Project focus: Professor Andrew Ewer

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Critical congenital heart defects (CCHD) occur in around 2-3/1,000 babies, and are a leading cause of infant death. Prior to work led by Prof Andy Ewer at the University, diagnostic testing identified only 50-70% of affected babies before discharge, resulting in babies being sent home before diagnosis where they could become unwell or die.

Blood oxygen levels are often low in CCHD.  Pulse Oximetry (PulseOx), a non-invasive method of measuring blood oxygen levels was developed back in the 1980s and provided a potential way to detect CCHD in newborn babies.  However its usage was inconclusively explored back in the 2000s.  Work led by Prof Andy Ewer demonstrated a clear need for larger, robust studies into its use for CCHD screening and in 2007 and following awarding of funding from the National Institute for Health Research (NIHR), Health Technology Assessment (HTA), a large multi-centre study, was launched.  Findings from the study, which screened 20,055 newborn babies, confirmed PulseOx as a rapid, painless, safe, non-invasive, acceptable and cost-effective method of detecting the low blood oxygen levels associated with CCHD.

The use of PulseOx identifies 30 additional cases per 100,000 live births compared to routine clinical examination alone, with 92% of babies with CCHDs being detected prior to discharge.  Up to 20% of Neonatal units across the UK have adopted PulseOx into routine practice (2010 national survey), a rise from just 7% prior to publication of the research.  Many more units have taken up screening since.

Andy is currently championing national rollout of PulseOx as a routine screening service for CCHD and since 2014 has been working with the National Screening Committee to initiate and complete a UK pilot study.  The pilot study which completed in Dec 2015, will inform an eagerly awaited decision as to whether to incorporate PulseOx screening into the national programme.

Andy is now also championing Impact across the College of Medical and Dental Sciences (MDS) as the MDS Impact lead.  A team of enthusiastic Institute Impact leads has been formed, who work closely with the Research Planning team, to support development and delivery of Impact from research undertaken by academics within the College.

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