The University of Southampton
Medicine

Dr Steve George MD, MSc, FRCP, FFPH

Emeritus Fellow

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Dr Steve George is Emeritus Fellow within Medicine at the University of Southampton.

Born and brought up in South Wales, Steve George studied medicine at St Bartholomew’s Medical College, qualifying in 1980. After six years in hospital medicine, including a period in medical imaging, he decided to follow a career in epidemiology. Entering public health training at the end of 1996 he was appointed Lecturer in Epidemiology at Sheffield University in 1988: he has worked in academic departments ever since, moving to a senior lectureship in Southampton in 1992. He has combined his health services research career with responsibilities at a national level for the UK Faculty of Public Health (first as Chair of Examiners, then Academic Registrar and later as Vice President) and is responsible for the introduction of both the current Part A and Part B exam formats.

He is married to another public health physician, and they have a daughter born in 1997. He is a bit of a musician, having been a head choirboy and having learnt the piano as a child. He currently has eleven guitars, plus a plethora of other fretted and keyboard instruments. He is also a keen maker of things, and has had the bits to make a harpsichord for several years, but not the time. When he finishes proper work he’d like to go to West Dean College at Chichester and do their course on guitar making.

Qualifications

MB BS University of London (1980)
MD University of Sheffield (1994)
MSc University of London (1984)
FRCP Royal College of Physicians of London (2005)
FFPH(M) UK Faculty of Public Health (1991)

Appointments held

Emeritus Fellow, University of Southampton: 2015

Reader in Public Health, University of Southampton: July 2000 - 2015

Director, Southampton Clinical Trials Unit, University of Southampton; April 2007 – October 2009

Honorary consultant epidemiologist, Southampton University Hospitals Trust: since July 1992

Senior Lecturer in Public Health Medicine, University of Southampton: July 1992 – June 2000

Lecturer in Epidemiology, University of Sheffield: May 1988 June 1992.

Registrar in Community Medicine, Trent RHA: October 1986 April 1988

Training positions in medicine and medical imaging, London and Sheffield, August 1980 - September 1986.

Research

Responsibilities

Publications

Teaching

Contact

Research interests

Dr George’s career project grant income (49 grants) exceeds £11,000,000, and he has held programme grants totalling another £7,000,000. Of his 94 peer reviewed papers (43 as principal author) 16 have appeared in either the BMJ or the Lancet (10 as principal author).

Dr George is known principally as a triallist, although about 25% of his published output has been in the area of outcome measurement. His work has often looked at changing systems of medical care, rather than individual patient treatment. Altogether he has undertaken, or is in the process of undertaking, fifteen large randomised controlled trials, all of complex interventions, and all of which so far have appeared in high profile journals. Over the 1990s his work looked at demand for medical care and ways to meet it. His work since then has aimed to improve cancer outcomes, whether by better organisation and delivery of cancer treatment or by earlier detection.

One current grant is for a trial aiming to start recruitment in late 2011/early 2012 and which will compare two diagnostic imaging methods to characterise solitary pulmonary nodules as malignant or not. The modalities being compared are Positron Emission Tomography combined with X-Ray Computerised Tomography (PET/CT – currently the gold standard recommended by NICE) and Dynamic Contrast Computerised Tomography (DCE CT - multiple CT images taken serially during the injection of X-ray contrast medium). The advantage of DCE CT, if it can be proved to be as sensitive to cancer as PET/CT, is that it is around one quarter to one third of the price, and thereby would allow imaging budgets to be used elsewhere or, conversely, would allow more people to have scans using the same budget.

Another current grant funds a systematic review comparing the effectiveness of local ablative methods for treating liver tumours not amenable to surgical resection. In recent years there has been increased interest in the use of local therapy for metastases, arising from improvements in systemic therapy. In the absence of effective systemic therapies, such local treatments have often been considered futile given both the difficulty in eliminating all sites of identifiable metastatic disease as well as realities regarding the rapid natural history of uncontrolled tumour dissemination. However, with a higher likelihood of patients surviving longer after effective systemic therapy, even if not cured, the eradication of residual metastases via potent local therapies may prove beneficial, and radiofrequency ablation plus chemotherapy has been shown to be superior in terms of survival to chemotherapy alone. Although surgical metastasectomy remains the most common and first-line standard among local therapies, nonsurgical alternatives, including various forms of thermal ablation, have become increasingly popular because they are generally less invasive than surgery and have demonstrated considerable promise in eradicating macroscopic tumour. This work is likely to lead on to an application to fund a definitive trial in this area in 2012. Dr George has also been working with interventional radiologists looking at the effectiveness of percutaneous cryoablation for renal carcinoma, again with a view to conducting a definitive trial.

Dr George is also a trial methodologist, and has published a series of papers on the use of quality of life measures in trials, in particular cancer trials. He is currently interested in the conduct of trials which involve a degree of operator expertise (e.g. surgical trials, trials of `therapies’) and in why correct methods for design and analysis of such trials are often not used.

Academic unit(s)

Primary Care & Population Sciences Academic Units

Affiliate academic unit(s)

Population Health Sciences Research group

Research project(s)

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).

Postgraduate student supervision

Val Lattimer PhD 1998
Paul Summersgill MPhil 1998
Paula Kersten PhD 1999
Christine Newsome PhD 1999
Deborah Fitzsimmons PhD 2000
Peter Pockney MD 2004
Karen Gerard PhD 2005
Chris Newman MS 2005
Solomon John MD 2011

Current

Jo Shim PhD

Faculty of Medicine

Deputy Head, Health Sciences Graduate School 2002-2004

University of Southampton

Senate 1996-1999

National and international Responsibilities

Dr George was Examiner for the Diploma and Part I Membership Examination of the UK Faculty of Public Health 1996 to 1999.
He was Chair of Part I Examiners for the Faculty 1999 to 2004. During this time he revised the examination into a slimmer but more discriminating exam.
He was appointed Academic Registrar of the Faculty in 2004, and extended the process of exam revision by replacing the old thesis based Part 2 with the current Objective Structured Public Health Exam. He also led the development of the Faculty’s Curriculum for Public Health Training in the UK, which was approved by the UK Postgraduate Medical Education and Training Board in 2007.
In 2007 he was elected Vice-President of the Faculty, and was elected for a second term in 2010, at the outset stating that he would serve one further year. During this period he was responsible for professional standards in public health, including the development of processes and standards for revalidation.
In 2011 he was awarded the Wilfrid Harding Prize for effort and achievement on behalf of the Faculty.

Articles

Conferences

Reports

Dr George led undergraduate teaching in Public Health at Southampton from his arrival in 1992 until 1996 and from 1999 to 2006, and he will be taking over responsibility for the course again in summer 2011.

He led Medical Statistics teaching from 2000 - 2008. He changed the direction of the course fundamentally, from teaching students how to analyse data (which few apart from those who go into research will need) to teaching them how to understand and criticise scientific papers containing statistical results (which all doctors need in order to keep up to date). In order to reinforce the importance of the subject in students’ perceptions critical appraisal of published literature now forms a major part of the Final BM examination.

He is or has been external examiner for six master’s courses (Sheffield, St George’s, Oxford, City University, London School of Hygiene and Tropical Medicine and currently Aberdeen) and to the undergraduate medical course at Oxford. He was also been the principal external assessor for the health care evaluation module of the London School of Hygiene’s distance learning Master’s in Public Health.

Dr George has supervised or is supervising ten doctoral students. Of his past PhD students, four have held senior academic positions at Southampton, one as a head of school (now a chair at a university outside the UK), one a chair and director of research (now a head of school at another UK university), one a reader still in Southampton, and one now head of postgraduate research at another UK university.

Dr Steve George
Phone: (023) 8120 6533 Fax: (023) 8120 6529 Email: Pluto@soton.ac.uk

Room Number:SGH/AB39/MP805

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