Bonus For GPs If Patients Join Drug Trials In Plan To Lure Firms To NHS
The title of this post, is the same as that of this article on The Times.
This is the sub-heading.
£650m boost for medical research after number of participants slumps
These three paragraphs outline what is to be done.
Tens of thousands more patients will be signed up for clinical trials as ministers promise drug companies better access to the NHS to expand the economy and develop cutting-edge treatments.
Jeremy Hunt, the chancellor, is promising a £650 million package to boost life sciences as he attempts to lure pharmaceutical giants to Britain.
GPs will be offered financial incentives to recruit patients into trials of new treatments and hospitals will be given research targets under plans to reverse a slump in clinical testing while the NHS struggles with the backlog from Covid-19.
It all sounds good to me.
I have been involved in several trials and medical research projects.
- As part of my coeliac disease diagnosis, one endoscopy was performed by Rebecca Fitzgerald at Cambridge, as she was taking samples of bile fluids for her research into Barrett’s esophagus.
- After the death of my wife, I was interviewed by PhD students in the Psychology Department at Liverpool University for their research into widowhood.
- Oxford University interviewed me on diet for their coeliac disease research.
- After my stroke, I spent an entertaining afternoon at the University of East London doing balance tests by computer. Their aim was to develop a reliable balance test for stroke and other patients, that could be carried out by physiotherapists quickly, than by more expensive doctors.
- I have also been on a drug trial at Queen Mary University, but that drug was useless and had no good or bad affects, so the trial was halted. However, it did lead to other enjoyable activities in the field of patient relations with treatment and research.
As a confirmed coward, I should note that with the exception of the drug trial, all of the other projects were low risk.
I should say, that I also sponsor pancreatic cancer research at Liverpool University, in memory of my son, who died from the disease. I wrote about the first Liverpool project in There’s More To Liverpool Than Football And The Beatles!.
A Database Of Projects Open For Volunteers
I believe that this is needed, so that those like me, who like to contribute to research can volunteer.
Perhaps some of the £650 million, that has been promised by Jeremy Hunt, could be used to create the database.
I also believe the database could be used for other non-medical research.
Coeliac Journey Through Covid-19 – Medical Research
Medical Research
I first got involved as a lab-rat in medical research, when I had my second endoscopy to check for coeliac disease at Addenbrooke’s Hospital in 1997. Rebecca Fitzgerald took a sample of fluid from my gut for her Barrett’s oesophagus research.
After my wife died, I asked my contact in Alumni Relations at Liverpool University, if they did widowhood research.
They are one of the few universities that do and I did several interviews for PhD students in the unit, which is in the Psychology Department. It was very much a positive experience and certainly helped with my grieving.
In some ways the most enjoyable piece of research I have been involved in, was at the University of East London, where they were using computers to measure the balance of those recovering from strokes.
My GP also suggested that I get involved in drug tests at Queen Mary University. The tests were abandoned as the drug didn’t have any good or bad effects, but now I’m one of the William Harvey Centre’s lab-rats.
I also help to sponsor pancreatic cancer research at Liverpool University in memory of my son.
In There’s More To Liverpool Than Football And The Beatles!, I detail some research, that I sponsored in a small way.
I may be tempted to do the fund-raising trip again.
I always advise people to get involved in medical or psychological research, as I have found it such a beneficial experience.
One thing that is needed, is an on-line database of all research projects that are looking for volunteers.
Remember, that much medical and psychological research is about as dangerous as meeting someone in a GP’s surgery for a chat or perhaps in a cafe and having a coffee.
Coeliac Journey Through Covid-19 – Coeliac Diagnosis
Coeliac Diagnosis
My health was very variable as a child.
I would often have months off school and my health only really improved, when my parents bought a second home in Felixstowe, where we spent most of our holidays.
Perhaps it was the sea air, as going to Liverpool University didn’t seem to adversely affect my health.
I had been having gut problems for years and then in Autumn 1997, I didn’t see my GP, but a very elderly locum, who as I had recently had my fiftieth birthday, gave me a present of my first blood test.
It turned out that I was very low on B12 and a course of B12 injections was arranged.
As the injections didn’t raise my levels, an appointment was made to see a consultant at Addenbrooke’s Hospital in Cambridge.
It was a Monday, when I went to the appointment and after a quick chat and no examination, the consultant said that they would take some blood. Which they did!
Within forty-eight hours a letter arrived on my door-mat saying that I was probably coeliac and it would be confirmed by endoscopy.
Two endoscopies without sedative or anaesthetic were performed and I was confirmed as coeliac.
The first was performed by Dr. Richard Hardwick and the second by Dr. Rebecca Fitzgerald.
My gut health has been better since, I’ve been on a gluten-free diet, backed up by three-monthly B12 injections.
A few years later, I was talking to a gastroenterologist in Cambridge and he told me that he thought he had more coeliac patients than any other in England.
The manager of Carluccio’s in the city, also told me that they sold a very high percentage of gluten-free food.
Were Cambridge testing a genetic test for coeliac disease or was it just a Whack-A-Coeliac policy?
They certainly had everything geared up for high-speed diagnosis. They even did the endoscopies without a sedative, so they didn’t need any recovery beds.
High Risk Of Coeliac Disease In Punjabis. Epidemiological Study In The South Asian And European Populations Of Leicestershire
The title of this post, is the same as that of this peer-reviewed paper on PubMed.gov.
This is the abstract of the paper.
The purpose of this study was to measure the incidence of coeliac disease in different ethnic communities and investigate the hypothesis that the incidence is decreasing in most European countries and the role incomplete retrieval of data may play. In a retrospective study of histologically confirmed cases of coeliac disease between 1975 and 1989 in the City of Leicester, 106 patients with coeliac disease were identified. Of these 86 were European and 20 Asian. The overall incidence of coeliac disease in Europeans was 2.5/10(5)/year (95% CI 2-3.2), in Gujaratis 0.9/10(5)/year (95% CI 0.4-1.8), and in Punjabis 6.9 (95% CI 3.2-12.3). These differences were independent of religious belief. The relative risk to Punjabis compared with Europeans is 2.9 (95% CI 1.5-5.3; chi 2 = 12.5, p < 0.01) and to Gujaratis 8.1 (95% CI 3-22.4; chi 2 = 25; p < 0.001). Gujaratis were at 0.4 risk of Europeans (90% CI 0.2-0.8; chi 2 = 6.7; p < 0.01). The incidence in the urban populations of Leicester was 6/10(5)/year (95% CI 1.3-1.9) which was significantly lower than the 3.2/10(5)/year (95% CI 2.7-3.8; chi 2 = 5.6; p < 0.001) in surrounding rural areas. This study shows that the incidence of coeliac disease in Punjabis (Sikhs, Hindus and Muslims) is 8 times higher than in Gujaratis (Hindus and Muslims) and 4 times higher than in Europeans in Leicester.
I find the last sentence in particular very significant.
I’m no medic, but I think it is reasonable to assume, that in a particular community for every diagnosed coeliac, there will be several undiagnosed coeliacs out there.
In this overview of coeliac disease on the NHS web site, this is said about the incidence of coeliac disease.
Coeliac disease is a condition that affects at least 1 in every 100 people in the UK.
But some experts think this may be underestimated because milder cases may go undiagnosed or be misdiagnosed as other digestive conditions, such as irritable bowel syndrome (IBS).
Reported cases of coeliac disease are around 3 times higher in women than men.
The one-in-100 figure is often used in web pages in European countries or Australia, Canada and the United States, so I’ll go along with that.
So does that mean that Punjabis living in Leicester, have a one-in-twenty-five likelihood of being coeliac?
Whether you have been diagnosed though, is a matter of pure luck.
I had been having gut problems for years and then one Autumn, I didn’t see my GP, but a very elderly locum, who as I had recently had my fiftieth birthday, gave me a present of my first blood test.
It turned out my B12 levels were very low and after several months of B12 injections, which made little difference to my B12, my GP decided to send me to a consultant at Addenbrooke’s Hospital in Cambridge.
My appointment was on a Monday morning and consultant took about ten minutes to ask a few questions, after which he said they would take a few bloods.
On the Wednesday morning, I received a letter that said, that I was probably suffering from coeliac disease and this would be confirmed by endoscopy.
Was I diagnosed solely by analysis of my blood? This was in 1997, which is after the date of the Leicester study.
Two endoscopies without sedative or anaesthetic were performed and I was confirmed as coeliac.
The first was performed by Dr. Richard Hardwick and the second by Dr. Rebecca Fitzgerald.
Both doctors feature in this story on the Cambridge University Hospitals web site, which is entitled Familial Gastric Cancer – Case Study.
My problems have been minor compared to the two sisters in the story.
My luck had been good and I recommend that everyone who feels they could be coeliac should get themselves tested.
Cases Of Covid-19 In Leicestershire
This article on the Leicester Mercury is entitled 11 Areas Of Leicestershire Have Among Worst Infection Rates in the UK.
In Coeliac Disease: Can We Avert The Impending Epidemic In India?, I started like this.
The title of this post, is the same as that of this article on the Indian Journal Of Research Medicine.
With the high levels of COVID-19 in Leicester and an Indian population who make up 28.3 % of the population of the city, I was searching the internet to see if there was any connection between those of Indian heritage and coeliac disease.
I know you should not try to prove a theory. But as a coeliac, I’m very interested to see how the millions of diagnosed coeliacs on a gluten-free diet like me, are faring in this pandemic.
I then talk about some extracts from the Indian research.
In a section entitled, which is entitled All Wheats Are Not Equal, I say this.
The other dimension to this problem is that not all wheat is alike when it comes to inducing celiac disease. The ancient or diploid wheats (e.g. Triticum monococcum) are poorly antigenic, while the modern hexaploid wheats e.g. Triticum aestivum) have highly antigenic glutens, more capable of inducing celiac disease in India, for centuries, grew diploid and later tetraploid wheat which is less antigenic, while hexaploid wheat used in making bread is recently introduced. Thus a change back to older varieties of wheat may have public health consequences.
So did all these factors come together to create the high levels of Covid-19 in Leicestershire?
Conclusion
I am getting bored with saying this. More research needs to be done!
The Anonymous Widower 