The Therapeutic Interventions in Malignant Pleural Effusions Trial (the TIME trial)

Lead Research Organisation: University of Oxford
Department Name: Unknown

Abstract

This application is for me to perform a clinical trial to improve care for patients with abnormal chest fluid collections between the lung and the chest wall, and to provide me with training in clinical trials. Over 250,000 patients in the UK and US each year develop fluid collections between the lung and the chest wall, which causes disabling breathlessness. One of the commonest causes of such fluid is cancer cells in the membranes between the lung and the chest wall that alter fluid regulation. To control this fluid, an irritant drug is applied to the chest cavity where the fluid collects to cause inflammation, adhering the lung to the chest wall. This treatment is very painful and this pain may be reduced by using non-steroidal painkillers rather than opiate painkillers (standard care), and by using small chest tubes for drug delivery. However, such non-steroidal analgesics may, theoretically, impair the efficiency of this treatment. This trial will establish if non-steroidal analgesics and small bore chest tubes can decrease pain, and whether non-steroidal analgesics do actually change treatment effectiveness. Whatever its result, this study will produce new information about treating these patients and will provide me with a thorough training in clinical trial method.

Technical Summary

This Training Fellowship is to perform a trial in malignant pleural effusion and to provide me with the research training in clinical trials.
The proposed study is a 2x2 factorial trial to assess whether non-steroidal (ibuprofen) analgesia and the use of small bore chest tubes reduce pain during pleurodesis for malignant effusion, compared to standard care. The trial will also define whether non-steroidal use decreases pleurodesis efficacy.
Based on our preliminary data, we hope to demonstrate improved pain control over 72 hours post pleurodesis using validated visual analogue scales (primary endpoint). Secondary endpoints are time to relapse of pleural effusion (survival analysis) and the presence of chronic chest pain at 3 months.
Delivery of this trial will be in collaboration with the MRC Clinical Trials Unit and will use the recruitment centres assembled by previous Oxford pleural trials (in pleural infection). In parallel with the delivery of this trial, I will gain statistical training and trials experience by involvement in the delivery processes of other Oxford and MRC CTU multi-centre trials, providing the foundation for a career in respiratory clinical research.

Publications

10 25 50

publication icon
Asciak R (2018) Malignant Pleural Effusion: From Diagnostics to Therapeutics. in Clinics in chest medicine

publication icon
Asciak R (2018) Chest Drain Fall-Out Rate According to Suturing Practices: A Retrospective Direct Comparison. in Respiration; international review of thoracic diseases

publication icon
Bhatnagar R (2018) Outpatient Talc Administration by Indwelling Pleural Catheter for Malignant Effusion. in The New England journal of medicine

publication icon
Bhatnagar R (2016) Advanced medical interventions in pleural disease. in European respiratory review : an official journal of the European Respiratory Society

publication icon
Bibby AC (2019) ERS/EACTS statement on the management of malignant pleural effusions. in European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

publication icon
Bibby AC (2018) ERS/EACTS statement on the management of malignant pleural effusions. in The European respiratory journal

 
Guideline Title BTS Pleural Disease Guidelines
Description Accurate measurement of pleural fluid pH
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in clinical guidelines
Impact Accurate measurement of pleural fluid pH for clinical decision making was defined in a study as a result of the research conducted (Pubmed reference 18556632) and is sited in these clinical guidelines as the reference standard for clinical practice in this area
URL http://europepmc.org/abstract/MED/18556632
 
Description Appointed as chair of BTS Pleural Specialist Advisory Committee
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact Committee formed to increase quality and access to high quality pleural services through the BTS
 
Description BRITISH THORACIC SOCIETY - appointed as chair of Plerual Specialist Advisory Group
Geographic Reach National 
Policy Influence Type Membership of a guideline committee
Impact Formation of a committee which looks critically at the provision of high quality pleural care across the UK, via the BTS
 
Description BTS pleural disease guidelines committee
Geographic Reach Multiple continents/international 
Policy Influence Type Membership of a guideline committee
 
Description British Thoracic Society National Guidelines
Geographic Reach Multiple continents/international 
Policy Influence Type Influenced training of practitioners or researchers
Impact The TIME1 trial addresses the questions of whether drain size or analgesic strategy infleunces the pain felt during malignant pleural effusion pleurodesis or affects its efficacy. The avoidance of non-steroidal analgesia and the use of smaller bore chest drains has become widespread throughout the UK, despite no robust evidence on which to base these treatment decisions. Increasing awareness of the rationale behind the TIME1 study has led to these questions remaining open in the latest draft of the National British Thoracic Society Guidelines on Pleural Disease, due to be published in Februaruy 2010.
 
Guideline Title American Thoracic Society Guideline in Management of MPE
Description Citations of Work in American Thoracic Society Guidelines in MPE 2018
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in clinical guidelines
Impact Multiple studies published by our group cited in this document, and used to inform answers to PICO questions and recommendations
 
Guideline Title ERS/EACTS statement on the management of malignant pleural effusions.
Description Citations of Work in ERS Guidelines in MPE 2018
Geographic Reach Multiple continents/international 
Policy Influence Type Citation in clinical guidelines
Impact Mulitiple published papers by our group cited in this evidence based guideline to guide care of patients with MPE
 
Description MRC New Investigator Grant
Amount £415,000 (GBP)
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start 01/2011 
End 01/2014
 
Description MRC Training Fellowship
Amount £250,000 (GBP)
Organisation Medical Research Council (MRC) 
Sector Academic/University
Country United Kingdom
Start 09/2015 
End 09/2018
 
Description NCRI and Synermed UK funding (Adjuvant urokinase for the treatment of malignant pleural effusion. The third therapeutic intervention in malignant effusion trial: TIME3-UK)
Amount £600,000 (GBP)
Organisation National Cancer Research Institute (NCRI) 
Sector Charity/Non Profit
Country United Kingdom
Start 03/2009 
End 03/2012
 
Description NIHR RFPB - TACTIC
Amount £349,000 (GBP)
Funding ID PB-PG-1217-20037 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 09/2019 
End 10/2022
 
Description Walport Clinical Lectureship (4 year post, 50% salary)
Amount £200,000 (GBP)
Organisation Wellcome Trust 
Sector Charity/Non Profit
Country United Kingdom
Start 08/2009 
End 08/2013
 
Title OpenClinica experience 
Description Through these two studies (PILOT and RAMMP), we have gained experience and are using the OpenClinica research tool to gather data. This is now occurring highly successfully, and will be used for future funded studies. 
Type Of Material Improvements to research infrastructure 
Provided To Others? No  
Impact We will use electronic data capture and design for our future studies. 
 
Title Pleural disease biobank 
Description The TIME1 study led to the establishment of several projects in malignant pleural disease which collected biological samples (biopsies and pleural fluid) in conjunction with accurate clinical data. These represent a valuable resource to begin exploring genetic and physiological mechanisms of maligant pleural disease genesis, treatment and models of risk 
Type Of Material Database/Collection of Data/Biological Samples 
Year Produced 2008 
Provided To Others? Yes  
Impact Assesssment of potential novel genetic virulence factors in malignant mesothelioma (work in progress). Use of soluble mesothelin to diagnose malignant mesothelioma in pleural fluid (Pubmed reference number : 19299498) 
URL http://europepmc.org/abstract/MED/19299498
 
Title Quantification of pleural shadowing on digital measurement of 2 dimensional chest radiographs 
Description In previous studies of pleural effusion, the amount of pleural shadowing on chest radiographs has been categorically "scored" by radiologists, which is a fast but imprecise method of assessing the amount of pleural fluid present. It is recognised that 3d imaging techniques (e.g. thoracic CT) is a more accurate method of assessing pleural fluid volume, but it is impractial and expensive to submit all patients in studies to thoracic CT pre and post intervention for the purposes of a trial alone. We therefore conducted a study assessing the relationship between precise volume of pleural fluid present (as measured by thoracic CT) and a digital measurement strategy using the chest radiograph, in 20 patients undergoing simultaneous thoracic CT and chest radiograph with pleural disease. This demonstrated that a simple and rapidly administered digital measurement strategy using chest radiographs alone is highly correlated to "real" pleural fluid volume as measured by thoracic CT (with an R2 value of 68% in linear regression). 
Type Of Material Data analysis technique 
Provided To Others? No  
Impact This study is in the process of publication. It will provide an accurate plerual fluid measurement strategy for the TIME1 study, and in addition, provides a simple and effective research tool for future pleural studies allowing accurate quantification of the amount of pleural fluid present using a chest radiograph. This has the potential to alter future trial design, obviating the need for thoracic CT in order to quantify pleural fluid 
 
Title Malignant effusion database 
Description We have conducted 4 randomised trials in malignant effusion (including the SIMPLE study) - 3 of which are completed and SIMPLE which is recruiting. This includes biological samples, collected and stored to HTA standards, associated with well curated clinical outcomes. This will allow future exploration of the biological and clinical characterstics of MPE patient and drive further translational research applications. 
Type Of Material Database/Collection of data 
Provided To Others? No  
Impact Nil as yet - to be the subject of biomarker and biological validation work in the future 
 
Title ORTU research patient database 
Description We have constructed an ethically approved and consented list of patients who are willing to be contacted for research with respirator disease 
Type Of Material Database/Collection of data 
Year Produced 2017 
Provided To Others? No  
Impact Increased recruitment to industry and other studies, place to conduct PPI work for future applications 
 
Description American Pleural Network 
Organisation Banner MD Anderson Cancer Center
PI Contribution I have put together a US collaboration of expert centres who will deliver future trials in pleural infection
Collaborator Contribution Willingness to contribute to studies in the future, and comment on trial design and deliverability
Impact Nil as yet - awaiting an NIH funded study, we hope in q4 2019
Start Year 2018
 
Description American Pleural Network 
Organisation Johns Hopkins Medicine
Country United States 
Sector Hospitals 
PI Contribution I have put together a US collaboration of expert centres who will deliver future trials in pleural infection
Collaborator Contribution Willingness to contribute to studies in the future, and comment on trial design and deliverability
Impact Nil as yet - awaiting an NIH funded study, we hope in q4 2019
Start Year 2018
 
Description American Pleural Network 
Organisation Texas Medical Center
PI Contribution I have put together a US collaboration of expert centres who will deliver future trials in pleural infection
Collaborator Contribution Willingness to contribute to studies in the future, and comment on trial design and deliverability
Impact Nil as yet - awaiting an NIH funded study, we hope in q4 2019
Start Year 2018
 
Description American Pleural Network 
Organisation Vanderbilt University
Department Vanderbilt Medical Center
Country United States 
Sector Academic/University 
PI Contribution I have put together a US collaboration of expert centres who will deliver future trials in pleural infection
Collaborator Contribution Willingness to contribute to studies in the future, and comment on trial design and deliverability
Impact Nil as yet - awaiting an NIH funded study, we hope in q4 2019
Start Year 2018
 
Description INTERNATIONAL RESEARCH PARTNERSHIP 
Organisation University of Stellenbosch
Country South Africa 
Sector Academic/University 
PI Contribution Through the MRC grant to conduct the PILOT study, we have established an international recruitment base for pleural trials which includes centres in Australia, the USA and South Africa. These are now actively recruiting patients to the trial and will be used in future for large scale pleural trials.
Collaborator Contribution Recruitment to trials, input on to trial committees
Impact Recruitment to current study, discussion around potential recruitment to future studies
Start Year 2015
 
Description INTERNATIONAL RESEARCH PARTNERSHIP 
Organisation University of Western Australia
Country Australia 
Sector Academic/University 
PI Contribution Through the MRC grant to conduct the PILOT study, we have established an international recruitment base for pleural trials which includes centres in Australia, the USA and South Africa. These are now actively recruiting patients to the trial and will be used in future for large scale pleural trials.
Collaborator Contribution Recruitment to trials, input on to trial committees
Impact Recruitment to current study, discussion around potential recruitment to future studies
Start Year 2015
 
Description INTERNATIONAL RESEARCH PARTNERSHIP 
Organisation Vanderbilt University
Department Vanderbilt Medical Center
Country United States 
Sector Academic/University 
PI Contribution Through the MRC grant to conduct the PILOT study, we have established an international recruitment base for pleural trials which includes centres in Australia, the USA and South Africa. These are now actively recruiting patients to the trial and will be used in future for large scale pleural trials.
Collaborator Contribution Recruitment to trials, input on to trial committees
Impact Recruitment to current study, discussion around potential recruitment to future studies
Start Year 2015
 
Description Malignant Effusion Mutlicentre Partnership 
Organisation Blackpool Teaching Hospitals NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution A total of 8 centres are in the recruitment / feasibility stage to be assessed for their eligibility for participation in the SIMPLE study. We are targeting centres which have delivered well to previous randomised studies run by my unit in malignant pleural effusion, with high data quality obtained including Taunton, Blackpool, Bristol, Kings College London and Cambridge. Update December 2016 - this study is now running actively in 9 centres with further centres planned. We are planning to expand to international sites in order to maintain the external validity of the study, subject to permissions. These currently include Oxford, Glasgow, Bristol, North Midlands, Pennine, Wythenshawe, Shrewsbury, Taunton and Kettering.
Collaborator Contribution The Oxford Respiratory Trials Unit is setting up this partnership in order to recruit to the study over the next 18 months.
Impact Nil as yet
Start Year 2015
 
Description Malignant Effusion Mutlicentre Partnership 
Organisation Taunton and Somerset NHS Foundation Trust
Country United Kingdom 
Sector Public 
PI Contribution A total of 8 centres are in the recruitment / feasibility stage to be assessed for their eligibility for participation in the SIMPLE study. We are targeting centres which have delivered well to previous randomised studies run by my unit in malignant pleural effusion, with high data quality obtained including Taunton, Blackpool, Bristol, Kings College London and Cambridge. Update December 2016 - this study is now running actively in 9 centres with further centres planned. We are planning to expand to international sites in order to maintain the external validity of the study, subject to permissions. These currently include Oxford, Glasgow, Bristol, North Midlands, Pennine, Wythenshawe, Shrewsbury, Taunton and Kettering.
Collaborator Contribution The Oxford Respiratory Trials Unit is setting up this partnership in order to recruit to the study over the next 18 months.
Impact Nil as yet
Start Year 2015
 
Description Malignant Effusion Mutlicentre Partnership 
Organisation University of Bristol
Country United Kingdom 
Sector Academic/University 
PI Contribution A total of 8 centres are in the recruitment / feasibility stage to be assessed for their eligibility for participation in the SIMPLE study. We are targeting centres which have delivered well to previous randomised studies run by my unit in malignant pleural effusion, with high data quality obtained including Taunton, Blackpool, Bristol, Kings College London and Cambridge. Update December 2016 - this study is now running actively in 9 centres with further centres planned. We are planning to expand to international sites in order to maintain the external validity of the study, subject to permissions. These currently include Oxford, Glasgow, Bristol, North Midlands, Pennine, Wythenshawe, Shrewsbury, Taunton and Kettering.
Collaborator Contribution The Oxford Respiratory Trials Unit is setting up this partnership in order to recruit to the study over the next 18 months.
Impact Nil as yet
Start Year 2015
 
Description Microbiology collaboration 
Organisation University of Oxford
Department Medical Sciences Division
Country United Kingdom 
Sector Academic/University 
PI Contribution Prospectively collected samples will be used to assess the microbiological profile of pleural infection, and tested using novel DNA based techniques.
Collaborator Contribution Advice has been received from collaborators in microbiology on optimal sample collection and storage for this future collaboration
Impact Nil thus far
Start Year 2012
 
Description National Cancer Research Network 
Organisation National Cancer Research Institute (NCRI)
Department National Cancer Research Network (NCRN)
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Support of multicentre recruitment to the TIME1 trial using NCRN registered nursing practitioners in all participating centres
Collaborator Contribution Support of multicentre recruitment to the TIME1 trial using NCRN registered nursing practitioners in all participating centres
Impact Inclusion of the TIME1 trial on the NCRN portfolio of studies has allowed centres to use NCRN nursing resource to aid recruitment and trial delivery locally
Start Year 2007
 
Description Oxford Radiology Collaboration 
Organisation University of Oxford
Department CRUK/MRC Oxford Institute for Radiation Oncology
Country United Kingdom 
Sector Academic/University 
PI Contribution Intellectual input, access to well defined clinical patient cohorts
Collaborator Contribution Essential support in trial design and delivery of pleural disease trials, assessing novel radiological techniques and imaging (thoracic ultrasound, CT) for malignant pleural disease
Impact The Oxford RTU works closely with the Department of Radiology in Oxford in the design and conduct of trials in pleural disease. This has enabled a large cohort of patients with well defined clinical pleural syndromes to be assessed with varying radiological techniques. This has led to new insights in to radiological assessment of pleural diseases (work ongoing).
 
Description Oxford Respiratory Trials Unit and MRC Clinical Trials Unit 
Organisation Medical Research Council (MRC)
Department MRC Clinical Trials Unit
Country United Kingdom 
Sector Public 
PI Contribution Collaboration in trial design, conduct and analysis of multicentre randomised studies in pleural disease
Collaborator Contribution Shared management of trial design / conduct / analysis between Oxford Respiratory Trials Unit and MRC Clinical Trials Unit for multicentre trials in pleural disease and sleep apnoea
Impact Completion and current analysis of a multicentre trial assessing novel therapies in pleural infection (MIST2). Ongoing recruitment to a randomised multicentre trial assessing optimal analgesic strategy and tube size for the treatment of malignant pleural effusion (TIME1) Ongoing recruitment to a randomised multicentre trial assessing the use of indwelling pleural catheters in the treatment of malignant pleural effusion (TIME2) Design and set up phase of a multicentre randomised trial assessing intrapleural fibrinolytic therapies for the treatment of malignant pleural effusion (TIME3)
 
Description UK Clinical Research Network 
Organisation National Institute for Health Research
Country United Kingdom 
Sector Public 
PI Contribution Application for inclusion of the TIME trials in the UKCRN portfolio. Access to UKCRN resource for centres delivering the trial
Collaborator Contribution Inclusion of multicentre pleural disease in portfolio of UKCRN trials permits recruitment of trial delivery nursing staff in local centres.
Impact The Oxford Respiratory Trials Unit is the only respiratory specific trials unit in the UK, and inclusion of multicentre pleural disease trials on its portfolio (TIME1 / TIME2 / TIME3) has permitted use of UKCRN resources to recruit to trials and smooth trial delivery This collaboration has enabled smooth and efficient trial delivery in centres, permitting multicentre recruitment and on target trial delivery
Start Year 2008
 
Description UK Clinical Research Network Oxford Respiratory Trials Unit Pleural Disease Research Network 
Organisation University of Bristol
Department Academic Respiratory Unit (ARU)
Country United Kingdom 
Sector Academic/University 
PI Contribution Recruitment of interested centres and clinicians to the collaboration, training of individual centres in effective trial delivery. This was started with the University of Bristol (Dr N Maskell) but now includes multiple (15) UK NHS sites.
Collaborator Contribution Recruitment to multicentre malignant pleural disease trials. This collaboration is now being used for a number of multi-centre clinical trials in pleural disease including an assessment of the use of indwelling pleural catheters, and a comparison of talc slurry pleurodesis compared to talc poudrage funded by the HTA process. This has now been extended to include 10 centres with an interest in pneumothorax for the RAMMP trial.
Impact The Maligant Pleural Disease Network will enable efficient recruitment to the TIME1 study, which is now on course to completion before the target date. Within each centre, the nomination of a single respiratory physician as Principle Investigator for TIME1 has enabled streamlining of treatment pathways for malignant pleural effusion which is a common and disabling disease. There are currently 12 UK centres in this colloboration (Nottingham, Taunton, Medway, Central Manchester, North Manchester, Hastings, Portsmouth, Basildon, Blackpool, Preston, Wolvehampton), and 2 international centres (Vancouver, California) actively recruiting to the TIME1 trial, with an additional 5 UK centres in the process of set up. For UK centres, the TIME1 study has been included in the portfolios of both the UK Clinical Research Network and the National Cancer Research Network. Through these established mechanisms, centres have been able to achieve resource to help delivery of the study. This resource will be used in future multi-centre interventional and observational studies of pleural disease thereby creating a network of recruting centres with a proven track record in trial delivery and recruitment. This has now been extended to include other disease areas such as pneumothorax.
Start Year 2007
 
Description Western Australia 
Organisation Sir Charles Gairdner Hospital
Department Lung Institute of Western Australia (LIWA)
Country Australia 
Sector Hospitals 
PI Contribution Contribution of clinical samples and clinical data
Collaborator Contribution Analysis of genetic markers of mesothelioma; investigation of the biology of pleurodesis permitting translation of novel molecules to the clinical setting
Impact The genetic profiling of malignant pleural disease, and specifically malignant mesothelioma, is a collaborative project formed between our unit and our collaborators. Our collaborators have an interest in the biology and physiological mechanisms behind malignant pleural disease and pleurodesis. The TIME1 trial has permitted the set up of a biobank of pleural fluid samples with associated clinical information, allowing meaningful translational work to be conducted.
Start Year 2007
 
Description "Breath Easy" Newsletter 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Primary Audience Participants in your research and patient groups
Results and Impact Invited to contribute an article toward the patient group written and delivered British Lung Foundation (Oxfordshire) newsletter on ongoing research in pleural disease and its potential impact

Dissemination of importance of ongoing clinical research
Year(s) Of Engagement Activity 2008
 
Description American College of Chest Physicians, Philadelphia 2008 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience Health professionals
Results and Impact Invited lecture on pleural infection, discussing ongoing research and future directions for study

Interest from centres in the USA in ongoing research studies
Year(s) Of Engagement Activity 2008
 
Description British Thoracic Society Summer Meeting 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience Health professionals
Results and Impact Invited lecture at the national BTS Summer Meeting (educational) to discuss ongoing research projects and future directions for the diagnosis and management of pleural malignancy

Interest from several UK centres in ongoing pleural trials
Year(s) Of Engagement Activity 2009
 
Description ERS 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach International
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact Asked to present data from malignant and infective pleural trials conducted by my group at the European Respiratory Society Conference, Vienna 2012

Several requests to host fellows in my research department, increased potential european collaborators
Year(s) Of Engagement Activity 2012
 
Description ERS Pleural Skills Course 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Organised and delivered (at request of the ERS) a pleural skills course, attracting delegates from around the world, and providing procedural and evidence base update to ensure high quality practice
Year(s) Of Engagement Activity 2018
 
Description ERS Video 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Video conducted with ERS to explain developments in pleural disease including in malignant and infectious effusion
Year(s) Of Engagement Activity 2018
 
Description NDM PODCAST 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Type Of Presentation Keynote/Invited Speaker
Geographic Reach National
Primary Audience Media (as a channel to the public)
Results and Impact Podcast conducted for the University of Oxford, explaining the importance of clinical trials research in respiratory medicine.

Nil as yet
Year(s) Of Engagement Activity 2013
URL http://www.ndm.ox.ac.uk/najib-rahman-respiratory-medicine
 
Description Oxfordshire British Lung Foundation 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience Participants in your research and patient groups
Results and Impact Invited to a patient group hosted seminar to explain the importance and progress of ongoing pleural trials in malignant pleural disease

Dissemination of importance of practice changing clinical studies and ongoing research interests
Year(s) Of Engagement Activity 2007
 
Description PRESENTATION TO MARIE CURIE 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Supporters
Results and Impact Requested to give a lecture to Marie Curie funders and Expert Patient Group - on the management of malignant effusion
Year(s) Of Engagement Activity 2018
 
Description Pleural Research Day 2018 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Yearly Pleural Research Day organised and conducted in Oxford 22nd June 2018 with over 120 delegates, discussing latest developments in pleural diseaes
Year(s) Of Engagement Activity 2018
 
Description UK Pleural Diseases Course 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience Health professionals
Results and Impact Invited to lecture on the UK Pleural diseases and Thoracoscopy Course (Dr N Ali, Nottinghamshire) on ongoing pleural research studies

Dissemination of importance of ongoing research, highlighting need for clinical studies adressing basic clinical questions which improve standards of care in pleural disease. Resulted in interest from several UK centres in participation in ongoing trials
Year(s) Of Engagement Activity 2007,2008,2009
 
Description UK Pleural Research Day 2015 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Study participants or study members
Results and Impact We hosted a national pleural research day attended by 100 delegates who were respiratory research teams from around the UK and with international speakers. This discussed a number of pleural trials including PILOT and RAMMP, generating significant interest.
Year(s) Of Engagement Activity 2015
 
Description UK Pleural Research Day 2017 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact The UK pleural research day 2017 involved presentations from around the UK of ongoing work - include an update on the SIMPLE trial and its excellent ongoing recruitment, and factors which had led to this success. This success has been used as an exemplar to other studies to try to improve their recruitment.
Year(s) Of Engagement Activity 2017
 
Description USA 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Primary Audience Health professionals
Results and Impact Discussion of research results of various outputs in malignant and infective pleural effusion at international American Thoracic Society Conference and American College of Chest Physicians 2010 and 2011.

Invited to be member of postgraduate courses teaching on these subjects in the future
Year(s) Of Engagement Activity 2010,2011
 
Description University College Access medicine event 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Schools
Results and Impact Gave a lecture on Respiratory Disease and how this impacts on patients, and how we approach it, to school students interested in applying for medicine.
Year(s) Of Engagement Activity 2018