ACIT-II: Activation of Coagulation and Inflammation in Trauma. A prospective, observational cohort study designed to investigate the molecular mechanisms activated by traumatic injury and how these relate to outcomes http://www.c4ts.qmul.ac.uk/research-programmes/acit
ASPIRED: The aim is to find out whether an extended (14 days) ECG monitoring can better detect abnormal heart rhythm compared to standard monitoring.
ASPIRED Study | The University of Edinburgh
Patients recruited to ASPIRED are also recruited to sub-study ASPIREDQ where possible.
BACHb: Breathing Assistance in CHildren with bronchiolitis (BACHb): a group-sequential two-stratum multicentre open-label randomised clinical trial of respiratory support in infants with acute bronchiolitis.
BIOAID: BioResource in Adult Infectious Diseases (2019-2024) aims to collect biological samples and clinical information from patients presenting to the hospital with suspected infectious diseases. https://imperialbrc.nihr.ac.uk/2020/01/28/bioaid/
CRASH4: The CRASH-4 trial aims to provide reliable evidence about the effects of early intramuscular TXA on intracranial haemorrhage, disability, death, and dementia in older adults with symptomatic mild head injury.
About the Trial – CRASH 4 Trial (lshtm.ac.uk)
DRAFT3 CASP: This study is a randomised non-inferiority trial comparing a splint versus a cast in treating non-displaced distal radius fractures in adults.
DURATION UTI: Impact of duration of antibiotic therapy on effectiveness, safety and selection of antibiotic resistance in adult women with urinary tract infections (UTI): a randomised controlled trial.
EMBRACE: The E.mbrace Study will assess the effectiveness and safety of an investigational vaccine in the prevention of blood infections in adults aged 60 or over. These blood infections can lead to serious complications such as dangerously low blood pressure or shock. EMROx is ready to support General Practice Teams if any patients who have been recruited to the study are admitted to the Emergency Department. Patients can self refer to the study.
EVIS: The aim of this research study is to compare two treatments (fluid and blood pressure medication via a drip) for patients in hospital with sepsis, a life-threatening condition caused by the overreaction of the body's immune system to infection. Early Vasopressors in Sepsis (EVIS) - NIHR Funding and Awards
GAINS -2: Genomic Advances in Sepsis Study (Sepsis Immunomics ) The overall aim of this study is to understand how and why some patients have an extreme response to infection in order to improve patient care.
Sepsis Immunomics - Health Research Authority (hra.nhs.uk)
Haemostasis in acutely ill patients with advanced liver disease:
Multi-centre, prospective observational cohort study of haemostasis in acutely ill patients with advanced chronic liver disease.
ORIF: It aims to establish if operative rib fixation, when given in addition to supportive management, reduces mortality and/or increases quality of life in patients who experience chest wall trauma.
The Operative Rib Fixation (ORiF) Study - Health Research Authority (hra.nhs.uk)
PACKMAN: It is a double-blind, randomised controlled trial of ketamine versus morphine for prehospital patients with traumatic pain.
https://wmas.nhs.uk/packman-2/
PARAMEDIC 3: The trial is looking at the most effective way to treat someone when their heart suddenly stops working out of hospital by giving drugs through a vein or into the bone.
https://warwick.ac.uk/fac/sci/med/research/ctu/trials/paramedic3/
PNEUMOTHORACES
---CONSEPT: The study aims to evaluate whether conservative care for large symptomatic primary spontaneous pneumothorax (PSP)is superior to usual care. CONSEPT – Bristol Trials Centre
---COMITED: The study aims to evaluate the clinical and cost-effectiveness of chest drain insertion in ED vs initial conservative management (i.e. no immediate chest drain) in traumatic pneumothorax.
About the study – CoMiTED (bristol.ac.uk)
---PRINCE: The study aims to assess whether needle aspiration is non-inferior to chest drain in the management of secondary pneumothorax.
RAIDS: This is a mix method research to find out in-depth studies that provide an opportunity to understand how crashes occur and, from this understanding, contribute to the development of safer roads and safer vehicles. https://www.gov.uk/government/publications/road-accident-investigation-road-accident-in-depth-studies/road-accident-in-depth-studies-raids
RAPID I: Phase IIb, randomised, double-blind, placebo-controlled, multi-centre trial of infliximab with transcriptomic biomarker and mechanism evaluation in patients with acute pancreatitis.
SIS: Spinal Immobilisation Study: Randomised controlled trial to assess whether movement minimisation is no worse than triple spinal immobilisation for patients who have may have or are suspected of a spinal injury in the pre-hospital and emergency setting.
Spinal Immobilisation Study (SIS) - NIHR Funding and Awards
STOP-D: A multi-centre randomised controlled trial of the clinical and cost-effectiveness of sertraline in preventing depression in adults following a traumatic brain injury.
STOP-D (TBI Study) - Health Research Authority (hra.nhs.uk)
SWIFT: A trial of the clinical and cost-effectiveness of pre-hospital whole blood administration versus standard care for traumatic haemorrhage.
https://www.nhsbt.nhs.uk/clinical-trials-unit/current-trials-and-studies/swift/
Patients recruited to the SWIFT study are also recruited to sub-study ACIT SWIFT where possible.
TAP: This study evaluates the effectiveness of 4factor PCC in patients with acute major bleeding associated with traumatic injury.
TAP Patient Recruitment (cslbehringtap.com)
TILIA: The study aims to evaluate the efficacy and safety of TAZORAKIMAB i hospitalised patients needing oxygen.
https://clinicaltrials.gov/ct2/show/NCT05624450
Emergency Medicine Research Oxford (EMROx) Team
Email: Emergency.Research@oxnet.nhs.uk
Tel no.01865 (2) 22003 or (2)27928
Bleep: 6680
ABRA: Evaluate the efficacy of Beralizumab in the treatment of eosinophilic exacerbations of airways disease
The ABRA Study - Health Research Authority (hra.nhs.uk)
ABC SEPSIS: Feasibility of 5% Albumin compared with Balanced Crystalloid, as intravenous fluid resuscitation in adult patients with sepsis, presenting as an emergency to hospital.
https://www.ed.ac.uk/usher/edinburgh-clinical-trials/our-studies/all-current-studies/abc-sepsis
AIRWAYS-2: AIRWAYS-2 is a randomised trial which is comparing the clinical and cost effectiveness of the i-gel supraglottic airway device with tracheal intubation in the initial airway management of patients who have suffered an out of hospital cardiac arrest (OHCA).
https://jamanetwork.com/journals/jama/article-abstract/2698493
ATOMIC 2: The purpose of this study is to assess whether the use of a commonly given antibiotic called Azithromycin can prevent or makes no difference to patients getting worse, otherwise known as disease progression of Novel Coronavirus-Induced Disease 2019 (COVID-19) in people who go to hospital, but who doctors decide there is no need to admit them for treatment.
AUSTERITY IN HEALTHCARE – UK: The aim of our study is to develop an understanding of how austerity-driven policies and subsequent system reforms impact and shape ideas and practices of ethical professional conduct.
BEST-2: A diagnostic accuracy study of point-of-care troponin in patients presenting with chest pain within 1 hour of ED presentation.
BEST-2 - Health Research Authority (hra.nhs.uk)
BRONCHSTART: Impact of Covid-19 on Respiratory Syncytial Virus Seasonality and Disease Severity in UK Children (BronchStart). https://clinicaltrials.gov/ct2/show/NCT04959734
CAP-IT: Efficacy, safety and impact on antimicrobial resistance of duration and dose of amoxicillin treatment for young children with Community-Acquired Pneumonia (CAP): a randomised controlled trial. https://jamanetwork.com/journals/jama/article-abstract/2785716
CAUDA EQUINA BIOMARKERS: A study exploring potential biomarkers for Cauda Equina Syndrome by comparing blood samples to spine MRI results in patients with suspected or confirmed Cauda Equina Syndrome.
CRAFFT: This is a randomised non-inferiority trial of surgical reduction vs non-surgical reduction for displaced distal radius fracture in children aged 4-10 y.o.
https://crafft-study.digitrial.com/
CRYOSTAT: Early Cryoprecipitate in major Haemorrhage in Trauma is a randomised open label study to determine whether early administration of cryoprecipitate in bleeding trauma patients is possible. https://academic.oup.com/bja/article/115/1/76/238264
CRYOSTAT 2: CRYOSTAT-2 will evaluate whether early administration of high-dose cryoprecipitate, in addition to standard major haemorrhage therapy, improves survival from traumatic bleeding.
DENS: The main aim of the study is to determine whether earlier removal of a hard collar is associated with a better quality of life in older and frail patients with a fracture of the odontoid process bone in the neck.
DENS | The University of Edinburgh
ECHO: This project aims to address the question of what the potential harm of handover failures along the emergency care pathway is and what common organisational deficiencies impact upon the reliability and quality of handovers. https://core.ac.uk/download/pdf/36771298.pdf
E-FIT: A multi-centre, randomised, double blind, placebo controlled trial evaluating the effects of early administration of fibrinogen concentrate in adults with major traumatic haemorrhage.
https://www.nhsbt.nhs.uk/clinical-trials-unit/completed-trials-and-studies/e-fit-1/
ENCEPH UK: The study aims to determine the early clinical features predictive of Herpes simplex virus (HSV) encephalitis to support the development of a predictive tool for HSV encephalitis based on these early clinical features.
EURODEM: European Dyspnoea survey in the Emergency Departments
FORCE: Forearm Fracture Recovery in Children Evaluation: A multi-centre prospective randomised equivalence trial of a soft bandage and immediate discharge versus current treatment with rigid immobilisation for torus fractures of the distal radius in children.
https://www.ndorms.ox.ac.uk/research/clinical-trials/completed-trials/force
HISPEC: A national randomised controlled trial exploring the benefits of ambulatory management in patients with pneumothorax due to underlying lung disease.
ICICLE: A case control study of the effectiveness of Q/LAIV versus inactivated influenza vaccine and no vaccine in subjects 2-17 years of age.
IPMED: Integrated Patient Monitoring in the Emergency Department https://www.ncbi.nlm.nih.gov/pubmed/25055312
ITACTIC: A multi-centre, prospective, randomized controlled study to compare outcomes of viscoelastic haemostatic assay (VHA)-guided resuscitation versus optimised conventional coagulation test resuscitation support in haemorrhaging trauma patients. https://pubmed.ncbi.nlm.nih.gov/33048195/
LEAK: A multicenter prospective cohort study on the diagnostic accuracy of NeutrophilGelatinase-Associated Lipocalin (NGAL) and Cystatin C for Acute Kidney Injury (AKI) inconsecutive adults admitted from the Emergency Department.
MP4OX: Research study to find out if the study drug, MP4OX, given together with standard treatment, is safe and effective in treating severely injured trauma patients with haemorrhagic shock. A randomised controlled trial of topical intranasal tranexamic acid versus placebo in patients presenting to the Emergency Department with spontaneous acute epistaxis.
NOPAC: A randomised controlled trial of topical intranasal tranexamic acid versus placebo in patients presenting to the Emergency Department with spontaneous acute epistaxis.
https://pubmed.ncbi.nlm.nih.gov/33612282/
ORANGE: Oral Anticoagulant Agent-associated Bleeding Events Reporting System (ORANGE) is an observational study on current management practices and clinical outcomes of OAC-associated major bleeding events across the UK, in order that we may develop better management strategies for the future and provide a knowledge base for further research.
http://www.haematologica.org/content/haematol/103/4/738.full.pdf
PARAMEDIC: Pre-hospital randomised assessment of mechanical compression device in cardiac arrest. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61886-9/abstract.
PARAMEDIC2: The PARAMEDIC2 trial is looking at whether adrenaline is helpful or harmful in the treatment of cardiac arrest which occurs outside of hospital. Answering this question will help to improve future treatment of people who have a cardiac arrest. https://www.nejm.org/doi/full/10.1056/NEJMoa1806842
POEM: The study aims to assess the adequacy of pain management in patients presenting to the ED with confirmed long bone fracture and/or dislocation isolated to a proximal or distal limb.
PRONTO: The primary aim is to compare PCT- supported assessment with standard care of suspected sepsis in adults presenting to the ED, and measure whether this approach reduces prescriptions of antibiotics without increasing mortality by decreasing uncertainty in the group who may not need IV antibiotics urgently within 1 hour, or not need antibiotics at all.
https://www.cardiff.ac.uk/centre-for-trials-research/research/studies-and-trials/view/pronto
RAMPP: Multi-centre randomised controlled trial comparing ambulatory management to standard care ( aspiration +/- standard chest drain insertion) with an observational cohort study of patients not requiring an intervention. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31043-6/fulltext
SCARTA: A Simple Cognitive task After a Road Traffic Accident. This research study is designed to investigate the effects of a simple cognitive task (a memory reactivation cue following by playing the computer game "Tetris") on flashbacks and other post-traumatic stress symptoms after a road traffic accident. http://www.ox.ac.uk/news/2017-03-28-tetris-used-prevent-post-traumatic-stress-symptoms
SHED: Subarachnoid Haemorrhage in the Emergency Department (SHED) aims to evaluate different strategies for investigating serious causes of headache. In particular, we are looking carefully at those patients who go on to have a scan of their brain and whether the timing of this affects the need for further investigations. https://ternresearch.co.uk/shed
SNAP-2: The 2nd Sprint National Anaesthesia Project: Epidemiology of Critical Care provision after Surgery (SNAP-2: EpiCCS)is an epidemiology study of perioperative risk and outcome, and critical care referral and admission after inpatient surgery in the UK.
STOP-APE: Stopping anticoagulation for isolated or incidental subsegmental pulmonary embolism. https://www.birmingham.ac.uk/research/bctu/trials/renal/stopape/index.aspx
RE-VERSE-AD: Evaluate the reversal of the anticoagulant effects of dabigatran by IV administration of 5.0g idarucizumab in patients treated with dabigatran etexilate who have uncontrolled bleeding or require emergency surgery or procedures.
SPRAINED: Synthesising a clinical Prognostic Rule of Ankle Injuries in the Emergency Department. This is a cohort study looking at how clinicians might predict which types of ankle sprains and or patient groups have better outcomes.
The Award Study: The hospitalised acute wheezy adult with airways disease: studying the different characteristics and treatment responses. https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/the-award-study/
WHIPLASH: Does peripheral neuroinflammation predict chronicity following whiplash?
Metcalfe D, Perry D C. (2024). Surgically reducing displaced distal radial fractures in children.
Bone Joint J2024;106-B(1):16-18.
Fu H, Novak A, Robert D, Kumar S, Tanamala S, Oke J, Bhatia K, Shah R, Romsauerova A, Das T, Espinosa A, Tadeusz Grzeda M, Narbone M, Dharmadhikari R, Harrison M, Vimalesvaran K, Gooch J, Woznitza N, Salik N, Campbell A, Kahn F, Lowe D, Shuaib H, Ather S. (2024) AI assisted reader evaluation in acute CT head interpretation (AI-REACT): protocol for a multireader multicase study. BMJ Open Vol 14, issue 2.
Coventry L, Oldrini I, Dean B, Novak A, Duckworth A, Metcalfe D. (2023) Which clinical features best predict occult scaphoid fractures? A systematic review of diagnostic test accuracy studies. Emergency Medicine Journal Vol 40, issue 8.
Glover, S J, Metcalfe D, Erasu V, Panduro T, Gibbs W, Immanuel P, Novak A, Shanahan TAG. (2023) Journal update monthly top five. Emergency Medicine Journal Vol 40, issue 8.
Metcalfe D, Lancaster S, Keene D. (2023) Revisiting the humble ankle sprain. Emergency Medicine Journal Vol 40, issue 8.
Metcalfe D, Hoeritzauer I, Angus M, Novak A, Hutton M, Woodfield J (2023). Diagnosis of caudia equina syndrome in the emergency department. Emergency medicine journal 2023;40: 787-793.
Oldrini I, Coventry L, Novak A, Gwilym S, Metcalfe D. (2023) Clinical predictors of fracture in patients with shoulder dislocation: systematic review of diagnostic test accuracy studies. Emergency Medicine Journal Vol 40, issue 5.
Burckett-ST Laurent, D, Metcalfe D, Sutcliffe E et. Al. Emerg MedJ Epub ahead of print 2023;0:1-2
doi:10.1136/emermed-2023-213354
Russell REK, Doggett T, Pavord I, Pullinger R, Beer S, Bafadhel M. (2016). S68 Copd in the ed: eosinophils, treatment and outcomes, data from the pre-award study. Thorax. 71. A40.2-A41.
Clifton D, Wong D, Fleming S, Wilson S, Way R, Pullinger R, Tarassenko, L. (2011). Novelty Detection for Identifying Deterioration in Emergency Department Patients. 6936. 220-227
Pullinger R, Wilson S, Way R, Santos M, Wong D, Clifton D, Birks J, Tarassenko, L. (2016). Implementing an electronic observation and early warning score chart in the emergency department: A feasibility study. European Journal of Emergency Medicine. 24.
Way R, Warnes K, Yousefi S, Beer S, Santos M, Wong D, Wilson S, Pullinger R, Tarassenko L. (2014). Paper and electronic early warning scoring systems: review of 6000 patients in the emergency department. International Emergency Nursing. 22. 259-259.
Wilson S J, Wong D, Pullinger R, Way R, Clifton D, Tarassenko, L. (2014). Analysis of a data-fusion system for continuous vital sign monitoring in an emergency department. European Journal of Emergency Medicine. 23
Clifton D, Wong D, Clifton L, Wilson S, Way R, Pullinger R, Tarassenko, L. (2013). A Large-Scale Clinical Validation of an Integrated Monitoring System in the Emergency Department. Biomedical and Health Informatics, IEEE Journal of Biomedical and Health Informatics. 17. 835-842. 10.1109/JBHI.2012.2234130.
Wilson SJ, Wong D, Clifton D, Fleming S, Way R, Pullinger R, Tarassenko, L. (2012). Track and trigger in an emergency department: An observational evaluation study. Emergency medicine journal 30.
Clifton D, Wong D, Fleming S, Wilson S J, Way R, Pullinger R, Tarassenko L. (2011). Novelty Detection for Identifying Deterioration in Emergency Department Patients. 6936. 220-227.
Curry N, Raja A, Hughes T, Black J, Pullinger R, Davenport R, Brohi K, Stanworth S. (2010). A prospective observational study evaluating changes in coagulation parameters in trauma admissions. 50th Annual Scientific Meeting of the British-Society-for-Haematology, Volume: 149 1010.
Keating L, Benger J, Beetham R, Bateman S, Veysey S, Kendall J, Pullinger R. (2006). The PRIMA Study: Presentation ischaemia-modified albumin in the emergency department. Emergency Medicine Journal 23. 764-8. 10.1136/emj.2006.036269.
Return to Research Projects Page