North West England Research Partnership to Improve Early Detection of Liver Disease

Liver disease is an epidemic and affects different regions of the nation disproportionately. It is a significant healthcare and societal burden. If detected early, it is possible to reverse the effects before clinical complications develop.

There is a disconnect between disease prevalence and research activity, whereby areas with the highest disease burden have been left behind in research activity. This is clearly exemplified in the Northwest of England where 4 of the top 5 regions with the highest liver mortality reside but research activity is very low outside of central Manchester.

We will address this by building a research partnership in the Northwest of England, combining regions with very high liver related mortality into partnership with research active areas.

Manchester has research infrastructure design, develop and deploy research (including NIHR facilities). Moreover, the Manchester based ID LIVER project has developed methodology to assess liver disease in patients' locality. It can act as a template to expand research access into traditionally underserved areas.

We propose to leverage these pathways, facilities and infrastructure to expand from Manchester into Greater Manchester and Northwest of England. We will partner with interested primary and secondary clinicians in areas of high disease burden to be active participants in the network and future research co-applicants. Monthly meetings will be supported by two in-person workshops and facilitated discussion to generate the outputs for future research applications.

Research design is a science and to generate fundable clinical research requires professional expertise. We will engage with nationally leading methodologists, health economists and implementation scientists to help co-develop a robust research proposal and aid with the skill development of clinical researchers who previously do not have a track record in clinical research.

This will give clinicians the tools to identify an evidence gap, design a research question and generate a proposal to answer the question.

Patient and public involvement and engagement (PPIE) are embedded throughout this project. This proposal has been written in collaboration with our public co-applicant. We have leveraged the work done in Manchester by our PPIE partners, VOCAL (as part of ID LIVER), to understand the unique needs of the communities who are traditionally underserved for research and liver disease.

We will use these established pathways to undertake similar work in Greater Manchester and Lancashire. We will identify barriers to engagement and develop pathways to improve access. We will develop partnerships with local community groups to understand their unique communities.

To ensure learnings from community engagement work are translated into proposal design, a public co-applicant will form part of the research partnership network and attend monthly network meetings.

In summary, we will build a research partnership in the Northwest of England, a region with disproportionately high liver disease. Working alongside research design and implementation scientists and PPIE partners we will develop a research proposal to address an important knowledge gap.