NICE requires research to help it decide which treatments and diagnostic methods should be funded by the NHS. NICE has highlighted the need for research into the methods for reviewing evidence from research. Identifying research studies underpins most NICE reviewing. Methodological search filters are widely used to identify specific research designs such as randomized controlled trials or economic evaluations. Search filters are carefully selected collections of words and phrases used to search databases to identify research. Little is known about how well search filters work in finding research. This means that their use as a standard tool for NICE researchers may not be informed by adequate information to indicate how search filters perform across different subjects, questions and databases. Our proposal is to investigate how search filter performance can be measured and what measures are most useful to researchers. We also plan to investigate systems and approaches to provide better access to relevant and useful performance data on methodological search filters. The benefits of this research would be to enhance the tools and knowledge of the tools available to find research evidence to inform NICE appraisals, guidelines and other guidance. The research findings would also benefit other national technology assessment agencies, guidelines groups and related bodies.

Around a quarter of patients with the most common cause of thyroid gland overactivity (Graves' disease) develop a complication known as Graves' orbitopathy (GO). In GO, tissues in the space behind the eyeballs (the orbit) become inflamed, causing pressure to build up. This causes intense pain, restriction of eye movements, and in some cases permanent damage to sight. The pressure causes the eyeballs to bulge forward (proptosis), causing a startled, staring appearance which is disfiguring and a cause of great psychological harm (at least a third develop significant depression and anxiety). Following an initial highly active phase, patients with GO develop long lasting changes in the tissues of the orbit, which means the eyeballs remain projected forwards. Patients may be treated with high doses of steroids, and some require surgery to decompress the orbit, both to save sight and also to improve the appearance of the eyes. It is well established that antibodies targeting a receptor which stimulates the thyroid gland are the cause of its overactivity in Graves' disease. Whilst this antibody is also important in GO, the majority of GD patients do not develop this complication. Why this might be is unknown. We also don't know if different antibodies are important in GO, and whether they are made by inflammatory cells local to the eye. The reason some patients develop long term disfigurement is also not understood. In this project, we will use advanced techniques to analyse the makeup of the inflamed orbit, one cell at a time, from samples taken during decompression surgery. We will look at the antibody producing cells in the orbit and compare them to those in the blood, to see whether they are likely to be driving the disease. We will also look to see how the cells in the orbit are different between the initial and long term phases, and if there are subsets which may be responsible for this progression. Finally, we will perform experiments to see how antibodies and other inflammatory molecules cause changes in fibroblasts, important structural cells of the orbit.

Every year scientific journals publish tens of thousands of articles describing findings from health research studies. However, readers and users of these articles, who include scientists, clinicians, systematic reviewers, and increasingly also patients, find many of these articles very difficult or impossible to use: many articles do not present enough information, present only selected information, or present information in a very unclear and misleading way. All this makes many papers unusable. The effort and money devoted to the research described in such an unsatisfactory manner is wasted. A simple solution to improve the completeness, accuracy and clarity of research papers is to follow reporting guidelines. Many guidelines exist that provide step by step guidance of what should be addressed in a paper reporting on a particular type of health research. These guidelines have been developed from the users' perspective and guide authors to provide minimum information a user needs to assess how well was the study done, to decide if the findings are relevant to his/her own work, and if needed to reproduce the study (ie. what was actually done and to whom, what was assessed and how, how were these findings analysed, and what they actually mean in the context of other similar studies). Although many good guidelines exist they are still not widely known and used by health scientists. Recent reviews of publications consistently show that essential information is missing from a large proportion of research articles. In this time of massive information overload it is important to have a single good quality resource where you can easily find all relevant information you need. In 2008, we launched the EQUATOR programme that aims to enhance the quality and transparency of health research. One of the most important outputs of this programme is a free online Library for Health Research Reporting that brings together all published reporting guidelines and other helpful tools that aid the writing and publication of research reports and thus improve the information provided to readers. The EQUATOR team educates scientist and journal editors, who play a key role in safeguarding the quality of published papers, to increase their knowledge of what should be included in research papers and how best to achieve it. EQUATOR also helps scientists to develop high quality reporting guidelines and conducts research investigating problems in research reporting. Our proposal outlines specific deliverables and activities for the next three years that will further advance the programme. The main outputs include: improved structure and content of our Library; development of unique EQUATOR 'signature' courses supporting rigorous research reporting; compilation of a manual for the development of robust reporting guidelines; a research report summarising the use of reporting guidelines by selected priority journals; and a database of evaluations of reporting quality of scientific papers across health research specialties. Medical journals publish large numbers of research reports that are of limited value because of crucial omissions. This waste is avoidable. The EQUATOR website and training can be compared to a well stocked and well promoted supermarket where you can get everything you need to write and publish first class research papers. The knowledge of what needs to be included in research papers that are clear and easy to use also improves the design of future research studies. Our work helps to improve usability and usefulness of published medical research and helps scientists to become outstanding research communicators.

Cardiovascular diseases (CVDs), such as strokes and heart attacks, are the leading causes of death amongst women globally. A particular group of women at high risk of cardiovascular disease are those who experience a pregnancy complicated by gestational diabetes mellitus (GDM) and/or a hypertensive disorder of pregnancy (HDP). Following a pregnancy affected by GDM, within 5 years up to 50% of women will develop T2DM; and following HDP, 30% of women will develop hypertension. Both these conditions greatly increase risk for CVD, however with timely detection and management these risks can be greatly reduced. The importance of breaking this link between high-risk pregnancy and CVD is widely acknowledged, yet to date there have been no trials demonstrating this can be achieved, and importantly whether it can be done affordably and at scale. Three key actions are needed: (i) effective primary prevention; (ii) regular screening, and (iii) evidence-based management when disease is detected. India is experiencing an epidemic of type 2 diabetes mellitus (T2DM) and hypertension. 73 million people have diabetes, and 207 million hypertension (2017 data). Rates of GDM and HDP are high, affecting 20% and 10% of pregnancies, respectively. There is an urgent need for effective and affordable preventative strategies to reduce the economic, social and health consequences of these conditions for women in India. In the UK, GDM and HDP are the commonest complications of pregnancy. After a pregnancy with GDM, women should undergo screening with their GP 6 week after birth for persistent high blood glucose. Attendance however is generally poor, with rates between 30-70% across the country. Following HDP, evidence is needed to guide care. The Fellowship will enable me to lead connected programs of work across two countries: India and the UK, determining the role digital innovations could play to deliver post-partum interventions in women globally. I will conduct two clinical studies, with active engagement with policy makers, clinicians, digital health companies and social enterprises throughout the Fellowship. SMART Health is a digital platform, developed by the George Institute for Global Health, that has been implemented in India, Indonesia, China, and Myanmar, to improve detection and management of diabetes and hypertension. The platform is aimed at rural community health workers and primary care doctors, enabling task shifting, clinical decision support, automated referral, SMS reminders, and patient tracking. Since 2017, I have been leading the group adapting this platform to improve the detection and management of anaemia, GDM and HDP in pregnant women living in rural India: SMART Health Pregnancy (SHP). Through this Fellowship I will extend SHP to facilitate prevention, screening, and early treatment of hypertension and T2DM in the years after a pregnancy complicated by GDM and/or HDP. The effect of this on achieving target blood pressure and blood glucose control after high risk pregnancy will be assessed in a large clinical trial in rural India, following 960 women for 5 years. In the UK, I was part of the team of clinicians and researchers in Oxford who developed a remote monitoring system for women with GDM (GDmHealth). We demonstrated in a clinical trial that this approach was safe, convenient and preferred by women and health workers. The technology was licensed to a commercial company (Sensyne) in 2018, and since then thousands of women have benefited from this innovation across the UK. Through this Fellowship I will lead a program of work adapting this approach for women in the year after birth, assessing whether remote monitoring improves screening attendance, deliver effective lifestyle support, offer a potential cost savings to the NHS, whilst being acceptable and more convenient for new mums. Theis approach could improve their health, for future pregnancies and lifelon

For older adults, exercise improves fitness and health, maximises participation, increases functional independence and enhances quality of life. Higher fitness-levels are linked to lower levels of emotional distress and depression, improved mobility, functionality and independence encouraging a higher level of behavioural activation and social inclusion Adherence and compliance with recommended exercise guidelines remains poor amongst ageing adults who frequently avoid participation for fear of falling, exacerbating symptoms or provoking pain or fatigue. The shortage of appropriately qualified trainers means some institutionalised elderly are sedentary for over 12 hours a day, their only energy expenditure being when getting in and out of bed. We have created a series of bed and chair-based programs for older adults, some of whom may be resistant to exercise, providing a graduated course of physical activity suitable for everyone, from the very frail to the healthy agile. We will engage older adults who may be isolated, bedbound, frail, have multiple health conditions, physical disabilities, learning difficulties or mental health issues, and lead them through specialised bed and chair-based exercises given remotely, linked by a live-stream platform such as Webinar or Zoom, presented on large-screen TV, through their own smartphone, tablet or laptop enabling everyone to work in a group. The sessions will be supplemented by videos and an App. During the next 12 months we will complete the filming, select the live-stream platform and test the system in community settings with the aim of producing a solution ready to roll out to the Care Home sector.