Three neurosurgery registrars from Lancashire Teaching Hospitals have formally participated in the National Institute for Health and Care Research (NIHR) Associate Principal Investigator (API) scheme - a prestigious opportunity that enables bright and enthusiastic clinicians to gain hands-on experience in leading clinical research studies.
This initiative allows registrars – senior doctors working below the level of a consultant - to contribute meaningfully to medical advancements while building research leadership skills.
The API scheme participants are Daniel Lewis, John Usuah, and Frazer O’Brien, each involved in critical studies targeting complex neurosurgical conditions.
Daniel Lewis recently completed a six-month tenure as an Associate PI on the SC IL-1Ra study under the guidance of consultant neurosurgeon Mr Andrew Alalade. This Phase 3 multi-centre trial, which recruited over 100 patients across the UK, explored the use of IL-1 receptor antagonists to treat aneurysmal subarachnoid haemorrhages.
Daniel shared that participating in this trial deepened his understanding of inflammation’s impact on stroke patients, noting the groundbreaking potential if the drug anakinra proves effective: "If successful, it will be revolutionary for patients, with literally no other current effective treatments for brain inflammation. If it doesn’t, it is also quite big news because it shows targeting this pathway will not be beneficial.”
“It’s a good feeling when studies are successful, you can give a good treatment or have a good operation and feel positive about that, but then participating in 
research, you are potentially changing outcomes for thousands of patients in the future.”
He added: “I learned a lot from being involved. For a unit of Preston’s size, to have the extensive research portfolio it does, and have a real variety of different studies at different phases, incorporating different pathologies, is very impressive.”
Frazer O’Brien is currently contributing as Associate PI on the Stop-D study with consultant neurosurgeon Mr Nick Park. This trial investigates whether an anti-depressant could help reduce the incidence of major depressive illness in patients who have experienced traumatic head injuries by giving soon after the injury rather than waiting to see if depression develops.
Frazer highlighted the potential of this psychological trial to change patient care: "If we can demonstrate a benefit, it could revolutionise how we treat the 60% of head injury patients who face major depression within a year post-injury."
He felt it was of significant benefit to help run the trial: “One of the things that is lacking in medicine generally is clinician involvement in research - the more research comes out of the department, the better clinical care is, so when you get a department of neurosurgical registrars all interested in research and wanting to do more of it, it’s a positive.
“It gave me an insight into the kind of things you need to be thinking about and the experiences you need to be having while running a trial, rather than just the day to day of making sure it’s delivered, the presentations to different departments, the circulation of information, all those extra elements to recruiting the patient.”
John Usuah completed his API scheme on the DENS study under consultant neurosurgeon Mr Kaushik Ghosh, focusing on whether rigid collars are beneficial in treating a particular type of neck fracture in elderly or frail patients, or whether such collars do more harm than good.
John express
ed enthusiasm about the opportunities API presents, emphasising that the scheme allows for a unique learning experience in running clinical studies, from patient recruitment to adverse event management: "The API scheme has had a significant impact on my clinical practice. It has fostered stronger connections with a wide cohort of clinical colleagues, allowing for better communication and collaboration on clinical trials and studies.
“This experience has enriched my clinical practice by blending research with patient care, leading to more effective and evidence-based approaches."
Allan Brown, Clinical Research Nurse for Neurosciences at the Trust, praised the dedication of the registrars and the unique research culture within the neurosurgery department: “All these studies illustrate how collaboration between the neurosurgery and research and innovation departments can lead to impactful advancements. It speaks very highly towards engagement of neurosurgical trainees with research. This is a great example for registrars to follow in other specialties across the Trust.”
