Medical research studies are often conducted in samples of participants that are not representative of the general population. Self-selected cohorts that rely on opt-in consent are known to differ from the general population, with fewer ethnic minority, socioeconomically deprived, less educated and poorer health participants. When systematic differences between those included in a study and the population of interest exist, the study results are likely to be biased, not generalisable, and have limited relevance to the general population. Any bias conclusions and recommendations made by the research may not apply to under-represented groups, which could result in them receiving sub-optimal health care. Representativeness is essential for accurate, unbiased, generalisable, and relevant medical research, and to avoid vulnerable people being overlooked for important benefits and be spared from identified harms.
This PhD aims to determine how statistical methods can be used to correct results from published consenting cohort studies to be more generalisable to the wider and more diverse population. The ethnic representation in COVID-19 research will be used as an applied case study to demonstrate and assess the methods. The student will conduct an in-depth systematic review to assess ethnic representation of COVID-19 consented cohort studies in the UK, and compare key demographics to the general population using UK census data. The student will identify existing statistical approaches for improving study generalisability and modify these to utilise aggregate data found in research publications. The modified approaches will be applied using existing study data to assess the impact of ethnicity and COVID-19 in healthcare workers. The approaches will be further tested using simulated data covering multiple potential scenarios.
The student will:
- Develop multiple essential research skills including; systematic review, methods development, application and assessment of methods, and writing for peer-reviewed publication.
- Contribute to broader research priorities of improving health of the general population.
- Gain experience working within, and being supported by, a multidisciplinary team with external collaborations and established PPI group.
United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK- REACH): a retrospective cohort study using linked routinely collected data, study protocol, Lucy Teece, Laura J Gray, Carl Melbourne, Chris Orton, David V Ford, Christopher A Martin, David McAllister, Kamlesh Khunti, Martin Tobin, Catherine John, Keith R Abrams, Manish Pareek & The UK- REACH Study Collaborative Group, BMJ Open.
Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study. Woolf K, McManus IC, Martin CA, Nellums LB, Guyatt AL, Melbourne C, Bryant L, Gogoi M, Wobi F, Al-Oraibi A, Hassan O, Gupta A, John C, Tobin MD, Carr S, Simpson S, Gregary B, Aujayeb A, Zingwe S, Reza R, Gray LJ, Khunti K, Pareek M; UK-REACH Study Collaborative Group. Lancet Reg Health Eur.
The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH): protocol for a prospective longitudinal cohort study of healthcare and ancillary workers in UK healthcare settings. Woolf K, Melbourne C, Bryant L, Guyatt AL, McManus IC, Gupta A, Free RC, Nellums L, Carr S, John C, Martin CA, Wain LV, Gray LJ, Garwood C, Modhwadia V, Abrams KR, Tobin MD, Khunti K, Pareek M; UK-REACH Study Collaborative Group. BMJ Open.
Ethnicity and clinical outcomes in COVID-19: A systematic review and meta-analysis. Sze S, Pan D, Nevill CR, Gray LJ, Martin CA, Nazareth J, Minhas JS, Divall P, Khunti K, Abrams KR, Nellums LB, Pareek M. EClinicalMedicine.