The only project of its kind anywhere that studies all acute vascular events, such as strokes and heart attacks, to develop better treatments has recruited its 10,000th Oxfordshire participant.
The Oxford Vascular Study (OXVASC) began in 2002 and involves University of Oxford staff at the John Radcliffe Hospital collecting detailed health data, blood samples and carrying out scans.
The study has provided vital data on the frequency, time-trends, causes and outcomes of heart attacks, strokes, transient ischaemic attacks (TIAs or mini strokes), aneurysms and other circulatory problems, as well as subsequent complications, such as dementia.
Without a doubt, OXVASC puts patients first and my patients' levels of satisfaction with the service are second to none.
Dr Andrew Schuman, GP
To date more than 200 scientific papers have been published, some leading to major changes in clinical practice locally, nationally and internationally. These include:
- Demonstration of the very high risk of major stroke after minor 'warning' symptoms which led to the development of emergency clinics.
- Showing that urgent treatment of patients following these events reduces the risk of major stroke by 80% - one of the most effective interventions across all of medicine.
- Identification of labile blood pressure as a powerful risk factor for vascular events.
- Use of mobile phone telemetric home blood pressure monitoring to properly diagnose high blood pressure and to monitor treatment.
Patients are enrolled whilst in hospital or following referral by participating GPs to a daily emergency out-patient clinic at the John Radcliffe Hospital.
Detailed clinical assessments are made and participants undergo state-of-the art investigations, including brain imaging at the University’s Acute Vascular Imaging Centre (AVIC) at the JR and home blood pressure monitoring, with measurements transmitted in real-time to the study doctors.
Relatives and friends can also consent to participate so that comparisons can be made between people who have had a vascular event and those that haven't.
The study is a good example of how relatively simple clinical research can still provide insights that substantially improve patient care as well as allowing us to study the causes of disease.
Professor Peter Rothwell, OXVASC Study Director
The 10,000th participant was Wantage's Peter Casey, 55, who was referred to OXVASC in April 2016 after experiencing a TIA which caused temporary confusion and memory loss.
Scans and tests showed the jewellery shop owner had high cholesterol and blood pressure and atrial fibrillation , an irregular heartbeat.
He said: 'The GP said "This is really fantastic study going on at the JR, they will be the people to look after you."
'At first I wanted the best people around me to look after me. Four months down the line, I thought ‘unless I am unlucky, I am out of the woods’. Then I thought it is time to say thank-you and the only way was to co-operate with anything they asked me to do for the study. I was happy to repay them.'
The study is the first in the world to assess and follow-up all vascular conditions at the same time in the same population. It is a collaboration with about 100 GPs covering a population of 100,000 residents of Oxfordshire.
One of its key strengths is that participation is extremely high, with more than 99 per cent of patients who are asked to take part in the study giving their consent to at least some collection of data, thus avoiding 'selection bias', where the sample may not represent the whole population.
This completeness of coverage allows researchers to draw conclusions from the data that are as reliable as possible on a host of different topics ranging from studies of genetic factors and other “biomarkers” for risk of disease to studies of how best to deliver high-quality clinical care.
Professor Peter Rothwell, who founded and directs the study, said: 'We are delighted to have reached this milestone in recruitment, and we want to thank all of the patients and their relatives in Oxfordshire who have helped us so much, as well as the local general practices who make the study possible. The study is a good example of how relatively simple clinical research can still provide insights that substantially improve patient care as well as allowing us to study the causes of disease.'
Dr Andrew Schuman, from Dr Kenyon & Partners in Oxford, which began referring patients in 2002, said: 'OXVASC provides a gold-standard service that is truly world-class.
'Whenever I have a patient that I'm worried may have suffered a TIA, I'm able to get straight on the phone to one of the experienced research doctors at OXVASC. Without reams of unnecessary, time-wasting administration and tick-boxes, the patient is whisked into the department, where they are extensively investigated, treated and followed-up.
'One of the many things I've learnt from being a GP participating in the OXVASC study is that this rapid response to at-risk patients massively reduces their risk of major stroke by as much as 80%. Without a doubt, OXVASC puts patients first and my patients' levels of satisfaction with the service are second to none.'
Public Health and Innovation Minister, Nicola Blackwood, said: 'The Oxford Vascular Study is a fantastic example of world class researchers and NHS staff coming together with the help of the British public to improve the care people receive every day.
'It is great news that this project has recruited so many patients from across Oxfordshire. A better understanding of vascular disease is crucial if we are to develop effective treatment against heart disease and strokes.'
OXVASC is co-ordinated by the University’s Centre for the Prevention of Stroke and Dementia in partnership with Oxford University Hospitals NHS Foundation Trust (OUH), which runs the John Radcliffe Hospital.
The study is planning to continue to recruit until at least 2022 and is funded by the Wellcome Trust, The Stroke Association and the NIHR Oxford Biomedical Research Centre, a partnership between Oxford University Hospitals NHS Foundation Trust and the University of Oxford. Previous funders have included the Medical Research Council and the Dunhill Medical Trust.