Increasing diversity in design to accelerate research into practice
Ten years on, and with my appointment as its third Director, it is timely to reflect on the undoubted success of NIHR Programme Grants for Applied Research (PGfAR) and to ask the question ‘where next’?
PGfAR funds collaborative, multidisciplinary programmes of applied research to solve health and social care challenges. The beauty of the scheme is its flexibility. It offers applicants the opportunity to ‘think outside the box’ and to use varied and novel research designs to provide answers that will make a step change in terms of benefits to patients.
The hallmark of the PGfAR scheme is its commitment to supporting the development and testing of complex interventions. Looking forwards, this will not change. However, we are keen to increase the diversity of study type and design submitted for PGfAR funding.
We are particularly keen to see programmes of research that speed up the timescale to patient benefit. We want to encourage applications that, for example, take advantage of ‘natural experiments’, use existing healthcare data or observational cohorts, or involve novel epidemiological or statistical approaches to answer important clinical questions.
We would also like to see programmes of research that investigate treatment outcomes in people with rare diseases, or in subsets of patients with more common conditions. In these cases, new data collection might not be always appropriate – individual patient data meta-analyses may be a more efficient and effective approach.
A particular priority is research that tackles neglected areas and stretches outside traditional healthcare settings, reaching into public health, social care or the voluntary sector. In line with NIHR strategy, we will carefully assess applications to make sure that research explicitly addresses and follows needs of patients, the public, and the health and social care system.
In order to ‘kick start’ this vision of increased diversity of PGfAR-funded research, for the next three funding calls (calls 31, 32 and 33) we are particularly inviting applications that fit this brief.
We’ve outlined the types of study design we’re looking for in our new guidance. Briefly, we’re interested in applications that:
- answer important applied research questions in the NHS, public health and social care sectors, to make a tangible step change in patient benefit and overall impact, thus demonstrating value for money for the NIHR
- are driven by clinical need and demonstrate a real partnership between clinicians (or their equivalent in public health or social care) and patients, the public and academics, as well as agencies with the remit and capacity to make change happen (policy makers, Academic Health Science Networks, charities etc)
- address stated local and or national priorities in health or social care, will be delivered in geographical areas of greatest need (rather than simply convenient locations for researchers), and consider and address issues relating to equality, diversity and inclusion
- include a diverse range of methodologies to address important clinical questions, and demonstrate how these methodologies can deliver patient benefits and impact in their own rights
- are ‘programmatic’ - that is, consist of a number of work packages that may run concurrently - and have clear plans for implementation and dissemination of findings.
We’ve asked some researchers who have previously been awarded PGfAR funding for novel methodologies or approaches to outline their programme of research, the design they used and the impact of their research:
- Improving the quality of care of patients with angina and heart attack
- Beyond maternal death: Improving the quality of maternity care through national studies of ‘near-miss’ maternal morbidity
- Optimising diagnosis of symptomatic cancer
- Understanding causes of and developing effective interventions for schizophrenia and other psychoses
We hope these case studies of varied and novel research designs will spark your imagination and provide ideas for your own research.
PGfAR offers a unique opportunity to drive forwards methodological advances in applied health research; we welcome extending our reach through programmes of research that rise to this challenge.
Professor Elaine Hay, Programme Director, NIHR Programme Grants for Applied Research and Professor of Community Rheumatology and Director, Arthritis Research UK Primary Care Centre, Keele University
The views and opinions expressed in this blog are those of the authors and do not necessarily reflect those of the NIHR, NHS or the Department of Health and Social Care.