Leading the local research portfolio focussed on tele-medicine and eHealth applied to oncology and supportive care, establishing myself as an academic clinician

Building on my previous work and on the acquired expertise and international collaborative networks, witnessed by the aforementioned scientific output spanning translational and biomedical research, I foresee leading the local research portfolio focussed on tele-medicine and eHealth applied to oncology and supportive care, establishing myself as an academic clinician.

This programme, which is cross-disciplinary and integrative, will involve my physician colleagues from oncology, palliative care, sleep and acute medicine, as well as the para-medical and allied health disciplines teams within the board. The domain of research in eHealth, particularly relevant in the geo-social context of Wales at large, is also broadly recognized as a critical oncological patient-centred research priority, as witnessed by the latest scientific literature and international conference topics [for instance, ASCO Educational Book 2016 & 2018]. Moreover, the relevance of continuous monitoring of behaviour and physiology, with regards to biological rhythms of about 24 hours (circadian), is strengthened by the award of the 2017 Nobel Prize in Medicine or Physiology to pioneers in circadian clock research.

Indeed, in particular to cancer research, the American Association for Cancer Research has recently defended the importance of circadian rhythms in cancer therapeutics [Cancer “Clock” Opens New Therapeutic Avenues; Cancer Discovery, 2017; DOI: 10.1158/2159- 8290.CD-NB2017-149], and the National Cancer Institute of the National Institutes of Health has set up a “provocative question” within their Research Answers focussed on the circadian clock [RFA-CA-17-018: How do circadian processes affect tumor development, progression, and response to therapy?].

In order to implement eHealth projects coupling state of the art clinical care and world-leading research delivery in circadian rhythms, sleep and physical activity, a cross-disciplinary collaborative effort is required. With this in mind, I will involve the international network of collaborators with complementary competences I have built up over time, including, among others, the Universities of Warwick, Paris South, Istanbul, Stanford, Rush, Toronto and Monash. My performance in this inclusive approach is reflected in the diversity of the expertise and departmental affiliations of the co-authors of the scientific papers I have published. Should I be successful in winning this post, my project will involve setting up the local research environment which will produce the initial multidimensional data, including physiology, behaviour and patient-reported outcome measures, remotely and seamlessly collected using up-to-date biosensors and mHealth solutions. I plan therefore to put together a pilot cohort observational study expected to recruit 40 patients with 12-week monitoring. This will aim at developing a mobile multiuser telecommunicating platform, fit for the remote surveillance of relevant individual patient’s physiology parameters and patient reported outcomes at home. This will eventually lead to a subsequent clinical trial proposal, testing personalised behavioural interventions aimed at improving patients’ experience with systemic anticancer treatment.

I have already made progress on paving the path for this pilot, through having obtained funding for:

• A multicentre study on multidimensional tele-monitoring in 25 cancer patients (IDEAs study);
• A prospective study testing a new commercial wearable multi-sensor in 40 healthy volunteers (CircaFinger study); A local study involving 10 patients and 30 healthy volunteers evaluating circulating immune-mediators alongside physiology monitoring;
• A local study offering electronic quality of life questionnaires in the outpatient clinic.

I would envisage at the end of this three year award to have completed the aforementioned studies, ideally secured additional funding for further ones, analysed and interpreted the data, and disseminated the results. I should have, therefore, acquired the groundwork data, purchased and validated the tools, and implemented this novel research expertise within the Board. This will have enabled me to have fully developed the optimized platform to be tested in the larger pilot study. Thus, by the end of the award I plan to have applied for funding to either the Clinical Trial Award from Cancer Research UK or the Intervention for Innovation award from the National Institute for Health and Care Research.

Other potential funding streams throughout and at the end of this award include the MRC, the EPSRC, NWCR, WCN and Tenovus, with specific calls to be identified according to the scientific and clinical unmet needs. Additionally, by teaching and conducting outreach activities, I hope to attract researchers interested in the domains of eHealth and biological rhythms in Oncology to come and live and work in Wales. This is an exciting future for the board as it has not been involved in this research field before. I plan moreover to strengthen the links with the team of researchers at the Wales Cancer Research Centre, with whom I have successfully commenced to collaborate.

This opportunity is therefore one which not only would enable me to maintain my clinical research skills for the benefit of oncology services here in North Wales, utilising and honing my many years of research experience on the continent and more latterly at Warwick University Medical School, but also to acquire new skills and insights across the spectrum of oncology, health science research and methodology with which Welsh Universities and Cancer Centres in particular have strong expertise and reputation.

For the teaching activities, my plan is to be supporting the supervision of the PhD project of Dr Nicholas Wreglesworth, a medical oncology registrar in our department, exactly during the three years of this award, in view of retaining him as a clinical academic, too, within the expanding local team I envisage to cultivate. Funding for this has been obtained by Bangor University and one of my clinical supervisors (Pr Gollins) from Wales Cancer Research, for a split-time project focussed on multidimensional monitoring and prediction of cancer patients. In addition, I foresee my implication in teaching activities of the newly-established Medical School within Bangor University.

Thus, I foresee my schedule to generally involve about 80% of the 0.2 WTE awarded for research and about 20% for teaching.