Dr Nathan Bray
Lecturer in Healthcare Sciences (Healthcare Improvement); ALPHAcademy Lead (Preventative Health)
n.bray@bangor.ac.uk
@drnathanbray
+447792670053
Qualifications
- PhD: Health Economics
Bangor University, 2015 - MSc: Public Health and Health Promotion
Bangor University, 2013 - BSc: Psychology
University of Liverpool, 2007
Overview
Dr Nathan Bray is a Senior Lecturer in Preventative Health, Lecturer in Healthcare Improvement and leads Bangor University’s Academy for Health Equity, Prevention and Wellbeing (AHEPW). He has an MSc in Public Health and Health Promotion and a PhD in Health Economics. His research focuses on public health and disability, in particular the application of methods of economic evaluation to disability and assistive technology. In 2016 Nathan was awarded a post-doctoral fellowship by Health and Care Research Wales to develop a new preference-based instrument for measuring the quality of life of people who use wheelchairs and other mobility aids. Dr Bray has received research funding from a range of organisations including the National Institute for Health Research, the European Commission’s Horizon 2020 programme, Health and Care Research Wales and NHS England. As lead applicant and co-applicant Dr Bray has contributed to over £7.5million worth of grant capture. From 2015 to 2018 Dr Bray chaired the International Society of Wheelchair Professionals’ comparative effectiveness research committee, and was an Associate Editor for the British Journal of Dermatology from 2017 to 2021. Nathan is currently a member of the Health and Care Research Wales Social Care PhD Studentship Committee and College Lead for Sustainability.
Postgraduate Project Opportunities
I am willing to supervise a PhD
Publications
2024
- E-pub ahead of printDevelopment of a value-based scoring system for the MobQoL-7D: a novel tool for measuring quality-adjusted life years in the context of mobility impairment
Bray, N., Tudor Edwards, R. & Schneider, P., 11 Jan 2024, (E-pub ahead of print) In: Disability and Rehabilitation. 10 p.
Research output: Contribution to journal › Article › peer-review
2023
- PublishedDeveloping a Novel Preference-Based Outcome Measure for Mobility-Related Quality of Life: The MobQoL Study,
Bray, N., Apr 2023, p. S15. 1 p.
Research output: Contribution to conference › Paper - PublishedHTA213 Undertaking Studies to Inform Public Policy: Managing Data Collection to Ensure Data Quality in the EQ-5D-5L UK Valuation Through the Use of Independent Quality Control Assessments
Rowen, D., Mukuria, C., Cooper, S., Bray, N., Carlton, J., Longworth, L., Meads, D., Oluboyede, Y., O'Neill, C. & Yang, Y., 2023, In: Value in Health. 26, 12, p. S361
Research output: Contribution to journal › Meeting Abstract - PublishedUK Valuation of EQ-5D-5L, a Generic Measure of Health-Related Quality of Life: A Study Protocol
Rowen, D., Mukuria, C., Bray, N., Carlton, J., Cooper, S., Longworth, L., Meads, D., O'Neill, C. & Yang, Y., Nov 2023, In: Value in Health. 26, 11, p. 1625-1635 11 p.
Research output: Contribution to journal › Article › peer-review
2022
- PublishedAssessing the comparative feasibility, acceptability and equivalence of videoconference interviews and face-to-face interviews using the time trade-off technique
Rowen, D., Mukuria, C., Bray, N., Carlton, J., Longworth, L., Meads, D., O'Neill, C., Shah, K. & Yang, Y., Sept 2022, In: Social Science and Medicine. 309, p. 115227
Research output: Contribution to journal › Article › peer-review - PublishedHTA135 Accessibility and Inclusivity for People Participating in Health Preference Research: How Does the Mode of Administering an Interview Impact on Time Trade-Off Studies?
Rowen, D., Mukuria, C., Cooper, S. J., Bray, N., Carlton, J., Longworth, L., Meads, D., O'Neill, C., Shah, K. & Yang, Y., Dec 2022, In: Value in Health. 25, 12, p. S322-S323
Research output: Contribution to journal › Meeting Abstract - PublishedPreference-based measurement of mobility-related quality of life: developing the MobQoL-7D health state classification system
Bray, N. & Tudor Edwards, R., 5 Jun 2022, In: Disability and Rehabilitation. 44, 12, p. 2915-2929 15 p.
Research output: Contribution to journal › Article › peer-review - PublishedUse of patient centred outcomes measures alongside the personal wheelchair budget process in NHS England: a mixed methods approach to exploring the staff and service user experience of using the WATCh and WATCh-Ad Tools
Tuersley, L., Quaye, N. A., Edwards, R. T. & Bray, N., 16 Aug 2022, MedRxiv, 49 p.
Research output: Working paper › Preprint - PublishedWhat innovations can address inequalities experienced by women and girls due to the COVID-19 pandemic across the different areas of life/domains: work, health, living standards, personal security, participation and education? Report number – RR00027 (January 2022). Gender Inequalities: COVID-19 initiatives
Spencer, L., Hartfiel, N., Hendry, A., Anthony, B., Makanjuola, A., Pisavadia, K., Davies, J., Bray, N., Hughes, D., Wilkinson, C., Fitzsimmons, D. & Edwards, R. T., 15 Jan 2022, Health and Care Research Wales.
Research output: Book/Report › Commissioned report › peer-review
2021
- PublishedDevelopment of the MobQoL patient reported outcome measure for mobility-related quality of life
Bray, N., Spencer, L., Tuersley, L. & Edwards, R. T., 6 Nov 2021, In: Disability and Rehabilitation. 43, 23, p. 3395-3404 10 p.
Research output: Contribution to journal › Article › peer-review - PublishedEconomic model to examine the cost-effectiveness of FlowOx home therapy compared to standard care in patients with peripheral artery disease
Ezeofor, V., Bray, N., Bryning, L., Hashami, F., Hoel, H., Parker, D. & Edwards, R. T., 14 Jan 2021, In: PLoS ONE. 16, 1, e0244851.
Research output: Contribution to journal › Article › peer-review - PublishedHave infection control and prevention measures resulted in any adverse outcomes for care home and domiciliary care residents and staff? Report number: RR_00018 (November 2021)
Spencer, L., Hartfiel, N., Hendry, A., Anthony, B., Makanjuola, A., Bray, N., Hughes, D., Wilkinson, C., Fitzsimmons, D. & Edwards, R. T., 1 Nov 2021, 36 p.
Research output: Book/Report › Other report › peer-review - PublishedPreference-based measurement of mobility-related quality of life: Developing the MobQoL-7D health state classification system
Bray, N. & Edwards, R. T., Jan 2021.
Research output: Contribution to conference › Paper - PublishedUnderstanding the Global Challenges to Accessing Appropriate Wheelchairs: Position Paper
Gowran, R. J., Bray, N., Goldberg, M., Rushton, P., Barhouche Abou Saab, M., Constantine, D., Ghosh, R. & Pearlman, J., 24 Mar 2021, In: International Journal of Environmental Research and Public Health. 18, 7, 3338.
Research output: Contribution to journal › Article › peer-review - PublishedWhich innovations can improve timeliness of investigations and address the backlog in endoscopy for patients with potential symptoms of upper and lower Gastrointestinal (GI) cancers? RR_00003 (August 2021)
Hendry, A., Anthony, B., Charles, J., Hartfiel, N., Roberts, J., Spencer, L., Bray, N., Wilkinson, C. & Edwards, R. T., Aug 2021, 34 p.
Research output: Book/Report › Other report › peer-review
2020
- PublishedAtopic dermatitis: economic burden and strategies for high-quality care
Ismail, N. & Bray, N., May 2020, In: British Journal of Dermatology. 182, 5, p. 1087-1088 2 p.
Research output: Contribution to journal › Article - PublishedPowered mobility interventions for very young children with mobility limitations to aid participation and positive development: the EMPoWER evidence synthesis
Bray, N., Kolehmainen, N., McAnuff, J., Tanner, L., Tuersley, L., Beyer, F., Grayston, A., Wilson, D., Edwards, R. T., Noyes, J. & Craig, D., 1 Oct 2020, In: Health Technology Assessment. 24, 50, p. 1-+ 194 p.
Research output: Contribution to journal › Article › peer-review - PublishedPreference-based measures of health-related quality of life in congenital mobility impairment: a systematic review of validity and responsiveness
Bray, N., Spencer, L. H. & Edwards, R. T., 21 Apr 2020, In: Health Economics Review. 10, 1, 9.
Research output: Contribution to journal › Article › peer-review
2019
- PublishedA randomised controlled trial and cost-consequence analysis of traditional and digital foot orthoses supply chains in a National Health Service setting: application to feet at risk of diabetic plantar ulceration
Parker, J. D., Nuttall, G. H., Bray, N., Hugill, T., Martinez-Santos, A., Edwards, R. T. & Nester, C., 8 Jan 2019, In: Journal of Foot and Ankle Research. 12, 2, p. 2
Research output: Contribution to journal › Article › peer-review - PublishedAppropriate Assistive Technology for Developing Countries
Toro-Hernández, M. L., Kankipati, P., Goldberg, M., Contepomi, S., Tsukimoto, D. R. & Bray, N., Nov 2019, In: Physical Medicine and Rehabilitation Clinics of North America. 30, 4, p. 847 - 865
Research output: Contribution to journal › Article › peer-review - PublishedDepressive symptoms in people with vision impairment: a cross-sectional study to identify who is most at risk
Nollett, C., Ryan, B., Bray, N., Bunce, C., Casten, R., Edwards, R. T., Gillespie, D., Smith, D. J., Stanford, M. & Margrain, T. H., 17 Jan 2019, In: BMJ Open. 9, 1, p. e026163
Research output: Contribution to journal › Article › peer-review - PublishedDevelopment of a Preference-Based Measure of Mobility-Related Quality of Life
Bray, N., Edwards, R. T. & Spencer, L., Jul 2019.
Research output: Contribution to conference › Abstract - PublishedEndoscopic ultrasound staging in patients with gastro-oesophageal cancers: a systematic review of economic evidence
Yeo, S. T., Bray, N., Haboubi, H., Hoare, Z. & Edwards, R. T., 9 Sept 2019, In: BMC Cancer. 19, 1, 19 p., 900.
Research output: Contribution to journal › Article › peer-review - PublishedPerceptions of the impact of disability and impairment on health, quality of life and capability
Bray, N., Edwards, R. T., Squires, L. & Morrison, V., 24 May 2019, In: BMC Research Notes. 12, 1, p. 287 6 p.
Research output: Contribution to journal › Article › peer-review - PublishedSynthesizing evidence for economic evaluations of public health interventions
Wu, O., Charles, J. & Bray, N. J., 14 May 2019, Applied Health Economics For Public Health Practice And Research. Edwards, R. & McIntosh, E. (eds.). 1 ed. Oxford: Oxford University Press, p. 87-107 (Handbooks in Health Economic Evaluation).
Research output: Chapter in Book/Report/Conference proceeding › Chapter
2018
- PublishedAllocation of biologics: health economics and clinical decision making in plaque psoriasis
Bray, N. & Wolf, P., May 2018, In: British Journal of Dermatology. 178, 5, p. 997-998 2 p.
Research output: Contribution to journal › Editorial - PublishedDevelopment of the Wheelchair outcomes Assessment Tool for Children (WATCh): A patient-centred outcome measure for young wheelchair users
Tuersley, L., Bray, N. & Edwards, R. T., 26 Dec 2018, In: PLoS ONE. 13, 12, p. e0209380
Research output: Contribution to journal › Article › peer-review - PublishedIncreased healthcare costs for filaggrin-related eczema and asthma: hope for targeted management and prevention
Akiyama, M. & Bray, N., Sept 2018, In: British Journal of Dermatology. 179, 3, p. 564-565 2 p.
Research output: Contribution to journal › Article - PublishedWheelchair Outcomes Assessment Tool for Children: Summary Report
Bray, N., Tuersley, L. & Edwards, R. T., 2018, Prifysgol Bangor University. 36 p.
Research output: Book/Report › Other report
2017
- PublishedA conceptual framework to assess effectiveness in wheelchair provision
Kamaraj, D. C., Bray, N., Rispin, K., Kankipati, P., Pearlman, J. & Borg, J., 8 Sept 2017, In: African journal of disability. 6, p. 355 5 p.
Research output: Contribution to journal › Article › peer-review - PublishedConceptualization of physical exercise and keeping fit by child wheelchair users and their parents
Noyes, J., Spencer, L. H., Bray, N., Kubis, H-P., Hastings, R. P., Jackson, M. & O'Brien, T. D., May 2017, In: Journal of Advanced Nursing. 73, 5, p. 1111-1123 13 p.
Research output: Contribution to journal › Article › peer-review - PublishedConsidering the role of health economics in pyoderma gangrenosum and other dermatology research
Bray, N., Dec 2017, In: British Journal of Dermatology. 177, 6, p. 1475-1476
Research output: Contribution to journal › Article › peer-review - PublishedCosts and outcomes of improving population health through better social housing: a cohort study and economic analysis
Bray, N. J., Burns, P., Jones, A., Winrow, E. & Edwards, R., Dec 2017, In: International Journal of Public Health . 62, 9, p. 1039-1050
Research output: Contribution to journal › Article › peer-review - PublishedDefining health-related quality of life for young wheelchair users: A qualitative health economics study
Bray, N., Noyes, J., Harris, N. & Edwards, R. T., 15 Jun 2017, In: PLoS ONE. 12, 6, p. e0179269
Research output: Contribution to journal › Article › peer-review - PublishedEffectiveness of portable electronic and optical magnifiers for near vision activities in low vision: a randomised crossover trial
Taylor, J. J., Bambrick, R., Brand, A., Bray, N., Dutton, M., Harper, R. A., Hoare, Z., Ryan, B., Edwards, R. T., Waterman, H. & Dickinson, C., 27 Jun 2017, In: Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists). 37, 4, p. 370-384 15 p.
Research output: Contribution to journal › Article › peer-review - PublishedMeasuring the health-related quality of life of children with impaired mobility: examining correlation and agreement between children and parent proxies
Bray, N., Noyes, J., Harris, N. & Edwards, R. T., 10 Aug 2017, In: BMC Research Notes. 10, 1, p. 377
Research output: Contribution to journal › Article › peer-review - PublishedPortable electronic vision enhancement systems in comparison with optical magnifiers for near vision activities: an economic evaluation alongside a randomized crossover trial
Bray, N., Brand, A., Taylor, J., Hoare, Z., Dickinson, C. & Edwards, R. T., 11 Jul 2017, In: Acta ophthalmologica. 95, 5, p. e415-e423
Research output: Contribution to journal › Article › peer-review
2016
- PublishedDepression in Visual Impairment Trial (DEPVIT): A Randomized Clinical Trial of Depression Treatments in People With Low Vision
Nollett, C. L., Bray, N. J., Bunce, C., Casten, R. J., Edwards, R., Hegel, M. T., Janikoun, S., Jumbe, S. E., Ryan, B., Shearn, J., Smith, D. J., Stanford, M., Xing, W. & Margrain, T. H., 31 Aug 2016, In: Investigative Ophthalmology & Visual Science. 57, p. 4247-4254
Research output: Contribution to journal › Article › peer-review - PublishedEconomic evidence for EUS staging in patients with gastro-oesophageal cancer (GOC): protocol for a systematic review
Yeo, S. T., Bray, N. J., Haboubi, H., Hoare, Z. & Edwards, R., 27 Jul 2016, NIHR PROSPERO (International Prospective Register of Systematic Reviews).
Research output: Other contribution - PublishedPrioritising wheelchair services for children: a pilot discrete choice experiment to understand how child wheelchair users and their parents prioritise different attributes of wheelchair services
Bray, N., Yeo, S. T., Noyes, J., Harris, N. & Edwards, R. T., 19 Jul 2016, In: Pilot and Feasibility Studies. 2, 32, 14 p.
Research output: Contribution to journal › Article › peer-review - PublishedWarm Homes for Health End of Study Briefing 2016: Exploring the costs and outcomes of improving population health through better housing
Edwards, R. T., Bray, N., Burns, P. & Jones, A., 2016, Prifysgol Bangor University. 4 p.
Research output: Book/Report › Other report
2015
- PublishedConceptualizations of wheelchair using children about their health and quality of life compared with generic measures of utility: A Qualitative health economics study
Bray, N., Noyes, J., Edwards, R. T. & Harris, N., 14 Jun 2015.
Research output: Contribution to conference › Paper - PublishedHigh Prevalence of Untreated Depression in Patients Accessing Low-Vision Services
Bray, N. J., Nollett, C. L., Bray, N., Bunce, C., Casten, R. J., Edwards, R. T., Hegel, M. T., Janikoun, S., Jumbe, S. E., Ryan, B., Shearn, J., Smith, D. J., Stanford, M., Xing, W. & Margrain, T. H., 13 Aug 2015, In: Ophthalmology. 123, 2, p. 440-441
Research output: Contribution to journal › Article › peer-review
2014
- Published'Keep fit' exercise interventions to improve health, fitness and well-being of children and young people who use wheelchairs: mixed-method systematic review protocol.
O'Brien, T. D., Noyes, J., Spencer, L. H., Kubis, H., Hastings, R. P., Edwards, R. T., Bray, N. & Whitaker, R., 18 May 2014, In: Journal of Advanced Nursing. 70, 12, p. 2942-2951
Research output: Contribution to journal › Article › peer-review - PublishedMore Than Mobility: A Mixed-Method Systematic Review Of Wheelchair Interventions For Children And Young People With Disabilities
Bray, N., Noyes, J., Edwards, R. T. & Harris, N., 15 Jun 2014.
Research output: Contribution to conference › Paper - PublishedPrioritizing Wheelchair Services: A Pilot Discrete Choice Experiment To Understand How Young Wheelchair Users And Their Parents Prioritize Different Attributes Of Wheelchair Services
Bray, N., Noyes, J., Edwards, R. T. & Harris, N., 5 Jun 2014.
Research output: Contribution to conference › Paper - PublishedThe Warm Homes for Health project: exploring the cost-effectiveness of improving population health through better housing
Bray, N. J., Edwards, R. T. & Bray, N., 19 Nov 2014, In: The Lancet. 384, S2, p. S80
Research output: Contribution to journal › Article › peer-review - PublishedWell-being, health and fitness of children who use wheelchairs: Feasibility study protocol to develop child-centred ‘keep-fit’ exercise interventions
OBrien, T. D., Kubis, H., Bray, N. J., O'Brien, T. D., Noyes, J., Spencer, L. H., Kubis, H. P., Edwards, R. T., Bray, N. & Whitaker, R., 24 Jul 2014, In: Journal of Advanced Nursing. 71, 2, p. 430-440
Research output: Contribution to journal › Article › peer-review - PublishedWheelchair interventions, services and provision for disabled children: a mixed-method systematic review and conceptual framework
Bray, N. J., Bray, N., Noyes, J., Edwards, R. T. & Harris, N., 17 Jul 2014, In: BMC Health Services Research. 14, 309
Research output: Contribution to journal › Article › peer-review
2013
- PublishedAntipsychotic and Benzodiazepine prescribing prevalence and costs in people with dementia and challenging behaviours, living in care homes
Bray, N., Hilton, A., Hounsome, B., Zou, L., Whitaker, C., Moniz-Cook, E., Hart, C., Woods, R. & Edwards, R. T., 24 Mar 2013.
Research output: Contribution to conference › Paper
Activities
2022
- Co-applicant
Leading economic evaluation
1 Feb 2022 – 30 Sep 2024
Activity: Other (Contributor)
2017
- Investing in housing for a return on health - can warmer homes save lives and money?
31 Oct 2017
Links:
Activity: Types of Public engagement and outreach - Media article or participation (Contributor) - Investing in warmer housing could save the NHS billions
5 Oct 2017
Links:
Activity: Types of Public engagement and outreach - Media article or participation (Contributor) - Warmer homes can improve population health in the UK
15 Jun 2017
Links:
Activity: Types of Public engagement and outreach - Media article or participation (Contributor)
Projects
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01/10/2023 – 15/10/2027 (Active)
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01/09/2022 – 31/03/2024 (Finished)
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LOad Monitoring and Alert System (LOMAS) to prevent diabetic foot ulceration
01/01/2021 – 31/03/2024 (Finished)
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01/04/2018 – 01/08/2022 (Finished)
Description
EMPoWER is an NIHR HTA funded evidence synthesis project examining the cost-effectiveness of earlier provision of powered wheelchair interventions for children with mobility limitations. The project is being led by Bangor University, in collaboration with Newcastle University. The aim of the EMPoWER project is to estimate the costs and benefits of providing very young disabled children (under 5 years) with powered mobility aids, such as mini wheelchairs and ride-on-cars. During the conduct of this evidence synthesis project, we will combine the results of existing research and produce an economic model to predict how cost-effective it is to provide powered mobility aids from a very early age.
More than 70,000 children in the UK use special equipment, such as wheelchairs, to help them move around. There are many different reasons why children may have issues with their mobility, and for some children powered or electric mobility aids (such as powered wheelchairs) may be the only way to move around on their own. Helping children under the age of 5 to move around on their own can have long-lasting benefits, including physical and mental development, increased independence and more participation in everyday life. These benefits can also have positive impacts on the physical and mental health of children’s parents, and may reduce later health, social care and education costs. What is currently unknown is whether providing powered mobility aids for very young children provides more benefits than waiting until after the child is aged 5. The NHS is the largest UK provider of powered mobility aids for children, but there is often variation in what different NHS services provide, particularly for children under the age of 5. At the moment there is no national guidance to help NHS services decide the best age to start providing powered mobility aids for children, or what costs and the benefits to consider.
As part of the EMPoWER project, we will gather all existing research and evidence about the costs and benefits of powered mobility aids for children. We will look at the quality of the evidence and combine all relevant information to get a better understanding of the extra costs and benefits of providing powered mobility aids (and related training and support) at a very early age, rather than waiting until after a child turns 5. Using this information we will develop an economic model, which will allow us to estimate whether the extra benefits of early powered mobility outweigh the additional costs.
If you would like find out more about this project, please contact chief investigator Dr Nathan Bray: n.bray@bangor.ac.uk / 07792670053
Links:
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Mobility and Quality of Life: Improving methods of economic evaluation
01/09/2016 – 31/01/2024 (Finished)
Description
In the UK over 11 million people live with an impairment, disability or limiting chronic illness; approximately 6% of children, 16% of working age adults and 45% of the elderly are classified as disabled. Mobility impairments are one of the most common causes of disability, and many disabled people require mobility aids, such as wheelchairs, to move around independently. The NHS is the largest supplier of mobility-aids in the UK, however more evidence is needed to understand which mobility-aids are the most cost-effective means of improving the mobility and quality of life of people with mobility impairments.
In the NHS resources for healthcare are limited, therefore evidence is needed to guide decisions about resource allocation. The National Institute for Health and Care Excellence (NICE) provides independent guidance to the NHS based on evidence of cost-effectiveness. Cost-effectiveness analysis is used to calculate the additional cost of achieving an outcome, such as increased quality of life. For cost-effectiveness analysis NICE recommends an outcome measurement known as the quality-adjusted life year (QALY). A QALY is calculated by multiplying the amount of time spent in a given health state by the associated quality of life of that health state. Health states are assigned utilities which are values representing a person’s preference for that health state. QALYs are universal because both quantity and quality of life are measured; therefore they can be used and compared across lots of different conditions and treatments. This helps the NHS to make efficient decisions about the use of resources.
Health-related quality of life (questionnaires are designed to measure the impact that health has on quality of life and the positive or negative impacts of a medical treatment. These questionnaires are often preference-based, which means they can be used to calculate QALYs. Because these questionnaire tools are so generic they are sometimes not sensitive to disease or condition specific changes to health or quality of life. For instance, the EQ-5D (a widely used health-related quality of life outcome measure) asks people to rate their mobility using 1 of 5 options, none of which account for mobility other than walking, for instance using a mobility-aid. At present there are no mobility-related quality of life questionnaires which can be used to calculate QALYs.
The aim of this project is to develop a questionnaire tool to specifically measure quality of life related to mobility. This will help researchers and medical professionals to understand how mobility-aids improve the quality of life of people with mobility impairments. This project will involve interviewing people with mobility impairments about how mobility affects quality of life, then developing a questionnaire based on their responses. In order to create a scoring system, we will then ask a large of number of people to state their preferences for all of the different health states identified in the new questionnaire. Throughout the project we will test the questionnaire to make sure that it is valid and reliable.
If you would like find out more about this project, please contact chief investigator Dr Nathan Bray: n.bray@bangor.ac.uk / 07792670053
Links: