Which skin diseases will be included and who will carry out the work ?
Good quality research into skin disease treatments is limited, even though they affect 25% of the population, and are the 4th most common reason why people go to their GP. This proposal comes from a team of health care workers, patients and researchers who already have a strong track record in giving the NHS high quality and unbiased information about treatments for skin diseases. Many of the team are based at the Centre for Evidence based Dermatology in Nottingham which is also home to the Uk Dermatology Clinical Trials Network. They will focus on just four of the 1,000 skin diseases: childhood eczema (which now affects 20% of UK children); vitiligo (which causes disfiguring white patches); squamous cell skin cancer (a common skin cancer that is on the rise); and pyoderma gangrenosum (a painful and mutilating condition that we don´t know how best to treat).
How the research will be conducted?
They are going to use a range of research methods to provide answers to the NHS about uncertainties for treating these 4 diseases, starting with systematic reviews of studies already done. These reviews will be carried out in a systematic way to reduce bias. They will show up a number of important research gaps for clinical trials, which need prioritising into those that patients and health care workers think are important. The team will work with an organisation called the James Lind Alliance to do this. Applications will have to made to the NHS HTA Programme for these trials to be funded, after completing some important pilot studies to sort out practical problems and to see if enough patients can be recruited. The preparatory work has already been done to run a national trial on treatments for pyoderma gangrenosum so that trial will be completed during the 5 year project. Once systematic reviews on eczema are done, the team will create and continuously update a national collection of all eczema trial reports and make these freely available for others to use in new reviews and for informing guidelines. This will save future researchers a lot of time. With regard to vitiligo there have been several new trials published since the first systematic review was published in 2006. They will update that review to establish gaps and help to prioritise which treatments for vitiligo should be studied in clinical trials. The involvement of the Vitiligo Society and people with vitiligo will be crucial to this process and the Society's website will keep you abreast of developments and how you can help.
Expected results of the research.
For each of the four skin diseases, we will produce detailed web-based information resources for patients, plus decision aids to help doctors and patients make shared, informed choices about treatments. We will also set up talks with the pharmaceutical industry to find better ways to help them develop new treatments for skin diseases in the NHS. For vitiligo this will mean a well conducted randomised trial and the possibility of a better evidence base for a treatment which could be specifically licensed for vitiligo. To build NHS research capacity, training will be given to 3 NHS researchers to do a higher degree and supportprovided for clinicians who wish to take part in the research. |
