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We talk to Dr Ann Van den Bruel, Associate Professor in the Nuffield Department of Primary Care Health Sciences and Director of the NIHR Diagnostic Evidence Cooperative.

Extracted from Issue 23, July 2015 OxfordMedSci News.

Tell us a little about your role

Dr Ann Van den BruelI am a Senior Clinical Research Fellow at the Nuffield Department of Primary Care Health Sciences. I am also the Director of the National Institute for Health Research (NIHR) Diagnostic Evidence Co-operative Oxford, which aims to facilitate the development of new diagnostic tests for primary care. My role is to coordinate and supervise the work being undertaken by our multidisciplinary team of researchers and support staff. In addition, I also run my own studies, which are mostly on diagnostic questions in primary care, and teach diagnostic test evaluation to postgraduates.

Tell us more about the NIHR Diagnostic Evidence Co-operative

Dr Ann Van den Bruel conducting diagnostic testOxford’s Diagnostic Evidence Co-operative has several strands: we produce short reviews on new, promising diagnostic technology in our Horizon Scanning programme. These reviews result in either new studies that are taken forward by researchers in our department, or we suggest topics to funders such as the NIHR Health Technology Assessment (HTA) programme. Secondly, we try to get a better understanding of the clinical needs of primary care clinicians: which tests do they consider useful, or what diagnostic questions are currently not addressed adequately by existing technology? Additionally, we explore the views of patients and clinicians on using new technology: what are the barriers and facilitators? We also investigate the impact new diagnostic technology makes in a new clinical setting (Abingdon’s Emergency Multidisciplinary unit) that cares for elderly patients and uses a lot of new modern diagnostic technology. Finally, our methods team develop new ways to evaluate diagnostic technology.

Dr Ann Van den Bruel conducting diagnostic testIn addition to these research topics, we also meet with diagnostics companies from across the UK to discuss innovative tests that might be relevant to primary care. Companies come and talk to us for a variety of reasons: to get a better understanding of the diagnostic needs of primary care and the requirements of a new test to be useful, to explore collaborative projects in primary care, or to seek advice on implementing new technologies in the NHS.

 

Why is this work important?

Dr Ann Van den Bruel conducting diagnostic testDiagnostic questions are at the heart of primary care. Diagnosing a patient provides a diagnostic label that explains that person’s symptoms. It directs people to the right treatment and provides guidance to clinicians and patients on how the illness might develop. Diagnostic tests are also used to monitor an illness or the treatment of that illness. But diagnostic tests may also introduce harm because they are dangerous in themselves and  also because they could provide incorrect information and lead to wrong treatment decisions. Evaluating the true value of diagnostic tests is therefore important, and these evaluations should be performed in the setting where the test will be used (in our case – in the doctor’s surgery).

Through our work with companies to collect the right type of evidence for their new technologies, we aim to facilitate the development of diagnostic tests that can be successfully implemented in practice, benefiting patient health and the NHS.

What’s currently at the top of your to do list?

I am currently in the midst of preparing a grant application for work to develop and assess different options for managing acutely unwell children in primary care. One of the options will be to introduce a set of point-of-care tests that can support the diagnosis of serious illnesses, such as pneumonia or diabetes.

Are there any collaborations/partnerships you’d like to pursue with colleagues in Oxford?

The Biomedical Engineering Group is doing some great stuff. We have worked on vital signs measurement devices with them in the past. It would be great to present them our wish-list again.

How did you get to where you are today?

Dr Ann Van den Bruel conducting diagnostic testI started my career in Belgium, where I trained as a general practitioner (GP) and obtained my PhD at the University of Leuven. As a postdoctoral researcher, I participated in a European collaboration on the diagnosis of serious infections in children (ERNIE), which introduced me to researchers from the primary care department here in Oxford. They encouraged me to apply for a NIHR Clinical Lecturer post, which lead to my position here now.

 

Who or what inspires you, and what is life like outside of work?

Although I am no longer in clinical practice, trying to improve how we can manage patients’ health problems has always been my main driver for being in research. In addition, there are many great researchers whom I greatly admire, including my own team. I get a lot of energy from working as a team and feel very fortunate with the people who I work with. When I’m not at work, I enjoy spending time with my family of four children, who always succeed in introducing me to new things.

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