Professor Sue Jowett PhD, MSc, BSc

• PhD in Health Economics, University of Birmingham, 2007
• MSc Applied Meteorology and Climatology, University of Birmingham, 1995
• BSc (Hons) Geography, University of Bristol, 1993

Sue Jowett qualified with a BSc in Geography from the University of Bristol in 1993 and completed an MSc in Applied Meteorology and Climatology at the University of Birmingham in 1995. A change of direction led Sue to join Primary Care Clinical Sciences at Birmingham in 1995 as a Research Associate and became a Research Fellow in 2001, undertaking health economic evaluations in collaboration with the Health Economics Unit (HEU).

In 2004 Sue moved to HEU and studied part-time for a PhD in Health Economics, gained in 2007. In 2010 she was appointed to a Senior Lecturer position to lead the health economics research within studies undertaken by the Arthritis Research UK Primary Care Centre at Keele University, as part of a formal collaboration between the HEU and Keele. She successfully gained a permanent HEFCE Senior Lecturer post in 2013 and was promoted to Reader in 2017. Sue was promoted to Professor in 2021.

The majority of Sue’s work to date has been in the area of economic evaluation alongside interventions for the prevention of cardiovascular disease, and management of musculoskeletal disease. Her initial health economics research was on three large clinical trials concerning AF and anticoagulation, and expertise gained in this area led to further collaboration with colleagues at Birmingham, Oxford and Cambridge. Sue advised the NICE Guidelines Development Group on the modelling undertaken for blood pressure diagnosis for their Hypertension Guidelines.

As lead of the collaboration with Keele, Sue oversees the health economics aspects many trials and cohort studies and is the lead health economist on research grant applications.

Sue has been a health economics co-applicant on a many successful research grants including ten National Institute for Health Research (NIHR) Programme Grants in chronic diseases and she has also been involved in a large number of Health Technology Assessment (HTA) funded studies concerning areas such as COPD, musculoskeletal conditions, liver disease, and management of acute stroke. She has also been a co-investigator on three Global Health projects in COPD and atrial fibrillation. More recent work has linked back to her original qualifications in geography and climatology, including a NERC-funded grant on air pollution in the West Midlands, a Wellcome Trust grant on the health implications of Net-Zero policies and two NIHR grants exploring carbon reduction on both surgery and primary care.

Teaching Programmes

• MSc Health Economics and Health Policy
• MSc Health Economics and Econometrics
• Medicine and Surgery MBChB: 2nd year Medicine in Society
• MSc MPH

• MSc Genomic Medicine

Sue has successfully supervised 7 PhD students to completion and currently supervises 3 PhD students in the topic areas of Surgical Site Infection prevention in LMICs, Delegation in Musculoskeletal Outpatient Physiotherapy and Decision-analytical modelling to estimate economic implications of population obesity and preventative actions on local authority budgets

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

• Decision modelling in economic evaluation
• Trial-based economic evaluation
• Aspects of economic evaluation in chronic disease (COPD, musculoskeletal disease, cardiovascular disease)
• Application of health economics to environmental issues (e.g. air pollution, Net-Zero)

Cardiovascular disease and anticoagulation

Sue has worked on numerous projects in the clinical topics of cardiovascular disease and anticoagulation since embarking on a career in health economics in 2001.

She advised on the modelling of the long-term cost-effectiveness of blood pressure diagnosis which was published in the Lancet and formed part of the NICE hypertension guidelines.  In collaboration with Oxford University, Sue has led the economic component on a number of studies on the diagnosis and management of hypertension in primary care, with an emphasis on self-monitoring, including the TASMINH, TASMIN2 & TASMIN-SR trials. More recently the TASMINH4 trial and the PROOF-BP study have had results published in The Lancet and Hypertension, and the OPTIMISE trial, which explored reducing antihypertension medication in the elderly was published in JAMA and Hypertension. Two global health studies, Global AF Reach  which undertook research into atrial fibrillation (AF) in Sri Lanka, Brazil and China, and Treats-AF which investigated an educational intervention for anticoagulation therapy in AF patients in Thailand are both completed and being written up for publication.

Sue’s current projects in this clinical area include the MAPS-2 trial (metoclopramide to prevent pneumonia after stroke), ABBRUPT, which looks at treatment for new onset AF in acute care settings and a NIHR programme grant concerning an intervention for post-stroke fatigue.

Musculoskeletal disease

Sue leads the health economics portfolio of research conducted in collaboration with Primary Care researchers at  Keele University on a wide variety of musculoskeletal disorders.  Core areas of research concern stratified care, osteoarthritis (OA) and inflammatory conditions. This long-standing research partnership has led to a number of key publications, for example the INSTINCTS trial, published in the Lancet, is the largest trial undertaken of corticosteroid injection compared with night splints for the relatively common but painful problem of carpal tunnel syndrome, and the first study to include a health economics analysis of these interventions.

Whilst the work with Keele has traditionally focussed on trial based economic evaluation, Sue has ensured that more recent work also includes a decision model-based evaluation to explore longer-term cost-effectiveness. Two NIHR Programme Grants containing trial and model-based economic evaluations are ongoing, concerning the use of prognostic and diagnostic information for targeting treatment in shoulder pain (PANDA-S) and a pharmacist-led primary care intervention for opioid-treated persistent non-cancer pain (PROMPPT). Three NIHR-funded trials HTA are also in progress on knee-braces for knee OA (PROP-OA), an allopurinol-based treat-to-target protocol for recurrent gout (T2T) and a vocational advice service for return to work (WAVE).

A new Programme Grant, CAM-PAIN, will determine the longer-term outcomes of child/adolescent musculoskeletal pain in primary care by describing overall prognosis, identifying prognostic factors, and estimating health service costs of children/adolescents presenting with new musculoskeletal pain, using Clinical Practice Research Datalink (CPRD) data. Additional new studies in their set up phase are FORENSIC assessing the effectiveness of lumbar fusion in severe low back pain and IDEAL, which will evaluate the diagnosis and Early referral of patients with AxiaL Spondyloarthiritis.

Three Keele-funded PhDs (with co-supervision from Sue) have been completed successfully on optimal care for OA, absenteeism and presenteeism in back pain patients and the use of decision modelling in the assessment of cost-effectiveness of stratified care in musculoskeletal disease.

Respiratory disease

Sue leads the health economics research on the programme of respiratory disease work, primarily concerning chronic obstructive pulmonary disease (COPD), led by colleagues within the Institute.

There are two NIHR-funded trials in this area with one assessing an intervention to manage acute exacerbations in COPD (Predict & Prevent), and one concerning smoking cessation with electronic cigarettes in COPD (ECal). Previous work includes Breathewell, an NIHR-funded Global Health programme of work of case finding and management of COPD in Brazil, China, Georgia and North Macedonia, and health economics is an integral component of the research in all four countries, and the TARGET-COPD case finding trial containing a within-trial and beyond-trial economic evaluation. The clinical trial has been published in Lancet Respiratory Medicine and the model-based analysis, the first of its kind, was published in Thorax.

Air pollution and Net-Zero

Bringing together her expertise in respiratory and cardiovascular disease, Sue is a co-investigator on WM-Air, a cross-College collaboration with the College of Life and Environmental Sciences, which secured £5m in funding from the NERC Regional Impact from Science of the Environment (RISE) Programme. The West Midlands Air Quality Improvement Programme (WM-AIR) includes a health strand, and Sue has led the development of a health economics-based toolkit for use by local public health decision makers (AQ-LAT). This downloadable web-based toolkit provides local estimates of how effective air pollution mitigation strategies will be in terms of reduction in mortality and morbidity, quality of life and health care resource use and costs. Sue is also part of the WM-Net Zero project, funded by the Wellcome Trust. This builds on the AQ-LAT modelling and will explore the health impacts of Net Zero polices. She is also a co-investigator on two new Net Zero studies, looking at decarbonisation in General Practice (GPNET-0, Warwick University) and the GreenSurg Programme, a £2.5m NIHR Programme Grant looking at interventions to reduce the carbon footprint of surgery.

Liver disease

More recently, Sue has become involved in Birmingham-led NIHR HTA trials concerning liver cirrhosis. CALIBRE compares carvedilol with variceal band ligation for the primary prevention of variceal bleeding in liver cirrhosis, and REACT-AVB compares Early transjugular intrahepatic portosystemic stent-shunt (TIPSS) in acute variceal bleeding.

External Examiner

• Executive MSc in Health Economics, Outcomes and Management in Cardiovascular Sciences, Department of Social Policy, London School of Economics (2016-2021)
• MSc in Health Research, Warwick Medical School, Warwick University (2017-2021)

Steering Committees

• Member of the Trial Steering Committee for the Optimising Prescription of Treatment In older patients with Mild hypertension at Increased risk of Serious adverse Events (OPTIMISE2) trial. Funded by the NIHR HTA programme. (Lead: Dr James Sheppard, University of Oxford) (2022-)
• Member of the Trial Steering Committee for the iRehab trial:Remote multicomponent rehabilitation intervention in survivors of critical illness post hospital discharge: a randomised controlled assessor blind clinical and cost effectiveness trial with internal pilot. Funded by the NIHR HTA programme. (Leads: Professor Danny McAuley (Queen’s University Belfast) and Dr Brenda O’Neill (Ulster University) (2022-)
• Member of the Trial Steering Committee for the PART trial: The clinical and cost-effectiveness of elective primary total knee replacement with PAtellar Resurfacing compared to selective patellar resurfacing. A pragmatic multicentre randomised controlled Trial with blinding (PART). Leads: Professor Ashley Blom & Dr Gulraj Matharu (University of Bristol) (2022-)
• Member of the Trial Steering Committee for the DEFINE trial: Determining the Effectiveness of a FeNO-guided asthma management intervention in primary care: a pragmatic randomised controlled trial with nested economic and process evaluations. Funded by the NIHR Programme for Applied Research. (Lead: Dr Kay Wang, University of Oxford) (2021-)
• Member of the WHiTE Platform Joint Oversight Committee and Trial Steering Committee for FRUITI (Fix or Replace Undisplaced Intracapsular fractures Trial of Interventions). Funded by the NIHR HTA programme. (Lead: Dr Xavier Griffin, University of Oxford) (2020-)
• Member of the Trial Steering Committee for the RISAPS trial: Rivaroxaban versus warfarin for stroke patients with antiphospholipid syndrome, with or without SLE (RISAPS): a randomised, controlled, phase II/III non-inferiority trial. Funded by Arthritis Research UK. (Lead: Dr Hannah Cohen, University College London) (2018-present)
• Member of the Trial Steering Committee for the ARTISAN trial: Acute Rehabilitation following traumatic anterior shoulder dislocation. Funded by the NIHR HTA programme. (Lead: Professor Rebecca Kearney, University of Warwick) (2018-2023)
• Member of the Trial Steering Committee for the GRASP trial:  Clinical and cost effectiveness of progressive exercise compared to best practice advice, with or without corticosteroid injection, for the treatment of rotator cuff disorders: a 2x2 factorial randomised controlled trial. Funded by the NIHR HTA programme. (Lead: Professor Sallie Lamb, Oxford University) (2018-2020)
• Member of the Study Steering Committee for the NIHR HS&DR project “Innovations in major system reconfiguration in England: a study of the effectiveness, acceptability and processes of implementation of different models of stroke care” (Lead Professor Naomi Fulop, UCL) (2013-2017)

Funding Committees

• Member of the NIHR HTA Clinical Evaluation and Trials Funding Committee (2016-2020)
• Member of the West Midlands Research for Patient Benefit (RfPB) funding committee (2012-2015)

Professional membership

• Member of the UK Health Economics Study Group (HESG)
• Member of the International Health Economics Association (IHEA)