Patterson Research Group

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Michelle is a Clinical Academic Speech and Language Therapist, specialising in dysphagia (swallowing difficulties), working across the University of Liverpool and Mid Cheshire NHS Trust. She is currently undertaking an NIHR Advanced Fellowship, developing and evaluating the feasibility of a novel intervention to improve swallow function for people following head and neck cancer, in addition to working clinically as an Advanced Clinical Specialist in head and neck oncology. She is passionate about developing innovative technologies through research to improve patient outcomes.

Michelle received her undergraduate degree in Speech Pathology and Therapy from Manchester Metropolitan University (BSc (Hons): first) in 2003. She went on to complete a PhD at the University of Manchester, winning a Stroke Association postgraduate Fellowship in 2013. As part of her PhD, Michelle developed a psychometric scale to measure the impact of developing a positive therapeutic alliance in aphasia rehabilitation, which is now being translated internationally. Following her PhD, she secured an NIHR postdoctoral bridging Fellowship in 2021 and Advanced Fellowship in 2023.

Michelle has over 20 years of clinical experience in assessment and management of dysphagia and communication impairment arising from multiple aetiologies. Her clinical and research interests include: prehabilitation, outcome measurement, instrumental assessment, respiratory disorders, psychosocial adjustment and novel swallow interventions. She has presented nationally and internationally and taught at undergraduate and postgraduate level. She is mentor for research-active healthcare professionals and a supervisor for pre-doctoral and doctoral students.

Michelle leads the ‘Improving Outcomes in Head and Neck Cancer’ research seminars at the Liverpool Head and Neck Centre. She is a mentor and research champion for The Royal College of Speech and Language Therapists and a steering group member of the Council of Allied Health Professions Research (CAHPR).

Academic qualifications                                                                                                                                      

2013 –2018                 PhD in Psychology

(part-time 0.6)            University of Manchester

2000 – 2003                BSc (Hons) in Speech Pathology and Therapy - first class

Manchester Metropolitan University

1994-1997                   BA (Hons) Degree in Social Sciences

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Sarah’s research aims to explore how transoral surgery affects swallowing and communication in the first six weeks following surgery for cancer of the oropharynx (part of the throat directly behind the mouth that helps you speak and swallow).

Sarah’s research will provide:

• In depth analysis of early post operative changes to function (speech and swallowing) which will allow clinicians to delineate which patients benefit functionally from transoral surgery thereby facilitating the complex treatment decision-making process

• Evidence on the impact of surgical technique (transoral laser microsurgery vs transoral robotic surgery) which will guide policy and clinical decision making

• Greater understanding of functional changes which will improve pre-treatment education, thus reducing anxiety and engagement (patients and carers) in the post-operative period.

• Qualitative data to enhance the understanding of oropharyngeal dysfunction, highlighting the timing and nature of functional problems, alongside patient and carer priorities.  This will optimise care pathways and efficient clinical management. It will also enhance understanding of patient experience of functional assessments and data collection processes.

• a set of core outcome measures, which has been identified by an international panel of experts (clinicians and patients), aiming to reduce heterogeneity in future research data, allowing for comparisons amongst observational studies, strengthening the evidence available to clinicians.

• Supervisors: Professor Jo Patterson,

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Laura-Jaynes doctoral thesis aims to better understand what care people with a laryngectomy and their families need at home.

Research Question:

What are the healthcare needs of laryngectomy patients and their families following discharge after surgery and how can these be incorporated into a prototype education and training package for use by community healthcare professionals?

Research Objectives:

1. To identify and critically review available laryngectomy education and training packages (ETP)

2. To explore patient and family members experiences and needs from community healthcare services following laryngectomy

3. To co-design a prototype laryngectomy ETP for community healthcare professionals

Methods:

There will be three work-streams in this research:

· Work-stream 1: Environmental scan of available laryngectomy ETP’s

· Work-stream 2: Semi-structured qualitative interviews with laryngectomy patients and family members

· Work-stream 3: Co-design workshops with patients, families and healthcare professionals to design a prototype ETP

Two simultaneous groups will run alongside the research: patient-advisory group and healthcare professional stakeholder advisory group. Both groups will review findings from the environmental scan and semi-structured interviews to shape the co-design phase and ensure the research stays grounded in patient experience and service needs.

Supervisors: Professor Jo Patterson,

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Shamah’s research aims to evaluate the diagnostic accuracy of screening tests for detecting aspiration in patients with head and neck cancers.  Throughout thesis, Shamah presents three different studies. An initial systematic review will be conducted to assess the diagnostic accuracy of swallowing screening tools for detecting aspiration among head and neck cancer patients. Using existing data, the second study will evaluate the diagnostic accuracy of the 100mL Water Swallow Test for detecting aspiration will be compared with videofluoroscopic swallowing evaluations for patients with HPV+ Head & Neck Cancer. The final study will use a modified water swallow test to screen people treated for head and neck cancer for aspiration.

Supervisors: Joanne Patterson, Michelle Lawton, Jenan Altamimi, Andrew Schache

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Understanding emotional challenges after treatment for head and neck cancer.

A head and neck cancer diagnosis can have a threat to life and treatments can be invasive and life changing. Treatment regimens can impair physical and psychological well-being caused by facial disfigurement and / or disability, such as difficulties speaking, breathing, or swallowing. Therefore, difficulties with emotional distress such as depression, anxiety and cancer-related post-traumatic stress symptoms can occur.  Studies have suggested that people with HNC have increased risk of emotional distress and suicidal tendencies in comparison with other tumour types as well as being four times higher than the general population.

Research exploring psychological mechanisms that underpin the development of emotional difficulties and keep them going is limited within HNC. This cross-sectional study will investigate the role of metacognitive beliefs and self-compassion in the development and maintenance of anxiety, depression, and cancer-related post-traumatic stress. The study will collect questionnaire measures at one time point and will use quantitative methods to analyse the data. Participants will be able to complete the measures using an online link or using paper and pen.

The study is being conducted as partial completion of the Doctorate in Clinical Psychology at the University of Liverpool and has been designed in conjunction with the Aintree Patient and Participation Involvement group at the HNC unit at Aintree Hospital. The findings will be published in a peer reviewed journal and will help us understand psychological interventions for people with HNC and how we can help minimise distress following treatments

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Heather Starmer is a Clinical Professor and Director of the Head and Neck Cancer Speech and Swallowing Rehabilitation Center. She is a Board Certified Specialist in Swallowing and Swallowing Disorders. in 2023 she was awarded the prestigious Fellow designation by the American Speech Language and Hearing Association (ASHA).

Prior to joining the faculty at Stanford University, Professor Starmer served as the lead of the head and neck cancer rehabilitation program at Johns Hopkins University.
She has pursued doctoral studies at the University of Liverpool with completion of her PhD in Applied Health Research in 2024. Her doctoral dissertation focused on the assessment of head and neck lymphedema with a particular emphasis on the patient experience and quality of life.

Professor Starmer specialises in the rehabilitation of speech, voice, and swallowing in patients with head and neck cancer. She has particular interest in prevention of communication and swallowing disorders associated with radiation and chemotherapy. She has a strong interest in head and neck cancer survivorship and helping patients to accomplish their personal goals and to optimize their quality of life long term.

Professor Starmer's academic goals include improving communication and swallowing outcomes following a diagnosis of head and neck cancer through clinical research. She was a key member of a collaborative research group at Johns Hopkins resulting in multiple publications and presentations on strategies to minimize speech and swallowing difficulties. Recent advances in pain management during radiation therapy developed by this research collaborative have already shown great promise in protecting patients from potential swallowing difficulties during and after their cancer treatment. She works closely with colleagues in surgery, radiation oncology, and medical oncology to tackle the often difficult problems encountered by patients with head and neck cancer. She has particular interest in investigating the role of innovative surgical techniques such as Transoral Robotic Surgery (TORS) in minimizing long term functional deficits. She regularly collaborates with colleagues around the globe to develop innovative solutions to challenges encountered by head and neck care teams and the patients they serve.

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 Biography

Adrian has been a member of the sport and exercise science programme team within the Department of Sport and Physical Activity since October 2012. He was previously a lecturer at the University of Hull at which he completed his PhD in exercise physiology. He currently leads BSc Sport and Exercise Science modules in exercise and health and in clinical exercise physiology. In addition to his academic qualifications in sport and exercise science, Adrian holds many vocational qualifications in health and fitness, including specialist qualifications in cancer, cardiovascular disease, obesity and diabetes, exercise referral, older adults, pre- and postnatal exercise, corrective exercise, and management of low back pain He is the Designated Individual for human tissue compliance within the University, and sits on the central university ethics committee.

Research Interests

Adrian’s is probably best known for his research into the measurement and development of cardiorespiratory fitness. He also has a strong interest in factors that explain exercise tolerance during maximal exercise. His current research focuses on exercise testing and prescription in clinical populations, such as those with head and neck cancer, cardiac disease, and pulmonary disease.

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Catriona joined the University of Sheffield in 2018 after obtaining a Yorkshire Cancer Research (YCR) ‘CONNECTS’ Senior Clinical Research Fellowship. She is also an Honorary Consultant in Palliative Medicine at Sheffield Teaching Hospitals NHS Foundation Trust.

Catriona was awarded my Doctor of Medicine (MD) degree from the University of Liverpool in 2010. Her MD evaluated quality of care for dying patients and their families (last days of life) as perceived by bereaved relatives. From this work, she developed and validated the international ‘Care Of the Dying Evaluation’ (CODETM) tool.

Catriona’s belief that palliative care should help address injustices and inequities drives her research interests. These include complex cancer groups e.g., head and neck cancer, mesothelioma, and improving access and integration of palliative care, including bereavement support, through inclusive methodology.

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Chris has made significant contributions to respiratory physiology over 35 years, publishing over 300 papers. His work focuses on human lung injury, remodeling, comorbidity, and treatment effects. Funded by organizations like NHMRC, MRC, and Wellcome, his research has practical implications. The Ward lab’s pioneering work on neutrophilic airway pathophysiology and differentiated airway epithelium has impacted lung research including COVID discovery research.

Supervision and Collaboration: Chris has supervised 15 PhD students in the UK, fostering effective working relationships. His postdocs have transitioned to clinician scientist roles, and overseas students have become PIs and associate professors.

Impact and Engagement: Chris actively engages with patients, initiating a fibrotic lung disease user group. His research has influenced clinical practice, including lung transplantation and CF clinics. His overseas students have applied their training in COPD prognostication and infectious diseases. His commitment to broader societal benefit extends to teaching and linking NHS and University colleagues.

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Mike joined Teesside University in November 2023 after a long career in the North-East NHS, leading groups that specialise in physiological measurement and in medical device development, regulation and assessment.

Mike’s academic activities have been linked with his NHS role in developing novel med-tech, and also with the training of healthcare professionals, notably through the UK's Scientist Training Programme (STP).

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David (known as “Winnie) is a consultant ENT, head, neck and thyroid surgeon at the Freeman Hospital in Newcastle. His clinical work centres on developing safe processes of care, reducing inequality and developing the roles of Allied Healthcare Professionals and trainee surgeons. He is currently the Health & Care Research Director for the North East and North Cumbria RRDN.

His research interests are broad but his main focus is on optimising patient centred outcomes in head and neck cancer. He has expertise in shared decision making and informed consent and co-led the development of the Royal College of Surgeons of Edinburgh “Informed Consent: Sharing the Decision” ICONS course. He is also the chief investigator for the Laryngeal Cancer Cohort (LARCH) which runs across the Northern Head and Neck Cancer Alliance

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Val spent 37 years in education before retiring in 2010 after undergoing Chemo/radiotherapy for Head and Neck Cancer ( HNC). The effects of this mean she is reliant on PEG feeding for most of her nutrition.

After taking part in a study into Altered Eating Val became involved in research. She is currently a co applicant on 5 studies and has co authored several papers.

In 2017 she was presented with a Giving Voice award on behalf of the RCSLT.

In 2022 she became the first Patient President at the Swallows International Conference.

In May 2023 she was awarded Honorary Life Membership of BAHNO.

She leads a small group of HNC patients called CHANGE who support studies, promoting the patient voice.

Vince is a head and neck cancer patient, who was initially diagnosed in 2005 and subsequently with osteoradionecrosis in 2016.   

He is Vice-Chair and Secretary of the HaNC PPI Research Forum Patient & Public Research Groups | Liverpool Head & Neck Centre a group of Cheshire and Merseyside patients and carers who support research into head and neck cancer, primarily undertaken by the Liverpool Head and Neck Centre.  

Vince is retired and was formerly a Director of the Shop Direct/Littlewoods Group and a Trustee of the Liverpool Everyman/Playhouse Theatres.