UK Survey Research Articles

Testing for quantile sample selection

Summary This paper provides distribution free tests for detecting sample selection in conditional quantile functions. The first test is an omitted predictor test with the propensity score as the omitted variable. In the case of rejection we cannot distinguish between rejection due to genuine selection or to misspecification. Thus, we suggest a second test using only individuals with propensity score close to one. The latter relies on an ‘identification at infinity’ argument, but accommodates cases of irregular identification, and neither of the two tests requires a continuous exclusion restriction. We apply our procedure to test for selection in log hourly wages using UK survey data and derive an extension of the tests to the conditional mean.

A UK survey evaluation of First Contact Practitioners' and musculoskeletal physiotherapists' confidence, recognition, and referral of suspected axial spondyloarthritis.

Axial Spondyloarthritis is an inflammatory disease associated with significant diagnostic delays. Steen et al. (2021)found inadequate consideration of axial Spondyloarthritis (axSpA) in physiotherapists back pain assessments. Since the previous survey, increased professional education on axSpA has occurred and First Contact Practitioners (FCPs), now widely established in General Practice, are key in supporting earlier recognition. (1) To re-evaluate physiotherapists' and evaluate FCPs' awareness, knowledge, and confidence in screening for and recognising features of axSpA and criteria prompting referral to rheumatology. (2) To compare these results to previous research (Steen et al., 2021). As per Steen et al. (2021), an online survey was undertaken combining back pain vignettes (reflecting axSpA, non-specific low back pain [NSLBP] and radicular syndrome) and questioning on features of suspected axSpA. 165 surveys were analysed. Only 73% (n=120/165) of respondents recognised the axSpA vignette compared to NSLBP 91% (n=80/88) and radicular syndrome 88% (n=68/77). An improvement in axSpA recognition was demonstrated compared with previous data. FCPs performed slightly better with 77% (n=67/87) of respondents recognising the axSpA vignette. Adequate awareness of national referral guidance was evident in only 55% of 'clinical reasoning' and 6% of 'further subjective screening' responses. There was still misplaced confidence in recognising clinical features of axSpA compared to knowledge levels shown, including high importance given to inflammatory markers. Musculoskeletal physiotherapists demonstrate some improved knowledge and awareness of axSpA compared with previous study findings. Consideration of axSpA is still not universal in musculoskeletal physiotherapists' or FCPs' approaches to persistent back pain assessments and awareness of national referral guidance remains limited. This study highlights the continued need for professional education. Enhanced knowledge of screening and referral criteria in musculoskeletal clinical practice would support earlier diagnosis and better outcomes.

Public priorities for local action to reduce the health impacts of climate change: Evidence from a UK survey

ObjectivesTo investigate public concerns about the impacts of climate change on people's health in the UK and their priorities for action by local government. In the UK, local government are responsible for the environmental protection and health of their local population. Study designCross-sectional survey. MethodsAn online survey of UK adults aged ≥18 years was conducted in 2021 (n = 4050). Representative quotas were set for gender, age group, ethnic group, educational attainment and location (UK country/England region). Survey participants were asked about their concerns about the health impacts of climate change and, excluding those reporting no concerns, their top priorities for their local government to address. ResultsThe dominant health concerns related to air pollution and severe floods. These exposures were also identified as the two most important priorities for local government to address. Separate logistic regression models investigated local-level factors that predicted the selection of each priority, taking account of socio-demographic factors. For both outcomes, awareness of the relevant exposure in the local area in the past 12 months doubled the odds of selecting it as a priority (air pollution: OR 2.01, 95%CI 1.71, 2.36; floods: OR 2.16, 95%CI 1.88, 2.48). ConclusionsThe study demonstrates the potential of surveys to capture public priorities for local action on the health impacts of climate change, and to yield clear policy advice on the issues of greatest public concern.

Surgeon and physiotherapist approaches to operative or non-operative management of people with recurrent patellar dislocation: A case-based UK survey.

Physiotherapists are often key decision-makers on when to refer patients with recurrent patellar dislocation for surgical opinion. Limited guidance exists to aid this decision. Differences in orthopaedic surgeons' and physiotherapists' views on which patients and when to refer people for surgical consideration or non-operative care may affect outcome. This study aimed to explore orthopaedic surgeons and physiotherapists decision-making surrounding treatment opinions for patients with recurrent patellar dislocation. An online survey performed. UK registered and practicing orthopaedic surgeons and physiotherapists were invited to participate. The survey utilised two vignettes and a series of related questions to ascertain respondents' views on decision-making to surgical referral for people with recurrent patellar dislocation. Data were analysed using descriptive statistics and inferential statistical tests to explore factors related to responses. Eighty four respondent surveys were analysed (38 surgeons, 46 physiotherapists). Overall, there was a low level of agreement amongst respondents for the management of the vignettes (k=0.215, p=<0.0005). Some disparity existed between the professions on the definition of recurrent patellar dislocations and the clinical features which may require an early surgical assessment. Physiotherapists were three times more likely to delay a surgical opinion for the vignettes presented in this study than the surgeons. This is the first study to investigate orthopaedic surgeons' and physiotherapists' views on decision-making around surgical or non-operative management for recurrent patellar dislocations. High-quality research is required to underpin explicit guidance on decision-making regarding management of recurrent patellar dislocation.

Proton education for clinical oncology training: 2021 national UK survey

Category: Educationalist/teaching

272 (PB-096) Poster - PATHways UK survey: Pathology perceptions on current biomarker testing and pathways for breast cancer in England

Background: The PATHways survey aimed to capture pathologists’ perspectives on current diagnostic pathways, the increasing role of molecular diagnostic tests, and improvement opportunities for optimising pathways to ensure equitable and timely access. Here we report the results for breast cancer (BC) testing.

Cybersecurity capabilities and cyber-attacks as drivers of investment in cybersecurity systems: A UK survey for 2018 and 2019

Our study explores how cyber-capabilities and cyber-attacks drive investment in cybersecurity systems. We assume that cybersecurity investment is a strategic decision in the organizations. To analyze this research question, we make use of the Cyber Security Breaches Survey data, with a sample consisting of 4,163 UK organizations in the periods 2018 to 2019, and employ machine learning techniques (ANN and K-mean cluster). The study extends the current literature on cybersecurity systems and improves our understanding of it in several ways. First, it provides evidence for how the cybersecurity systems are developed in organizations. Second, regarding what factors affect investment in cybersecurity systems, it shows that organizations invest in cybersecurity based on their cybersecurity capabilities and the experienced cyber-attacks. Third, from a managerial point of view, the paper contributes to understanding cybersecurity within the management of the organization.

Biologic therapy practices in severe asthma; outcomes from the UK Severe Asthma Registry and survey of specialist opinion.

several biological treatments have become available for management of severe asthma. There is a significant overlap in the indication of these treatments with lack of consensus on the first-line biologic choice and switching practice in event of treatment failure. to evaluate outcomes of biologic treatments through analysis of the UK Severe Asthma Registry (UKSAR), and survey of the UK severe asthma specialists' opinion. patients registered in the UKSAR database and treated with biologics for severe asthma in the period between January 2014 and August 2021, were studied to explore biologic treatments practice. This was complemented by survey of opinion of severe asthma specialists. a total of 2,490 patients from 10 severe asthma centres were included in the study (mean age 51.3 years, 61.1% female, mean BMI 30.9kg/m2 ). Biologics use included mepolizumab 1,115 (44.8%), benralizumab 925 (37.1%), omalizumab 432 (17.3%), dupilumab 13 (0.5%), and reslizumab 5 (0.2%). Patients on omalizumab were younger and had earlier age of onset asthma than those prescribed mepolizumab or benralizumab. Patients prescribed mepolizumab and benralizumab had similar clinical characteristics. Those on benralizumab were more likely to continue treatment at approximately one year follow up (93.9%), than those on mepolizumab (80%), or omalizumab (69.6%). The first choice biologic differed between centres and changed over the study time period. Experts' opinion also diverged in terms of biologic initiation choice and switching practice. We observed significant variation and divergence in the prescribing practices of biologics in severe asthma that necessitates further research and standardisation.

219P UK survey measuring informational needs &amp; QoL in women living with metastatic breast cancer (LIMBER)

Studies have shown that there are considerable knowledge gaps related to the diagnosis and management of advanced/metastatic breast cancer (ABC/MBC), and limited availability of patient-focussed information around areas of concern. Workshop findings from 92 advocates from 27 countries (ABC19 conference) highlighted many practical concerns and unmet information needs, but there were several cultural variations and healthcare delivery differences. We wanted to compare these findings with those from a UK population via an on-line survey.

Digital competency: a survey of UK allied health professionals

Background/Aims The need to develop digital skills and confidence among NHS staff is reflected in research and government strategies across the UK. This study aimed to measure the confidence, motivation and competence of the allied health professional workforce in relation to data and digital technology. Methods A quantitative, cross-sectional design was used, with an online survey distributed to measure respondents' characteristics and their self-rating of confidence, motivation and experience in data and digital technology, and of competence relative to the domains of the Health Education England allied health professions digital competency framework. Mean scores were calculated to measure self-rated confidence, motivation and experience. Results Mean scores on confidence and motivation to use digital technologies at work were moderate to high (7.34/10 and 8.33/10 respectively). High degrees of competence and applicability were reported in the ‘general’ and ‘data management and clinical informatics’ domains. Conversely, in the ‘decision support’ domain, 79.6% (n=490) of respondents reported that the competencies were applicable, but also had low competency rates (64.6%, n=397). In the domains of ‘meta competency’ and ‘records, assessments and plans’, 48.3% and 91% of respondents respectively reported low competence. Conclusions Allied health professions have a moderate–high degree of confidence and motivation towards engaging with digital technologies in practice. However, self-perceived competence in some aspects of the domains of the digital competency framework is lacking. Workforce development programmes should consider learning needs related to electronic health records, decision support and use of machine learning or artificial intelligence. Focus should also be directed towards the development of digital leadership and strategy development skills.

Effect of linguistic framing and information provision on attitudes towards induced seismicity and seismicity regulation

Shale gas is an expanding energy source worldwide, yet ‘fracking’ remains controversial. Amongst public concerns is induced seismicity (tremors). The UK had the most stringent induced seismicity regulations in the world, prior to instating a moratorium on shale gas development. The Government cited induced seismicity as the key rationale for its November 2019 English moratorium. Yet, little is known about how the public perceives induced seismicity, whether they support regulatory change, or how framing and information provision affect perceptions. Across three waves of a longitudinal experimental UK survey (N = 2777; 1858; 1439), we tested whether framing of induced seismicity influences support for changing regulations. The surveys compared (1) quantitative versus qualitative framings, (2) information provision about regulatory limits in other countries and (3) seismicity from other industries, and (4) framing a seismic event as an ‘earthquake’ or something else. We find low support for changing current policy, and that framing and information provision made little difference to this. The one strong influence on perceptions of seismic events came from the type of activity causing the event; shale gas extraction clearly led to the most negative reactions. We discuss implications for future UK policy on shale gas and geothermal energy in an evolving energy landscape.

Smoking and socioeconomic factors linked to acute exacerbations of COPD: analysis from an Asthma + Lung UK survey

BackgroundUnderstanding the factors driving acute exacerbations of chronic obstructive pulmonary disease (COPD) is key to reducing their impact on human health and well-being.Methods5997 people with COPD, mean 66 years, 64%...

P-069 Men’s fertility knowledge and attitudes to starting a family in Greece, Nepal and the UK

Study questionWhat are the views of men from Greece, Nepal, and the UK on having children and what is their knowledge of fertility?Summary answerBetween countries, there were similarities and differences in men’s views to having children. Men showed limited fertility knowledge, and access to fertility information varied.What is known alreadyThe global total fertility rate (TFR) has dropped to below 2.5 compared to 5 in 1950, currently being 1.61 in the EU. Internationally, the age at which people are having children has increased and is over 30 in many countries. Delaying parenthood is leaving many with smaller family sizes than desired or involuntary childlessness due to age-related infertility.Although many men are keen to be fathers, existing studies relating to fertility knowledge and having children focus heavily on women. Compared to women, men’s fertility knowledge is limited as fertility education is rarely taught or tailored for men.Study design, size, durationTwo anonymous surveys were conducted. The UK survey (live from 25 April – 1 December 2021) was launched via social media. Men internationally could complete the survey, and high numbers of men from Nepal participated.The Greek survey (live from 11 – 26 May 2021) was launched in Greece through a market research company. The end sample size was n = 244 for Greece, n = 205 for Nepal and n = 128 for the UK.Participants/materials, setting, methodsMen aged 25 to 45 years old, who wanted children but were currently childless, were included. There were four parts to the survey: basic demographics; their attitude to having a family; their fertility concerns; and their fertility knowledge. For the UK survey, since one of the authors had a link with Nepal, particular effort was made to recruit from Nepal as well as from the UK.Main results and the role of chanceWhen asked how many children men wanted, most Greek (59%), Nepalese (66%) and UK (58%) men wanted two children, but higher levels of Greek (24%) and UK (25%) men wanted three children compared to Nepalese men (9%)(p < 0.001).The ideal age men wanted to have had/have their first child was 35 years in Greece (23%), but it was 30 years in Nepal (24%) and in the UK (30%). The COVID-19 pandemic had not affected most men’s decision to have children: Greece’s (64%), Nepal (48%), UK (70%). But it had affected 21% Greek, 27% Nepalese and 16% UK men who are now intending to delay having children.Greek (46%), Nepalese (48%) and UK (47%) men felt moderately informed on female fertility. Greek (45%), Nepalese (50%) and UK (45%) men felt more informed about male than female fertility. When questioned on when they think a woman is fertile in her menstrual cycle, 50% Greek, 38% Nepalese, and 42% UK men answered incorrectly.The internet was the most common source men accessed fertility information from: Greece (67%), Nepal (30%) and the UK (26%). The second most common source for Greece (18%) was doctors, but for Nepalese (18%) and UK (18%) men, it was school.Limitations, reasons for cautionThe study had a relatively small sample size (n = 577). It is well documented that men typically do not show high engagement with surveys. It was only promoted on social media. Respondents were typically highly educated, active on social media and knew English or Greek to an adequate level.Wider implications of the findingsThe International Fertility Education Initiative is developing resources to deliver tailored fertility education across different populations. This survey shows that there are cultural differences that need to be considered when designing such resources.Trial registration numberNot applicable

US partisan conflict uncertainty and households' access to bank credit: Evidence from UK survey data

This paper explores how US political uncertainty, stemming from partisan conflict, affects UK households' access to bank credit. Using data from a unique UK survey database and the US news-based Partisan Conflict Index developed by Azzimonti (2018), the findings document that US partisan policy uncertainty negatively affects UK households' access to loans and credit cards. Banks' increased caution on deal selection also appears to be an underlying channel through which partisan political uncertainty can affect lending activities. Further evidence suggests that this partisan uncertainty also increases loan interest rates.

Consensus statements on optimal adult post-autism diagnosis support and services: Delphi process following a UK survey of autistic adults, relatives and clinicians.

Research has identified types of support helpful to autistic people, for example, physical and mental health interventions, psycho-education, peer support, developing positive identities and affiliation with social groups. However, accessing suitable post-autism diagnosis support and services is extremely difficult. We asked autistic adults, relatives and clinicians about their experiences of receiving and delivering post-autism diagnosis support/services. In Stage 1, 343 autistic adults and 45 relatives completed a survey. They answered questions about their experiences of UK autism post-diagnosis support/services for adults within 12 months after receiving a diagnosis. Thirty-five clinicians completed a similar survey. Just over half of adults and relatives said there was a follow-up appointment or discussion about support after diagnosis. Fewer than 40% received any support/services in 12 months after diagnosis. We used information from the surveys to create 11 statements describing characteristics of appropriate adult post-autism diagnosis support/services. In Stage 2, we asked clinicians for their views on the statements - they agreed with all of them. For example, those adults are offered an additional follow-up meeting after diagnosis and have access to mental and physical health services. We shared results with autistic adults, relatives and clinicians at two events. Some autistic adults, relatives and clinicians were positive about post-autism diagnosis support/services. However, they described many areas for improvement. The study findings can be used to define, develop and improve the types of adult post-diagnosis support services.

Early mobilisation and rehabilitation in the PICU: a UK survey

ObjectiveTo understand the context and professional perspectives of delivering early rehabilitation and mobilisation (ERM) within UK paediatric intensive care units (PICUs).DesignA web-based survey administered from May 2019 to August 2019.SettingUK...

Views about primary care health checks for autistic adults: UK survey findings.

Compared with the general population, autistic adults experience higher rates of physical and mental health conditions, premature morbidity and mortality, and barriers to health care. A health check for autistic people may improve their health outcomes. To establish the views of autistic people towards a primary care health check for autistic people. Cross-sectional questionnaire study in England and Wales. A questionnaire was sent to autistic adults with physical health conditions in England and Wales. A total of 458 people (441 autistic adults and 17 proxy responders) completed the questionnaire. Most responders (73.4%, n = 336) thought a health check is needed for all autistic people. Around half of the participants thought a health check should be offered from childhood and the health check appointment should last between 15 and 30 minutes. Autistic people were positive about providing primary care staff with contextual information regarding their health and the reasonable adjustments they would like before their health check appointment. Training about autism and the health check was considered important, alongside adequate time for discussions in the health check appointment (all by over 70% of responders). The clinician's autism knowledge, seeing a familiar clinician, environmental adaptations, appropriate information, and accessible appointments were considered particularly important in making a health check accessible. Autistic people and relatives were supportive of a primary care health check for autistic people. Information gathered was used to support the design of a primary care health check for autistic adults.

Estimating the total prevalence of PTSD among the UK police force: Formal comment on Stevelink et al. (2020).

Two recent surveys have reported widely differing prevalence rates for posttraumatic stress disorder (PTSD) within the U.K. police force. Stevelink et al. (2020) reported a rate of 3.9% whereas a survey conducted for the charity Police Care UK reported a rate of 20.6%. In this comment we discuss how definitions and methodological factors can impact prevalence rates. We consider a number of possible reasons for the discrepancy between the surveys, and conclude that it is most likely a method artefact. Stevelink et al.’s survey reported the prevalence of recent-onset DSM-IV PTSD only, whereas the Police Care UK survey reported the total ICD-11 PTSD and Complex PTSD prevalence, regardless of when in the person’s career the traumatic events occurred. Analysing the Police Care UK data using Stevelink et al.’s procedures produced practically identical prevalence rates, suggesting that the discrepancy was apparent rather than real.

PO-1666 Results of a 2020 UK survey for the use of online treatment monitoring solutions for IMRT/VMAT

PO-1666 Results of a 2020 UK survey for the use of online treatment monitoring solutions for IMRT/VMAT

The organisation of nurse staffing in intensive care units: A qualitative study

To examine the organisation of the nursing workforce in intensive care units and identify factors that influence how the workforce operates. Pre-pandemic UK survey data show that up to 60% of intensive care units did not meet locally agreed staffing numbers and 40% of ICUs were closing beds at least once a week because of workforce shortages, specifically nursing. Nurse staffing in intensive care is based on the assumption that sicker patients need more nursing resource than those recovering from critical illness. These standards are based on historical working, and expert professional consensus, deemed the weakest form of evidence. Focus groups with intensive care health care professionals (n = 52 participants) and individual interviews with critical care network leads and policy leads (n = 14 participants) in England between December 2019 and July 2020. Data were analysed using framework analysis. Three themes were identified: the constraining or enabling nature of intensive care and hospital structures; whole team processes to mitigate nurse staffing shortfalls; and the impact of nurse staffing on patient, staff and intensive care flow outcomes. Staff made decisions about staffing throughout a shift and were influenced by a combination of factors illuminated in the three themes. Whilst nurse:patient ratios were clearly used to set the nursing establishment, it was clear that rostering and allocation/re-allocation during a shift took into account many other factors, such as patient and family nursing needs, staff well-being, intensive care layout and the experience, and availability, of other members of the multi-professional team. This has important implications for future planning for intensive care nurse staffing and highlights important factors to be accounted for in future research studies. In order to safeguard patient and staff safety, factors such as the ICU layout need to be considered in staffing decisions and the local business case for nurse staffing needs to reflect these factors. Patient safety in intensive care may not be best served by a blanket 'ratio' approach to nurse staffing, intended to apply uniformly across health services.