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Author: Louise Stanley

Increasing transparency and tackle potential bias in medical AI technologies: BHP researchers publish new recommendations

Written by Louise Stanley on . Posted in Health inequalities.

Patients will be better able to benefit from innovations in medical artificial intelligence (AI) if a new set of internationally agreed recommendations – published in The Lancet Digital Health and NEJM AI – are followed.

Led by the University of Birmingham and University Hospitals Birmingham NH Foundation Trust, ‘STANDING Together (STANdards for data Diversity, INclusivity and Generalisability)’ is an international initiative and its recommendations are based on a research study involving more than 350 experts from 58 countries, aiming to help improve the way datasets are used to build Artificial intelligence (AI) health technologies and reduce the risk of potential AI bias. 

Innovative medical AI technologies may improve diagnosis and treatment for patients, however some studies have shown that medical AI can be biased, meaning that it works well for some people and not for others. This means some individuals and communities may be ‘left behind’ or may even be harmed when these technologies are used.

The STANDING Together recommendations aim to ensure that medical AI can be safe and effective for everyone. They cover many factors which can contribute to AI bias, including:

  • Encouraging medical AI to be developed using appropriate healthcare datasets that properly represent everyone in society, including minoritised and underserved groups;
  • Helping anyone who publishes healthcare datasets to identify any biases or limitations in the data;
  • Enabling those developing medical AI technologies to assess whether a dataset is suitable for their purposes;
  • Defining how AI technologies should be tested to identify if they are biased, and so work less well in certain people. 

Dr Xiao Liu, Associate Professor of AI and Digital Health Technologies at the University of Birmingham and Chief Investigator of the study said: “Data is like a mirror, providing a reflection of reality. And when distorted, data can magnify societal biases. But trying to fix the data to fix the problem is like wiping the mirror to remove a stain on your shirt. To create lasting change in health equity, we must focus on fixing the source, not just the reflection.”

The STANDING Together recommendations aim to ensure that the datasets used to train and test medical AI systems represent the full diversity of the people that the technology will be used for. This is because AI systems often work less well for people who aren’t properly represented in datasets.

People who are in minority groups are particularly likely to be under-represented in datasets, so may be disproportionately affected by AI bias. Guidance is also given on how to identify those who may be harmed when medical AI systems are used, allowing this risk to be reduced.

Professor Kiran Patel, Chief Medical Officer at University Hospitals Birmingham NHS Foundation Trust (UHB), said: “In the UK, and especially in cities like Birmingham, where communities from diverse backgrounds form a significant part of the population, ensuring diversity in datasets is essential for improving health outcomes for all patients.”

“As technology advances, these recommendations are crucial in preventing the health inequalities we know exist in our communities from persisting or worsening, ensuring vulnerable populations have access to the treatments they need.”

The research has been conducted with collaborators from over 30 institutions worldwide, including universities, regulators (UK, US, Canada and Australia), patient groups and charities, and small and large health technology companies.

The work has been funded by The Health Foundation and the NHS AI Lab and supported by the National Institute for Health and Care Research (NIHR), the research partner of the NHS, public health and social care.

In addition to the recommendations themselves, a commentary published in Nature Medicine written by the STANDING Together patient representatives highlights the importance of public participation in shaping medical AI research.    

Sir Jeremy Farrar, Chief Scientist of the World Health Organisation, said:  “Ensuring we have diverse, accessible and representative datasets to support the responsible development and testing of AI is a global priority. The STANDING Together recommendations are a major step forward in ensuring equity for AI in health”

Dominic Cushnan, Deputy Director for AI at NHS England, said: “It is crucial that we have transparent and representative datasets to support the responsible and fair development and use of AI. The STANDING Together recommendations are highly timely as we leverage the exciting potential of AI tools and NHS AI Lab fully supports the adoption of their practice to mitigate AI bias’’

The recommendations were published on Wednesday 18 December 2024, and are available open access via The Lancet Digital Health.

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£3.4m boost for research into paediatric autoimmune brain inflammation

Written by Louise Stanley on . Posted in Birmingham Health Partners, Inflammation and chronic disease.

Dr Sukhvir Wright at Aston University‘s Institute for Health and Neurodevelopment (IHN) and Honorary Consultant Neurologist at Birmingham Children’s Hospital (BCH) – both BHP member organisations – has been awarded a £3.4m Career Development Award from Wellcome to research paediatric autoimmune encephalitis (AE), an inflammatory brain condition.

Every minute, someone in the world is diagnosed with encephalitis, which can be caused by an infection or have an autoimmune cause, where the body’s own immune system starts attacking the brain. The expert neuro-immunology team at BCH cares for children with autoimmune encephalitis all year round.

AE accounts for around a third of cases worldwide, with patients experiencing seizures, cognitive and sleep dysfunction and movement disorders. Although medical professionals are getting better at recognising and treating AE earlier, the long-term outcomes remain frustratingly poor, particularly in children under five.

Some symptoms of the disease, such as seizures, can resolve but others, such as problems with learning and memory, behavioural change and sleep disorders, can become chronic. Why some of these symptoms get better and others persist is not well understood. 

Dr Wright carried out a world-first preliminary study in a group of children with AE at least 18 months after they first developed the condition, using magnetoencephalography (MEG) brain scans. She found distinct long-term brain structure and network changes and believes that these brain changes are responsible for the chronic symptoms of the disease.

During her Career Development Award, Dr Wright will use laboratory models to characterise the mechanisms causing the chronic symptoms, examining the underlying changes from single brain cells to whole brain networks. She will also examine longitudinal brain network changes in children immediately following the acute attack of AE and for up to eight years afterwards using a new optically pumped magnetometer (OPM) MEG scanner.

IHN is an ideal location for the research project, as it houses the UK’s only paediatric clinical and research Wellcome Trust MEG laboratory. The MAG4Health OPM MEG scanner that will be used by Dr Wright was installed in 2024 following a Medical Research Council (MRC) equipment grant for £800,000 led by Aston University’s Dr Caroline Witton in partnership with BCH. The Aston-BCH OPM MEG uses an adjustable cap with sensors which is placed on the patient’s head, which allows some degree of movement and is therefore more acceptable for children.

Combining the data from the laboratory models and human patients will enable Dr Wright and her research team to identify commom pathophysiological targets, mechanisms and predictive biomarkers to reduce the adverse effects of AE and improve long-term outcomes.

Dr Wright is part of the expert neuroimmunology team at BCH, led by Professor Evangeline Wassmer, Paediatric Neurology Consultant. The AE research project will involve Professor Wassmer’s team, the BCH Psychology department led by Jo Horton, Professor Stefano Seri (neurophysiology) and Dr Laavanya Damodaran (liaison psychiatry).

Children and families with lived experience of AE will be directly involved with all aspects of the research to ensure it is answering questions that matter to them, including the family of one of the first AE patients ever treated by the neurology team at BCH. This patient and family involvement will be facilitated by the Epilepsy Research Institute’s Shape Network and Encephalitis International, two charities with which Dr Wright has strong links.

Dr Wright said: “We hope that this project will transform outcomes and optimise brain health in paediatric autoimmune encephalitis and beyond by delivering a significant shift in understanding the acute and long-term effects that autoimmune encephalitis has on children and young people.”

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Central and North West Midlands Awarded Prestigious NIHR Commercial Research Delivery Centre

Written by Louise Stanley on . Posted in Birmingham Health Partners, Clinical trials, Health inequalities.

Birmingham Health Partners (BHP) has successfully led a bid to establish one of the UK’s new National Institute for Health and Care Research (NIHR) Commercial Research Delivery Centres (CRDCs) to expand access to innovative clinical trials and deliver life-changing treatments to some of the UK’s most underserved communities.

This transformative £7m investment will establish the Central and North West Midlands (C&NWM) Commercial Research Delivery Centre, hosted by BHP founding member Birmingham Women’s and Children’s NHS Foundation Trust (BWC), working closely with regional partners Midlands Partnership University NHS Foundation Trust – host of Staffordshire and Shropshire, Telford and Wrekin Health Research Partnership (SSHERPA) – and the Black Country Provider Collaborative.

The new CRDC will make it easier for individuals across the C&NWM region to take part in research trials for cutting-edge healthcare treatments, partnering with drug companies to deliver treatment trials in a safe and responsible way. The new centre will also work closely with local businesses, patient groups and charities to help it reach a broad range of communities, including those that haven’t taken part in research before.

The C&NWM region, home to 4.2 million people, includes many of the UK’s most economically deprived communities who face significant health inequalities and higher rates of serious illness. The CRDC will focus on addressing these inequities by increasing access to clinical trials for patients who have the greatest need – dovetailing with BHP’s strategic focus on addressing health inequalities and giving greater opportunities for residents to participate in research.

Professor Lorraine Harper, Managing Director of Birmingham Health Partners and Director of the C&NWM CRDC, said: “This is an incredibly exciting opportunity to transform the health outcomes of our communities through world-class clinical research.

“By bringing together the expertise, resources, and passion of over 25 clinical and academic partners from across our region, we will create a thriving research ecosystem that not only delivers cutting-edge treatments but also makes clinical trials more accessible to all, including those in underserved populations. The NIHR’s investment will enable us to innovate and collaborate to improve healthcare in the Central and North West Midlands.”

Jeremy Kirk, R&D Director at BWC and Deputy Director of the CRDC said: “The primary objectives of the CRDC are to increase the number of trials in the region, boost participation from diverse communities, and speeding up the clinical trial process through streamlined workflows and innovative trial designs. BHP is already leading work to optimise academic trials and reduce bureaucracy, and so extending this programme into commercial trials is a natural next step.”

Professor Neil Hanley, Executive Director of Birmingham Health Partners and Pro-Vice-Chancellor and Head of the College of Medicine and Health at the University of Birmingham, said: “The success of the Central and North West Midlands CRDC bid is testimony to the deepening relationship between BHP’s partners. All of our academic and clinical member organisations were involved in developing our bid, which will bring tangible benefits to the wider partnership and help drive better health outcomes and economic growth to the region. It is yet more proof of the central importance of the health and life sciences sector to the region and country.”

Innovative approaches such as community-based trial locations, mobile research units, and digital technologies will ensure the CRDC reaches individuals who have never previously participated in research. Public involvement will be central to every stage of the Centre’s work, ensuring that its methods are inclusive, supportive, and effective in addressing local healthcare challenges.

Professor Lucy Chappell, Chief Executive Officer of the NIHR and Chief Scientific Adviser at the Department of Health and Social Care, said: “Clinical trials help improve lives. Boosting the NHS’s capacity to deliver commercial clinical research through these new Commercial Research Delivery Centres will support recruitment across all communities and bring innovative treatments to patients.

“The effects of these centres will be felt right across the four nations, bringing investment into the UK’s life sciences sector.”

£72 million investment

A total of 20 CRDCs are being established across the UK. In addition to the CRDCs in England, there will be four in Scotland, and a one nation approach in Wales and Northern Ireland. As part of the 10 Year Health Plan, the centres will shift clinical trials beyond large hospital trusts and into community settings, meaning those in underserved regions will now be able to participate in research, boosting access to new treatments in the trial stage.

This £72 million investment over seven years, beginning in April 2025, is awarded from the £400 million Voluntary Scheme for Branded Medicine Pricing, Access, and Growth (VPAG) Investment Programme and partly from NIHR in England.

The VPAG programme is a unique partnership between the UK Government and the pharmaceutical industry to boost the global competitiveness of the UK life science sector and stimulate economic growth. It will invest up to £300 million to bolster commercial clinical trial activity and help advance the delivery of new medicines and vaccines to patients.

The full list of C&NWM partners is:

  • HOST: Birmingham Women’s and Children’s NHS Foundation Trust
  • Aston University
  • Balsall Heath and Sparkhill Primary Care Network (PCN)
  • Birmingham and Solihull Mental Health NHS Foundation Trust
  • Birmingham Community Healthcare NHS Foundation Trust
  • Black Country Healthcare NHS Foundation Trust
  • Dudley Integrated Health and Care NHS Trust
  • Dudley and Netherton PCN
  • East Staffordshire PCN
  • GPS Healthcare and Solihull Healthcare Partnership
  • Keele University
  • Midlands Partnership NHS Foundation Trust
  • Modality Partnership Limited
  • NHS Birmingham and Solihull Integrated Care Board (ICB)
  • NHS Black Country ICB
  • NHS Shropshire, Telford and Wrekin ICB
  • NHS Staffordshire and Stoke-on-Trent ICB
  • North Staffordshire Combined Healthcare NHS Trust
  • Our Health Partnership
  • Sandwell and West Birmingham NHS Trust
  • Shrewsbury and Telford Hospital NHS Trust
  • Shropshire Community Health NHS Trust
  • Solihull Healthcare Partnership
  • The Dudley Group NHS Foundation Trust
  • The Royal Orthopaedic Hospital NHS Foundation Trust
  • The Royal Wolverhampton NHS Trust
  • University Hospitals Birmingham NHS Foundation Trust
  • University of Birmingham
  • Walsall Healthcare NHS Trust
  • West Birmingham PCN

Letters of support were gratefully received from:

  • Community Resource
  • Egton Medical Information Systems Limited (EMIS)
  • Health Innovation Network West Midlands
  • Medpace UK
  • Mental Health Mission Midlands Translational Centre
  • Qube
  • Roche Products Ltd
  • STAY
  • Support Staffordshire
  • VAST
  • West Midlands Research Delivery Network

(BHP member organisations in bold type).

BHP’s health inequality lead set to head up NIHR Challenge Maternal Disparities Consortium

Written by Louise Stanley on . Posted in Birmingham Health Partners, Health inequalities, Maternal health.

Professor Joht Singh Chandan – BHP’s heath inequalities lead and Clinical Professor of Public Health at the University of Birmingham – has been announced as co-lead of a new consortium which will research inequalities faced by expectant and new mothers.

The new NIHR Challenge Maternity Disparities Consortium is led by nine UK universities, all aiming to tackle inequalities in maternity care while building capacity for further research to help improve services over time. The consortium will help support professionals who plan and deliver services for women and babies across both health and social care.

Professor Chandan said: “I am honoured to take on the role of co-lead for the NIHR Maternity Disparities Consortium. Tackling inequalities in maternity care is a critical priority, and this consortium brings together a wealth of expertise to drive meaningful change.

“Our goal is to address disparities before, during, and after pregnancy by focusing on research that leads to real improvements in care for families and their babies across the UK. I am particularly looking forward to learning from and working alongside the communities most affected by these inequalities, ensuring that their insights shape our work and lead to lasting, impactful solutions.”

Professor Chandan will be joined by co-lead Dr Victoria Hodgetts Morton from the University of Birmingham, Dr Beck Taylor from Warwick University, Professor Will Parry-Smith from Keele University and Dr Marion Gibbon from Birmingham City Council.

Professor William Parry-Smith, Professor of Obstetrics and Gynaecology at Keele University, said: “I’m pleased to be leading Keele’s contribution to this nationally important work. Research and capacity building undertaken by the consortium will tackle the problem of maternity disparities. We have the opportunity in the West Midlands to understand and to then make a real difference crucially to improving maternity outcomes.”

Dr Beck Taylor, Clinical Associate Professor in Public Health, University of Warwick said: “This new consortium is an unparalleled opportunity to tackle the persistent maternity inequalities affecting life chances across the UK. These unacceptable differences are felt particularly by communities in our own region, the West Midlands. This consortium the first of its kind, and we cannot wait to get started on this programme. As part of the consortium we’ll bring together the communities, professionals and researchers to drive the change that women, babies and society urgently needs.”

Professor Marian Knight, Scientific Director for NIHR Infrastructure, said: “We are delighted by the level of engagement shown by researchers with this important research priority. I am confident we have an exceptional consortium to tackle the challenge of maternity inequalities; working in partnership with existing NIHR funded infrastructure and programmes. We look forward to working with the consortium and their collaborators across the UK to develop the final plans for their ground-breaking new research projects over the next few months.”

Health Minister Baroness Gillian Merron said: “Every woman should receive safe, personalised and compassionate maternity care, regardless of background. We are determined to tackle the stark and unacceptable inequalities in maternity services and are working with NHS England to urgently improve care. Government-funded research like this is crucial to driving positive change.

“This is part of our mission to build an NHS fit for the future by harnessing the full potential of our research and life sciences sector.”

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One year in: Birmingham Health Partners drives progress in reducing bureaucracy in clinical trials

Written by Louise Stanley on . Posted in Birmingham Health Partners, Clinical trials.

Birmingham Health Partners (BHP) is marking a year of transformative work on its Reducing Bureaucracy in Clinical Trials programme, which launched in November 2023 with the aim of establishing Birmingham a leader in delivering cutting-edge clinical research more efficiently. The ambitious initiative was established in response to the national drive for innovation, as outlined in the Lord O’Shaughnessy and Tickell reviews.

A year in, the programme has made significant progress toward streamlining clinical trial processes and developing pragmatic solutions, with active participation from our partner organisations. focusing on areas such as grants, contracting and site setup. Work is ongoing to: develop tools to help researchers navigate the complex research landscape more effectively, including piloting an e-request form; standardise template agreements across the partnership and establish standard operating procedures (SOPs) for pre-award grants; and create a consistent NHS-academic costing model.

Amy Smith, Senior Programme Lead, said: “This first year has been about laying a strong foundation for transforming how clinical trials are delivered across Birmingham. We’re particularly appreciative of the 100+ individuals who submitted responses to our survey over the summer, allowing us to understand the researcher experience and tailor our programme accordingly.

“By working collaboratively, we are making real progress in reducing the administrative burden on researchers and getting vital innovations to our patients faster. We’re excited to see what the next year brings as we continue to refine and expand this work – starting with a report on the results of our survey which we will be publishing soon, and a Town Hall event where investigators and researchers can learn more about our programme, ask questions and share their thoughts.”

Register for the online Town Hall event – Monday 9 December at 2.30pm – at the following link: https://forms.office.com/e/4Tu7Q4u1pg

This initiative comes at a pivotal time, with Lord Darzi’s independent investigation underscoring the essential role of research in preparing the NHS for the future and the newly elected Labour Government setting out bold ambitions for the NHS – including speeding up clinical trial recruitment, improving diversity, and reducing the time it takes to introduce high-impact innovations to patients. Other reforms aim to move away from hospital care to more services delivered in the community, digitising healthcare, and prioritising prevention rather than focusing only on treating illness.

At a national level, the Health Research Authority (HRA) has made strides by meeting or exceeding targets for trial setup times, and the transition from Clinical Research Networks (CRNs) to Research Delivery Networks (RDNs) on October 1st marked a shift towards research in broader health and care settings. Despite these advances, national performance indicators suggest there is still progress to be made, particularly in commercial trial setups and recruitment of first patients.

BHP remains committed to transforming Birmingham’s healthcare through high-impact innovation – delivering research that matters to patients.

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