Research Overview
Marion’s main research interests are in the design, conduct and analysis of clinical trials especially complex trial design and the design and conduct of surgical and device trials. She has also published widely on clinical trials methodology including on cluster randomised trials, design of trials of non-pharmacological interventions, pragmatic trials and trials reporting.
Some examples of current and recent research include:
REINFORCE: The NIHR-funded REINFORCE study aims to evaluation the introduction and scale up of robot-assisted surgery across the NHS. Further information is available at: https://www.abdn.ac.uk/hsru/what-we-do/research/projects/reinforce-291
UK-REBOA: The NIHR-funded UK-REBOA trial aims to establish the clinical and cost-effectiveness of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), in addition to standard major trauma centre treatment, for the treatment of patients with life-threatening torso haemorrhage. The trial results have been published in JAMA (https://jamanetwork.com/journals/jama/fullarticle/2810757) and found that REBOA did not reduce and may increase mortality.
TOPKAT: The NIHR-funded TOPKAT trial is investigating the clinical and cost effectiveness of partial (PKR) vs total (THR) knee replacements. The trial recruited 528 patients from across the UK. Five year results have been published in the Lancet (https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)31281-4/fulltext) and showed that PKR has similar, if not a slightly better clinical outcome than TKR. More importantly, the economic benefit of using PKR is substantial. Patients are now being followed up to 10 years.
CLASS: The NIHR-funded CLASS trial is assessing the clinical and cost-effectiveness of three treatment modalities for the treatment of varicose veins: a) foam; b) EVLA with subsequent foam to varicosities when required; and c) surgery. A total of 798 adult patients were recruited into the trial and randomised to one of the treatment options. Early results (http://www.nejm.org/doi/full/10.1056/NEJMoa1400781) and five year follow-up results (https://www.nejm.org/doi/full/10.1056/NEJMoa1805186 were published in the New England Journal of Medicine.
KAT: The NIHR-funded KAT trial, explores different knee replacement surgery options (the effects of patellar resurfacing, mobile bearings and metal backing were investigated). A total of 116 surgeons in 34 UK centres participated and 2352 participants were randomised. Ten year outcomes were previously published (https://www.journalslibrary.nihr.ac.uk/hta/hta18190/#/abstract); long term follow up to 20 years is underway.