Probing the difficult questions of the value of research

Each year, UK universities receive over £10 billion in research funding. About two thirds of this funding comes from direct government sources. The rest comes from charities, businesses, private individuals and the EU. The latter funding stream is already beginning to dry up as a consequence of Brexit.  I have been doing research for the past 20 years, and during that time have secured some £1.5 million in research funding. Undertaking research has enabled me to travel the world, work with many creative people and explore some challenging questions. 

However, last year I was asked whether the research I have done in my time as an academic had actually changed anything, saved money or was remotely interesting to anyone else other than myself. It was a tough question to answer. In fact, it can be a tough question for many researchers to answer. Of course, the people who provide the money to support research being undertaken are also very interested in answering these questions. In the UK, the quality and perhaps more importantly, the impact of the research undertaken by universities is measured through something called the Research Excellence Framework (REF). The first REF was carried out in 2014, and the next will be in 2021. 

The REF is based upon a review of peer-reviewed published papers undertaken by expert panels made up of senior academics, international researchers and research users. I took part in the 2014 REF, and I can say it was a very rigorous process. It needs to be as the outcomes of REF are not only important to the funding bodies, but also for institutional reputation and academic careers. I won’t be entering the 2021 REF, but some of my papers will be used, as I write with others, some of whom will be submitting. 

Measuring the impact of your research can be difficult. There must be a direct line of sight between the research undertaken and the impact. For some types of research, the impact flowing from the research outcomes can sometimes take many years to accrue. A lot of evidence of the connections between a piece of research and how that was used can be lost, making it difficult to establish that clear line of sight. For example, I once did some research on why mental health nurses were reluctant to ask patients whether they had experienced childhood abuse, particularly child sex abuse. It should have been part of a standard assessment but was often skipped over. There were lots of reasons why, such as embarrassment, fear of having to do something if the answer was yes, and the avoidance of someone ‘reliving’ their abuse. 

The research led to the development of a training and education programme which was rolled out to a number of mental health services. It would require a follow up study to see if this programme had made a difference to the assessment approaches of mental health nurses, and of course there might be many other factors which also could be said to be responsible. This is a simple example; many others can be much more complex and complicated.   

So, it was great last week to see a piece of research that was clear in directly demonstrating the impact of its outcomes. It was a piece of research that was close to my heart, well actually closer to another part of my anatomy… 

…Vincent Ganapragasam is a urologist and researcher at the University of Cambridge and Cambridge University Hospital. Back in 2016 he developed the CamProbe. It was a prototype device that would make taking prostate biopsies much, much safer. After being able to demonstrate the value of the prototype, he was awarded a major government grant to develop it into a low-cost disposable device that can be used in any hospital outpatient clinic. This he has done, and he has received more funding to undertake a year of clinical trials around the UK. These are just about to start. Why was I excited by this news?

Well prostate cancer is the most common cancer in men in the UK. 1 in 8 men will get prostate cancer during their lifetimes. The number of men with prostate cancer is growing, and the early stages of prostate cancer can be symptom free. The current diagnostic tests are both high risk and not always reliable. The current method is to use a transrectal ultrasound probe to take the biopsy. This method poses a high risk of urinary infections and sepsis, as the needle has to pass through the bowel wall to reach the prostate. Around 40,000 prostate biopsies are done using this method. Around 12% of which will incur an infection or sepsis. 

The CamProbe allows for a different approach through the skin under the scrotum and avoiding the bowel. It’s a procedure that can be done under local anaesthetic.  Research using the prototype showed infections and sepsis could be avoided entirely. It also showed that most men preferred this method! If the clinical trials prove successful, it will mean this low-cost device could become the approved approach, saving the NHS an estimated £7-11 million every year in associated costs and of course, help save many more lives too. Now that is a research impact to shout about.