Developing novel patient centred pathways, following acute presentation with mild traumatic brain injury
A fully funded PhD at the University of Cambridge, under the supervision of Dr Virginia Newcombe is available.
An estimated 60 million people worldwide each year sustain a traumatic brain injury of which 80%-90% are classified as a mild TBI (mTBI, concussion). Common causes include sporting injuries, falls and road traffic collisions.
Current clinical pathways in the ED focus on immediate needs. For example, using a CT scan of the brain to decide whether a patient needs surgery urgently for bleeding, and do not take into account potential longer term problems. Reducing ED waiting time may be important for patients as symptoms may worsen in the noisy environment. In addition, the number of people attending EDs for all health issues is rising, leading to longer waiting times.
There is also growing appreciation that "mild" is a misnomer as these patients may have ongoing functional, symptomatic and cognitive deficits that may benefit from further management. Our failure to prognosticate in this group means those with persisting problems are often lost to the ongoing care they need, and a presentation to ED could be a potential opportunity for stratification of need and signposting to appropriate onward care.
Rapidly evolving technologies offer potential to change the clinical pathway in EDs and improve care of people who have sustained a mTBI. For example a machine learning algorithm developed to detect TBI lesions on CT (BLAST-CT, developed by our group in collaboration with academics at Imperial College London) has the potential to assist emergency physicians to identify patients with normal scans. Blood biomarkers offer the potential to aid both diagnosis and prognostication in mTBI in the Emergency Department (ED) setting. Understanding the potential clinical utility of these technologies requires an understanding of existing care pathways, how these are enacted in practice, any inadvertent consequences, challenges in adoption and acceptance by both clinicians and patients, and where the information provided by them would make the most difference to both clinical decision making and ultimately patient outcomes.
This project will aim to understand how implementation such technologies may effect pathways. This work will involve scoping of existing care pathways and the impact on mTBI patient experience, including the identification of care gaps and unmet need. It will take advantage of data collected as part of the NIHR EME funded study BRAINS-TBI (Biomarkers for RAtional Investigation for Neurological decision Support in TBI, Chief Investigator Newcombe, NIHR159241); a UK multi-centre study of >2000 patients with mTBI, as well as other linked datasets, and consider health delivery models that could incorporate such innovations and technologies into routine practice. Specific details of the PhD project will be determined by the student's interests.
This project, home fees and stipends, is funded through the NIHR HealthTech Research Centre in Brain Injury (HRC) Fellowship Programme, which has been designed to support the research needs across its 5 themes: prevention & education, acute care & monitoring, restoration & rehabilitation, diagnostics and life-course. Central to the programme are the 7 core academic projects, across 4 academic partners.
In addition to the institutional training and education support, the HRC rolling educational programme will be delivered through a mixture of tutorials, workshops, web-based training resources, networking events and peer-led activities. This will equip fellows with unique considerations for developing HealthTech solutions, including modules in navigating the Regulatory and Commercial landscape, Essentials of Health Economics, Patient and Public Involvement and Engagement, How to Sell to the NHS, Research Inclusion, Research Design and Funding Support.
This studentship covers a stipend at the current UK Research and Innovation rate Home Fees and University Fees at the Home rate. International students will be considered if the shortfall in fees is covered from elsewhere
The studentship will be funded for three years from October 2025.
Closing date: 16th May 2025
To be appointed applicants must meet our minimum entry criteria which can be found at: https://www.postgraduate.study.cam.ac.uk/courses/directory/cvmdpdmed
For eligibility for home fees please check: https://www.postgraduate.study.cam.ac.uk/finance/fees/what-my-fee-status.
Applicants should hold (or expect to obtain) the equivalent of a UK 2.1 or higher in an undergraduate honours or Masters degree in a relevant subject.
All applications should be made online via the University's Applicant Portal for a PhD in Medicine - https://www.postgraduate.study.cam.ac.uk/courses/directory/cvmdpdmed. Applications should include academic transcripts, CV, statement of purpose and 2 references.
An application is only complete when all supporting documents, including the 2 academic references, are submitted. It is the applicant's responsibility to ensure their referees submit their references before the closing date.
Please also explain your motivation why you wish to pursue a PhD in this area, outline your research interests and background, and describe the qualities and experience you will bring to the role.
If you have any queries regarding the application process please contact the Clinical School HR Team via email cshrstaffhub@admin.cam.ac.uk.
For information about how your personal data is used as an applicant, please see the section on Applicant Data (https://www.hr.admin.cam.ac.uk/hr-staff/hr-data/applicant-data )on our HR web pages.
Please quote reference RC45467 on your application and in any correspondence about this vacancy.
The University actively supports equality, diversity and inclusion and encourages applications from all sections of society.
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