Posted by: ayrshirehealth | June 25, 2014

Clinical research – SHARE by @waelagur

Research why bother?

While some interventions and treatments are evidence-based, many still lack such evidence despite being common practice. Clinical judgement, person-centeredness and use of best available evidence are the 3 principles underpinning best practice. Evidence triadUnnecessary variations stem from prior training opportunities, availability of treatment as well as individual clinician’s preferences or can we say prejudices? Reduction of such variations is a function of evidence-based guidelines that come about following robust clinical research studies. Helping with current research studies must be a noble and honourable cause. 

Research study in a busy life?

Incorporating research into busy clinical life can be difficult. After all, we are already busy professionals so why add more work? Sometimes we forget that new and better treatments and improvements today are largely a result of commitments of past professionals to synthesise evidence through research. Research requires time with patients to explain the study and explore individual preferences. A working team including Research & Development (R&D) nurses, fellows and assistants is invaluable to incorporate studies into our busy clinical settings. Scotland’s Chief Scientist Office supports local R&Ds through extensive research networks including NHS Research Scotland.

 The Equipoise

After years of ‘standard practice’, to conduct a study comparing the standard to something new, one should be standing at equal distance between the two options. ScalesWith equipoise restored, one is to remain confident and comfortable expressing a degree of uncertainty about the best treatment options for patients, who have no doubt that ‘doctor knows best’.

Important to remember that, for most patients, participating in trials has many advantages including more contact with the health service and professionals and more ownership of treatment, in addition to the possible placebo effect.

What to research?

While a researcher’s imagination can be unlimited, there are disease areas that are far more important to patients and NHS than others. Two hundred and fifty years ago, James Lind – the Scottish naval surgeon – chose to confront the uncertainties surrounding the deadly disease scurvy. His clinical trial of 6 proposed remedies concluded that oranges and lemons were dramatically better than others. JamesLind

Today, the James Lind Alliance (JLA) facilitates priority setting partnerships of patients, carers and clinicians to identify and prioritise for research the treatment uncertainties which they agree are the most important. Research funding can then be targeted to such prioritised uncertainties, the top-tens in many medical fields (

The biggest hurdle

Recruitment remains the most challenging aspect of running a research project. In a review of a cohort of multicentre trials funded by two public bodies: the UK Medical Research Council (MRC) and the Health Technology Assessment (HTA) Programme, less than a third (31%) of the trials achieved their original recruitment target and half (53%) were awarded an extension. This could impact the validity and generalisability of results and may not be good value for tax-payers money. While only 10% of UK population, Scotland receives 15% of UK health research funding. Across Scotland, 10% more people took part in health research studies in 2012/13 compared to the previous year. The Scottish Government aims to build on this to recruit up to one million people to SHARE.


SHARE is The Scottish Health Research Confidential Register, an NHS Research Scotland initiative for people interested in participating in health research. SHARE will use the coded data in various NHS computer records to check whether individuals might be suitable for health research studies. Such register opens up the whole country for endless research possibilities. SHAREFor example, a researcher in Dundee will find a potentially eligible participant in Ayrshire for an asthma study who will then be asked for possible participation. This country-wide access can be incredibly useful when it comes to developing new treatments and cures for a wide variety of health conditions.

The SHARE register is open to everyone, from the healthiest to the most unwell. It takes a minute to join and you might be invited to take part in a health research study in the future. It would be up to you at the time to decide if you wanted to participate.

Recruit and get yourself recruited to help shape better treatment for our generation and the next. To help build on Scotland’s strong tradition of health research that has led to many medical breakthroughs for patients world-wide.

This week’s blog was by @waelagur (Wael Agur), Lead Urogynaecologist, NHS Ayrshire & Arran |Career Fellow, NHS Research Scotland | Honorary Senior Clinical Lecturer, University of Glasgow.



  1. […] call for involvement in “Clinical Research – SHARE” was the topic tackled by Dr Wael Agur (@waelagur) on the Ayrshirehealth […]

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