The Epidemiology of Common Hand Conditions

Lead Research Organisation: University of Oxford
Department Name: NDORMS

Abstract

The aim of this research is to establish a greater understanding of the pathophysiology of clinically significant hand osteoarthritis and carpal tunnel syndrome through the use of large-scale epidemiological study. The project focuses upon UK primary and secondary care data linked to prospective cohort studies UK Biobank and Million Women Study, with external validation between cohorts and through comparison to international datasets. Patients and lay advisors perceived treatment variation, prevention of progression, and greater understanding of disease prognosis as key priorities for the work, which is reflected in these aims:
1. To evaluate the burden of disease and methods of treatment on a national and international level, investigating the potential effects of geographical and demographic variation.
2. To identify medical, pharmacological, lifestyle, occupational and demographic factors for developing disease.
3. To determine the effect of these factors upon the spectrum of disease severity, pain, and functional impairment.
4. To identify subsets of the disease-free population likely to develop disease, as targets for prevention.
5. To identify those patients that are most likely to require treatment, as targets for trials of earlier intervention.
6. To investigate the potential of targets found to progress to feasibility study.

Publications

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Studentship Projects

Project Reference Relationship Related To Start End Student Name
MR/N013468/1 30/09/2016 29/09/2025
1959917 Studentship MR/N013468/1 30/09/2017 29/09/2021 Jennifer Lane
 
Description European Medicines Agency warning regarding use of Hydroxychloroquine
Geographic Reach Europe 
Policy Influence Type Implementation circular/rapid advice/letter to e.g. Ministry of Health
Impact Discussion of potential risks of new use of hydroxychloroquine within emerging Covid 19 treatment
URL https://www.ema.europa.eu/en/news/covid-19-reminder-risk-serious-side-effects-chloroquine-hydroxychl...
 
Description Patient decision making tool about carpal tunnel syndrome
Geographic Reach National 
Policy Influence Type Contribution to new or improved professional practice
Impact as above- greater information for patients making healthcare decisions
URL https://www.england.nhs.uk/wp-content/uploads/2022/07/Making-a-decision-about-carpal-tunnel-syndrome...
 
Description Arthritis Research UK Clinical Research Fellowship
Amount £242,146 (GBP)
Funding ID 21605 
Organisation Versus Arthritis 
Sector Charity/Non Profit
Country United Kingdom
Start 12/2017 
End 12/2020
 
Description Clinical Lecturer starter grant
Amount £30,000 (GBP)
Organisation Academy of Medical Sciences (AMS) 
Sector Charity/Non Profit
Country United Kingdom
Start 08/2023 
End 08/2025
 
Description Early Career Fellowship
Amount £50,000 (GBP)
Organisation Orthopaedic Research UK 
Sector Charity/Non Profit
Country United Kingdom
Start 01/2024 
End 12/2024
 
Description HTA
Amount £1,350,000 (GBP)
Funding ID FLARE NIHR HTA Trial 
Organisation National Institute for Health Research 
Sector Public
Country United Kingdom
Start 01/2023 
End 06/2026
 
Description MRC DRF Supplementary Funding
Amount £9,061 (GBP)
Organisation MRC Doctoral Training Program 
Sector Academic/University
Country United Kingdom
Start 03/2019 
End 06/2021
 
Description MRC-DTP supplementary grant award
Amount £10,000 (GBP)
Funding ID Oxford MRC-DTP supplementary award 
Organisation MRC Doctoral Training Program 
Sector Academic/University
Country United Kingdom
Start 07/2020 
End 09/2021
 
Description UK Regulatory Science and Innovation Networks - Discovery phase
Amount £60,000 (GBP)
Organisation Innovate UK 
Sector Public
Country United Kingdom
Start 03/2024 
End 06/2024
 
Description University of Oxford studentship
Amount £21,000 (GBP)
Organisation University of Oxford 
Sector Academic/University
Country United Kingdom
Start 08/2017 
End 09/2020
 
Title Validation study for use of routinely collected data for research into common hand conditions 
Description External Validation study showing the positive predictive value of a prescribed set of codes (Procedural OPCS and diagnosis ICD codes) that can accurately identify a true case of carpal tunnel syndrome and base of thumb osteoarthritis 
Type Of Material Improvements to research infrastructure 
Year Produced 2018 
Provided To Others? Yes  
Impact Currently awaiting results of submission to formal journal; published on Biorxiv in interim. This study has enabled me to continue research in the field using these codes within large datasets 
URL https://www.biorxiv.org/content/early/2018/03/02/274167
 
Description Million Women's Study; musculoskeletal collaboration 
Organisation Million Women Study
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Personally acting as expert advisor in my role as an active clinician within this pilot study with MWS, to note the validity and potential role of MWS in future musculoskeletal research with NDORMS
Collaborator Contribution Offering the resource of their database, and also epidemiological assistance in designing the pilot study and analysing the data produced
Impact collaboration only just begun; multidisciplinary between basic scientists in epidemiology and clinicians.
Start Year 2016
 
Description OHDSI network 
Organisation Observational Health Data Sciences and Informatics
Sector Charity/Non Profit 
PI Contribution The Observational Health Data Sciences and Informatics (or OHDSI, pronounced "Odyssey") program is a multi-stakeholder, interdisciplinary collaborative to bring out the value of health data through large-scale analytics. All our solutions are open-source. OHDSI has established an international network of researchers and observational health databases with a central coordinating center housed at Columbia University. I have been leading a new network study investigating the association between hormonal breast cancer therapies and musculoskeletal side effects with a data partner - IQVIA
Collaborator Contribution IQVIA have offered methodological assistance and access to their 19 datasets in order to replicate the data- this contribution is priceless
Impact still in early stages of study design
Start Year 2020
 
Description UK Biobank; pilot musculoskeletal validation study 
Organisation UK Biobank
Country United Kingdom 
Sector Charity/Non Profit 
PI Contribution Entering into collaborative work with epidemiologists in the UK Biobank, Edinburgh in order to undertake pilot study investigating the validity of the BioBank for the study of musculoskeletal conditions. I am involved in this work within the role as an expert clinical advisor regarding the coding of clinical processes. Should this pilot work be successful, the aim is to engage in further study through this collaborative in planning a DPhil research project.
Collaborator Contribution Collaborative just established; work due to begin May 2016
Impact due to begin
Start Year 2016