Browsing by Author "Lewis, S."

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    The Brownings correspondence, Volume 15, 1848 - 1849
    (Wedgestone Press, 2007) Lewis, S.; Kelley, Philip
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    The Brownings correspondence, Volume 16, 1849-1851 (letters 2813-2900)
    (Wedgestone Press, 2007) Lewis, S.; Hagan, Edward; Kelley, Philip
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    Measuring health related quality of life of care home residents: comparison of self-report with staff proxy responses
    (Oxford University Press, 2018-09-04) Hinsliff-Smith, K.; Usman, A.; Lewis, S.; Long, A.; Housley, G.; Jordan, J.; Gage, H.; Dening, T.; Gladman, J.R.F.; Gordon, Adam Lee
    Introduction: Care home residents are often unable to complete Health Related Quality of Life questionnaires for themselves because of prevalent cognitive impairment. This study compared care home resident and staff proxy responses for two measures, the EQ-5D-5L and HowRU. Methods: A prospective cohort study recruited residents ≥ 60 years across 24 care homes who were not receiving short stay, respite or terminal care. Resident and staff proxy EQ-5D-5L and HowRu responses were collected monthly for three months. Weighted kappa statistics and intra-class correlation coefficients (ICCs) adjusted for clustering at the care home level were used to measure agreement between resident and proxies for each time point. The effect of staff and resident baseline variables on agreement was considered using a multilevel mixed-effect regression model. Results: 117, 109 and 104 matched pairs completed the questionnaires at 1, 2 and 3 months respectively. When clustering was controlled for, agreement between resident and staff proxy EQ-5D-5L responses was fair for mobility (ICC: 0.29) and slight for all other domains (ICC  0.20). EQ-5D Index and Quality Adjusted Life Year scores (proxy scores higher than residents) showed better agreement than EQ-5D-VAS (residents scores higher than proxy). HowRU showed only slight agreement (ICC  0.20) between residents and proxies. Staff and resident characteristics did not influence level of agreement for either index. Discussion: The levels of agreement for EQ-5D-5L and HowRU raise questions about their validity in this population.
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    Measuring health related quality of life of care home residents: comparison of self-report with staff proxy responses for EQ-5D-5L and HowRu: protocol for assessing proxy reliability in care home outcome testing
    (BMJ, 2018-06-01) Gage, H.; Gladman, J. R. F.; Usman, A.; Lewis, S.; Hinsliff-Smith, K.; Long, A.; Housley, G.; Jordan, J.; Gage, H.; Dening, T.; Gordon, Adam Lee
    Introduction: Care home residents are often unable to complete Health Related Quality of Life questionnaires for themselves because of prevalent cognitive impairment. This study compared care home resident and staff proxy responses for two measures, the EQ-5D-5L and HowRU. Methods: A prospective cohort study recruited residents ≥ 60 years across 24 care homes who were not receiving short stay, respite or terminal care. Resident and staff proxy EQ-5D-5L and HowRu responses were collected monthly for three months. Weighted kappa statistics and intra-class correlation coefficients (ICCs) adjusted for clustering at the care home level were used to measure agreement between resident and proxies for each time point. The effect of staff and resident baseline variables on agreement was considered using a multilevel mixed-effect regression model. Results: 117, 109 and 104 matched pairs completed the questionnaires at 1, 2 and 3 months respectively. When clustering was controlled for, agreement between resident and staff proxy EQ-5D-5L responses was fair for mobility (ICC: 0.29) and slight for all other domains (ICC  0.20). EQ-5D Index and Quality Adjusted Life Year scores (proxy scores higher than residents) showed better agreement than EQ-5D-VAS (residents scores higher than proxy). HowRU showed only slight agreement (ICC  0.20) between residents and proxies. Staff and resident characteristics did not influence level of agreement for either index.
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    A Quality Improvement Collaborative Aiming for Proactive HEAlthcare of Older People in Care Homes (PEACH): a realist evaluation protocol
    (BMJ, 2018-11-12) Devi, R; Banerjee, J; Chadborn, N; Hinsliff-Smith, K.; Dening, T.; Goodman,; Gordon, Adam Lee; Meyer, J; Fletcher Gladman, J; Long, A.; Usman, A.; Housley, G.; Bowman, C; Martin, F; Logan, P; Lewis, S.
    Introduction This protocol describes a study of a Quality Improvement Collaborative (QIC) to support implementation and delivery of Comprehensive Geriatric Assessment (CGA) in UK care homes. The QIC will be formed of health and social care professionals working in and with care homes and will be supported by clinical, quality improvement, and research specialists. QIC participants will receive quality improvement training using the Model for Improvement. An appreciative approach to working with care homes will be encouraged through facilitated shared learning events, quality improvement coaching, and assistance with project evaluation. Methods and analysis The QIC will be delivered across a range of partnering organisations which plan, deliver and evaluate health services for care home residents in 4 local areas of one geographical region. A realist evaluation framework will be used to develop a programme theory informing how QICs are thought to work, for whom, and in what ways when used to implement and deliver CGA in care homes. Data collection will involve participant observations of the QIC over 18 months, and interviews/focus groups with QIC participants to iteratively define, refine, test, or refute the programme theory. Two researchers will analyse field notes, and interview/focus group transcripts, coding data using inductive and deductive analysis. The key findings and linked programme theory will be summarised as context-mechanism-outcome configurations (CMOs) describing what needs to be in place to use QICs to implement service improvements in care homes. Ethics and dissemination The study protocol was reviewed by the NHS Health Research Authority (London Bromley research ethics committee reference: 205840) and the University of Nottingham ethics committee (reference: LT07092016). Both determined that the PEACH study was as a service and quality improvement initiative. Findings will be shared nationally and internationally through conference presentations, publication in peer-reviewed journals, a graphic illustration, and a dissemination video.
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    The SNAP trial: a randomised placebo-controlled trial of nicotine replacement therapy in pregnancy; effectiveness and safety until 2 years after delivery, the economic evaluation
    (HTA, 2014-08-26) Lewis, S.; Thornton, J. G.; Marlow, N.; Watts, K.; Britton, J.; Grainge, M. J.; Tagger, J.; Essex, H.; Parrott, S.; Dickson, A.; Whitemore, R.; Coleman, T.; Cooper, S.
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    Statistical analysis plan for the proactive healthcare of older people in care homes (PEACH) study
    (East Midlands Research into Ageing Network (EMRAN) Discussion Paper Series, 2018-09) Usman, A.; Lewis, S.; Jordan, J.; Gage, H.; Housley, G.; Hinsliff-Smith, K.; Long, A.; Devi, R.; Chadborn, N.
    The Proactive Healthcare for Older People living in Care Homes (PEACH) study aims to evaluate whether Quality Improvement Collaboratives can be an effective way to work with local health and social care stakeholders, including representatives of the care home sector, to implement Comprehensive Geriatric Assessment (CGA) in the care home setting. It will enlist the support of four Area Improvement Collaboratives from South Nottinghamshire, UK to make changes to enable CGA in care homes in their areas. The primary outcome measure is health-related quality of life (HRQoL), measured using the EuroQoL 5-domain 5-level (EQ-5D-5L) index. A cluster-randomised (where care homes represent clusters) approach will be taken. Secondary outcome measures will be Health Service Resource by service category. These will be analysed using an interrupted time series approach. The methodology is challenging and introduces the need to control for multiple sources of contamination, clustering, time effects including lag effect and measurement issues with the primary outcome variable, including the uncertain reliability of care home staff proxy responses. This paper outlines the statistical analysis plan for the study, describing how these challenges have been addressed. It acts as reference point for further publications from the PEACH study.
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