Optimise Suspected-Cancer referrals in people with Anxiety (OSCA)

Five days before Christmas we received the wonderful news that our NIHR School for Primary Care Research grant application “OSCA” had been successful. Our study focuses on attendance at suspected-cancer investigations in people with anxiety and/or depression. The ideas arose from NIHR programme grant “Spotting Cancer Among Comorbidities” and from people’s stories about how their anxiety and depression impacted whether they turned up to appointments arranged by their family doctor to test if cancer was causing their symptoms.

In the New Year, we started planning to ensure we’d be ready for our September start. Our study duration – 11 months – meant that even a slight delay would risk our not completing on schedule. We honed in on ethics and recruitment of a qualitative researcher as the most time-critical tasks. I focused on the former and Liz on the latter.

As an ethics newbie, I was overwhelmed by the number of acronyms, regulatory bodies involved and forms that needed to be completed. Raff Calitri, Pam Baxter, Mary Carter and Grace McCutchan (University of Cardiff), in particular, provided sound guidance as I navigated the Integrated Research Application System. With their support, I actually found it a really useful process – feedback that the ethics committee confessed they didn’t often receive. The usefulness lay in having the space to walk through and imagine every step of the study and make contingency plans. To our delight we got ethics approval on 25th July, in plenty of time.

Meanwhile, Liz was navigating the hoops required to recruit a researcher in post. Getting the right balance of essential and desirable criteria that are needed for the job and likely held by someone at a graduate research assistant grade was hard. As we sat grading our 74 applications, we decided in retrospect that we could have tightened our criteria. We invited a shortlist of ten for interview, of whom three candidates were outstanding. After much deliberation, Luke, Liz and I offered the post to someone with vast experience of listening to people’s stories about being diagnosed with and treated for cancer.

Of the many lessons learned since January, a number stand out. We hadn’t appreciated that the amount of work to set up a study is similar regardless of its study duration – we’ve decided to avoid applying for multiple small grants in future. Secondly, there’s a lot to be said for naming a researcher on a grant application. Not only does it support them with their career, but it saves on hours of work recruiting a researcher in post. That said, by opening the field we have recruited someone who brings a new skillset to our group. Finally, we will delay choosing an acronym. Our original plan was to study how to Optimise Suspected-Cancer referrals in people with Anxiety and/or depression (hence OSCA). Over time, our research focus shifted and, try as we might, we couldn’t shoehorn attendance at suspected-cancer appointments into “OSCA”, but by then it seemed impossible to change it on the IT systems. One of the first questions that the ethics committee asked us was “why OSCA?” to which we had a very lame answer.

Sarah Price & Liz Shepherd

The blog was originally published on Collaboration for Academic Primary Care (APEx) Blog