Krish Nirantharakumar completed his medical degree in 2002 and trained in hospital medicine at University Hospital of North Staffordshire (UHNS), University Hospitals of Birmingham (UHB) and Sandwell and West Birmingham NHS Trust (SWBT). He was elected through exams as a Member of the Royal College of Physicians (MRCP) in 2007. Later he specialised in Public Health Medicine (2007 – 2012) completing a Masters in Public Health (MPH), Membership exams of the Faculty of Public Health (MFPH) and the certificate for completion of specialist training (CCT) in Public health Medicine. During his specialty training he worked across many healthcare sectors including health authorities, health protection units, general practices and hospitals. While in specialty training, he simultaneously pursued a doctoral research degree studying the potential role of informatics and digital technology in improving the care of hospitalised patients with diabetes.
Krish was awarded a clinical research fellowship by the West Midlands Deanery in March 2012 to continue his research work at the University of Birmingham. In April 2013 to gain experience in working within a cross disciplinary environment consisting of computer scientists, engineers and mathematicians in the field of informatics and digital technology in healthcare, he joined the Institute of Digital Healthcare (IDH), University of Warwick. During this period on behalf of the IDH he led and worked on the digital theme of the West Midlands Academic Health Science Network (WM AHSN). He also campaigned for joint working in the field of health informatics in the West Midlands region and as a result found the West Midlands Health Informatics Network (www.wmhin.org). He returned back to University of Birmingham (March 2014) as a Senior Clinical Lecturer after being admitted to the degree of Doctor of Medicine (Dec 2013).
In his current position Krish focusses his research on the role of informatics and digital technology in the management of diabetes and multiple morbidities. He has published in leading diabetes journals including Diabetes Care, Diabetologia and Diabetic Medicine. In addition to this he has an interest in studying the clinical epidemiology of endocrinological disorders.
Krish has vast experience in teaching. He is the programme lead for the Masters in Public Health (MPH) programme and founder/coordinator of the Health Informatics module at University of Birmingham. He has also developed and provided Evidence Based Medicine / Healthcare courses in the West Midlands region and abroad.
Krish has honorary appointments with Public health England (Academic Consultant in Public health: Health Informatics) and University Hospitals Birmingham to carry out his clinical public health duties.
Krish is interested in supervising doctoral and masters research students in the following areas:
The role of informatics and digital technology in the management of diabetes and multiple morbidities.
Epidemiology of endocrinological disorders
Public Heath Informatics and Clinical Informatics
If you are interesting in studying any of these subject areas please contact Krish on the contact details above, or for any general doctoral research enquiries, please email: firstname.lastname@example.org or call +44 (0)121 414 5005.
For a full list of available Doctoral Research opportunities, please visit our Doctoral Research programme listings.
Clinical Decision Support Systems in caring for patients with diabetes
• Clinical Decision Support Systems (CDSS) in the care of hospitalised patients with diabetes:
This project was initially developed as a sub theme under the Birmingham Black Country Collaboration for Leadership in Applied Health Research and Care (BBC – CLAHRC) Theme 9. Krish lead the project under the supervision of Dr.Jamie Coleman and Dr. Tom Marshall in which he and colleagues examined the potential of CDSS to improve in-patient care provided for patients with diabetes. This project has resulted in several publications and presentations in international and national conferences. At present discussions are underway to translate the research findings into CDSS tools and incorporate them as part of electronic medical records in University Hospital of Birmingham and other interested hospitals.
• A novel advanced decision support system for caring patients with diabetic foot disease:
There is considerable variation in amputation rates in patients with diabetic foot disease locally (UK) and globally. One option to reduce variation is to standardise care by using computer interpretable guideline that can provide patient specific advice at the point of care. Krish and colleagues aim to develop and validate one such advanced decision support system with features that could: represent knowledge in National Institute of Health and Care (NICE) guideline on diabetic foot disease in a computer executable format; characterise foot ulcer description in a computer interpretable structured format; denote collected data as per the Association of medical Royal Colleges (AMRC) standards in documenting clinical information; and overcome challenges in managing patients with multiple morbidities. The project is collaboration between many academic institutions nationally and internationally using the www.OpenClinical.net platform and tools developed by Prof. John Fox and colleagues at University of Oxford. Initial exploration to look at the technical feasibility of the project has been promising.
Mobile applications in diabetes
This project is carried out by a doctoral student at University of Warwick supervised by Dr. Paul Sutcliffe and Krish. The student will: 1) look at the evidence on the role of mobile applications in diabetes and 2) aim to develop an app that will help healthcare professionals in managing complex diabetes patients.
Epidemiological studies on diabetes and other endocrinological disorders using routinely available electronic medical records data
In this project Krish and colleagues are working on a series of research questions they aim to answer using the THIN database (primary care data from more than 400 practices). These questions include: 1) the risk of diabetes in those using bisphosphonates; 2) the relationship between glycaemic control in diabetes and fragility fracture; 3) factors that influence bisphosphonate prescription in patients with fragility fracture; and 4) Long term outcome of patients with pituitary disorders . Most of the funding comes from the National School for Primary Care Research (NSPCR).
Born in Guangzhou (BIG) cohort study, China
This is a collaborative project between Guangzhou Women and Children Medical Centre and University of Birmingham. The study will be looking at the genetic, environmental and social factors that will influence health of the mother and the child. In the first phase over the next three years 10,000 paired mothers and babies will be recruited for the project. Krish’s role involved visiting Guangzhou and advising on project management and development of the project plan and monthly meetings to develop questionnaires and assist with writing the cohort profile. His research focus will be on birth and maternal outcome of mothers with endocrinological disorders (diabetes and hypothyroidism).
Targeted intervention to diabetes patients at risk of complications funded by NHS Walsall: 2010 – 2012 (Completed)
This project was a sub theme under CLAHRC Theme 6 (Cardio Vascular Disease Prevention). A pilot cluster randomised trial in a primary care setting where diabetes patients with high risk of complications, defined as UKPDS ten year mortality risk score of greater than 20% and a high HbA1c level, are identified through a population information system and invited to be seen by community diabetes specialist nurses. Sixteen general practices took part in this trial. The trial has successfully concluded and the potential feasibility of such an approach was presented at the primary care diabetes society conference in 2011-12.
Evidence synthesis to determine the benefits of physical activity in type 1 diabetes: Time scale 2010-2012 (Completed)
In this collaborative project lead by Dr. Parth Narendran (Senior Clinical Lecturer) at the Centre for Endocrinology, Diabetes and Metabolism (CEDAM), University of Birmingham, Krish provided methodological input for literature review, systematic review and meta-analysis. In addition to this Krish and colleagues have also used DCCT data to explore the benefits of physical activity in type 1 diabetes. The project has resulted in three publications including one in Diabetologia.
Toulis KA, Hemming K, Stergianos S, Nirantharakumar K, Bilezikian JP. β-adrenergic receptor antagonists and fracture risk: a meta-analysis of selectivity, gender, and site-specific effects. Osteoporos Int. 2014 Jan; 25(1):121-9.
Nirantharakumar K, Hemming K, Narendran P, Marshall T, Coleman JJ. A Prediction Model for Adverse Outcome in Hospitalized Patients With Diabetes. Diabetes Care. 2013 Nov;36(11):3566-72
Nirantharakumar K, Saeed M, Wilson I, Marshall T, Coleman JJ. In-hospital mortality and length of stay in patients with diabetes having foot disease. J Diabetes Complications. 2013 Sep-Oct;27(5):454-8.
Mohammed MA, Marshall T, Nirantharakumar K, Stevens A, Fitzmaurice D. Patterns of warfarin use in subgroups of patients with atrial fibrillation: a cross-sectional analysis of 430 general practices in the United Kingdom. PLoS One. 2013 May 2;8(5):e61979.
Nirantharakumar K, Marshall T, Hemming K, Narendran P, Coleman J.J. Electronic prescription data can identify ‘lost’ discharge codes for diabetes . Diabet Med. 2012 Dec;29(12):e430-5.
Nirantharakumar K, Marshall T, Hodson J, Narendran P, Deeks J, Coleman JJ, Ferner RE. Hypoglycemia in non-diabetic in-patients: clinical or criminal? PLoS One. 2012;7(7):e40384.
Chimen M, Kennedy A, Nirantharakumar K, Pang TT, Andrews R, Narendran P. What are the health benefits of physical activity in type 1 diabetes mellitus? A literature review. Diabetologia. 2012 Mar;55(3):542-51.
Nirantharakumar K, Chen YF, Marshall T, Webber J, Coleman JJ. Clinical decision support systems in the care of inpatients with diabetes in non-critical care setting: systematic review. Diabet Med. 2012 Jun;29(6):698-708