(Clinical Trials) & CTU Co-Director
I am an Associate Professor and Co-Director of our UKCRC accredited Clinical Trials Unit. Our primary research area is in the design and conduct of trials to determine the effectiveness of time critical interventions in severely ill patients. Our research include the MRC-CRASH trial which was designed to assess the effect of corticosteroid in traumatic brain injury. This trial was the largest to be conducted in traumatic brain injury and included over 10,000 participants and to date is the only trial to provide Class A evidence for the treatment of traumatic brain injury (see news item).
I had a lead role in the CRASH-2 trial (including Chair of the writing committee) which assessed the effect of tranexamic acid (TXA) on mortality in patients with traumatic bleeding. This trial recruited over 20,000 participants in 40 countries. The CRASH-2 trial impacted directly the clinical care of patients globally within one year of the first presentation of the results. The results led directly to tranexamic acid being included in the WHO list of essential medicines and its incorporation into civilian and military trauma guidelines world-wide. We have estimated that over 100,000 lives per year worldwide could be saved if bleeding trauma patients were to receive tranexamic acid. The CRASH-2 trial won the British Medical Journal 'Research Paper of the Year' award in 2011. Dissemination and implementation work is still ongoing for example see http://www.traumapromise.org/.
I am a principal investigator of the WOMAN Trial which is looking at the effect of tranexamic acid as a treatment for postpartum haemorrhage (PPH). It is already one of the largest randomised control trials to be conducted in this vulnerable population. It required the creation of a global network of doctors, midwives, nurses, administrators and pharmacists all working without financial incentives to answer this important clinical question.
I am collaborating with a team at the University College Hospital, Ibadan Nigeria on the WOMAN-ETAC study which aims to evaluate the effect of TXA on markers of coagulation. I am also collaborating on the with the Obstetric Gynecology University Hospital Koço Gliozheni, Albania and Ludwig-Maximilians-Universität, Germany on the WOMAN-ETAPlat study. This study aims to examine the haemostatic and antithrombotic effect of TXA.
I have also previously done laboratory based research and early phase clinical trials including lead investigator in the BRAIN Trial (looking at the effect of bradykinin B2 receptor antagonist as a treatment for traumatic brain injury).
I am a tutor on the Distance Learning MSc Clinical Trials and Module Organiser Organiser for CT210 (the Integrating Module which is taken at the end of the students' studies to integrate their learning from the course (www.lshtm.ac.uk/prospectus/masters/dmsct.html)
I have taught on several modules including CT103 (Clinical Trials in Practice), 104 (Reporting and Reviewing Clinical Trials), 201 (Protocol Development), 203 (Project Management and Research Coordination), 204 (Regulatory Affairs, GCP and Ethics) and 205 (Data Management).
See details of my work above. I work with an amazing network of collaborators here at LSHTM and in over 50 countries (see http://ctu.lshtm.ac.uk/). I am interested in making sure that regulations which govern the conduct of clinical trials are sensible and allow for critically ill patients to benefit for scientific advances. I am aslo interested in developing novel ways of communicating the work we do to clinicians, policy makers and the wider public to make sure patients benefit from the results of our research.