Melody studied Decision Sciences at the London School of Economics where she taught decision theories and practices to undergraudates and master students.
Melody's research focuses on applying decision analysis methodologies to medicine. This includes finding ways to improve clinical decison making where uncertainties abound, generating evidence when it is scarce, handling data when they are heterogeneous, performing cost-benefit/risk-benefit analyses that takes into account perspectives of multiple stake holders. She is currently working on developing effective and efficient methods for the assessment of health technologies.
Since 2014, Melody has been collaborating with a large and dynamic group of clinicians, scientists and industry partners as part of the NIHR-London In Vitro Diagnostics Co-operative (formerly NIHR Diagnostic Evidence Cooperative). The aim of methodology research is to develop efficient ways of evidence generation that could quicken the porcess from "bench-to-bedside", converting exciting new ideas into tangible benefits to patients and soceity.
Uncertainties are abundant in mediine. Melody's first project at Imperial examined safety of using various bedside methods for siting nasogastric feeding tubes. We found that even chest x-rays, the current gold-standard, can be misinterpreted. We used Bayesian networks to synthesise evidence retrieved from the literature and analyse the dynamics between test results and feeding safety. Using the existing test method (pH paper), under the current cutoff (5.5), will not be able to achieve the goal of making feeding incident a 'never event'. Better technology and better approach are needed. We won an Innovate UK grant to collaborate with a Scottish SME Ingenza and are developing new generation of pH tests. We are currently running a multi-centred trial, supported by NIHR Clinical Research Network.
Previously, Melody has been carrying out educational research within the National Training Programme (http://www.lapco.nhs.uk/), funded by the Department of Health. Lapco trained 144 consultant colorectal surgeons in 11 national training centres. The education team developed tailor-made assessment forms and methods based on clinical outcomes and operative videos collected directly from the trainees, lending insights into the process and assessment of skill acquisition at the post-graduate level.
Lapco also provided a fertile ground for conducting research into surgical quality. One well-known factor is surgeon caseload. In an analysis of HES data we found that 30-day mortality from gastrectomy, oesophagectomy and pancreatectomy continued to improve as more cases were being carried out. That is, performances were yet to plateau. This lends support to the notion of continued practice at the specialists level.
et al., 2018, Evaluation of a hub-and-spoke model for the delivery of femtosecond laser-assisted cataract surgery within the context of a large randomised controlled trial., Br J Ophthalmol
et al., Surgical versus general practitioner assessment: diagnostic accuracy in two-week wait colorectal cancer referrals (poster), Association of Surgeons of Great Britain and Ireland (ASGBI), Bournemouth, UK, 11-13 May 2011
et al., Hospital volume and survival in oesophagectomy and gastrectomy for cancer: a population-based cohort study (oral presentation), Association of Surgeons of Great Britain and Ireland (ASGBI), Bournemouth, UK, 12 May 2011