THE IMPACT OF COLLABORATION: THE VALUE OF UK MEDICAL RESEARCH TOEU SCIENCE AND HEALTH

Study co-funded by The Academy of Medical Sciences (AMS), Arthritis Research UK, the Association of Medical Research Charities (AMRC), the British Heart Foundation (BHF), Cancer Research UK (CRUK), the Medical Research Council (MRC), MQ: Transforming Mental Health and Wellcome.

Research byPeter Varnai, Maike Rentel, Anoushka Davé, Marika De Scalzi, Wia Timmerman, Cristina Rosemberg-Montes, Paul SimmondsTechnopolis Group (May 2017)

APPENDICES

2

CONTENTS

APPENDIX A METHODOLOGY 3

APPENDIX B LIST OF INTERVIEWEES 9

APPENDIX C RESEARCH INFRASTRUCTURE SUPPLEMENTARY DATA 12

APPENDIX D SUPPLEMENTARY CLINICAL TRIALS DATA 17

APPENDIX E BIBLIOMETRIC ANALYSIS OF CITATION IMPACT 20

APPENDIX F SUPPLEMENTARY eCORDA DATA 22

APPENDIX G HESA SUPPLEMENTARY DATA 24

APPENDIX H RESEARCHFISH® SUPPLEMENTARY DATA 33

APPENDIX K EUROPEAN RESEARCH COUNCIL GRANTS 39

APPENDIX L BIBLIOMETRIC ANALYSIS OF EU NATIONAL HEALTH ADVISORY COMMITTEE MEMBERS 44

ENDNOTES 48

The report together with the appendices, case studies and executive summary are available at cruk.org/UKandEUresearch

3

APPENDIX A METHODOLOGY

A.1 Desk researchDesk research included firstly a review of existing literature (both peer reviewed and grey literature) demonstrating the contribution of UK medical research to the EU member states and secondly identifying suitable data sources for original analyses to address the research questions set out for this study. Desk research was also conducted to inform the interviews and case studies.

A.2 Interviews

A.2.1 Scoping interviews

We conducted scoping interviews with representatives of UK medical research funders (eg MRC and Wellcome Trust) as well as key researcher leaders in specific disease types (both in the UK and in EU). This allowed us to obtain additional context on the UK’s role and contribution in EU member states. We also enquired about data sources to address the research questions (including internally-held data), suggestions for case studies illustrating the UK’s contribution to the EU research community and patients.

A.2.2 Stakeholder interviews

Primary data was collected through 28 semi-structured interviews. The qualitative interviews were carried out in order to test emerging insights from the desk research, as well as to gather existing perceptions from a diverse set of high-level, senior stakeholders regarding the value of UK medical research for the EU. We focused on five EU member states (Germany, France, Italy, Netherlands and Poland), as well as key individuals linked to medical research in pan-European organisations. Interviewees were selected by a) the type of stakeholder, b) the disease area or country where relevant, and c) gaps in the information needed to answer the evaluation questions. The interviews were conducted by phone and permission was obtained from interviewees prior to including attributable quotes in the report.

A.3 Case studiesIn order to illustrate the UK’s contribution to EU science and policy, we developed a set of eight short case studies. These were chosen to highlight different aspects of this study, with the aim of covering each broad area: education, expertise and research facilities, EU national health and benefit to patients, and pan-EU trials. In addition, four case studies concentrated on unique UK contribution in the fields of cancer, cardiovascular diseases, mental health and musculoskeletal conditions.

The cases studies were predominantly based on desk research, with some additional input from focussed interviews with key stakeholders with in-depth knowledge of the impact of the research in EU member states.

A.4 Data analysis Data were obtained from online databases or individual institutions, and analysed with a focus on EU member states, particularly France, Germany, Italy, the Netherlands and Poland, and on four disease areas, namely cancer, cardiovascular diseases, mental health and musculoskeletal

4

conditions. Data concerning REF impact case studies and EU clinical trials were obtained from the relevant online databases. Case studies and clinical trials relevant to specific disease areas were identified using keywords. The package “ctrdata” was used with the R system to download and analyse trials from the European Union Clinical Trials Register. To aid analysis, the downloaded trial data was converted to a Microsoft Excel compatible format with the use of the MongoDB data programme and Python coding.

User and trainee data were obtained directly from UK research facilities either in aggregated form for EU member states minus the UK or disaggregated by country and year. Average yearly data were presented as proportion of total users or trainees from all EU member states excluding those from the UK.

A.5 Bibliometric analysis: definition of medical research

Table 1 Subject categories used in the bibliometric analysis to define Medical and Health research

Main field Field Subfield Subject category

Medical and Life Sciences

Health Sciences Health Sciences Geriatrics & Gerontology

Gerontology

Health Care Sciences & Services

Health Policy & Services

Nursing

Rehabilitation

Social Work

Sport Sciences

Substance Abuse

Life Sciences Basic Life Sciences Biochemical Research Methods

Biochemistry & Molecular Biology

Biophysics

Biotechnology & Applied Microbiology

Cell Biology

Developmental Biology

Genetics & Heredity

Microbiology

Reproductive Biology

Biological Sciences Mathematical & Computational Biology

Medical Sciences Basic Life Sciences Cell & Tissue Engineering

Basic Medical Sciences Chemistry, Medicinal

Engineering, Biomedical

Materials Science, Biomaterials

Medical Informatics

5

Main field Field Subfield Subject category

Medical and Life Sciences

Medical Sciences Biomedical Sciences Anatomy & Morphology

Immunology

Integrative & Complementary Medicine

Medical Laboratory Technology

Medicine, Research & Experimental

Neuroimaging

Neurosciences

Pharmacology & Pharmacy

Physiology

Radiology, Nuclear Medicine & Medical Imaging

Toxicology

Virology

Clinical Medicine Allergy

Andrology

Anesthesiology

Audiology & Speech-Language Pathology

Cardiac & Cardiovascular Systems

Clinical Neurology

Critical Care Medicine

Dentistry/Oral Surgery & Medicine

Dermatology

Emergency Medicine

Endocrinology & Metabolism

Gastroenterology & Hepatology

Hematology

Infectious Diseases

Medicine, General & Internal

Obstetrics & Gynecology

Oncology

Ophthalmology

Orthopedics

Otorhinolaryngology

Parasitology

Pathology

Pediatrics

Peripheral Vascular Disease

6

Main field Field Subfield Subject category

Medical and Life Sciences

Medical Sciences Clinical Medicine Primary Health Care

Psychiatry

Public, Environmental & Occupational Health

Respiratory System

Rheumatology

Surgery

Transplantation

Tropical Medicine

Urology & Nephrology

Multidisciplinary Journals

Multidisciplinary Journals

Multidisciplinary Journals

Multidisciplinary Sciences

Social and Behavioral Sciences

Social Sciences Psychology Psychology, Applied

Psychology, Biological

Psychology, Clinical

Psychology, Developmental

Psychology, Experimental

Psychology, Mathematical

Psychology, Multidisciplinary

Psychology, Psychoanalysis

Psychology, Social

Social and Behavioral Sciences, Interdisciplinary

Social Sciences, Biomedical

Source: Technopolis and CWTS, Leiden University; data source: Web of Science core collection Clarivate Analytics

7

APPENDIX B LIST OF INTERVIEWEES

Name Affiliation Country

Professor Celso Arango President of The European College of Neuropsychopharmacology (ECNP); Hospital General Universitario Gregorio Marañón, Universidad Complutense, CIBERSAM, Madrid

Spain

Dr Edvard Beem Co-Director, The Netherlands Organisation for Health Research and Development (ZonMW)

The Netherlands

Professor Francis Berenbaum

Chair of Rheumatology, Faculty of Medicine, University Pierre and Marie Curie Paris

France

Professor Johannes Bijlsma

President-Elect of the European League Against Rheumatism (EULAR); Professor of Rheumatology and Clinical Immunology, University Medical Center Utrecht

The Netherlands

Professor Jean-Pierre Bourguignon

President of the European Research Council (ERC)

European organisation

Professor Leena Bruckner-Tuderman

Vice President of the Deutsche Forschungsgemeinschaft (DFG); Professor of Dermatology, Albert-Ludwigs-University of Freiburg

Germany

Dr Virginie Bros-Facer Research Infrastructure Project Manager, EURORDIS – Rare Diseases Europe

European organisation

Dr Erika Buitenhuis Teammanager Research, Dutch Heart Foundation

The Netherlands

Professor Bernard Charpentier

President of the Federation of European Academies of Medicine (FEAM); Emeritus Professor of Medicine, University of Paris Sud

European organisation

Magda Chlebus Director of Science Policy at the European Federation of Pharmaceutical Industries and Associations (EFPIA)

European organisation

Professor Detlev Ganten German National Academy of Sciences Leopoldina; President, World Health Summit; Charité – Universitätsmedizin Berlin

Germany

Professor Bill Hansson Vice President, Biology and Medicine Section, Max Planck Society

Germany

Professor Liselotte Højgaard

Chair of the Advisory Group on Health for H2020; Former Chair of the European Medical Research Council; Professor in Medicine and Technology, University of Copenhagen

Denmark

8

Name Affiliation Country

Dr Frank Hulstaert Senior Researcher, Belgian Health Care Knowledge Centre (KCE), Brussels

Belgium

Professor Dipak Kalra President of the European Institute for Health Records (EuroRec)

European organisation

Dr Giovanni Leonardi Director General of Research and Innovation in Healthcare, Ministry of Health

Italy

Professor Adriana Maggi Department of Pharmacological and Biomolecular Sciences, University of Milan

Italy

Professor Iain Mattaj Director General, European Molecular Biology Laboratory (EMBL) Heidelberg

Germany

Dr Pierre Meulien Executive Director, Innovative Medicines Initiative (IMI)

European organisation

Professor Andreas Meyer-Lindenberg

Director of the Central Institute of Mental Health, University of Mannheim

Germany

Dr Hubert Misslisch Coordinator ‘International Cooperations’, DLR Project Management Agency, Health Research, on behalf of the Federal Ministry of Education and Research

Germany

Professor Peter Naredi President of the European Cancer Organisation (ECCO); Professor of Surgery, University of Gothenburg

Sweden

Professor Piotr Rutkowski Professor of Surgical Oncology, Maria Skłodowska-Curie Memorial Cancer Center and Institute of Oncology, Warsaw

Poland

Professor Jos van den Meer

Professor of Medicine, Radboud University Medical Center, Nijmegen

The Netherlands

Professor Wiek van Gilst Head of Experimental Cardiology, University Medical Center Groningen

The Netherlands

Dr Bonnie Wolff-Boenisch Head of Research Affairs, Science Europe European organisation

Programme Officer Non-governmental organisation Poland

Senior representative Pharmaceutical industry Poland

9

APPENDIX C RESEARCH INFRASTRUCTURE SUPPLEMENTARY DATA

C.1 Health Protection Agency Culture CollectionsTable 2 National Collection of Type Cultures (requests in 2016)

Number of ampoules sold

Country Direct sales

Argenta Star Ecotronics

Medisell Normax Dicoex ProMedia

Australia 4

Austria 10

Belgium 10

Canada 2

Chile 6

China 14

Croatia 13

Cyprus 0 8

Czech Republic 3

Denmark 42

Finland 7

France 11

Germany 57

Hungary 3

India 7

Iran, Islamic Republic of 2

Iraq 1

Ireland 88

Israel 17

Italy 11 5

Japan 48

Jordan 1

Kenya 11

Korea, Republic of 8

Lebanon 4

Netherlands 6

New Zealand 2

Pakistan 1

Peru 1

Philippines 1

Poland 1 11

Romania 1

10

Number of ampoules sold

Country Direct sales

Argenta Star Ecotronics

Medisell Normax Dicoex ProMedia

Russian Federation 16

Rwanda 1

Slovenia 3

Spain 8 1

Sweden 3

Switzerland 38

Taiwan 11

United Arab Emirates 23

United Kingdom 1,136

United States 115

Figure 1: European Collection of Authenticated Cell Cultures sales

Nu

mb

er o

f S

igm

a sa

les

1,528

0

100

200

300

400

500

600

700

UKCHSEESPTNONLLUITIEISGRDEFRFIDKBEAT

2015 2016

Country

Table 2 (cont)

11

C.2 Cohort user statisticsFigure 2: 1958 cohort data downloads by EU country and year, 2009-2016 (excl UK)

Table 3 National Survey of Health and Development enquiries by country and year

Country 2012 2013 2014 2015 2016 Total

Denmark 0 3 1 1 0 5

Finland 1 1 0 0 0 2

France 0 4 0 0 0 4

Germany 0 1 0 0 0 1

Ireland 1 0 0 0 0 1

the Netherlands 0 1 0 2 1 4

Norway 0 0 0 0 0 0

Poland 0 0 0 0 0 0

Sweden 0 0 1 0 1 2

UK 56 58 48 43 49 254

Rest of the World 15 9 13 5 11 53

Total 73 77 63 51 62 326

(Country of enquiry was not collected in data sharing database until 2012)

0

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200

300

400

500

600

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mb

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f d

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2011 2012

Country

SEESROPTPLNONLITIEHUDEFIDKCZHRBGBEAT FR CH

2009 2010 2014 20162013 2015

12

Table 4 UK Biobank user data by country and year

  Year of project approval  

Country 2012 2013 2014 2015 2016 Total

Belgium 0 0 0 0 1 1

Denmark 0 0 0 0 1 1

Estonia 0 0 0 1 1 2

France 0 0 1 0 1 2

Germany 0 0 0 0 1 1

Greece 0 0 0 0 1 1

Ireland 0 0 0 0 1 1

Italy 0 0 0 0 0 0

Netherlands 3 1 0 2 2 8

Norway 0 0 0 0 1 1

Poland 0 0 0 0 0 0

Spain 0 0 0 1 1 2

Sweden 0 1 1 2 3 7

Switzerland 0 0 0 0 1 1

UK 8 23 26 58 61 176

Rest of world 0 2 3 19 39 63

Total 11 27 31 83 115 267

13

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15

C.4 Wellcome Trust Sanger InstituteFigure 3: Advanced courses attendees (EU = EU27)

Per

cen

tag

e (%

)

570 685

595 610 670

185 160 155

0

10

20

30

40

50

60

70

80

90

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2016/2015/2014/2013/2012/2011/2010/2009/2008/2007/

UK delegates EU delegates International

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16

APPENDIX D SUPPLEMENTARY CLINICAL TRIALS DATA

Table 7 Number of European Clinical trials per country and type

Country Rare diseases trials (n)

Paediatric trials (n) – participants under 18 years old

Trials without partner countries (n)

Trials with other EU countries (n)

Austria 528 327 738 2,538

Belgium 736 605 705 3,659

Bulgaria 127 168 42 1,243

Croatia 26 22 3 193

Czech Republic 437 375 175 3,135

Denmark 392 292 889 1,977

Estonia 39 112 39 813

Finland 166 300 412 1562

France 550 401 1,184 2217

Germany 1,334 1,026 2,453 6,435

Greece 212 140 96 1171

Hungary 361 445 158 3227

Ireland 174 118 130 747

Italy 960 870 2,415 3,582

Latvia 45 102 19 849

Lithuania 79 132 27 991

Luxembourg 0 0 0 7

Malta 0 0 1 17

Netherlands 698 530 1,390 2,526

Poland 243 283 77 1,688

Portugal 142 107 39 1,059

Romania 18 32 10 183

Slovakia 67 101 18 863

Slovenia 32 37 30 259

Spain 1,012 917 1,712 5,328

Sweden 456 394 677 2,423

UK 1,349 1,193 2,864 4,883

Source: Data analysis: Technopolis Group; Data source: European Clinical Trials Database

17

Table 8 Number of European Clinical trials per country and disease area

Country Cancer (n) Cardiovascular diseases (n)

Mental health (n) Musculoskeletal conditions (n)

Austria 888 303 211 148

Belgium 1,358 329 205 245

Bulgaria 196 114 144 143

Croatia 33 12 21 15

Czech Republic 695 343 233 308

Denmark 671 345 101 196

Estonia 99 81 122 87

Finland 368 212 242 124

France 1,114 229 214 147

Germany 2,120 686 580 468

Greece 412 115 56 88

Hungary 761 327 230 311

Ireland 318 88 25 48

Italy 2,025 531 329 265

Latvia 123 78 82 74

Lithuania 144 110 114 103

Luxembourg 5 0 0 0

Malta 7 2 1 3

Netherlands 1,063 409 221 195

Poland 407 114 115 150

Portugal 303 108 84 69

Romania 37 13 34 12

Slovakia 158 89 100 72

Slovenia 79 31 17 22

Spain 2,011 547 441 397

Sweden 699 321 259 161

UK 1,914 586 427 439

Source: Data analysis: Technopolis Group; Data source: European Clinical Trials Database

18

APPENDIX E BIBLIOMETRIC ANALYSIS OF CITATION IMPACT

Citation analysis was conducted by CWTS, Leiden University, using the Web of Science core collection Clarivate Analytics for publication data in the ‘Medical and Health’ research fields between 2005 and 2014.

Table 9 The effect of collaboration between UK and EU26 countries or five individual EU member states on the citation impact of medical and health research publications (2005-2014)

Country Collaboration type

Number of publications

Mean Normalised Citation Score

Proportion of the top 10% most cited publications in the area

EU26 EU26 - UK 486,105 1.37 0.15

UK - EU26 104,648 1.6 0.18

UK + EU 122,995 1.98 0.22

France FR - UK 93,645.5 1.49 0.17

UK - FR 203,052 1.69 0.19

UK + FR 24,591.5 2.78 0.31

Germany DE - UK 150,650 1.45 0.16

UK - DE 191,137 1.69 0.19

UK + DE 36,506.8 2.43 0.27

Italy IT - UK 79,540.3 1.47 0.17

UK - IT 203,109 1.72 0.2

UK + IT 24,534.8 2.5 0.28

Netherlands NL - UK 67,783.3 1.6 0.19

UK - NL 203,393 1.71 0.2

UK + NL 24,250.5 2.58 0.29

Poland PL - UK 16,136.5 1.2 0.12

UK - PL 223,108 1.78 0.2

UK + PL 4,535 2.84 0.29

Source: Data analysis conducted by CWTS, Leiden University, Data source: Web of Science core collection Clairvate Analytics

19

Table 10 The effect of collaboration between UK and EU26 countries on the citation impact of publications (2005-2014) in medical and health research or in four individual disease/research area

Disease/ research area

Collaboration type

Number of publications

Mean Normalised Citation Score

Proportion of the top 10% most cited publications in the area

All medical and health research

EU26 - UK 486,105 1.37 0.15

UK - EU26 104,648 1.6 0.18

UK + EU 122,995 1.98 0.22

Cancer EU26 - UK 34,593.5 1.58 0.18

UK - EU26 5,303.5 1.81 0.22

UK + EU 8,666.25 2.25 0.26

Cardiovascular diseases

EU26 - UK 18,919.3 1.59 0.2

UK - EU26 2,716.75 1.6 0.19

UK + EU 5,488.25 2.14 0.27

Musculoskeletal conditions

EU26 - UK 9,171.5 1.29 0.14

UK - EU26 1,928.5 1.39 0.16

UK + EU 2,787.5 2.13 0.23

Public, environmental and occupational health

EU26 - UK 18,570 1.13 0.11

UK - EU26 7,974.5 1.44 0.15

UK + EU 6,097.25 1.62 0.18

Source: Data analysis conducted by CWTS, Leiden University, Data source: Web of Science core collection Clairvate Analytics

20

APPENDIX F SUPPLEMENTARY eCORDA DATA

Data analysis conducted by the MRC Information and Analysis Team and Technopolis Group.

Table 11 Participation in health-related projects in Framework Programme 7 (FP7) and Horizon 2020

FP7 Horizon 2020

Projects Participations EU Contribution (in EUR million)

Projects Participations EU Contribution (in EUR million)

UK 755 1708 808.8 280 600 416.3

Germany 719 1735 779.2 256 508 279.8

France 553 1079 486.9 191 354 186.7

Italy 473 941 351.1 206 365 135.7

Netherlands 512 907 478.4 208 406 244.2

Poland 102 119 24.4 46 49 13.3

Grand Total (all countries)

1,006 11,528 4,785.8 256 508 279.8

Source: eCORDA iSearch (March 2017). Note that projects for individual countries are defined as the number of signed grant agreements with at least one participant from that country. The grand total represents all health-related projects funded in the respective programmes; projects are assigned to multiple countries and hence project numbers do not add up to the grant total.

Table 12 Percentage participation in health-related projects in Framework Programme 7 (FP7) and Horizon 2020

FP7 Horizon 2020

Percentage of all projects

Percentage of all participations

Percentage of EU Contribution (%)

Percentage of all projects

Percentage of all participations

Percentage of EU Contribution (%)

UK 75% 15% 17% 44% 14% 20%

Germany 71% 15% 16% 40% 12% 14%

France 55% 9% 10% 30% 8% 9%

Italy 47% 8% 7% 33% 9% 7%

Netherlands 51% 8% 10% 33% 10% 12%

Poland 10% 1% 1% 7% 1% 1%

Source: eCORDA iSearch (March 2017). Note that percentage of projects for individual countries are defined as the number of signed grant agreements with at least one participant from that country, out of the grand total of all health-related projects in the respective programmes; projects are assigned to multiple countries and hence percentage of projects do not add up to 100%.

21

Table 13 EU contribution to health-related projects relative to overall research base [FTE, full time equivalent]

EU Contribution to Framework Programme 7 & Horizon 2020 (in EUR million)

Researchers (FTE) (average for the period 2007-2014)

EU Contribution per 1000 researchers (EUR million)

UK 1,225.1 256,072 4.8

Germany 1,059.0 326,338 3.2

France 673.6 243,116 2.8

Italy 486.8 103,863 4.7

Netherlands 722.6 59,098 12.2

Poland 37.7 64,489 0.6

Source: Data analysis by MRC Information and Analysis Team and Technopolis Group; data source: eCORDA iSearch (March 2017) and Eurostat (total number or researchers FTE, [rd_p_persocc])

22

APPENDIX G HESA SUPPLEMENTARY DATA

Higher education data in the UK is collected by the Higher Education Statistics Agency (HESA). HESA student data was accessed and analysed via the HEIDI portal by the MRC Information and Analysis team.

Full person equivalent (FPE) counts were chosen for all data extracted. Figures are rounded by each UK institution and so aggregates will be over-stated. ‘Other EU’ refers to all EU member states except the UK.

A description of the data captured by HESA, definition of FPE, nationality and domicile can be found at https://www.hesa.ac.uk/support/definitions/students.

Table 14 Total population of students (‘stock’), broken down by domicile (residence immediately before taking up study)

UK % Other EU

% Non-EU % Not known

% Total

2012/13 1,915,015 82% 125,290 5% 299,970 13% 2,340,275

2013/14 1,863,860 81% 125,300 5% 310,195 13% 2,299,355

2014/15 1,829,195 81% 124,575 5% 312,010 14% 295 0% 2,266,075

Table 15 Total number/proportion of qualifiers, by domicile

UK % Other EU

% Non-EU % Not known

% Total

2012/13 593,640 75% 50,330 6% 143,930 18% 787,900

2013/14 580,895 75% 49,055 6% 147,850 19% 777,800

2014/15 544,665 73% 47,250 6% 152,975 21% 115 0% 744,890

23

G.1 Students in the UK, subjects relevant to biomedicineHESA uses the Joint Academic Coding System (JACS) system to classify academic subjects. A JACS code for a single subject consists of a letter and three numbers; there are 164 codes. 24 JACS principal subject codes were selected as relevant to biomedical research:

(A0) Broadly-based programmes within medicine & dentistry

(A1) Pre-clinical medicine

(A2) Pre-clinical dentistry

(A3) Clinical medicine

(A4) Clinical dentistry

(A9) Others in medicine & dentistry

(B0) Broadly-based programmes within subjects allied to medicine

(B1) Anatomy, physiology & pathology

(B2) Pharmacology, toxicology & pharmacy

(B3) Complementary medicines, therapies & well-being

(B4) Nutrition

(B5) Ophthalmics

(B6) Aural & oral sciences

(B8) Medical technology

(B9) Others in subjects allied to medicine

(C0) Broadly-based programmes within biological sciences

(C4) Genetics

(C5) Microbiology

(C7) Molecular biology, biophysics & biochemistry

(C8) Psychology

(C9) Others in biological sciences

(D1) Pre-clinical veterinary medicine

(D2) Clinical veterinary medicine & dentistry

(I5) Health informatics

Students enrolled at UK institutions (all years)

Table 16 Total stock (students in any year of their course) with studies relevant to biomedicine, by domicile

UK % Other EU

% Non-EU % Not known

% Total

2012/13 281,705 87% 15,415 5% 25,675 8% 0% 322,795

2013/14 281,720 87% 15,690 5% 27,010 8% 0% 324,420

2014/15 281,365 87% 16,005 5% 27,765 9% 10 0% 325,145

24

Table 17 Stock biomedical postgraduate students, by domicile

  UK % Other EU

% Non-EU % Not known

Total Population

2012/13 65,730 78% 6,275 7% 11,905 14% - 83,910

2013/14 65,230 77% 6,495 8% 12,575 15% - 84,300

2014/15 65,885 77% 6,590 8% 13,030 15% 5 85,510

Figure 4 Stock biomedical postgraduate students, by domicile

Nu

mb

er o

f st

ud

ents

Figure 22

0

10,000

20,000

30,000

40,000

50,000

60,000

70,000

80,000

90,000

2014/152013/142012/13

65,730 65,230 65,885

6,275 6,495 6,590

11,905 12,575 13,030

Non-EU

Other EU

UK

25

Table 18 Stock biomedical undergraduate students, by domicile

  UK % Other EU

% Non-EU % Total Population

2012/13 215,955 90% 9,125 4% 13,775 6% 238,855

2013/14 216,455 90% 9,210 4% 14,450 6% 240,115

2014/15 215,470 90% 9,410 4% 14,725 6% 239,605

Figure 5 Stock biomedical undergraduate students, by domicile

0

50,000

100,000

150,000

200,000

250,000

2014/152013/142012/13

Nu

mb

er o

f st

ud

ents

215,955 216,455 215,470

9,125 9,210 9,41013,775 14,450 14,725

Non-EU

Other EU

UK

26

G.1.1 Students awarded a qualification in subjects relevant to biomedicine (‘qualifiers’)

‘Qualifiers’ are students who were awarded a higher education qualification during the HESA reporting period.

Table 19 Total proportion of biomedical qualifiers, by domicile

UK % Other EU

% Non-EU % Not known

% Total

2012/13 79,510 84% 5,485 6% 9,390 10% 0% 94,385

2013/14 80,030 84% 5,340 6% 9,775 10% 0% 95,145

2014/15 79,275 83% 5,475 6% 10,395 11% 20 0% 95,165

Table 20 Qualifying biomedical postgraduate students in subjects relevant to biomedicine, by domicile

  UK % Other EU

% Non-EU % Total Population

2012/13 22,520 73% 2,925 9% 5,545 18% 30,990

2013/14 22,980 73% 2,745 9% 5,900 19% 31,625

2014/15 24,030 74% 2,810 9% 5,730 18% 32,570

Figure 6 Qualifying biomedical postgraduate students, by domicile

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

2014/152013/142012/13

Nu

mb

er o

f st

ud

ents

Non-EU

Other EU

UK

22,520 22,980 24,030

2,925 2,7452,810

5,545 5,9005,730

27

Table 21 Qualifying biomedical undergraduate students, by domicile

  UK % of total in this table

Other EU % of total in this table

Non-EU % of total in this table

Total

2012/13 57010 90% 2550 4% 3455 5% 63015

2013/14 57040 90% 2570 4% 3875 6% 63485

2014/15 55260 89% 2655 4% 3890 6% 61805

Figure 7 Qualifying biomedical undergraduate students, by domicile

50,000

52,000

54,000

56,000

58,000

60,000

62,000

64,000

2014/152013/142012/13

Nu

mb

er o

f st

ud

ents

57,010 57,04055,260

2,550 2,570

2,655

3,455 3,875

3,890

Non-EU

Other EU

UK

28

G.1.2 Destinations of Leavers from Higher Education (DLHE) survey

HESA carries out the Destinations of Leavers from Higher Education (DLHE) survey, which collects information on what all ‘leavers’ from higher education (HE) programmes are doing six months after qualifying from their course. The number of qualifiers contacted by HESA is lower than the total number of qualifiers (76% in 2014/15). This is referred to as the “target” population.

The approach of the DHLE survey is explained further, with results from 2012/13, at https://www.hesa.ac.uk/data-and-analysis/publications/destinations-2012-13/introduction.

Target population

77% of the target population provided responses, which represents approximately 60% of all qualifiers in subjects relevant to biomedicine (“respondents”).

Table 22 Total (target) population for subject codes relevant to biomedicine, by domicile

  UK % of total Other EU % of total Total % of all qualifiers

2012/13 68,480 93% 4,825 7% 73,305 78%

2013/14 69,375 94% 4,735 6% 74,110 78%

2014/15 67,885 93% 4,905 7% 72,790 76%

Table 23 Respondents for subject codes relevant to biomedicine, by domicile

  UK % of total Other EU % of total Total % of total target

population

2012/13 53,205 95% 3,000 5% 56,205 77%

2013/14 54,125 95% 2,915 5% 57,040 77%

2014/15 52,930 94% 3,125 6% 56,055 77%

Table 24 Postgraduate, undergraduate (first degree) and other undergraduates in respondents relevant to biomedicine

Postgraduate First degree Other undergraduate

Total

2012/13 13,740 37,005 5,465 56,205

2013/14 14,005 38,610 4,415 57,040

2014/15 14,730 36,975 4,355 56,055

29

Postgraduate respondents

Table 25 Locations of employment for postgraduate students relevant to biomedicine with previous other EU-domicile

  UK % of total

Other EU

% of total

non-EU

% of total

not employed

% of total

not known

Total

2012/13 510 35% 455 31% 75 5% 415 28% 5 1,460

2013/14 505 37% 415 30% 70 5% 375 27% 5 1,370

2014/15 595 40% 415 28% 55 4% 420 28% 15 1,500

Figure 8 Locations of employment for postgraduate students relevant to biomedicine with previous other EU-domicile

0

10

20

30

40

50

60

70

80

90

100

2014/152013/142012/13

Per

cen

tag

e (%

)

Not known

Not employed

Non-EU

Other EU

UK

Figure 20

510 505 595

415 375 420

455 415 415

75 70 55

30

Figure 9 Destinations of postgraduate students relevant to biomedicine with previous other EU-domicile (2014/15)

Undergraduate respondents

Table 26 Locations of employment for undergraduate students relevant to biomedicine with previous other EU-domicile

  UK % of total

Other EU

% of total

non-EU

% of total

not employed

% of total

not known

Total

2012/13 615 43% 185 13% 10 1% 595 42% 15 1,420

2013/14 570 42% 160 12% 15 1% 610 45% 5 1,360

2014/15 685 45% 155 10% 10 1% 670 44% 0 1,520

28%

40%

28%

UK

Other EU

Non-EU

Not employed

4%

31

Figure 10 Locations of employment for undergraduate students relevant to biomedicine with previous other EU-domicile

Figure 11 Destinations of undergraduate students relevant to biomedicine with previous other EU-domicile (2014/15)

0

10

20

30

40

50

60

70

80

90

100

2014/152013/142012/13

Per

cen

tag

e (%

)

Not known

Not employed

Non-EU

Other EU

UK

Figure 20

Figure 22

615 570 685

595 610 670

185 160 155

10%

45%44%

UK

Other EU

Non-EU

Not employed

4%

32

Table 27 Flow of biomedical students, leavers survey 2013/14

Graduates in employment in other EU countries (after qualifying in the UK)

Total EU-domiciled leavers in employment

Net flow of students from other EU countries

EU-domiciled 958

UK-domiciled 433

Total 1,391 2,892 -1,500

Source: Data analysis by MRC Information and Analysis Team and Technopolis; data source: HESA

33

APPENDIX H RESEARCHFISH® SUPPLEMENTARY DATAResearch council data on next destinations collected via Researchfish®

In 2014 the research councils adopted a harmonised method for the collection of research outputs and outcomes data via Researchfish®i,ii. Researchfish® is an online system for capturing structured information about research progress used by multiple funding agencies. Researchers can, alongside information about a wide range of output types, provide brief feedback on staff that have ceased to be funded by the awards they hold. Funders aim to gather high level information on the next destinations of staff, where this is known. While working on projects staff gain experience and may transfer these skills to other sectors and job roles. Approximately 40% of those that have received MRC awards responded.

Table 28 Summary of moves to specific EU-28 member statesiii

Research Council

DE FR IT NL PO UK Other EU27

Non-EU

Unknown Grand Total

AHRC 19 3 4 2 491 42 64 4 629

BBSRC 87 69 14 25 7 2,083 161 432 50 2,928

EPSRC 296 262 78 92 42 7,273 567 1747 372 10,729

ESRC 18 8 6 15 635 26 141 9 858

MRC 279 225 80 58 18 7,352 562 1,683 525 10,782

NERC 28 30 2 11 3 730 73 212 14 1103

STFC 51 35 16 17 2 462 77 201 57 918

Grand Total 778 632 200 220 72 19,026 1508 4,480 1,031 27,947

Data analysis by MRC Information and Analysis Team and Technopolis; data source: Researchfish® MRC data

The Researchfish data provides evidence, over ten years (2006-2016) for the support of almost 28,000 people at some point in their career.

i Research Councils UK. About Researchfish® available from www.researchfish.com [Accessed 8 Feb 2017]

ii Research Councils UK. Research Outcomes available from http://www.rcuk.ac.uk/research/researchoutcomes/ [Accessed 8 Feb 2017]

iii Where a year of the move is reported, and is between 2006 and 2016 inclusive. Results from Researchfish are first de-duplicated, by funder, using an ID for the reported output (as outputs can be attributed to multiple awards)

34

Table 29 All data for moves to EU-28 member states

AHRC BBSRC EPSRC ESRC MRC NERC STFC Grand Total

Austria, Republic of 5 11 44 2 43 2 107

Belgium, Kingdom of 3 8 43 3 26 2 4 89

Bulgaria, Republic of 2 4 1 7

Croatia, Republic of 1 2 3

Cyprus, Republic of 1 11 7 1 20

Czech Republic 4 19 1 11 3 38

Denmark, Kingdom of 3 8 27 31 9 3 81

Estonia, Republic of 1 2 1 1 5

European Union (EU)iv 10 33 105 5 91 17 39 300

Finland, Republic of 7 14 3 11 4 8 47

France, French Republic 3 69 262 8 225 30 35 632

Germany, Federal Republic of 19 87 296 18 279 28 51 778

Greece, Hellenic Republic 1 6 39 25 3 74

Hungary, Republic of 2 4 9 11 1 1 28

Ireland, Republic of 8 14 54 3 48 8 2 137

Italy, Italian Republic 4 14 78 6 80 2 16 200

Latvia, Republic of 1 1

Lithuania, Republic of 1 1 3 1 6

Luxembourg, Grand Duchy of 4 4

Malta, Republic of 1 6 1 4 12

Netherlands, Kingdom of the 2 25 92 15 58 11 17 219

Poland, Republic of 7 42 18 3 2 72

Portugal, Portuguese Republic 1 10 22 31 4 4 72

Romania 8 2 10

Slovakia (Slovak Republic) 1 1 2 1 5

Slovenia, Republic of 2 1 2 10 1 16

Spain, Kingdom of 6 35 107 4 140 9 9 310

Sweden, Kingdom of 14 43 4 62 12 1 136

Subtotal for EU-27 70 349 1,294 69 1,160 135 197 3,274

United Kingdom of Great Britain & Northern Ireland (UK)

491 2,083 7,273 635 7,352 730 462 19,026

Grand Total 561 2,446 8,610 708 8,574 877 660 22,436

Data analysis by MRC Information and Analysis Team and Technopolis; data source: Researchfish® MRC data iv

iv European Union is a less-specific location chosen by some respondents, the assumption is that the move is somewhere in the EU-27

35

Table 30 Role in MRC-funded group and next destination country

UK DE FR IT NL PO other EU

Non-EU

Unknown Total

Post Doctoral Researcher

2,463 120 121 31 33 5 276 652 154 3,855

Research Fellow 1,109 40 59 20 5 2 108 258 78 1,679

Research Project Leader

197 6 9 2 1 11 52 14 292

Research Student 1,283 77 26 15 8 3 82 424 101 2,019

Researcher (No PhD)

1809 33 10 10 10 7 71 249 144 2,343

Management/Admin/Policy

384 2 2 1 6 32 29 456

Engineer 4 1 1 1 7

Technician 103 1 1 7 15 4 131

Total 7,352 279 225 80 58 18 562 1,683 525 10,782

Data analysis by MRC Information and Analysis Team and Technopolis; data source: Researchfish® MRC data

Table 31 Role after leaving MRC-funded group, and next destination country

UK DE FR IT NL PO other EU

Non-EU

Unknown Total

Post Doctoral Researcher

2489 120 110 36 33 4 246 777 140 3955

Research Fellow (individual fellowship)

290 6 14 6 1 31 97 11 456

Research Project Leader (with budgetary responsibility)

458 37 46 9 4 95 220 21 890

Full-time lecturer/teacher

303 8 7 1 1 19 69 3 411

Research Student

432 30 8 6 5 2 25 76 23 607

Researcher (No PhD)

740 19 4 3 2 4 29 104 46 951

Engaged in study 149 5 2 2 4 8 19 2 191

Full-Time Study 64 1 7 1 73

Health care/Medical Staff

628 9 4 2 4 22 71 27 767

Management/Admin/Policy

330 7 6 2 2 18 38 19 422

36

UK DE FR IT NL PO other EU

Non-EU

Unknown Total

Management/Admin/Policy for a research organisation

142 1 1 18 6 168

Not employed/on career break/maternity/paternity leave

263 13 8 5 1 3 21 47 34 395

Other Research Occupation

442 14 7 4 3 26 69 31 596

Unknown/Other 464 11 8 4 1 21 65 148 722

Retired 148 1 5 9 163

Deceased 10 4 14

Total 7,352 279 225 80 58 18 562 1,682 525 10,781

Data analysis by MRC Information and Analysis Team and Technopolis; data source: Researchfish® MRC data

Table 32 Sector of employment and destination, after leaving MRC-funded group

UK DE FR IT NL PO other EU

Non-EU

Unknown Total

Academic (e.g. university based)

4,266 184 156 52 36 14 398 1,222 222 6,550

Charitable (non profit making)

151 1 3 5 31 3 194

Health/health care (e.g. hospital based; NHS or private)

873 9 6 4 4 30 79 35 1,040

Not Applicable/Unknown

770 17 14 9 1 4 32 105 180 1,132

Other Public Sector (e.g. research agency/government)

241 11 17 2 1 16 74 13 375

Other Research Council (e.g. research unit/institute/head office)

272 9 10 6 1 16 34 21 369

Private (profit making e.g. industry, commerce)

779 48 19 7 15 65 138 51 1,122

Total 7,352 279 225 80 58 18 562 1,683 525 10,782

Data analysis by MRC Information and Analysis Team and Technopolis; data source: Researchfish® MRC data

Table 31 (cont)

37

Table 33: Role and destination country of MRC-funded postdoctoral researchers

UK DE FR IT NL PO other EU

Non-EU

Unknown Total

Full-time lecturer/teacher

165 5 4 15 42 2 233

Health care/Medical Staff

67 5 2 1 5 11 6 97

Research Project Leader (with budgetary responsibility)

197 21 25 3 3 49 122 6 426

Research Fellow (individual fellowship)

143 5 9 4 1 22 51 3 238

Total 2463 120 121 31 33 5 276 652 154 3855

Table 34: Next role and destination country of MRC-funded research fellows

UK DE FR IT NL PO other EU

Non-EU

Unknown Total

Full-time lecturer/teacher

77 2 3 1 1 2 12 1 99

Health care/Medical Staff

207 3 1 1 1 8 15 4 240

Research Project Leader (with budgetary responsibility)

118 14 17 5 1 35 51 7 248

Research Fellow (individual fellowship)

99 1 4 2 6 19 4 135

Total 1109 40 59 20 5 2 108 258 78 1679

Data analysis by MRC Information and Analysis Team and Technopolis; data source: Researchfish® MRC data

38

APPENDIX K EUROPEAN RESEARCH COUNCIL GRANTSAll data was provided by the European Research Council (ERC) Office. Data as of 14/12/2016, includes: Starting Grants 2007-2016, Consolidator Grants 2013-2016, Advanced Grants 2008-2015. Current signatories of the grant agreement have been taken into account.

Table 35 Location and nationality of ERC grant holders

Country of host institution

Number of all grants

Number of grantees already resident in the country Number of grantees moving to the country

All grantees staying in the country

Staying (own nationals)

Staying (other EU/Associated-country nationals)

Staying (non-EU/AC nationals)

UK 1,488 1,348 736 428 184 140

DE 1,031 912 687 166 59 119

FR 888 815 610 154 51 73

NL 593 535 394 107 34 58

ES 384 353 276 64 13 31

IT 380 340 319 18 3 40

BE 240 220 197 20 3 20

SE 232 218 144 64 10 14

AT 180 143 50 83 10 37

DK 139 120 87 21 12 19

FI 108 101 86 14 1 7

PT 68 63 55 5 3 5

IE 66 57 41 15 1 9

NO 66 58 37 11 10 8

HU 54 48 43 5 0 6

CH 468 386 120 223 43 82

IL 372 360 351 7 2 12

Other 150 131 117 12 2 19

Total 6,907 6,208 4,350 1,417 441 699

Source: European Research Council (ERC) Office

39

Table 36 Top institutions and research organisations hosting ERC grant holders

Country Higher-Education Institution

Starting Grants

Consolidator Grants

Advanced Grants

Total LS PE SH

UK University of Oxford 78 36 75 189 52 76 61

UK University of Cambridge 83 34 71 188 66 88 34

UK University College London

65 27 41 133 53 39 41

CH Swiss Federal Institute of Technology Lausanne (EPFL)

53 15 48 116 33 81 2

CH Swiss Federal Institute of Technology Zurich (ETH Zurich)

45 7 58 110 34 72 4

IL Weizmann Institute 55 23 32 110 64 44 2

IL Hebrew University of Jerusalem

55 15 34 104 45 42 17

UK Imperial College 49 14 23 86 30 54 2

UK University of Edinburgh 34 14 35 83 28 32 23

NL University of Amsterdam 38 14 19 71 7 24 40

DK University of Copenhagen

32 21 16 69 29 24 16

IL Tel Aviv University 40 10 16 66 29 31 6

BE University of Leuven 34 11 20 65 18 33 14

DE University of Munich (LMU)

28 4 29 61 25 21 15

NL Radboud University Nijmegen

32 10 14 56 21 12 23

NL Delft University of Technology

27 14 15 56 6 44 6

NL Utrecht University 26 17 13 56 10 25 21

UK University of Bristol 22 7 26 55 9 36 10

CH University of Zurich 22 9 20 51 31 9 11

NL Leiden University 25 9 16 50 21 29

FI University of Helsinki 25 8 15 48 32 11 5

IL Technion – Israel Institute of Technology

32 6 10 48 16 31 1

FR National Centre for Scientific Research (CNRS)

186 83 83 352 103 210 39

DE Max Planck Society 86 24 68 178 95 72 11

DE Helmholtz Association of German Research Centres

50 28 20 98 58 39 1

40

Country Higher-Education Institution

Starting Grants

Consolidator Grants

Advanced Grants

Total LS PE SH

FR National Institute of Health and Medical Research (INSERM)

43 23 23 89 83 3 3

FR French Alternative Energies and Atomic Energy Commission

40 5 16 61 9 50 2

ES Spanish National Research Council (CSIC)

27 18 16 61 19 36 6

FR INRIA 29 4 14 47 47

LS = Life Sciences; PE = Physical and Engineering Sciences; SH = Social Sciences and Humanities

Source: European Research Council (ERC) Office

Table 37 Top Host Institutions – Life Sciences domain only

Starting Grants

Consolidator Grants

Advanced Grants

Total

University of Cambridge 29 11 26 66

Weizmann Institute 33 17 14 64

University College London 29 8 16 53

University of Oxford 17 11 24 52

Hebrew University of Jerusalem 24 8 13 45

Karolinska Institute 20 6 16 42

Swiss Federal Institute of Technology Zurich (ETH Zurich)

16 1 17 34

Swiss Federal Institute of Technology Lausanne (EPFL)

12 4 17 33

Flanders Institute for Biotechnology (VIB) 14 12 6 32

University of Helsinki 17 6 9 32

University of Zurich 14 3 14 31

Imperial College 21 2 7 30

University of Copenhagen 13 10 6 29

Tel Aviv University 19 6 4 29

University of Edinburgh 12 3 13 28

Uppsala University 16 4 6 26

University of Munich (LMU) 10 2 13 25

Curie Institute 12 4 9 25

Source: European Research Council (ERC) Office

Table 36 (cont)

41

Table 38 Top host institutions located in EU28 – Life Science domain only

Starting Grants

Consolidator Grants

Advanced Grants

Total

University of Cambridge 29 11 26 66

University College London 29 8 16 53

University of Oxford 17 11 24 52

Karolinska Institute 20 6 16 42

Flanders Institute for Biotechnology 14 12 6 32

University of Helsinki 17 6 9 32

Imperial College 21 2 7 30

University of Copenhagen 13 10 6 29

University of Edinburgh 12 3 13 28

Uppsala University 16 4 6 26

Source: European Research Council (ERC) Office

42

APPENDIX L BIBLIOMETRIC ANALYSIS OF REFERENCES IN EU CLINICAL GUIDELINES AND PUBLICATIONS BY EU NATIONAL HEALTH ADVISORY COMMITTEE MEMBERS

L.1 Background to clinical guidelines“Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances.”

(Field and Lohr, 1990. p:38){1}

Clinical guidelines are being used increasingly to inform medical practice. They normally provide recommendations based on a careful review of the available evidence, much of which is in the form of papers in the peer-reviewed serial literature. Conversely, an examination of the papers that are so cited can be used to show the practical value of medical research. The first such study was on a very small scale{15} but was extended the following year to a larger sample and this paper attracted much more attention{16}. The procedure was extended again{17} and showed that many of the papers cited on UK guidelines had been funded by industry, but very few by the Wellcome Trust, probably because they tended to be clinical rather than basic research. A more detailed examination of UK cancer clinical guidelines{18} revealed the important contributions of Edinburgh and Glasgow, especially to the guidelines published in Scotland by the Scottish Intercollegiate Guidelines Network (SIGN), and confirmed the over-citation of UK research on these 43 guidelines.

More recent work both in the UK{19},{20} and in Chile{21} has confirmed that the citations of papers on clinical guidelines form a useful means to evaluate medical research. The preferential citation of clinical, as opposed to basic, papers is a welcome counter-balance to their under-citation in the academic literature. Although national guidelines do tend to over-cite their own country’s research, this is something that occurs in the serial literature, with smaller countries over-citing their fellow-countrymen much more than larger countries do{22}.

The results presented here were taken from a major mapping exercise carried out by King’s College London and supported by the European Commission. This examined, inter alia, the impacts of European research in five non-communicable diseases (NCDs) including cancer, cardiovascular disease and stroke, and mental disorders. The first set of impacts, those of UK research on members of national health advisory committees from other Member States, has been provided previously. This report describes the extent to which UK research is cited on European Clinical Guidelines (ECGs) published by five target European Union Member States (EU MSs) namely France, Germany, Italy, the Netherlands and Poland, and the other EU Member States.

L.2 Five target Member State Countries NCD mortality and clinical guidelines’ profiles

Non-communicable diseases (NCDs) are the leading cause of death in Europe and worldwide. The five target EU MSs give specific emphasis on clinical guidelines’ development, quality assurance and adherence on chronic conditions like cancer, cardiovascular diseases (CVD) and mental health disorders. France, Germany, the Netherlands and England are recognised as “leading” countries in the development of clinical practice guidelines{2}. The profile of each country around CGs development and patterns of NCD mortality is as follows, for:

43

L.2.1 The United Kingdom (UK)

In the UK, there is the National Institute for Health and Care Excellence (NICE) for England and the Scottish Intercollegiate Guidelines Network (SIGN) for Scotland responsible for the development of evidence based clinical practice guidelines. In the UK, 89% of 557,000 deaths in 2014 were due to NCDs, with cardiovascular diseases as the leading cause (31%), followed by cancers (29%) and other NCDs (29%){9}.

In England, through funding from NICE, the National Collaborating Centre for Chronic Conditions (NCCCC) is responsible for the development of clinical guidelines on chronic conditions, based at the Royal College of Physicians (RCP){2}. The National Clinical Guideline Centre (NGC) is commissioned to develop NICE clinical practice guidelines on chronic conditions{12}. The SIGN guidelines are developed through a systematic literature review process working in partnership with several organisations through Europe on clinical guidelines{13}.

L.2.2 Germany (DE)

In Germany, the Association of the Scientific Medical Societies (AWMF) coordinates the development of voluntary clinical guidelines{2}. There are also the Federal Joint Committee (GBA), the Institute for Quality and Efficiency in Health Care (IQWiG), the National Association of Statutory Health Insurance Physicians (KBV), the National disease management guidelines (NVL) and the Agency for Quality in Medicine (ÄZQ) focusing on chronic conditions. The NVL ensures the implementation and adherence to the clinical guidelines, while the National Academy of Family Physicians ensures their evaluation{2}.

In 2014, there were 866,000 deaths in Germany, with 91% due to NCDs. CVDs accounted for 40% of all deaths, followed by cancer (26%) and other NCDs (25%){9}.

L.2.3 France (FR)

In France, the French National Authority for Health (Haute Autorité de Santé, HAS) is responsible for the development and dissemination of centralised clinical guidelines, sometimes in collaboration with professional associations and medical societies{2}.

In 2014, there were 87% of 554,000 deaths due to NCDs with the leading cause of deaths in France being cancer (31%), followed by CVD (28%) and other NCDs (28%){9}.

L.2.4 Italy (IT)

In Italy, there is the National Guideline System (SNLG) and the Centre for the Evaluation of the Effectiveness of Health Care (CeVeAs) responsible for the quality control of the production of clinical guidelines{2}. There is also the National Agency for Regional Healthcare Systems (AGENAS) responsible for the adherence to the guidelines{2}. Like France, the development of centralised clinical guidelines is the responsibility of the SNLG, which is part of the National Institute of Health (ISS) (under the Ministry of Health) with medical societies and regional agencies involved in the process of development and implementation of CGs{2}.

In Italy, over 92% of 573,000 deaths in 2014 were due to NCDs with CVDs as the leading cause of death (37%), then cancer (29%) and other NCDs (26%){9}.

44

L.2.5 The Netherlands (NL)

Similar to Germany, there are various organisations involved in the development of clinical guidelines around the prevention and treatment of NCDs in the Netherlands. In contrast to Germany though, these organisations, like the National Institute for Public Health and the Environment (RIVM), the Dutch Institute for Healthcare Improvement (CBO), the Dutch Council for Quality of Care and the Dutch College of General Practitioners (NHG) operate without central co-ordination. In addition, these organisations follow different methods on evidence-base synthesis and there is no official regulation on clinical guidelines evaluation of quality control{2}.

In the Netherlands, 89% of 140,000 deaths were due to NCDs with over a third from cancer (33%), 29% from CVDs and 28% from other NCDs{9}.

L.2.6 Poland (PL)

In Poland, there is no legal basis for the development of clinical guidelines, and this process is decentralised with the work mainly carried out by professional organisations, specialists, medical societies, the National Centre for Quality Assessment in Healthcare and the College of Family Physicians (CoPFiP). There is no standardised guidance, no quality control, and no incentive on adherence to guidelines, CGs evaluation or implementation.

In 2014, 90% of 374,000 deaths were attributed to NCDs, with 49% of all deaths due to cardiovascular diseases followed by cancer (26%) and other NCDs (16%){9}.

L.3 Analysis of publications by National Health Advisory Committee members

Most EU member states have sets of committees that provide advice to their ministries of health. These usually consist of experts in the relevant subject area, many of them active researchers and clinicians. It was hypothesised that some of them would have carried out their research, in collaboration with scientists from other MS, and that this would demonstrate the utility of European research activitiesv. By the same token, some of the members‘ research would have been done in partnership with the UK, and this would provide a route by which UK medical researchers could influence health policy in other member states.

During 2014-15, King’s College London contributed to an EU-funded project on the mapping of research on five non-communicable diseases (NCDs) in Europe. As part of the project, health advisory committees in 21 member states were identified, including the UK, with a total membership of 1,431, during the five years 2009-13. Table 1 lists the member states with the numbers of advisory group members for the country, and the numbers of biomedical research papers that they collectively published. The bibliographic details of the 12,854 papers published by the committee members were extracted from the Web of Science Thomson Reuters database and analysed.

The table shows that the numbers of advisers was very uneven, with some countries having large numbers (notably Hungary, and also Germany, Italy and Estonia) but others having very few. There was also a big variation in the amount of research being conducted by members. It averaged over 20 papers per member in the Netherlands and Spain, and was more than 10 in the Czech Republic, Germany, Poland and the UK, but was less than unity in Luxembourg, Ireland and Bulgaria.

v Pallari E & Lewison G. The research publications of members of European national noncommunicable disease health advisory committees. Journal of Scientometric Research. 2015 Sep 1;4(3):124.

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The main analyses were of the contribution of the UK to committee members’ papers: (1) from each of the five selected (target) members states, namely France, Germany, Italy, the Netherlands and Poland; (2) from the other European countries. Comparisons were made with the contributions of (1) the other four target MS, or for the other 25 countries, all five; (2) the USA; (3) the other European countries; and (4) the rest of the world. These comparisons were designed to show the contribution of the UK in context. The analyses were carried out on the basis of both fractional and integer contributions. For example, a paper with two French addresses and one German one would be counted 1 each for FR and DE on integer counting, but 0.67 and 0.33 respectively on fractional counting. The latter gives a fairer representation of the contribution of each country, but the former allows a country’s contribution to be compared with its presence in the relevant field of science. For these advisory committees, with a very wide range of interests, we took all biomedical research as the relevant field, and determined individual country presence in this field in WoS papers by means of a special filter based on address words and contractions

Table 39 Membership of national health advisory committees in EU MS in 2009-13, and the number of biomedical papers in the Web of Science that they wrote.

Member state ISO2 code No. of committees

No. of members No. of papers

Austria AT 4 189 1,384

Bulgaria BG 1 9 7

Croatia HR 1 19 39

Cyprus CY 3 26 36

Czech Republic CZ 4 51 969

Denmark DK 2 42 111

Estonia EE 2 106 347

Finland FI 1 16 100

France FR 3 46 294

Germany DE 5 125 2,010

Hungary HU 5 247 1,311

Ireland IE 2 49 10

Italy IT 4 107 965

Lithuania LT 9 89 145

Luxembourg LU 1 31 4

Netherlands NL 5 83 2,554

Poland PL 3 60 794

Portugal PT 1 16 51

Spain ES 1 46 1,179

Switzerland CH 3 39 141

United Kingdom UK 2 35 403

Total   62 1,431 12,854

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Table 40 Contributions (percentages of foreign contributions to papers, fractional counts) from target MS, the UK, the USA, the other 25 European countries and the Rest of the World to the committee members’ papers from the target MS and the other 25 countries (data available only for 15).

Cttees Other 4 UK US EUR 25 RoW

DE 21.4 8.7 21.8 28.1 19.4

FR 14.0 15.8 12.1 33.0 21.4

IT 27.4 11.5 26.9 21.2 12.2

NL 17.5 17.3 21.3 27.3 12.5

PL 27.1 7.7 24.9 23.0 16.1

EUR 15 45.0 10.9 26.4 15.9

Table 41 Contributions (percentages of integer counts of foreign contributions to papers) from target MS, the UK, the USA, the other 25 European countries and the Rest of the World to the committee members’ papers from the target MS and the other 25 countries (data available only for 15).

Cttees Other 4 UK US EUR 25 RoW

DE 60.7 22.0 34.5 90.2 50.0

FR 76.6 42.1 29.9 133.6 129.0

IT 70.9 25.9 43.1 72.5 36.4

NL 57.6 38.3 37.7 118.4 46.7

PL 100.0 28.6 48.0 140.3 107.7

EUR 15 107.3 27.0 37.6   57.7

Table 42 Percentages of internationally co-authored papers in biomedical research from target MS, the UK, the USA, the other 25 European countries and the Rest of the World co-authored with the countries and groups in column 1, 2009-13.

Countries Other 4 UK US EUR 25 RoW

DE 29.3 20.8 33.7 69.4 52.8

FR 34.4 23.0 31.6 74.4 72.0

IT 37.4 25.3 38.0 80.7 57.5

NL 38.6 27.9 32.9 76.2 55.7

PL 48.3 25.7 35.6 134.7 112.4

EUR 25 47.7 23.2 33.8 52.5

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Table 43 Percentage presence of papers in biomedical research from target MS, the UK, the USA, the other 25 European countries and the Rest of the World that are NOT co-authored with the countries and groups in column 1, 2009-13. Note: for EUR25, “Other 4” presence is actually “Other 5”.

Countries Other 4 UK US EUR 25 RoW

DE 14.7 9.7 36.2 20.7 53.0

FR 17.1 9.4 35.0 20.0 51.3

IT 16.9 9.4 35.1 20.0 51.4

NL 18.1 9.3 34.6 19.8 50.7

PL 19.2 9.1 33.8 19.3 49.6

EUR 25 24.1 10.7 39.8 22.8 58.4

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ENDNOTES

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bhf.org.uk wellcome.ac.uk

acmedsci.ac.uk cruk.org

amrc.org.uk mqmentalhealth.org

Study co-funded by:

arthritisresearchuk.org mrc.ac.uk