Research projects
Our multidisciplinary researchers are working to better understand, diagnose and treat COVID-19 in the community. These brief project summaries link out to further information where it is available.
Rapid evidence reviews, data analysis and thought-provoking writing relating to the coronavirus pandemic.
The COVID-19 Evidence Service produces rapid reviews in response to questions from health professionals and policy makers at the front line of the coronavirus pandemic. More than 230 articles have been published since March 2020 and reviews have been cited across the global media and in international clinical guidelines. Reviews are produced by evidence synthesis experts from across the Nuffield Department of Primary Care Health Sciences and our partners.
Project lead: Professor Carl Heneghan
Research Group: Centre for Evidence-Based Medicine
Funding: Maris and David Willetts
Understanding the dynamics of policy development and healthcare worker behaviour in the UK during the COVID-19 public health emergency.
Research lead: Dr Nina Gobat
Research group:
Funding: UKRI
CONDOR provides a single national route to evaluate new diagnostic tests for COVID-19.
The CONDOR platform is accelerating how quickly promising COVID-19 diagnostics make it into real-world use. It is evaluating new COVID-19 diagnostics in the settings they will be used, such as in GP surgeries, care homes or hospitals, as well as their performance in laboratory settings.
The CONDOR platform consists of six different workstreams – three clinical evaluation studies, and three cross cutting studies.
Clinical evaluation studies:
- FALCON-C19: The FALCON-C19 study covers hospital emergency departments, inpatient areas, e.g. COVID wards, acute medical units and critical care, and 'Hospital at Home Services'.
- CONDOR-CH: The CONDOR-CH study is looking at rapid testing specifically in care home settings.
- RAPTOR-C19 is focussed on community settings, such as GP surgeries and COVID-19 testing centres
Cross cutting studies:
- Care Pathway Analysis: "Care pathway mapping” studies will identify where new technologies could have the most impact on patient health during the different phases of the pandemic.
- Human Factors analysis: Analysing the interaction between people and technologies in real-world healthcare.
- Analytical performance: Evaluating which tests should be trialled in the different clinical settings and putting the right ones forward into our clinical studies.
Co-led between the University of Oxford with Manchester University’s Diagnostic and Technology Accelerator (DiTA), project partners include the University of Nottingham, NIHR MedTech and In Vitro Diagnostic Co-operatives based in Oxford, Leeds, London and Newcastle, AHSN North East and North Cumbria, and Yorkshire and Humber AHSN.
Oxford co-leads: Associate Professor Gail Hayward (CONDOR), Dr Brian Nicholson (RAPTOR C-19)
Research Groups: NIHR Community Healthcare MedTech and In Vitro Diagnostics Co-operative, Cancer Research Group
Funding: UKRI, NIHR, Asthma UK, British Lung Foundation.
Project Lead: Professor Ly-Mee Yu
Research group: Infection & Acute Care
Funding: NIHR
| The aim of the study is to analyse using data from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), the use of e-consultations (via Skype, Zoom, email, etc.) and telephone consultations versus face-to-face consultations (in the practice or at home) and compare their outcomes for patients with different characteristics in terms of prescriptions, referrals and admissions, before, during and after the COVID-19 pandemic |
Project lead: Dr Catio Nicodemo
Funding: NIHR ARC Oxford & Thames Valley
Project lead: Professor Stavros Petrou
Research Group: Health Economics
Funding: HEI, ESRC Impact Acceleration Account
Project lead: Professor Richard Stevens
Funding: MSD
The UK media and perhaps public are now awake to the challenges of medical statistics. We are particularly concerned with the understanding of death data, which has been the source of much confusion. A single BBC graphic (reproduced here) suggests simultaneously that 67% of covid-19 deaths occur in hospital (top panel) and that 90% of covid-19 deaths occur in hospital (bottom panel), despite being produced by world-standard media professionals. We have long-standing expertise in interpreting medical statistics and can show where, between these two extremes, the truth lies. In the figure below we show that at the time of the BBC graph, 78% of deaths were in hospital, and that on the most recent data is that 83% of covid-19 deaths have been in hospital. In this proposed project we will monitor (a) covid-19 deaths, and their location and (b) all-cause deaths, relative to what would be expected for the time of year. Professional handling and reporting of this data will inform the politics and governance around lockdown, and its eventual (presumed gradual) lifting.
Figure
1 . BBC covid 19 reporting
shows that 67% of deaths are in
hospital (top) and that 90% of
deaths are in hospital (bottom)
reproduced from BBC News
website, April 14th.
Project lead: Professor Simon de Lusignan
Research Group:
Funding: European Commission
Many partners, already involved in studies within the I-MOVE (Influenza – Monitoring Vaccine Effectiveness in Europe) network, came together as the I-MOVE-COVID-19 consortium, and were successful in a bid for the European Commission H2020 call on “Advancing knowledge for the clinical and public health response to the novel coronavirus epidemic”.
The I-MOVE-COVID-19 consortium aims to obtain epidemiological and clinical information on patients with COVID-19 as well as virological information on SARS-CoV-2, through (a) provision of a flexible surveillance platform (adaptable to the epidemiological situation), (b) research studies and (c) evaluation of public health interventions (e.g. vaccination, antivirals), in order to contribute to the knowledge base, guide patient management, and inform the public health response. This will be achieved through adaptation and expansion of the existing, long-running, Europe-wide influenza surveillance network (I-MOVE) to include COVID-19. The network includes primary care networks, hospitals, and national laboratory reference centres in 10 countries across the WHO European Region.
INSTINCT - Integrated Network for Surveillance, Trials and Investigations into COVID-19 Transmission
Project lead: Professor Simon de Lusignan
Research group: RCGP Surveillance Centre
Funding: NIHR
Coronavirus disease 2019 (COVID-19), caused by a new human virus, SARS-CoV-2, has quickly spread around the world. Given the speed of spread, we still know very little about the virus and the body’s immune response to it. We are hoping that our study will provide answers to these key questions: What proportion of household contacts get infected? What proportion of cases are symptom-free? How many are infectious? Which initial immune responses post-exposure protect against (a) infection and (b) symptomatic COVID-19 disease? How long does immunity last?
The study will collect throat swabs (for virus) and blood samples (for immune responses) from two cohorts of adults and children within a few days of exposure to the virus. The first cohort will comprise individuals who present to their general practitioner (GP) with symptoms of COVID-19 and go on to be tested as positive and their household contacts. The second, healthcare workers who have been exposed to the virus. If these individuals consent, they will have samples taken at up to five time-points over the course of 6 months.
| Use of routine clinical data to generate practice dashboards on clinical performance in metrics linked to evidence-based care pathways with comparisons to national performance to help prioritise national recovery of clinical care post COVID, initially focussing on cancer, CVD, respiratory, CKD prevention recovery |
This project will analyse the UK pandemic response by collecting real-time responses from senior policymakers and stakeholders (Public Health England, Department of Health and Social Care, National Health Service) and the frontline experiences of healthcare workers, and by studying media and document sources. Their findings will inform senior policymakers. The project is a collaboration with Professor Sally Sheard at the University of Liverpool.
Oxford co-lead: Dr Nina Gobat
Research Group: Infections and acute care
Funder: UKRI
A secure analytics platform for electronic health records in the NHS.
OpenSAFELY is a new secure analytics platform for electronic health records in the NHS, created to deliver urgent results during the global COVID-19 emergency. It is now successfully delivering analyses across more than 24 million patients’ full pseudonymised primary care NHS records.
Project lead: Dr Ben Goldacre
Research Group: DataLab
Funding: TBC
Project lead: Professor Richard Hobbs
Research group:
Funding: MSD
Community surveillance of COVID-19 and research in partnership with GP practices.
The RCGP Research Surveillance Centre is monitoring suspected cases of COVID-19 in the community via its national network of sentinal GP practices. The network are actively involved in clinical research studies, including the urgent national priority PRINCIPLE trial. The surveillance centre produce weekly reports for Public Health England via the COVID-19 Observatory.
Project lead: Professor Simon de Lusignan
Research Group: Clinical Informatics and Health Outcomes Research Group
Identifying treatments for COVID-19 in older people in the community.
The PRINCIPLE trial platform is the national urgent public health trial for primary care and aims to find treatments for COVID-19 for older people. We want to find medicines that can help people with COVID-19 symptoms get better quickly and stop them needing to go to hospital. The trial is recruiting participants online via more than 800 GP practices across the UK.
Lead Investigators: Professor Chris Butler, Professor Richard Hobbs.
Research Group: Primary Care Clinical Trials Unit, Oxford RCGP Research & Surveillance Centre / Clinical Informatics and Health Outcomes Research Group
Funder: National Institute for Health Research, UKRI.
This project consists of several aspects:
- COVID record linkage project
- COVID research platform
- Data to investigate the association between smoking, nicotine use, respiratory illness, treatments for respiratory illness and Covid-19
Project lead: Professor Julia Hippisley-Cox
Research group:
Funding: NIHR
Real-time infectious disease system reporting from 4,000 GP practices every day to inform the national pandemic response.
Project lead: Professor Julia Hippisley-Cox
Research group: Primary Care Epidemiology
Funding: HEIF, ESRC Impact Acceleration Account, Covid-19 Economic, social, cultural, & environmental impacts - urgent response fund
Evaluation of rapid COVID-19 tests against reference standards (PCR swabs) as technologies become available. Scaling up testing will be a key UK priority to better understand and control COVID-19 transmission.
Project leads: Professor Richard Hobbs, Dr Brian Nicholson
Research group:
Funding:
Project lead: Professor Chris Butler
Research group: Infection & Acute Care
Funding: EU H2020
Components include:
- A point prevalence audit survey where clinicians in contrasting European countries register consultations for acute Respiratory infection, and report on testing and management. The goal is to benchmark care, and to identify good practice and share it.
- A prospective study in which primary care clinicians register clinical features of patients with suspected Covid-19, their testing, and management strategy, together with patient follow-up of patient outcomes.
- We are feeding into the development of a Europe-wide platform trial that may evaluate point of care diagnostics for Covid-19.
- We are contributing to social science work exploring the perceptions of healthcare workers, patients and home carers about their experiences with COVID-19, and how this might enhance risk communication.
Adressing the micro, meso and macro-level challenges of a radical new service model
This project will address the technological tools that GP surgeries use to interact with patients; the organisational and wider infrastructure changes that might be required to scale up and deliver better remote care; and what insights can be gleaned from this time of crisis that will help build a more resilient NHS. It consists of a mixed methods study with four work packages including RECAP early warning tool and four discrete case studies in primary care sites and policy impact.
Project lead: Professor Trish Greenhalgh
Research Group: IRIHS
Funding: Economic and Social Research Council
A data-driven risk prediction model for individualised shielding advice.
We are developing a data-driven risk prediction model for COVID-19, supported by NHS Digital. This new model could be applied in a variety of health and care settings, including supporting GPs and specialists in consultations with their patients to provide more targeted and individualised advice based on individual levels of risk.
The tool will be developed based on an analysis of the anonymised electronic health records of 8 million adults in the UK, accessed through the QResearch database. The data will be analysed to identify factors that can be used to predict those at highest risk of infection and serious illness from COVID-19.
The project was commissioned from the Office of the Chief Medical Officer for England involves partners from across the UK.
Project lead: Professor Julia Hippisley-Cox
Research Group: Primary Care Epidemiology / QResearch
Funding: National Institute for Health Research, University of Oxford COVID-19 Rapid Response Fund
Interdisciplinary work in two work packages to evaluate spread and provide case studies of organisational change and to deliver outputs for practitioners, public, policy and academic audiences.
Project lead: Sara Shaw
Research group:
Funding: Health Foundation