INSPIRE
2014 Research Studentship Award
Kelly Wilkinson
BMBS- Peninsula Medical School
International multicentre study comparing risk scoring systems for patients
presenting with upper gastrointestinal bleeding.
In April 2014, I was delighted to be granted the INSPIRE Research Studentship
Award in order to broaden my existing participation in an international multicentre
study. My award will subsidise a number of opportunities for further involvement in
this study, primarily a visit to Glasgow to perform the final statistical analysis and
interpretation of the international data. I further aspire to use my award to fund my
attendance at international conferences in gastroenterology where the results of the
study will be presented. The following report provides an insight into the study;
including my role so far, my ambitions, and the learning achieved during my
studentship to date. I would also like to use this as an opportunity to express my
deepest gratitude to all those involved in my studentship.
Background
There are a number of scoring tools developed for use in the early risk
assessment of patients who present with upper gastrointestinal bleeding.
Numerous studies have compared various combinations of risk scores for upper
gastrointestinal bleeding; however relatively few are multicentre and therefore
international comparison is incredibly limited. The optimum score for use in
clinical practice remains uncertain, thus highlighting the significance of our
study.
Aim
The aim of the study is to compare the predictive abilities and therefore the
clinical utility of a variety of risk scores in a prospective, multicentre,
international cohort of patients presenting with upper gastrointestinal bleeding.
The data will be further analysed to assess whether an enhanced new score can
improve the prediction of outcome for patients with this presentation. Following
its development, the performance of the new risk score will be compared with
that of the existing risk score systems.
Method
Consecutive patients presenting with upper gastrointestinal bleeding who fulfill
the criteria for inclusion are included at each of the participating centres. These
centres include those in Canada, Denmark, New Zealand, Scotland, Singapore and
the USA. All centres collect the same data; including patients’ characteristics,
blood tests, findings at endoscopy (if undertaken), and interventions in the form
of blood transfusion, endoscopic treatment, surgery or radiological intervention.
Uncontrolled bleeding, re-bleeding, in-hospital death and 30-day mortality are
also recorded.
My role so far
I have undertaken the lead role in the logistics of patient capture and data entry;
coordinating team members and data collaboration. I am collecting the local data
in accordance with the study protocol and adding these to the local database on a
daily basis.
INSPIRE studentship
The INSPIRE studentship award has opened up several exciting opportunities
and has enabled me to take me an additional step through the research process. I
am using my grant to visit Glasgow, following completion of the study in Spring
2015. Here I will spend time with Doctor Oliver Blatchford, who is in charge of
the statistical aspects of the study. During my time with Doctor Blatchford I will
perform database cleansing, data interpretation, and preparation of provisional
statistical results. This will enable me to make sense of the data collected and
understand the practical application of statistical methodology to the data that
my colleagues and I have already collected. Following my role in final statistical
analysis of the data, I endeavor to support the formulation of an improved new
risk score and I would also like to be involved, under Doctor Harry Dalton’s
guidance, with writing up the results section of the paper. I aspire to be involved
with the presentation of the study results at international conferences in
gastroenterology and publication of the results in an international peer reviewed
journal.
The value of attaining first-hand experience of a multicentre, international study
is indisputable. I have been provided with a fantastic opportunity to develop my
research methodology skills and better my understanding of what is involved in
audit and research. Before participating in this study and being awarded the
INSPIRE studentship award, my knowledge of research was incredibly limited
and my experience in this area was essentially nil. I have since been exposed to a
whole new and exciting aspect of Medicine and as a consequence have developed
an enthusiasm for research and enhanced a range of personal and professional
skills. The INSPIRE studentship award has provided me with the expenses to
fund such exceptional opportunities. I am extremely excited for what will now
come, following completion of the study in February 2015.