Authors: Govind Oliver & Hridesh Chatha / Editor: Charlotte Kennedy / Codes: HAP29 & CC2O / Published: 28/08/2018
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 Clinical Studies Group Day, and is co-branded by the RCEM and the National Institute of Health Research (NIHR) Clinical Research Network (CRN). It is awarded to recognise outstanding contributions towards clinical research in the field of Emergency Medicine (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 Clinical Studies Group 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 2017-2018 winner: Dr Hridesh Chatha
Dr Hridesh Chatha won the 2017-2018 award. Hridesh, “a young clinical academic with exceptional potential” in the words of our College Professor Rick Body, won the award whilst an ST5 level Senior Clinical Fellow at the Sheffield Teaching Hospital NHS Foundation. Professor Stephen Smye, Speciality Cluster Lead for the NIHR CRN, commented that “There was a really impressive number of strong applications to the schemes and the award winners demonstrated particularly impressive commitment to research.”
Prior to winning the Young Investigator of the Year award, what was your research background and experience?
My interest in research didn’t occur until late in my SHO career; at the time I was about to finish my ST3 year. I largely felt that I had missed the boat in terms of entering formal research training. I decided to take an out of programme year and became a Research Fellow at Aintree University hospital. The trust had newly become a trauma centre and had started to use Whole Body CT (WBCT) much more frequently. When I examined the research, I discovered that there was very little evidence to support Whole Body CT over targeting clinically indicated regions. I decided I wanted to develop a decision tool for the use of WBCT to identify when it was actually indicated and beneficial. The scale of the project meant that what started out as a one-year OOPE became two. In these two years I did receive some formal training in research methods whilst completing the distance learning MSc in Advanced Emergency Care from the University of Sheffield. I re-entered training at ST4 two years ago and am currently completing an out-of-programme training (OOPT) year, during which I hope to apply for PhD funding.
What was the research idea and question which you based your successful proposal on?
The research idea was to examine the impact that crowding has on mortality and inpatient length of stay.
How did you develop your research idea?
I became interested in crowding research, as it is a daily problem in the ED that impacts on every day practice, as such it is the No.1 priority for research in the James Lind Alliance and RCEM research priority setting partnership. There are many harms of crowding but in particular I decided to examine the impact of crowding on mortality and inpatient length of stay. On examining the previous research, I found that some studies had associated mortality with crowding. However, none of these previous studies were UK based. Given the unique health care system present in the UK I felt it was necessary to examine the impact of crowding on mortality in the UK.
How did you go about answering this?
The research project is separated in to two sections: the first part is a systematic literature review and the second part is a cohort study. The systematic review will identify crowding measures in the literature associated with the primary outcome of inpatient mortality or the secondary outcome of inpatient length of stay. The cohort study will use an existing linked data set, from another study (The Connected Health Cities Project), which consists of 15 million acute attendances to 13 trusts in Yorkshire and Humber between 2010-17. The crowding measures identified by the systematic review will be tested against both mortality as the primary outcome measure, using logistic regression analysis, and inpatient length of stay as the secondary outcome measure, using multiple linear regression analysis.
What does your research look like one year on from the award, both for you and the project?
I currently have a 50:50 Clinical/Academic split within my OOPT. I am working on this project two days a week. We are halfway through the systematic literature review. All the database searches have been completed and we are working our way through the 73 relevant articles identified by the searches. The data for the cohort study has been collected and is currently being coded and cleaned.
When can we hope to see your findings?
Hopefully within the next 12 months.