Dr Steven MacLennan

Biography

Steven is a Research Fellow in the Academic Urology Unit at the University of Aberdeen. His research themes cover the broad spectrum of evidence-based medicine in urology. This encompasses assessing the effectiveness of treatments in clinical trials, developing core outcome sets, providing critical reviews of the evidence base, creating evidence-based (or where necessary consensus-based) clinical practice guidelines, and implementing guideline recommendations in clinical practice. Steven is a member of the European Association of Urology (EAU) methodology committee which oversees the quality of the EAU’s systematic review and clinical practice guideline programme and delivers training on core evidence-based medicine skills in systematic reviews and guideline production. He is also a founding member of the IMpact Assessment of Guidelines Implementation and Education (IMAGINE) group which aims to assess current variations in practice, investigate barriers and facilitators to guideline adherent practice, and improve adherence to strong, high level of evidence, guideline recommendations. Prostate Cancer DIagnOsis and TreatmeNt Enhancement through the Power of Big Data in EuRope (PIONEER) is one of Steven’s recent projects, where his heaviest involvement is in the work to help standardise outcome definitions across all stages of disease to support the Big Data analysis work and improve the consistency of outcome reporting, outcome definition and measurement in future clinical trials and clinical audit.

Research Overview

An overview of current projects: 

Core Outcome Set Development Projects

Renal Cancer Core Outcome Sets (R-COS)

In this project, part funded by the Arcobaleno Cancer Trust and NHS Grampian Endowments, we are developing three seperate Core Outcome Sets (COS) for localised, locally advanced, and metastatic stages of kidney cancer. This includes two systematic reviews, an interview study and three Delphi studies. The COMET registration, giving full study details is accessible here: https://www.comet-initiative.org/studies/details/1406  

Bladder Cancer Core Outcome Sets (B-COS) 

In this project, we are developing Core Outcome Sets for the various stages of bladder cancer. Forming the initial statge of the project, we published an article reviewing outcome reporting heterogeneity in non-muscle invasive bladder cancer - accessible here: https://content.iospress.com/articles/bladder-cancer/blc201510

The COMET registration, giving full study details is availabe here: https://www.comet-initiative.org/studies/details/1135

Prostate Cancer Core Outcome Sets

We devleoped a COS for localised prostate cancer. The results can be accessed here: https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1111/bju.13854

Our prostate cancer COS work was subsequently updated and incorporated in the PIONEER project. More detail about PIONEER can be viewed here: https://prostate-pioneer.eu/

Implementation Science Projects

IMAGINE (IMpact Assessment of Guidelines Implementation and Education)

IMAGINE is a European Association of Urology (EAU) working group focussing on  mapping adherence to EAU guidelines and, where variation or suboptimal practice is identified, investigating the barriers and facilitators to guideline adherence, and developing implementation interventions to adress the barriers and leverage the facilitators. You can read more about the IMAGINE group in this editorial

RESECT (Transurethral REsection and Single instillation intra-vesical chemotherapy Evaluation in bladder Cancer Treatment (RESECT) Improving quality in TURBT surgery.)

RESECT is a collaborative project with the British Urology Researchers in Surgical Training (BURST) group, including researchers from the Academic Urology Unit and HSRU. A main aim of RESECT is to test intereventions aimed at improving adherence to guidelines around single instilation of chemotherapy adn documentation of the procudure - which have been shown to be associated with improved patient outcomes. You can read more about RESECT here: https://www.bursturology.com/Studies/Resect/Overview/

OPTIMA (OPtimal Treatment for patients wiht solid tumours in Europe through Artificial Intelligence)

OPTIMA is a 34 partners-based  IMI project. The programme aim is to design, develop and deliver the first interoperable and GDPR-compliant European real-world oncology data and evidence generation platform based on the needs of the clinicians and patients, in an inclusive and sustainable way. It will be built on a combination of federated and centralised access to a vast network of European data providers to help answer the highest priority research questions in prostate, breast and lung cancer, especially where current existing evidence underpinning clinical practice guidelines is weak.  In parallel, comprehensive decision support toolsets based on national and international guidelines with approved regular updates of guideline recommendations underpinned by evidence from advanced statistical analysis and AI will be made available to fill the guidelines gaps and better support shared decision making by clinicians and patients.

Deimplementing ADT

There is evidence to suggest that Androgen Deprivation Therapy (ADT) is overused in men with localised prostate cancer. it is unclear why, and it is unclear what the best strategies for deimplementing ADT are. This reserach problem is the focus of Jennifer Dunsmore's PhD project, which Steven is supervising. You can read more about Jennifer and her reserach here: https://www.abdn.ac.uk/iahs/research/urology/metis/profiles/j.dunsmore.19

Guideline Development Projects 

Steven sits on the European Association of Urology (EAU) Guidelines Office Methodology Committee. This committee oversees the training of Guidelines Associates through Systematic Review workshops. 

EVOLVE (giving patients a meaningful voice in the design and delivery of care)

EVOLVE is a unique collaboration of a profession society (European Association of Urology), guideline panels, researchers, clinicians and patient representatives to improve guideline development and implementation for genitourinary cancers in Europe.  The aim of the project is to develop a model of patient involvement that will give patients a meaningful voice in the design and delivery of care and will investigate how wider stakeholders can help to integrate the patient voice into guidelines. You can read more about EVOLVE here: https://www.abdn.ac.uk/iahs/research/urology/metis/evolve-1618.php

Teaching Responsibilities

Steven contributes to the design, delivery and assessment of the MSc. level courses in the Institute of Applied Health Sciences linked above. He also supervises MSc. dissertations and often supervises medical student summer placements in the Aberdeen Summer Research Scholarship (ASRS) programme. 

Steven currently supervises two PhD. projects and is intersted in supervising any project aligning with his broad interests in the desing and delivery of urology health services.   

Non-course Teaching Responsibilities

Alongside formal teaching at the University of Aberdeen, Steven and his colleagues also developed a 2.5 day course for the European Association of Urology (EAU) on systematic reviews for clinical practice guidelines. 

Steven also teaches the systematic review element for the European Organisaiton for Research and Treatment of Cancer (EORTC) 'clinical trial statistics for non-statisticians' course. https://event.eortc.org/stats2021/