Professor Sue Jowett PhD, MSc, BSc

Professor Sue Jowett

Institute of Applied Health Research
Professor of Health Economics

Contact details

Address
Health Economics Unit
Institute of Applied Health Research
IOEM Building
University of Birmingham
Edgbaston
Birmingham, B15 2TT

Sue Jowett is a Professor in the Health Economics Unit (HEU) and an Honorary Senior Lecturer at the Primary Care Centre Versus Arthritis at Keele University.

Sue has an extensive portfolio of applied research concerning trial and model-based economic evaluations in chronic diseases. Sue oversees all health economics research within studies undertaken by the Primary Care Centre Versus Arthritis at Keele University, as part of a formal collaboration between the HEU and Keele. She also collaborates on a large number of projects at the University of Birmingham and is the health economics lead and co-investigator on over 20 major grants, the majority funded by the NIHR Health Technology Assessment and Programme Grant for Applied Research funding streams. Sue is also involved in NERC-funded WM-AIR programme of work on air pollution in the West Midlands, and is leading the economic component of the health strand. Whilst most of her work has a UK focus, more recent work has considered chronic disease detection and management in LMICs.

Sue has published a large number of economic evaluations in the area of chronic disease prevention and treatment in a community care setting. Her principal clinical areas are musculoskeletal disease, chronic obstructive pulmonary disease (COPD), primary and secondary cardiovascular disease prevention, acute stroke care, liver disease and venous thromboembolism.

Sue teaches health economics, particularly in the area of economic evaluation methodology including decision modelling, to students on the HEU’s MSc in Health Economics and Health Policy, as well as 2nd year medical students at both Birmingham and Keele.

Qualifications

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

Biography

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 her to join Primary Care Clinical Sciences at Birmingham in 1995 as a Research Associate and became a Research Fellow in 2001.

In 2004 Sue moved to the Health Economics Unit (HEU) and studied part-time for a PhD in Health Economics, gained in 2007. In 2010 Sue 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.

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 on 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. She is developing methodological research with Keele and is particularly interested in modelling interventions within musculoskeletal disease.

Sue has been a health economics co-applicant on a large number of successful research grants including seven 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, anticoagulation for pulmonary embolism and management of acute stroke. She is also a co-investigator on three Global Health projects in COPD and atrial fibrillation, and a NERC-funded grant on air pollution in the West Midlands.

Teaching

Postgraduate supervision

Sue has successfully supervised 7 PhD students to completion and currently supervises 2 PhD students in the topic areas of Surgical Site Infection prevention in LMICs, and Ethics and economics of medically unexplained symptoms in Primary Care.

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)

Research

Research Activity

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.

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.

Sue’s current projects in this clinical area include the STOP-APE trial (stopping anticoagulation for sub-segmental pulmonary embolism), the MAPS-2 trial (metoclopramide to prevent pneumonia after stroke and two global health studies, Global AF Reach  which is undertaking research into atrial fibrillation (AF) in Sri Lanka, Brazil and China, and Treats-AF which is investigating an educational intervention for anticoagulation therapy in AF patients in Thailand.

Musculoskeletal disease

Sue leads the health economics portfolio of research conducted in collaboration with the Primary Care Centre Versus Arthritis at Keele University on a wide variety of musculoskeletal disorders.  Core areas of research concern stratified care, osteoarthritis (OA) and inflammatory conditions. Whilst this work 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 are ongoing, concerning the use of prognostic and diagnostic information for targeting treatment in shoulder pain and a pharmacist-led primary care intervention for opioid-treated persistent non-cancer pain. Three NIHR-funded trials HTA are also in progress on knee-braces for knee OA, an allopurinol-based treat-to-target protocol for recurrent gout and a vocational advice service for return to work.

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. The HTA-funded SCOPiC trial (Lancet Rheumatology) was the first trial of a stratified care in primary care for patients with sciatica.

So far, 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 expanding programme of respiratory disease work, primarily concerning chronic obstructive pulmonary disease (COPD), led by colleagues within the Institute.

There are four current NIHR-funded trials underway in this area with two assessing interventions to manage acute exacerbations in COPD (Colour COPD, Predict & Prevent), one concerning smoking cessation with electronic cigarettes in COPD (ECal) and an acute care study looking at ambulatory oxygen for pulmonary fibrosis (Oxypuf). Also ongoing is 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. Previous work includes 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

Bringing together her expertise in respiratory and cardiovascular disease, Sue is also 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 is leading the development of a health economics-based toolkit for use by local public health decision makers. This web-based toolkit will provide 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.

 

 

 

Other activities

External Examiner

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

Steering Committees

  • 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 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 ARTISAN trial: Acute Rehabilitation following traumatic anterior shoulder dislocation. Funded by the NIHR HTA programme. (Lead: Professor Rebecca Kearney, University of Warwick) (2018-present)
  • 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 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)

Peer review

Review Editor. Frontiers in Health. Costs and Resource Allocation (April 2021-present)

Professional membership

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

Publications

Recent publications

Article

Pan, Z, Dickens, A, Chi, C, Kong, X, Enocson, A, Cooper, B, Adab, P, Cheng, KK, Sitch, A, Jowett, S, Adams, R, Correia-de-Sousa, J, Farley, A, Gale, N, Jolly, K, Maglakelidze , M, Maglakelidze , T, Martins , S, Stavrikj, K, Stelmach , R, Turner, A, Williams, S & Jordan, R 2021, 'Accuracy and cost-effectiveness of different screening strategies for identifying undiagnosed COPD among primary care patients (≥40 years) in China: a cross-sectional screening test accuracy study. Findings from the Breathe Well group', BMJ open.

Holden, MA, Callaghan, M, Felson, D, Birrell, F, Nicholls, E, Jowett, S, Kigozi, J, McBeth, J, Borrelli, B, Jinks, C, Foster, N, Dziedzic, K, Mallen, CD, Ingram, C, Sutton , A, Lawton, S, Halliday, N, Hartshorne, L, Williams, H, Browell, R, Hudson, H, Marshall, M, Sowden, G, Herron, D, Asamane, E & Peat, G 2021, 'Clinical and cost-effectiveness of bracing in symptomatic knee osteoarthritis management: protocol for a multi-centre, primary care, randomised, parallel-group, superiority trial', BMJ open, vol. 11, no. 3, e048196. https://doi.org/10.1136/bmjopen-2020-048196

Scobie , S, Jowett, S, Lambe, T, Patel, S, Woolley, R, Rowland, N, Rick, C, Smith, C, Brady , M, Clarke, CE & Sackley, C 2021, 'Lee Silverman voice treatment versus standard speech and language therapy versus control in Parkinson’s disease: preliminary cost-consequence analysis of the PD COMM pilot randomised controlled trial', Pilot and Feasibility Studies, vol. 7, no. 1, 154. https://doi.org/10.1186/s40814-021-00888-y

Harper, L, Hewitt, C, Litchfield, I, Morgan, M, Chanouzas, D, Caulfield, H, Coughlan, L, Dean, C, Fletcher, K, Cramp, F, Greenfield, S, Rowland, N, Jowett, S, Kodabuckus, S, Tearne, S, Sehmi, S, Edwardson, C, Dawkins, NP & Daley, A 2021, 'Management of fatigue with physical activity and behavioural change support in vasculitis: a feasibility study', Rheumatology. https://doi.org/10.1093/rheumatology/keaa890

Hoogendoorn, M, Jowett, S, Dickens, A, Jordan, R, Enocson, A, Adab, P, Versteegh, M & Rutten-van Mölken, M 2021, 'Performance of the EQ-5D-5L plus respiratory bolt-on in the Birmingham COPD Cohort Study', Value in Health. https://doi.org/10.1016/j.jval.2021.05.006

Dunn, KM, Campbell, P, Lewis, M, Hill, JC, van der Windt, D, Afolabi, E, Protheroe, J, Wathall, S, Jowett, S, Oppong, R, Mallen, CD, Hay, EM & Foster, NE 2021, 'Refinement and validation of a tool for stratifying patients with musculoskeletal pain', European Journal of Pain. https://doi.org/10.1002/ejp.1821

Oppong, R, Jowett, S, Lewis, M, Roddy, E, Ogollah, R, Zwierska, I, Datta, P, Hall, A, Hay, E, Shufflebotham, J, Stevenson, K, van der Windt, DA, Young, J & Foster, N 2021, 'The cost-effectiveness of different approaches to exercise and corticosteroid injection for subacromial pain (impingement) syndrome', Rheumatology. https://doi.org/10.1093/rheumatology/keaa903

Sackley, C, Rick, C, Au, P, Brady , MC, Beaton , G, Burton, C, Caulfield, M, Dickson , S, Dowling, F, Hughes, M, Rowland, N, Jowett, S, Masterson-Algar, P, Nicoll , A, Patel, S, Smith , CH, Woolley, R & Clarke, CE 2020, 'A multi-centre randomised controlled trial to compare the clinical and cost effectiveness of Lee Silverman voice treatment versus standard NHS speech and language therapy versus control in Parkinson’s disease: a study protocol for a randomised controlled trial', Trials, vol. 21, no. 1, 436. https://doi.org/10.1186/s13063-020-04354-7

Adab, P, Jordan, R, Fitzmaurice, D, Ayres, J, Cheng, KK, Cooper, B, Daley, A, Dickens, A, Enocson, A, Greenfield, S, Haroon, S, Jolly, K, Jowett, S, Lambe, T, Martin, J, Miller, M, Rai, K, Riley, RD, Sadhra, S, Sitch, A, Siebert, S, Stockley, RA & Turner, A 2020, 'Chronic obstructive pulmonary disease in primary care; from case finding to improving patient outcomes: the Birmingham Lung Improvement Studies (BLISS) research programme', NIHR Journals Library. <https://www.journalslibrary.nihr.ac.uk/#/>

Sarigiovannis, P, Jowett, S, Saunders, B, Corp , N & Bishop, A 2020, 'Delegation by Allied Health Professionals to Allied Health Assistants: a mixed methods systematic review', Physiotherapy. https://doi.org/10.1016/j.physio.2020.10.002

Eldabe, S, Duarte, RV, Gulve, A, Thomson, S, Baranidharan, G, Houten, R, Jowett, S, Sandhu, H, Chadwick, R, Brookes, M, Kansal, A, Earle, J, Bell, J, Robinson, J, Walker, S, Rhodes, S & Taylor, R 2020, 'Does a screening trial for spinal cord stimulation in patients with chronic pain of neuropathic origin have clinical utility and cost-effectiveness (TRIAL-STIM)? a randomised controlled trial', Pain, vol. 161, no. 12, pp. 2820-2829. https://doi.org/10.1097/j.pain.0000000000001977

Sheppard, JP, Burt, J, Lown, M, Temple, E, Lowe, R, Fraser, R, Allen, J, Ford, GA, Heneghan, C, Hobbs, FDR, Jowett, S, Kodabuckus, S, Little, P, Mant, J, Mollison, J, Payne, R, Williams, M, Yu, L-M & McManus, RJ 2020, 'Effect of antihypertensive medication reduction vs usual care on short-term blood pressure control in patients with hypertension aged 80 years and older: The OPTIMISE randomized clinical trial', JAMA The Journal of the American Medical Association, vol. 323, no. 20, pp. 2039-2051. https://doi.org/10.1001/jama.2020.4871

Gjorgjievski, D, Ristovska, R, Stavrikj, K, Farley, A, Adab, P, Adams, R, Dickens, A, Enocson, A, Stanoevski, G, Gale, N, Jowett, S, Rai, K, Sitch, A, Stamenova, A, Krstevska, E & Jordan, R 2020, 'Effectiveness of combining feedback about lung age or exhaled carbon monoxide levels with Very Brief Advice (VBA) and support for smoking cessation in primary care compared to giving VBA and support alone – protocol for a randomized controlled trial within the Breathe Well research program', Open Access Macedonian Journal of Medical Sciences, vol. 8, no. E, pp. 28-36. https://doi.org/10.3889/oamjms.2020.4519

Sheppard, J, Lown, M, Burt, J, Temple, E, Lowe, R, Ashby, H, Todd, O, Allen, J, Ford, GA, Fraser, R, Heneghan, C, Hobbs, FDR, Jowett, S, Little, P, Mant, J, Mollison, J, Payne, R, Williams, M, Yu, L-M & McManus, RJ 2020, 'Generalisability of blood pressure lowering trials to older patients: cross-sectional analysis', Journal of the American Geriatrics Society. https://doi.org/10.1111/jgs.16749

Roddy, E, Clarkson, K, Blagojevic-Bucknall, M, Mehta, R, Oppong, R, Avery, A, Hay, E, Heneghan, C, Hartshorne, L, Hooper, J, Hughes, G, Jowett, S, Lewis, M, Little, P, McCartney, K, Mahtani, K, Nunan, D, Santer, M, Williams, S & Mallen, C 2020, 'Open-label randomised pragmatic trial (CONTACT) comparing naproxen and low-dose colchicine for the treatment of gout flares in primary care', Annals of the Rheumatic Diseases, vol. 79, no. 2, pp. 276-284. https://doi.org/10.1136/annrheumdis-2019-216154

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Expertise

Health Economics