Authors: Sophie Richter, Virginia Newcombe / Editors: Charlotte Kennedy, Govind Oliver / Codes: CC20, HAP29 / Published: 07/05/2019
This Academic Careers piece follows on from our previous blog, Young Investigator of the Year – one year on, to introduce this year’s award winner.
What is the Young Investigator of the Year award?
Many Emergency Physicians may not be aware that this fantastic award exists. This annual award is made at the RCEM Emergency Medicine (EM) Research Engagement Day, previously known as the Clinical Studies Group Day. It is awarded to recognise outstanding contributions towards clinical research in the field of EM. The award is open to Trainees and Consultants (within 5 years of their CCT) with a commitment to EM research. Previous research experience and the support of a research active institution are not essential. The judges look at the submitted written proposals, and in conjunction with the oral presentation at the Research Engagement Day, make the award based on: commitment, the quality of the idea, the rigor of the methodology alongside its achievability and feasibility, and the potential impact on winning further funding.
Meeting the 2019 winner: Dr Sophie Richter
Dr Sophie Richter won the 2018-19 award in January at the EM Research Engagement Day held in Bristol. She is a ST3 level trainee at Addenbrookes Hospital, Cambridge.
Prior to winning the Young Investigator of the Year award, what was your research background and experience?
I was first introduced to research in my intercalated degree in Oxford. This however was lab-based research and I soon realised that I wanted to do research that would immediately benefit patients, so I started initiating my own projects. In 2013 I took up an Academic Foundation Post in Medical Education in Leicester, which included 6 months clinical work in the Emergency Department, where I gained some experience in ED-based research. In 2015 I was appointed to an NIHR Academic Clinical Fellowship in Emergency Medicine in the East of England. I concentrated initially on health services research. My clinical experience then motivated me to want to change the pathways for one patient group in particular: those with a “mild” traumatic brain injury.
What was the research idea and question which you based your successful proposal on?
The idea was to improve pathways for patients who present to our emergency departments with a “mild” traumatic brain injury.
In particular I want to see if we can
- Better identify patients who require a CT Head
- Better identify patients who are at risk of post-concussion syndrome
- Assess the clinical and cost-effectiveness of such decision-tools
How did you develop your research idea?
I became interested in traumatic brain injury (TBI) because it is such a common presentation. I see about 1 patient per shift and collectively we see 1 million patients in UK emergency departments every year. 90% of those patients have a “mild” traumatic brain injury (GCS 13-15) and yet we don’t really have good patient pathways for them. As highlighted in the research recommendations of the NICE Head injury guidelines, we could do so much better in selecting patients for CT since only 1 in 10 CTs come back positive. This would help flow through our overcrowded EDs. Furthermore 15-30% of patients continue to suffer from post-concussion symptoms more than 3 months after their injury, but we don’t follow anyone up or offer early intervention since we cannot predict who will be affected. If we could, we could really improve patient care. Fortunately, Cambridge has world-leading expertise in Neurotrauma Research and is one of the co-ordinating centres for the large European CENTER-TBI study. I was able to join the research team in the Division of Anaesthesia and under the supervision of Professor David Menon and Dr Virginia Newcombe, was given the chance to develop these ideas into a proposal for a PhD project.
How will you go about answering this?
I will be using data from one of the largest prospective multicentre TBI studies, CENTER-TBI which enrolled more than 2000 mild TBI patients. The data set is unparalleled in its granularity including data on clinical assessment, psycho-cognitive testing, blood biomarkers, CT and MRI imaging and two-year follow up. I will apply both conventional regression and modern machine learning techniques to try to predict CT findings and post-concussion symptoms. I will also undertake a cost-effectiveness analysis of the models within the UK context. The models will then be used to develop clinical decision tools in collaboration with a patient focus group.
When might we be able to expect some results?
I will be starting my Wellcome Trust PhD Fellowship in May 2019 and am looking forward to sharing my findings throughout the following 3 years.