Hayley Anne Hutchings

Swansea University | SWAN · College of Medicine

Background There is limited evidence in the literature on the long-term effectiveness and cost-effectiveness of treatments for Acute Severe Ulcerative Colitis (ASUC). The study aimed to perform decision analytic model-based long-term cost-utility analysis (CUA) of infliximab versus ciclosporin for steroid-resistant ASUC investigated in CONSTRUCT pr...

Background: there is currently limited research examining the QoL of patients with Ulcerative colitis (UC) following treatment of acute severe colitis (ASUC). Objective: to examine the long-term QoL of ASUC patients enrolled in the CONSTRUCT trial following treatment of UC with infliximab or ciclosporin and to compare the differences in the QoL...

Introduction The introduction of information technology was one of the key priorities for policy-makers in health care organisations over the last two decades due to the potential benefits of this technology to improve health care services and quality. However, approximately 50% of those projects failed to achieve their intended aims. This was a re...

Introduction Fibroadenomas are benign lesions found in the breast tissue. Widespread access to and use of the internet has resulted in more individuals using online resources to better understand health conditions, their prognosis and treatment. The aim of this study was to investigate the readability and visual appearance of online patient resourc...

Background Basal Cell Carcinoma (BCC) represents the most commonly occurring cancer worldwide within the Caucasian population. Reports predict 298 308 cases of BCC in the UK by 2025, at a cost of £265-366 million to the National Health Service (NHS). Despite the morbidity, societal and healthcare pressures that manifest, routinely collected healthc...

Background Over the last 10 years, research has highlighted emerging potential risk factors for poor outcomes following blunt chest wall trauma. The aim was to update a previous systematic review and meta- analysis of the risk factors for mortality in blunt chest wall trauma patients. Methods A systematic review of English and non- English articles...

Introduction At present, vaccines form the only mode of prophylaxis against COVID-19. The time needed to achieve mass global vaccination and the emergence of new variants warrants continued research into other COVID-19 prevention strategies. The severity of COVID-19 infection is thought to be associated with the initial viral load, and for infectio...

Background Oral anticoagulation therapies (OATs) are often prescribed in conjunction with medications to restore normal heart rate rhythm which can limit the risk of an atrial fibrillation (AF) related stroke and systemic thromboembolism. However, they are associated with the serious side effect of bleeding. Both clinically relevant nonmajor bleedi...

Introduction Routinely collected healthcare data are a powerful research resource, but often lack detailed disease-specific information that is collected in clinical free text such as histopathology reports. We aim to use Natural Language Processing (NLP) techniques to extract detailed clinical and pathological information from histopathology repo...

Looked after children (LAC) continue to be one of the most vulnerable groups in society with numbers and rates in care increasing year-on-year. The aim of this study was to explore the unique perspectives, perceptions and opinions of experienced social workers on the little explored subject of neurodevelopmental disorders (NDDs) in this population....

Background: Crohn's and Ulcerative Colitis Questionnaire-32 (CUCQ-32) is a validated questionnaire to measure the quality of life (QoL) in Inflammatory Bowel Disease (IBD). However, it does not have stoma-specific questions and can be lengthy. This study aimed to validate a subset of the CUCQ-32 that would be suitable for patients with a stoma. M...

Introduction Approximately 5%–10% of new rectal cancers are locally advanced (locally advanced rectal cancer (LARC)) at presentation with 4%–8% recurring (locally recurrent rectal cancer (LRRC)) after initial treatment. Patients with potentially curable disease have to consider many trade-offs when considering major exenterative surgery. There are...

Introduction There is a UK-wide need to increase the number of Clinical Endoscopists (CEs). From April 2019 CEs were recruited to an accelerated programme of training (small group teaching, Masters level modules; simulation; JAG courses; training lists; and on-line courses & tutorial groups) – to achieve JAG accreditation. Methods We conducted qua...

Introduction Increased demand for endoscopy has created a need to increase the number of Clinical Endoscopists (CEs) contributing to service delivery. From April 2019 CEs were recruited to an accelerated programme of blended training interventions (Core teaching; Masters level modules; Simulation; JAG courses; online lesion recognition (SLATE) cour...

It is increasingly recognised that collecting patient reported outcome measures (PROMs) data is an important part of healthcare and should be considered alongside traditional clinical assessments. As part of a more holistic view of healthcare provision, there has been an increased drive to implement PROM collection as part of routine clinical care...

Background: Crohn’s and Ulcerative Colitis Questionnaire-32 (CUCQ-32) is a validated questionnaire to measure the quality of life (QoL) in inflammatory bowel disease (IBD). However, it does not have stoma specific questions and can be lengthy. This study aimed to validate a subset of the CUCQ-32 that would be suitable for patients with a stoma. Met...

Introduction Chronic pain and disability are now well-recognised long-term complications of blunt chest wall trauma. Limited research exists regarding therapeutic interventions that can be used to address these complications. A recent feasibility study was completed testing the methods of a definitive trial. This protocol describes the proposed def...

Background Looked after children (LAC) that are placed in either a foster, kinship, residential care setting or transition to adoption continue to develop debilitating disorders that significantly impact their overall health and social well-being. The prevalence of these disorders is often depicted under broad categories such as mental, behavioural...

The introduction of IT was one of the key priorities for policy-makers in healthcare organisations over the last two decades, due to the potential benefits of this technology to improve healthcare services and quality. However, about 50% of those projects failed to achieve their intended aims. This was as a result of several factors, and included t...

Background To review whether online decision aids are available for patients contemplating pelvic exenteration (PE) for locally advanced and recurrent rectal cancer (LARC and LRRC). Methods A grey literature review was carried out using the Google Search™ engine undertaken using a predefined search strategy (PROSPERO database CRD42019122933). Writ...

Introduction: At present, vaccines form the only mode of prophylaxis against COVID-19. The time needed to achieve mass global vaccination and the emergence of new variants warrants continued research into other COVID-19 prevention strategies. The severity of COVID-19 infection is thought to be associated with the initial viral load and for infectio...

Objectives The FACE-Q Skin Cancer module is a patient reported outcome measure (PROM) for facial skin cancer. It has been anglicised for the UK population and undergone psychometric testing using classical test theory. In this study further evaluation of construct validity using Rasch measurement theory and hypothesis testing was performed. Method...

Introduction The severity of Covid-19 infection is associated with viral load. For infection to occur, viruses including SARS-CoV-2 must first penetrate the respiratory mucus to attach to the host cell surface receptors. Iota-carrageenan (I-C), a sulphated polysaccharide extracted from red edible seaweed, has shown efficacy against a range of virus...

Introduction Most individuals newly diagnosed with type 1 diabetes (T1D) have 10%–20% of beta-cell function remaining at the time of diagnosis. Preservation of residual beta-cell function at diagnosis may improve glycaemic control and reduce longer-term complications. Immunotherapy has the potential to preserve endogenous beta-cell function and the...

IntroductionThe centralisation of pancreatic cancer (PC) services still varies worldwide. This study aimed to assess the impact that a centralisation has had on patients in South Wales, UK.MethodsA retrospective cohort analysis of patients in South Wales, UK, with PC prior to (2004–2009), and after (2010–2014) the formation of a specialist centre....

Background Using computer software in general practice to predict patient risk of emergency hospital admission has been widely advocated, despite limited evidence about effects. In a trial evaluating the introduction of a Predictive Risk Stratification Model (PRISM), statistically significant increases in emergency hospital admissions and use of ot...

Skin cancer is more common in transplant recipients, although the quoted incidence is variable. This study investigated the incidence of skin cancer in solid organ transplant recipients (OTRs) in a national cohort and the effect of pharmacotherapeutic agents Transplant patients were identified from Patient Episode Database for Wales (PEDW) using Of...

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia. Oral anticoagulation therapies (OATs) are often prescribed in conjunction with medications to restore normal heart rate rhythm which can limit the risk of an AF-related stroke and systemic thromboembolism. However, they are associated with the serious side effect of bleeding...

Background Multidisciplinary team meetings are an integral component of skin cancer service provision, enabling implementation of evidence-based decisions and standardised patient outcomes. Objectives We sought to evaluate the composition, quoracy and cost of Specialist Skin Cancer Multidisciplinary Teams (SSMDT's) in the United Kingdom (UK) to es...

Objectives: Listening effort may be defined as the attentional and cogni-tive resources needed to understand an auditory message, modulated by motivation. Despite the use of hearing devices such as hearing aids or cochlear implants (CIs), the requirement for high listening effort remains a challenge for individuals with hearing loss. The Listening...

Objectives: Listening effort may be defined as the attentional and cognitive resources needed to understand an auditory message, modulated by motivation. Despite the use of hearing devices such as hearing aids or cochlear implants (CIs), the requirement for high listening effort remains a challenge for individuals with hearing loss. The Listening...

Aim In a trial evaluating the introduction of a predictive risk stratification model (PRISM) into primary care we reported statistically significant increases in emergency hospital admissions and use of other NHS services without evidence of benefits to patients or the NHS. The aim of this study was to explore the views and experiences of general p...

Background The optimal duration of dual antiplatelet therapy is a matter of ongoing research. Clinical studies are assessing the optimal duration with the most favourable risk to benefit ratio. The efficacy of P2Y12 receptor inhibitors has been shown comparable to aspirin in preventing recurrent ischaemic events in patients with coronary artery dis...

Phenylketonuria (PKU) is a condition that results in the build-up of phenylalanine in the blood. This can cause severe brain damage and neurological issues if left untreated. Management can be complex and many individuals may turn to the internet to access further information. It is important that resources are understood as misinterpretation could...

Facial skin cancer is common, and its treatment affects patient's health-related quality of life (HRQoL), as demonstrated by patient-reported outcome measures (PROMs). In this study, we anglicise and validate the novel FACE-Q Skin Cancer Module for the UK population. Anglicisation of the FACE-Q Skin Cancer Module followed international guidance for...

Background: Stratifying patient populations by risk of adverse events was believed to support preventive care for those identified, but recent evidence does not support this. Emergency admission risk stratification (EARS) tools have been widely promoted in UK policy and GP contracts. Aim: To describe availability and use of EARS tools across the...

Introduction: The measures implemented to manage the COVID-19 pandemic have been shown to impair mental health. This problem is likely to be exacerbated for carers. Method: Informal carers (mainly parents) of children and adults with intellectual disabilities, and a comparison group of parents of children without disabilities, completed an onlin...

Background: The aim was to complete a feasibility study that would test the methods of the main trial, that will investigate whether early thoracic and shoulder girdle exercises reduce chronic pain in patients with blunt chest wall trauma, when compared with normal care. Methods: A single centre, parallel, feasibility randomised controlled trial...

Background: To establish what online decision aids are currently available for patients contemplating pelvic exenteration (PE) for locally advanced and recurrent rectal cancer (LARC and LRRC). Methodology: A grey literature review was carried out using the Google SearchTM engine undertaken using a predefined search strategy (PROSPERO database CRD42...

In medicine, "big data" refers to the interdisciplinary analysis of high-volume, diverse clinical and lifestyle information on large patient populations. Recent advancements in data storage and electronic record keeping have enabled the expansion of research in this field. In the United Kingdom, Big data has been highlighted as one of the governmen...

Background Policy initiatives have incentivised use of EARP tools in primary care to reduce emergency admissions. A recently published trial in South Wales found that EARP increased emergency admissions and emergency department attendances without clear benefits. This cost the NHS an additional £76 per patient per year. But the use of EARP in prima...

Background: In recent years, researchers and clinicians have been developing prognostic prediction tools (PPTs) as a way of identifying patients at risk of deterioration. The use of PPTs in the clinical environment not only impacts the risk of adverse outcomes for patients, but the use of these tools also effect clinical practice. Much attention h...

皮肤癌是西方人群最常见的癌症类型,而黑色素瘤是最危险的疾病形式。近年来,出现了“社会决定因素”和黑色素瘤之间的联系。社会决定因素包括社会经济因素(包括收入、教育、贫困水平、居住地区、职业和社会状况)和生活方式因素(包括紫外线暴露情况、婚姻状况、业余爱好、吸烟、肥胖)。 本研究由位于英国斯旺西和伦敦的一组研究人员进行,旨在重新分析人们的吸烟习惯及社会经济地位与黑色素瘤发生和进展之间的关系。 为了实现这一目标,团队使用了一个群体数据库,该数据库提供了在威尔士诊断和治疗的患者的详细信息。研究者们能够分析在本研究中包括的过去 5 年里超过 9000 名诊断患有黑色素瘤的患者中的数据,此外,他们还审查了 26000 名无黑色素瘤患者的信息。 他们发现,吸烟与黑色素瘤的发生率下降相关,并且它对黑色素瘤本...

Skin cancer is the most common cancer type in Western populations and melanoma is the most dangerous form of the disease. In recent years, a link between ‘social determinants’ and melanoma has emerged. Social determinants encompass both socioeconomic factors (including income, education, poverty level, area of residence, occupation and social statu...

Background: A looked after child (LAC) is defined as a child or young adult, that has been placed in either a foster care, kinship, residential or adoption care setting. While embedded in the care of these services, these children still develop debilitating disorders that significantly impact their future overall wellbeing. Prevalence of these diso...

Background: Looked after children (LAC) placed in either a foster care, kinship, residential or adoption care settings continue to develop debilitating disorders that significantly impact their future overall wellbeing. Prevalence of these disorders are often depicted under broad categories such as mental, behavioural or neurodevelopmental disorder...

Background For patients with blunt chest wall trauma, no evidence exists regarding the optimal physiotherapy treatment aimed at addressing the longer-term complications, specifically chronic pain and disability. The overall aim of this phase of work, is to investigate whether early thoracic and shoulder girdle exercises improve chronic pain in pati...

LINKED CONTENT This article is linked to Alrubaiy et al and and Gulamhusein and Jackson papers. To view these articles, visit https://doi.org/10.1111/apt.15554 and https://doi.org/10.1111/apt.15588.

Background: Current guidelines in primary biliary cholangitis ( PBC) recommend routine screening for symptoms. However, at present there are no validated practical tools suitable for screening use in practice. Aim: To develop a short quality of life questionnaire for PBC METHODS: The short PBC HRQL questionnaire was derived and validated by anal...

It is common to undertake qualitative research alongside randomised controlled trials (RCTs) when evaluating complex interventions. Researchers tend to analyse these datasets one by one and then consider their findings separately within the discussion section of the final report, rarely integrating quantitative and qualitative data or findings, and...

Background: A nested qualitative interview study within the CONSTRUCT trial was conducted to explore experiences and perceptions of patients with acute severe ulcerative colitis following treatment with infliximab or ciclosporin, surgery, or other medication. Methods: Two hundred seventy patients with steroid-resistant ulcerative colitis were ra...

Background: Previous studies have identified an inverse association between melanoma and smoking; however data from population based studies are scarce. Objective: To determine the association between smoking and socioeconomic status on the risk of development of melanoma. Furthermore, we sought to determine the implications of smoking and socio...

To investigate long-term health sequelae of cryptosporidiosis, with especial reference to post-infectious irritable bowel syndrome (PI-IBS). A prospective cohort study was carried out. All patients with laboratory-confirmed, genotyped cryptosporidiosis in Wales, UK, aged between 6 months and 45 years of age, over a 2-year period were contacted. Fiv...

Introduction Listening effort may be defined as the cognitive resources needed to understand an auditory message. A sustained requirement for listening effort is known to have a negative impact on individuals’ sense of social connectedness, well-being and quality of life. A number of hearing-specific patient-reported outcome measures (PROMs) exist...

Objective A new prognostic model has been developed and externally validated, the aim of which is to assist in the management of the blunt chest wall trauma patient in the emergency department (ED). The aim of this trial is to assess the feasibility and acceptability of a definitive impact trial investigating the clinical and cost-effectiveness of...

We would like to thank Lee and colleagues for their comments on our systematic review¹. As they have pointed out, their psychometric validation paper for the FACE‐Q Skin Cancer Module was published after the date of this review article's inclusion period and as such was not included. We are very aware of this well conducted psychometric paper² and...

Aim We evaluated the introduction of a predictive risk stratification model (PRISM) into primary care. Contemporaneously National Health Service (NHS) Wales introduced Quality and Outcomes Framework payments to general practices to focus care on those at highest risk of emergency admission to hospital. The aim of this study was to evaluate the cost...

Background:. The keystone perforator island flap provides a versatile form of reconstruction. Perceived benefits include better donor-recipient color match, less contour defect, and fewer complications. To date, there has been no high-quality evidence comparing keystone flaps to split-thickness skin grafts (SSG) from both a qualitative and quantita...

Background The value of qualitative methods within trials is widely recognised, but their full potential is not being realised. There are also issues with the visibility, recognition and reporting of qualitative methods in trials. To identify potential improvements in qualitative research within trials, we need to study trials that have included qu...

Introduction Skin cancer is the commonest malignancy worldwide, often occurring on the face. Both the condition and treatment can lead to scarring and facial disfigurement, affecting a patient's health‐related quality of life (HRQoL), which can be measured using patient‐reported outcome measures (PROMs). This systematic review identifies PROMs for...

Background: A patient's health-related quality of life (HRQoL) can be significantly impacted by facial scarring and disfigurement. Facial soft tissue reconstruction should aim to improve HRQoL, with outcomes measured from the patient's perspective using patient-reported outcome measures (PROMs). This systematic review identifies PROMs for soft tis...

Background The ageing UK population needs safe approaches to reduce emergency hospital admissions. Predictive risk stratification modelling (PRiSM) estimates risk that individuals will suffer emergency admission to hospital within 12 months and selects patients for preventative community care to avoid admissions. Aim To evaluate the introduction o...

Objectives: To investigate the impact of a six-week supervised exercise programme on cardiopulmonary fitness, balance, muscle strength and anxiety and depression in patients who have been discharged home from hospital following an intensive care unit length of stay of greater than 48 h. To investigate patients' perceptions of a six-week supervised...

Objective: To develop and undertake initial validation of a patient-reported outcome measure (PROM) to assess health-related quality of life in patients with breast cancer-related upper limb lymphedema (ULL). Study design and setting: We developed and validated the Upper Limb Lymphedema Quality of Life (ULLQoL) scale in two stages: devising the...

This study examined university gym use by staff and students using mixed methods: participant observation and an e-survey. Research in three UK universities entailed 16 observation sessions and an e-survey that reached 3396 students and staff. The research focused on gym use, the gym environment, the presentation of the self, and social interaction...

The use of patient-reported outcome measures (PROMs) is increasing across all medical specialties, as their importance to patient care is validated. They are likely to play a particularly important role in plastic and reconstructive surgery where outcomes are often subjective, and the recent guidance from the Royal College of Surgeons of England ad...

Objectives: Individuals with hearing loss often report a need for increased effort when listening, particularly in challenging acoustic environments. Despite audiologists' recognition of the impact of listening effort on individuals' quality of life, there are currently no standardized clinical measures of listening effort, including patient-repor...