Medicine

James Raftery

MA, PhD

Primary position:
Professor of Health Technology Assessment
Other positions:
Chair NETSCC, Director Wessex Institute

Background

The University of Southampton

James is professor of health technology assessment at the University of Southampton and chair of the NIHR Evaluation Trials and Studies Cooodinating Centre (NETSCC). For 2010 he was acting NETSCC director the NIHR’s SDO, HSR and PHR programmes. He has led several research projects including the impact of the HTA programme, incentives for clinicians to join trials and the development of metadata on the performance, conduct and results of clinical trials.

He is an active health economist heading a small group providing health economics input mainly to clinical trials. Research themes include the costs and benefits of clinical trials, overdiagnosis/overtreatment and the political economy of healthcare. He has written widely on health economic matters particularly relating to NICE, including a NICE blog on the BMJ website.

Qualifications

BA Economcis and Philsophy, 1972 Southamtpton University
MA Economics of Education and Science, UCD, 1974
PhD LSE 1993

Professor James Raftery's photo

Publications

The University of Southampton's electronic library (e-prints)

Article

McCann, Donna C., Thompson, Margaret, Daley, David, Barton, Joanne, Laver-Bradbury, Cathy, Hutchings, Judy, Coghill, David, Stanton, Louise, Maishman, T., Dixon, E., Caddy, Josh, Chorozoglou, Maria, Raftery, James and Sonuga-Barke, Edmund (2014) Study protocol for a randomized controlled trial comparing the efficacy of a specialist and a generic parenting programme for the treatment of preschool ADHD. Trials, 15, (1), 142. (doi:10.1186/1745-6215-15-142).
Culliford, David, Maskell, Joe, Judge, A., Arden, N.K., Cooper, C., Mullee, M., Raftery, J., Carr, A., Price, A., Javaid, K., Beard, D., Altman, D., Clarke, N., Latham, J., Glynn-Jones, S. and Barrett, D. COAST Study group (2013) A population-based survival analysis describing the association of body mass index on time to revision for total hip and knee replacements: results from the UK general practice research database. BMJ Open, 3, (11), 1-9. (doi:10.1136/bmjopen-2013-003614). (PMID:24285628).
Bruton, Anne, Kirby, Sarah, Arden-Close, Emily, Taylor, L, Webley, F, George, S, Yardley, L, Price, D, Moore, M., Little, P., Holgate, S., Djukanovic, R., Lee, AJ, Raftery, J., Chorozoglou, M, Versnel, J, Pavord, I, Stafford-Watson, M and Thomas, M. (2013) The BREATHE study: Breathing REtraining for Asthma - Trial of Home Exercises. A protocol summary of a randomised controlled trial. Primary Care Respiratory Journal, 22, (2), PS1-PS7. (doi:10.4104/pcrj.2013.00047).
Djulbegovic, B., Kumar, A., Glasziou, P.P., Perera, R., Reljic, T., Dent, Louise, Raftery, J., Johansen, M., Di Tanna, G.L., Miladinovic, B., Soares, H.P., Vist, G.E. and Chalmers, I. (2012) New treatments compared to established treatments in randomized trials (Review). The Cochrane Library , (10) (doi:10.1002/14651858).
Djulbegovic, Benjamin, Kumar, Ambuj, Glasziou, Paul P., Perera, Rafael, Reljic, Tea, Dent, Louise, Raftery, James, Johansen, Marit, Di Tanna, Gian Luca, Miladinovic, Bramko, Soares, Heloisa P., Vist, Gunn E. and Chalmers, Iain (2012) New treatments compared to established treatments in randomized trials. The Cochrane Library, 10, 1-50. (doi:10.1002/14651858.MR000024.pub3). (PMID:23076962).
Raftery, James, Fairbank, Eleanor, Douet, Lisa, Dent, Louise, Price, Alison, Milne, Ruairidh and Walley, Tom (2012) Registration of noncommercial randomised clinical trials: the feasibility of using trial registries to monitor the number of trials. Trials, 13, (1), 140. (doi:10.1186/1745-6215-13-140). (PMID:22906196).
Young, Amanda, Milne, Ruairidh, Raftery, James, Dent, Louise, Turner, David, Davidson, Peter and Cook, Andrew (2011) Research to meet the needs of the NHS: a review of published NIHR HTA clinical trials. Trials, 12, supplement 1, A86. (doi:10.1186/1745-6215-12-S1-A86).
Raftery, James and Chorozoglou, Maria (2011) Possible net harms of breast cancer screening: updated modelling of Forrest report. BMJ, 343, d7627. (doi:10.1136/bmj.d7627). (PMID:22155336).
Turner, David, Raftery, James, Cooper, Keith, Fairbank, Eleanor, Palmer, Stephen, Ward, Sue and Ara, Roberta (2011) The CHD challenge: comparing four cost-effectivess models. Value in Health, 14, (1), 53-60. (doi:10.1016/j.jval.2010.10.009 ).
Lasseter, G.M., McNulty, C.A.M. and Hobbs, F.D.R. et al. for the PRImary care Streptococcal Management (PRISM) Investigators Group (2011) Effect of swab type on the analytical sensitivity of five point-of-care tests for group A streptococci. British Journal of Biomedical Science, 68, (2), 91-94. (PMID:21706921).
Cutress, R.I., McDowell, A., Gabriel, F.G., Gill, J., Jeffrey, M.J., Agrawal, A., Wise, M., Raftery, J., Cree, I.A. and Yiangou, C. (2010) Observational and cost analysis of the implementation of breast cancer sentinel node intra-operative molecular diagnosis. Journal of Clinical Pathology, 63, (6), 522-9. (doi:10.1136/jcp.2009.072942 ).
Turner, David, Little, Paul, Raftery, James, Turner, Sheila, Smith, Helen, Rumsby, Kate and Mullee, Mark on behalf of the UTIS team (2010) Cost effectiveness of management strategies for urinary tract infections: results from randomised controlled trial. BMJ, 340, c346. (doi:10.1136/bmj.c346). (PMID:20139218).
Culliford, David, Maskell, Joseph, Beard, D., Murray, D., Price , Alison, Arden, Nigel K., Azagra, R., Carr, Arthur, Clarke, Nicholas, Cooper, Cyrus, Javaid, K., Mullee, Mark and Raftery, James and the COAST Study Group (2010) Temporal trends in hip and knee replacement in the United Kingdom: 1991-2006. The Journal of Bone and Joint Surgery, 92B, (1), 130-135. (doi:10.1302/0301-620X.92B1.22654 ).
Yardley, Lucy, Kirby, Sarah, Barker, Fiona, Little, Paul, Raftery, James, King, Debbie, Morris, Anna and Mullee, Mark (2009) An evaluation of the cost-effectiveness of booklet-based self-management of dizziness in primary care, with and without expert telephone support. BMC Ear, Nose and Throat Disorders, 9, (13), 1-12. (doi:10.1186/1472-6815-9-13).
Jones, Rob, Sheehan, Bart, Phillips, Patrick, Juszczak, Ed, Adams, Jessica, Baldwin, Ashley, Ballard, Clive, Banerjee, Sube, Barber, Bob, Bentham, Peter, Brown, Richard, Burns, Alistair, Dening, Tom, Findlay, David, Gray, Richard, Griffin, Mary, Holmes, Clive, Hughes, Alan, Jacoby, Robin, Johnson, Tony, Jones, Roy, Knapp, Martin, Lindesay, James, McKeith, Ian, McShane, Rupert, Macharouthu, Ajay, O'Brien, John, Onions, Caroline, Passmore, Peter, Raftery, James, Ritchie, Craig and Howard, Rob (2009) DOMINO-AD protocol: donepezil and memantine in moderate to severe Alzheimer's disease - a multicentre RCT. Trials, 10, 57. (doi:10.1186/1745-6215-10-57).
Raftery, J. and Dent, L. (2009) Should avastin be used to treat age-related macular degeneration in the NHS? – Yes. Eye, 23, (6), 1247-1249. (doi:10.1038/eye.2009.85). (PMID:19407834).
Raftery, J. (2009) NICE and the challenge of cancer drugs. British Medical Journal, 338 (doi:10.1136/bmj.b67).
Raftery, James, Hanney, Stephen, Green, Colin and Buxton, Martin (2009) Assessing the impact of England's National Health Service R&D Health Technology Assessment program using the “payback” approach. International Journal of Technology Assessment in Health Care, 25, (1), 1-5. (doi:10.1017/S0266462309090011).
Jolly, K., Lip, G.Y.H., Taylor, R.S., Raftery, J., Mant, J., Lane, D., Greenfield, S. and Stevens, A. (2009) The Birmingham rehabilitation uptake maximisation study (BRUM): a randomised controlled trial comparing home-based with centre-based cardiac rehabilitation. HEART, 95, (1), 36-42. (doi:10.1136/hrt.2007.127209).
Raftery, J., Bryant, J., Powell, J., Kerr, C. and Hawker, S. NCCHTA (2008) Payment to healthcare professionals for patient recruitment to trials: systematic review and qualitative study. Health Technology Journal, 12, (10), 1-128.
Raftery, J., Bentham, P, Gray, R, Hills, R, Crome, P and Sellwood, E AD2000 Collaborative Group (2008) Aspirin in Alzheimer's disease (AD2000): a randomised open label trial. Lancet Neurology, 7, (1), 41-49. (doi:10.1016/S1474-4422(07)70293-4). (PMID:18068522).
Raftery, James P. (2008) Paying for costly pharmaceuticals: regulation of new drugs in Australia, England and New Zealand. Medical Journal of Australia, 188, (1), 26-28. (PMID:18205559).
Cooper, K., Davies, R., Raftery, J. and Roderick, P. (2008) Use of a coronary heart disease simulation model to evaluate the costs and effectiveness of drugs for the prevention of heart disease. Journal of the Operational Research Society, 59, (9), 1173-1181. (doi:10.1057/palgrave.jors.2602468).
Fitzmaurice, D.A., Hobbs, F.D., Jowett, S., Mant, J., Murray, E.T., Holder, R., Raftery, J.P., Bryan, S., Davies, M., Lip, G.Y.H. and Allan, T.F. (2007) Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial. British Medical Journal, 335, (7616), 1-6. (doi:10.1136/bmj.39280.660567.55).
Raftery, J.P. and Lotery, A. (2007) Ranibizumab and bevacizumab - The cheaper drug, bevacizumab, should be referred to NICE. British Medical Journal, 334, (7590), 381-382. (doi:10.1136/bmj.39128.708565.3A.).
Miners, A.H., Yao, G., Raftery, J. and Taylor, R.S. (2007) Economic evaluations of calcineurin inhibitors in renal transplantation: a literature review. PharmacoEconomics, 25, (11), 935-947. (PMID: 17960952).
Raftery, J., Clegg, A., Jones, J., Tan, S.C. and Lotery, A. (2007) Ranibizumab (Lucentis) versus bevacizumab (Avastin): modelling cost effectiveness. British Journal of Ophthalmology, 91, (9), 1244-1246. (doi:10.1136/bjo.2007.116616).
McCabe, C., Tsuchiya, A., Claxton, K. and Raftery, J. (2006) Orphan drugs revisited. Quarterly Journal of Medicine (QJM), 99, (5), 341-345. (doi:10.1093/qjmed/hcl033).
Chase, D., Roderick, P., Cooper, K., Davies, R., Quinn, T. and Raftery, J. (2006) Using simulation to estimate the cost effectiveness of improving ambulance and thrombolysis response times after myocardial infarction. Emergency Medical Journal, 23, (1), 67-72. (doi:10.1136/emj.2004.023036).
Raftery, James (2006) Review of NICE's recommendations, 1999-2005. British Medical Journal, 332, (7552), 1266-1268. (doi:10.1136/bmj.332.7552.1266).
Hobbs, F.D.R., Fitzmaurice, D.A., Mant, J., Murray, E., Jowett, S., Bryan, S., Raftery, J., Davies, M. and Lip, G. (2005) A randomised controlled trial and cost-effectiveness study of systematic screening (targeted and total population screening) versus routine practice for the detection of atrial fibrillation in people aged 65 and over. The SAFE study. Health Technology Assessment, 9, (40), [93pp].
Mohammed, Mohammed A., Mant, Jonothan, Bentham, Louise and Raftery, James (2005) Comparing processes of stroke care in high- and low-mortality hospitals in the West Midlands, UK. International Journal for Quality in Health Care, 17, (1), 31-36. (doi:10.1093/intqhc/mzh088).
Stevens, Andrew J., Raftery, James and Roderick, Paul (2005) Can health technologies be assessed using routine data? International Journal of Technology Assessment in Health Care, 21, (1), 96-103. (doi:10.1017/S0266462305050129).
Raftery, James P., Yao, Guiqing Lily, Murchie, Peter, Campbell, Neil C. and Ritchie, Lewis D. (2005) Cost effectiveness of nurse led secondary prevention clinics for coronary heart disease in primary care: follow up of a randomised controlled trial. British Medical Journal, 330, (7493), 707-710. (doi:10.1136/bmj.38342.665417.8F).
Fitzmaurice, D.A., Murray, E.T., McCahon, D., Holder, R., Raftery, J.P., Hussain, S., Sandhar, H. and Hobbs, F.D.R. (2005) Self management of oral anticoagulation: randomised trial. British Medical Journal, 331, (7524), 1057-1059. (doi:10.1136/bmj.38618.580903.AE).
Courtney, C., Farrell, D., Gray, R., Hills, R., Lynch, L., Sellwood, E., Edwards, S., Hardyman, W., Raftery, J., Crome, P., Lendon, C., Shaw, H. and Bentham, P. AD2000 Collaborative Group (2004) Long-term donepezil treatment in 565 patients with Alzheimer's disease (AD2000): randomised double-blind trial. The Lancet, 363, (9427), 2105-2115. (doi:10.1016/S0140-6736(04)16499-4).
Mohammed, Mohammed, Raftery, James, LeatherBarrow, Martin, Harley, Mike and Marshall, Tom (2004) Counting in-hospital deaths in England: a comparison of hospital computer systems and mortuary registers. Journal of Health Services Research and Policy, 9, (2), 100-103. (doi:10.1258/135581904322987517).
McCahon, Debroah, Fitzmaurice, David A., Murray, Ellen T., Fuller, Christopher J., Hobbs, Richard F.D., Allan, Teresa F. and Raftery, James P. (2003) SMART: self-management of anticoagulation, a randomised trial [ISRCTN19313375]. BMC Family Practice, 4, (11), [7pp]. (doi:10.1186/1471-2296-4-11).
Woolacott, N.F., Jones, L., Forbes, C.A., Mather, L.C., Sowden, A.J., Song, F.J., Raftery, J.P., Aveyard, P.N., Hyde, C.J. and Barton, P.M. (2002) The clinical effectiveness and cost-effectiveness of bupropion and nicotine replacement therapy for smoking cessation: a systematic review and economic evaluation. Health Technology Assessment, 6, (16), [245pp].
Song, Fujian, Raftery, James, Aveyard, Paul, Hyde, Chris, Barton, Pelham and Woolacott, Nerys (2002) Cost-effectiveness of pharmacological interventions for smoking cessation: a literature review and a decision analytic analysis. Medical Decision Making, 22, (5 Suppl), S26-S37. (doi:10.1177/027298902237708).
Kendrick, T., Stevens, L., Bryant, A., Goddard, J., Stevens, A., Raftery, J. and Thompson, C. (2001) Hampshire Depression Project: changes in the process of care and cost consequences. British Journal of General Practice, 51, (472), 911-913.

Monograph

Little, Paul, Hobbs, FD Richard, Moore, Michael, Mant, David, Williamson, Ian, McNulty, Cliodna, Lasseter, Gemma, Cheng, MY Edith, Leydon, Geraldine, McDermott, Lisa, Turner, David, Pinedo-Villanueva, Rafael, Raftery, James, Glasziou, Paul and Mullee, Mark (2014) PRImary care Streptococcal Management (PRISM) study: in vitro study, diagnostic cohorts and a pragmatic adaptive randomised controlled trial with nested qualitative study and cost-effectiveness study. Southampton, GB, NIHR Journals Library, 132pp. (HTA Journal Series, (doi:10.3310/hta18060) , 18 6).
 

Research

Research Interests

Recent publications includes:

  1. Treatment success in pragmatic randomized controlled trials: a review of trials funded by the UK Health Technology Assessment programme. L.Dent, J. Raftery. Trials 2011)
  2. "Flogging dead horses": evaluating when have clinical trials achieved sufficiency and stability? A case study in cardiac rehabilitation. L Dent, J. Raftery .Trials 2011)
  3. The CHD challenge: comparing four cost-effectiveness models. D. Turner, J Raftery, Jan;14(1):53-60. ... Turner D, Raftery J, Cooper K, Fairbank E, Palmer S, Ward S, Ara R. Accepted Value in Health. 2011.
  4. Multiple Sclerosis risk sharing scheme: a costly failure. JR. BMJ, 340. 3/6/2010
  5. Should NICE’s threshold range for cost per QALY be raised? No. James Raftery. BMJ 2009;338:b185, doi: 10.1136/bmj.b185 (Published 26 January 2009).
  6. NICE and the challenge of cancer drugs. James Raftery BMJ 2009;338:b67, doi: 10.1136/bmj.b67 (Published 13 January 2009).
  7. Payment to healthcare professionals for patient recruitment to trials: systematic review and qualitative study. J Raftery, J Bryant, J Powell, C Kerr, S Hawker. Health Technology Assessment 2008, Volume 12, no .10.)
  8. The Birmingham rehabilitation uptake maximisation study (BRUM): a randomised controlled trial comparing home-based with centre-based cardiac rehabilitation. K Jolly, G Y H Lip, R S Taylor, J Raftery, J Mant, D Lane, S Greenfield, and A Stevens. Heart 2009; 95: 36-42. doi:10.1136/hrt.2007.127209. (Heart 
  9. See monograph report The Birmingham Rehabilitation Uptake Maximisation Study (BRUM). Home-based compared with hospital-based cardiac rehabilitation in a multi-ethnic population: cost-effectiveness and patient adherence. K Jolly,1* R Taylor,2 GYH Lip,3 S Greenfield,4 J Raftery,5 J Mant,4 D Lane,3 M Jones,4 KW Lee6 and A Stevens1 HTA Health Technology Assessment 2007; Vol 11: number 35.
  10. Paying clinicians to join clinical trials: a review of guidelines and interview study of trialists James Raftery, Christine Kerr1, Sheila Hawker1 and John PowellTrials 2009, 10:15 doi:10.1186/1745-6215-10-15.
  11. Payment to healthcare professionals for patient recruitment to trials: systematic review and qualitative study. J Raftery, J Bryant, J Powell, C Kerr, S Hawker. Health Technology Assessment 2008, Volume 12, no .10.
  12. Aspirin in Alzheimer’s disease (AD200): a randomised open label trial. AD2000 Collaborative Group. Neurology Lancet. 7 January 2008. (see below for JR role in AD2000 Collaborative).
  13. Paying for cost pharmaceuticals: regulation of new drugs in Australia, England and New Zealand. Raftery J. Medical Journal of Australia. 188, 1. 26-28. 7 January. 2008
  14. An assessment of the impact of the NHS health technology assessment programme. S Hanney, M Buxton, C Green, D Coulson, J Raftery. Health Technology Assessment 2007. 11,53.
  15. Assessing the impact of England's National Health Service R&D Health Technology Assessment program using the “payback” approach. James Raftery, Stephen Hanney, Colin Green and Martin Buxton, International Journal of Technology Assessment in Health Care (2009), 25: 1-5. DOI: 10.1017/S0266462309090011.
  16. Ranibizumab (lucentis) versus bevacizumab (avastin): modelling cost effectiveness James Raftery, Jeremy Jones, Andew Clegg, and Andrew Lotery. British Journal of Ophthalmology. September 2007 91:1244-1246.
  17. A brief pan management program compared with physical therapy for low back pain: results from an economic analysis alongside a randomized clinical trial. DG Whitehurst, M Lewis, GL Yao, S Bryan, JP Raftery, R Mullis EM Hay. Arthritis and Rheumatism. 57, 3, 2007. 466-473.
  18. DNA may not mean ‘did not participate’: a qualitative study of reasons for non-adherence tat home and centre based cardiac rehabilitation Jones M, Jolly K, Raftery J, Lip GYH, Greeenfield S. on behalf of the BRUM Steering Group. Family Practice 2007 24: 343-357.
  19. The Birmingham Rehabilitation Uptake Maximisation Study (BRUM). Home-based compared to hospital-based cardiac rehabilitation in a multi-ethnic population: cost effectiveness and patient adherence. Jolly K, Taylor R, Lip GYH, Greenfield S, Raftery J, Mant J, Land D, Jones M, Lee KW, Stevens A. Health Technology Assessment 2007, vol 13, No 35. 
  20. Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trail. Fitzmaurice DA, Hobbs FDR, Jowett S, Mant J, Murray ET, Holder R, Raftery JP, Bryan S, Davies M, Lip GYH, Allan TF.BMJ, Aug 2007; 335: 383.
  21. Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham atrial fibrillation treatment of the aged study, BAFTA): a randomised controlled trial. Mant J, Hobbs R, Fletcher K, Mant J, Fletcher K, et al; BAFTA investigators; Midland Research Practices Network (MidReC). Lancet 2007;370:493-503. (JR was member of BAFTA investigators.] 
  22. A systematic review and economic evaluation of epoetin alfa, epoetin beta and darbepoetin alfa in anaemia associated with cancer, especially that attributable to cancer treatment. J Wilson, GL Yao, J Raftery, J Bohlius, S Brunskill, J Sandercock, S Bayliss,P Moss, S Stanworth and C Hyde. Health Technology Assessment 2007 Volume 11, 13
  23. Economic Evaluations of Calcineurin Inhibitors in Renal Transplantation: A Literature Review. Miners AH, Yao G, Raftery J, Taylor RS.Pharmacoeconomics. 2007;25:935-947.

Academic unit:  Primary Care & Population Sciences

Research project

BREATHE (Breathing Retraining for Asthma Trial of Home Exercise)

Although effective medicinal treatment exists for asthma, many people continue to have distressing symptoms and impaired quality of life. People with asthma have expressed interest in non-drug asthma treatments, particularly in breathing exercises. Several recent studies have shown benefits from a short course of breathing exercises taught by a respiratory physiotherapist for people with asthma who remained symptomatic despite usual treatment. We believe that many NHS patients could potentially benefit from these exercises, but unfortunately, there is currently not enough access to suitable trained physiotherapists able to provide such a service. We propose to provide the same breathing training programme that we have previously shown to be effective when taught 'face-to-face' by a physiotherapist in the form of a DVD, or internet download. Patients will use this in their own home at times convenient to them, in addition to their standard treatment (e.g. with inhalers). We will find out whether this type of instruction is better than the 'usual care' that is currently provided, and whether it is as good as the 'face to face' physiotherapist instruction (which is more expensive and less convenient for patients).

Responsibilities

Currently supervising one PhD student

Provides health economics inputs on request to research bids from Southampton University. Currently providing health economics input to some 20 funded research projects.

NETSCC runs 5 UK wide research programmes for the National Insitute of Health Research (NIHR) . NETSCC also represents NIHR internationally.

Teaching Responsibilities

• Health economics
• Overtreatment
• Clinical trials
• NICE
• Use of routine data in HTA

Contact

Professor James Raftery
Faculty of Medicine
University of Southampton
Southampton General Hospital
Mailpoint 801
South Academic Block
Tremona Road
Southampton
SO16 6YD
or
Faculty of Medicine
University of Southampton
Building 85
Life Sciences Building
Highfield Campus
Southampton
SO171BJ