Dr Stephen Bourke
Honorary Clinical Senior Lecturer
- Email: email@example.com
- Telephone: 0191 293 4026
- Address: Northumbria Healthcare NHS Foundation Trust.
North Tyneside General Hospital
I am a member of the Respiratory Medicine Research Group
I have a major interest in COPD, and in motor neuron disease, as outlined in more detail in the adjacent RESEARCH section.
My interests include clinical research in chronic obstructive pulmonary disease (COPD) and respiratory aspects of motor neurone disease.
COPD exacerbation is the 2nd commonest reason for hospitalisation. NICE guidelines endorse hospital at home and early (supported) discharge services in this condition, recommend that selection should be informed by risk of death but acknowledge the (previous) lack of a robust prognostic score. I led development of the DECAF prognostic score to risk stratify such patients, with multicentre validation, in 2,645 patients consecutively admitted to participating sites. DECAF is simple to apply at the bedside, offers excellent discrimination for in-hospital death and outperforms other tools sometimes used in this setting. Routine use to inform care is endorsed by: UK COPD Audit Report and BTS COPD Specialist Advisory Group 2015 and an independent Thorax Editorial 2016. I conceived and supervised a RCT of hospital at home selected by low risk DECAF score (RfPB funded); up to 50% of admitted patients are eligible thus the potential clinical and cost benefits are large. Based on this research, I won a NIHR Clinical Research Impact of the year award 2016.
Following preliminary pilot work, I performed a RCT of NIV in motor neurone disease (MND) / amytrophic lateral sclerosis (Lancet Neurology 2006). NIV was associated with substantial improvements in survival and quality of life. Regarded by NICE, Cochrane and others as the best available evidence, this trial has changed worldwide practice. Surveys conducted in the UK spanning publication of the RCT showed a 3.4 fold increase in the number of patients successfully established on NIV, with similar improvements elsewhere. This programme of research was included by Newcastle University in the 2014 Research Excellence Framework submission. I am currently working with NICE Quality Standards Committee and was previously involved in the development of guidelines on NIV in MND. I was a co-applicant and on the steering group for a RCT showing that diaphragmatic pacing reduced survival by eleven months (Lancet Neurology 2015). The device had previously been granted FDA approval on humanitarian grounds and was in clinical use. The results of this trial will prevent further harm to patients and highlights the importance of strict adherence to scientific method.
Recently completed studies:
1. Internal and external validation of the DECAF scoring system; a prognostic tool to predict inpatient mortality in acute exacerbations of COPD (UKCRN 14214). CI.
2. A randomised controlled trial of hospital at home compared to conventional in-patient care in patients presenting with an acute exacerbation of COPD and at low risk of death by the DECAF prognostic score. CI.
3. HOT HMV in COPD: Randomised controlled trial of home mechanical ventilation in hypercapnic COPD patients post acute hypercapnic exacerbation (UKCRN 8059). PI..
4. A randomised controlled trial in patients with respiratory muscle weakness due to motor neurone disease of the NeuRx RA/4 Diaphragmatic Pacing System (DiPALS) (HTA 09/55/33; UKCRN 10660). Co-applicant and steering group.
5. A 52-week treatment, multi-center, randomized, double blind, double dummy, parallel-group, active controlled study to compare the effect of QVA149 (indacaterol maleate / glycopyrronium bromide) with salmeterol/fluticasone on the rate of exacerbations in subjects with moderate to very severe COPD (UKCRN 7132). PI.
6. A Clinical Outcomes Study to compare the effect of Fluticasone Furoate/Vilanterol Inhalation Powder 100/25mcg with placebo on Survival in Subjects with moderate Chronic Obstructive Pulmonary Disease (COPD) and a history of or at increased risk for cardiovascular disease. PI.
Dr Nicholas Hart, Lane Fox Respiratory Unit, St Thomas' Hospital and the members of the HOT HMV steering group.
Dr Christopher McDermott, University of Sheffield, and the members of the DiPALS steering group.
Dr Robert Rutherford, Consultant Respiratory Physician, University Hospital Galway.
Dr Richard Harrison, University Hospital of North Tees.
Dr Meme Wijesinghe, Royal Cornwall Hospitals Trust.
Prof John Gibson, Emeritus Professor of Respiratory Medicine, Newcastle University.
Dr David Cooper, Consultant Respiratory Physician, North Tyneside General Hospital.
Dr Sean Parker, Consultant Respiratory Physician, North Tyneside General Hospital.
Dr Gbenga Afolabi, Consultant Respiratory Physician, North Tyneside General Hospital.
Dr Catherine O’Neill, Consultant in Palliative Care, North Tyneside General Hospital.
Dr Tim Williams, Consultant Neurologist, Royal Victoria Infirmary, Newcastle.
Dr Christopher Stenton, Consultant Respiratory Physician, Royal Victoria Infirmary, Newcastle.
I regularly teach undergraduate students from the Newcastle undergraduate medical curriculum.
Current : Dr Carlos Echevarria
a) Internal and external validation of the Dyspnoea, Eosinopenia, Consolidation, Acidaemia and atrial Fibrillation (DECAF) prognostic score in acute exacerbations of COPD, triaged to hospital admission.
b) Randomised controlled trial of hospital at home compared to conventional in-patient care in patients presenting with an acute exacerbation of COPD and at low risk of death by the DECAF prognostic score.
- Anwar GA, McDonnell MJ, Worthy SA, Bourke SC, Afolabi G, Lordan J, Corris PA, De Soyza A, Middleton P, Ward C, Rutherford RM. Phenotyping adults with non-cystic fibrosis bronchiectasis: A prospective observational cohort study. Respiratory Medicine 2013, 107(7), 1001-1007.
- Steer J, Gibson J, Bourke SC. The DECAF Score: predicting hospital mortality in exacerbations of chronic obstructive pulmonary disease. Thorax 2012, 67(11), 970-976.
- O'Neill CL, Williams TL, Peel ET, McDermott CJ, Shaw PJ, Gibson GJ, Bourke SC. Non-invasive ventilation in motor neuron disease: an update of current UK practice. Journal of Neurology, Neurosurgery and Psychiatry 2012, 83(4), 371-376.
- Bourke SC, O'Neill CL, Williams TL, Peel ET, Gibson GJ, Mc Dermott CJ, Shaw PJ. The changing landscape of non-invasive ventilation in amyotrophic lateral sclerosis. Journal of Neurology, Neurosurgery and Psychiatry 2012, 83(4), 368-369.
- Steer J, Norman E, Afolabi OA, Gibson GJ, Bourke SC. Dyspnoea severity and pneumonia as predictors of in-hospital mortality and early readmission in acute exacerbations of COPD. Thorax 2012, 67(2), 117-121.
- McDermott CJ, Maguire C, Cooper CL, Ackroyd R, Baird WO, Baudouin S, Bentley A, Bianchi S, Bourke SC, Bradburn MJ, Dixon S, Ealing J, Galloway S, Karat D, Maynard N, Morrison K, Mustfa N, Stradling J, Talbot K, Williams T, Shaw P. Protocol for diaphragm pacing in patients with respiratory muscle weakness due to motor neurone disease (DiPALS): a randomised controlled trial. BMC Neurology 2012, 12, 74.
- Steer J, Gibson G, Bourke S. Predicting outcomes following hospitalization for acute exacerbations of COPD. QJM: An International Journal of Medicine 2010, 103(11), 817-829.
- Dhar R, Anwar GA, Bourke SC, Doherty L, Middleton P, Ward C, Rutherford RM. Efficacy of nebulised colomycin in patients with non-cystic fibrosis bronchiectasis colonised with Pseudomonas aeruginosa. Thorax 2010, 65(6), 553-553.
- Anwar GA, Bourke SC, Afolabi G, Middleton PG, Ward C, Rutherford RM. Effects of long-term low-dose azithromycin in patients with non-CF bronchiectasis. Respiratory Medicine 2008, 102(10), 1494-1496.
- Servera E, Sancho J, Bourke SC, Tomlinson M, Williams TL, Bullock RE, Shaw PJ, Gibson GJ. Non-invasive ventilation in amyotrophic lateral sclerosis. Lancet Neurology 2006, 5(4), 291-292.
- Bourke SC, Tomlinson M, Williams TL, Bullock RE, Shaw PJ, Gibson GJ. Effects of non-invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis: A randomised controlled trial. The Lancet Neurology 2006, 5(2), 140-147.
- Bourke SC, Gibson GJ. Sleep and breathing in neuromuscular disease. European Respiratory Journal 2002, 19(6), 1194-1201.
- Bourke SC, Gibson GJ. Non-invasive ventilation in ALS: Current practice and future role. Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders 2004, 5(2), 67-71.
- Bourke SC, McColl E, Shaw PJ, Gibson GJ. Validation of quality of life instruments in ALS. Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders 2004, 5(1), 55-60.
- Bourke SC, Bullock RE, Williams TL, Shaw PJ, Gibson GJ. Noninvasive ventilation in ALS: Indications and effect on quality of life. Neurology 2003, 61(2), 171-177.
- Bourke SC, Nicholson AG, Gibson GJ. Erdheim-Chester disease: Pulmonary infiltration responding to cyclophosphamide and prednisolone. Thorax 2003, 58(11), 1004-1005.
- Bourke SC, Williams TL, Bullock RE, Gibson GJ, Shaw PJ. Non-invasive ventilation in motor neuron disease: Current UK practice. Amyotrophic Lateral Sclerosis and Other Motor Neuron Disorders 2002, 3(3), 145-149.
- Bourke SC, Shaw PJ, Gibson GJ. Respiratory function vs sleep-disordered breathing as predictors of QOL in ALS. Neurology 2001, 57(11), 2040-2044.
- Bourke SC, Clague H. Review of cryptogenic fibrosing alveolitis, including current treatment guidelines. Postgraduate Medical Journal 2000, 76(900), 618-624.
- Bourke SC. Respiratory involvement in neuromuscular disease. Clinical Medicine 2014, 14(1), 72 -75.
- Echevarria C, Bourke SC, Gibson GJ. Profound bradycardia associated with NIV removal. Respiratory Medicine Case Reports 2012, 5, 73-75.
- Bourke SC. Acute Respiratory Failure in ALS: non-invasive ventilation. In: Rassegna di Patologia dell’Apparato Respiratorio. 2008.
- Echevarria C, Brewin K, Horobin H, Bryant A, Corbett S, Steer J, Bourke SC. Early Supported Discharge/ Hospital At Home For Acute Exacerbation Of Chronic Obstructive Pulmonary Disease: A Review and Meta-Analysis. COPD: Journal of Chronic Obstructive Pulmonary Disease 2016, 13(4), 523-533.
- Echevarria C, Steer J, Heslop-Marshall K, Stenton SC, Hickey PM, Hughes R, Wijesinghe M, Harrison RN, Steen N, Simpson AJ, Gibson GJ, Bourke SC. Validation of the DECAF score to predict hospital mortality in acute exacerbations of COPD. Thorax 2016, 71(2), 133-140.
- McDermott CJ, Bradburn MJ, Maguire C, Cooper CL, Baird WO, Baxter SK, Bourke SC, Imam I, Bentley A, Ealing J, Elliott M, Hanemann CO, Hughes P, Orrell RW, Shaw PJ, Talbot K, Williams T, Ackroyd R, Berrisford R, Galloway S, Karat D, Maynard N, Sarela A, Simonds AK, Taylor L, Leek R, Darlison R, Leigh N, Dewey M, Radunovic A. Safety and efficacy of diaphragm pacing in patients with respiratory insufficiency due to amyotrophic lateral sclerosis (DiPALS): a multicentre, open-label, randomised controlled trial. Lancet Neurology 2015, 14(9), 883-892.
- Echevarria C, Steer J, Heslop-Marshall K, Stenton SC, Hickey PM, Hughes R, Wijesinghe M, Harrison RN, Steen N, Simpson AJ, Gibson GJ, Bourke SC. The PEARL score predicts 90 day readmission or death following hospitalisation for an exacerbation of COPD. In: BTS Winter Meeting 2015. 2015, BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND: BMJ Group.
- Brooks KG, Echevarria C, Cooper D, Bourke SC. Case-based discussion from North Tyneside General Hospital: somatostatin analogues in yellow nail syndrome associated with recurrent pleural effusions. Thorax 2014.
- Bourke SC, Gibson GJ. Amyotrophic lateral sclerosis. In: Elliott,M; Nava,S; Schonhöfer,B, ed. Non-invasive Ventilation and Weaning: Principles and Practice. London: Hodder Arnold, 2010, pp.351-360.
- Echevarria C, Gray J, Hartley T, Steer J, Miller J, Simpson AJ, Gibson GJ, Bourke SC. Home treatment of COPD exacerbation selected by DECAF score: a non-inferiority, randomised controlled trial and economic evaluation. Thorax 2018, epub ahead of print.
- Murphy PB, Rehal S, Arbane G, Bourke S, Calverley PMA, Crook AM, Dowson L, Duffy N, Gibson GJ, Hughes PD, Hurst JR, Lewis KE, Mukherjee R, Nickol A, Oscroft N, Patout M, Pepperell J, Smith I, Stradling JR, Wedzicha JA, Polkey MI, Elliott MW, Hart N. Effect of home noninvasive ventilation with oxygen therapy vs oxygen therapy alone on hospital readmission or death after an acute COPD exacerbation: a randomised clinical trial. JAMA 2017, 317(21), 2177-2186.
- Al-momani H, Perry A, Jones R, Bourke S, Doe S, Perry J, Anderson A, Forrest T, Forrest I, Griffin M, Brodlie M, Pearson J, Ward C. Nontuberculous mycobacteria in gastrostomy fed patients with cystic fibrosis. Scientific Reports 2017, 7, 46546.
- Echevarria C, Steer J, Heslop-Marshall K, Stenton SC, Hickey PM, Hughes R, Wijesinghe M, Harrison RN, Steen N, Simpson AJ, Gibson GJ, Bourke SC. The PEARL score predicts 90-day readmission or death after hospitalisation for acute exacerbation of COPD. Thorax 2017, 72(8), 686-693.
- McDermott CJ, Bradburn MJ, Maguire C, Cooper CL, Baird WO, Baxter SK, Cohen J, Cantrill H, Dixon S, Ackroyd R, Baudouin S, Bentley A, Berrisford R, Bianchi S, Bourke SC, Darlison R, Ealing J, Elliott M, Fitzgerald P, Galloway S, Hamdalla H, Hanemann CO, Hughes P, Imam I, Karat D, Leek R, Maynard N, Orrell RW, Sarela A, Stradling J, Talbot K, Taylor L, Turner M, Simonds AK, Williams T, Wedzicha W, Young C, Shaw PJ. DiPALS: Diaphragm Pacing in patients with Amyotrophic Lateral Sclerosis - a randomised controlled trial. Health Technology Assessment 2016, 20(45), 1-185.
- Bryant JM, Grogono DM, Rodriguez-Rincon D, Everall I, Brown KP, Moreno P, Verma D, Hill E, Drijkoningen J, Gilligan P, Esther CR, Noone PG, Giddings O, Bell SC, Thomson R, Wainwright CE, Coulter C, Pandey S, Wood ME, Stockwell RE, Ramsay KA, Sherrard LJ, Kidd TJ, Jabbour N, Johnson GR, Knibbs LD, Morawska L, Sly PD, Jones A, Bilton D, Laurenson I, Ruddy M, Bourke S, Bowler ICJW, Chapman SJ, Clayton A, Cullen M, Dempsey O, Denton M, Desai M, Drew RJ, Edenborough F, Evans J, Folb J, Daniels T, Humphrey H, Isalska B, Jensen-Fangel S, Jonsson B, Jones AM, Katzenstein TL, Lillebaek T, MacGregor G, Mayell S, Millar M, Modha D, Nash EF, O'Brien C, O'Brien D, Ohri C, Pao CS, Peckham D, Perrin F, Perry A, Pressler T, Prtak L, Qvist T, Robb A, Rodgers H, Schaffer K, Shafi N, Van Ingen J, Walshaw M, Watson D, West N, Whitehouse J, Haworth CS, Harris SR, Ordway D, Parkhill J, Andres Floto R. Emergence and spread of a humantransmissible multidrug-resistant nontuberculous mycobacterium. Science 2016, 354(6313), 751-757.
- Echevarria C, Hartley T, Gray J, Muirhead C, Van-Wersch A, Miller J, Steer J, Simpson AJ, Gibson GJ, Bourke SC. Hot decaf: a rct comparing home treatment and inpatient care in copd exacerbations selected by low risk decaf score. In: British Thoracic Society Winter Meeting 2016. 2016, London: BMJ Group.
- Murphy PB, Arbane G, Bourke S, Calverley P, Crooks A, Dowson L, Duffy N, Gibson GJ, Hughes P, Hurst JR, Lewis K, Mukherjee R, Nickol A, Oscroft N, Pepperell J, Rehal S, Smith I, Stradling J, Wedizcha W, Polkey MI, Elliott M, Hart N. Hot-hmv uk trial secondary outcome analysis: early readmission is reduced by the addition of home mechanical ventilation to home oxygen therapy in copd patients with chronic respiratory failure following a life-threatening exacerbation. In: British Thoracic Society Winter Meeting 2016. 2016, London: BMJ Group.
- Al-Momani H, Perry A, Stewart CJ, Jones R, Krishnan A, Robertson AG, Bourke S, Doe S, Cummings SP, Anderson A, Forrest T, Griffin SM, Brodlie M, Pearson J, Ward C. Microbiological profiles of sputum and gastric juice aspirates in Cystic Fibrosis patients. Scientific Reports 2016, 6, 26985.
- Dismore L, Echevarria C, Van-Wersch A, Simpson AJ, Gibson GJ, Bourke SC. Positive drivers and potential barriers to implementation of hospital at home selected by low risk decaf score. In: British Thoracic Society Winter Meeting 2016. 2016, London: BMJ Group.