黑料社

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How effective is PPI in health research?

Paul Bissell Professor of Public Health and Dean of the School of Human and Health Sciences

Professor Paul Bissell

Professor of Public Health and Dean of the School of Human and Health Sciences

Professor Paul Bissell’s recent articles have cast doubt on patient and public involvement as a means of bringing real-world experience to treatments. Based on PPI used with cancer treatment patients led him to offer a “positive but cautionary note” of warning

HEALTH research projects in the UK have increasingly sought the participation of patients and the public.  The hope is that their real-world experience 鈥 such as undergoing cancer treatment 鈥 will offer valuable new perspectives.

But doubts have been cast by a 黑料社 professor who has completed a trilogy of articles in which he and his collaborators have investigated the process known as patient and public involvement (PPI).  The research has led him to strike what he describes as a 鈥減ositive but cautionary note鈥.

 is Professor of Public Health and Dean of the School of Human and Health Sciences.  His latest co-authored article is titled  in the journal Sociology.

Based on extensive analysis of PPI in a cancer research project in England, the article鈥檚 conclusion is that 鈥淧PI in this setting is less about exploring differences with regard to a plurality of expertise and more about simply watching or supporting the professional researchers at work鈥.

The authors do not suggest that PPI is without benefits for the system or the participants themselves.  鈥淏ut we would also caution against an uncritical assertion that PPI in health research settings can unproblematically bring life-world expertise into the realm of the system鈥.

Patient and public involvement

Working with colleagues who include his former PhD student Dr Jill Thompson 鈥 of Sheffield University 鈥 Professor Bissell has now published three articles that probe PPI.

The first was 2012鈥檚 Credibility and the 鈥榩rofessionalised鈥 lay expert, which appeared in the journal Health.  This was followed by 2014鈥檚 Exploring the impact of patient and public involvement in a cancer research setting, in Qualitative Health Research.

Now comes the Sociology article, co-authored by Professor Bissell and Dr Thompson with Professor Barry Gibson of Sheffield University.  A key theme is that the authors relate patient and public involvement to the social theories of the German thinker J眉rgen Habermas.

Speaking about his work on PPI, Professor Bissell argues that patients鈥 often have very different agendas to those of professional researchers.

鈥淲hat is often written about PPI is that it involves the experiences of patients in health research, but that's not really what鈥檚 going on at all.  What we see is that the research takes place and the patients are connected to it but they are not central to it.

鈥淧PI is worth pursuing but we have to be careful about the benefits of it,鈥 continued Professor Bissell.

鈥淲e have to be more nuanced about its benefits in relation to health research.  I am not saying it is a bad thing, but it is secondary to what clinical and professional researchers want to see, which is improved research, improved publications and patient outcomes.

鈥淲hat emerges in our study is that patients were largely peripheral to that.  They were watching the experts doing the work and were not really engaged in the process.鈥

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