Vice-Chancellor's Visit School

Innovation in Research: Drivers and pressures Professor Trevor McMillan PhD FRCR (Hon) MRCP (Hon) FRSB Vice-Chancellor Keele University The ideal sunscreen? Sunlight

Safe tan Sunscreen No biomolecular damage + melanin stimulation + Vitamin D production Project Safe Tan (A Fictitious University, NHS, Business collaboration) Principle proven in vitro

Authorisation by: University NHS Company Award of Funding Recruitment and delivery of

trial Dissemination of results Medical Innovation: between standard practice and clinical research. Criticized for doing something V

Criticized for NOT doing something How much evidence is needed for the application of innovation to be appropriate? Personalized medicine: A medical model that separates patients into different groups - with medical decisions, practices, interventions and/or products being tailored to the individual

patient based on their predicted response or risk of disease Therapeutic ratio: Effect on tumour V Effect on normal tissue Individuals vary in their sensitivity to ionising radiation.

Ataxia telangiectasia 1 in 300 000 progressive cerebellar ataxia, ocular motor dyspraxia, dysarthria deficiency in cell-mediated immunity thymic hypoplasia, hypogonadism, growth retardation, telangiectasia increased radiosensitivity 10% of homozygotes develop a malignancy in

childhood or early adulthood 6 4 F re q u e n c y Sensitivity of fibroblasts from BRCA1 families

High dose-rate response 2 0 4 Low dose-rate response

2 0 5 6 7 D0.01 (gray)

8 9 Final thoughts Innovative Practice should not be a substitute for full randomised clinical trials where such trials possible. But some major trends in treatments (e.g. personalisation) may not be suitable for standard trial design and/or standard

statistics. Therefore a innovation framework that protects patients and clinicians is likely to become increasingly required.

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