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January 2019
Research & DevelopmentTaighde & Forbairt
Research Activity in the HSE and its Funded Organisations
AM Terrés, MC O’Hara, P Fleming, N Cole, D O’Hanlon, P Manning
A report of staff engaged in research, research studies undertaken, publication output and research networks
Executive Summary 4
1. Introduction and Context 12
2. Methodology 14 2.1. Research Activity Indicators and Associated Datasets 15 2.2. Time periods 16 2.3. ClassificationMethodology 17
3. ActivityIndicator1:HealthServiceStaffinvolvedinResearch 18 3.1. SurveyofResearchActiveStaff 19 3.1.1.SurveyAnalysisbyPlaceofWork 19 3.1.2. Survey Analysis by Profession 21 3.1.3. Survey Analysis of EducationalQualifications 22 3.1.4. Survey Analysis of Researcher Competencies 24 3.1.5.SurveyAnalysisofResponsesfromStaffLinkedwithHEIs 27 3.1.6.SurveyAnalysisofTimeAvailabletoConductResearch 27 3.2. MedicalConsultantswithaFormalAcademicAppointment 29 3.2.1.DistributionofMedicalConsultantswithAcademicAppointmentsbyLocation 29 3.2.2.DistributionofConsultantswithaFormalAcademicAppointmentbyDiscipline 31
4. ActivityIndicator2:ResearchStudies 34 4.1. StudiesApprovedbyResearchEthicsCommitteesin2017 35 4.1.1.ResearchCategoriesandGeographicalDistribution 40 4.1.2.ResearchinPrimaryCareandGeneralPractice 43 4.2. HRBfundedStudieswithHealthcareProfessionalsasPIsorCo-PIin2017 44 4.2.1.HRBStudiesAwardedtoHCPsin2017 45 4.2.2.HRBstudiesawardedtoCFAAin2017 47 4.3. EUFundedStudiesinvolvingtheHSEin2017 48 4.4. RegulatedClinicalTrials(medicinalproducts)andInvestigations(medicaldevices) 48 4.4.1.RegulatedClinicalTrialsinIrelandin2017 49 4.4.2.ClinicalInvestigationofMedicalDevices 51 4.5. ResearchRelatedActivityintheThirdLevelSectorFundedbytheHSEin2017 52
5. ActivityIndicator3:ScopusIndexedPublications,2013-2017 56 5.1. AnalysisofPublicationNumberperYearfrom2013-2017 57 5.2. Analysisofoverallpublicationoutputbytopicandresearchactivitytype 59 5.3. AnalysisofPublicationsbyMedicalConsultantswithaFormalAcademicAppointment 63
6. ActivityIndicator4:ClinicalResearchNetworks 64 6.1. ClinicalTrialNetworks(CTNs) 65 6.2. CollaborativeClinicalResearchNetworks 69
7. Conclusions 70
Appendices 74Appendix1:UKHRCScategorydescriptions 75Appendix2:UKHRCSbyHSERegion 77Appendix3:ClinicalResearchFacilities(CRFs)andClinicalResearchCentres(CRCs) 78
Contents
Conte
nts
CNOH: CappaghNationalOrthopaedicHospital
CT-IMP: ClinicalTrialofInvestigationalMedicinalProduct
CHO: CommunityHealthOrganisation
CFAA: Medicalconsultantwithaformalacademicappointment
CUH: CorkUniversityHospital
CHITIN: Cross-borderHealthcareInterventionTrialsinIrelandNetwork
CÚRAM: CentreforResearchinMedicalDevices
EEA: European Economic Area
EU: European Union
EudraCT: EUClinicalTrialsRegister
GUH: GalwayUniversityHospital
HCP: HealthcareProfessional
HEI: HigherEducationInstitution
HG: HospitalGroup
HPRA: HealthProductsRegulatoryAuthority
HR: HumanResources
HRCS: HealthResearchClassificationSystem
HSCP: HealthandSocialCareProfessional
HSE: HealthServiceExecutive
ICGP: IrishCollegeofGeneralPractitioners
ICHGCP: InternationalConferenceonHarmonisation,GoodClinicalPractice
IDSI: Infectious Diseases Society of Ireland
ISGE: IrishSocietyofGastroenterology
LUH: LetterkennyUniversityHospital
MUH: MayoUniversityHospital
MUH,Cork: MercyUniversityHospital,Cork
NMH: NationalMaternityHospital
NRH: NationalRehabilitationHospital
NSAI: National Standards Authority of Ireland
NUIGalway: NationalUniversityofIreland,Galway
OLCHC: OurLady’sChildren’sHospital,Crumlin
PI: PrincipalInvestigator
Glossary
2 Research Activity in the HSE and its Funded Organisations
Glo
ssary
QUB: Queen’sUniversity,Belfast
R&D: Research and Development
REC: Research Ethics Committee
RCSI: RoyalCollegeofSurgeonsinIreland
RVEEH: RoyalVictoriaEyeandEarHospital
SJH: StJames’sHospital
SVUH: StVincent’sUniversityHospital
SFI: ScienceFoundationIreland
SUH: SligoUniversityHospital
TCD: TrinityCollegeDublin
TUH: TallaghtUniversityHospital
UCC: UniversityCollegeCork
UCD: UniversityCollegeDublin
UHL: UniversityHospitalLimerick
UL: UniversityofLimerick
ULH: UniversityofLimerickHospitals
AcknowledgementsSincerethankstoalltheinternalandexternalstakeholderswhocontributedwithdataandinformation,withoutwhichthecompilationofthisreportwouldnothavebeenpossible:theResearchOfficesfromthethirdleveleducationinstitutionsinIreland,theHealthResearchBoard,theResearchEthicsCommitteesintheHSEandassociatedorganisations,theHealthProductsRegulatoryAuthority,andallthestaffmemberswhoansweredtheResearchSurvey2018.
InparticularwewouldliketoacknowledgethesupportofDrVirginiaMinogueandourcolleaguesfromtheHSEHealthIntelligenceUnitandtheNationalLibraryandKnowledgeService,NiamhBrennanfromtheTrinityCollegeDublinLibrary,FionnualaKeanefromHRBClinicalResearchCoordinationIreland,andcolleaguesfromtheHealthProductsRegulatoryAuthority.
3Research Activity in the HSE and its Funded Organisations
Glo
ssary
Executive Summary
5
1 Numberofresponsesdividedbytotalnumberofstaffinthathospitalgroup.2 Numberofrespondentsdividedbytotalnumberofprofessionalsinthatcategory.
Exe
cutive
Sum
mary
ThisstudywascarriedoutinresponsetotheActionPlanforHealthResearch2009-2013,whichplacedontheHSEtheresponsibilityforestablishingabenchmarkofresearchactivityinthehealthserviceagainstwhichopportunitiescanbeidentified,effortscoordinatedandfutureresearchactivitymonitored.
ThisreportpresentstheresultsofsuchastudyasthefirstattempttobenchmarktheresearchactivitywithinthepublichealthandsocialcareservicesinIreland.Avarietyofdifferentaccessibledatasetswereusedasanindicationofresearchactivityandoutput.Theresultsaredescribedaroundfourmaincategories:staffinvolvedinresearch,researchstudiesundertaken,publicationoutputsandClinicalResearchNetworks.Theseindicatorsshowthatthevolumeofon-goingresearchissignificantandthatbroad experience and capability across a variety of domains currently exists.
Informationrelatedtostaffinvolvedinresearchwasexploredusingtwoapproaches:
1) Anationalsurveyofself-declaredresearchactivestaff
Thenationalresearchsurveyreceived1,904validresponsesfromstaffmemberswhoself-identifiedasbeingresearchactive.Itindicatedthat:
• Staffwereengagedinresearchinallareasoftheservice,includingacuteandcommunitysettings,aswellasnationalservicesandHSEcorporate,andmanywerealsolinkedtoacademia.
• Themajorityofrespondentswerebasedinhospitals(40%)andcommunity-basedhealthcareorganisations(31%).
• TheDublinMidlandsHospitalGroup(HG)wastheonewiththelargestpercentageofrespondentsfollowedbytheSouth/SouthWestHG.However,thelargestproportionalresponserate1wasfromtheNationalChildren’sHG,followedbytheDublinMidlandsHG.
• StafffromtheHealthandSocialCareProfessions(HSCPs)represented32%oftherespondents,followedbyNursingandMidwifery(21%)andMedicalDoctors(15%).Proportionally,theresponserate2fromMedicalDoctorswashighest.
• ThemajorityofHSCPrespondentswerecommunity-based,whilethemajorityofNursingandMidwiferyandMedicalDoctorrespondentswerebasedinacutehospitals.
– Themajorityofcommunity-basedrespondentswerebasedinCommunityHealthcareOrganisation(CHO)7coveringDublinWest,DublinSouthCity,DublinSouthWest,Kildare,andWestWicklow.
Activity Indicator
1Staff Involved in Research
Research Activity in the HSE and its Funded Organisations
– 48%ofallNursingandMidwiferyrespondentshadamaster’sdegree.MedicalDoctorsandHSCPrespondentshadthehighestproportionofPhDs(23%and22%respectively).
– Themajorityofrespondentsengagedinindependentresearch(abletocarryoutresearchwithoutsupervision)belongedtotheMedicalDoctorcategory.
– NursingandMidwiferyrespondentsindicatedthattheyweremoreprominentlyinvolvedinenablingandassistinginresearchactivity,andasearlystageresearchers.
• 60%ofrespondentshadnoassociationwiththethirdlevelsector.Theremainder40%,indicatedanassociationwiththethirdlevelsector,eithercontractuallyboundornot.
• Themajorityofrespondentsspendbetween1and10hoursconductingresearchperweek.
• Themajorityofthosewhospendbetween11-20+hoursinresearchperweekwerelinkedtoanacademic institution.
2) Assessment of numbersanddistributionofconsultantswithacademicappointments,hence formally linked to the university sector and whose contract generally includes time for research:
• Fromatotalof2,700medicalconsultantsintheHSEandfundedhospitals,189hadaformaljointuniversityacademicappointmentin2018.Thisrepresents7%ofthetotalnumberofconsultantpostsemployed by model 4 and speciality hospitals.
• Thepercentageofclinicalstaffwithanadjunctorhonoraryappointmentsignificantlyoutnumbersthosewithaformalacademicappointment(approximately9:1).
• Atotalof21of50publichospitalsemployconsultantswithanacademicappointment.
• Themajorityofmedicalconsultantswithaformalacademicappointment(CFAA)belongedtotheRoyalCollegeofSurgeonsinIreland(RSCI)HG(n=42,22%),followedbythoseinDublinMidlandsHG(n=34,18%).
• ThehospitalwiththelargestnumberofconsultantswithanacademicappointmentwasGalwayUniversityHospital.
• ThemajorityofCFAAs(69%)arebasedinModel4hospitals.
• TheuniversitywiththelargestnumberofCFAAwasRCSI(25%),followedbyNUIGalway,UniversityCollegeDublin(UCD),TrinityCollegeDublin(TCD)andUniversityCollegeCork(UCC),rangingbetween16-19%.
• ThemajorityofCFAAweregeneralsurgeons(13%),followedbypsychiatrists(11%)andobstetriciansandgynaecologists(10%).ThesethreediscipleshaveadisproportionatelyhigherrepresentationofCFAAcomparedwiththenationalpicture.Theremaining27specialitieswereeachrepresentedbyfewerthan10%ofclinicians.
6
Exe
cutive
Sum
mary
Research Activity in the HSE and its Funded Organisations
Intheabsenceofanationalregisterforresearchprojectswithinthehealthservice,informationwasgatheredfromalternativesourcesincludingtheResearchEthicsCommittees(RECs),theHealthResearchBoard(HRB),theEUparticipantportal,theEuropeanClinicalTrialsRegister(EudraCT)andtheHealthProductsRegulatoryAuthority(HPRA)amongothers.
1) StudiesApprovedbyRECsin2017
• Atotalof32RECswereidentifiedintheHSEanditsfundedorganisations,allofwhichwereaskedforthetitlesofprojectsapprovedin2017forthepurposeofthisreport.
• Titleinformationwasreceivedfrom30outofthe32RECscontacted.Notitleinformationbuttotalnumberofproposalsapprovedin2017wasreceivedfromtheBeaumontREC.NodatawasreceivedfromtheDaughtersofCharityREC.
• ThemajorityofRECssubmittedinformationfor2017,but3(2ofthemwithverysmallnumbers)submittedinformationforadifferentyear.Inspiteofthisandgiventhesmallnumbers,webelievetheanalysis reasonably represents annual turnover overall.
• Thetotalnumberofstudyproposalapprovedbythe31outofthe30RECswas1,829.AsmanyofthestudiesinvolvedmultiplesitesandmaybereviewedbymorethanoneREC,thisnumberreflectsanundeterminedlevelofduplication,thereforethetotalnumberofprojectsreviewedbyRECsinoneyearwouldbelessthanthat.
• TheregionwiththelargestamountofRECsandofRECapprovalswastheEastRegion,withalmost678RECapprovalsin2017(involving20RECs),andfollowedcloselybytheSouthWestRegionwith525(reviewedbyasingleREC).
• Approximatelyone-quarterofallthe1,772studyproposalsreviewedbytheregionalRECswereofGenericHealthRelevance3,followedbyCancer,MentalHealth,ReproductiveHealthandChildbirth,CardiovascularandNeurologicalHealth.ThestudiesmostcommonlyinvolvedTreatmentEvaluationandHealthServicesResearch.
• Anationaltotalof75researchprojectsapprovedwerespecifictoprimarycare;57receivedbytheIrishCollegeofGeneralPractitioners(ICGP)and18bythePrimaryCareResearchCommittee.ThemajorityofthesewereofGenericHealthRelevanceandmostcommonlyinvolvingHealthServicesResearch.
7
3 GenericHealthrelevancereferstoresearchapplicabletoalldiseasesandconditionsortogeneralhealthandwellbeingofindividuals,publichealthresearch,epidemiologyandhealthservicesresearchthatisnotfocusedonspecificconditionsandunderpinningbiological,psychosocial,economicormethodologicalstudiesthatarenotspecifictoindividualdiseasesorconditions.
Exe
cutive
Sum
mary
Activity Indicator
2Research Studies Undertaken
Research Activity in the HSE and its Funded Organisations
2) HRBFundedStudies
• Healthcareprofessionalswereinvolvedin45(38%)HRBawardsin2017,worthatotalof€44,610,3694.TheresearchtopicsmostoftenfundedwereGenericHealthRelevance,followedbyCancer,Neurological,MentalHealth,Cardiovascular,andReproductiveHealthandChildbirth.
• 23ofthesegrantswereawardedto18consultantswithajointacademicappointment.Thetotalamountoffundingreceivedbythiscohortamountedto€23,093,127;whichrepresents29%ofallHRBgrants,and52%ofallHRBgrantsawardedtohealthcareprofessionals.ThisincludesfundingforClinicalResearchFacilities.
3) EUResearchGrants
• ThereweresixEUresearchgrantsawardedin2017whichinvolvedtheHSEasapartner.Thetotalvalueofthese(toalltheEUprojectpartners)was€102,317,219,ofwhich€695,245wasawardedtotheHSE.Thenumbersofpartnersrangedfrom13to109andthemajorityofprojectstopicswereofGenericHealthRelevance.
• ThetotalvalueofEUresearchfundingreceivedbytheHSEinthelast10years(from2009to2019)is€2,019,069.56.
4) RegulatedClinicalTrials
• AccordingtotheEudraCTdatabase,atotalof27ClinicalTrialsofInvestigationalMedicinalProducts(CT-IMPs)startedinIrelandin2017,while70wereon-going.TheseareasmallpercentageofallRECapprovedstudies.AlmostallwerecommercialtrialsforthepurposeofTreatmentEvaluation(92%),and33%ofthoserelatedtoCancer.
• ThesefiguresaresignificantlylowerthanEuropeancountrieswithasimilarpopulation;DenmarkandFinland,whichhad365and180clinicaltrialsrespectivelyregisteredonEudraCTduringthesametime period.
• In2017,sevenclinicalinvestigationsofmedicaldeviceswereapprovedbytheHPRA.OnehadanIrishacademicsponsorandtheremainderwereindustrysponsored.Nearlyhalfofthemwereclinicalinvestigationsrelatedtodevicesforcardiovascularconditions.TheSaoltaUniversityHealthCareGroupwasthemostcommonhostfortheseclinicalinvestigations.ThismayberelatedtothefactthatCÚRAM,theScienceFoundationIreland(SFI)CentreforResearchinMedicalDevicesishostedinNUIGalway.
5) ResearchinthethirdlevelsectorfundedbytheHSEin2017
• In2017therewere56researchrelatedprojectscommissionedbytheHSEfromthirdlevelinstitutions.Thisrepresentedatotalspendof€6.5million;32%ofwhichwasawardedtoUCC.ThemajorityofstudieswereofGenericHealthRelevance(68%),andrelatedtoHealthServicesResearch(62%).
8
4 Notefundingtoclinicalresearchfacilitiesisincludedinthisfigure.
Exe
cutive
Sum
mary
Research Activity in the HSE and its Funded Organisations
PublicationoutputwasmeasuredbythenumberofjournalarticlespublishedinScopusindexedjournals.
• ThetotalnumberofpublicationsfromHSEorganisationsandsection38hospitalsnationallyfrom2013to2017was13,466(thisincludestotalHSEHospitals,n=4,050;totalVoluntaryHospitals, n=8,934;andtotalCommunityandNon-Hospital,n=482)
• Publicationoutputhasincreasedslightlyyear-on-year,butcommunityandnon-hospitalresearchonlyaccountforbetween3to4%ofthetotaloutputeachyear.
• Thetotalnumberofjournalarticlespublishednationallyin2017was2,975.Thiswascomparabletothetotalpublicationoutput(alldisciplines)ofuniversitiessuchasTCDorUCDin2017(excludingpublicationoutputofuniversity-associatedinstitutions).
• StJames’sHospital(SJH)wasthehospitalwiththelargestpublicationoutputin2017,followedbyBeaumontHospitalandStVincent’sUniversityHospital(SVUH).
• DublinMidlandsHGandIrelandEastHGhadthehighestnumberofpublicationsbuttheChildren’sHGshowedthehighestpublicationratio(publicationoutputdividedbythetotalnumberofstaffin theHG).
• Asthemajorityofpublicationswerefromstaffaffiliatedwithhospitals,thedistributionoftheresearchtopicsatnationalandhospitallevelwereidentical:thetopresearchtopicswereGenericHealthRelevance5(17%),followedbyCancer(15%),Cardiovascular(9%),Neurological(8%)andReproductiveHealthandChildbirth(7%)research.TreatmentEvaluationrepresentednearlyhalfofthetotalresearchactivityofpublicationsin2017(43%),followedbyAetiology(27%),HealthServices(14%),DetectionandDiagnosis(8%)andDiseaseManagement(3%).
• Adifferentprofileofpublicationtopicswasobservedforcommunityandnon-hospitalbasedresearch,wherethemajorityofpublicationsrelatedtoMentalHealth(27.9%),followedbyGenericHealthRelevance(23%),Infection(10%),Cancer(7%)andNeurological(5%).TreatmentEvaluationrepresentedoverhalfofthetotalresearchactivityofpublicationsin2017(54%).
• Ofthetotal13,466articlespublishedbetween2013and2017withintheIrishpublichealthsystem,4,964(37%)werepublishedbyconsultantswithaformalacademicappointment.Thisindicatesthatthepublicationoutputofthiscohortisveryprolificastheyrepresentonly7%ofthetotalnumberofexistingconsultants.Italsoindicatesthat63%ofthepublicationoutputisproducedbystaffwithouta formal university appointment.
9
5 GenericHealthrelevancereferstoresearchapplicabletoalldiseasesandconditionsortogeneralhealthandwellbeingofindividuals,publichealthresearch,epidemiologyandhealthservicesresearchthatisnotfocusedonspecificconditionsandunderpinningbiological,psychosocial,economicormethodologicalstudiesthatarenotspecifictoindividualdiseasesorconditions.
Exe
cutive
Sum
mary
Activity Indicator
3Scopus Indexed Publications, 2013-2017
Research Activity in the HSE and its Funded Organisations
Forthepurposeofthisreport,ClinicalResearchNetworksaredefinedasnetworksofclinicianswithaninterestinaparticulardiseaseortopicwhoaredevotedtotheimprovedcareofpatientsandhealthservicesthroughresearchinthatparticulartopic.ClinicalResearchNetworksindicatetheexistenceofacriticalmassofresearchactivityaroundaspecificdisease.Someofthesenetworksofteninvolveotheractorssuchasacademics,scientists,patients,professionalbodies,etc.Wedividedclinicalresearchnetworksintotwotypes:ClinicalTrialNetworks(focusedonclinicaltrialsofmedicinalproducts,clinicalinvestigationsofmedicaldevicesandotherclinicalresearchstudies)andCollaborativeClinicalResearchNetworks(focusedonimprovingunderstandingandthesharingofknowledgeandresearchexpertise).
ClinicalTrialNetworks
• WedefinedClinicalTrialNetworksasthosewithafocusonclinicaltrialsofmedicinalproducts,clinicalinvestigationsofmedicaldevicesandotherclinicalresearchstudies.
• Thereare10ClinicalTrialNetworksinIreland,manyofthemfundedbytheHRB,andtheseconductthevastmajorityoftrialactivityinIreland.
• Thereareanumberofnetworksandorganisationsthatsupporttheconductofmulticentreclinicaltrials(bothcommercialandacademic)acrossIreland,includingHRBClinicalResearchCoordinationIreland(HRB-CRCI),HRBTrialsMethodologyResearchNetwork(HRB-TMRN)andCancerTrialsIreland(CTI).
• Cross-borderHealthcareInterventionTrialsinIrelandNetwork(CHITIN)isanewcross-borderinitiativeaimedatpromotinghealthcareinterventiontrialstopreventandcureillness,andtopromoteimprovedhealthandwellbeinginNorthernIreland,IrelandandIrishcross-borderareas.
• Asper2018,therearesevenClinicalResearchFacilities/Centres(CRFs/Cs)jointlyassociatedwithuniversitiesandtheirassociateduniversityhospitals,and14OncologyClinicalTrialsUnitsassociatedwithCTI.
CollaborativeClinicalResearchNetworks
• CollaborativeClinicalResearchNetworksareclinician-ledandfocusonimprovingunderstandingandthesharingofknowledgeandresearchexpertise.Thisreporthighlightsfiveofthem,althoughthisisanon-exhaustivelist.
10
Exe
cutive
Sum
mary
Activity Indicator
4Clinical Research Networks
Research Activity in the HSE and its Funded Organisations
In summary this study showsAsignificantpercentageofstaffintheHSEanditsfundedorganisationsareresearchactive,andtheoutputscannotbeunderestimated.Despitethefactthatresearchisbyandlargenotformallyembeddedwithintheprocessofservicedelivery,itisverymuchapartoftheon-goingactivityinthehealthandsocialcareservice,anditcannotbeignored.Thedatainthisstudyshowsthehugepotentialforimpactthatcouldbeleveragedbyaligningtheresearchactivitytoserviceneeds,inordertoobtainthemaximumbenefitforourhealthserviceandthehealthandwellbeingofourpatientsandthegeneralpopulation.
11
Exe
cutive
Sum
mary
1,904 Valid Survey responses
1,829 REC
approvals
51 Grant Awards
45 HRB
6 EU 2,975 Publications
34 HPRA Regulated studies
27 new clinical trials
7 new medical
device trials
Research Activity in the HSE and its Funded Organisations
Research Activity 2017
1. Introduction and Context
Healthresearchcontributestotheadvancementofscientificknowledgeandtheevidencebase.Theutilisationofthisevidenceisessentialtoimprovethehealthandwellbeingofpatients,toimprovehealthservicedeliveryandtheequityofhealthcareprovision.Evidencehasshownthatresearch-activeorganisationsdeliverbetterpatientoutcomes,includingreducedmortalityrates6andagrowingbodyofevidenceindicatesthathealthcareorganisationswithastrongresearchculturedeliverbettercare.Suchacultureisassociatedwithbetterorganisationalperformance,reducedstaffturnover,improvedpatientsatisfactionandimprovedorganisationalefficiency,andthesebenefitsgobeyondthoseexperienceddirectly by research participants.7Furthermore,theeconomicbenefitsofhealthresearchcannotbeunderestimated;abriefingdocumentpublishedin2014bytheWellcomeTrust8 in the UK indicates that eachpoundinvestedincancer-relatedresearchbythetaxpayerandcharitiesreturnsaround40pencetothe UK every year thereafter.
ResearchwillthereforebecentraltoachievingthedesiredreformoftheIrishhealthsystemoverthecomingyears,sincetransformationofthewayinwhichhealthcareisdelivered,managedandfinancedwillrequirehighqualityclinical,populationhealth,andhealthservicesresearch.
In2018theHSEestablishedtheHSEResearchandDevelopment(R&D)function.Thisnewfunctionaimstoascertainwhatisrequiredtoembedresearchaspartoftheculturalfabricofhealthservicedeliveryandtotakethestepstoensurethatthisbecomesarealityinthemediumtolong-termfuture.InordertoinformthefutureworkofthisfunctionandtodeliverononeoftheHSEobjectivesarticulatedintheGovernment’sActionPlanforHealthResearch2009-13,anassessmentoftheexistinglevelofresearchactivityintheHSEanditsfundedorganisationswascarriedout.Thiswillrepresentabenchmarkagainstwhichfutureprogresscanbemeasured.
Forthepurposeofthisreport,researchisdefinedinaccordancewiththeUKResearchGovernancePolicyFrameworkas“theattempttoderivegeneralisableortransferablenewknowledgetoanswerorrefinerelevantquestionswithscientificallysoundmethods”. It refers to research that takes place intheHSEanditsfundedorganisations,andthatinvolvestheirpatients,data,stafforinfrastructure.Thisincludes:
• activitiesthatarecarriedoutinpreparationfor,orasaconsequenceof,theinterventionalpartoftheresearch,suchasscreeningpotentialparticipantsforeligibility,obtainingparticipants’consentandpublishingresults,
• non-interventionalhealthandsocialcareresearch(i.e.studiesthatdonotinvolveanychangeinstandardtreatment,careorotherservices),
• studiesthataimtogeneratehypotheses,methodologicalresearch,anddescriptiveresearch,
• studieswhoseprimarypurposeiseducationaltotheresearcher,eitherinobtaininganeducationalqualificationorinotherwiseacquiringresearchskills,whichalsofallintothedefinitionofresearch.
Projectsthatarenotstrictlyresearchaccordingtothedefinition(e.g.standardserviceevaluations)areoftenreviewedandapprovedbyresearchethicscommitteesandpublished.Itwasthereforenotpossibletoexcludetheserelatedactivitiesfromsomeofthedatasetsandconsequentlysomeofthisactivityisincluded in the analysis presented in this report.
13
6 OzdemirBA,KarthikesalinghamA,SinhaS,PolonieckiJD,HinchliffeRJ,ThompsonMM,GowerJD,BoazAandHoltPJE.ResearchActivityandtheAssociationwithMortality.PLOS ONE2015,10(2):e0118253.https://doi.org/10.1371/journal.pone.0118253
7 HardingK,LynchL,PorterJ,TaylorNF.Organisationalbenefitsofastrongresearchcultureinahealthservice:asystematicreview.Australian Health Review2016,41(1)45-53.https://doi.org/10.1071/AH15180.
8 The2014MedicalResearch:What’sitworth?StudybyRANDEurope,theHealthEconomicsResearchGroupatBrunelUniversityandKing’sCollegeLondon;andcommissionedbytheAcademyofMedicalSciences,CancerResearchUK,theDepartmentofHealthandtheWellcomeTrust.www.wellcome.ac.uk/economicbenefitscancer
1. Intro
ductio
n a
nd C
onte
xt
Research Activity in the HSE and its Funded Organisations
2. Methodology
2.1. Research Activity Indicators and Associated Datasets
InordertoassessresearchactivityintheHSEandassociatedorganisations,fourkeyactivityindicatorswereused:• staffinvolvedinresearch• researchstudiesundertaken• publicationoutputs• ClinicalResearchNetworks
Thelackofcomprehensivedatasetsanddifficultiesaccessingexistingdatasetsweresignificantimpedimentsforthisstudy.However,whiletheinformationavailablewaslimitedandimperfect,ithasenabledustopaintthefirstpictureofthiskindandhashighlightedthegapsininformationmanagementthatneedtobeaddressedtorepeatthisexerciseinthefutureinamoresubstantialway.Theproblemsencountered and alternative approaches used are outlined in Table 1.
Table1:Keyresearchactivityindicators
KeyActivityIndicator
Impediments Approach
Staff involved •Involvementinresearchisoftenapartialoccupation,notformallyrecordedaspartoftheHRprocessforthedifferenthealthservice professions.
•Full-timeresearchersarehiredunderotherHRgrades(i.e.Administration)andarethereforeimpossibletoquantifyusingHRsystems.
•AssociationofclinicalstaffwithuniversitiesviahonoraryoradjunctpositionsisnotformallytrackedbytheHSE.
•Anationalsurveywasusedtocapturedataonself-declaredresearchactivestaff.
•HRdatawasusedtoassessthenumbersofclinicalstaffwithformalacademic appointments.
Research Studies undertaken or commissioned
•Thehealthserviceisdeliveryfocused;researchactivityisnotmeasured,thereforeit is not systematically recorded: there are no national or local research information systems or protocols to record research activity.
•Fundedstudiesarenotregisteredinthefinancialsystemsasthefundingisgenerallymanagedbyexternalorganisations(i.e.universities,foundations,etc.).
•MostResearchEthicsCommitteesinthe health service provided information onresearchstudiesreviewed.
•TheHealthResearchBoardwasapproached for information on funded research studies that involved health servicestaffinaPrincipalor Co-principalInvestigatorcapacity.
•InformationonEUfundedstudiesinwhichtheHSEwasaparticipantwasobtained from the EU participant portal.
•ResearchOfficesinUniversitiesandHEIsprovidedinformationonHSEcommissioned studies.
•InformationonregulatedclinicaltrialsinIrelandwasobtainedfromtheEUClinical Trials Database.
•TheHPRAprovidedinformationonregulatedclinicalinvestigations.
15
2. M
eth
odolo
gy
Research Activity in the HSE and its Funded Organisations
KeyActivityIndicator
Impediments Approach
Publication Output
•Somehealthprofessionalslinkedtouniversities publish their research outputs usingonlytheiruniversityaffiliation.
•Muchoftheresearchactivitydoesnotgetformallypublishedinpeer-reviewedpublications but rather in the form of reports published at local level. While some of these outputs are published in the LenusOpenAccessrepositoryoftheHSENationalHealthLibraryandKnowledgeService,itwasnotpossibletodetermineiftheseweretheresultofresearchactivityornot,andthereforecouldnotbeincludedinthis study.
•PublicationsindexedinScopuswereanalysedusingtheSciValanalysistool.These included all indexed publications (journalarticles,books,bookchapters,etc.).
•Publicationsofstaffwithaformalacademicappointmentwereavailablevia Scopus.
Clinical Research Networks
•Lackofspecificdefinitions.
•ManynetworksareassociatedwiththeUniversitysectorwithamoreacademicfocusmakingitdifficulttoclassifytheinformation available.
•InformationwasobtainedfromCRDIandtheHRB.Internetaccessibleinformationwasalsoobtainedandvalidated via telephone calls.
A further description of each dataset used is provided in each chapter.
2.2. Time periods
Whiletheoriginalintentionofthisstudywastoascertainresearchactivitywithinthelastfiveyearsthiswasgenerallynotpossibleduetothenatureofthedatasetsandthelimitationsofdataavailability.Thefollowingtime-periodswereanalysedforthedifferentindicators:
a) Staffinvolved:2018
• Surveyofstaffself-identifyingasbeinginvolvedinresearchasperJune2018.
• StaffwithaformalacademicappointmentasperFebruary2018.
b) Researchstudiesundertaken:2017
• Thedataavailablefromthedifferentdatasourceswasoriginallyavailablefordifferenttimeperiods.Inorder to simplify the information for this report and to use a consistent approach across the datasets toenablecomparisons,onlydatafor2017hasbeenincludedinthisstudy.
16
2. M
eth
odolo
gy
Research Activity in the HSE and its Funded Organisations
c) Publicationoutput:2013-2017
• Publicationoutputwasanalysedforafiveyearperiod,from2013to2017.Thereisgenerallyatime-lapsebetweentheresearchbeingperformedandtheoutputbeingpublished;thereforeitisnotpossible to relate this dataset to any of the above.
• ToenableamorecomprehensiveunderstandingofthetypesofIrishhealthresearchbeingpublishedinScopus-indexedjournals,anin-depthclassificationandanalysisofthe2017publicationswasconducted.
d) ClinicalResearchNetworks:2018
• TheClinicalResearchNetworksidentifiedwereinexistenceasper2018.
2.3. Classification Methodology
Inordertoanalysethedatasetsassociatedwithresearchstudiesandpublicationoutputs,thedata wascategorisedusingtheUKHealthResearchClassificationSystem(HRCS)9 developed in 2005. Twodimensionsoftheframeworkwereusedforthisstudy:
• 21HealthCategories,denotingtheareaofhealthortypeofdiseasebeingstudied(e.g.cancer,mentalhealth,reproductivehealthandchildbirth,etc.).
• Eighttop-levelresearchactivitycodesdenotingthetypeofresearchbeingconducted(e.g.treatmentevaluation,healthservicesresearch,etc.).
ThismethodologyhasalsobeenusedbytheHealthResearchBoard(HRB)inIrelandtoclassifyHRBfunded research.10,11AdetailedbreakdownanddescriptionofthecategoriesisavailableinAppendix1.
17
9 HealthResearchClassificationSystem,February2018.MedicalResearchCouncilonbehalfoftheUKClinicalResearchCollaboration.ISBN978-0-903730-27-3.
10 CurranBandBarettR(2014).Outputs,outcomesandimpactsarisingfromtheHRB’s2000-09grantsportfolio.HealthResearchBoard,Dublin.
11 HineyM(2018).Astudyofactivityfrom2011to2015usingtheHealthResearchClassificationSystem.HealthResearchBoard,Dublin.
2. M
eth
odolo
gy
Research Activity in the HSE and its Funded Organisations
3. Activity Indicator 1: Health Service Staff involved in Research
Thefollowingsectionfocusesonthestaffconductingresearchwithinthepublichealthandsocialcareservice.ManyofthesewouldbethestaffmembersinvolvedintheresearchstudiesreferredtoinSection4,thoseresponsibleforpublishingtheoutputsreferredtoinSection5,andmembersofthenetworksdescribedinSection6.Thisactivityindicatorwasexploredbywayoftwoapproaches:
1.Analysisofinformationfromself-declaredresearchengagedstaffworkingintheHSEanditsfundedorganisations,whichwascapturedbywayofanationalsurveylaunchedinJune2018.Thesurveywasdistributedviaanumberofchannelsincludingemailbroadcastsandtargetedmailinglistsofprofessionalassociationsandnetworks,viasocialmediaandthroughtheHSEwebsite.
2.Analysisofinformationrelatedtomedicalconsultantswithauniversityacademicappointmentforthepurposeofresearchandteaching.
3.1. Survey of Research Active Staff
Atotalof1,920respondentscompletedthesurvey,but16indicatedthattheyworkedintheprivatehealthcaresector,sotheirresponseswereremovedfromthedataset.Theresultsbelowrepresentananalysis of the information provided by the 1,904respondents. It should be noted that the results must beinterpretedinthecontextofresponsestothesurvey,ratherthanasabsolutenumbers.
3.1.1. SurveyAnalysisbyPlaceofWork
The responses indicated that staffwereengagedinresearchinallareasoftheservice,includingtheacuteandcommunitysectors,aswellasnationalservicesandHSEcorporate,andmanywerealsolinkedtoacademia(Figure1).Respondentswereabletoselectmorethanoneplaceofwork,withsomeselectinguptosix.Intotal,11%indicatedmorethanoneplaceofwork.
Ofthe1,904respondents,40%workedinacutehospitals,31%workedinthecommunity,16%workedinnationalservices,programmesorHSEcorporate,19%workedinacademiaand3%inotherareasoftheservice(Figure1).
.
19
Figure 1: Place of work of respondents (indicated as number and percentage of the total sample)
Hospital Community National Academia Other
800
700
600
500
400
300
200
100
0
No.
of R
espo
nden
ts
HSEHospital
Corporate/NationalServices
CHO
Other
VoluntaryHospital
Academia
PrimaryCare/CommunityServices
4%27%
16%19%
3%
12%
28%
3. A
ctivity Indica
tor 1
Research Activity in the HSE and its Funded Organisations
Fromthesubsetofhospital-basedstaff,31%ofhospitalrespondentsworkedinvoluntaryhospitalsandtheremaining69%werebasedinHSEhospitals.Thismatchesthegeneraldistributionofpublichospitals,whereby32%(16outof50)arevoluntaryhospitals.Allhospitalgroups(HG)wererepresentedintheresponse(Figure2),andtheDublinMidlandsHospitalGroupwastheonewiththelargestpercentageofrespondents(26%).
Figure 2: Number (including percentage) of research active respondents from each hospital group
DublinMid Leinster
South/ South West
Saolta Ireland East ChildrensRCSI University Limerick
250
200
150
100
50
0
No.ofR
espo
nden
ts
26%
19%17%
13%10% 9%
7%
Hospitalgroupsvarygreatlyintheirsize(numberofhospitalspergroup,andnumberofstaffperhospital).Inordertomakeamoremeaningfulcomparison,thenumberofresponsesperhospitalgroupwasdividedbythetotalstaffnumberfromeachhospitalgroup,includingbothclinicalandnon-clinicalstafftocalculateresponserates.Fromthisperspective,thelargestproportionalresponseratewasfromtheNationalChildren’sHospitalGroup,followedbytheDublinMidlandsHospitalGroup.
AnalysisoftheCommunityHealthOrganisation(CHO)distributionofrespondentsindicatedthatthemajorityofrespondents(22%)wereinCHO7(Figure3).Aswithhospitalgroups,thegeographicalareaofCHOsaswellastheirtotalstaffnumber,variesgreatly.Again,inordertomakeamoremeaningfulcomparison,theresponseratewascalculatedasaratiobetweenthetotalnumberofresponsesperCHOandthetotalnumberofstaffineachCHO.ThisstillshowedthatthelargestproportionalresponseratewasinCHO7.
Figure 3: Percentage (including number) of respondents by CHO
CHO7 CHO9 CHO4 CHO2 CHO6 CHO3CHO8 CHO5 CHO1
25%
20%
15%
10%
5%
0%
Percen
tage
ofR
espo
nden
ts
261
176153
137
101 100 9673 71
20
3. A
ctivity Indica
tor 1
Research Activity in the HSE and its Funded Organisations
3.1.2. SurveyAnalysisbyProfession
Analysisbyprofession(Figure4)indicatedthatthemajorityoftherespondentsbelongtotheHealthandSocialCareprofessions12(32%)closelyfollowedbyNursingandMidwifery(21%)andMedicalDoctors(15%).
21
Figure 5: Responce ratio (total number of respondents per category by total number of staff in that category) by profession
MedicalDoctor Nursing&Midwifery
HealthProfessionalCategory
HSCP
0.06
0.05
0.04
0.03
0.02
0.01
0RatioofN
o.ofR
espo
nden
tsto
No.ofS
taff
0.053
0.007 0.005
Figure 4: Percentage (including number) of respondents by profession
0% 5% 10% 15% 25% 35%20%
ResponseRates(%)
30%
Health&SocialCare
Nursing&Midwifery
MedicalDoctor
Researcher
Administration
Management
Other
Academic
Ambulance Service
HealthInformatics
Missing
608
395
277
167
166
99
74
51
25
24
18
Staffnumbersineachofthesecategoriesvarygreatlyatnationallevelhowever,sotheresultswerenormalisedbythetotalnumberofprofessionalspergroupfortheclinicalcategories(medical,nursing/midwiferyandHSCP)andthisindicatedthatmedicaldoctorswereoverwhelminglythemostresearchactive(Figure5).
12 HSCPreferstothe14designatedhealthandsocialcareprofessions:ClinicalBiochemist,Dietitian,DispensingOptician,MedicalScientist,OccupationalTherapist,Optometrist,Orthoptist,Physiotherapist,Podiatrist,Psychologist,Radiographer,SocialCareWorker,SocialWorker,SpeechandLanguageTherapist.
3. A
ctivity Indica
tor 1
Research Activity in the HSE and its Funded Organisations
Themajorityofdoctorsandnurse/midwiferyrespondentswerebasedinacutehospitals,whilethemajorityofHSCPsrespondentswerebasedincommunitysettings(Figure6).
Figure 6: Number (including percentage) of staff in research by profession and health service area (or location)
Health& Social Care
(655)
Nursing&Midwifery (431)
MedicalDoctor (343)
HealthcareProfessionalCategories
Researcher (184)
Management (106)
Administration (168)
300
250
200
150
100
50
0
No.ofR
espo
nden
ts
AcuteHospital National ServiceCommunity Academia Other
33%
51%
11%
13%26%
57%
43%
7%
23%
38%13%
30%
8%
18%
42%
33%10%19%
6%
13%
57%
13%3%
9%
3% 7% 8%1%
1%
3%
3.1.3. SurveyAnalysisofEducationalQualifications
Surveyrespondentswereaskedabouttheirhighestacademicqualification.Clinicalstaffcategories(medicaldoctor,HSCP,nursing/midwifery)hadhigherqualificationsthannon-clinicalstaff(Figure7).Thehighestmostcommonlyoccurringqualificationlevel,acrossthethreemainclinicalprofessionalgroupswasamaster’sdegree(Figure8),withthepercentageslistedrepresentingtheproportionofeachqualificationwithineachprofessionalgroup:48%ofallnursingandmidwiferyrespondentshadamaster’sdegree, and medicaldoctorsandHSCPsrespondentshadthehighestproportionofPhDs(23%and22%respectively).
22
3. A
ctivity Indica
tor 1
Research Activity in the HSE and its Funded Organisations
23
3. A
ctivity Indica
tor 1
Figure 7: Number (including percentage which represents the proportion within the Clinical and Non-Clinical grouping) of respondents by highest qualification level
Masters Degree PhD Higher Diploma
MD Diploma Other Advanced /Higher
Cert
Leaving Cert
600
500
400
300
200
100
0
No.ofR
espo
nden
ts
29.1%
13.2%
11.7%
7.2%
3% 1.5%
1.3%
0.7%
0.3%
8.7%
4.3%
10%
1.7% 0%
2.4% 0.8%
1.6%
2.4%
HealthcareQualificationLevel
Clinical Non-Clinical
Figure 8: Percentage (including number) of clinical staff by highest qualification level
ResponseRates(%)
Highe
stQua
lifica
tionLe
velb
yHea
lthca
re
Professiona
lCateg
ory
4
17
0
56
51
50
20
1
8
1
1
0
99
20
190
73
24
64
Nursing&Midwifery
(396)
Medical Doctor (280)
6
0
14712
66
18281
134
Health& Social Care
(611)
Other
Degree Diploma
MD
LeavingCert
PhD
Advanced/HigherCert
Masters HigherDiploma
0% 5% 10% 15% 25% 40%35%20% 30% 45% 50%
Research Activity in the HSE and its Funded Organisations
24
3. A
ctivity Indica
tor 1
3.1.4. SurveyAnalysisofResearcherCompetencies
Respondentswereaskedtopickthedescriptionthatbestdescribedtheirresearchcompetenciesortheirinvolvement in research as indicated in Table 2.
Table2:Self-reportedresearchcompetencies
ResearcherCategory
ResearchCompetencies
Research Enabler
•Idonotactivelyparticipateinthecollection,analysisorreportingofdata
•Igenerateresearchideas,identifyresearchneedsandappropriatepeopletoundertakethisbodyofwork
•Ihavecontributedtodesignandresearchgrantapplicationswhenrequested
•Icommissionresearch
Research Assistant
•Icontributetoawiderresearchteambycarryingoutdatacollection
•Iorganiseaccesstodata
•Icleanandpreparedataforuseinanalysis
•Iconductliteraturesearches
Early stage researcher
•Icarryoutresearchundersupervision,demonstratingtheabilitytocollect,analyseand interpret data
•Icancriticallyevaluateandsynthesisenewinformation
•Ihaveexcellentcommunicationskillsandamabletocommunicatetheoutcomesofmy research
Experienced Research team member
•Idesignandimplementresearchstudies
•Ipresentmyresearchatconferenceseitherorallyorbyposter
•Imanagearesearchprojectandcontributetograntapplications
•Ihaveproducedasubstantialbodyofworkthatmeritspublicationinpeer-reviewedjournals
Independent researcher13
•Idesignandimplementresearchaspartofawiderresearchprogramme
•Iapplyforresearchgrants
•Imanageandsuperviseateamofresearchstaff
•Imentorresearchstaffandcontributetoarticlesinhigh-qualitypeer-reviewedjournals
•Ipresentresearchnationally/internationally
13 Independentresearchers,researchleadersorinternationalresearchleadersmaybecarryingontheirresearchactivityundertheauspicesoftheHSEorassociatedorganisationsuchasauniversity.
Research Activity in the HSE and its Funded Organisations
25
3. A
ctivity Indica
tor 1
ResearcherCategory
ResearchCompetencies
Research Leader
•Idesignandimplementasubstantialprogrammeofresearch,includingmanagementofaresearchteam,grantapplicationsandfinancialmanagement
•Ihaveatrackrecordofpublishinginhigh-qualitypeer-reviewedjournalsasfirstauthor and present research internationally
•Ihaveteachingexperiencebasedonmyownresearchwithatrackrecordofmentoringresearchstaff
•Ihaveathoroughunderstandingoftheresearchenvironmentnationallyandinternationally
International Research Leader
•Ihaveaninternationalreputationbasedonresearchexcellence
•Imakeasubstantialcontributiontomyfieldormultipleareas
•Iidentifyandexecuteresearchactivitiesandleadaresearchteam
•Irecognisethebroaderimplicationsofmyresearchandcontributetothestrategicvisionforfutureresearchinmyfield
•Ipublishandpresentinfluentialpapersandbooks,serveonconferenceorganisingcommittees and deliver invited talks
Thecategoriesofindependentresearcher,researchleaderandinternationalresearchleaderdescribestaffcapableofcarryingonresearchactivitywithoutsupervision(i.e.independentresearchactivity)and these three representedatotalof15%oftherespondents(Figure9).
Figure 9: Number (including percentage) of respondents by research competencies
Research Enabler
Research Assistant
EarlyStageResearcher
Experienced Research Team
Member
Research Leader
Independent Researcher
International Research Leader
400
350
300
250
200
150
100
50
0
No.ofR
espo
nden
ts
14%
12%
18%17%
6%
4%5%
TypeofResearchers
Research Activity in the HSE and its Funded Organisations
26
3. A
ctivity Indica
tor 1
RespondentsfromtheHSCPgrouparerepresentedacrossallcategories(Figure10),butarepredominantlyintheearlystageandexperiencedresearchteammembercategories,whilea total of11%ofHSCPrespondentsdescribethemselvesasbeingengagedinindependentresearchactivity (independentresearcher,researchleaderandinternationalresearchleader).Medicaldoctorswerealsorepresentedacrossallcategories,butwithmorerespondentsclassifyingthemselvesashavingthecompetenciesofaninternationalresearchleadercomparedwithHSCPsornurses.Intotal,42%ofmedicaldoctorrespondentsdescribedthemselvesasbeingengagedinindependentresearch. The response of nursesandmidwiferyprofessionalsindicatedthattheyweremorepredominantlyinvolved in enablingandassistingresearchactivity,andasearlystageresearchers.HSCPrespondentsweremorecommonlyintheearlystageresearcherandexperiencedresearchteammembercategories.
Figure 10: Number (including percentage which represents a proportion within the HSCP, Medical and Nursing groups) of respondents by type of researcher and profession (clinical types)
300
250
200
150
100
50
0
No.ofR
espo
nden
ts
Health&SocialCareProfessionals Nursing&MidwiferyMedicalDoctor
TypeofResearchersbyProfession
Research Enabler(176)
24%
15%
14%
Research Assistant (153)
24%
7%
14%
EarlyStageResearcher
(261)
32%
12%
28%
Experienced Research Team
Member (254)
13%
24%
32%
Independent Researcher
(71)
3%
15%
5%
Research Leader (43)
1%7%
4%
International Research Leader (68)
1%
20%
2%
Research Activity in the HSE and its Funded Organisations
27
3. A
ctivity Indica
tor 1
3.1.5. SurveyAnalysisofResponsesfromStafflinkedwithHEIs
Respondentswereaskediftheyheldapositionwithacademicinstitutions:60%indicatedthattheywerenotassociatedwithathirdlevelacademicinstitution,while40%indicatedanassociationwiththethirdlevelsector,eithercontractuallyboundornot. The types of activities carried out in the HigherEducationInstitutions(HEIs)aredescribedinFigure11.
3.1.6. SurveyAnalysisofTimeAvailabletoConductResearch
Thesurveysoughttodeterminehowmanyhours(inatypicalweek)respondentsspendonresearch(Figure12),andtheresultsshowedthatthevastmajorityofrespondentsspentbetweenoneand tenhoursperweekconductingresearchduringworkinghours(clinical14n=728,62%,non-clinical n=292,51%).
Figure 11: Percentage (including numbers) of respondents by their academic activities in HEIs
0% 5% 10% 15% 25% 35% 40% 45% 50%20%
Percentage
Acad
emicActivity
of
Respo
nden
tsin
Universities
30%
Tutor
Advisory
Board/Committee
Adjunct
Research
Teaching
16
53
83
164
359
376
Figure 12: Hours spent on research during the working week by the number of respondents (percentages represent proportion within the clinical or non-clinical grouping)
Zero 1 to 10 11to20+
800
700
600
500
400
300
200
100
0
No.ofR
espo
nden
ts
HoursSpentConductingResearchinWork(perweek)
Clinical Non-Clinical
27%
25%
62%
11% 24%
51%
14 ClinicalreferstoHSCP,medicaldoctorsandnursingandmidwiferyprofessionals.Non-clinicalreferstoallotherprofessions.
Research Activity in the HSE and its Funded Organisations
28
3. A
ctivity Indica
tor 1
Manyindicatedtheirinvolvementinresearchactivityoutsideofworkinghours.Ofthese,71%ofclinicalstaff(n=763)and63%ofnon-clinicalstaff(n=287)spentonetotenhours,while10%ofclinicalstaffreportedspendingbetween11andover20hoursconductingresearchafterformalworkinghours(Figure13).27%ofclinicalstaffand25%ofnon-clinicalstaffcarryoutresearchexclusivelyoutsideworkinghours.
Onlystaffmembersengagedinresearchwereaskedtoparticipateinthesurvey.Thereforeitisassumedthatthoseindicating“zero”duringworkinghourswereengagedinresearchoutsideworkinghours.
Furtheranalysisindicatedthatthemajorityofthosewhospendbetween11-20+hoursinresearchhadanacademiclink(Figure14).
Figure 13: Hours spent on research outside of working hours by the number of respondents (percentages represent proportion within the clinical or non-clinical grouping)
Figure 14: Hours spent on research inside and outside of working hours (percentages represent the proportion of respondents with and without an academic post)
Zero 1 to 10 11to20+
900
800
700
600
500
400
300
200
100
0
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
No.ofR
espo
nden
tsRespo
nseRate(%
)
HoursSpentConductingResearchOutsideWork(perweek)
Hours(perweek)
Clinical Non-Clinical
Hourswithinworkingday Hoursoutsideworkingday
Academic Post No Academic Post
19%32%
Zero
92
369
1 to 10
464559
11to20+
194
70
Zero
63
292
1 to 10
555
498
11to20+
7948
71%
10% 5%
63%
Research Activity in the HSE and its Funded Organisations
29
3. A
ctivity Indica
tor 1
3.2. Medical Consultants with a Formal Academic Appointment
Healthprofessionalsinvolvedinresearchoftenhavecloselinkswiththeuniversitysector.Someofthoselinkagesinvolveaformalcontractualacademicappointmentgenerallyforthepurposeofeducationand/orresearch(Section3.1.5).Ingeneral,staffmemberswithformalacademicappointmentshaveprotectedacademictime,fullaccesstosupportandresourcesofferedbythethirdlevelinstitution,andfurtheropportunities to establish academic collaborations.
Ontheotherhand,therearemanyotherhealthcarestaffwhoarenon-contractuallyengagedwithacademicinstitutions,butwhohaveadjunctorhonoraryconnections.Theseprovideformaluniversityacknowledgementoftheircontributionstoacademicactivities,recognisingthatmanycontributestronglydespitehavingnoprotectedacademictime,althoughtherangeofuniversitysupportsofferedtothiscohortvariesgreatly.
Theacademicaffiliation/sandkeydisciplineofmedicalconsultantswithacademicappointments(CFAA)asper2018wereanalysedinordertodeterminehowthesestaffaredistributedacrossclinicalsitesandhowthisvariesbyspeciality.Manymedicalconsultantswithaformalacademicappointmenthadappointmentswithmorethanonehospital.Forthepurposeofthereport,theanalysiswasbasedonthe principal clinical site and does not include vacant posts.
Unfortunately,dataonmedicalconsultantswithhonorary/adjunctacademicappointmentswasnotavailableornotprovidedtousbysomeoftheuniversities.However,informationreceivedfromtwouniversities[TrinityCollegeDublin(TCD)andUniversityofLimerick(UL)]seemstoindicatethat thepercentageofclinicalstaffwithanadjunctorhonoraryappointmentsignificantlyoutnumbersthosewithaformalacademicappointment(approximately9:1).
3.2.1. DistributionofMedicalConsultantswithAcademicAppointmentsby Location
In2018therewere189CFAAs.Atotalof21outof50publichospitals(42%)inIrelandemployconsultantswithanacademicappointment.ThebreakdownofCFAApostsbyhospitalgroup(basedonprincipalclinicalsite)isshowninFigure15(‘Other’indicatesanon-hospitalappointment).ThemajorityofCFAAsbelongedtotheRCSIhospitalgroup(n=42,22%),followedbytheDublinMidlandshospitalgroup(n=34,18%).Table3showsthebreakdownofdualappointmentsaccordingtohospitalwithinthevarioushospitalgroups.
FurtheranalysisindicatedthatthemajorityofCFAAs(69%)arebasedinModel4hospitals(hospitalsproviding24/7acutesurgery,acutemedicine,criticalcare,tertiarycareand,incertainlocations,supra-regionalcare).OftheUniversities,RoyalCollegeofSurgeonsIreland(RCSI)hadthelargernumberofCFAAposts(n=47,25%),withGalway(NUIG),UCD,TCDandUCChavingbetween16%and19% (n=30to34).
Research Activity in the HSE and its Funded Organisations
30
3. A
ctivity Indica
tor 1
Figure 15: Number (including %) of CFAA posts by Hospital Group (based on principle clinical site)
0 5 10 15 25 35 40 4520
No.ofCFAAposts
Hos
pitalG
roup
s
30
UL
Children’s
Other
Ireland East
South/SouthWest
Saolta
DublinMidlands
RCSI
11%
4%
4%
13%
14%
14%
18%
22%
Table3:DistributionofCFAApostsperHospitalGroupandHospitals(onlyhospitalswithCFAApostsareshown)
HospitalGroup Hospital No.ofCFAAposts
NationalChildren’s
OurLady'sChildren'sHospital,Crumlin 5
TempleStreetChildren'sUniversityHospital 3
IrelandEast MaterMisericordiaeUniversityHospitalDublin 11
StVincent'sUniversityHospital 9
RoyalVictoriaEye&EarHospital 2
CappaghNationalOrthopaedicHospital 1
Saolta GalwayUniversityHospital 27
PortiunculaUniversityHospital 1
DublinMidlands StJames'sHospital 21
TallaghtUniversityHospital 7
CoombeWomen&InfantsUniversityHospital 6
StLuke'sHospital,Rathgar 1
South/SouthWest CorkUniversityHospital 24
MercyUniversityHospital,Cork 2
RCSI BeaumontHospital 25
ConnollyHospital 11
RotundaHospital 6
UL UniversityHospitalLimerick 7
Research Activity in the HSE and its Funded Organisations
31
3. A
ctivity Indica
tor 1
ThenumberofCFAAswassubsequentlycomparedtothetotalnumberofconsultantpostsinthosehospitalswherejointpostsexist(i.e.HospitalsinTable3,excludinghospitalswherenodualappointmentsexists),anditwasnotedthatclinicianswithaformalacademicappointmentrepresentaverysmallproportion(7%)ofthetotalnumberofconsultantpostsinthehospitals.
3.2.2. DistributionofConsultantswithaFormalAcademicAppointmentby Discipline
ThedistributionofCFAAswasanalysedbyprimarydisciplineandasaproportionofnationaldistribution(seeTable4).Themajorityweregeneralsurgeons(13%),followedbythoseinpsychiatry(11%)andobstetricsandgynaecology(10%).ThetopthreedisciplinesweredisproportionatelyrepresentedbyCFAAscomparedwiththenationalpicture.Theremaining27specialitieswereeachrepresentedbyfewerthan10%ofclinicians.
Table4:DistributionofCFAAbydiscipline
Discipline CFAA %oftotalCFAA National%bydiscipline
General Surgeon 25 13% 6%
Psychiatry 20 11% 9%
Obstetrics and Gynaecology 18 10% 5%
Paediatrics 13 7% 4%
General Physician 11 6% 0%
Histopathology 11 6% 4%
Endocrinology and Diabetes Mellitus 10 5% 2%
Geriatrics 7 4% 4%
Microbiology 7 4% 2%
Anaesthesia 7 4% 13%
Respiratory 7 4% 2%
Gastroenterology 6 3% 2%
Infectious Diseases 5 3% 1%
Radiology 5 3% 9%
Haematology 4 2% 2%
Oral & Maxillofacial 4 2% 0.4%
Pharmacology & Therapeutics 4 2% 0.2%
Nephrology 4 2% 1%
Cardiology 3 2% 2%
Research Activity in the HSE and its Funded Organisations
32
3. A
ctivity Indica
tor 1
Discipline CFAA %oftotalCFAA National%bydiscipline
Otolaryngologist 3 2% 2%
Rheumatology 3 2% 1%
Ophthalmology 3 2% 1%
Emergency 2 1% 3%
Neonatology 2 1% 1%
Orthopaedic 1 1% 4%
Urology 1 1% 2%
Immunity 1 1% 0.3%
Genetics 1 1% 0.1%
Neurology 1 1% 2%
Radiation Oncologist 1 1% 1%
Research Activity in the HSE and its Funded Organisations
7% of medical consultants have a joint
university academic appointment.
The majority of independent
researchers were doctors.
Doctors 15%Nursing 21% HSCPs 32%
Doctors & HSCPs have the highest
proportion of PhDs (23% & 22%).
1,904 valid survey responses.Majority of respondents
were hospital based (40%).
1 - 10 hours conducting researchper week.
33
3. A
ctivity Indica
tor 1
Research Activity in the HSE and its Funded Organisations
Survey Responses
4. Activity Indicator 2: Research Studies
Thefollowingsectionexploresthetypesandvolumeofresearchstudiesthattheresearchactivestaffreferredtoaboveareengagedin.DatawerereceivedfromavarietyofsourcesincludingResearchEthicsCommittees,theHealthResearchBoard,theEUparticipantportal,theEUclinicaltrialsdatabase,theHPRAandtheresearchofficesofthirdlevelinstitutions:
4.1 Studies Approved by Research Ethics Committees in 201715
Researchinvolvingpatients,eitherdirectlyorindirectly(e.g.concerningtheirbiologicalsamplesortheirdata),requiresethicalapproval.Muchoftheresearchtakingplaceinthehealthservice,therefore,requiresResearchEthicsCommittee(REC)approval.Intheabsenceofformalresearchprojectregistersinmosthospitals,communityhealthcareorganisationsandotherpartsofthehealthservice,theRECsrepresentauniquerepositoryofinformationaboutresearchactivity.
SomeRECsreviewproposalsforbothhospitalandCHObasedresearch,whileothers(mainlyintheDublinandsurroundingregion)reviewexclusivelyhospital-basedresearch.ThereisamisalignmentbetweentheregionalRECcatchmentareas(whicharebasedontheoldhealthboardregions),andtheHospitalGroupsandCHOs,soanalysisbyHospitalGrouporCHOareawasnotpossiblewiththedatareceived.Withtheexceptionofstudiesongeneralpractice(whichareapprovednationallybytheIrishCollegeofGeneralPractitionersREC),aregionalapproachtotheanalysiswasdeemedthemostadequategiventhenatureofthedatasets.Figure16indicatestheregionaldivisionusedfortheanalysis.Table5indicatestheRECsassociatedwitheachregionandthedatasettime-periodinquestion.Table6indicatesthecounties,hospitalsandCHOsectionscoveredbyeachRECregion.
Atotalof32committeesservingthehealthservicenationallywereidentified.TheseincludehospitalandHSEregionalRECsinadditiontoRECsinsection38/39organisations.All32RECswerecontactedtorequestinformationrelatedtotheprojecttitlesofresearchstudiesapprovedbythecommitteesduring2017.Thevastmajorityofcommitteesrespondedwithinformation(n=30,94%),althoughthreereportedinformationfrom2016(orearlier)ratherthan2017(Table5).BeaumontHospitalandDaughtersofCharityRECsdidnotsubmittitleinformation(Table5andTable6),thereforetheEastRegiondatasetisslightlyincomplete. The time period of the datasets used for the analysis is indicated in Table 5.
Notethateleven(outofatotalof12)oftheRECsthatsharedtheirinformationareapprovedbytheDepartmentofHealthtoreviewClinicalTrialsofInvestigationalMedicinalProducts(CT-IMP)atnationallevel.Astheoriginofthesestudiescouldnotbeidentifiedbythetitlealone,theanalysisindicatesregionalisationofRECapprovalratherthanregionalisationoftheactualresearchactivity.Furthermore,nonCT-IMPstudiesthatinvolvemultiplesitesrequiremultipleRECapprovals,thereforethenumbersincludeanundeterminedlevelofduplicationandhenceindicateapprovalsratherthanabsoluteprojectnumbers.
35
4. A
ctivity Indica
tor 2
15 See caveats in text related to dates of some datasets
Research Activity in the HSE and its Funded Organisations
36
4. A
ctivity Indica
tor 2
Figure 16: REC regions used for the analysis
Research Activity in the HSE and its Funded Organisations
Donegal
Sligo
Mayo
Galway
Roscommon
LeitrimCavan
Monaghan
Louth
MeathDublinNorth
DublinSouthKildare
Wicklow
Wexford
Carlow
Kilkenny
Waterford
Laois
Offaly
Westmeath
ClareTipperary
North
TipperarySouth
Limerick
CorkKerry
South/SouthWest
East
West/NorthWest
South East
MidWestern
Midlands
North East
37
4. A
ctivity Indica
tor 2
Table5:RECsapproachedforinformationperregionandtimeperiodofdatasetsupplied
Region AssociatedRECs Yearofdataincluded in Analysis16
Totalnumberofapprovalsper region
Midlands Region HSEMidlandsAreaREC17 2017 32Mid-Western Region #HSEMid-WesternArea&Universityof
LimerickHospitalGroupREC172017 157
South East Region #HSESouth-EasternAreaREC17 2017 72North East Region #HSENorthEastAreaREC17 2017 21South/South West Region
#ClinicalRECoftheCorkTeachingHospitals(CREC)atUCC18
2017 526
West/North West Region
SligoUniversityHospitalREC19 2017(n=43) 367MayoUniversityHospitalREC20 2017(n=31)LetterkennyUniversityHospitalREC20 2017(n=17)#GalwayUniversityHospitalREC19 June‘16–
Feb’17(n=276)East Region CappaghNationalOrthopaedicHospitalREC21 2017(n=9) 597
ConnollyHospitalREC21 2017(n=14)CoombeHospitalREC21 2017(n=30)Enable Ireland21 2016(n=2)#MaterMisericordiaeREC21 2017(n=34)NaasGeneralHospital21 2017(n=9)#NationalMaternityHospitalREC21 2017(n=36)NationalRehabilitationHospitalREC21 2013(n=4)#OurLady’sChildren’sHospital,CrumlinREC21 2017(n=83)RotundaHospitalREC21 2017(n=13)RoyalVictoriaEye&EarHospitalREC21 2017(n=11)StJohnofGod21 2017(n=24)StLuke’sHospital,RathgarREC21 2017(n=5)StMichael’sHouse21 2017(n=14)#St.Vincent’sHospitalREC21 2017(n=93)StewartsHospital21 2017(n=1)TempleStreetChildren’sHospitalREC21 2017(n=78)TUH/SJHJointREC21 2017(n=135)LauraLynn21 2017(n=2)^#BeaumontHospitalREC21 2017(n=78)*DaughtersofCharity21 *No data supplied.
#National REC for approvalofIMPclinical trials.
National #IrishCollegeofGeneralPractitionersREC 2017 57TOTALnumberofRECreviews(Note:someproposalsarereviewedbymorethanoneREC,hencethetotalnumberofprojectsis,therefore,lessthanthetotalnumberofreviews)
1,829
^Submittedtotalnumberofstudiesbutnofurtherdata,hencetheseprojectsarenotincludedinfurtheranalysis.* No data supplied. #NationalRECforapprovalofIMPclinicaltrials.16 SomeRECssubmitteddataindifferentyearperiodduetoadministrativecapacityconstraints.17 RegionalResearchEthicsCommittees:ReviewsHospitalandCHObasedresearch.18 UniversitybasedRECwhichreviewsHospitalsandCHObasedresearch.19 HospitalbasedRECswhichalsoreviewCHObasedresearch.20 HospitalbasedRECwhichreviewsHospitalbasedresearchonly(somereviewcommunityresearchoccasionally.21 CommunityServices(Section39)OrganisationREC.
Research Activity in the HSE and its Funded Organisations
38
4. A
ctivity Indica
tor 2
Table6:RECregionalcoverage(counties,hospitals,CHOorCHOsection)
RECs Counties Hospitals CHO
HSEMidlandsREC Longford,Westmeath,Offaly,Laois.
IrelandEastHGHospitals:
•MidlandRegionalHospitalMullingar
DublinMidlandsHGHospitals:
•MidlandRegionalHospitalPortlaoise
•MidlandRegionalHospitalTullamore
•NaasGeneralHospital
CHO8 (Laois,Offaly,Westmeath)
HSEMid-WesternAreaREC
Limerick,Clare,NorthTipperary.
UniversityLimerickHGHospitals:
•Mid-WesternRegionalHospital
•LimerickEnnisGeneralHospital
•NenaghGeneralHospital
•StJohn’sHospital
•LimerickMid-WesternRegionalMaternityHospital
•Mid-WesternRegionalOrthopaedic
CHO3
HSESouth-EasternAreaREC
Kilkenny,Wexford,Carlow,Waterford,South Tipperary.
IrelandEastHGHospitals:
•StLuke’sGeneralHospitalCarlowKilkenny
•WexfordGeneralHospital
South/SouthWestHGHospitals
•UniversityHospitalWaterford
•SouthTipperaryGeneralHospital
•LourdesOrthopaedicHospital,Kilcreene
CHO5
HSENorthEastAreaREC Monahan,Cavan,Louth,Meath
IrelandEastHGHospitals:
•OurLady’sHospital,Navan
RCSIHGHospitals:
•CavanandMonaghanHospital
•OurLadyofLourdesHospital,Drogheda
•LouthCountyHospitalDundalk
CHO1(CavanandMonahan)
CHO8(LouthandMeath)
Clinical REC of the Cork TeachingHospitals(CREC)atUCC
Cork,Kerry South/SouthWestHGhospitals:
•CorkUniversityHospital/CorkUniversityMaternityHospital
•UniversityHospitalKerry
•MercyUniversityHospital
•SouthInfirmaryVictoriaUniversityHospital
•BantryGeneralHospital
•MallowGeneralHospital
CHO4
Research Activity in the HSE and its Funded Organisations
39
4. A
ctivity Indica
tor 2
RECs Counties Hospitals CHO
SUHREC
MUHREC
LUHREC
GUHREC
Galway,Sligo,Mayo,Roscommon,Leitrim,Donegal
SaoltaHospitalGroup:
•GalwayUniversityHospital
•SligoUniversityHospital
•LetterkennyUniversityHospital
•MayoUniversityHospital
•MerlinParkUniversityHospital
•PortiunculaUniversityHospital
CHO1 (Donegal,Sligo,Leitrim)
CHO2 (Mayo,Roscommon,Galway)
RotundaHospitalREC
StLuke’sHospitalREC
RVEEHREC
NRHREC
TempleSt.Children’sHospitalREC
NMHREC
MaterMisericordiaeREC
TUH/SJHJointREC
CNOHREC
StewartsHospital
StMichaelsHouse
Enable Ireland
ConnollyHospitalREC
CoombeHospitalREC
BeaumontHosp.REC
OLCHCREC
SVUHREC
NaasGeneralHospitalREC
StJohnofGodREC
LauraLynnREC
DaughtersofCharityREC
Dublin,Wicklow&Kildare
RCSIHGHospitals:
•RotundaHospitalDublin
•ConnollyHospitalDublin
•BeaumontHospital
IrelandEastHGHospitals:
•MaterMisericordiaeUniversityHospitalDublin
•StMichael’sHospital,DunLaoghaire
•CappaghNationalOrthopaedicHospitalDublin
•RoyalVictoriaEyeandEarHospitalDublin
•NationalMaternityHospitalDublin
•StVincent’sUniversityHospitalDublin
•StColumcille’sHospitalLoughlinstown
DublinMidlandsHGhospitals:
•StJames’HospitalDublin
•StLuke’sRadiationOncologyNetwork
•TallaghtUniversityHospital
•TheCoombeWomen&InfantsUniversityHospital
•NaasGeneralHospital
Children’sHospitalGroup:
•OurLady’sChildren’sHospital,Crumlin
•TempleStreetChildren’sUniversityHospital
CHO6
CHO7
CHO9
Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
4.1.1. ResearchCategoriesandGeographicalDistribution
Thetitlesof1,772researchproposalsreviewedbytheRECsineachregion(projectsreviewedbyICGPRECnotincludedhereasithasnationalremit,seesection4.1.2)werecategorisedaccordingtotheUKHealthResearchClassificationsystem(UKHRCS)aspertheMethodologysection.ThisdatasetrepresentstotalstudiesreviewedbytheseRECsin2017(withsomeexceptions,seeTable5).TheEastregion,whichhas20outofthe32RECs,approved34%ofthetotalnumberofstudiesfollowedbytheSouth/SouthWestregion(1REC)andtheWest/NorthWestregion(4RECs)(Figure17).
GenericHealthRelevance accounted for almostaquarterofallstudiesapproved(Figure18).Thisreferstoresearchapplicabletoalldiseasesandconditionsortothegeneralhealthandwellbeingofindividuals,publichealthresearch,epidemiologyandhealthservicesresearchthatisnotfocusedonspecificconditionsorunderpinningbiological,psychosocial,economicormethodologicalelementsspecifictoindividualdiseases.
Cancer,MentalHealth,ReproductiveHealthandChildbirth,CardiovascularandNeurologicalwerethenextmostprevalentresearchactivitycategories(Figure18).AnalysisbyregionshowsasimilaremphasisonGenericHealthRelevancealthoughtheSouthEastshowedhigherratesofMental Health research,closelyfollowedbyMidlandsandNorthEastregions(Figure19,andAppendix2).
Figure 17: Number of proposals approved per region in 2017 or nearest year as indicated in Table 5
*ThedataforEastregionisslightlyincompleteasindicatedinTable5andTable6
0 100 200 300 500 700400
No.ofStudiesApproved
HSE
Reg
ion
600
EastRegion*
South/SouthWest
West/North-West
Mid-Western
South East
Midlands
North East
30%
34%
21%
9%
4%
2%
1%
40 Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
Figure 18: Percentage and numbers of REC approved studies for the six top health categories nationally
*DataforEastregionisslightlyincompleteasindicatedinTable5andTable6
0 5 10 2015
Percentage
UKHRCSTop6Hea
lthCateg
ories
25
Neurological
Cardiovascular
ReproductiveHealth& Childbirth
MentalHealth
Cancer
GenericHealthRelevance
119
126
147
180
180
394
Figure 19: Percentage and number of REC approved studies for the six top health categories per region Percentage and numbers
HSERegion
120
100
80
60
40
20
0
No.ofS
tudies
GenericHealthRelevance
Cancer Reproductive Health&Childbirth
MentalHealth Cardiovascular Neurological
18%
East
8%10%
8%6%
8%
24%
W/NW
9%5%
9%14%
4% 31%
Midlands
9%
28%3%
21%
S/SW
13%11%
9%4%
9%
19%
South East
17%7%
24% 3%6%
37%
Mid-Western
8%4%11% 8% 3%
29%
North East
10%14%
29%
41Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
Furtheranalysisbyresearchactivitytype,indicatedthatTreatmentEvaluationwasthemostfrequenttypeofresearchactivity(36%).ThiswascloselyfollowedbystudiesrelatedtoHealthServicesResearch(25%)andAetiology(20%)(Figure20).
Researchactivityanalysisbyregionindicatesthatnationaldistributionisalignedwithregionaldistributionin the South/South-West,West/North-WestandEast,withtreatmentevaluation,healthservicesresearchandaetiologyaccountingforthelargestproportionofresearchactivity(Figure21).In the remainingregions(Figure22),healthservicesresearchaccountsforthemajorityofapprovedstudies,i.e.Mid-Western(50%),South-East(37%),Midlands(31%)andNorth-East(38%).
42
Figure 20: Percentage and number of studies classified by research activity in the overall sample
0% 5% 10% 15% 25% 40%35%20% 30%
Percentage
UKHRCSResea
rchAc
tivity
Cod
es Other
Detection and Diagnosis
Aetiology
HealthServices
Treatment Evaluation
179
163
356
438
636
Figure 21: Percentage and number of studies classified by type of research activity for the regions with more annual project throughput
HSERegion
300
250
200
150
100
50
0
No.ofS
tudies
42%
East
22%17%
9% 4% 2% 1%3% 1%
35%
S/SW
22%25%
8%5%
1%
2%1% 1%
37%
W/NW
18%26%
8%2%4% 1%2% 1%
Treatment Evaluation
Treatment Development Underpinning
Aetiology
Prevention
HealthServices
NA
DetectionandDiagnosis DiseaseManagement
Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
43
Figure 22: Percentage and number of studies classified by type of research activity for the regions with less annual project throughput
Figure 23: Percentage and number of studies by health categories from the ICGP and PCRC at national level
HSERegion
80
70
60
50
40
30
20
10
0
40
35
30
25
20
15
10
5
0
No.ofS
tudies
No.ofS
tudies
19%
Mid-West
50%7%
11%1% 6%
2%3% 1%
61%
ICGP
14%
7% 5% 4% 4% 2%2% 2%
56%
PCRC
6% 6% 6%22% 6%
19%
Midlands
31%9%
19%19%
3%
38%
SE
40%10%11% 11% 5%
NE
38% 29% 19% 10%
4.1.2. ResearchinPrimaryCareandGeneralPractice
NationaldatawerealsoreceivedforresearchstudiesinprimarycarefromthePrimaryCareResearchCommittee*(PCRC,n=18studiesin2017),andforresearchstudiesingeneralpracticefromtheIrishCollegeofGeneralPractitioners(ICGP)REC(n=57studiesin2017).ThevastmajorityofstudieswereofGenericHealthRelevancewith61%and56%forICGPandPCRCrespectively(Figure23).
Treatment Evaluation
Treatment Development Underpinning
Aetiology
Prevention
HealthServices
NA
DetectionandDiagnosis DiseaseManagement
GenericHealthRelevance
Nurological Ear
Cardiovascular
Skin Other Oral&Gastrointestinal Stroke
Infection
InflammatoryandImmuneSystem
MentalHealth
ReproductiveHealthandChildbirth
*NotethatthePCRCisnotaREC,butagovernancebodythatapprovesresearchprojectsforPrimaryCareintheCHOswhichhavepriorRECapproval.HencethestudiesinthePCRCsample(n=18)arealsoincludedintheanalysis of section 4.1.1.
Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
44
Analysisbyresearchactivityindicatedthatthemajorityofresearchactivityrelatedtohealthservicesresearch,accountingfor65%ofapprovedstudiesbyICGPand61%bythePCRC(Figure24).
Figure 24: Percentage and number of studies by research activity from the ICGP and PCRC at national level
UKHRCSResearchActivityCodes
40
35
30
25
20
15
10
5
0
No.ofS
tudies
65%
ICGP
26%
2% 2%
5%
61%
PCRC
17% 11% 6% 6%
HealthServices Treatment EvaluationUnderpinning DetectionandDiagnosis
AetiologyDiseaseManagement
4.2 HRB funded Studies with Healthcare Professionals as PIs or Co-PI in 2017
TheHealthResearchBoard(HRB)isastateagencyandthefundingarmoftheDepartmentofHealth.TheHRBfundshealthresearchtoprovideevidencetopreventillness,toimprovehealthandtocontributetowardsthetransformationofpatientcare.TheHRBhasanannualbudgetofover€45million,andmanagearesearchinvestmentportfolioofapproximately€200milliononanannualbasis.Tobeeligibleforfunding,arecipientmustbeaffiliatedwithapre-approvedorganisationthathasbeenawarded‘researchhostinstitution’status,withthecapacitytorobustlymanagetheassociatedfinancialreportingrequirements,andthemanagementofintellectualproperty.HospitalsandHSEfundedhealthcaredeliveryorganisationsdonotholdthestatusof“researchhostorganisation”andthereforecannotreceivedirectfundingfromtheHRB.HencefundingreceivedfromtheHRBforstudiesinvolvinghealthcarestaffisgenerallyawardedtotheuniversitysector.
TheHRBkindlyprovidedinformationaboutstudiesawardedoverthelastfiveyears.Inordertomaintainaconsistentapproachacrossthedifferentproject-relateddatasets,only2017dataarepresentedforthepurposeofthisreport.ThedatasetwasgeneratedthroughtheHRBgrantsapplicationsystem(GrantE-ManagementSystemknownasGEMS).ItidentifiedindividualslistedasgrantrecipientPrincipalInvestigators(PIs),Co-PIsorCo-Applicantswhohadindicatedthattheywerea‘healthprofessional’.WithinGEMS,ahealthprofessionalisanyonewitharecognisedqualificationchosenfromthefollowinglist(andincludesthosewithadualappointmentwithathirdlevelinstitute):
• Dentistry
• Dietetics/Nutrition
• Medical/SurgicalDoctor
Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
45
• NurseorMidwife
• ClinicalResearchNurse
• OccupationalTherapy
• Ophthalmology/VisualSciences
• PharmacyorPharmacology
• Physiotherapy
• Podiatrist/Chiropodist
• PsychologyorBehaviouralScience
• Radiography
• SocialCareorSocialServices
• SpeechandLanguageTherapy
Thedatasetincludesallawards,whicharemainlyprojecttypeawards,butalsoincludesfundingforHRBfundedClinicalResearchFacilities.
4.2.1. HRBStudiesAwardedtoHCPsin2017
During2017theHRBissuedatotalof118awardsworth€79,690,355(Figure25&Figure26).Ofthe 118awards,38%involvedhealthcareprofessionals(HCP)(n=45)inthecapacityofPI,Co-PIor Co-Applicant(Figure25),whichrepresented56%ofthefundingawarded(Figure26).
Figure 25: Number of HRB awards issued in 2017 for Healthcare Staff and Non-Healthcare Staff
Non-HealthcareStaff HealthcareStaff
80
70
60
50
40
30
20
10
0
No.ofH
RB-Fu
nded
Awards
StaffType
62%
38%
Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
46
Figure 26: Annual value of HRB awards issued in 2017, for Healthcare Staff and Non-Healthcare Staff
Non-HealthcareStaff HealthcareStaff
50,000,000
45,000,000
40,000,000
35,000,000
30,000,000
25,000,000
20,000,000
15,000,000
10,000,000
5,000,000
0
Annu
alValue
ofH
RB-Fu
nded
Awards
(€)
StaffType
€44,610,36956%
€35,079,98644%
AnalysisbyHRCSHealthCategoriescodes(Figure27)showedthatthetopfundedfocusareaswereGenericHealthRelevance(28%),Cancer(19%),Neurological(10%),andMentalhealth(9%).
Figure 27: Percentage and number of HRCS top 6 health categories for HRB funded research studies in 2017
0% 5% 10% 15% 25%20% 30%
Percentage
UKHRCSTop6Hea
lthCateg
ories Reproduction
Health&Childbirth
Cardiovascular
Mental
Neurological
Cancer
Generic
5
8
4
9
18
26
Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
47
Figure 28: Percentage and number of HRB-funded studies by health categories by CFAAs
0 1 2 3 54 6
No.ofStudies
UKHRCSHea
lthCateg
ories
Stroke
Respiratory
Eye
CongenitalDisorders
Cardiovascular
Cancer
Metabolic&Endocrine
Reproduction Health&Childbirth
GenericHealthRelevance
MentalHealth
Neurological
9%
13%
4%
13%
17%
22%
4%
4%
4%
4%
4%
4.2.2. HRBstudiesawardedtoCFAAsin2017
ThenumberofHRBawardsmadetomedicalconsultantswithaformalacademicappointment(CFAA)wassubsequentlyanalysed.Fromthe45HRBgrantsinvolvingHCPsin2017;23grantswereawardedto18CFAAs(fiveofthemreceivedtwoawards).
AsindicatedinSection3.2,therewereatotalof189CFAAsin2018.Ifweassumenomajorchangesinthenumberofthesepositionsbetween2017and2018,thisindicatesthatonly9.5%ofCFAAsareinreceiptofHRBfunding.Thetotalamountoffundingreceivedbythiscohortamountedto€23,093,127;whichrepresents29%ofallHRBgrants,and52%ofallHRBgrantsawardedtohealthcarestaff.
Thehealthcategoriesofthesestudiesawardedtothiscohortwerefurtheranalysed.GenericHealthRelevanceandMentalHealth(Figure28)werethetopcategories.ThisisconsistentwiththefactthatPsychiatryisoneofthetopdisciplinesforCFAAs(Section3.2.2,Table4).
Analysis by research activity area indicated that themajorityofstudiesrelatedtoAetiology(22%),TreatmentEvaluation(17%)andPrevention(17%).
Research Activity in the HSE and its Funded Organisations
4.3. EU Funded Studies involving the HSE in 2017
ThemainresearchfundingvehicleoftheEuropeanCommissionistheHorizon2020programme.Thisprogramme(2014to2020)isthelargestEUresearchandinnovationprogrammetodate,withfundingofalmost€80billionbeingmadeavailable.TheprogrammeisbasedaroundpartnershipswithotherEuropeaninstitutionalcollaboratorsandindustry.Horizon2020fundshealthresearchundermanyoftheirdifferentprogrammes,inparticular,thecallsunderSocietalChallenges.
TheECalsofundshealthresearchviatheThirdHealthProgramme,whichisthemaininstrumentthattheCommissionusestoimplementtheEUHealthStrategy.Ittargetsinitiativestopromotehealth,topreventdiseases,andtofacilitateaccesstobetterandsaferhealthcare,amongothers.
InformationrelatedtoEUfundedstudiesinvolvingtheHSEwasobtainedfromtheEUparticipantportal.In2017thereweresixEUfundedstudiesinwhichtheHSEwasaprojectpartner.TheseincludedthreeHorizon2020awardsandthreefromtheThirdHealthProgramme.TheHSEparticipatedasapartner rather than as the coordinator in all studies.
EUfundedstudiesusuallyinvolveparticipantsfromseveralEUcountries,withthenumberofpartnersperstudyinthisdatasetrangingfrom13to109.Thetotalawardvalueofthesestudies(forallpartners)in2017was€102,317,219.Ofthis,€695,245wasawardedtotheHSEin2017.The total value of EU researchfundingreceivedbytheHSEinthelast10years(from2009to2019)is€2,019,069.56.
ClassificationusingtheUKHealthResearchclassificationsystemshowedthatthemajorityofstudieswereofGenericHealthRelevance(n=4,67%),andtheremainderrelatedtoEnvironmentalHealth(n=2,33%).
4.4. Regulated Clinical Trials (medicinal products) and Clinical Investigations (medical devices)
HealthProductsRegulatoryAuthority(HPRA)regulatedclinicalresearchfallsintotwocategories:clinicaltrialsofinvestigationalmedicinalproducts(CT-IMP)andclinicalinvestigationsofmedicaldevices.22 In Ireland,theHPRAisdesignatedastheCompetentAuthorityfortheirregulationandensurescompliancewiththeEUlegislation[EuropeanCommunities(ClinicalTrialsonMedicinalProductsforHumanUse)Regulations,2004,transposedintoIrishlawthroughSINo190of2004].23
Forthepurposeofthisreport,thetermClinicalTrialisusedasdefinedinthelegislation(SINo190of2004);anyinvestigationinhumansubjects,otherthananon-interventionaltrial,intendedto:
a) Discoverorverifytheclinical,pharmacologicalorotherpharmacodynamiceffectsofoneormoreinvestigationalmedicinalproducts,or
b) Identifyanyadversereactionstooneormoresuchinvestigationalmedicinalproducts,or
4. A
ctivity Indica
tor 2
48
22 https://www.hpra.ie/23 S.I.No.190/2004-EuropeanCommunities(ClinicalTrialsonMedicinalProductsForHumanUse)Regulations,2004.Available
onhttp://www.irishstatutebook.ie/eli/2004/si/190/made/en/print.AccessedonDecember06,2018.
Research Activity in the HSE and its Funded Organisations
c) Studyabsorption,distribution,metabolismandexcretionofoneormoresuchinvestigationalmedicinalproducts,or
d) Discover,verify,identifyorstudyanycombinationofthemattersreferredtoatsubparagraphs(a),(b),and(c),withtheobjectofascertainingthesafetyorefficacyofsuchproducts,orboth.
RegulatedclinicaltrialsarealsosubjecttotheguidanceofICHGCP(InternationalConferenceonHarmonisation-GoodClinicalPractice)andtheDeclarationofHelsinki.InadditiontoHPRAapproval,clinicaltrialsmustalsobeapprovedbyadesignatedResearchEthicsCommittee(REC).Therearecurrently12ResearchEthicsCommittees(REC)inIrelandrecognisedandauthorisedbytheDepartmentofHealthtoconsideranapplicationforIMPclinicaltrials.24
TheothermaintypeofregulatedstudyisaClinicalInvestigationofaMedicalDevice. These are alsoregulatedbyEUlawwhichwasenactedinApril2017.25TheseareregulatedbytheHPRAandtheNationalStandardsAuthorityofIreland(NSAI)Regulations,andalsorequireethicalapproval.Themedicaldevicesregulationoverlapsinmanyareaswiththeclinicaltrialsregulations,butunlikethose,thereisnoprovisionforasinglenationalethicsopinionformulti-siteregulatedClinicalInvestigations.
Regulatedstudiesrequireasponsor,whichisapersonorentitythattakesresponsibilityfortheinitiation,managementand/orfinancingofthestudy.ThesponsordoesnotneedtobelocatedinanEUMemberStatebutmusthavealegalrepresentativeintheEEA.Theinvestigatorandthesponsormaybethesameperson,andthesponsormaydelegateanyorallofhistrial-relateddutiesandfunctionstoanotherpersonororganisation.Thesponsorremainsresponsibleforensuringthattheconductofthetrialandthedatageneratedcomplywithallrelevantregulations.
4.4.1. RegulatedClinicalTrialsinIrelandin2017
InformationaboutIrishRegulatedClinicalTrialsisavailableintheEUClinicalTrialsRegister(EudraCT).ThisregistercontainsinformationonauthorisedinterventionalclinicaltrialsofmedicinesconductedintheEuropeanUnion(EU),ortheEuropeanEconomicArea(EEA),afterMay01,2004.TheRegistercontainsPhaseII-IVclinicaltrialsonadultsandpaediatricpopulationsconductedintheEU/EEA,andregistrationonthisregisteriscompulsoryforallsuchregulatedtrials.
Studiesareregisteredbythestudysponsor,andthedatabaseisusedbytheHPRAfordatarelatedtoclinicaltrialprotocols.TheHPRAaddstheauthorisationonlywhenafavourableethicscommitteeopinionis provided by the sponsor. Whilethesponsorsare,inmanycases,pharmaceuticalcompanies,organisationssuchasCancerTrialsIreland(CTI),HRBClinicalResearchCoordinatorIreland(HRB-CRCI)haveakeyroleincoordinatingandsupportingthesetrials.Inaddition,someuniversitiescanalsotaketheroleofsponsor.
4. A
ctivity Indica
tor 2
49
24 ResearchEthicsCommitteesinIrelandrecognisedtoconsiderapplicationsforclinicaltrials.DepartmentofHealth2012.25 Regulation(EU)2017/745oftheEuropeanParliamentandoftheCouncilof5April2017onmedicaldevices,amending
Directive2001/83/EC,Regulation(EC)No178/2002andRegulation(EC)No1223/2009andrepealingCouncilDirectives90/385/EECand93/42/EEC.
Regulation(EU)2017/746oftheEuropeanParliamentandoftheCouncilof5April2017oninvitrodiagnosticmedicaldevicesandrepealingDirective98/79/ECandCommissionDecision2010/227/EU.
Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
50
Forthepurposeofthisstudy,theEUclinicaltrialsdatabasewassearchedforclinicaltrialsthatwereconductedinIrelandin2017(thosewhichhadbeenauthorisedbytheHPRAandforwhichtheHPRAhavereceivedconfirmationofRECapproval).
AccordingtotheinformationinEudraCT,27clinicaltrialswithanIrishsitelocationwererecordedashavingastartdate(thedatethestudywasauthorisedtoproceed)in2017.Therewereanadditional70clinicaltrialsidentifiedas‘on-going’withanIrishsitelocation.All97clinicaltrialshavebeenapprovedbytheHPRA.Thesefiguresaresignificantlylowerthancountrieswithasimilarpopulation;DenmarkandFinland,whichhad365and180clinicaltrialsrespectivelyregisteredonEudraCTduringthesametimeperiod.
ThemajorityoftheseIrishclinicaltrialsweresponsoredbyindustry(n=24,89%).AbbVieDeutschlandGmbH&Co.KGandAimmuneTherapeutics,Inc.,werethemostcommonsponsor,withthree trials each. Theremainingthreenon-industrysponsoredtrialsweresponsoredbyaforeignuniversity,anIrishhospitalandaHSEcommunityarea.
AccordingtotheUKHRCScategories,themajority(n=9,33%)oftheseclinicaltrialswererelatedtoCancerand15%(n=4)wererelatedtoInflammatoryandImmunediseases(Figure29).
TreatmentEvaluationrepresented92.6%(n=25),whileDiseaseManagement(n=1,3.7%)andTreatmentDevelopment(n=1,3.7%)accountedfortheremainder.
Figure 29: Percentage and number of Irish clinical trials by the six most frequent HRCS health categories on the EudraCT
0% 5% 10% 15% 25%20% 35%30%
Percentage
UKHRCSTop6Hea
lthCateg
ories Neurology
Infection
CongenitalDisorders
Cardiovascular
Inflammatory&Immune
Cancer
2
2
2
2
4
9
Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
51
4.4.2. ClinicalInvestigationofMedicalDevices
InformationrelatedtoapprovedclinicalinvestigationsofmedicaldevicesduringthesametimeperiodwasprovidedbytheHPRA.In2017thereweresevenclinicalinvestigationsofmedicaldevicesapprovedbytheHPRA.
Thestudiesweresponsoredbysevendifferententities,ofwhichonlyonewasanIrishacademicsponsor,withtheremainingfivestudiessponsoredbyindustry.SaoltaUniversityHealthCareGrouphostedthehighestnumberofapprovedclinicalinvestigations;n=4,57%(Figure30).
Figure 30: Percentage and number of HPRA approved clinical investigations by Hospital Group
0 1 2 3 54
No.ofHPRAApprovedClinicalInvestigations
Hos
pitalG
roup
s
DublinMidlands
RCSI
NationalChildren’s
Saolta University
14%
14%
14%
57%
AccordingtotheUKHRCScategories,themajority(n=3,43%)oftheseclinicalinvestigationsrelatedtodevicesforCardiovascularconditions(Figure31).TreatmentEvaluationrepresented71%(n=5),whileDetectionandDiagnosisaccountedfortheremainder.
Figure 31: Percentage and number of HPRA approved clinical investigations by health categories
0 1 2 3 4
No.ofHPRAApprovedClinicalInvestigations
UKHRCSHea
lthCateg
ories Cancer
Neurology
Renal&Urogenital
Metabolic&Endocrine
Cardiovascular
14%
14%
14%
14%
43%
Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
52
4.5. Research Related Activity in the Third Level Sector Funded by the HSE in 2017
TheHSEengagestheIrishuniversitysectortocommissionhealthservicesresearchandtoevaluaterelatedstudies.TheresearchsupportofficesintheUniversitiesandInstitutesofTechnologykindlyprovidedinformationaboutstudiesfundedbytheHSEoverthelastfiveyears.Forthepurposeofthisreport,only2017datahasbeenincludedtoensureconsistencywiththeotherdatasets.
In2017theHSE-funded56studieswithin10differentHEIs(Table7),whichtotalledalmost€6.5million.
Table7:Studies/collaborationsbyHEI
HigherEducationInstitution NumberofStudies/Collaborations
PercentageofTotalStudies/Collaborations
UniversityCollegeCork 17 30
UniversityCollegeDublin 9 16
RoyalCollegeofSurgeonsinIreland 8 14
TrinityCollegeDublin 8 14
Dublin City University 5 9
WaterfordInstituteofTechnology 3 5
UniversityofLimerick 3 5
NUIGalway 1 2
DundalkInstituteofTechnology 1 2
MaynoothUniversity/NUIMaynooth 1 2
UniversityCollegeCorksecuredthelargestnumberofstudies(30%)(Table7),andthehighestproportionofHSEfundingovertheperiod,representing32%(€2,112,996)ofthetotalspend (Figure32).
DundalkITreceivedthesecondlargestamountoffundingfromtheHSEdespitehavingjustoneproject(€1,804,580,28%ofthetotalfunding),followedbyRCSI(€1,036,751,16%ofthetotalfunding).Theproportionoffundingvariesbetween6%and0.2%fortheremainingsevenHEIs.
ThelownumberamongsomeoftheotherinstitutionsmaybeduetostudiesbeingconductedbetweenagivenHEIandvoluntaryhospitals(ratherthanaHSEinstitution).Also,itisnotclearifstudiesrecordedas“fundedbyHSE”intheHEIsinformationmanagementsystemsreferredtofundingfromHSECorporate/NationalDepartmentsortoHSEfundedorganisations(i.e.someuniversitiesmayhaverecordedfundingfromaHSEhospitalbythehospitalnamewhichwillthenexcludeitfromthesearchcriteria).
Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
53
Figure 32: Percentage proportion of funding by HEI in 2017
UCC
TCD
WIT
RCSI
MaynoothUniversity
NUIGalway
Dundalk IT
UL
DCU
UCD
32%
28%
16%
6%
6%
6%
3%3% 1%1%
Whencategorisedbyhealthcategory,themajorityofHSEfundedstudieswereofGenericHealthRelevance;68%(Figure33).Thisisnotunexpectedsinceuniversitieswouldgenerallybecontractedtoconductevaluativeresearch,forexample,basedonchangesinservicedelivery.Withregardtoresearchactivitytype,HealthServicesresearchwasthemostprominentat65%(Figure34).
Figure 33: Percentage and number of studies by top six HRCS health categories
0% 10% 20% 30% 50%40% 80%70%60%
Percentage
UKHRCSTop6Hea
lthCateg
ories Metabolic&
Endocrine
Other
ReproductiveHealth& Childbirth
Cancer
MentalHealth
GenericHealthRelevance
2
3
1
4
8
38
Research Activity in the HSE and its Funded Organisations
4. A
ctivity Indica
tor 2
54
Figure 34: Percentage and number of studies by HRCS research activity codes
0% 10% 20% 30% 50%40% 70%60%
Percentage
UKHRCSResea
rchAc
tivity
Cod
es
Treatment Evaluation
Detection & Diagnosis
Prevention
Unknown
NA
Disease Management
Aetiology
HealthServices
3
1
3
2
1
5
5
63
Research Activity in the HSE and its Funded Organisations
56 research projects commissioned
by the HSE from third level
institutions
51 Grant Awards45 HRB 6 EU
1,829 REC approvals
34 HPRA Regulated studies
27 new clinical trials
7 new medical device trials
32 Research Ethics
Committees
The majority (1/4) of REC approved studies were of ‘Generic Health
Relevance’
4. A
ctivity Indica
tor 2
55Research Activity in the HSE and its Funded Organisations
Research Studies undertaken
5. Activity Indicator 3: Scopus Indexed Publications, 2013-2017
One important measure of research activity is publication output. Research outputs can bedisseminatedinmanydifferentways,butforthepurposeofthisreport,wefocusedtheanalysisonresearcharticlespublishedinjournalsindexedinScopus.Thistypeofpublicationoutputwaschosenbecause:
• Indexationisconsideredtobeavalidationofthequalityofagivenjournal,indicatingthatitpublisheshigh-qualityresearcharticles.
• ScopusistheElsevierabstractandcitationdatabaseandindexesjournalsfromthefieldsofscience,technology,medicine,socialsciences,artsandhumanities.Italsoprovidesresearchanalysisandtrackingtools.Thisdatabaseincludesover36,000titlesandover11,000publishers,ofwhichover34,000arepeer-reviewedjournalsintop-levelfields,includinglifesciencesandhealthsciences.
Trendsovertimewereanalysedforjournalarticlespublishedbetween2013and2017.TheanalysisofScopusindexedpublicationswascarriedoutusingSciVal,abibliometrictoolthatusesScopusdatatoanalysetheresearchperformanceofindividuals,groupsorinstitutions.AsthereisnoHSEpublicationpolicy,hospitalpublicationsweregenerallynotaffiliatedwiththeHSEbuttoindividualhospitalsorCHOs.InordertousetheSciValtool,thehospitaldatasetswereextractedfromScopusindividually,curatedand
then imported into SciVal for analysis.
5.1. Analysis of Publication Number per year from 2013-2017
ThetotalnumberofpublicationsfromHSEorganisationsandsection38hospitalsnationally indexed in Scopus inthefiveyearperiodfrom2013to2017was13,466(thisincludestotalHSEHospitals,n=4,050;totalVoluntaryHospitals,n=8,934;andtotalCommunityandNon-Hospital,n=482,whereatleastoneoftheauthorshasknownHSEaffiliation).Thefiguresincludethepublicationoutputofmedicalconsultantswithanacademicappointment.Therehasbeenaslightsteadyincreasesince2013inthetotalnumberofpublicationsfromthehealthservice(Figure35),althoughcommunity andnon-hospitalresearchonlyaccountforbetween3to4%ofthetotaloutputeachyear. This may indicatethatmuchresearchisnotpublishedorispublishedinother(non-peerreviewed)outlets.
57
5. A
ctivity Indica
tor 3
Figure 35: Total number of publications between 2013 and 2017 by HSE Hospitals, Voluntary Hospitals, Community & Non-Hospital and Total
2013
Total Total Voluntary Hospitals
TotalHSEHospitals
Community and Non-Hospital
2014 2015 2016 2017PublicationYear
Num
bero
fSco
pus-Inde
xedPu
blications
(2013-2017)
3,500
3,000
2,500
2,000
1,500
1,000
500
080 87 102 102 111
727 815 764 855 889
1,742 1,758 1,698 1,7611,975
2,549 2,660 2,5642,718
2,975
Research Activity in the HSE and its Funded Organisations
5. A
ctivity Indica
tor 3
58
Figure 36: Comparison of 2017 Scopus indexed publications between the health services nationally and the university sector.
3,500
3,000
2,500
2,000
1,500
1,000
500
0No.ofS
copu
sInde
xedPu
blications
in2017
UCD
3,106
2,975
UL
1,169
2,975
UCC1,943
2,975
RCSI
655
2,975
TCD
3,007
2,975
DCU
1,022
2,975
UCG
1,594
2,975
MU
506
2,975
Institutions
UniversityOutput,2017* HealthServiceNationalOutput,2017
Fromanannualperspective,thetotalnumberofjournalarticlespublishednationallyin2017was2,975.Thisiscomparabletothetotaloutput(alldisciplines)ofsomeIrishuniversitieslikeTCD*orUCD*inonesingleyear(Figure36).
Thetotalnumberofpublicationsbyhospitalsin2017was2,864.Nineoutofthe50publichospitalsaccountedforthree-quartersoftheoverallhospitalpublicationoutput;73%(n=2,103)(Figure37),whichmayindicatethecloseassociationwiththeacademicsectorastheyareallteachinghospitals.
*Notethatonlypublicationswithauniversityaffiliationarecapturedhere,itexcludesassociatedaffiliations (i.e.hospitals,institutes)
Figure 37: Hospitals with a publication output of 100 or more journal articles in 2017
0 50 100 150 250200 350 400300
No.ofScopusIndexedPublicationsin2017
University
Hos
pitals
St.James’s
Beaumont
St.Vincent’s
MaterMisericordiae
Cork
Galway
OLCH,Crumlin
Tallaght
Limerick
8%
10%
8%
8%
11%
12%
6%
6%
3%
Research Activity in the HSE and its Funded Organisations
59
5. A
ctivity Indica
tor 3
ThepublicationswereanalysedbyHospitalGroup(Figure38),andthepatternwasconsistentacrossallfiveyears,withDublinMidlandsHospitalGroupandIrelandEastHospitalGrouphavingthehighestnumberofpublications.
Figure 38: Scopus indexed publication output per hospital group per year from 2013-2017
PublicationYear
700
600
500
400
300
200
100
0
No.ofS
copu
sInde
xedPu
blications
by
Hos
pitalG
roup
s
20%
2013
20%19%18%
20% 17%19%
20%
2015
19%18%18%
19%19%
18%
21%
2014
19%20%20%
18%19%
21%
19%
2016
21%19%
22%20%21%
21%
21%
2017
22%23%22%
23%24%
21%
Ireland East
Saolta UL
RCSIDublinMidlands South/SouthWest NationalChildren’s
Publicationratiosforeachhospitalgroupwerealsocalculatedbydividingthetotalnumberofpublicationsofahospitalgroupbythenumberofstaffperhospitalgroup.Whencomparingthepublicationratios,theChildren’sHospitalGroupshowedthehighestrelativeoutput.
5.2. Analysis of overall publication output by topic and research activity type
ToenableamorecompleteanalysisofthetypesofhealthresearchbeingconductedintheHSEandfundedorganisations,asubsetoftheScopus-indexedpublications,relatedto2017only,werecodedusingtheUKHealthResearchClassificationSystem.In2017,therewere2,975publicationsintotal.
Thetopresearchtopics(Figure39)wereGenericHealthRelevance26(17%),followedbyCancer(15%),Cardiovascular(9%),Neurological(8%)andReproductiveHealthandChildbirth(7%)research.
TreatmentEvaluation(Figure40)representednearlyhalfofthetotalresearchactivitytypeofpublicationsin2017(43%),followedbyAetiology(27%),HealthServices(14%),DetectionandDiagnosis(8%)andDiseaseManagement(3%).
26 GenericHealthrelevancereferstoresearchapplicabletoalldiseasesandconditionsortogeneralhealthandwellbeingofindividuals,publichealthresearch,epidemiologyandhealthservicesresearchthatisnotfocusedonspecificconditions.
Research Activity in the HSE and its Funded Organisations
5. A
ctivity Indica
tor 3
60
Figure 39: Percentage and number of Scopus indexed publications in 2017 by top six health categories nationally
Figure 40: Percentage and number of Scopus indexed publications in 2017 classified using the UK HRCS research activity codes nationally
%ofScopus-IndexedPublications
0 2 4 6 10 168 1412 18
Infection
Reproductive and Childbirth
Neurological
Cardiovascular
Cancer
GenericHealthRelevance
187
209
230
254
434
505
UKHRCSTop6Hea
lthCateg
ories
%ofScopus-IndexedPublications
0 5 10 15 25 4035 5020 30 45
Underpinning
Prevention
NA
Treatment Development
DiseaseManagement
Detection&Diagnosis
HealthServices
Aetiology
Treatment Evaluation
11
22
50
73
98
249
402
788
1,282
UKHRCSResea
rchAc
tivity
Cod
es
Research Activity in the HSE and its Funded Organisations
61
5. A
ctivity Indica
tor 3
Figure 41: Percentage and number of Scopus indexed publications in 2017 by the top six health categories for community and non-hospital areas
5.2.1 TopicsandresearchactivitytypeofCommunityandNon-Hospital Researchpublications
Communityandnon-hospitalresearchonlyrepresent4%ofthetotalpublicationsidentifiedin2017.ThemajorityofpublicationsrelatedtoMentalHealth(27.9%),followedbyGenericHealthRelevance(23%),Infection(10%),Cancer(7%)andNeurological(5%)(Figure41).TreatmentEvaluation(Figure42)representedoverhalfofthetotalresearchactivityofpublicationsin2017(54%),followedbyAetiology(20%),HealthServices(12%),notapplicable/relevant(6%)andDetectionandDiagnosis(5%).
%ofScopus-IndexedPublications
0 5 10 15 2520 30
CongenitalDisorders
Neurological
Cancer
Infection
GenericHealthRelevance
MentalHealth
5
6
8
11
26
31
UKHRCSTop6
Hea
lthCateg
ories
Figure 42: Percentage and number of Scopus indexed publications in 2017 classified using the UK HRCS research activity codes for community and non-hospital areas
%ofScopus-IndexedPublications
0 10 20 30 5040 60
Treatment Development
Detection&Diagnosis
NA
HealthServices
Aetiology
Treatment Evaluation
4
5
7
13
22
60
UKHRCSResea
rchAc
tivity
Cod
es
Research Activity in the HSE and its Funded Organisations
5. A
ctivity Indica
tor 3
62
Figure 44: Percentage and number of Scopus indexed publications in 2017 by research activity codes for total hospitals
Figure 43: Percentage and number of Scopus indexed publications in 2017 classified by the top six health categories for total hospitals
5.2.2 Hospitalresearchpublications–topicsandresearchactivitytype
Hospitalresearchrepresentedthevastmajorityofthetotalpublicationsidentifiedin2017(96%),hencetheresultsoftheanalysisofhospital-basedresearchareverysimilartothenationaltotal.ThemajorityoftheresearchwasofGenericHealthRelevance(17%),followedbyCancer(15%),Cardiovascular(9%),Neurological(8%)andReproductiveHealthandChildbirth(7%)research (Figure43).TreatmentEvaluation(Figure44)representednearlyhalfofthetotalresearchactivityofpublicationsin2017(43%),followedbyAetiology(27%),HealthServices(14%),DetectionandDiagnosis(9%)andDiseaseManagement(3%).
%ofScopus-IndexedPublication
0 2 4 6 10 16148 12 18
Infection
ReproductionHealth and Childbirth
Neurological
Cardiovascular
Cancer
GenericHealthRelevance
176
205
224
251
426
479
UKHRCSTop6Hea
lthCateg
ories
%ofScopusIndexedPublications
0 5 10 15 25 4035 5020 30 45
Underpinning
Prevention
NA
Treatment Development
DiseaseManagement
Detection&Diagnosis
HealthServices
Aetiology
Treatment Evaluation
11
22
43
69
98
244
389
766
1,222
UKHRCSResea
rchAc
tivity
Cod
es
Research Activity in the HSE and its Funded Organisations
63
5. A
ctivity Indica
tor 3Figure 45: Scopus indexed CFAA publications indexed in the Scopus database from 2013 to 2017
5.3. Analysis of Publications by Medical Consultants with a Formal Academic Appointment
Ofthetotal13,466articlespublishedbetween2013and2017withintheIrishpublichealthsystem,4,964(37%)werepublishedbyCFAAs(Figure45),whichindicatesthatthepublicationoutputofthiscohortisveryprolificastheyrepresentonlyaverysmallpercentageofthetotalnumberofexistingconsultants.
2013 2014 2015 2016 2017
3,500
3,000
2,500
2,000
1,500
1,000
500
0
No.ofS
copu
sInde
xedPu
blications
1,028 39%
1,632 1,561
990 36%
1,7282,046
929 31%
1,535
1,003 39%
1,014 40%
PublicationYear
CFAA NoFormalUniversityAppointment
2,975 Publications
(in 2017).
13,466 publications between 2013 and
2017. Slight increase year-on-year.
37% were published by consultants with a formal academic
appointment.
The majority of publications were by Hospital-based staff
(primarily in Voluntary Hospitals).
The majority of publications
were on topics of ‘Generic Health
Relevance’.
Research Activity in the HSE and its Funded Organisations
Publications
6. Activity Indicator 4: Clinical Research Networks
Forthepurposeofthisreport,ClinicalResearchNetworksaredefinedasnetworksofcliniciansinterestedinaparticulardiseaseortopicwhicharedevotedtotheimprovedcareofpatientsandhealthservicesthroughresearchinthatparticulartopic.Theexistenceofthesenetworksindicatesacriticalmassofresearchactivityinagiventhematicarea.Someofthenetworksinvolveotheractorssuchasacademics,scientists,patients,professionalbodies,etc.
Thesenetworkscanbefundedinavarietyofways:
• HealthResearchBoard,statefundingorotherresearchfundingagencies,e.g.WellcomeTrust
• Membershipfees
• Fundraisingorviaanassociatedcharity
• Philanthropicorotherfunding
Thisreportfocusesonnetworkswithaclinicalresearchfocus.Otherhealthresearchnetworksorcentreswithamorebasicresearch,translationaloracademicfocus,patient-lednetworks,professionalbodynetworksoracademicresearchcentresareoutsidethescopeofthisreport.
WehaveclassifiedtheClinicalResearchNetworkintotwodistincttypes:ClinicalTrialNetworks(withafocusonclinicaltrialsandstudies)andCollaborativeClinicalResearchNetworks(withafocusonknowledgesharing,disseminationandcollaboration).
6.1. Clinical Trial Networks (CTNs)
Thesenetworkshaveastrongfocusonclinicaltrialsofmedicinalproductsbutmayalsobeinvolvedinclinicalinvestigationsofmedicaldevicesandotherclinicalstudies.Thoseinvolvedinregulatedclinicaltrialsrequiresignificantfundingandinfrastructuretomanagetheirregulatory,financialandoversightrequirementsandareoftenfundedbytheHRB.
Thisgroupincludesthefollowingnetworks:
• CancerTrialsIreland(CTI)
• BloodCancerNetworkIreland(BCNI)
• HRBCriticalCareClinicalTrialsNetworkIreland(HRBCCTNI)
• HRBMother&BabyClinicalTrialsNetworkIreland(CTNI)
• HRBPrimaryCareClinicalTrialNetworkIreland(PrimaryCareCTNI)
• InvestigatorNetworkforInflammatoryBowelDiseaseTherapyinIreland(INITIative)
• IrishHepatitisCOutcomesResearchNetwork(ICORN)
• TheVasculitisIrishNetwork(VINE)
• RespiratoryandAsthmaResearchNetwork(INCA)
• NeurologyResearchGroupinSt.Vincent’sUniversityHospital/SVUH
FurtherdetailonthesenetworksisincludedinTable8.
65
6. A
ctivity Indica
tor 4
Research Activity in the HSE and its Funded Organisations
6. A
ctivity Indica
tor 4
66
Table8:ClinicaltrialNetworksinIreland
PrimaryTopic NetworkName/Acronym/Start Date
Membership Core funding
Aim
Cancer Cancer Trials Ireland/CTI
1996
17CancerTrialResearch Units in Cork,Limerick,Offaly,Galway,Sligo,Donegal,Waterford and Dublin.
Members:Almostallcancertreatingspecialists in Ireland areMembersofCTI(98%).
HRB,IrishCancer Society,grantincome,monitoringincome.
CTIs vision is to be able to provide everypatientwithcancer,accesstopotentiallyhigh-qualityandlife-alteringcancertrialsandmakeIrelandahighlyattractivelocationto open cancer trials.
CTI’smissionistodiscovernewdiagnosticsandtreatmentsthatwillextendandenhancethelivesofthemillionsofpeoplewhoarediagnosedwithcancereachyear.
BloodCancer BloodCancerNetworkIreland/BCNI
2015
NUIGalway/UHG,UCC/CUH,TCD/SJH,The National Cancer RegistryIreland,BeaumontHospitalandTheMaterHospital
SFIandICS TheaimofBCNIistoprovideIrishbloodcancerpatientswithaccessto novel and innovative cancer treatmentsthroughtheprovisionofearlyphaseclinicaltrials,offeringtheopportunitytotestnew,potentiallylife-savingtreatmentsanddrugs.Thenetworkalsocollects information and samples from blood cancer patients in Ireland in order to improve their understandingandtouncovernewwaystocombatthisdisease.
Critical Care HRBCriticalCare Clinical TrialsNetworkIreland(HRBCCTNI)
2015
Thenetworkencompasses more than75%ofalltheICUcapacity in Ireland.
HRB TheHRBCCTNIbringstogetherdoctors,nursesandresearcherstotestnewtreatmentsthatcanimprove outcomes for critically ill patients in intensive care units.
Perinatal health HRBMother&BabyClinicalTrialsNetworkIreland(CTNI)
2015
The members includeresearchers,consultants,obstetricians,neonatologists,midwivesandrelatedprofessionals from sevenofthelargestmaternity hospitals in Ireland.
HRB The aim of the CTNI is to addressproblemsinwomenandchildren’shealththatwillhaveaglobalimpact.CTNIhasawell-established record in collaborative researchandinconductinglarge-scale,multicentre,randomisedcontrolled trials.
Primary Care HRBPrimaryCare Clinical TrialNetworkIreland (PrimaryCareCTNI)
2015
NUIGalway,RCSI&QUBandICGPwithmanyGPsandotherprimary care health professionals.
HRB Itsaimsarethedesign,conductanddisseminationofhighquality,internationallyrecognised,randomised trials in Irish primary care,whichaddressimportantandcommon problems.
Research Activity in the HSE and its Funded Organisations
67
6. A
ctivity Indica
tor 4
PrimaryTopic NetworkName/Acronym/Start Date
Membership Core funding
Aim
InflammatoryBowelDisease
InvestigatorNetworkforInflammatoryBowelDiseaseTherapy inIreland/INITIative
ClinicalandscientificinvestigatorswithaninterestinCrohn’sDisease and Ulcerative Colitisthroughouttheisland of Ireland
Not available It aims to foster collaboration andencouragemulti-centreinvestigator-initiatedstudiesinCrohn'sDiseaseandUlcerativeColitis in Ireland.
HepatitisC IrishHepatitisC Outcomes Research Network/ICORN
2012
CollaborationbetweenClinicians from BeaumontHospital,CUH,GUH,theMaterHospital,St.Luke’sHospital,Kilkenny,SJHandSVUH,patientadvocacygroupsandhealthcare service providersincludingISGE,IDSI,andtheNCPE.
AbbVie Ireland and BristolMyersSquibb
TheinitialgoalofthiscollaborationwastooptimisethequalityofcareofpatientswithHepatitisC(HCV)undergoingtreatmentwithdirect-actingantiviraltherapy(DAAs).Othernetworkresearchthemesdeveloped since 2012 include innovative research studies on modelsofcareandscreeningforHCVinfection.
Vasculitis VINE/TheVasculitis Irish Network
2012
SJH/TUH,SVUH,OLCHC,CUH,GUH,SouthernHealth&SocialCareTrust,UKand Vasculitis Ireland Awareness.
HRB,Vasculitis Ireland,
Thenetworkiscomprisedofdedicatedmulti-disciplinarycentresthatprovideacoordinatedcare-pathforpatientswithprimarysystemic small vessel vasculitis (PSV),fromdiagnosistorelapseandontolongtermremission.Itprovides access to clinical trials for patientswithPSV.
Respiratory Respiratory and Asthma Research Network/INCA Studies
2011
A collaborative researchprogrammedelivered from the RCSI Research Centre and TCD Bioengineering.
SFI The focus is on clinical investigationsforrespiratorydevices,particularlydevelopinganoveltechnologywhichcanbe used in clinical practice as an objectiveassessmentofpatientadherence to inhaled therapy.
Neurology NeurologyResearch GroupinSVUH
2003
UCDandSVUH SFI,HRBand industry
Their areas of excellence are in neuroinflammatorydisorders,inparticular,multiplesclerosis,movementdisordersandcognitiveneurology.Thefocusisonrunningnumerous clinical pharmaceutical trials,academicresearchstudies–bothclinicalandbasicscience,andinterventionalstudieswithallied health professionals. Several nationalneurologyregistriesandresearch databases are also coordinatedfromtheSVUHsite.
Research Activity in the HSE and its Funded Organisations
6. A
ctivity Indica
tor 4
68
Theperformanceofaclinicaltrialrequiresagreatdealofsupportandinfrastructure.Anumberoforganisations,manygenerallyfundedbytheHealthResearchBoard,providesignificantsupportforthisactivity:
HRBClinicalResearchCoordinationIreland(CRCI)27 HRB-CRCIprovidessupportforclinicaltrialsundertakenintheuniversityassociatedClinicalResearchFacilities/Centres(CRF/Cs).CharacteristicsandinformationoneachCRF/CcanbefoundinTable4ofAppendix 3.
TheHRB-CRCIservicesandactivitiesincludebeingthecentralpointofcontactforsponsorslookingtostartatrial,streamliningnationalprocessesforfeasibilitystudies,improvingstudystart-uptimelinesforstudysetup,recruitmenttrackingandcollationofmetrics,provisionofadviceinrelationtoregulatorypathwaysandresearchethicalapproval,andauditandmonitoring,amongothers.
HRB-CRCIishostedbyClinicalResearchDevelopmentIreland(CRDI)28,whichisanot-for-profitresearchpartnershipcomprisingNUIGalway,RCSI,TCD,UCC,UCD,andUL,theirmedicalschools,associatedacademichospitalsandCRFs,withtheobjectiveofacceleratingthetranslationofbiomedicalresearchintoimproveddiagnostics,therapiesanddevicesforpatients.ItwasformallylaunchedbytheMinisterforHealthonOctober2nd,2017.CRDIbuildsontheachievementsofMolecularMedicineIrelandwhichwasestablishedin02October,2017.
HRBTrialsMethodologyResearchNetwork(TMRN)29
TheHRB-TRMNisanew,collaborativeinitiativebetweenanumberofIrishandinternationalhighereducationinstitutesandmethodologycentres.ItisfundedbytheHRBandwillprovidedirectsupportintwoways,firstlythroughthedevelopmentofaClinicalTrialExpertiseDatabase(C-TED)andalsothroughtheTrialMethodologyandReportingAdvisoryService(TMRAS).
CancerTrialsIreland(CTI)30 CTIprovidessupportsforoncologyclinicaltrialswithintheOncologyClinicalTrialunitsacross14publicandthreeprivatehospitalsitesinCork,Limerick,Offaly,Galway,Sligo,Donegal,WaterfordandDublin.Itisanot-for-profitorganisationwithcharitablestatus.Servicesprovidedincludeplanning,opening,co-coordinating,supporting,monitoringandauditingcancertrialsinIreland.Inaddition,theorganisationprovidestrainingfacilitates,co-operationbetweenallprofessionalsworkinginthearea,andsupportsthedevelopment of cancer trials research units around the country.
Cross-borderHealthcareInterventionTrialsinIrelandNetwork(CHITIN)TheCHITINinitiativewaslaunchedinSeptember2018andisauniquecross-borderpartnershipbetweenthePublicHealthAgencyinNorthernIrelandandtheHealthResearchBoardintheRepublicofIreland,todevelopinfrastructureanddeliverhealthcareinterventiontrialsinhealthandsocialcare.Theinitiativewillhelppreventandcureillness,andpromoteimprovedhealthandwellbeinginNorthernIreland,IrelandandIrishcross-borderareas.Itwillalsoenhanceall-Irelandpartnershipsforresearchersandhealthprofessionals.
27https://www.hrb-crci.ie/28https://www.crdi.ie/29https://www.hrb-tmrn.ie/30http://www.cancertrials.ie/
Research Activity in the HSE and its Funded Organisations
69
6. A
ctivity Indica
tor 4
6.2. Collaborative Clinical Research Networks
Thefocusoftheseclinicalnetworksismainlyonattractingcliniciansandotherprofessionalsinterestedinaparticulardiseaseortopicforthepurposeofimprovingunderstanding,andthesharingofknowledgeandresearchexpertise.Theycanalsobefocusedonthedevelopmentofdiseaseregistriesorbiobanks.Table9includesfurtherdetailonthesenetworks*.
Table9:CollaborativeClinicalResearchNetworks
PrimaryTopic
NetworkName/Acronym/Start Date
Membership Core funding
Aim
Neurology/Pain
Irish Pain Research Network(IPRN)
2015
Healthcareprofessionals and scientists,withexpertise in pain management.
Irish Pain Society and other funders.
Thisnetworkaimstobringtogetherallactive pain researchers on the island of Ireland(NorthandSouth)forthepurposesofsharingresearchresultsandideasandfacilitatingcross-institutionalcollaborationin the area of pain research.
MentalHealth
Irish Psychosis Research Network(IPRN)
RCSI,TCD,StPatrick’sHospital,UCC,NUIGalway,QUBandUCD.
RCSI,SFIandHRB.
Thenetworkaimstosharecurrentknowledgeandnewdiscoveriesaboutthecausesof,andtreatmentfor,psychoticdisorders. Research areas include disordersthataffectperception,cognitionandmoodinwaysthatarechallengingand,attimes,disablingforthoseaffected.
Diabetes GalwayDiabetes Research Centre (GDRC)
2012
NUIGalwayandSaolta University HealthCareGroup.
SFIandHRBs.
The centre is a hub for collaborative effortofresearchersandclinicians,withapassionforthiswork,toprovideagreaterunderstandingofhowdiabetesdevelopsandtheunderlyingmechanisms,thedevelopmentofnewandbettertherapiesforpatients,andassessinghealthcareinterventions and delivery for patients.
Arthritis Arthritis Research Coalition
2016
SVUH,GUH,LUH,OLCHC,MaterHospital,CUHandBeaumontHospital.
Arthritis Ireland and theHRB–CRCI.
The primary aim of the biobank is to recruitpatientswithcommonrheumaticdiseases,andtoobtainbio-samplesthatwillunderpinclinicalresearch.Asecondary aim is to increase national involvement in clinical trials of novel therapeuticagents.
Research Activity in the HSE and its Funded Organisations
*Healthresearchnetworksorcentreswithamorebasicresearch,translationaloracademicfocus,patient-lednetworks,professionalbodynetworksoracademicresearchcentresareoutsidethescopeofthisreport.
7. Conclusions
ThisreportisthefirstbenchmarkofresearchactivityinpubliclyfundedhealthandsocialcareservicesinIreland.Theprocessofinformationgatheringwaslaboriousandhighlightedthelackofinformationsystemsandinfrastructuretosupportthecollectionofmeaningfulresearchrelatedmetrics.Hence,alargeportionoftheanalysishasbeenpossibleonlythankstothegenerosityofalltheentitiesthatcontributedinformation,suchastheRECs,theHRB,theHPRA,thevariousClinicalTrialNetworks,UniversitiesandofcoursetheHealthServicestaffwhorespondedtothesurvey.
Despitethediversityofdatasets,sometimesincompleteorimperfect,andtheimpossibilityoflinkingthemtoobtainaclearerpicture,thisanalysisprovidesareasonablesnapshotofresearchactivityinthehealthserviceinrecenttimesagainstwhichfutureprogresscanbemeasured.Theinformationhasbeenpresentedaroundfourresearchactivityindicators;people,projects,publicationsandnetworks.Moresophisticatedkeyperformanceindicatorstraditionallyusedforresearchinothersettings(i.e.researchfunding,etc.)couldnotbeusedduetothelackofavailableinformation.
ThisstudyshowsthattheHSEanditsfundedorganisationsareresearchactive.Staffmembersengagedinresearcharedistributedacrosstheserviceinhospitals,thecommunityandcorporateservices,andalthoughthemajorityofresearchactivestaffbelongtotheclinicalprofessions(medicaldoctors,nursesandmidwives,andhealthandsocialcareprofessionals),therearealsoresearchactivestaffamongtheadministrationandmanagementcategories.
Whileresearchactivestaffexistinbothhospitalandcommunitybasedservices(i.e.40%ofstaffsurveyrespondentswerehospitalbasedand31%werecommunitybased),thepeerreviewedpublicationoutput(indexedinScopus)wasmainlyauthoredbyhospitalbasedstaff.Thismayindicatethatcommunity-basedstaffengagedinresearchmaydisseminatetheirresultsviadifferentoutletsratherthanviapeer-reviewpublicationsindexedinScopus(i.e.presentationatconferences,non-peerreviewedpublications,internalreports,etc.),maynotpublishtheirresearchoutputsormaydosobyco-authoringwithhospital-basedstaff.
Thesurveyalsoindicatedthatalargeproportionofrespondents(37%)werefromtheHealthandSocialCareprofessions.However,whenthenumberofrespondentswascomparedtothetotalnumberofprofessionalsineachcategory,theproportionalresponsefrommedicaldoctorswasthehighest.ThismayindicatethatitismorecommonformedicaldoctorstoberesearchactivethanitwouldbeforstaffintheHealthandSocialCareortheNursingandmidwiferyprofessions.
Interestingly,overaquarterofsurveyrespondentswerebasedintheDublinMidlandsHospitalGroup(230)andCHO7(261).DublinMidlandsHospitalGroupwasalsooneoftheHospitalGroupswiththelargestpublicationoutput(withSt.JamesHospitalbeingthetopperformer),togetherwiththeIrelandEastHospitalGroup(withSt.Vincent’sandtheMaterHospitalbeingthetopperformersofthegroup).Understandably,thepublicationoutputofteachinghospitalscloselyassociatedwithuniversitypartnerswasthegreatest.Interestingly,nearlythree-quarterofallpublicationsin2017wereproducedbyninehospitals,andforthemostpart,althoughnotalways,thehospitalswithlargerpublicationoutputalsohadthelargernumberofconsultantswithjointacademicappointments.ThiswasnotthecaseforOurLady’sChildren’sHospitalsCrumlinhowever,whichonlyhadfivejointappointmentsbuthadasignificantpublicationoutput.Ontheotherhand,ConnollyHospitalhad11jointappointmentsbutwasnotoneofthetopninepublicationperformers(i.e.withover100publicationsperyear).
71
7. Conclu
sions
Research Activity in the HSE and its Funded Organisations
Conclu
sions
72
Medicalconsultantswithanacademicappointmentrepresent7%ofallconsultants,butareresponsiblefor37%ofthepublicationofjournalarticlesindexedintheScopusdatabase,andwereinreceiptof30%ofthetotalHRBfundingin2017.Thesejointpoststhereforeappeartobeakeydriverofresearchactivity.Howeverthevastmajorityofhealthservicestaffdonothaveanacademicaffiliation,andhavethereforenoaccesstosupportsofferedbytheacademicsector.Inspiteofthelackofothersupportmechanismsandtimeavailablility,theirinvolvementinresearchandresearchoutputareadmirable;60%ofsurveyrespondentshadnolinkage(formalorotherwise)withtheacademicsector,and63%ofpublicationswereauthoredbystaffwithoutformalacademicappointments.Thesurveyalsoindicatesthatmanystaffcarryoutresearchafterworkinghoursontopoftheirnormalclinicalduties,whichshowsthecommitmentofresearchactivestafftothisactivity.
Themostprevalentresearchtopicnationally,bothforresearchprojectsandforpublicationswas“generichealthrelevance”.Thisisresearchthatisapplicabletoalldiseasesandconditions.CancerwasthesecondmostcommonresearchtopicasdeterminedbyanalysisoftheRECapprovedstudies,regulatedclinicaltrials,HRBawardsandpublications;withmoststudiesrelatingtotheevaluationofcancertreatment.ThismayrelatetotheexistenceofCancerTrialsIreland,whichovertheyearshashadakeyroleinsupportingcancerclinicaltrialsandstudiesinIreland.Cancerwasthesecondmostprevalenttopicofpublicationsfromhospitalbasedstaff,whilementalhealthwastheprioritytopicofpublicationsfromcommunitybasedstaff.
Theanalysisofthedataprovidedbytheresearchethicscommitteesprovidesinterestinginsightsintothevolumeofprojectapprovalsonanannualbasisandthetopicsofinterest.Thisanalysishastobeconsideredinthecontextthatnon-regulatedclinicalstudiesinvolvingmultiplesitesrequiremultipleapprovalsforasingleproject.Halfofallapprovalswererelatedtotheevaluationoftreatmentsandhealthservicesresearch.RegionalanalysisofprojectapprovalsshowedlargedifferencesintheregionalRECserviceprovision:theSouth/South-WestregionreviewedoveraquarterofthetotalnumberofprojectswithonlyoneREC,whiletheEastregionreviewedasimilarnumberofproposalsbuthad20hospitalbasedRECs,andlacksaRECtoreviewCHObasedresearchinthearea.
Duetothefactthatmulti-sitestudiesmustbeapprovedbymultipleRECs,thetotalnumberofprojectapprovalsatnationallevelis,therefore,largerthanthetotalnumberofprojects,whichunfortunatelycouldnotbespecificallydetermined.Asthetotalnumberofapprovalswasover1,800,wecanonlyconcludethatthetotalnumberofprojectsstartingin2017waslessthanthat.Asonly27regulatedclinicaltrialsandnineregulatedclinicalinvestigationscommencedinthatyear,thedataimpliesthatthemajorityoftheprojectsapprovedinvolvednon-HPRAregulatedresearch.
AsimplecomparisonofthenumberofclinicaltrialsinothercountriesofsimilarsizetoIreland,suchasDenmarkandFinland,indicatesthatthereissignificantroomforimprovementinIreland.Overthelast10yearsasignificantamountofinvestmentinthedevelopmentofclinicalresearchnetworksandclinicalresearchinfrastructurehastakenplace,andmuchofthisinvestmenthastakenplaceviatheacademicsector.Asshowninchapter6,asignificantamountofnetworksandinfrastructurecurrentlyexisttosupportclinicalresearch,butyetthehealthserviceisunderperforminginthisregardwhencomparedtoother EU countries.
Research Activity in the HSE and its Funded Organisations
73
Conclu
sions
TheanalysisofEUgrantsinvolvingtheHSEasaparticipantshowsthatthisisamissedopportunity.OnlysixprojectswereawardedtotheHSEin2017,whichreceivedamarginalpartoftheoveralltotalawardedprojectfunding.Also,whiletheHSEisalsoactivelyinvolvedincommissioningresearchrelatedservicesfromthethirdlevelsectorinIreland,only€6millionwasinvestedinthisactivityin2017,whichseemsverysmallconsideringtheevidencerequirementofsuchalargehealthserviceandthelinksthatalreadyexistwiththeuniversitysector.
Overall,thisstudyshowsthatasignificantpercentageofstaffintheHSEanditsfundedorganisationsareresearchactive,andtheoutputscannotbeunderestimated.Despitethefactthatresearchis,byanlarge,notformallyembeddedwithintheprocessofservicedelivery,itisverymuchpartoftheon-goingactivityinthehealthservice,anditcannotbeignored.Thedatainthisstudyshowsthehugepotentialforimpactthatcouldbeleveragedbyaligningresearchactivitytoserviceneeds,inordertoobtainthemaximumbenefitforourhealthservice,andthehealthandwellbeingofourpatientsandthegeneralpopulation.
Research Activity in the HSE and its Funded Organisations
Appendices
Appendix 1: UK HRCS category descriptions
TableA1:UKHealthResearchClassificationSystemHealthCategories
Category Description
1 Blood Haematologicaldiseases,anaemia,clotting(includingthrombosisandvenousembolisms)andnormaldevelopmentandfunctionofplateletsanderythrocytes
2 Cancer Alltypesofneoplasms,includingbenign-malignantcancers(includesleukaemia)
3 Cardiovascular Coronaryheartdisease,diseasesofthevasculatureandcirculationincludingthelymphaticsystem,andnormaldevelopmentandfunctionofthecardiovascular system
4 CongenitalDisorders PhysicalabnormalitiesandsyndromesthatarenotassociatedwithasingletypeofdiseaseorconditionincludingDown’ssyndromeandcysticfibrosis
5 Ear Deafness and normal ear development and function
6 Eye Diseases of the eye and normal eye development and function
7 Infection Diseasescausedbypathogens,acquiredimmunedeficiencysyndrome,sexuallytransmittedinfectionsandstudiesofinfectionandinfectiousagents
8 InflammatoryandImmune System
Rheumatoidarthritis,connectivetissuediseases,autoimmunediseases,allergiesandnormaldevelopmentandfunctionoftheimmunesystem
9 InjuriesandAccidents Fractures,poisoningandburns
10 MentalHealth Depression,schizophrenia,psychosisandpersonalitydisorders,addiction,suicide,anxiety,eatingdisorders,learningdisabilities,autisticspectrumdisordersandstudiesofnormalpsychology,cognitivefunctionandbehaviour
11 MetabolicandEndocrine
Metabolicdisorders(includingDiabetes)andnormaldevelopmentandfunction.Includesallresearchonpineal,thyroid,parathyroid,pituitaryandadrenalglands.
12 Musculoskeletal Osteoporosis,osteoarthritis,muscularandskeletaldisordersandnormalmusculoskeletalandcartilagedevelopmentandfunction
13 Neurological Dementias,transmissiblespongiformencephalopathies,Parkinson’sdisease,neurodegenerativediseases,Alzheimer’sdisease,epilepsy,multiplesclerosisand studies of the normal brain and nervous system
14 Oral and Gastrointestinal
Inflammatoryboweldisease,Crohn’sdisease,diseasesofthemouth,teeth,oesophagus,digestivesystemincludingliverandcolon,andnormaloralandgastrointestinaldevelopmentandfunction
15 RenalandUrogenital Kidneydisease,pelvicinflammatorydisease,renalandgenitaldisorders,andnormaldevelopmentandfunctionofmaleandfemalerenalandurogenitalsystem
16 ReproductiveHealthand Childbirth
Fertility,contraception,abortion,invitrofertilisation,pregnancy,mammaryglanddevelopment,menstruationandmenopause,breastfeeding,antenatalcare,childbirthandcomplicationsofnew-borns
75
Appendix 1
Research Activity in the HSE and its Funded Organisations
Appendix 1
76
Category Description
17 Respiratory Asthma,chronicobstructivepulmonarydisease,respiratorydiseasesandnormal development and function of the respiratory system
18 Skin Dermatologicalconditionsandnormalskindevelopmentandfunction
19 Stroke Includesbothischaemic(bloodclots)andhaemorrhagic(cerebralhaemorrhage)strokes
20 GenericHealthRelevance
Researchapplicabletoalldiseasesandconditionsortogeneralhealthandwellbeingofindividuals.Publichealthresearch,epidemiologyandhealthservicesresearchthatisnotfocusedonspecificconditions.Underpinningbiological,psychosocial,economicormethodologicalstudiesthatarenotspecifictoindividualdiseasesorconditions
21 DisputedAetiologyand Other
Conditionsofunknownordisputedaetiology(suchaschronicfatiguesyndrome/myalgicencephalomyelitis),orresearchthatisnotofgenerichealthrelevanceandnotapplicabletothetop19specifichealthcategorieslisted above
TableA2:UKHealthResearchClassificationSystemResearchActivityCodes
Category Description
1 UnderpinningResearch
Researchthatunderpinsinvestigationsintothecause,development,detection,treatmentandmanagementofdiseases,conditionsandillhealth
2 Aetiology Identificationofdeterminantsthatareinvolvedinthecause,riskordevelopmentofdisease,conditionsandillhealth
3 Prevention of Disease andConditions,andPromotionofWell-Being
Researchaimedattheprimarypreventionofdisease,conditionsorillhealth,orpromotionofwell-being
4 Detection,ScreeningandDiagnosis
Discovery,developmentandevaluationofdiagnostic,prognosticandpredictivemarkersandtechnologies
5 Development of Treatments and Therapeutic Interventions
Discoveryanddevelopmentoftherapeuticinterventionsandtestinginmodelsystemsandpreclinicalsettings
6 Evaluation of Treatments and Therapeutic Interventions
Testingandevaluationoftherapeuticinterventionsinclinical,communityorappliedsettings
7 ManagementofDiseases and Conditions
Researchintoindividualcareneedsandmanagementofdisease,conditionsor ill health
8 HealthandSocialCareServices Research
Research into the provision and delivery of health and social care services,healthpolicyandstudiesofresearchdesign,measurementsandmethodologies
Research Activity in the HSE and its Funded Organisations
77
Appendix 2
Appendix 2: UK HRCS by HSE Region
TableA3:UKHealthResearchClassificationSystem–ResearchCategoriesofRECapprovedstudiesperregion.
HRCSHealthCategories
East* South/South West
West/North-West
Mid-Western
South East
Midlands NorthEast
TOTAL
GenericHealthRelevance
106 111 89 58 14 10 6 393
Cancer 46 70 34 13 12 3 2 180
Reproductive HealthandChildbirth
57 58 17 7 5 3 147
MentalHealth 49 48 34 17 17 9 6 179
Cardiovascular 36 21 53 13 2 1 126
Neurological 48 49 13 5 4 119
MetabolicandEndocrine
30 22 21 12 1 86
Musculoskeletal 29 21 22 3 3 78
Oral and Gastrointestinal
22 23 8 2 55
Infection 25 16 15 5 4 1 66
InflammatoryandImmune System
31 23 10 3 1 1 1 70
Other 12 13 4 2 4 35
Respiratory 12 10 10 3 35
Eye 16 5 5 1 5 32
Blood 14 10 2 2 2 2 32
Renal and Urogenital
9 2 8 4 2 25
Stroke 8 6 7 1 1 23
CongenitalDisorders
16 9 2 5 32
Skin 17 5 7 2 1 32
InjuriesandAccidents
7 4 2 1 14
Ear 7 0 7
NA 4 0 4
597 526 367 157 72 32 21 1772
*StudiesapprovedbyBeaumontHospitalandDaughtersofCharityRECsnotincluded.
Research Activity in the HSE and its Funded Organisations
Appendix 3
78
Appendix 3: Clinical Research Facilities (CRFs) and Clinical Research Centres (CRCs)n
TheCRFandCRCprovide“infrastructure,physicalspaceandfacilities,experiencedresearchandspecialistsupportstaffandthenecessaryqualityandoversightprogrammesthatarecriticalforthesuccessfulconductofworld-classpatient-focusedresearch”.ResearchinCRFsandCRCsissupportedbyClinicalResearchCoordinationIreland(TableA4):
Asper2018,thefollowingCRFs/CRCsexist:
• HRBCRFCorkatUniversityCollegeCorkandMercyUniversityHospital
• HRBCRFGalwayatUniversityHospitalGalway
• RoyalCollegeofSurgeonsIrelandCRCatBeaumontHospital
• UniversityCollegeDublinCRCatMaterMisericordiaeUniversityHospitalandSt.Vincent’sUniversityHospital
• WellcomeTrust–HRBCRFatSt.James’sHospital
• NationalChildren’sResearchCentreatOurLady’sChildren’sHospitalCrumlin
• HealthResearchInstitute(HRI)ClinicalResearchSupportUnit(CRSU)attheUniversityofLimerickandUniversityLimerickHospitals
TheCRF/Csarecommittedtoprovidingstate-of-the-artfacilitiesandequipmenttofacilitateresearchinpartnershipwithacademiaandthecommercialsector,inordertogainabetterunderstandingofhowdrugsworkonhumans,andtodeveloplife-enhancingtherapiesthroughclinicaltrialsandbasicresearch.Researchcarriedoutattheselocationsaimstofindbreakthroughsindrugtreatments,foodtherapies,foodsupplementationsandmedicaldevices,whichwillbeconvertedintobetterandsafertreatmentsforpatients.Patient-focusedresearchistopoftheagenda.Theunitsfacilitateawiderangeofresearchersinconductingclinicaltrials,observationalstudiesandthecollectionofbiologicalmaterialsinareassuchasexperimentalmedicine,earlyandlatephaseclinicaltrials,and,studiesbyalliedhealthprofessionals.
Thestructuresandset-upoftheCRFs/Csvaryfrominstitutiontoinstitutionandareoftenco-locatedonahospitalsiteratherthanthemainuniversitycampus.CRFs/Cssupportinstitutionalsponsoredtrials,industry-sponsoredtrials,investigator-ledtrials,regulatedandnon-regulatedtrials.Theysupportavarietyofpersonnelincludinginvestigators,researchers(includingtrialnurses),clinicians,honoraryappointees,projectmanagers,biomedicalengineers,translationalscientists,industrysponsorsandotherresearchsupportstaff.
Research Activity in the HSE and its Funded Organisations
79
Appendix 3
TableA4:AsummaryofClinicalResearchFacilities/CentresacrossIrelandandNorthernIreland
No. Facility/Centre Funder
Institution(s) Established Director Coverage Core Team
Studies
1 HRBClinicalResearch FacilityCork(HRBCRF-C)
HRB/UCC
UCC and MUH,Cork
2011 Professor Joseph Eustace
SouthandSouth-WesternregionsofIrelandwithapopulation of over 1million(greaterMunsterregion)
69 108ActiveStudies
2 HRBClinicalResearch Facility,Galway(HRBCRFG)
HRB
NUIGalway,GUHSaoltaUniversity HealthCareGroup
2008 Professor MartinO’Donnell
West and North regionofIrelandwithapopulationofjustunder1million
58inCRFG
9inCancer Clinical Trials Unit (CCTU)
Non-Oncology:48active studies
CRFGDataManagementand Statistics: 16 active studies
CCTU: Unknown
3 Wellcome TrustHRBClinical Research FacilityatSJH(WellcomeTrustHRBCRFSJH)
Wellcome Trust and the HRB
TCDandSJH 2013 Professor MartinaHennessy
GreaterDublinMidlandsareagenerally.Forsome specialist areasSt.James’sis the National Centre for many specialist services (e.g.Haemophilia,Burns,BoneMarrowTransplant,OesophagealCancer)
23 41 studies currently open to patient recruitment.
53 studies completed and closed since 2013
4 RCSI Clinical Research Centre(RCSICRC)
RCSI
RCSI and BeaumontHospital
2000 Professor Dermot Kenny
GreaterDublin/North East area
30 MajorSupport=40
Research Activity in the HSE and its Funded Organisations
Appendix 3
80
No. Facility/Centre Funder
Institution(s) Established Director Coverage Core Team
Studies
5 UCD Clinical Research Centre(UCDCRC)
HEAinvestment for the initial three years,NowUCD School ofMedicine&LeveragedFunding
UCD,MaterMisericordiaeandSVUH,
National MaternityHospital&Ireland East HospitalGroup
2006 Professor Peter Doran
Dublin/Leinsterand other national tertiary referrals
18Core
22ProjectSpecific
225
6 Children’sClinical Research Unit,NationalChildren’sResearch Centre(NCRC)
Children’sMedicalResearch Foundation(CMRF)
OLCHC(Children’sHealthIrelandfrom January 2019)
NCRC is over 50 years but theChildren’sClinical Research Unit (CCRU)wasestablished in 2010
Professor Colm O'Donnell
OurLady’sChildren’sHospital,Crumlin,withspecificstudies also supported by NCRCstaffatTemple Street Children’sUniversity Hospital,TallaghtUniversity Hospital,UniversityHospitalLimerickandUniversityCollegeHospitalGalway.Centralised clinical research support service is available to all paediatric centres. Per the national paediatric modelofcare,themajorityofquaternaryandtertiary paediatric healthcare services are delivered by OLCHCandTSCUH(Children’sHospitalGroup).
26 131
OLCHC:110(46Haematology/OncologyTrialsUnit)
TSCUH:6
TUH:6
UCHG:1
UHL:8
Research Activity in the HSE and its Funded Organisations
81
Appendix 3
No. Facility/Centre Funder
Institution(s) Established Director Coverage Core Team
Studies
7 HealthResearch Institute Clinical Research Support Unit Limerick(HRICRSU)
UHLandUL
ULHandUL 2014 Professor Rachel Msetfi
Mid-WestregionofIrelandwithapopulationofjustunder400,000
8 Majorsupport=5
Minorsupport=3
8 Wellcome Trust-WolfsonClinical Research Facility(NICRF)
Wellcome Trust and Wolfson Foundation
QUB,TheBelfastHealthandSocial Care Trust,UlsterUniversity and The Northern Ireland HealthandSocial Care Research and Development division
2013 Professor Judy Bradley
Northern Ireland 9F.T.E.
(10Staff)
25 studies inset-up/approved and 47studiesActive/Completed
Research Activity in the HSE and its Funded Organisations
Table
s
82
TableofTables
Table 1: Key research activity indicators 15
Table2: Self-reportedresearchcompetencies 24
Table3: DistributionofCFAApostsperHospitalGroupandHospitals(onlyhospitalswith CFAApostsareshown) 30
Table4: DistributionofCFAAbydiscipline 31
Table5: RECsapproachedforinformationperregionandtimeperiodofdatasetsupplied 37
Table6: RECregionalcoverage(counties,hospitals,CHOorCHOsection) 38
Table7: Studies/collaborationsbyHEI 52
Table8: ClinicaltrialNetworksinIreland 66
Table9: CollaborativeClinicalResearchNetworks 69
TableA1:UKHealthResearchClassificationSystemHealthCategories 75
TableA2:UKHealthResearchClassificationSystemResearchActivityCodes 76
TableA3:UKHealthResearchClassificationSystem–ResearchCategoriesofREC approvedstudiesperregion. 77
TableA4:AsummaryofClinicalResearchFacilities/CentresacrossIrelandandNorthernIreland 79
TableofFigures
Figure1: Placeofworkofrespondents(indicatedasnumberandpercentageofthetotalsample) 19
Figure2: Number(includingpercentage)ofresearchactiverespondentsfromeachhospitalgroup 20
Figure3: Percentage(includingnumber)ofrespondentsbyCHO. 20
Figure4: Percentage(includingnumber)ofrespondentsbyprofession 21
Figure5: Responseratio(totalnumberofrespondentspercategorybytotalnumberofstaff inthatcategory)byprofession 21
Figure6: Number(includingpercentage)ofstaffengagedinresearchbyprofessionand healthservicearea(orlocation) 22
Figure7: Number(includingpercentagewhichrepresentstheproportionwithintheClinical andNon-clinicalgrouping)ofrespondentsbyhighestqualificationlevel 23
Figure8: Percentage(includingnumber)ofclinicalstaffbyhighestqualificationlevel 23
Figure9: Number(includingpercentage)ofrespondentsbyresearchcompetencies 25
Figure10: Number(includingpercentagewhichrepresentsaproportionwithintheHSC,Medical andNursinggroups)ofrespondentsbytypeofresearcherandprofession(clinicaltypes) 26
Figure11: Percentage(includingnumbers)ofrespondentsbytheiracademicactivitiesinHEIs 27
Research Activity in the HSE and its Funded Organisations
83
Table
s
Figure12: Hoursspentonresearchduringtheworkingweekbythenumberofrespondents (percentagesrepresentproportionwithintheclinicalornon-clinicalgrouping) 27
Figure13: Hoursspentonresearchoutsideofworkinghoursbythenumberofrespondents (percentagesrepresentproportionwithintheclinicalornon-clinicalgrouping) 28
Figure14: Hoursspentonresearchinsideandoutsideofworkinghours(percentagesrepresent theproportionofrespondentswithandwithoutanacademicpost) 28
Figure15: Number(including%)ofCFAApostsbyHospitalGroup(basedonprincipleclinicalsite) 30
Figure16: RECregionsusedfortheanalysis 36
Figure17: Numberofproposalsapprovedperregionin2017ornearestyearasindicatedin Table 5 40
Figure18: PercentageandnumbersofRECapprovedstudiesforthesixtophealthcategories nationally 41
Figure19: PercentageandnumberofRECapprovedstudiesforthesixtophealthcategories perregionPercentageandnumbers 41
Figure20: Percentageandnumberofstudiesclassifiedbyresearchactivityintheoverall sample 42
Figure21: Percentageandnumberofstudiesclassifiedbytypeofresearchactivityforthe regionswithmoreannualprojectthroughput 42
Figure22: Percentageandnumberofstudiesclassifiedbytypeofresearchactivityforthe regionswithlessannualprojectthroughput 43
Figure23: PercentageandnumberofstudiesbyhealthcategoriesfromtheICGPandPCRC at national level 43
Figure24: PercentageandnumberofstudiesbyresearchactivityfromtheICGPandPCRC at national level 44
Figure25: NumberofHRBawardsissuedin2017forHealthcareStaffandNon-HealthcareStaff 45
Figure26: AnnualvalueofHRBawardsissuedin2017,forHealthcareStaffand Non-HealthcareStaff 46
Figure27: PercentageandnumberofHRCStop6healthcategoriesforHRBfundedresearch studiesin2017 46
Figure28: PercentageandnumberofHRB-fundedstudiesbyhealthcategoriesbyCFAAs 47
Figure29: PercentageandnumberofIrishclinicaltrialsbythesixmostfrequentHRCShealth categoriesontheEudraCT 50
Figure30: PercentageandnumberofHPRAapprovedclinicalinvestigationsbyHospitalGroup 51
Figure31: PercentageandnumberofHPRAapprovedclinicalinvestigationsbyhealthcategories 51
Figure32: PercentageproportionoffundingbyHEIin2017 53
Figure33: PercentageandnumberofstudiesbytopsixHRCShealthcategories 53
Figure34: PercentageandnumberofstudiesbyHRCSresearchactivitycodes 54
Research Activity in the HSE and its Funded Organisations
Table
s
84
Figure35: Totalnumberofpublicationsbetween2013and2017byHSEHospitals, VoluntaryHospitals,Community&Non-HospitalandTotal 57
Figure36: Comparisonof2017Scopusindexedpublicationsbetweenthehealthservices nationallyandtheuniversitysector. 58
Figure37: Hospitalswithapublicationoutputof100ormorejournalarticlesin2017 58
Figure38: Scopusindexedpublicationoutputperhospitalgroupperyearfrom2013-2017 59
Figure39: PercentageandnumberofScopusindexedpublicationsin2017bytopsix healthcategoriesnationally 60
Figure40: PercentageandnumberofScopusindexedpublicationsin2017classifiedusingthe UKHRCSresearchactivitycodesnationally 60
Figure41: PercentageandnumberofScopusindexedpublicationsin2017bythetopsixhealth categoriesforcommunityandnon-hospitalareas 61
Figure42: PercentageandnumberofScopusindexedpublicationsin2017classifiedusingthe UKHRCSresearchactivitycodesforcommunityandnon-hospitalareas 61
Figure43: PercentageandnumberofScopusindexedpublicationsin2017classifiedbythe topsixhealthcategoriesfortotalhospitals 62
Figure44: PercentageandnumberofScopusindexedpublicationsin2017byresearchactivity codes for total hospitals 62
Figure45: ScopusindexedCFAApublicationsindexedintheScopusdatabasefrom2013to2017 63
Research Activity in the HSE and its Funded Organisations
January 2019
Research & DevelopmentTaighde & Forbairt
Research Activity in the HSE and its Funded Organisations
AM Terrés, MC O’Hara, P Fleming, N Cole, D O’Hanlon, P Manning
A report of staff engaged in research, research studies undertaken, publication output and research networks