Humans of health research

Professor Pallav Shah is Professor of Respiratory Medicine at the National Heart and Lung Institute and a consultant respiratory physician at the Royal Brompton and Chelsea and Westminster Hospitals.

He has been working at the forefront of researching new treatments for lung cancer and other long-term lung conditions, such as Chronic Obstructive Pulmonary Disease (COPD - the name for a group of conditions where the lungs are damaged or inflamed, making it difficult to breathe).   

“When I first became a respiratory consultant, I realised that many patients with lung cancer were only offered palliative care. If they weren’t fit for surgery, there wasn’t really anything else in our clinical toolkit to offer them. Similarly, we had very few treatments for people living with COPD.  I just thought that wasn’t good enough, so I had to push for new treatments. That’s how my journey into clinical research started.    

“I’d describe myself as a clinician first, researcher second and educator third. I’m always looking for new breakthroughs and new ways to offer hope. I can’t do that on my own: I look for partnerships with scientists and with patients who are prepared to push and break boundaries by trying new treatments.    

“I’m often amazed by my patients – they have such strength and resilience when living with debilitating conditions that make breathing – the very essence of life – difficult. It’s their motivation that inspires me to do better for them.    

“Some of the treatments I’ve worked on are now regarded as ‘gold-standard’ and routinely available on the NHS. For example, with emphysema - a lung condition that causes shortness of breath - the lungs get hyper-inflated, and this splints the diaphragm imparting their function.  So, we explored different approaches to reduce lung volume.

"The most successful development was one-way valves inserted into the airways through a bronchoscope - a long tube with a camera - which would allow air to escape from a lobe of the lung but not get back in. This would shrink the lung, so that the diaphragm was able to work effectively again.   

“For patients where this worked, it was life-changing: they could wash and dress without getting breathless, go to the shops for their newspaper or pint of milk. But it didn’t work for everyone. I had to find out why. Basically, our valves weren’t able to close off the inflow of oxygen completely. So, we worked with other groups to develop other methods for reducing lung volume such as coils, sealants and vapour treatment. 

“These are now improving the lives of thousands of people every day.   A journey that started 20 years ago for me has resulted in several new therapies some of which are globally considered standard care, and we’re no longer relying just on palliative care.

"Being involved from the very beginning and developing something right through to gold-standard, evidence-based practice has been very exciting and hugely gratifying.     

“We also have new treatments for chronic bronchitis (inflammation of the airways), such as rheoplasty, where we treat the airways with pulsed electrical waves to ‘zap’ all the mucous glands, so people have less mucus and coughing. We can also use liquid nitrogen to freeze damaged cells in the lungs, thereby reducing mucus and coughing.   

“The ultimate aim is to identify and treat illnesses like chronic bronchitis before they develop into COPD and emphysema – effectively to eradicate some of these life-limiting lung conditions.”   

 “What’s really driven my research is seeing those patients who didn’t really have any options, and no-one really trying to do anything for them. That made me think about what I could do for them.

"I’m a clinical researcher, always working in clinic with patients to try new things and then sharing them with others. I think education, research and clinical medicine are all integrated.  

"I supervise a number of PhD students and I run courses on new procedures once or twice a year, to share and spread new knowledge and increase the number of patients we can reach.

"It’s so gratifying seeing so many of my juniors becoming consultants themselves and setting up specialist centres like this in other parts of the country.    

“During my career, we have gone from basic bronchoscopy through to complex therapeutic procedures and now robotic assisted procedures. I feel like I’ve come full circle: I started my career with lung cancer patients and now we’re developing new ways to target lung cancer tumours, including using microwave energy to burn them away. 

“But there’s so much more to do and, at heart, I’m just a working doctor trying to provide my patients with the best possible care. That’s why I involve them in research – because it gives them access to the best possible care.”    

  

Theresa Akasi took part in the TRUFFLE 2 study - a study to investigate the best technique to manage poor growth in babies during the later stages of pregnancy – after being diagnosed with the condition. The study is funded by the National Institute of Health Research (NIHR) Imperial Biomedical Research Centre. Theresa gave birth to a baby boy called Clive Adonis Bernard in September 2021, following the trial. 

  “When the doctors told me that my baby was quite small and the blood flow to the baby wasn’t where it should be I was worried, confused and didn’t know what to do.  

“The clinical team have been doing their best to support me during my pregnancy and told me about the Truffle 2 study.  I wanted the best outcome for my child and decided to participate in the study.   

"As part of the study I had to come in regularly for scans.  The doctors also monitored my heart rate, blood pressure and urine sample.   

“It has been a great experience and I would do it again as I felt very supported throughout the process.  The team were great at answering my questions and explaining things to me.    

“Being part of this study has shown me just how important research is and I hope my participation will help others going through the same thing as me.” 

  

  

Dr Sadia Khan is a consultant cardiologist at West Middlesex University Hospital, part of Chelsea and Westminster Hospital NHS Foundation Trust. She is also an honorary clinical senior lecturer at the National Heart and Lung Institute.

Her research focuses on using technology such as wearable devices to monitor patients’ health in the community. 

“I became a doctor because I was good at science and wanted to apply my knowledge to help people. I’ve always been interested in learning and discovering new things, so that’s what took me into research.

"I really want to improve health outcomes for the individual patient and the broader population. My research interests are pathways and models of care, and I found that data and digital technology have increasingly become key enablers to deliver this. 

 “I’ve been working on projects that use wearable devices in hospitals for about seven or eight years now. For example, we introduced a wearable patch that automatically checks heart rate, breathing and temperature every two minutes, so nurses don’t have to wake patients during the night to monitor their vital signs.  

“When COVID-19 came along, I became much more interested in using wearables in the community. This was what enabled us to set up ‘virtual’ COVID wards. Patients were able to monitor their own blood oxygen levels accurately at home and so we only brought people into hospital when we were certain they needed to be here.

"We were able to re-purpose some of the apps we were using for outpatient care, so we didn't lose contact with our patients during COVID.  

“I firmly believe in Sir Isaac Newton’s approach of standing on the shoulders of giants. In my research, I’m taking existing innovations and pushing the boundaries, trying them out in new environments.

"To take another example, almost everyone has a smartphone now, so it seems logical to see where we can use it in healthcare. We have developed an app called FibriCheck that uses the phone camera to measure pulse and pressure signals and can help us quickly identify when people with heart rhythm disorders need clinical intervention. 

“I suspect I am an improver at heart: I do research because I want to build on what we have and provide a better care experience for our current patients and future generations.  

“Working in digital and technology, I’m also very mindful that there can be sections of the community who get left behind. So I’m involved in some partnership working to improve digital inclusion.

"I work with people from our local authority partners, Imperial College Health Partners, community and voluntary organisations and adult social care and adult education. We’re doing research in the community to find out what barriers people face in accessing technology and then putting in place some practical solutions aimed at helping improve health outcomes.

“I suspect I am an improver at heart: I do research because I want to build on what we have and provide a better care experience for our current patients and future generations.  

"For example, we have started to recycle council and NHS laptops. We strip out the hard drives and then give them to a local charity which employs people with learning disabilities to re-build them. They’re then redistributed to people in the community who wouldn’t otherwise be able to afford them. More people then have access to digital training for any health-based apps they use, as well as being able to do things like online shopping and banking and check council services. 

“The NHS can be a very challenging environment to work in, so it is very satisfying to see how things we have done have changed care.

"I know I’m making a difference and that means I’m happy at work. By working in partnership, we make a bigger difference. Then you realise that actually you are making big changes happen in a system that can seem impossible to change on your own.  

“To the next generation of researchers coming through, I would say: work with others and dream big!”