Mr Gavin Rudge Msc

Mr Gavin Rudge

Institute of Applied Health Research
Research Fellow

Contact details

Telephone
+44 (0)121 414 7852
Email
g.rudge@bham.ac.uk
Address
Murray Learning Centre
University of Birmingham
Edgbaston
Birmingham
B15 2TT
UK

Gavin is a Research Fellow specialising in observational studies in healthcare. He is particularly interested in linkage studies, secondary care service utilisation, cohort studies and the use of spatial data in health research.  He also works as a front-line advisor in the West Midlands Research Design Service, where he provides specialist advice to clinicians and academics who are developing research proposals for submission to grant awarding bodies.

Qualifications

  • MSc in Managing Quality in Healthcare, University of Birmingham, 2003

Biography

Gavin joined the University of Birmingham in 2000 having had a background in the NHS. He started his health service career in Workforce analytics in the Regional Health Authority and moved into Clinical Audit shortly after it was first introduced into the NHS in the early 1990s.  He worked initially in Clinical Audit in primary care, specialising in diabetes and later as a Clinical Audit Manager in a Community Health Trust where he delivered clinical audit programmes in acute psychiatry, learning disability, community paediatrics and allied health professions providing community services. 

On joining the University Gavin worked for the West Midlands Levy Fund, a portfolio of applied research commissioned by Directors of Public Health in the West Midlands. He delivered work on case-mix analysis, health needs assessments and managed a Regional A&E Surveillance Centre which provided intelligence on how populations used Emergency Departments. He was also involved in Geographical Information Systems (GIS) in decision support and worked with a team of researchers to develop the first GIS capability in the Department.  After the Public Health Reforms of 2012 the focus of applied health research shifted to the Collaboration for Leadership in Applied Health and Care (CLAHRC). The University won funding from the NIHR to run a CLAHRC and Gavin was one of the researchers who joined at its inception, working on a portfolio that included elective surgery outcomes, health and housing and child and maternal health. The CLAHRC model involved spinning off a number of funded projects and Gavin has worked on a number of these. 

Gavin remains a Research Fellow in the Institute with a varied research portfolio as outlined in the research section below. 

Teaching

MBChB

  • Evidence Based Medicine and Research Methods

 Master’s in Public Health

  • Health Information and Health Informatics
  • Sociology and Social Policy

Postgraduate supervision

Master's in Public Health (MPH) 

Research

Gavin tackles research questions which rely on understanding how populations use acute hospital care.  Acute hospitals in the English NHS have a common data set which is highly complex and evolves over time.  It is a challenging data set to work with, as it records many millions of patient contacts every year and uses complex coding systems which require specialist knowledge to work with.  Gavin has over 20 years’ experience working with these data and typically delivers at-scale observational studies on large populations.

He is currently working on a study of survivors of childhood cancer. He is exploring how survivors use hospitals in their life course, not just for subsequent cancers, but also any other illness requiring treatment. This has involved linking data on survivors to hospital admissions data and then comparing the admission patterns of survivors to that of the general population.

Gavin is also working with the Child and Maternal Health team of the West Midlands ARC to explore emergency readmission following giving birth.  This is a study of over 6 million births in England occurring between 2007 and 2017. It seeks to understand the factors that may predict emergency readmission and to explore why the proportion of births affected and the underlying readmission diagnoses are changing over time. The analysis has been completed and a paper is currently being written.

This work draws on notable observational studies he has previously worked on many of which have been published in high-impact journals.  He undertook the largest mother and baby hospital linkage study that has been published thus far.  He linked admission records of over 7 million children in early life course back to their birth events.  This NIHR funded study was used to explore how changes in antibiotic protocols affected prevalence of auto-immune and other diseases in offspring.  As parents and their children are not linked on national NHS IT systems, a deterministic / probabilistic matching algorithm had to be used to deliver this work.  The results were published in the British Medical Journal 

Another hospital-based study Gavin has worked on was the HiSLAC study. This was an NIHR funded national evaluation of the Seven Day Services policy introduced in 2014. This study examined the association between case-mix adjusted mortality with consultant staffing at weekends.  It analysed admissions and mortality in 20 Hospital Trusts. The work required calculating the secular trend of case-mix adjusted in-hospital mortality for the whole of England for several years which involved interrogating tens of millions of hospital admission records. Seven papers relating to this study were published including one in The Lancet.  He was invited to collaborate on this study following earlier work he had done on hospital mortality and patient safety.

The other area of Gavin’s work is using spatial data in health research.  Typically, he collaborates with cohort studies which need to add geographic variables to their data and analyse them with respect to environment or location. He also undertakes his own research in this area, an example being as a well-cited study of how distance from hospital affects the use of A&E departments (https://doi.org/10.1371/journal.pone.0067943). He is also interested in how urban form affects walkability and in turn, how this affects physical activity. He has collaborated with several teams of researchers in Germany and has explored the relationship between physical activity in cohort subjects and walkability of their neighbourhoods using GIS-based metrics he has developed himself (https://doi.org/10.1136/BMJOPEN-2019-033941). He is also working on a similar study using a general health and lifestyle cohort in Taiwan which is being prepared for publication.

Gavin contributes to pedagogy in the College of Medical and Dental Sciences, where he teaches research methods to undergraduate medical students.  He also lectures on demographics, health informatics, and health and place on the Master’s in Public Health Programme (MPH). He also supervises Master’s dissertations on the MPH.

Gavin also works part-time as a Front Line Advisor for the West Midlands Research Design Service where he assists applicants for research funding from the health and knowledge economies of the Region to develop their research proposals for submission.

Publications

Mathers, J., Poyner, C., Thompson, D., Rudge, G., & Pritchett, R. V. (2022). Exploration of the uptake of asymptomatic COVID-19 lateral flow testing in Birmingham, UK: survey and qualitative research. BMJ Open, 12(4), e056606. https://doi.org/10.1136/bmjopen-2021-056606

Parulekar, P., Powys-Lybbe, J., Knight, T., Smallwood, N., Lasserson, D., Rudge, G., Miller, A., Peck, M., & Aron, J. (2022). CORONA (COre ultRasOund of covid in iNtensive care and Acute medicine) study: National service evaluation of lung and heart ultrasound in intensive care patients with suspected or proven COVID-19: Journal of the Intensive Care Society,  https://doi.org/10.1177/17511437211065611

Šumilo, D., Nirantharakumar, K., Willis, B. H., Rudge, G. M., Martin, J., Gokhale, K., Thayakaran, R., Adderley, N. J., Chandan, J. S., Okoth, K., Harris, I. M., Hewston, R., Skrybant, M., Deeks, J. J., & Brocklehurst, P. (2022). Long term impact of prophylactic antibiotic use before incision versus after cord clamping on children born by caesarean section: longitudinal study of UK electronic health records. BMJ, 377, e069704. https://doi.org/10.1136/BMJ-2021-069704

Bion, J., Aldridge, C., Girling, A. J., Rudge, G., Sun, J., Tarrant, C., Sutton, E., Willars, J., Beet, C., Boyal, A., Rees, P., Roseveare, C., Temple, M., Watson, S. I., Chen, Y. F., Clancy, M., Rowan, L., Lord, J., Mannion, R., … Lilford, R. (2021). Changes in weekend and weekday care quality of emergency medical admissions to 20 hospitals in England during implementation of the 7-day services national health policy. BMJ Quality and Safety, 30(7), 536–546. https://doi.org/10.1136/bmjqs-2020-011165

Singhal, R., Ludwig, C., Rudge, G., Gkoutos, G. V., Tahrani, A., Mahawar, K., Pędziwiatr, M., Major, P., Zarzycki, P., Pantelis, A., Lapatsanis, D. P., Stravodimos, G., Matthys, C., Focquet, M., Vleeschouwers, W., Spaventa, A. G., Zerrweck, C., Vitiello, A., Berardi, G., … Saydam, M. (2021). 30-Day Morbidity and Mortality of Bariatric Surgery During the COVID-19 Pandemic: a Multinational Cohort Study of 7704 Patients from 42 Countries. Obesity Surgery, 31(10), 4272–4288. https://doi.org/10.1007/S11695-021-05493-9/FIGURES/1

Crowe, F., Zemedikun, T., Okoth, K., Adderley, J., Rudge, G., Sheldon, M., Nirantharakumar, K., & Marshall, T. (2020). Comorbidity phenotypes and risk of mortality in patients with ischaemic heart disease in the UK. Heart, 106, 810–816. https://doi.org/10.1136/heartjnl-2019-316091

Kartschmit, N., Sutcliffe, R., Sheldon, M. P., Moebus, S., Greiser, K. H., Hartwig, S., Thürkow, D., Stentzel, U., van den Berg, N., Wolf, K., Maier, W., Peters, A., Ahmed, S., Köhnke, C., Mikolajczyk, R., Wienke, A., Kluttig, A., & Rudge, G. (2020). Walkability and its association with prevalent and incident diabetes among adults in different regions of Germany: results of pooled data from five German cohorts. BMC Endocrine Disorders, 20(1), 7. https://doi.org/10.1186/s12902-019-0485-x

Kartschmit, N., Sutcliffe, R., Sheldon, M. P., Moebus, S., Greiser, K. H., Hartwig, S., Thürkow, D., Stentzel, U., Van Den Berg, N., Wolf, K., Maier, W., Peters, A., Ahmed, S., Köhnke, C., Mikolajczyk, R., Wienke, A., Kluttig, A., & Rudge, G. (2020). Walkability and its association with walking/cycling and body mass index among adults in different regions of Germany: a cross-sectional analysis of pooled data from five German cohorts. BMJ Open, 10(4), e033941. https://doi.org/10.1136/BMJOPEN-2019-033941

Akiboye, F., Adderley, N. J., Martin, J., Gokhale, K., Rudge, G. M., Marshall, T. P., Rajendran, R., Nirantharakumar, K., & Rayman, G. (2019).  Impact of the Diabetes Inpatient Care and Education ( DICE ) project on length of stay and mortality . Diabetic Medicine, 1–9. https://doi.org/10.1111/dme.14062

Rudge, G. (2019). The rise and fall of the weekend effect. Journal of Health Services Research and Policy, 24(4), 217–218. https://doi.org/10.1177/1355819619869366

Šumilo, D., Nirantharakumar, K., Willis, B. H., Rudge, G., Martin, J., Gokhale, K., Thayakaran, R., Adderley, N. J., Chandan, J. S., Okoth, K., Hewston, R., Skrybant, M., Deeks, J. J., & Brocklehurst, P. (2019). Long-term impact of giving antibiotics before skin incision versus after cord clamping on children born by caesarean section: protocol for a longitudinal study based on UK electronic health records. BMJ Open, 9(9), e033013. https://doi.org/10.1136/bmjopen-2019-033013

Sun, J., Girling, A. J., Aldridge, C., Evison, F., Beet, C., Boyal, A., Rudge, G., Lilford, R. J., & Bion, J. (2019). Sicker patients account for the weekend mortality effect among adult emergency admissions to a large hospital trust. BMJ Quality and Safety, 28(3), 223–230. https://doi.org/10.1136/bmjqs-2018-008219

Jones, E., Taylor, B., Rudge, G., MacArthur, C., Jyothish, D., Simkiss, D., & Cummins, C. (2018). Hospitalisation after birth of infants: Cross sectional analysis of potentially avoidable admissions across England using hospital episode statistics. BMC Pediatrics, 18(1), 1–10. https://doi.org/10.1186/s12887-018-1360-z

Bion, J., Aldridge, C. P., Girling, A., Rudge, G., Beet, C., Evans, T., Temple, R. M., Roseveare, C., Clancy, M., Boyal, A., Tarrant, C., Sutton, E., Sun, J., Rees, P., Mannion, R., Chen, Y.-F., Watson, S. I., & Lilford, R. (2017). Two-epoch cross-sectional case record review protocol comparing quality of care of hospital emergency admissions at weekends versus weekdays. BMJ Open, 7(12), e018747. https://doi.org/10.1136/bmjopen-2017-018747

Rudge, G., Hartwig, S., Sheldon, M., Kluttig, A., Sutcliffe, R., & Greiser, K. (2017). Developing a walkability metric to explore the association between built environment and walking behaviour in seven German cities. Gesundheitswesen, 79, 656–804. https://doi.org/10.1055/s-0037-1605655

Saunders, P. J., Middleton, J. D., & Rudge, G. (2017). Environmental Public Health Tracking: A cost-effective system for characterizing the sources, distribution and public health impacts of environmental hazards. Journal of Public Health (United Kingdom), 39(3), 506–513. https://doi.org/10.1093/pubmed/fdw130

Rudge, G., Sheldon, M., Jenkinson, D., & Howie, F. (2015). Alcohol specific hospital admission in under-age drinkers and neighbourhood alcohol retail environment: a geospatial analysis set in a population in central England. Journal of Epidemiology and Community Health, 69(Suppl 1), A72.2-A72. https://doi.org/10.1136/jech-2015-206256.143

Aldridge, C., Bion, J., Boyal, A., Chen, Y. F., Clancy, M., Evans, T., Girling, A., Lord, J., Mannion, R., Rees, P., Roseveare, C., Rudge, G., Sun, J., Tarrant, C., Temple, M., Watson, S., & Lilford, R. (2016). Weekend specialist intensity and admission mortality in acute hospital trusts in England: a cross-sectional study. The Lancet, 388(10040), 178–186. https://doi.org/10.1016/S0140-6736(16)30442-1

Hartwig, S., Rudge, G., Sheldon, M., Greiser, K. H., Haerting, J., Thürkow, D., & Kluttig, A. (2016). Methods of Assessment of Walkability and its Association with Physical Activity and Anthropometric Markers in a Population-based Study in the City of Halle (Saale). Journal of Epidemiology and Community Health, 70(Suppl 1), A114 LP-A114. https://doi.org/10.1136/jech-2016-208064.233

Mohammed, M. A., Lilford, R., Rudge, G., Holder, R., & Stevens, A. (2013). The findings of the Mid-Staffordshire Inquiry do not uphold the use of hospital standardized mortality ratios as a screening test for ‘bad’ hospitals. QJM: An International Journal of Medicine, 106(9), 849–854. https://doi.org/10.1093/QJMED/HCT101

Mohammed, M. a, Rudge, G., Watson, D., Wood, G., Smith, G. B., Prytherch, D. R., Girling, A., & Stevens, A. (2013). Index blood tests and national early warning scores within 24 hours of emergency admission can predict the risk of in-hospital mortality: a model development and validation study. PloS One, 8(5), e64340. https://doi.org/10.1371/journal.pone.0064340

Rudge, G. M., Mohammed, M. A., Fillingham, S. C., Girling, A., Sidhu, K., & Stevens, A. J. (2013). The combined influence of distance and neighbourhood deprivation on Emergency Department attendance in a large English population: a retrospective database study. PloS One, 8(7), e67943. https://doi.org/10.1371/journal.pone.0067943

Rudge, G. M., Suglani, N., Saunders, P., & Middleton, J. (2013). Are Fast Food Outlets Concentrated in more Deprived Areas? A Geo-Statistical Analysis of an Urban Area in Central England. Journal of Epidemiology and Community Health, 67(Suppl 1), A14 LP-A14. https://doi.org/10.1136/jech-2013-203126.24

Mohammed, M. A., Sidhu, K. S., Rudge, G., & Stevens, A. J. (2012). Weekend admission to hospital has a higher risk of death in the elective setting than in the emergency setting: A retrospective database study of national health service hospitals in England. BMC Health Services Research, 12(1), 1–10. https://doi.org/10.1186/1472-6963-12-87

Prytherch, D., Rudge, G., Nangalia, V., Briggs, J., Mohammed, M. A., Holder, R., Wood, G., & Smith, G. (2012). Which Is More Useful in Predicting Hospital Mortality -Dichotomised Blood Test Results or Actual Test Values? A Retrospective Study in Two Hospitals. In PLoS ONE (Vol. 7, Issue 10, p. e46860). https://doi.org/10.1371/journal.pone.0046860

Benning   Maisoon Ghaleb, Anu Suokas, Mary Dixon-Woods, Jeremy Dawson, Nick Barber, Bryony Dean Franklin, Alan Girling, Karla Hemming, Martin Carmalt, Gavin Rudge, Thirumalai Naicker, Ugochi Nwulu, Sopna Choudhury, A., & Lilford, R. (2011). Large scale organisational intervention to improve patient safety in four UK hospitals: Mixed method evaluation. BMJ, 342:d195.

Benning, A., Dixon-Woods, M., Nwulu, U., Ghaleb, M., Dawson, J., Barber, N., Franklin, B. D., Girling, A., Hemming, K., Carmalt, M., Rudge, G., Naicker, T., Kotecha, A., Derrington, M. C., & Lilford, R. (2011). Multiple component patient safety intervention in English hospitals: controlled evaluation of second phase. BMJ (Clinical Research Ed.), 342, d199.

Greiser, K. H., Tiller, D., Kuss, O., Kluttig,  a., Rudge, G., Schumann, B., Werdan, K., & Haerting, J. (2011). Association of neighbourhood socioeconomic status and individual socioeconomic status with cardiovascular risk factors in an Eastern German population - the CARLA Study 2002-2006. Journal of Epidemiology & Community Health, 65(August), A249–A249. https://doi.org/10.1136/jech.2011.142976i.39

Mohammed, M. A., Deeks, J. J., Girling, A., Rudge, G., Carmalt, M., Stevens, A. J., & Lilford, R. J. (2009). Evidence of methodological bias in hospital standardised mortality ratios: retrospective database study of English hospitals. BMJ (Clinical Research Ed.), 338, b780.

Taylor, J. C., Law, G. R., Boyle, P. J., Feng, Z., Gilthorpe, M. S., Parslow, R. C., Rudge, G., & Feltbower, R. G. (2008). Does population mixing measure infectious exposure in children at the community level? European Journal of Epidemiology, 23(9), 593–600. https://doi.org/10.1007/s10654-008-9272-0

Downing, A., Rudge, G., Cheng, Y., Tu, Y.-K., Keen, J., & Gilthorpe, M. S. (2007). Do the UK government’s new Quality and Outcomes Framework (QOF) scores adequately measure primary care performance? A cross-sectional survey of routine healthcare data. BMC Health Services Research, 7, 166.

Downing, A., & Rudge, G. (2006). A study of childhood attendance at emergency departments in the West Midlands region. Emergency Medicine Journal : 23(5), 391–393.