HaemSTAR: A national network of haematologist trainees engaging in non-malignant audit and research

Gemma Scott; Phillip Nicolson; Amelia Fisher; Michael Desborough; Zara Sayar; Henna Wong; Claire Burney; Emily Hopkins; Sarah Wharin; Abbas Zaidi; Ferras Alwan; Kieran Burton; Laura Jardine; Chris Bailey; Indy Karpha

doi:10.7861/clinmedicine.19-2-s92

Aims

To promote trainee-led clinical research and audit in non-malignant haematology.

Methods

Haematology Specialty Trainee Audit and Research (HaemSTAR) is a national network of haematology trainees. HaemSTAR is a new initiative, conceived in 2016 and supported by the National Institution for Health Research (NIHR). The objectives are to:

increase recruitment to non-malignant haematology clinical trials nationally
increase exposure to and develop skills in clinical research thus training principal investigators of the future; something which is not part of the registrar curriculum
enable transition of worthy local audits to the national scale by coordination of time-efficient data collection enabling high-quality data to be collected in a cost-effective manner
use the audit model to then expand and develop our own prospective national studies (aligned to NIHR priorities).

The most recent project is using a ‘crowd-sourced’, technology-driven approach to undertake a national audit utilising a large number of investigators each collecting a relatively small amount of data. Investigators will be coordinated through the HaemSTAR network with a secure web-based database (REDCap) used to host an online audit protocol. This will allow multicentre data entry that is secure, accessible, and consistent between centres. The project is set to complete in early 2019.

Results

HaemSTAR has already had real impact by supporting several studies as investigators and collaborators. The studies supported include TRAIT (a registry study looking at real-world use of romiplostim in immune thrombocytopenic purpura (ITP), FLIGHT (a multicentre randomised trial in the frontline treatment of ITP) and the MASCOT registry (a study examining the occurrence and management of splanchnic vein thrombosis in patients with myeloproliferative neoplasms). HaemSTAR members have enabled additional sites to be opened along with significant numbers of additional patients recruited (106 of the 255 patients entered into TRAIT were recruited by HaemSTAR).

The ‘crowd-sourced’ audit is examining the use of intravenous immunoglobulin (IVIg) in ITP, an area where there is known variability in management. The dose of IVIg and its duration of use will be evaluated in centres across the country. Outcome data including response rates and time to response will also be collected.

Conclusion

The future aims of HaemSTAR are to continue to promote studies in our current portfolio and open more studies to which we can make a meaningful contribution. A national audit examining IVIg use should enable improvements in patient care allowing maximum efficacy of therapies, the avoidance of adverse events and prudent healthcare. The successful use of this innovative method of data collection will allow this method to be used in future projects.