemic on 11 March 2020. Vaccine development and deployment were swiftly prioritised as a method to manage and control disease spread. The development of an effective vaccine relies on people's participation in randomised trials. Recruitment to vaccine trials is particularly challen...
Background
Housing insecurity can be understood as experiencing or being at risk of multiple house moves that are not through choice and related to poverty. Housing has been shown to impact the health and wellbeing of children and young people (CYP) in diverse ways. However, the pathways linking housing and child health and wellbeing are complex an...
Background
GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative Research) is a methodological approach to systematically and transparently assess how much confidence decision makers can place in individual review findings from qualitative evidence syntheses. The number of reviews applying GRADE-CERQual is rapidly expanding in guide...
Background:
There is a considerable body of systematic review evidence considering the effectiveness of rehabilitation programmes on clinical outcomes. However, much less is known about effectively engaging and sustaining patients in rehabilitation. There is a need to understand the full range of potential intervention strategies.
Methods:
We co...
Objective:
We aim to quantify the co-existence of age-related macular degeneration (AMD), glaucoma, or diabetic retinopathy (DR) and cognitive impairment or dementia.
Method:
MEDLINE, EMBASE, PsycINFO and CINAHL were searched (to June 2020). Observational studies reporting incidence or prevalence of AMD, glaucoma, or DR in people with cognitive...
Background: Winter pressures are a familiar phenomenon within the NHS and represent the most extreme of many regular demands placed on health and social care service provision. This review focuses on a part of the pathway that is particularly problematic: the discharge process from hospital to social care and the community. Although studies of disc...
Well-conducted systematic reviews and other evidence syntheses are important in informing policy and practice decisions. It is reasonable to expect that the processes by which reviews are planned, conducted, analysed and reported are informed by up-to-date research evidence. However, many of the decisions taken when ‘doing’ systematic reviews and o...
Our previous work identified that nine leading guidance documents for seven different types of systematic review advocated the same process of literature searching. We defined and illustrated this process and we named it ‘the Conventional Approach’. The Conventional Approach appears to meet the needs of researchers undertaking literature searches f...
Objectives:
A rapid review is a form of evidence synthesis considered a resource-efficient alternative to the conventional systematic review. Despite a dramatic rise in the number of rapid reviews commissioned and conducted in response to the coronavirus disease 2019 pandemic, published evidence on the optimal methods of planning, doing, and shari...
What is new and objectives:
Older people from ethnic minorities experience the intersectionality of age and ethnicity in relation to complex medication management and polypharmacy. Minority ethnic groups in the United Kingdom are at risk of poor medication management because factors such as cultural beliefs, language barriers, lack of knowledge of...
Background
Mild cognitive impairment in older adults is a risk factor for dementia. Mild cognitive impairment is a result of a diverse range of underlying causes and may progress to dementia, remain stable or improve over time.
Objectives
We aimed to assess the evidence base around the assessment and management pathway of older adults with mild co...
Background:
Supplementary search methods, including citation searching, are essential if systematic reviews are to avoid producing biased conclusions. Little evidence exists on how to prioritise databases for citation searching or to establish whether using multiple sources is beneficial.
Objectives:
A systematic review examining urgent and emer...
Background
Breast-feeding holds considerable potential to reduce infant mortality. Feeding choices, already complex, take on additional complexity against a backdrop of the risk of transmissible Ebola Virus. This review describes the factors that influence infant feeding and attitudes of pregnant women, mothers, family members and health practition...
Background
As chronic and progressive age‐related diseases, there are commonalities between age‐related macular degeneration (AMD), glaucoma, and diabetic retinopathy (DR), and cognitive impairment (CI) and dementia. We undertook a systematic review to quantify such associations.
Method
MEDLINE, EMBASE, PsycINFO and CINAHL were searched (from ince...
Objective
To explore the burdens experienced by family carers who support older relatives to manage their medications at home.
Methods
This study, based on a larger UK medication management study: MEdication Management in Older people: Realist Approaches Based on Literature and Evaluation (MEMORABLE), reports on findings from family carer intervie...
Background: The value of rapid reviews in informing health care decisions is more evident since the onset of the coronavirus disease 2019 (COVID-19) pandemic. While systematic reviews can be completed rapidly, rapid reviews are usually a type of evidence synthesis in which components of the systematic review process may be simplified or omitted to...
Background
The term ‘safeguarding’ covers the protection of health, wellbeing and human rights. Effective safeguarding enables people (particularly children, young adults and other vulnerable people) to live free from fear of abuse, harm or neglect. The UK Children Act 2004 required key agencies, including health and social care providers, to consi...
A considerable proportion of quantitative research remains unpublished once completed. Little research has documented non‐dissemination and dissemination bias in qualitative research. This study aimed to generate evidence on the extent of non‐dissemination in qualitative research. We followed a cohort of qualitative studies presented as conference...
Background: Mild cognitive impairment (MCI) in older adults is a risk factor for dementia. MCI results from diverse underlying causes and may progress to dementia, remain stable or improve over time. Objectives: To assess the evidence base around the assessment and management pathway of older adults with MCI in community/primary care, hospital and...
Background
For systematic reviews to be rigorous, deliverable and useful, they need a well-defined review question. Scoping for a review also requires the specification of clear inclusion criteria and planned synthesis methods. Guidance is lacking on how to develop these, especially in the context of undertaking rapid and responsive systematic revi...
Background: The value of rapid reviews in informing health care decisions is more evident since the onset of the coronavirus disease 2019 (COVID-19) pandemic. While systematic reviews can be completed rapidly, rapid reviews are usually a type of evidence synthesis in which components of the systematic review process may be simplified or omitted to...
The aim of this rapid evidence review was to identify the main challenges involved in implementing digital and data-driven technologies in health and social care. We aimed to address the following research questions: RQ1: what are the main challenges involved in successfully implementing and using digital and data-driven technologies in health and...
Introduction:
A significant proportion of the global population regularly experience air quality poorer than that recommended by the World Health Organization. Air pollution, especially fine particulate matter (PM2.5), is a risk factor for various noncommunicable diseases (NCDs) and is emerging as a risk factor for dementia. To begin to understand...
Introduction
Community pharmacists and their teams have remained accessible to the public providing essential services despite immense pressures during the COVID-19 pandemic. They have successfully expanded the influenza vaccination programme and are now supporting the delivery of the COVID-19 vaccination roll-out.
Aim
This rapid realist review ai...
This study developed, validated, and evaluated a framework of factors influencing dietary behaviours in urban African food environments, to inform research prioritisation and intervention development in Africa. A multi-component methodology, drawing on concept mapping, was employed to construct a framework of factors influencing dietary behaviours...
Purpose:
Persistent physical symptoms (PPS) are often associated with profound physical disability and psychological distress. Interventions for PPS that promote behavioural change aim to reduce levels of symptoms and improve overall functioning in patients. The evidence for these interventions is mixed, with effective relationships between patien...
Background
Vascular services is changing rapidly, having emerged as a new specialty with its own training and specialised techniques. This has resulted in the need for reconfiguration of services to provide adequate specialist provision and accessible and equitable services.
Objectives
To identify the effects of service configuration on practice,...
Background/objectives:
Coexistent seizures add complexity to the burden of Alzheimer's disease (AD). We aim to estimate the incidence and prevalence of coexistent seizures and AD and summarize characteristics.
Design:
A systematic review and meta-analysis (PROSPERO protocol registration CRD42020150479).
Setting:
Population-, community-, hospit...
Introduction
Community pharmacists and their teams have remained accessible to the public providing essential services despite immense pressures during the COVID-19 pandemic. They have successfully expanded the influenza vaccination programme and are now supporting the delivery of the COVID-19 vaccination roll-out.
Aim
This rapid realist review aim...
This is a translation of Cochrane Review, Houghton C, Meskell P, Delaney H, Smalle M, Glenton C, Booth A, Chan XHS, Devane D, Biesty LM., Barriers and facilitators to healthcare workers’ adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis. Cochrane Database of...
Background:
Obesity and nutrition-related non-communicable diseases (NR-NCDs) are increasing throughout Africa, driven by urbanisation and changing food environments. Policy action has been limited - and influenced by high income countries. Socio-economic/political environments of African food systems must be considered in order to understand what...
Introduction
High-quality facility-based birth reduces maternal and perinatal morbidity and mortality. Previous multi-country systematic reviews have analysed qualitative research studies to understand the barriers and facilitators of delivery in a health facility. However, questions remain as to the extent to which generic multi-context reviews ca...
Background
Breastfeeding is recommended by many organisations, but feeding choices can take on complexity against a backdrop of a transmissible infection risk. The aim of this synthesis is to explore what is known about the values and preferences of pregnant women, mothers, family members and health practitioners, policy makers and providers (midwi...
Background
The COVID-19 pandemic has created a sense of urgency in the research community in their bid to contribute to the evidence required for healthcare policy decisions. With such urgency, researchers experience methodological challenges to maintain the rigour and transparency of their work. With this in mind, we offer reflections on our recen...
Aim
To review when, how, and in what context knowledge mobilization (KMb) has crossed patient‐practitioner‐researcher boundaries.
Background
KMb is essential in contemporary health care, yet little is known about how patients are engaged.
Design
Integrative review.
Data sources
Ten academic databases and grey literature.
Review methods
We follo...
Background:
The term 'medically unexplained symptoms' is used to cover a wide range of persistent bodily complaints for which adequate examination and appropriate investigations do not reveal sufficiently explanatory structural or other specified pathologies. A wide range of interventions may be delivered to patients presenting with medically unex...
Background
Service reconfigurations sometimes increase travel time and/or distance for patients to reach their nearest hospital or other urgent and emergency care facility. Many communities value their local services and perceive that proposed changes could worsen outcomes for patients.
Objectives
To identify, appraise and synthesise existing rese...
Background
To date, there has been little research into the causes of, and solutions to, loneliness among migrant and ethnic minority people.
Objectives
The objectives were to synthesise available evidence and produce new insights relating to initiatives that aim to address loneliness among these populations, plus the logic, functioning and effect...
Background:
More older people are living in the community with multiple diagnoses and medications. Managing multiple medications produces issues of unrivalled complexity for those involved. Despite increasing literature on the subject, gaps remain in understanding how, why and for whom complex medication management works, and therefore how best to...
This study aimed to address the question: what does “effectiveness” mean to researchers in the context of literature searching for systematic reviews?
We conducted a thematic analysis of responses to an e‐mail survey. Eighty‐nine study authors, whose studies met inclusion in a recent review (2018), were contacted via e‐mail and asked three question...
Background
The number and proportion of older people in the UK are increasing, as are multimorbidity (potentially reducing quality of life) and polypharmacy (increasing the risk of adverse drug events). Together, these complex factors are challenging for older people, informal carers, and health and care practitioners.
Objectives
MEMORABLE (MEdica...
Objective
To identify factors influencing dietary behaviours in urban food environments in Africa and identify areas for future research.
Design
We systematically reviewed published/grey literature (protocol CRD4201706893). Findings were compiled into a map using a socio-ecological model on four environmental levels: individual, social, physical a...
Background:
Reconfiguration of urgent and emergency care services often increases travel time/distance for patients to reach an appropriate facility. Evidence of the effects of reconfiguration is important for local communities and commissioners and providers of health services.
Methods:
We performed a systematic review of the evidence regarding...
Background:
This review is one of a series of rapid reviews that Cochrane contributors have prepared to inform the 2020 COVID-19 pandemic. When new respiratory infectious diseases become widespread, such as during the COVID-19 pandemic, healthcare workers' adherence to infection prevention and control (IPC) guidelines becomes even more important....
Objective
To synthesise evidence of urban dietary behaviours (macronutrients, types of foods, dietary diversity and dietary practices) in two African countries in relation to postulated changes in the context of nutrition transition.
Design
Systematic review and meta-analyses, including six online databases and grey literature, 1971–2018 (Protocol...
Aim:
To explore "missed care" in relation to primary and community care, including nursing homes to build an understanding of implications for patients, public, politicians and policy makers.
Background:
Missed care occurs when any aspect of required patient care is omitted or delayed. Little attention has examined missed care in primary, commun...
Background: More older people are living in the community with multiple diagnoses and medications. Managing multiple medications produces issues of unrivalled complexity for those involved. Despite increasing literature on the subject, gaps remain in understanding how, why and for whom complex medication management works, and therefore how best to...
Background
In 2015, approximately 2.16% of adults were recorded as having intellectual disabilities. UK government policy is that adults with intellectual disabilities should access mainstream health services. However, people with intellectual disabilities experience challenges when accessing primary and community health services that can lead to i...
Objective:
High blood pressure is one of the main modifiable risk factors for dementia. However, there is conflicting evidence regarding the best antihypertensive class for optimizing cognition. Our objective was to determine whether any particular antihypertensive class was associated with a reduced risk of cognitive decline or dementia using com...
Background The World Health Organization’s Global Polio Eradication Initiative (GPEI) has succeeded in reducing the cases of Polio by 99%. The persistence of the remaining 1% in Pakistan, Afghanistan and Nigeria has continued to pose threats to polio-free neighbouring countries. This systematic review aims to contribute to ongoing efforts to eradic...
The requirement that literature searches that identify studies for inclusion in systematic reviews should be systematic, explicit and reproducible extends, at least by implication, to other types of literature review. However, realist reviews commonly require literature searches which challenge systematic reporting; searches are iterative and invol...
Noncommunicable disease now contributes to the World Health Organization top 10 causes of death in low-, middle- and high-income countries. Particular examples include stroke, coronary heart disease, dementia and certain cancers. Research linking clinical and lifestyle risk factors to increased risk of noncommunicable disease is now well establishe...
The revised edition of the Handbook offers the only guide on how to conduct, report and maintain a Cochrane Review.
The second edition of The Cochrane Handbook for Systematic Reviews of Interventions contains essential guidance for preparing and maintaining Cochrane Reviews of the effects of health interventions. Designed to be an accessible resou...
Background Increasing numbers of older people are living in the community with multiple diagnoses and medications. Managing multiple medications produces issues of unrivalled complexity for those involved. Despite a growing body of literature on the subject, gaps remain in understanding how, why and for whom complex medication management works, and...
Aims:
To examine the strengths and weaknesses of multi-context (international) qualitative evidence syntheses in comparison with single-context (typically single-country) reviews. We compare a multi-country synthesis with single-context syntheses on facility-based delivery in Nigeria and Kenya.
Design:
Discussion Paper.
Background:
Qualitative...
Background: Service reconfigurations sometimes increase travel time and/or distance for patients to reach their nearest hospital or other urgent and emergency care (UEC) facility. Many communities value their local services and perceive that proposed changes could worsen outcomes for patients. Objectives: To identify, appraise and synthesise existi...
Background and objectives:
The last decade has witnessed increased recognition of the value of literature reviews for advancing understanding and decision making. This has been accompanied by an expansion in the range of methodological approaches and types of review. However, there remains uncertainty over definitions and search requirements beyon...
Background
The NHS currently faces increasing demands on accident and emergency departments. Concern has been expressed regarding whether the needs of vulnerable groups are being handled appropriately or whether alternative methods of service delivery may provide more appropriate emergency and urgent care services for particular groups.
Objective...
Background
The global ageing population and the long prodromal period for the development of cognitive decline and dementia brings a need to understand the antecedents of both successful and impaired cognitive ageing. It is increasingly apparent that the trajectory of risk-factor change, as well as the level of the risk factor, may be associated wi...
Background
Digital and online symptom checkers and assessment services are used by patients seeking guidance about health problems. NHS England is planning to introduce a digital platform (NHS111 Online) to operate alongside the NHS111 urgent-care telephone service. This review focuses on digital and online symptom checkers for urgent health proble...
This chapter provides authors (who already have experience of undertaking qualitative research and qualitative evidence synthesis) with additional guidance on undertaking a qualitative evidence synthesis that is subsequently integrated with an intervention review. There are two main designs for synthesizing qualitative evidence with evidence of the...
Background: In 2015 approximately 21.6% of adults had intellectual disabilities (ID). Government policy is that they should access mainstream health services. However, people with ID experience challenges when accessing primary and community health services that can lead to inequalities and lower life expectancy. Objectives: To map and review the e...
Objectives:
There are many rapid review methods; however, there is little pragmatic guidance on which methods to select. This study aimed to reach consensus among international rapid review experts outlining areas to consider when selecting approaches for rapid reviews.
Study design and setting:
A two-round modified online Delphi survey was cond...
Background:
Qualitative evidence synthesis is increasingly used alongside reviews of effectiveness to inform guidelines and other decisions. To support this use, the GRADE-CERQual approach was developed to assess and communicate the confidence we have in findings from reviews of qualitative research. One component of this approach requires an appr...
The association of Apolipoprotein E (APOE) with late-onset Alzheimer’s disease (LOAD) and cognitive endophenotypes of aging has been widely investigated. There is increasing interest in evaluating the association of other LOAD risk loci with cognitive performance and decline. The results of these studies have been inconsistent and inconclusive. We...
Objectives:
The objective of the study was to identify existing methodological guidance for the conduct of rapid qualitative evidence syntheses and examples of rapid qualitative evidence syntheses to describe the methods used.
Study design and setting:
We conducted a systematic scoping review. We searched MEDLINE, CINAHL, gray literature, includ...
Background
There have been calls for greater consideration of applicability and transferability in systematic reviews, to improve their usefulness in informing policy and practice. Understanding how evidence is, or is not applicable and transferable to varying local situations and contexts, is a key challenge for systematic review synthesis in heal...