NIHRDataInsights/HRCSData huggingface dataset:
Title: Assessing the feasibility of a sensor-rich gait wearable and advanced behavioural science platform to improve care and rehabilitation outcomes for knee arthroplasty patients
Funder: Innovate UK

Abstract: Over 125,400 total KAs (TKAs) are carried out in the UK each years, costing the NHS ~£812M pa. Driven in part by an aging population and increase in conditions such as Rheumatoid arthritis (RA), Parkinson's Disease (PD) and Osteoarthritis (OA), the last 10 years have seen a 39% increase in cost, and a 33% increase in surgery delays, dramatically impacting patient's mobility, ability to stay active and quality of life. Path Insight (PIn), is an advanced at-home gait monitoring system that combines a unique and patented, sensor-rich insoles and patient-adapting machine learning to accurately map, metricate and baseline a persons gait symmetry, pronation, supination, pressure distribution, balance, falls risk and significant changes in activity, amongst a range of other clinically accurate metrics. From this, our platform can infer to high-degree of accuracy (validated) a number of clinically-interesting health indicators and biomarkers such as mobility, activity, falls risk assessment and measuring disease progression or therapeutic impact. From this, patients can be stratified and prioritised for surgery or physiotherapy much more accurately, rather than it being on 'first-come, first-serve' basis currently, which leads to delays, creates regional and social inequalities and damages QoL for patients. Target NHS saving = £177m pa (~23% KA-NHS spend;2021).


Research activity codes: 5.3 MEDICAL DEVICES
Health categories: MUSCULOSKELETAL
Title: 3D bio-printing human pluripotent stem cell-derived skeletal muscle constructs for disease modelling and drug discovery
Funder: National Centre for the Replacement, Refinement and Reduction of Animals in Research

Abstract: The largest tissue of human body is skeletal muscle, which is responsible for voluntary


Research activity codes: 2.5 RESEARCH DESIGN AND METHODOLOGIES (AETIOLOGY)
Health categories: MUSCULOSKELETAL
Title: Investigating biomechanical responses in healthy and diseases ageing cartilage - a tissue engineering approach
Funder: National Centre for the Replacement, Refinement and Reduction of Animals in Research

Abstract: Musculoskeletal conditions are a severe burden on the modern ageing society, with an estimated 8.5 million


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS
Health categories: MUSCULOSKELETAL
Title: Design of Genetically Engineered Tensile Load-Bearing Soft Tissues Inspired by Embryonic Tendon Development
Funder: Department for the Economy, Northern Ireland

Abstract: The aim of this project is to develop a new stratified approach to creating load bearing tissue-engineered tendon constructs using ‘state of the art’ nanotechnology-based approaches.


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS;2.5 RESEARCH DESIGN AND METHODOLOGIES (AETIOLOGY)
Health categories: MUSCULOSKELETAL
Title: Genipin-polydopamine reactive films for titanium surface functionalization
Funder: The Academy of Medical Sciences

Abstract: Enhancing the longevity and performance of orthopedic titanium (Ti) implants continues to attract worldwide interest. Despite improvements in prosthesis design around 8% of total joint replacements fail through a process of aseptic loosening and a further 1-2% fail because of infection. The annual cost for England and Wales alone exceeds £300m. Reducing the socioeconomic impact of implant failures will ease the strain on an already over-stretched NHS and help redirect funds for tackling other healthcare issues. One way in which aseptic loosening might be reduced is to develop Ti coatings with suitable agents that are predicted to promote superior, early osseointegration. To this end, we have explored the use of polydopamine (PDA) reactive platforms to capture agents at the Ti surface that are known to target bone-forming osteoblasts [1]. The use of PDA as a reactive film for many materials has emerged from our understanding as to how edible marine mussels (Mytilus edulis) tenaciously attach to wet surfaces. Specialized mussel foot proteins are rich in lysine and DOPA residues, each of which bears -amino and catechol groups respectively, and which are responsible for the adhesive properties. Interestingly if dopamine hydrochloride is dissolved in mildly alkaline (~pH 8) solutions it spontaneously polymerizes to PDA. Any object that is present during polymerization becomes functionalized with a PDA thin film, even Teflon! The PDA in turn is reactive towards a multitude of agents including peptides, proteins, lipids, oligonucleotides, and noble metals. The reactive nature of PDA enables further material functionalization to suit a particular application, e.g., affinity sorbents and catalytic platforms [2]. Whilst PDA coatings have attracted widespread interest we have found that functionalized surfaces are susceptible to PDA loss and compromised performance. Stabilizing the PDA films with a suitable cross-linking agent might provide a solution. In realizing this the overall aim of the project is to explore the potential of genipin to help stabilize the PDA film. Genipin, a natural cross-linking reagent, is obtained from Gardenia fruits (Gardenia jasminoides Ellis) and has been successfully employed in the generation of stabilized polymeric gels. Cross-linking is through reaction with amino groups, the products of which are bright blue [e.g., 3]. Available amino groups are present within PDA films and have been exploited, for example, in the capture of enzymes in generating catalytic technologies. We will now examine the potential of genipin to react with deposited PDA films in generating more robust Ti surface functionalizations. References [1] Baldwin et al. (2020) Molecules, 25, 1583; doi:10.3390/molecules25071583. [2] Ryu et al. (2018) ACS Applied Materials & Interfaces DOI: 10.1021/acsami.7b19865. [3] Muzzarelli et al. (2016) International Journal of Biological Macromolecules 93, 1366–1381.


Research activity codes: 5.4 SURGERY;2.1 BIOLOGICAL AND ENDOGENOUS FACTORS
Health categories: MUSCULOSKELETAL
Title: Mimicking Nature Adhesive for Bone Repair
Funder: Royal Academy of Engineering

Abstract: Currently, there is still no suitable glue in orthopaedics to fix highly comminuted bone fractures. In nature, bioadhesives underpin many biological systems, e.g., mussels, barnacles and amphipods have highly developed, effective bioadhesive systems that enable them to stick to surfaces underwater in highly saline and hostile conditions. This research investigates natural bioadhesive systems and their translation into a bone glue.


Research activity codes: 5.1 PHARMACEUTICALS
Health categories: MUSCULOSKELETAL
Title: Does anti-RANKL therapy prevent glucocorticoid induced bone loss and promote muscle function in a mouse model of Duchenne muscular dystrophy?
Funder: LifeArc

Abstract: Duchenne muscular dystrophy (DMD) is a devastating genetic disease that affects 1 in 4,000 boys. A child with the condition will experience a deterioration of their physical abilities. Sadly, there is no cure and most lose their ability to walk between the ages of 10 to 14 years. Treatment with steroids can help slow down muscle damage and weakness – keeping boys walking for around two to three years longer. But the long-term use of these medicines can cause unwanted side effects, including fragile bones (osteoporosis) – which increases the risk of fractures. Around one-half of all children with DMD lose the ability to walk after their first long-bone fracture. Spinal fractures are also common and can lead to ongoing back pain that affects their quality of life. Currently, the only effective treatment for preventing bone fractures in children with DMD are drugs called bisphosphonates. But these medicines cause unpleasant side effects and also need to be given through a vein, which can be challenging in these boys. Recently, a new drug called denosumab – which is given as an injection – has been proven to be effective for adults with osteoporosis. Professor Colin Farquharson and his team will perform a series of laboratory experiments to evaluate the potential of denosumab for preventing bone fractures in young people with DMD – and investigate the best strategies for using the drug in combination with steroids and bisphosphonates. Their results will set the stage for future clinical trials to evaluate whether this medicine can provide a safe, effective and convenient new treatment for children with the condition.


Research activity codes: 2.1 BIOLOGICAL AND ENDOGENOUS FACTORS;5.1 PHARMACEUTICALS
Health categories: MUSCULOSKELETAL
Title: Understanding and improving decision making for joint replacement surgery in older patients with other complex health needs.
Funder: Nuffield Foundation

Abstract: Why is this research important? This research concerns older people (aged 70 or over) with severe knee osteoarthritis who are being considered for joint replacement surgery. Many also have multiple other health conditions, both physical and mental. Weighing up the risks and benefits of surgery is not easy for them, their carers and healthcare professionals (HPs). Understanding the issues involved is needed to help inform decision making. Aims Our aims are: 1.To understand the issues and concerns of older people with severe knee osteoarthritis additional to other physical or mental health problems, when faced with a decision about joint replacement surgery. 2.To use this information to develop a web-based ‘patient experience’ resource to support older people with multiple health problems and their clinicians in making treatment decisions about surgery. Design and methods We will conduct in-depth interviews with a national sample of 60 older patients with severe knee osteoarthritis and multiple other conditions, who have been referred for possible surgery, to understand what is important to them in terms of their health and illness, lives, relationships and hobbies. Patients will be followed up with interviews, whether or not they had surgery, to see whether and how their views changed following their decision. Output Results from these interviews will be used to develop a patient-friendly resource to enhance decision making, for inclusion in the widely-used "Healthtalk" website. Engagement with patient charities will help ensure the resource developed is relevant and of value to older osteoarthritis patients and HPs who treat them.


Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING
Health categories: MUSCULOSKELETAL
Title: Integrating enriched, longitudinal multi-level data for local population musculoskeletal health intelligence: North Staffordshire & Stoke-on-Trent
Funder: Nuffield Foundation

Abstract: Reducing the burden of common musculoskeletal (MSK) conditions and addressing NHS priorities requires better integration of data upstream of hospital care. Meaningful data collected from population level surveys, primary care electronic health records (EHR) and MSK community service providers have not been co-ordinated and linked together to inform public health and primary care policy making. In this project, we seek to overcome these barriers by developing a novel and scalable approach within North Staffordshire & Stoke-on-Trent (population ˜ 483,000). From population level surveys, primary care records and MSK community service providers, we will: (1) collect the same patient outcomes on MSK severity, impact, and levels of patient engagement (knowledge, confidence, understanding), together with measures of patient experience, processes of care (e.g. waiting times), general health status, and wider social determinants (2) create scalable methods to link different data sources relevant to MSK prevention and management, (3) produce templates for health intelligence reports, based on expert analysis and user feedback, to stimulate dialogue and action among decision-makers, service providers and the public to improve MSK health and care quality. We will test the resulting system using questions that exemplify priorities of key stakeholders. Can such a system: • reliably quantify inequalities in musculoskeletal health and identify those at greatest need? • identify unwarranted variations in outcomes and processes of care? • provide the evidence needed to evaluate the impact on MSK health and hospital admissions of local service reorganisation and other local/national policy initiatives? • provide practical insights that influence national MSK health intelligence systems?


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: MUSCULOSKELETAL
Title: Assembling the data jigsaw: powering robust population research in MSK disease
Funder: Nuffield Foundation

Abstract: Arthritis and musculoskeletal (MSK) conditions are a leading cause of disability with significant impact on quality of life. However, lots of gaps remain in our understanding: for example, exactly how common it is, how it progresses, what treatments are best, and who needs which services and when. Research using health data can answer such questions. But in MSK disease, progress is hampered by availability of the right data. There is, surprisingly, no national system for recording diagnoses in hospital outpatient clinics, nor a standard way of tracking disease progress. Outpatient letters sometimes include this information, but hidden in a jumble of words making it difficult to analyse. Feedback from patients does not fully capture their experiences. Other pieces of the "data puzzle" exist, such as social care use, but these are not linked to health data and are inaccessible for research. Our aim is to "assemble the data jigsaw" in Greater Manchester to improve MSK research, in turn advancing care for patients and informing policy. Building on existing primary care research datasets, we will use computers to find and extract data automatically from hospital clinic letters, test ways of collecting coded information from rheumatologists and from patients using touchscreens in waiting areas. This will be joined with other data sources including social care and social media data. All the data assembly work is designed to be transferrable to other NHS settings. Importantly, we will ensure public trust throughout by keeping data safe and maintaining clear communication with patient communities.


Research activity codes: 8.4 RESEARCH DESIGN AND METHODOLOGIES (HEALTH SERVICES)
Health categories: MUSCULOSKELETAL
Title: Geographical mapping of prevalence and outcomes in rheumatic and musculoskeletal conditions across Wales and Scotland: a data linkage study
Funder: Nuffield Foundation

Abstract: For those with rheumatic and musculoskeletal disease (RMD), diagnostic and treatment delays are associated with poorer outcomes. Up to one third of the UK population live in rural areas, which presents a significant challenge to the delivery of timely and equitable healthcare services. However, the prevalence and health outcomes for those with RMD conditions in rural versus urban settings is largely unquantified. Understanding the existence and extent of geographical differences in health outcomes, and factors driving such differences at a population level, is an essential first step to inform both the development of workable evidence-based solutions for policy, clinical practice and resource allocation. Scotland and Wales, with large rural populations and unique national healthcare record linkage capabilities, provide ideal settings to address this key evidence gap. This proposal brings together investigators with a strong track record in delivering internationally excellent health informatics and health services research. We aim to determine the prevalence of RMD conditions across rural and urban areas, patterns of healthcare use and health care outcomes. We will use population level routine health care data spanning community, ambulatory and hospitalised care to explore this. We will also conduct a priority setting survey to explore the priorities of patients with RMD living in rural and urban areas. At the end of the study we will produce an interactive digital geographical map of RMD conditions across Scotland and Wales. Together with results from the priority setting survey, we will produce recommendations to inform UK national strategy on delivery of care for those with RMD. We will also ensure that our data science methods and datasets are transparent and available for use by other researchers.


Research activity codes: 8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: MUSCULOSKELETAL
Title: How does arthritis affect earnings over time? Longitudinal evidence from three UK panel datasets
Funder: Nuffield Foundation

Abstract: Arthritis affects people’s lives in many ways, including through its effect on employment. This can include job loss, early retirement, an inability to find appropriate work or a lack of career progression. Our study will capture these consequences by assessing how people’s earnings evolve over many years. The project’s aim is to better understand how individual-level earnings are affected by arthritis. It will bring together three existing nationally representative datasets which are underutilised in arthritis research. The trajectory of employment earnings over time of 20,685 people of working age with arthritis will be compared to 41,370 people who don’t have arthritis. Groups of individuals, for whom an arthritis diagnosis is expected to have a particularly detrimental effect on earnings, will be examined separately. These groups will likely include women, and people with comorbidities or lower educational qualifications, however final decisions will be made during the project using existing evidence and through engagement with expert patients, professionals and policy makers. The research will improve understanding of the impact of arthritis and its role in exacerbating inequalities. It will provide an estimate (in £s) of the arthritis-attributable loss in earnings both to individuals with arthritis, and across the whole UK economy. This could provide fresh impetus for investment in (government and workplace) interventions for improving management, treatment and prevention. It will also support decisions about targeting such interventions during particular life stages and amongst particular individuals who would benefit most. Our software coding will be released for use in further arthritis research.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: MUSCULOSKELETAL
Title: The impact of musculoskeletal conditions on outcomes of other illnesses: a linked electronic health record study
Funder: Nuffield Foundation

Abstract: People with musculoskeletal pain often have other illnesses. Health professionals may not prioritise management of this pain when they feel another illness is more serious. Yet pain, alongside associated poor function and sleep interference, may reduce the effectiveness and delivery of treatment for other illnesses and so increase the chance of a poor outcome from these illnesses. Our study will identify whether having musculoskeletal pain leads to worse outcomes for other illnesses. We will use information collected from a large UK database of general practice records linked to hospital records and mortality data. We will analyse data of patients newly diagnosed with heart attack, stroke, pneumonia, dementia, or cancer. These illnesses have major impacts on quality of life and are of high priority for the NHS. We will determine whether having existing musculoskeletal pain leads to more and longer hospital stays, worse outcomes such as death and faster progression of illness, and differences in management. We will assess if the impact of musculoskeletal pain on these illnesses is different for people of different age or ethnicity, or who live in different areas of the country, in a rural area, or in a deprived area. If we find there is a link of musculoskeletal pain with poor outcomes, this will provide new evidence of the need to test better musculoskeletal management strategies before and during hospital admission (for example, exercise/physiotherapy, aids/devices for daily living, and better drug treatment) to reduce pain and improve function, that may improve outcomes across other illnesses.


Research activity codes: 7.1 INDIVIDUAL CARE NEEDS
Health categories: MUSCULOSKELETAL
Title: The clinical and cost-effectiveness of arthroscopic versus open surgical repair for tears of the rotator cuff (UKUFF trial)
Funder: Department of Health (England)

Abstract: The rotator cuff is a group of muscles that control movements within the shoulder. Tears of the rotator cuff are one of the most common causes of shoulder pain and dysfunction. The clinical evidence available regarding the natural history and the treatment of rotator cuff tears is limited and conflicting.Different methods of rotator cuff tear management are practiced throughout the United Kingdom. These include:ArthroscopicRepair - where the tear is repaired through key-hole surgeryOpen Repar - involving a longer skin incision to undertake the procedure under direct visionNon-Surgical Treatment - where a programme of Rest then Exercise is practicedThis study was designed to assess these three methods of treatment.We will investigate over 600 patients from 70 centres through out the United Kingdom. Information to be collected and analysed includes:Patient focused questionnaires regarding shoulder pain and functionPatient focused questionnaires regarding the economic cost of the treatmentHealth care resources used (i.e. hospital stays operating theatre equipment)MRI scans 12 months after the surgical repairs (to see if the repair is intact)Histological findings from tissue samples harvested during surgical repairs (to see if tissue quality influences success)Patients will be introduced to the trial by their consultant orthopaedic surgeon at his/her out-patient clinic. Patients who are interested will then receive information regarding UKUFF from the Oxford Trial office. Those who consent to participate will be randomised to undergo an arthroscopic repair or an open repair or to complete the rest then exercise programme. All participating patients will be placed on the NHS waiting list for surgery. Those allocated to the Rest then Exercise programme will still be placed on the waiting list. However if they feel their shoulder has improved after completing the programme they can decline surgery.A free-phone helpline will be established so patients have easy access to communicate with members of the research team in Oxford.


Research activity codes: 6.4 SURGERY;6.7 PHYSICAL
Health categories: MUSCULOSKELETAL