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Sonography research during a global pandemic

12 October, 2020
Emily Skelton, Research Sonographer, KCL and CoR Doctoral Fellow, City, University of London and Jackie Matthews, Research Sonographer and NIHR Doctoral Fellow, KCL
Emily Skelton, Research Sonographer, KCL and CoR Doctoral Fellow, City, University of London and Jackie Matthews, Research Sonographer and NIHR Doctoral Fellow, KCL

Friday 13 March 2020 was a milestone for our iFind research project. We scanned the final two participants needed for our prospective clinical pilot study and gave ourselves a pat on the back. It was the end of a busy few months of technological tweaking and data collection, and we were excited this day had finally arrived.

Our elation was short-lived. That afternoon we were advised to work from home where possible in anticipation of a national lockdown in response to the global coronavirus pandemic.

By the end of March, all non-Covid-19 research studies involving face-to-face contact with participants had been temporarily suspended. We signed ourselves up to return to the NHS and waited to be called upon, though we were never required.

We diligently set up our ‘home offices’ anywhere we could find space, tested our internet connections and tried to acclimatise to our new way of working. It’s fair to say that the first few weeks were a strange time of adjusting: trouble-shooting technical difficulties, risk-assessing our new desk spaces and remembering to unmute during the many video calls, as well as juggling family care commitments and watching daily news updates on the progression of the virus.

With clinical colleagues redeployed to the wards, and some research coordinators furloughed, our professors chaired multiple meetings to discuss how they could facilitate research continuity during these uncertain times.

As the weeks went by, the longer-term impact of lockdown on research became evident. In response to the significant disruption caused by the pandemic, some ongoing studies were granted six-month extensions to help achieve completion and thankfully this included our project, iFIND.

The Intelligent Fetal Imaging and Diagnosis (iFIND) project is a large-scale research project which aims to improve routine fetal anomaly screening through the use of advanced imaging technologies including machine learning algorithms and robotics.

However, as new projects focused on the virus that had turned our lives upside down, many R&D departments were inundated. The inevitable decision was made to exclusively prioritise review of Covid-19 studies. This resulted in many other early stage projects being subject to significant delays in awaiting ethical and sponsorship review, with the backlog of work in R&D departments anticipated to take until early 2021 to be cleared.

Wherever possible, researchers in this position have been encouraged to apply for university-level ethical approvals if appropriate, creatively adapt their study designs and seek alternative methods to face-to-face research, such as phone interviews or online questionnaires.

Although we have been unable to recruit participants to our studies during this time, we have still been able to make progress both with iFIND and our individual doctoral projects. Our efforts have been largely focussed on writing papers, including reporting the results of our prospective clinical pilot study for the iFIND project and other articles in varying stages of production, submission and resubmission.

Two articles have also been accepted for publication during this time: a review of electronic consent for use in conducting research remotely1 which was inspired by the change of study design enforced by Covid-19; and an original paper titled ‘Fetal Body MRI and its application to Fetal and Neonatal Treatment. An illustrative review has just been accepted in the Lancet Child and Adolescent Health Journal.

We have begun to shape new research proposals from stark reminders of the substantial inequalities in health outcomes for BAME communities, and unconscious biases in research that have been exacerbated during the pandemic.

We have also seen the power of social media in keeping people connected, with so many diverse community groups willing to have conversations and therefore making research accessible to underrepresented groups. This is an active area of interest for us as our individual pieces of doctoral work will need to incorporate voices that are often unheard.

A further benefit of the pandemic has been the redesign of many seminars, conferences and courses to be hosted online. Although the opportunities for in-person networking are limited in this virtual space, presentations can be live-streamed or downloaded to be viewed on-demand, allowing greater access to these events. For example, between June-July 2020, the UK Imaging and Oncology (UKIO) congress delivered virtual sessions to 14,500 attendees across 48 countries and made the sessions available online for the rest of the year.

We also both had the opportunity to present at the online Radiography 2020 event hosted by City, University of London and the British Institute of Radiology in July. The virtual environment allowed for our presentations to be viewed by 600 participants from more than 45 countries, at least three times more than would have been able to attend in-person.

As lockdown restrictions ease, approvals to recommence non-Covid-19 research studies have begun. It will not be a simple case of ‘pick up where you left off’. Those that have been furloughed or working largely remotely must complete significant ‘re-onboarding’ training courses and risk assessments to ensure safety and compliance.

Our desks need to be booked in advance and physical distancing measures must be in place in the office and scan clinics. At present, pregnant research participants are recognised as clinically vulnerable to Covid-19, therefore all precautions must be taken to ensure the safety of both participants and staff before we are able to resume research ultrasound scan clinics.

The pandemic has forced our lives to change in many ways. We may be using new approaches to conduct our research and embracing the virtual learning environments, but we cannot underestimate the ideas and collaborations that are borne from a chance meeting in a corridor, an informal introduction by a mutual colleague in a coffee shop queue, or at ‘real world’ conferences and study days.

This time has given us the opportunity to practice gratitude for what we do and reminded us that research is not just about a specialist knowledge base and a quiet writing space – research is for everyone, by everyone and can be practiced anywhere.

Emily Skelton is a Research Sonographer (iFIND project, King’s College London) and CoR Doctoral Fellow (City, University of London) @emily_s_skelton
Jackie Matthew is a Research Sonographer (iFIND project, King’s College London) and NIHR Doctoral Fellow (King’s College London) @JackieMatthewJM
You can find updates from Emily on their blog of doctoral work.
You can also find Jackie on Facebook and Instagram.

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