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

In 2004 she moved to the 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.

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.   She 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, she 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.

She has been a health economics co-applicant on a large number of successful research grants including five NIHR Programme Grants in chronic diseases and she has also been involved in a large number of HTA funded studies concerning areas such as COPD, anticoagulation for VTE, oxygen for acute stroke and speech therapy for Parkinson’s disease

Teaching Programmes

• MSc Health Economics and Health Policy
• MSc Health Economics and Econometrics
• Medicine and Surgery MBChB 2^nd year Medicine in Society
• BSc Economics 3rd year Health Economics module

Sue has successfully supervised 4 PhD students to completion and currently supervises 3 PhD students in topic areas of the use of decision modelling in assessment of cost-effectiveness of stratified care in musculoskeletal disease, incorporating spillovers into economic evaluations and model guidelines and cardiovascular disease. 

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 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 currently oversees the health economics research on three NIHR Programme Grants (VTE, hypertension, stroke in primary care) and a SPCR-funded trial on hypertension treatment in the elderly.   She has also advised on the modelling of the long-term cost-effectiveness of blood pressure diagnosis which forms part of the NICE hypertension guidelines.

The VTE programme includes a trial and model based economic evaluation of extended warfarin therapy for unprovoked VTE, and linked to this is a recently published HTA study on stopping rules for anticoagulation after VTE, which included economic modelling.   In collaboration with Oxford University, Sue leads the economic components of the programme grant “Optimising the diagnosis and management of hypertension in primary care through self-monitoring of blood pressure”, which builds on the previously published work from the TASMINH, TASMIN2 & TASMIN-SR trials. The OPTIMISE trial, also led by Oxford concerns optimising antihypertension medication in the elderly with mild systolic hypertension.  She is also a co-investigator on one Cambridge-led study – a programme grant looking at primary care management of stroke patients.   The Stroke Prevention programme grant report is now complete and work has either been published (TASMIN-SR, PAST-BP), or being written up for publication (polypill for primary prevention). The SOS trial concerning oxygen supplementation in acute stroke care is awaiting publication by the HTA.

Previous studies which have been published have included the SAFE, SMART and BAFTA trials, The TASMINH2 trial, the European Action on Anticoagulation trial which investigated the use of computerised decision support software in dosing of anticoagulation and a patient cost sub-study of the SPORTIF III trial concerning new treatments for AF.

Using the SAFE trial, Sue completed a PhD entitled ‘"Using decision analytical modelling techniques in health economics: an application to screening for and treatment of atrial fibrillation".   The research consisted of two core components i) the application of decision analytic modelling to explore the most cost-effective method of screening for AF and ii) the investigation of different approaches to modelling, including the investigation of the circumstances of scenarios where the modelling approaches of Markov and individual sampling models are most appropriate.   A parallel modelling exercise was conducted using these different approaches.

Musculoskeletal disease

Sue leads the health economics portfolio of research conducted in collaboration with the Arthritis Research UK Primary Care Centre at Keele University on a wide variety of musculoskeletal disorders.   Three core areas of research concern back pain, osteoarthritis and stratified care.   An NIHR-funded programme of work on back pain contained three workstreams of which two contained health economics aspects. In the physical workstream the ATLAS (Assessment and Treatment of Leg pain Associated with the Spine) cohort study included an exploration of quality of life, health care and wider societal costs associated with back pain, and the social workstream concerned the primary care management of work-related issues in back pain patients (the SWAP trial). Both have been submitted to journals for publication.

An NIHR funded programme of work on osteoarthritis is also complete and contained four components, three of which contained trials, each including health economics aspects.   BEEP is an exercise trial in knee pain, POST is a trial to screen for anxiety and depression in OA and MOSAICS is exploring model OA consultations in primary care.   The fourth study was conducted as a PhD to look at predictors of persistent pain and optimal primary care for OA. Again, all are in the process of being submitted for publication, with the clinical paper for POST being published in PLOS Medicine.

Two further NIHR Programme Grants are ongoing. One grant is exploring the use of stratified care for musculoskeletal disease, building on Keele’s previous work on stratified care in back pain The other grant concerns the use of prognostic and diagnostic information for targeting treatment in shoulder pain. Additional research either ongoing or being written up for publication includes trials concerning treatments for gout and carpal tunnel syndrome, self-referral to physiotherapy, and stratified care for sciatica.

As part of the collaboration and musculoskeletal portfolio of research, two PhDs have been funded by Keele University, one based in Birmingham and one in Keele, but both with supervision teams spanning both Universities. Sue is the lead supervisor for James Hall, based at Keele, who is exploring the use of decision modelling in the assessment of cost-effectiveness of stratified care in musculoskeletal disease.

Previously, two Keele-funded PhDs have been completed successfully - Jerome Wulff from Keele University who undertook research on optimal primary care for osteoarthritis which included decision modelling and was part of the OA programme grant and Jesse Kigozi from the University of Birmingham who looked at the economics of back pain, concentrating on the measurement of absenteeism and presenteeism and associated productivity costs.

Respiratory disease

Sue is leading the health economics research on a programme of work concerning chronic obstructive pulmonary disease (COPD) led by colleagues within the Institute.   Projects include a case finding RCT containing a within-trial and beyond-trial economic evaluation, and a primary care cohort study which is exploring resource use and quality of life of COPD patients, and provides data for decision modelling in COPD. The clinical trial and within trial analysis has been published in Lancet Respiratory and the model-based analysis is being written up for publication.

Two HTA-funded systematic reviews with economic modelling have been published, one concerning non-invasive ventilation in end-stage COPD and the other considered self-management strategies for moderate to severe COPD patients. Self-management is also the focus of a NIHR NSPCR-funded trial, which is currently being written up for publication.

Research Centres

http://www.keele.ac.uk/pchs/

 External Examiner

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

Steering Committees

• 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” led by Professors Naomi Fulop & Steve Morris (UCL) (2013-present)

Funding Committees

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