Professor James N'Dow

Biography

James N’Dow is Director of the Academic Urology Unit since its establishment in 2001. His research activity spans across evidence synthesis, trials, guideline development, implementation science and the use of big data to complement traditional trial data. He has consistently secured significant funding for research totalling over £43 million over the past 20 years; including being the Coordinator of two large EU IMI funded big data for better outcomes projects. He is Coordinator of the €12M EU IMI funded 5 year project on prostate cancer big data (https://prostate-pioneer.eu/), a large European Multidisciplinary Consortium of 35 partners from 9 countries to harness the power of Big data to inform clinical practice recommendations. He recently successfully coordinated a second €21.3M EU IMI funded large consortium of 36 partners called OPTIMA researching three solid cancers (Prostate, Breast and Lung cancers).

He was Coordinating Editor of the Cochrane Incontinence Review Group and has a track record in delivering NIHR funded national trials in urology. He is co-lead for the recently funded British Association of Urological Surgeons TUF Trials Unit awarded to CHaRT. Appointed Chair of European Association of Urology Guideline Office Board in 2014. Under his leadership, the EAU Guidelines have become the most comprehensive and trusted urological surgical practice guidelines globally, endorsed by 75 countries.

Co-founder and MD of UCAN. UCAN has led 3 fundraising campaigns over the past 15 years, raising over £7 million in philanthropic contributions (cash and in-kind) galvanising the support of the local business community. UCAN funded the opening of the first Urological Cancer Care Centre in Scotland, brought the first robotics surgical system to Scotland as well as contributing £2,517,000 to University of Aberdeen for urological cancer related research. He is also Founder and trustee for Horizons Trust UK charitable trust.

Research Overview

About Urology Trials:

Urology (AUU) has a strong track record of delivering NIHR funded multicentre randomised trials in collaboration with other urologists across the UK as well as uro-gynaecologists and forms a significant proportion of CHaRT’s trial portfolio. Some examples of Urology trials are:

James N’Dow (AUU Director) and Graeme MacLennan (CHaRT Director) are co-Lead for the British Association of Urological Surgeons TUF Trials Unit 3 year award (starting 2021).

 A unique strength has always been AUU’s willingness to support other clinical academic surgeons as aspiring trialists to develop and lead trials themselves thereby building capacity of senior academic surgeons as Chief Investigators. The BAUS TUF Trials Unit allows AUU and CHaRT to support the Urological Community to mentor and develop the next generation of Urological Surgeon trialists. 

About PIONEER:
A €12M EU IMI funded 5 year project on prostate cancer big data (https://prostate-pioneer.eu/), a large European Multidisciplinary Consortium of 35 partners from 9 countries to encourage the global urological community to harness the power of real world (Big) data to inform clinical practice recommendations in the field of Prostate Cancer.

Nature Reviews Urology Publication – Introducing PIONEER https://rdcu.be/cqUmi

PIONEER presents a unique opportunity to contribute to critical patient focussed Pan-European Prostate Cancer research. PIONEER has prioritised 56 unanswered research questions using Delphi consensus methodology with all key stakeholders involved in the prioritisation exercise. Prostate Cancer patients from Grampian, across the UK and from the EU countries were involved.

The EAU Prostate Cancer Guideline panel and other prostate cancer Key Opinion Leaders were consulted to propose the most critical questions in the field of prostate cancer to be answered using big data. A two round Delphi survey including 73 healthcare professionals and 57 patients participated in round one followed by 49 healthcare professionals and 169 patients (including 53 English; 19 French; 31 German; 53 Italian; 13 Spanish) in round two, twelve additional questions were proposed during this first round. 56 questions were finally prioritised to be “critically important”.

Over the next 5 years, we expect to answer 10 prioritised research questions using federated analytics methodologies. To do this, PIONEER has had to map datasets to a common data model (OMOP) to allow reliable comparisons of outcomes across different datasets and countries (PIONEER has over 90 datasets in the pipeline for onboarding onto the PIONEER platform).

PIONEER is also exploring inclusion of hospital EHR data with Grampian (DaSH) being an early pilot centre. Researchers will only access pseudonymised data and no patient level data will be released from the DaSH environment. The results of this research will inform European Prostate cancer clinical practice guidelines.

About OPTIMA:
OPTIMA is a € 21.3 million European Commission Innovative Medicines Initiative funded research on patients with solid tumours leveraging the power of real world data analytics and artificial intelligence (AI). It is a five-year project, involving 36 partners across 13 countries. OPTIMA’s mission is to design, develop and deliver the first interoperable and GDPR-compliant European real-world oncology data and evidence generation platform. To achieve this ambitious goal OPTIMA will:

1. Establish a harmonised large scale real-world evidence data platform for prostate, breast and lung cancer with real-world date covering > 200 million people. The platform will be secure, sustainable and interoperable hosting datasets, data analysis tools, federated learning tools, AI algorithms, and electronic decision support tools.
2. Drive new knowledge generation through advanced analytics and AI-models. OPTIMA will identify and prioritise the main knowledge gaps in prostate, breast and lung cancer. Based on the key unanswered questions in each of the 3 cancer types, OPTIMA will develop specific AI-models to fill knowledge gaps and propose improved guideline recommendations.
3. Develop electronic shared decision support tools. These tools will be based on computer-interpretable guidelines developed by combining declarative AI and clinical care pathways developed from the leading clinical practice guidelines for prostate, breast and lung cancer. The electronic decision support tools will be interfaced with patient electronic health records (EHR).

OPTIMA aims at personalisation of treatment, encompassing the richness of available data by processing high-dimensional data across datasets and sources, and using deep learning to identify the decisive factors that enable personalised, real-time decisions for each individual patient based on the most accurate and complete weighing of available knowledge. If successful in its objectives OPTIMA will also inform policy on a European level when it comes to the clinical deployment of AI algorithms in healthcare.

As academic coordinator for both PIONEER and OPTIMA, there are unique opportunities to expand evidence generation to include incorporation of real world evidence into the evidence profiles underpinning clinical practice guidelines development. This would further cement the Academic Urology Unit and the EAU as leaders in the methodologies of Clinical Practice Guidelines development by incorporating real world data analytics and new evidence informed by AI models.

About Clinical Practice Guidelines and Implementation Science:
Whilst the development and global dissemination of evidence based guidelines was transformative for urological practice, it was clear that adherence to guideline recommendations was still suboptimal and there were potentially a myriad of reasons for non-adherence:

IMAGINE (IMpact Assessment of Guidelines Implementation and Education):
IMAGINE is a Pan-European National Urological Society Implementation Science Collaborative established to monitor clinical practice variation across over 40 European countries, to monitor baseline adherence to guideline recommendations and to identify determinants of non-adherence. IMAGINE will go on to develop knowledge transfer interventions geared to improve adherence. The first pilot has seen adherence data capture relating to treatment of over 6000 patients. To find out more on IMAGINE’s objectives, please see the following editorial and a recent publication. 

Improving guideline adherence in urology  2021 - Accepted/In press European Urology Focus

MacLennan, S., Duncan, E., Skolarus, T. A., Roobol, M. J., Kasivisvanathan, V., Gallagher, K. M., Gandaglia, G., Sakalis, V., Smith, E. J., Plass, K., Ribal, M. J., N'Dow, J., Briganti, A.: 

Collaborations

Extensive collaborations across the world.

National – well connected with Urologists across the UK and strong links with the British Association of Urological Surgeons.

International – having spearheaded the engagement and endorsement of the European Urological clinical practice guidelines by National Urological Societies in 75 countries between 2014 – 2021, a strong network exists across all continents around the globe. As adjunct Secretary General of the EAU responsible for Education, I meet with representatives of all European National Urological Societies few times a year to discuss shared interests and collaborative opportunities.

PIONEER Partners:

 OPTIMA Partners:

1. Stichting EAU Foundation for Urological Research (EAU) NL
2. Lund University (LU) SE
3. Erasmus Universitair Medisch Centrum Rotterdam (EMC) NL
4. Association EISBM (EISBM) FR
5. The University Court of the University of Aberdeen (UoA) UK
6. Tartu Ülikool (TU) EE
7. Universita Vita-Salute San Raffaele (UNISR) IT
8. Queen Mary University of London (QMUL) UK
9. CASUS, Helmholtz-Zentrum Dresden - Rossendorf (HZDR) DE
10. Helios Klinikum Emil von Behring (HC) DE
11. Uppsala University (UU) SE
12. Oxford University (UOXF) UK
13. University of Vienna (UNIVIE) AT
14. European Institute of Oncology (IEO) IT
15.Ludwig-Maximilians-University Munich (LMU) DE
16. University College London (UCL) UK
17. European Organisation for Research and Treatment of Cancer (EORTC) BE
18. Institut de Cancerologie de l’Ouest (ICO) FR
19. Maastricht University (MU) NL
20. Institut Universitari d’Investigacio en Atencio Primaria (IDIAPJGol) ES
21. European Respiratory Society (ERS) CH
22. German Cancer Society (DKG) DE
23. European Lung Foundation (ELF) UK
24. European Cancer Patient Coalition (ECPC) BE
25. ttopstart (TTOP) NL
26. GMV Soluciones Globales de Internet SAU (GMV) ES
27. Information Technology for Translational Medicine (ITTM) LU
28. SmartReporting GMBH (SR) DE
29. Owkin (OWK) FR
30. Arttic Innovation (ART) DE
31. YDEAL software PT
32. Pfizer UK
33. Bayer AG DE
34. Amgen CH
35. Roche CH
36. Abbvie US

Funding and Grants

Non-course Teaching Responsibilities

Trainer of East of Scotland Urology Specialist Registrars.

Provide research training to medical students as part of the Aberdeen Summer Research Scholarship programme (ASRS).

PhD supervisor.

Trainer and mentor of young academic urological surgeons in evidence synthesis methodology and real world data analytics.

Responsible for Education portfolio of European Association of Urology that has a membership of 19,000 urological surgeons.