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Author: Louise Stanley

Simple tool predicts mental health and treatment needs for new inflammatory bowel disease patients

Researchers at BHP founding-members the University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, delivered through the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC), have shown how early use of the IBD Disk questionnaire can help forecast which patients are likely to experience more severe physical and mental health outcomes over the following year.

More than half a million patients in the UK have inflammatory bowel disease (IBD), and research suggests that up to 30% experience mental ill health as a result. Now, a new study outlines how many of the 25,000 new patients diagnosed each year could receive more tailored mental health support thanks to a simple tool that identifies psychological distress and predicts disease severity.

The paper published in Frontiers in Gastroenterology shows how a patient-reported questionnaire called IBD Disk – currently used to track impact of disease on daily life – can also be powerful prediction tool, detecting anxiety and depression symptoms from the outset of a patient’s diagnosis for the inflammatory condition.

The Birmingham study is the first to show that the tool can be used at the point of diagnosis to identify patients at risk of mental health challenges and predict who may need more intensive treatment.

This dual-purpose use – both as a mental health screener and a predictor of disease trajectory – could help clinicians intervene earlier and personalise care for patients more effectively.

Dr Peter Rimmer, lead author of the study, researcher at the University of Birmingham and Consultant Gastroenterologist at University Hospitals Birmingham NHS Foundation Trust said: “This is the first time we’ve shown that the IBD Disk can act as both a mental health screener and a predictive tool for clinical outcomes at the very start of a patient’s journey.

“The findings support the use of the IBD Disk not only as a disability tracker, but as a proactive tool to guide early treatment decisions and mental health support. It’s a simple intervention that could help personalise care and reduce long-term burden on the NHS.”

Mental health conditions more common for IBD patients

Mental health conditions including anxiety and depression are more common in people with established IBD than in the general population, with some studies suggesting that 20-30% of patients are affected by mood disorders.

However, very few studies have been undertaken among patients when they are first diagnosed – at a time when their new IBD symptoms and uncertainty around diagnosis can contribute to psychological distress.

This study found that patients with higher levels of disease-associated physical disability and psychological distress at diagnosis were more likely to need escalating treatments such as stronger medication or surgical interventions, or require an emergency admission to hospital later on – adding to growing evidence that early identification of these symptoms could play a key role in improving long-term outcomes for people with IBD.

The study followed 188 patients attending a rapid-access clinic for suspected IBD who were subsequently diagnosed with either Crohn’s Disease or Ulcerative Colitis. At their first visit – before diagnosis – patients completed the IBD Disk, and a subgroup also completed the Hospital Anxiety and Depression Scale (HADS) to assess mental health. After diagnosis, patients were treated according to standard clinical guidelines and followed for 12 months.

Researchers analysed whether scores on the IBD Disk, particularly in the “Emotions” domain, could identify patients with moderate to severe anxiety or depression symptoms, and whether those scores predicted the need for advanced therapies, hospitalisation, and persistent disease activity.

Statistical analysis showed that an “Emotions” score of 7 or higher was highly correlated with moderate to severe depression symptoms. Patients with higher IBD Disk scores at diagnosis were significantly more likely to experience poor clinical outcomes, especially those with ulcerative colitis. Where medical treatments were not effective and their IBD remained active, patients were more likely to experience ongoing symptoms of psychological distress.

The study involved collaborators from Hoffmann-La Roche, Beaumont Hospital Dublin, and Royal Wolverhampton NHS Trust. Hoffmann-La Roche provided funding for the study and the Roche author participated in manuscript writing, review and editing.

West Midlands Living Lab: connecting healthcare through technology

A new initiative will see researchers work with digital technology leaders and industry to meaningfully impact healthcare services and improve patient outcomes in the Midlands.

The West Midlands Living Lab will explore the use of digital technology to improve patient communication, enable community care, avoid unnecessary hospital admissions, and support a more prevention-based health service.

Working with worldwide technology giant Cisco, BHP founder-member the University of Birmingham will lead the latest of the Lister Alliance Living Labs in the country’s richly diverse second city. With approximately 6.2 million people, and more than 100 languages spoken, the diverse West Midlands population truly reflects the global community. Research conducted in the region will be widely applicable, meaning it provides the ideal test bed.

University Hospitals Birmingham’s Professor Simon Ball, who is also Senior Responsible Officer for the West Midlands Secure Data Environment and co-lead for the living lab said: “The West Midlands is the perfect place to do this innovative work, with our leading researchers bringing together key stakeholders to connect state-of-the-art NHS facilities and uniquely diverse local communities. Working with an industry partner with the capability and reach of Cisco working alongside us is a testament to the scale of our ambition and drive to improve health outcomes using innovative technology and analytics.”

Professor Neil Hanley, Pro Vice Chancellor and Head of College of Medicine and Health, said: “We’re delighted that the University of Birmingham, led by Professor Kotecha, is at the forefront of this collaboration. It was great to attend the recent launch event and inspiring to feel the cross-sector work- the genuine triple helix of universities, public sector and industry – all focussed on stopping readmission to hospital and, in particular, addressing the health inequalities associated with this. Aligning all this with skills, innovation, entrepreneurship and commercialisation really excites me. And of course, with the make-up of Birmingham and the West Midlands being the demographic of the world, lessons learned and experiences gained will be rapidly translatable across the UK and internationally.”

The West Midlands Living Lab, funded by Cisco’s Country Digital Acceleration programme, will take advantage of considerable and unique health data resources, including the West Midlands Secure Data Environment which is connecting health systems across the region, and DaRe2THINK, which provides a national digital clinical trial platform for NHS Primary Care.

Pilot studies are planned to run through community hubs, NHS Primary Care and hospital trusts, looking at how best to break down siloes between existing services and orchestrate better, connected health and social care. Partnerships with community organisations will help address the needs of diverse neighbourhoods and be a blueprint for global benefit.

Professor Dipak Kotecha, School of Medical Sciences, University of Birmingham, said: “Our new living lab focused on health technology will allow us to bring together health data and industry partners to innovate towards better healthcare for all. This includes exploring technologies for remote monitoring, developing AI tools for prediction, improving how people get discharged from hospital, and integrating health data to keep people informed and well in their own homes.

“For example, our previous research, now adopted into the NHS 10-year plan, has shown that wearable devices for health monitoring can provide information similar to that recorded at hospital visits. These early indications show promise for a less hospital-centric and more personalised approach to care, delivered in the community by using new healthtech.”

Declan Hadley, Healthcare Lead, Cisco UKI, said: “We are looking forward to harnessing the creativity, experience and collective capabilities in the West Midlands to improve routine NHS care through technology but also need to be mindful that we don’t exacerbate existing heath inequalities. Living labs are just as much about finding out what does work as what doesn’t, and we plan to achieve this through co-production with local community leaders.”

International initiative to tackle heart health inequalities in cities to be led from Birmingham

Researchers from BHP founder the University of Birmingham will collaborate with international partners on an ambitious project aiming to help reduce the burden of cardiovascular disease in urban environments, as well as reducing the health inequality gap.

Cardiovascular disease is the leading cause of death globally, accounting for over 20 million deaths per year and costing the EU an estimated €282bn annually. To tackle this, the European Union Innovative Health Initiative has funded the new Cities@Heart consortium which will design, pilot and evaluate a series of city-level strategies to improve cardiovascular health for all.

Addressing cardiovascular disease in urban environments is challenging due to factors like poor access to healthcare and healthy food, exposure to pollution, and lack of safe spaces for physical activity. Urban infrastructure, food systems, and socio-economic disparities also contribute to adverse cardiometabolic outcomes.

While there are many interventions for cardiovascular disease, a lack of effective implementation means these often fail to reach individuals who would benefit most. This is particularly evident in underserved city populations such as those experiencing poverty, and in certain ethnic groups, disabled people, and women.

Addressing these complex issues requires a whole-city, integrated approach that changes health policy through co-production of suitable interventions with communities and community leaders.

The Cities@Heart project, starting in January 2026 and coordinated by the University of Birmingham, the University Medical Center Utrecht (Netherlands) and Novartis (Switzerland), will combine medical, technical, social and policy innovations to achieve a transformation in outcomes for communities experiencing health inequality.

Led by Professor Dipak Kotecha, the project will utilise existing infrastructure from seven city councils across Europe, embedding new health innovations and technologies from industry partners to tackle the challenge of urban cardiovascular disease on a significant scale.

The strategies will target obesity, hypertension, dyslipidaemia and diabetes, key drives of common and high-cost cardiovascular disease, such as heart attacks, stroke, heart failure, atrial fibrillation and vascular dementia. These disproportionately impact underserved and disadvantaged communities in urban areas.

Professor Dipak Kotecha, Professor of Cardiology at the University of Birmingham, researcher at the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre, through which this project will be delivered, Honorary Professor at the University Medical Center Utrecht and Global Director of Cities@Heart said: “Huge strides have been made to better manage disease of the heart and circulation, but they still remain the world’s biggest killers. We will jointly develop approaches with affected citizens, community leaders, city councils, clinicians, health policy leaders and industry partners to achieve long-term change.”

Collaboration across Europe

The project consortium involves 34 international partners, including the World Health Organization (WHO) European Healthy Cities Network, World Heart Federation, European Heart Network, European Society of Cardiology, European Public Health Association and multiple European universities.

Birmingham joins another six cities committed to city-wide improvement that will test and implement strategies that can be scaled across the WHO’s network of more than 1,800 cities: Belfast (Northern Ireland), Cork (Republic of Ireland), Łódź (Poland), Izmir (Turkey), Udine (Italy) and Utrecht (Netherlands).

The vision of the consortium is that evidence-based prevention, early detection, and management of cardiovascular disease is universally accessible in urban areas, supported by new health technology developments. The Cities@Heart project aims to reduce the economic burden of cardiovascular disease on society and improve quality-of-life and life expectancy for millions.

Birmingham joins £50m MRC Centre for clinical trial innovation

Academics at BHP founder-member the University of Birmingham will be part of a new Medical Research Council Centre of Research Excellence in Clinical Trial Innovation (MRC CoRE) which aims to speed up patient and participant access to new medicines and trials, for improved patient care.

The Centre, in partnership with the National Institute for Health and Care Research (NIHR), will receive up to £50 million over 14 years to transform the landscape of clinical trials – shaking up approaches to trial design and delivery by developing pioneering new ways to accelerate processes and drive improvements in treatment and recovery.

The University of Birmingham will be one of six leading research intensive institutions to join forces to support MRC CoRE, with Professor Thomas Pinkney bringing his expertise in running complex surgical clinical trials including the ROSSINI-Platform trial, the UK’s largest ever surgical trial to make future operations safer.

MRC CoRE will see UK trials move away from the current approach of testing a single intervention in a single disease one at a time. Finding efficient way to test multiple drugs in multiple diseases at the same time would be a game changer both for industry and the academic community.

Professor Pinkney said: “This new funding will give a major boost to the latent potential around the UK to design and run clinical trials for new treatments for participants and patients.

“Birmingham brings a huge breadth of clinical trials experience both here in the UK and around the world, including surgical trials, complex cancer trials including with children, and many more besides. In addition, the West Midlands offers a unique opportunity with clinical trials for working with a diverse population and socioeconomic background, and so we are ideally placed to help accelerate the development of medicines for patients.”

Professor Patrick Chinnery, Medical Research Council Executive Chair explained: “The UK medical research community is very effective at gaining insights about disease biology and developing potential new treatments and interventions, especially in underserved areas such as multiple long-term conditions and rare diseases.

“It is essential to quickly move such interventions forward to the right patients, at the right doses, durations and combinations.”

Leading the world in innovative trial design

A key area of focus are clinical trials aimed at identifying the minimum ‘intensity’ – such as duration, frequency, or dose required – for a drug to be effective. For instance, finding the lowest effective dose of a chemotherapy drug could help make cancer treatment gentler for patients by reducing side effects.

The MRC CoRE team will be led by Professor Max Parmar will build on the team’s past work which created the highly innovative ‘multi-arm multi-stage’ platform clinical trials. These designs have revolutionised clinical trials to be more flexible, able to add or remove new drugs for testing over time, depending on results and new breakthroughs.

The leadership group will include researchers from the University College London, London School of Hygiene & Tropical Medicine, University of Cambridge, University of Edinburgh, University of Birmingham, and Newcastle University.

Professor Max Parmar, Director of the MRC CoRE in Clinical Trial Innovation, said: “Basic science is rapidly producing more understanding of biology and consequently many new interventions to help us in a range of diseases – both by industry and academic routes. Clinical trials are the way in which we evaluate all these new treatments. However, they are too slow and costly meaning it takes some 20 years to get a new invention from the laboratory into routine clinical practice at a cost of some £2 billion. Our goal with this CoRE is to substantially reduce this time so that patients can benefit much sooner from new treatments and also bring the costs of testing new treatments down.”

Professor Lucy Chappell, Chief Scientific Adviser at the Department of Health and Social Care and Chief Executive Officer of the NIHR, said: “Success for this Centre will be having efficient adaptive trials becoming part of the mainstream, in the range of approaches to carrying out clinical trials. With increasingly complex interventions being developed for our diverse population, we’re excited for the UK to be taking a leadership role in innovative trial design and look forward to seeing effective and more targeted treatment regimes being evaluated at pace and informed by novel methodology approaches.”

ROH and Aston University establish international research group to develop novel bone cancer therapy

BHP members the Royal Orthopaedic Hospital NHS Foundation Trust and Aston University have come together with the Brazilian Aeronautics Institute of Technology (ITA) to found Biomedical Technologies for Regenerative Orthopaedics (BioTROCS) – a group aiming to advance research in the development, characterisation, and pre-clinical and clinical evaluation of novel biomaterials for bone regeneration and bone cancer applications.

ITA, Aston University and the Royal Orthopaedic Hospital have already been collaborating for several years to explore the use of gallium in treating bone cancer patients, and the formalisation of this alliance will make it easier for the three organisations to secure funding to further this ground-breaking research.

Dr Lucas Souza, Dubrowsky Regenerative Medicine Laboratory Manager at the Royal Orthopaedic Hospital, commented: “Collaboration is the core principle for groundbreaking research and solving real-world problems requires a multidisciplinary approach. BioTROCS is the officialisation of a long-term international collaboration between Brazil- and UK-based physicists, chemists, biologists and clinical researchers that has already made significant contributions to the advancement of technologies for the treatment of bone disorders such as critical-sized bone defects and bone tumours.

“This new phase represents the first step to establishing a strategic partnership that aims to facilitate the flow of researchers, materials, and data between participating institutions to foster an even richer research environment to accelerate discoveries in the field of biomaterials for bone regeneration and bone cancer.”

The new research group has successfully secured funding to further the group’s development of an injectable paste for use in bone cancer surgeries. The funding includes a PhD scholarship in Brazil, with the student also coming to Aston University for a 12-month placement.

Professor Dr Joao Lopes, Aeronautics Institute of Brazil, added: “The formalisation of the BioTROCS group is a key step in strengthening international scientific cooperation and represents a strategic opportunity to expand our research efforts in cutting-edge therapies for bone regeneration and bone cancer treatment. This partnership between institutions in Brazil and the UK not only enhances the development of novel biomaterials and advanced therapies, but also significantly increases our ability to secure funding from agencies that offer exclusive calls for international collaborative projects. In addition to enabling the exchange of researchers and knowledge, BioTROCS fosters a more dynamic innovation ecosystem that supports the development of high-impact clinical and technological solutions.”

Professor Richard Martin, Aston University, commented: “Aston University and the Royal Orthopaedic Hospital have successfully collaborated for five years in this area of research and the formation of an international research group will help drive forward the use of biomaterials for bone regeneration and bone cancer.

“This area of research has huge potential – for example in September 2024, our tests found that bioactive glasses doped with gallium have a 99% success rate of eliminating cancerous cells and can even regenerate diseased bones. My team at Aston University is looking forward to hosting the new PhD researcher who will help further advance our research.”

Members of the BioTROCS team in Brazil

Clinical use of nitrous oxide could help treat depression

Patients with major depressive disorder, including those who have not responded to first-line antidepressants, may benefit from short-term nitrous oxide treatment, say researchers from BHP members the University of Birmingham and Birmingham and Solihull Mental Health NHS Foundation Trust, working with colleagues from the University of Oxford.

The largest meta-analysis of global trial data has been published in BioMedicine and assessed the best available clinical information to show how clinically administered nitrous oxide (N2O) can offer fast-acting depressive symptom relief for adults with major depressive disorder (MDD) and treatment-resistant depression (TRD).

TRD is characterised as depression that isn’t effectively managed after a patient tries two different antidepressants. It affects approximately 48% of UK patients who experience limited benefit from standard treatments, according to a previous study led by the research team.

Researchers assessed seven clinical trials and four protocol papers published by investigators from around the world. Each research study looked at the use of nitrous oxide, also used as pain relief in a range of medical situations, for treating depressive disorders, including MDD, TRD and bipolar depression.

The team found that a single treatment of inhaled clinical nitrous oxide at 50% concentration (in three trials), produced rapid and significant reductions in depressive symptoms within 24 hours, although these effects were not sustained at one week. In contrast, repeated dosing over several weeks led to more durable improvements, suggesting that multiple treatment sessions (compared to a single dose) may be required to maintain clinical benefit. It is thought to target glutamate receptors in a similar way to ketamine, another rapid-acting antidepressant, and this may help explain why improvements in mood can be observed soon after inhalation.

Professor Steven Marwaha from the University of Birmingham, Honorary Consultant Psychiatrist at Birmingham and Solihull Mental Health NHS Foundation Trust, and senior author of the study said: “This is a significant milestone in understanding the potential of nitrous oxide as an added treatment option for patients with depression who have been failed by current treatments. This population has often lost hope of recovery, making the results of this study particularly exciting. These findings highlight the urgent need for new treatments that can complement existing care pathways, and further evidence is needed to understand how this approach can best support people living with severe depression.”

Kiranpreet Gill, a PhD researcher funded by the Medical Research Council at the University of Birmingham and first author of the study, said: “Depression is a debilitating illness, made even more so by the fact that antidepressants make no meaningful difference for almost half of all patients diagnosed with it. There is a growing body of research on repurposing treatments from other clinical domains to alleviate low mood. This study brings together the best possible evidence indicating that nitrous oxide has the potential to provide swift and clinically significant short-term improvements in patients with severe depression.

“Our analyses show that nitrous oxide could form part of a new generation of rapid-acting treatments for depression. Importantly, it provides a foundation for future trials to investigate repeated and carefully managed dosing strategies that can further determine how best to use this treatment in clinical practice for patients who don’t respond to conventional interventions.”

Further research required

The meta-analysis of studies found strong evidence for short-term improvements in mood following nitrous oxide administration. Due to the limited number of existing trials, there was notable variability in how depressive symptoms were measured and reported, as well as in the timing of these assessments. Further studies are needed to determine the optimal dose, nitrous oxide’s long-term safety, and the best way to integrate it into existing treatment pathways.

The team also examined the safety and potential side effects of nitrous oxide. Some patients experienced side effects such as nausea, dizziness and headaches, all of which passed quickly and resolved without medical intervention. While higher dosing (at 50% concentration) increased the likelihood of these side effects, none of the studies reported any short-term safety concerns. The researchers emphasised that longer-term safety must be assessed through future studies with extended follow-up periods.

The study was conducted by researchers at the Mental Health Mission Midlands Translational Centre, led by the University of Birmingham and funded by the National Institute for Health and Care Research through the NIHR Oxford Biomedical Research Centre. The team are working on improving treatment options for treatment-resistant depression in superdiverse and deprived populations. The Centre aims to accelerate the development and delivery of innovative, evidence-based interventions to improve outcomes and reduce disparities in mental health care.

This work also aligns with ongoing efforts within the Birmingham Clinic for Advanced Mood Disorder Management (CALM), where innovative, evidence-based treatments such as ketamine and neuromodulation are being delivered to people with severe or treatment-resistant depression.

Building on this translational pathway from discovery to clinical practice, the team is now preparing the first NHS trial in the UK to assess whether nitrous oxide can be delivered safely and acceptably as a treatment for major depression. The findings will help determine how nitrous oxide could be integrated into NHS care and may expand the range of innovative options available for patients who have not benefited from standard approaches.