Keele
| Title of Project | Brief Summary |
| The primary care pathways to healthcare access for people with axial spondyloarthritis and the disease understanding of healthcare professionals in this community |
Axial spondyloarthritis (axSpA) is an inflammatory rheumatic condition of the spine. Lower back pain is a typical symptom of axSpA, but this is also commonly seen in primary care for other reasons. As such, delay in diagnosis is common. Our current research project aims to understand which primary care services these patients are accessing over this pre-axSpA diagnosis period. If we can understand which, of the many potential, primary care services people with axSpA are accessing, then we may be able to find ways to identify them more quickly. In addition to identifying the services being used, we also want to determine the level of understanding of axSpA within the different types of health care professionals (HCP) in contact with these patients. Again, if we can understand this, we may be able to identify how these patients can be identified more quickly. This research involves three separate studies to investigate this issue, and depending on the time-period of the internship, the student will have the opportunity to work on one or more of these. These studies include: 1. An online quantitative survey of Primary Care Network (PCN) managers to understand the services available for people experience lower back pain symptoms across England |
| Diagnostic classification of shoulder pain: comparison of findings from clinical examination versus imaging (diagnostic ultrasound) |
Shoulder pain is one of the most common musculoskeletal conditions, with the median population prevalence estimated at 16% globally. Annually approximately 3% of adults consult primary care for an episode of shoulder pain. Most people recovery quickly, but in 40-50% pain and disability persist for more than 6 months. Diagnosing the cause of the pain based on physical examination or imaging can be difficult and is contentious, leading to uncertainty in management, including treatment or referral decisions. As part of a prospective cohort study investigating the prognosis and management of shoulder pain (PANDA-S), we invited people presenting with shoulder pain in primary care to attend a research clinic (link cohort protocol). Participants (n=152) received an examination of their shoulder by a physiotherapist and an ultrasound scan by an experienced sonographer. The assessments were conducted independently, blind to each other’s findings and conclusions. The findings will be reported in a research paper and/or conference presentation, and will help to identify areas of uncertainty in the diagnostic classification of shoulder pain. The work will also help to identify subgroups of patients with shoulder pain in primary care where diagnostic imaging may provide different or complementary information to physical examination. |
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Non-surgical and non-pharmacological interventions for osteoarthritis in joints other than the knee: an Evidence and Gap Map |
The intern will join an ongoing project led by Dr Corp at Keele University, in collaboration with the international OARSI Rehabilitation Discussion Group Steering committee (chair: Prof Holden, https://oarsi.org/membership-discussion-groups/discussion-groups-rehabilitation). The project aims to develop an Evidence and Gap Map (EGM) to systematically identify and chart the evidence base and highlight critical evidence gaps in osteoarthritis (OA) rehabilitation interventions for joints other than the knee. OA impacts multiple joints (hip, hand, foot, ankle, shoulder, elbow, spine, temporomandibular joint), however, research on rehabilitation (non-surgical, non-pharmacological) disproportionately focuses on knee OA1,2. Clinical guidelines often extrapolate knee OA evidence to other joints, e.g. hand or ankle/foot3, potentially overlooking joint-specific disease characteristics and thus compromising treatment applicability. Patient perspectives reinforce this gap: during a patient and public involvement workshop, an individual with ankle OA described feeling like the "forgotten cousin", underscoring the urgent need for joint-specific evidence. The EGM will provide a structured, visual summary of research on rehabilitation for OA in joints other than the knee: summarising evidence across multiple dimensions including interventions, outcomes, populations, geographical contexts, and study design. This will inform future research priorities and strengthen the evidence base for OA rehabilitation across all affected joints. The intern will contribute to the conduct of the EGM and participate in relevant team meetings, with anticipated involvement in screening and/or data extraction and critical appraisal. They will receive authorship credit for their work in any resulting publication(s). Ongoing support will be provided through regular supervisory meetings and access to in-house systematic review training resources. References |
