WSPCR Research Themes

  • Infections and antibiotic resistance
  • Integrated care for the frail / long term and / or chronic conditions
  • Rehabilitation
  • Out of hours care
  • Effectiveness of interventions / quality of care
  • Health communication and behaviour change
  • Cancer in primary care
  • Research leadership

Case Studies

Demonstrating the value of our research to patients, service users and the general public. 

The DUTY Study

The DUTY study continues to be an excellent example of how the NISCHR infrastructure collaborated to innovate and deliver great research results. Key groups included the WSPCR, SEWTU and CRC.

DUTY: ‘Diagnosis of Urinary Tract Infection (UTI) in Young children’ has been a highly successful NIHR HTA trial, co-CI Professor Butler (http://www.dutystudy.org.uk).  The study developed a clinical rule to help identify, in children under 5 years old presenting acutely unwell to primary care, those in whom a urine sample should and needn’t be obtained as part of the diagnostic pathway.

This is important because:

  1. UTI in young children has been associated with long-term complications including renal scarring, renal failure and hypertension. Early recognition and treatment is thought to reduce this risk. But UTI in young children is often missed because the symptoms are non-specific.
  2. Preliminary data from an ongoing primary care study suggest that around 2% of children under 5 years old, presenting to primary care with any acute illness may have a UTI. Evidence suggests that we currently miss around 50% of UTIs, though this figure could be higher.
  3. NICE had published a guideline concerning UTI in children. This emphasised prompt diagnosis and treatment of UTI in children, and promoted a higher level of suspicion, with increased urine sampling in young children with non-specific symptoms.


The study therefore aimed to find out the best way to diagnose a UTI in children younger than 5 years of age, and specifically which children should be targeted for urine testing, and if a point-of-care urine dipstick test adds diagnostic value.

DUTY was a large multicentre observational sponsored by the University of Bristol.  The study is UK CRC registered (UK CRN 7897) and each of the study’s four research centres (Bristol, Cardiff, Southampton and London) are being directed by leading academics.

The study is a shining example of collaboration within Wales and beyond, demonstrated by the recruitment target of 6,000 children being exceeded ahead of schedule.