Dr Sue Mallett

Dr Sue Mallett

Institute of Applied Health Research
Senior Lecturer in Medical Statistics

Contact details

Address
Institute of Applied Health Sciences
College of Medical and Dental Sciences
University of Birmingham
Edgbaston
Birmingham
B15 2TT
UK

Dr Sue Mallett is a Senior Lecturer in Medical Statistics in Test Evaluation Research Group (TERG) at University of Birmingham. She has dual training as a medical statistician and also as a biochemist and molecular immunologist.

Sue has published over 50 papers, many focussed on diagnosis and prognosis research. Her experience includes research as a methodologist, systematic reviewer and clinical trial statistician.

Sue is keen to promote better methods in the design and analysis of clinical trials in diagnostic accuracy and the impact of tests on patient therapeutic management. She is lead trial statistician and co-applicant on 5 NIHR funded trials including four diagnostic accuracy trials comparing imaging in patient pathways.

Actively pursuing her interest in stronger research evidence, Sue is a member of the Cochrane Diagnostic Test Accuracy peer review and Editorial team. She is a member of international Steering Committees for risk of bias tools in diagnosis (QUADAS2) and prediction studies (PROBAST). She serves as a member of BMBF grant review board (German Federal Ministry of Education and Research).

Sue is an enthusiastic teacher of statistics and research methods, and frequently teaches on workshops, particularly related to test evaluation, at local, national and international events.

Qualifications

  • Senior Lecturer in Medical Statistics 2015
  • University Research Lectureship, University of Oxford (2011-2014)
  • Fellow Royal Statistical Society 2010
  • Diploma in Statistics, Open University, 2004
  • DPhil Molecular Immunology, University of Oxford,  1991
  • BA Hons Biochemistry, University of Oxford, 1988

Biography

Dr Sue Mallett is a Senior Lecturer in Medical Statistics in Test Evaluation Research Group (TERG) led by Prof Jon Deeks at University of Birmingham (2015). Her current work is both as a methodologist and clinical trial statistician, specialising in diagnosis and prognosis. Sue has dual skills training as a medical statistician and in laboratory research as a biochemist and molecular immunologist.

Sue Mallett qualified with a B.A. Hons in biochemistry at Oxford University and a DPhil in molecular immunology on CD4 T cell activation markers. She worked for 6 years in immunology and virology, including 2 years at University of California San Francisco.

Sue re-trained as a statistician through the Open University UK, whilst working in a range of jobs to build up her experience and portfolio in statistics and clinical trial design. She worked with Prof Sir Roy Anderson and Prof Neil Ferguson at the start up company Oxford Biologica Ltd on modelling of drug resistance in HIV and influenza. She joined the UK Cochrane Centre for a short project working with Prof Mike Clarke and Dr Sally Hopewell on understanding a typical Cochrane review and publication bias. She worked on cancer pathways in the NHS with the Oxford Cancer Intelligence Unit.

In 2002 she joined the Centre for Statistics in Medicine at Oxford University, working with Prof Doug Altman and Prof Jon Deeks on the methods, design and analysis of diagnostic accuracy studies and diagnostic accuracy systematic reviews.  She extended her research to include prognostic studies through collaborations with Prof Patrick Royston on a review of methods and on evidence underlying the REMARK reporting guidelines for tumour marker studies with Prof Willi Sauerbrei.

She built up long term collaborations with leading researchers in radiology through Prof Steve Halligan (UCL), Prof Stuart Taylor (UCL) and Prof Vicky Goh (Kings College London), including methodological and radiological research, and NIHR funded diagnostic accuracy studies.

Her collaborations have included a very successful NIHR programme grant led by Prof Steve Halligan included: methodological work on issues with ROC AUC in diagnostic imaging studies, the first studies using eye tracking in 3D medical imaging using CT colonography, support for FDA approval of computer assisted technology in CT colonography and decision choice experiments with patients and health professionals on diagnostic testing.

In 2011 Sue moved to the Department of Primary Care Health Sciences in Oxford where she taught on the MSc in Evidence Based Health Care, and developed collaborations including a systematic review of studies predicting risk of hospitalisation in at risk children with influenza.

In 2015 Sue moved to Test Evaluation Research Group (TERG) at University of Birmingham to work with Prof Jon Deeks. Her work includes leading statistical analysis on five NIHR funded diagnostic accuracy or prediction study clinical trials (STREAMLINE lung & STREAMLINE colon for cancer metastasis, METRIC for Crohn’s disease) and two NIHR prognostic studies (PROSPECT for colon cancer recurrence, ARCHIE: antibiotics for at risk children with influenza). Sue joins the statistical team on diagnostic trials ongoing in the Birmingham Clinical Trials Unit.

Sue has over 50 peer reviewed research publications, most in diagnosis and prognosis, including design, analysis and methodology research. She is a member of the Cochrane Diagnostic Test Accuracy Editorial team, co-author of a chapter in The Cochrane Diagnostic Test Accuracy Handbook, regularly reviews Cochrane protocols and is on the Steering Committee for QUADAS-2 (risk of bias assessment tool for diagnostic accuracy studies) and PROBAST (risk of bias assessment tool for prediction studies).

Teaching

Postgraduate supervision

Sue is interested in supervising doctoral research students in the following areas

  • Methods for evaluation of medical tests and biomarkers
  • Risk of bias in diagnostic studies or prediction studies
  • Non-randomised clinical trial design
  • Methods for systematic reviews

If you are interested in studying in these areas, contact Sue directly. For general doctoral research enquiries, please email dr@contacts.bham.ac.uk

Research

OVERVIEW OF CURRENT RESEARCH

My research is to design and analyse diagnostic and prognostic studies, including ongoing clinical trials and methodological work. I work closely with clinical teams to improve diagnostic pathways in the NHS, by designing studies and identifying best methods and evidence to inform NHS practice and future NICE guidelines.

My current research as a statistician is informed by 10 years experience as a laboratory based molecular immunologist and includes the following areas:

Statistician on clinical trials

Currently statistician on four multi-centre trials funded by the NIHR working on design and analysis

  • Improving the prediction of metastatic disease in primary colorectal cancer (PROSPECT)
  • Comprehensive staging of newly diagnosed lung and colorectal cancer: prospective multicentre comparison of whole body MRI with standard diagnostic imaging pathways (STREAMLINE)
  • The use of ultrasound and magnetic resonance imaging in the assessment of Crohn’s disease (METRIC0
  • The early use of Antibiotics for at Risk CHildren with InfluEnza in primary care (the ARCHIE programme): development of risk scores for influenza-related clinical deterioration and complications

Previous statistical analysis of diagnostic studies

  • CT colonography - Assessment of radiologist performance with and without Computer Aided Detection. Two studies (i) inexperienced radiologists (ii) experienced radiologists (Prof Steve Halligan)
  • Evaluation of diagnostic strategies for bladder cancer using computed tomography (CT) urography, flexible cystoscopy and voided urine cytology: results for 778 patients from a hospital haematuria clinic (Dr Nigel Cowan)
  • Human papillomavirus testing by self-sampling: assessment of accuracy in an unsupervised clinical setting (Dr Anne Szareswski)

Diagnostic methodology research

  • Systematic reviews of diagnostic accuracy studies: CT colonography in colorectal cancer, Computer Aided Detection in CT colonography, CT colonography for the detection of colonic neoplasia after positive fecal occult blood testing, Reflectance confocal microscopy for melanoma diagnosis in patients with clinically equivocal skin lesions
  • Methodological reviews: Multi-reader multi-case studies using the area under the receiver operator curve as a measure of diagnostic accuracy - Systematic review with a focus on quality of data reporting; Systematic review: Bias in imaging studies - The effect of manipulating clinical context, recall bias and reporting intensity; Systematic reviews of diagnostic tests in cancer: Review of methods and reporting.
  • Design and analysis of the first studies in 3D medical imaging using eye tracking of radiologists reading 3D fly through images of colon.  These studies aim to understand the nature of diagnostic errors and techniques used by experts in search and image interpretation. 
  • Methodological work on measurements of diagnostic accuracy including the disadvantages of ROC AUC and longitudinal missing data methods 
  • Member of Steering Committee for QUADAS2.

Prognostic research

  • Systematic review of prognostic studies including IPD MA: Children at risk of influenza-related complications in primary and ambulatory care: a systematic review of published and unpublished data
  • Steering Committee member for PROBAST risk of bias tool for prediction modelling studies
  • Collaborative project with Professor Seena Fazel and Dr Tom Fanshawe on clinical prediction rules for persons diagnosed with a first episode of severe mental illness for risk of violent crime and suicide
  • Member of TRIPOD prediction modelling reporting guideline group
  • Collaboration with Professor Carl Moons on checklist for data extraction for systematic reviews of prognostic studies
  • Collaboration with Prof Willi Sauerbrei on REMARK reporting guidelines
  • Methodology reviews of prediction modelling studies in cancer with Prof Doug Altman and Prof Patrick Royston.

Other activities

  • NIHR Imaging group under NIHR Statistics group. Joint lead setting up group and remit. Two workshops (Oct 2014, Apr 2015) and networking email list.
  • Member of International Steering Committee for a risk of bias tool for prognostic modelling studies  (PROBAST: Prediction study Risk Of Bias Assessment Tool)
  • Member of International Steering Committee for QUADAS2, a risk of bias assessment tool for diagnostic accuracy studies.  This tool is used for NICE, HTA, The Cochrane Collaboration Diagnostic Test Accuracy reviews as well as other international Health Technology organisations developing health guidance on behalf of governments. 
  • Member of Cochrane Diagnostic Test Accuracy Editorial Team (Feb 2015)
  • Member, Cochrane Diagnostic Tests Accuracy Working Group
  • Member of Diagnostic Evidence Co-operatives (DEC) Methodology group
  • Member of BMBF grant review panel for German Federal Ministry of Education and Research (2015).
  • Visiting fellow of Kellogg College, Oxford University (supernumerary 2015-)
  • Fellow of Kellogg College, Oxford University (supernumerary 2013-2014)

Publications

Helbren E, Fanshawe TR, Phillips P, Mallett S, Boone D, Gale A, et al. The effect of computer-aided detection markers on visual search and reader performance during concurrent reading of CT colonography. Eur Radiol 2015 epub.

Taylor S, Mallett S, Bhatnagar G, Bloom S, Gupta A, Halligan S, et al. METRIC (MREnterography or ulTRasound in Crohn's disease): a study protocol for a multicentre, non-randomised, single-arm, prospective comparison study of magnetic resonance enterography and small bowel ultrasound compared to a reference standard in those aged 16 and over. BMC Gastroenterol 2014;14:142.

Plumb AA, Halligan S, Pendse DA, Taylor SA, Mallett S. Sensitivity and specificity of CT colonography for the detection of colonic neoplasia after positive faecal occult blood testing: systematic review and meta-analysis. Eur Radiol 2014;24(5):1049-58.

Plumb AA, Boone D, Fitzke H, Helbren E, Mallett S, Zhu S, et al. Detection of Extracolonic Pathologic Findings with CT Colonography: A Discrete Choice Experiment of Perceived Benefits versus Harms. Radiology 2014:131678.

Pluddemann A, Wallace E, Bankhead C, Keogh C, Van der Windt D, Lasserson D, et al. Clinical prediction rules in practice: review of clinical guidelines and survey of GPs. Br J Gen Pract 2014;64(621):e233-42.

*7. Moons KG, de Groot JA, Bouwmeester W, Vergouwe Y, Mallett S, Altman DG, et al. Critical appraisal and data extraction for systematic reviews of prediction modelling studies: the CHARMS checklist. PLoS Med 2014;11(10):e1001744.

Mallett S, Phillips P, Fanshawe TR, Helbren E, Boone D, Gale A, et al. Tracking Eye Gaze during Interpretation of Endoluminal Three-dimensional CT Colonography: Visual Perception of Experienced and Inexperienced Readers. Radiology 2014:132896.

Mallett S, Halligan S, Collins GS, Altman DG. Exploration of Analysis Methods for Diagnostic Imaging Tests: Problems with ROC AUC and Confidence Scores in CT Colonography. PLOS ONE 2014;9(10):e107633.