NIHRDataInsights/HRCSData huggingface dataset:
Title: Budget Impact Modelling of AI-assisted early fracture detection in the emergency department
Funder: Department of Health and Social Care

Abstract: X-ray is the first-line examination in the evaluation of bone trauma in emergency departments, but a lack of radiological resources restricts real-time interpretation by a trained expert, increasing the risk of errors. Fracture interpretation errors represent up to 80% of diagnostic errors in A&E (1), and up to 24% of harmful mis-diagnoses (2). In the UK, between 2013-2018 the total cost of malpractice claims in radiology was &pound;386.9m, with a significant amount due to missed fractures (3). Discordant interpretation of radiographic examinations occurs in up to 5.4%, but when the reporting is delayed this number increases to 7.9% (4,5,6). Only 8.7% of X-rays are reported before the patient s discharge (7), leading to inappropriate onward referrals to orthopaedic fracture clinics (8). Earlier accurate detection of normal XRs at the point of care could significantly reduce these associated costs. Gleamer (France) has developed BoneView, an AI solution that detects fractures, dislocations and effusions on X-ray examinations and acts as an automated safety net. Its clinical relevance was demonstrated in two studies (9)(10), showing increased sensitivity, reduced reading time, and significant decrease in false positives and false negatives. The lack of reimbursement pathways for AI technologies poses the question of financing. Financial pressure on hospitals prevents short-term investment without further evidence of direct return on investment. Question: what is the 1-5 year direct budget impact for NHS Trusts to implement AI-assisted X-ray reporting for fractures? This will address the evidence gap of the ROI for trusts as a whole when implementing a technology that serves three departments: Accident & Emergency, Radiology and Orthopaedics. This project will enable Trusts to understand the value proposition and budget impact, in keeping with the proposed NICE ESF, which highlights Budget Impact Modelling (BIM) as a key evidence requirement for novel health technologies.


Research activity codes: 8.2 HEALTH AND WELFARE ECONOMICS
Health categories: INJURIES AND ACCIDENTS
Title: It takes a community to prevent a fall
Funder: Economic and Social Research Council

Abstract: 1. Develop a simplistic electronic tool to assess fall risk to be used by older individuals, carers, pharmacist, opticians, podiatrist, audiologists etc. 2. Develop a mechanism to collect, process and analyse responses. 3. Develop a referral system for moderate to high risk older individuals to be given a full fall and fracture risk screening. 4. Develop/ identify a full fall and fracture risk screening process. 5. Develop an intervention feedback referral process whereby moderate to high risk fall individuals can have appropriate interventions by: a. Appropriate community service providers: ie podiatrists, opticians, audiologist, pharmacy b. Community fall prevention exercise classes and/ or home-based options c. Specialist NHS providers: Occupational therapist, physiotherapist, hospital fall prevention centres.

Lay abstract: Title: It takes a community to prevent a fall Aim: To develop a community based, easily accessible self- referral tool to identify individuals in the community who are at risk of a fall and/or a fracture. Vision: For each community to host self-service screening kiosks located with GP surgeries, pharmacies, libraries etc. Older adults, or their friends or family, would answer a series of questions taken from a previously validated questionnaire and be classified as Low, Moderate or High risk of a fall or fracture. All users irrespective or classification will be offered a resource package containing information and activities to maintain good balance and bone strength. Individuals identified as moderate to high risk of a fall, will be invited to a full fall and fracture prevention health check. This assessment will by a trained fall prevention specialist. This will include muscles strength and balance assessments, bone fracture risk assessment, eyes, ears and feet assessment. Following this assessment, specific recommendations will be made as to how to lower fall and fracture risk. Where appropriate, interventions will be offered to help to prevent a future fall and fracture. This may include an invitation to our strength and balance class and/or referral to an optician, audiologist, pharmacist or podiatrist. Where necessary, we will liaise with the health service for referral to specialist services such as home hazard assessment or the fall prevention clinic at the local day hospital or equivalent.

Research activity codes: 7.3 MANAGEMENT AND DECISION MAKING
Health categories: INJURIES AND ACCIDENTS
Title: Progressing existing snake venom toxin-specific antibodies into humanised, thermostable monoclonal therapies for preclinical manufacture and clinical trials in Africa and India
Funder: Wellcome Trust

Abstract: Antivenom treatment of snakebite is failing to reduce the annual 138,000 deaths - predominantly in impoverished tropical communities. With a focus upon the most medically-important African and Indian snake venoms, we are developing toxin-neutralising, recombinant, humanised, thermostable monoclonal antibodies (mAbs) that will be more dose- and polyspecifically-effective, affordable and safer than antivenoms, and possess critical economies of scale and manufacturing incentives to secure sustained production/delivery.We have collected sera and B cells (producing immunoglobulins of distinct structure and therapeutic/mAb-development promise) from: • multi-envenomed humans • cows, camels, baboons, mice immunised with the most pathogenic African and Indian venom toxins • horses used to manufacture African or Indian antivenoms. Using High-Throughput platforms, we will rank B cells producing these globally-unique animal and human antibodies by in vitro toxin-binding affinity and toxin-function neutralisation, prioritising cross-generic/continental functionality. Genes from top-ranked B cells will be processed into recombinant mAbs (220-500).Subsequent rounds of in vitro and in vivo (neutralisation of venom-induced lethality in a mouse model of envenoming) down-selection will output 20-40 mAbs for gene-manipulation to deliver ‘humanised’ and thermostable mAbs.A final round of in vitro/in vivo selection will deliver 5-10 mAbs/3 mAb mixtures of proven pan-Africa/India polyspecific efficacy for downstream preclinical manufacture and clinical trials.


Research activity codes: 5.1 PHARMACEUTICALS
Health categories: INJURIES AND ACCIDENTS
Title: Generation of venom-neutralising recombinant chimeric antibodies
Funder: Wellcome Trust

Abstract: The main therapeutic intervention for snakebite envenomation relies on the century-old approach of injecting victims with animal-derived polyclonal antiserum. Animal immunisation generates high affinity antibodies and undoubtedly saves lives but the use of immune antiserum has a number of limitations around consistency, redundancy and immunogenicity. Recombinant antibody technology will allow the capture, sequencing and characterisation of the monoclonal antibody repertoire arising from immunisation. Furthermore, the resulting high affinity antibodies will be made more human-like by fusing animal-derived variable domains with human constant domains (chimeric antibodies). This project will generate phage display libraries from horses and llamas immunised with venoms of 4 sub-saharan African snakes represented in the co-applicants antivenom EchiTab-Plus_ICP. We will generate antibody panels by phage selection, screening and sequencing. This resolution of the immune repertoire to a complex venom into its monoclonal components essentially transforms the problem into one of deconvolution. Affinity capture-mass spectrometry will be used to identify the target of thousands of individual antibodies based on their distinct mass-defined target. Following triage based on binding profiles, antibodies to individual targets will be expressed as chimeric antibodies and validated using in vitro and in vivo animal models of envenomation towards generation of life-saving, chimeric antibody cocktails.


Research activity codes: 5.1 PHARMACEUTICALS
Health categories: INJURIES AND ACCIDENTS
Title: Novel platforms to develop polyspecifically-effective, safe, affordable and thermostable monoclonal camelid VHH nanobodies to treat snake venom-induced necrosis in India and sub-Saharan Africa
Funder: Wellcome Trust

Abstract: 400,000 tropical snakebite victims require, every year, life-saving surgical debridement/amputation because there is no medicine to treat the disabling, income-depleting effects of snake venom-induced necrosis. A new therapy is urgently needed to prevent the severe health and socioeconomic consequences upon already-impoverished victims and health facilities. Our evidence-underpinned hypothesis is that rationally-selected recombinant, humanised camelid VHH targeting necrosis-inducing venom toxins (NITs) will possess the efficacy, rapid in-tissue distribution, safety, thermostability, affordability and large scale production characteristics appropriate for future development of a community-dispensed therapy – a paradigm shift in the clinical management of venom-induced necrosis to reduce morbidity. To achieve this for Africa and India, our partners bring new approaches, platforms and all required resources to select candidate recombinant NIT-specific monoclonal VHH from (i) B cells of NIT-immunised camels and (ii) a synthetic VHH library - complementary approaches maximising likely success. Deploying sequential in vitro, ex vivo human skin and mouse in vivo assays of venom-induced necrosis enables down-selection of the most efficacious, thermostable recombinant VHH. ‘Humanising’ the latter donates the key safety criterion. E.coli expression enables inexpensive and large-scale production of humanised VHH. These therapy-characteristics and the vast panAfrica/India need, provide economy-of-scale production incentives for future manufacturing partners.


Research activity codes: 5.1 PHARMACEUTICALS
Health categories: INJURIES AND ACCIDENTS
Title: Tailored Fall prevention exergaming, helping improve uptake and long term self management of Standing Strength and Balance among elderly Populations, and the NHS Reduce Costs
Funder: Innovate UK

Abstract: eXyo is a UK-based SME that intends to address the issue of a lack of effective therapy solutions for fall prevention. This lack is most felt in the over-65 population, a third of whom are expected to suffer at least one fall annually. Age UK have identified falls as the leading cause of injury and death for over 65s. Covid-19 and the associated restrictions have caused considerable additional strain for this population and the associated NHS falls services and have increased fall rates. Fall rates shall continue to rise due to the rapidly ageing population; current numbers of over 60s will double, and over 80s will triple by 2050\. eXyo's core team, comprises Andrew Morgan, Christopher Hughes and Jonathan Charlesworth, who are experienced in product design, business development, clinical development and mechanical engineering specialising in rehabilitative technologies. eXyo are developing a standing/balance rehabilitation aid that facilitates remote supervision and gamified therapy. Implementation of eXyo's end product with just 1% market share, as informed by this research, could save the NHS £14.8M annually by 2027 through reducing falls.


Research activity codes: 5.3 MEDICAL DEVICES
Health categories: INJURIES AND ACCIDENTS
Title: Modular multi-material crash-box for tailored impact energy absorption during low-speed collision (PROTECT)
Funder: Innovate UK

Abstract: Low-speed (20 mph) accidents saw year-on-year increase of 31% (2016-2017, Department of Transport); injury increase was broken down as fatal (+79%), serious (+47%), and slight (+42%). A crash box is a thin-walled structure attached between the vehicle bumper structure and the side rail to improve crash performance in low-speed accidents. The determination of the crash box geometry is important to absorb the impact energy, since the installation space of the crash box is not very large. Conventional crash boxes (i.e. those manufactured from steel or aluminium) exhibit high-peak force and have no way of controlling the rate of deceleration following a crash. Composite alternatives are limited in use due to unpredictable failure. PROTECT is an innovative new crash-box with better impact energy-absorption capabilities; enabling minimal damage to the vehicle itself, its occupants, and other road users. In the event of a low-speed collision, PROTECT will help reduce damage to the vehicle, its occupants and the wider public. This will result in safer roads and vehicles, along with minimised repair costs. As a result of this innovative solution, the consortium partners expect to create 227 jobs and generate cumulative revenues of £51.6 million by 2029\.


Research activity codes: 5.3 MEDICAL DEVICES
Health categories: INJURIES AND ACCIDENTS
Title: Ultra Safe Industrial Helmets
Funder: Innovate UK

Abstract: Industrial workers are at significant risk of severe head injuries, for example the HSE reported 5,400 significant head injuries in 2019 with 60% of all fatalities involved a head injury. Injuries to the head are often life-changing, resulting in long-term damage such as memory loss, behavioral change and spinal damage. The economic cost of these workplace injuries was estimated to be £0.5 bn p.a. and accounted for half a million lost working days. It is likely that the problem is far worse due to poor reporting, e.g. Headway found that 52% of workers who had experienced a head injury did not report it to their manager, with only 6% of those injured seeking medical attention. In order to address the market need for an improved solution, we (HEXR Ltd) in collaboration with Imperial College London (ICL) aim to develop an ultra safe industrial helmet.


Research activity codes: 3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS
Health categories: INJURIES AND ACCIDENTS
Title: Development and commercialization of ultra-safe 3D printed motorbike helmets
Funder: Innovate UK

Abstract: Motorcyclists are among the most vulnerable road users. Traumatic brain injury (TBI) is the most common injury that motorcyclists sustain in road traffic collisions, which can often be fatal and have life changing consequences. TBI is predominately caused by rotational motion and currently the certification standards only test for linear motion. If rotational motion could be reduced by 30%, nearly half of fatalities caused by TBI would be eliminated. Hence there is a significant opportunity to improve motorbike helmets. Our understanding of the biomechanics that cause TBI has grown significantly thanks to brain simulation and modelling. Also development of complex lattice structures using 3D printing is more affordable with a wider range of suitable energy absorbing materials. HEXR has developed the world's first custom fit bicycle helmet using 3D printing. Imperial College are the world leading experts in TBI and helmet testing. Through this 18-months industrial research project, HEXR Ltd and Imperial College London are collaborating to developing a motorbike helmet that provides the lowest chance of TBI, potentially saving thousands of lives and reducing the £15 bn economic cost of TBI to the UK economy.


Research activity codes: 3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS
Health categories: INJURIES AND ACCIDENTS
Title: Movetru ‘Rehab’: A Smart Wearable Medical Device to Prevent Injury from Occurrence through Machine Learning
Funder: Innovate UK

Abstract: Imagine a world without preventable injury, a world which values the physical and mental health of all at an affordable price. With over 2 million people worldwide suffering from anterior cruciate ligament (ACL) injuries, Movetru has the ability to change lives, globally. Movetru is the home physio for anyone, anytime, and anywhere. With key health data to reduce injury rate and recovery time, we will help to take your potential to the next level. With Movetru's wearable technology, you will be provided with a full-body reboot, coupled with individualised information which will optimise your performance, reduce injuries, and expedite injury recovery. Our goal is to increase customers' quality of life by minimising pain and maximising health. From overworking muscles or incorrect posture to complete muscular tears and career-ending surgeries, we have all suffered some degree of exercise-related pain. At 14 years old, I injured myself in ballet and I took over three years to recover. I knew there must be a better way to treat injuries. If we are entering the age of self-driving cars, why have we not figured out how to prevent injuries? I took it as a challenge, deciding I had to be the change I desperately wanted to see and so, I combined my passion for dance and engineering to create Movetru. Movetru is a body suit with embedded sensors which will supply you the ability to correct your form, with specialised knowledge assisting you the whole way through. With a user-centric design and no requirement of understanding complex analysis, Movetru can benefit any user, regardless of their background or geographic location. The sports industry has been missing the technology necessary to monitor performance and reduce rehabilitation time, costing them millions in injury-related decrements in performance every year. With Movetru we are developing this technology and are ready to fly in with a cape of innovation to save money, save time, and save careers with the latest "hands-off" technology! We aim to abolish preventable injury and help everybody perform at their best, without compromising their health or wallet. Movetru, the easy-to-use, revolutionary device is here to change lives. Movetru -- aligning your future.


Research activity codes: 5.3 MEDICAL DEVICES
Health categories: INJURIES AND ACCIDENTS
Title: VENTETE - Novel collapsible cycle helmet with multi-density structural system, aiming to prevent traumatic brain injury and increase portability
Funder: Innovate UK

Abstract: Air quality, carbon emissions, health, wellbeing, and road congestion are serious issues facing British society and active travel i.e., walking and cycling is a key DfT strategy to improve them all. The statutory DfT Cycling and Walking Investment Strategy has £21.2bn over 2 years pledged for infrastructure and active travel projects with the ambition to double cycling for short journeys by 2025\. Although cycling has proven health benefits, cyclists are the most vulnerable of road users and in 2020 UK data shows 141 were killed and 16,294 seriously injured on the roads with fatality and injury rates per billion miles of 28 and 3240 respectively compared to 3 and 307 for cars. Swedish data shows that head and skull trauma account for 26% of all serious cycling injuries with a 42% rate of severe impairment. Work at Imperial shows that current helmet test standards are limited as they only consider linear impacts and not rotational impacts shown to contribute towards traumatic brain injuries (TBI). UK Helmet usage rates are typically only 20%. Practical reasons commonly cited for not wearing helmets include carriage and storage between journeys particularly when commuting, discomfort i.e., too hot, or cold, uncomfortable, or heavy. There is a clear need for a cycling safety helmet that can be stored compactly between uses. Our solution is VENTETE, a cycle helmet with a lightweight inflatable structural system that when deflated occupies 1/10 of its original volume and provides superior cooling compared to conventional helmets. BSI test data shows that VENTETE exceeds current standards and is best-in-class for linear impacts. Work at Imperial shows the existing VENTETE concept also performs highly under rotational impact loads. The objective of this collaborative project between VENTETE, Adreco and Imperial College is to build upon the VENTETE concept and develop a class leading design that will perform exceptionally in rotational impact tests. It will meet or exceed the anticipated additional standard under discussion by ISO for introduction in 1-2 years' time.


Research activity codes: 3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS
Health categories: INJURIES AND ACCIDENTS
Title: Prevention of thermal injuries in infants and toddlers: a controlled trial
Funder: Division for Social Care and Health Research (Wales)

Abstract: Every year in the UK an estimated fifty thousand children are seen in emergency departments with burns and scalds, 5,000 of whom are admitted to burns and plastics units for treatment. The highest proportion are seen in infants and toddlers under three years of age. The commonest causes are burns in the home from hot drinks in cups or mugs or hot domestic heat sources (irons, radiators and oven doors) that are in reach of the child. Ten percent of these injuries follow neglect or physical abuse and a further 20% are children “in-need” or from families where the life style is chaotic and supervision and safety provision in the home is inadequate. These injuries are all potentially preventable and Health Visitors are well placed to co ordinate a prevention programme to pre school children. This study offers an evaluation of an integrated prevention programme. The primary component will focus on the prevention of burns and scalds to infants and toddlers who are gaining the skills of independent mobility. The secondary component will take the form of a triage tool and will be used in the emergency department to improve the early recognition of children “in-need” or victims of child abuse or neglect and facilitate early assessment and intervention or child protection intervention respectively. Study out comes will be compared in a controlled clinical trial.


Research activity codes: 3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS;8.1 ORGANISATION AND DELIVERY OF SERVICES
Health categories: INJURIES AND ACCIDENTS