My main interests are in the designing and conduct of clinical trials and other clinical investigations to evaluate new treatments and to investigate new biomarkers, or risk stratification variables, for people with respiratory disease. I led the first large-scale non-commercial multi-centre clinical trial in Idiopathic Pulmonary Fibrosis (IPF) in the UK which was one of the largest non-commercial IPF trials at the time. This created a network of research sites in the UK, which has allowed me to receive nearly continuous funding from the National Institute for Health Research (NIHR) to undertake IPF clinical trials since 2007. This work has convincingly shown that, despite clear theoretical reasons, prophylactic antibiotic therapy is not beneficial for people with moderate-severe IPF, and we are currently determining whether proton pump inhibitors have a role.

Other research in interstitial lung disease has shown that fatigue is an important component of the symptomatology in people with sarcoidosis, but is different in character from those with IPF, and a trial of methylphenidate, a stimulant used in other causes of fatigue, is feasible. We have also shown that accelerometers can be used to track the activity of people with interstitial lung disease, and they have more sedentary behaviour than healthy individuals. We are evaluating the utility of exhaled volatile organic compounds as a biomarker for sarcoidosis.

We have evaluated the role of palliative care in people with interstitial lung disease and the influence of socioeconomic status on outcomes in people with idiopathic pulmonary fibrosis.

In terms of asthma, I have had separate funding from Asthma UK and the NIHR to evaluate at risk stratification in asthma. This work has generated an algorithm for predicting those with asthma who at a high risk of being admitted to hospital using routinely collected primary care data. It has shown that targeting care to those with severe asthma can be helpful and a definitive trial, the largest in the UK, is currently ongoing. Separate to this our team have received funding for a clinical trial from NIHR to determine the efficacy of fatty acid supplementation in people with non-steroidal exacerbated airways disease, a commonly overlooked phenotype of asthma. Recently we have received funding to explore the role of weight reduction in people with asthma who are living with obesity.

In addition, I have experience in efficient trial design, remote assessments in clinical trials, secondary analysis clinical trial data and large-scale databases and biomarkers including exhaled volatile organic compounds, exhaled breath condensate, exhaled nitric oxide, induced sputum and blood biomarkers. I have an interest in home spirometry assessment including automated review, health-related quality of life, self-efficacy, exercise and weight related assessments and interventions in respiratory disease.

Biomedicine, MED

Clinical trials, asthma, interstitial lung disease, biomarkers, quality of life, biomarkers

• 2000 MD University of Edinburgh
• March 1995 MRCP (UK)
• July 1992 MB ChB, University of Edinburgh

I have an interest in the delivery of clinical teaching to undergraduate and post-graduate students especially in the areas of Respiratory Medicine and General Medicine. In particular I have an interest in alternative, non-lecture based, teaching methods for undergraduate students. Teaching activities have included:

PBL Tutor

Personal Advisor

Lecturer and Seminar Leader in Respiratory Medicine and Clinical Pharmacology

Student Research Project Supervisor

• 1 November 2004 to Present Clinical Senior Lecturer in Respiratory Health, University of East Anglia, Norwich and Honorary Consultant Physician in Respiratory Medicine, Norfolk and Norwich University Hospital, Colney Lane, Norwich, NR4 7UY. 
• 1 June 2003 – 1 November 2004 Clinical Lecturer and Honorary Specialist Registrar in Clinical Pharmacology, Respiratory Medicine and General Medicine, Department of Medicine and Therapeutics, Ninewells Hospital & Medical School, University of Dundee, DUNDEE
• 1 June 2002 – 1 June 2003 Clinical Fellow to Prof AE Holbrook, Prof FE Hargreave and PM O’Byrne. McMaster University 1200 Main Street, Hamilton Ontario Canada L8N 3Z5.
• 1 June 1998 – 1 June 2002 Clinical Lecturer and Honorary Specialist Registrar in Clinical Pharmacology, Respiratory Medicine and General Medicine, Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital & Medical School, University of Dundee, DUNDEE
• 1 August 1996- 1 June 1998 Clinical Research Fellow in Clinical Pharmacology and Honorary Registrar at Department of Clinical Pharmacology and Therapeutics, Ninewells Hospital & Medical School, University of Dundee, DUNDEE
• 1 August 1994 – 31 July 1996 Senior House Officer in Medical Rotation at Salford Royal Hospitals NHS Trust, SALFORD
• 1 August 1993- 31 August 1994 Senior House Officer in Medical Rotation. Calderdale Healthcare, HALIFAX. HX3 0PW
• Feb 93-Aug 93 Medical HO: Dumfries and Galloway Royal Infirmary, DUMFRIES
• Aug 92-Feb 93 Surgical HO: Western General Hospital, EDINBURGH