My research interests are methods for test evaluation, evidence synthesis for policy, health technology assessment and health data science.
I am a Senior Research Fellow in Screening and Test Evaluation at Warwick Medical School. I graduated from the University of Birmingham with a BSc in Biological Sciences. I completed a MSc in Evidence Based Health Care and Health Technology Assessment at the University of Birmingham and a PhD in Health Sciences (NIHR doctoral fellowship) at the University of Warwick. In 2022 I undertook an NIHR Development and Skills Enhancement Fellowship in Health Data Science with a focus on causal inference methods for the analysis of observational data. In my PhD I combined routine data with published evidence to assess the transferability of test accuracy data from secondary care to primary care with the aim of translating evidence into practice. My current research focuses on test evaluations using systematic review methods and routine data to produce high quality evidence to inform national policy advisers on test use and changes to screening programmes. As part of my work for Warwick Screening I lead the analysis of the Sloane atypia data with outcomes expected to inform recommendations on the management of women with atypia detected through routine breast screening. Prior to that I led the evidence review on artificial intelligence for image analysis in breast cancer screening for the UK National Screening Committee (UK NSC). My work as a clinical effectiveness reviewer for Warwick Evidence involves producing health technology assessments for the National Institute for Health and Care Excellence (NICE). I was the lead systematic reviewer on three Diagnostic Assessment Reports including an assay for guiding dose adjustment in patients receiving chemotherapy for colorectal cancer, assays for the monitoring of drugs in Crohn's disease patients, and pathogen panel tests for patients with gastroenteritis. For an overview of other review topics I have been involved in please refer to my publication list. I am co-leader of the postgraduate Health Screening module which is a collaboration between Warwick Medical School and the UK National Screening Committee, and I am a member of the NHS breast screening research, innovation and development advisory committee (RIDAC) contributing to the advice on the feasibility of research using national breast screening programme data.
- Freeman, Karoline, Mansbridge, Alice, Stobart, H., Clements, K., Wallis, M. G., Pinder, S. E., Kearins, O., Shaaban, A. M., Kirwan, C. C., Wilkinson, L. S., Webb, S., O?Sullivan, E., Jenkins, J., Wright, S., Taylor, K., Bailey, C., Holcombe, C., Wyld, L., Edwards, K., Jenkinson, David J. et al (Select to open full list), 2024. Evidence-informed recommendations on managing breast screening atypia : perspectives from an expert panel consensus meeting reviewing results from the sloane atypia project. British Journal of Radiology, 97 (1154), pp. 324-330
- Freeman, Karoline, Jenkinson, David J., Clements, K., Wallis, M. G., Pinder, S. E., Provenzano, E., Stobart, H., Stallard, Nigel, Kearins, O., Sharma, N., Shaaban, A., Kirwan, C. C., Hilton, B., Thompson, A. M., Taylor-Phillips, Sian, 2024. Atypia detected during breast screening and subsequent development of cancer : observational analysis of the Sloane atypia prospective cohort in England. BMJ, 384
- Brettschneider, Julia, Morrison, Breanna, Jenkinson, David J., Freeman, Karoline, Walton, Jackie, Sitch, Alice, Hudson, Sue, Kearins, Olive, Mansbridge, Alice, Pinder, Sarah E., Given-Wilson, Rosalind, Wilkinson, Louise, Wallis, Matthew G., Cheung, Shan, Taylor-Phillips, Sian, 2024. Development and quality appraisal of a new English breast screening linked dataset as part of the Age, test Threshold and frequency of Mammography screening (ATHENA-M) study. British Journal of Radiology, 97 (1153), pp. 98-112
- Taylor-Phillips, Sian, Jenkinson, David J., Stinton, Chris, Kunar, Melina A., Watson, Derrick G., Freeman, Karoline, Mansbridge, Alice, Wallis, Matthew G., Kearins, Olive, Hudson, Sue, Clarke, Aileen, 2024. Fatigue and vigilance in medical experts detecting breast cancer. Proceedings of the National Academy of Sciences, 121 (11)
- 'Freeman, Karoline, 'Willis, Brian H., 'Ryan, Ronan, 'Taylor-Phillips, Sian, 'Clarke, Aileen, 2022. 'Comparing outcomes from tailored meta-analysis with outcomes from a setting specific test accuracy study using routine data of faecal calprotectin testing for inflammatory bowel disease. BMC Medical Research Methodology, 22 (1)
- Jenkinson, David J., Freeman, Karoline, Clements, Karen, Hilton, Bridget, Dulson-Cox, Joanne, Kearins, Olive, Stallard, Nigel, Wallis, Matthew G., Sharma, Nisha, Kirwan, Cliona, Pinder, Sarah, Provenzano, Elena, Shaaban, Abeer M., Stobart, Hilary, McDonnell, Samantha J., Thompson, Alastair M., Taylor-Phillips, Sian, 2022. Breast screening atypia and subsequent development of cancer : protocol for an observational analysis of the Sloane database in England (Sloane atypia cohort study). BMJ Open, 12 (1)
- Freeman, Karoline, Taylor-Phillips, Sian, Willis, Brian H., Ryan, Ronan, Clarke, Aileen, 2021. Test accuracy of faecal calprotectin for inflammatory bowel disease in UK primary care : a retrospective cohort study of the IMRD-UK data. BMJ Open, 11 (2)
- Wyckoff, Myra H., Singletary, Eunice M., Soar, Jasmeet, Olasveengen, Theresa M., Greif, Robert, Liley, Helen G., Zideman, David, Bhanji, Farhan, Andersen, Lars W., Avis, Suzanne R., Aziz, Khalid, Bendall, Jason C., Berry, David C., Borra, Vere, Böttiger, Bernd W., Bradley, Richard, Bray, Janet E., Breckwoldt, Jan, Carlson, Jestin N., Cassan, Pascal et al (Select to open full list), 2021. 2021 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations : summary From the Basic Life Support; Advanced Life Support; Neonatal Life Support; Education, Implementation, and Teams; First Aid Task Forces; and the COVID-19 Working Group. Circulation, 145 (9), pp. e645-e721
- Freeman, Karoline, Ryan, Ronan, Parsons, Nicholas R., Taylor-Phillips, Sian, Willis, Brian H., Clarke, Aileen, 2021. The incidence and prevalence of inflammatory bowel disease in UK primary care: a retrospective cohort study of the IQVIA Medical Research Database. BMC Gastroenterology, 21 (1)
- Freeman, Karoline, Ryan, Ronan, Parsons, Nicholas R., Taylor-Phillips, Sian, Willis, Brian H., Clarke, Aileen, 2021. Faecal calprotectin testing in UK general practice : a retrospective cohort study using The Health Improvement Network database. The British Journal of General Practice, 71 (712), pp. e854-e861
- Couper, Keith, Taylor-Phillips, Sian, Grove, Amy L., Freeman, Karoline, Osokogu, Osemeke, Court, Rachel A., Mehrabian, Amin, Morley, Peter T., Nolan, Jerry P., Soar, Jasmeet, Perkins, Gavin D., 2020. COVID-19 in cardiac arrest and infection risk to rescuers : a systematic review. Resuscitation, 151, pp. 59-66
- Seedat, Farah, Geppert, Julia, Stinton, Chris, Patterson, Jacoby, Freeman, Karoline, Johnson, Samantha Ann, Fraser, Hannah, Brown, Colin Stewart, Uthman, Olalekan A., Tan, Bee K., Robinson, Esther R., McCarthy, Noel D., Clarke, Aileen, Marshall, John, Visintin, Cristina, Mackie, Anne, Taylor-Phillips, Sian, 2019. Universal antenatal screening for group B streptococcus may cause more harm than good. BMJ, 364 (364)
- Freeman, Karoline, Willis, Brian H., Fraser, Hannah, Taylor-Phillips, Sian, Clarke, Aileen, 2019. Faecal calprotectin to detect inflammatory bowel disease : a systematic review and exploratory meta-analysis of test accuracy. BMJ Open, 9 (3)
- Seedat, Farah, Brown, Colin Stewart, Stinton, Chris, Patterson, Jacoby, Geppert, Julia, Freeman, Karoline, Tan, Bee K., Johnson, Samantha Ann, Fraser, Hannah, Uthman, Olalekan A., Robinson, Esther R., McCarthy, Noel D., Clarke, Aileen, Taylor-Phillips, Sian, 2018. Bacterial load and molecular markers associated with early-onset Group B Streptococcus. The Pediatric infectious disease journal, 37 (12), pp. e306-e314
- Freeman, Karoline, Tsertsvadze, Alexander, Taylor-Phillips, Sian, McCarthy, Noel D., Mistry, Hema, Manuel, Rohini, Mason, James, 2017. Agreement between gastrointestinal panel testing and standard microbiology methods for detecting pathogens in suspected infectious gastroenteritis : test evaluation and meta-analysis in the absence of a reference standard. PLoS One, 12 (3)
- Seedat, Farah, Stinton, Chris, Patterson, Joseph P., Geppert, Julia, Tan, Bee K., Robinson, Esther R., McCarthy, Noel D., Uthman, Olalekan A., Freeman, Karoline, Johnson, Samantha Ann, Fraser, Hannah, Brown, Colin Stewart, Clarke, Aileen, Taylor-Phillips, Sian, 2017. Adverse events in women and children who have received intrapartum antibiotic prophylaxis treatment : a systematic review.. BMC Pregnancy and Childbirth, 17 (1)
- Geppert, Julia, Stinton, Chris, Freeman, Karoline, Fraser, Hannah, Clarke, Aileen, Johnson, Samantha Ann, Sutcliffe, P. (Paul), Taylor-Phillips, Sian, 2017. Evaluation of pre-symptomatic nitisinone treatment on long-term outcomes in Tyrosinemia type 1 patients : a systematic review. Orphanet Journal of Rare Diseases, 12 (1)
- Freeman, Karoline, Mistry, Hema, Tsertsvadze, Alexander, Royle, Pamela, McCarthy, Noel D., Taylor-Phillips, Sian, Manuel, Rohini, Mason, James, 2017. Multiplex tests to identify gastrointestinal bacteria, viruses and parasites in people with suspected infectious gastroenteritis : a systematic review and economic analysis. Health Technology Assessment, 21 (23), pp. 1-188
- Taylor-Phillips, Sian, Geppert, Julia, Stinton, Chris, Freeman, Karoline, Johnson, Samantha Ann, Fraser, Hannah, Sutcliffe, P. (Paul), Clarke, Aileen, 2017. Comparison of a full systematic review versus a rapid review approaches to assess a newborn screening test for tyrosinemia type 1. Research Synthesis Methods, 8 (4), pp. 475-484
- Stinton, Chris, Geppert, Julia, Freeman, Karoline, Clarke, Aileen, Johnson, Samantha Ann, Fraser, Hannah, Sutcliffe, P. (Paul), Taylor-Phillips, Sian, 2017. Newborn screening for Tyrosinemia type 1 using succinylacetone ? a systematic review of test accuracy. Orphanet Journal of Rare Diseases, 12
- Freeman, Karoline, Taylor-Phillips, Sian, Connock, M., Court, Rachel A., Tsertsvadze, Alexander, Shyangdan, D. (Deepson), Auguste, Peter, Mistry, Hema, Arasaradnam, Ramesh P., Sutcliffe, P. (Paul), Clarke, Aileen, 2017. Test accuracy of drug and antibody assays for predicting response to anti-Tumour Necrosis Factor treatment in Crohn?s disease : a systematic review and meta-analysis. BMJ Open, 7
- Taylor-Phillips, Sian, Freeman, Karoline, Geppert, Julia, Agbebiyi, Adeola, Uthman, Olalekan A., Madan, Jason, Clarke, Angus, Quenby, Siobhan, Clarke, Aileen, 2016. Accuracy of non-invasive prenatal testing using cell-free DNA for detection of Down, Edwards and Patau syndromes : a systematic review and meta-analysis. BMJ Open, 6 (1)
- Pulikottil-Jacob, Ruth, Connock, M., Ngianga-Bakwin, Kandala, Mistry, Hema, Grove, Amy L., Freeman, Karoline, Costa, Matthew L., Sutcliffe, P. (Paul), Clarke, Aileen, 2016. Has metal-on-metal resurfacing been a cost-effective intervention for health care providers? - a registry based study. PLoS One, 11 (11)
- Freeman, Karoline, Connock, M., Auguste, Peter, Taylor-Phillips, Sian, Mistry, Hema, Shyangdan, D. (Deepson), Court, Rachel A., Arasaradnam, Ramesh P., Sutcliffe, P. (Paul), Clarke, Aileen, 2016. Clinical effectiveness and cost-effectiveness of use of therapeutic monitoring of tumour necrosis factor alpha (TNF-?) inhibitors [LISA-TRACKER® enzyme-linked immunosorbent assay (ELISA) kits, TNF-?-Blocker ELISA kits and Promonitor® ELISA kits] versus standard care in patients with Crohn?s disease: systematic reviews and economic modelling. Health Technology Assessment, 20 (83), pp. 1-288
- Auguste, Peter, Tsertsvadze, Alexander, Pink, Joshua, Court, Rachel A., Seedat, Farah, Gurung, Tara, Freeman, Karoline, Taylor-Phillips, Sian, Walker, Clare, Madan, Jason, Kandala, Ngianga-Bakwin, Clarke, Aileen, Sutcliffe, P. (Paul), 2016. Accurate diagnosis of latent tuberculosis in children, people who are immunocompromised or at risk from immunosuppression and recent arrivals from countries with a high incidence of tuberculosis : systematic review and economic evaluation. Health Technology Assessment, 20 (38), pp. 1-678
- Perkins, Gavin D., Griffiths, Frances, Slowther, Anne, George, R., Fritz, Zoe?, Satherley, P., Williams, B., Waugh, Norman, Cooke, Matthew, Chambers, Sue, Mockford, Carole, Freeman, Karoline, Grove, Amy L., Field, R., Owen, S., Clarke, B., Court, Rachel A., Hawkes, Claire, 2016. Do-not-attempt-cardiopulmonary-resuscitation decisions : an evidence synthesis. Health Services and Delivery Research, 4 (11)
- Freeman, Karoline, Saunders, Mark P., Uthman, Olalekan A., Taylor-Phillips, Sian, Connock, M., Court, Rachel A., Gurung, T., Sutcliffe, P. (Paul), Clarke, Aileen, 2016. Is monitoring of plasma 5-fluorouracil levels in metastatic / advanced colorectal cancer clinically effective? A systematic review. BMC Cancer, 16 (1)
- Fisher, Joanne D., Freeman, Karoline, Clarke, Aileen, Spurgeon, Peter, Smyth, Michael A., Perkins, Gavin D., Sujan, Mark-Alexander, Cooke, Matthew, 2015. Patient safety in ambulance services : a scoping review. Health Services and Delivery Research, 3 (21)
- Freeman, Karoline, Field, R. A., Perkins, Gavin D., 2015. Variation in local trust Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) policies : a review of 48 English healthcare trusts. BMJ Open, 5 (1)
- Royle, Pamela, Mistry, Hema, Auguste, Peter, Shyangdan, D., Freeman, Karoline, Lois, Noemi, Waugh, Norman, 2015. Pan-retinal photocoagulation and other forms of laser treatment and drug therapies for non-proliferative diabetic retinopathy : systematic review and economic evaluation. Health Technology Assessment, 19 (51), pp. 1-248
- Pulikottil-Jacob, Ruth, Connock, M., Kandala, Ngianga-Bakwin, Mistry, Hema, Grove, Amy L., Freeman, Karoline, Costa, Matthew L., Sutcliffe, P. (Paul), Clarke, Aileen, 2015. Cost effectiveness of total hip arthroplasty in osteoarthritis : comparison of devices with differing bearing surfaces and modes of fixation. Bone & Joint Research, 97 (4), pp. 449-457
- Freeman, Karoline, Connock, M., Cummins, Ewen, Gurung, Tara, Taylor-Phillips, Sian, Court, Rachel A., Saunders, Mark, Clarke, Aileen, Sutcliffe, P. (Paul), 2015. Fluorouracil plasma monitoring : systematic review and economic evaluation of the My5-FU assay for guiding dose adjustment in patients receiving fluorouracil chemotherapy by continuous infusion. Health Technology Assessment, 19 (91), pp. 1-322
- Clarke, Aileen, Pulikottil-Jacob, Ruth, Grove, Amy L., Freeman, Karoline, Mistry, Hema, Tsertsvadze, Alexander, Connock, M., Court, Rachel A., Kandala, Ngianga-Bakwin, Costa, Matthew L., Suri, Gaurav, Metcalfe, David, Crowther, Michael, Morrow, Sarah, Johnson, Samantha J., Sutcliffe, P. (Paul), 2015. Total hip replacement and surface replacement for the treatment of pain and disability resulting from end-stage arthritis of the hip (review of technology appraisal guidance 2 and 44) : systematic review and economic evaluation. Health Technology Assessment, 19 (10), pp. 1-668
- Clarke, Aileen, Pulikottil-Jacob, Ruth, Grove, Amy L., Freeman, Karoline, Mistry, Hema, Tsertsvadze, Alexander, Connock, M., Court, Rachel A., Kandala, Ngianga-Bakwin, Costa, Matthew L., Sutcliffe, P. (Paul), 2014. Hips : hip replacement interventions for osteoarthritis in the UK ? a clinical and cost-effectiveness analysis. Journal of Epidemiology & Community Health, 68 (1), pp. a37-a38
- Tsertsvadze, Alexander, Grove, Amy L., Freeman, Karoline, Court, Rachel A., Johnson, Samantha Ann, Connock, M., Clarke, Aileen, Sutcliffe, P. (Paul), 2014. Total hip replacement for the treatment of end stage arthritis of the hip : a systematic review and meta-analysis. PLoS One, 9 (7)
- Sutcliffe, P. (Paul), Connock, M., Gurung, T., Freeman, Karoline, Johnson, Samantha Ann, Kandala, Ngianga-Bakwin, Grove, Amy L., Gurung, Binu, Morrow, Sarah, Stranges, Saverio, Clarke, Aileen, 2013. Aspirin in primary prevention of cardiovascular disease and cancer : a systematic review of the balance of evidence from reviews of randomized trials. PLoS One, 8 (12)
- Sutcliffe, P. (Paul), Connock, M., Gurung, T., Freeman, Karoline, Johnson, Samantha Ann, Kandala, Ngianga-Bakwin, Grove, Amy L., Gurung, B., Morrow, S., Clarke, Aileen, 2013. Aspirin for prophylactic use in the primary prevention of cardiovascular disease and cancer : a systematic review and overview of reviews. Health Technology Assessment, 17 (43), pp. 1-253
- Szczepura, Ala, Osipenko, Leeza, Freeman, Karoline, 2011. A new fetal RHD genotyping test : costs and benefits of mass testing to target antenatal anti-D prophylaxis in England and Wales. BMC Pregnancy and Childbirth, Vol.11 (No.1)
- Freeman, Karoline, Szczepura, Ala, Osipenko, Leeza, 2009. Non-invasive fetal RHD genotyping tests : a systematic review of the quality of reporting of diagnostic accuracy in published studies. European Journal of Obstetrics, Gynecology and Reproductive Biology, Vol.142 (No.2), pp. 91-98
- Freeman, Karoline, Willis, Brian, Fraser, Hannah, Taylor-Phillips, Sian, Clarke, Aileen, 2018. Was evidence on test accuracy from secondary care enough to approve faecal calprotectin testing for primary care use?. Methods for Evaluation of medical prediction Models, Tests And Biomarkers (MEMTAB) 2018 Symposium, Utrecht, The Netherlands, 2-3 Jul 2018, Published in Diagnostic and Prognostic Research, pp. 1-44
- Freeman, Karoline, 2020. The role of faecal calprotectin testing in primary care.
- Freeman, Karoline, Connock, M., Cummins, E., Gurung, T., Taylor-Phillips, Sian, Court, Rachel A., Saunders, Mark, Clarke, Aileen, Sutcliffe, P. (Paul), 2014. Diagnostic Assessment Report commissioned by the NIHR HTAProgramme on behalf of the National Institute for Health and CareExcellence ? Final report. Fluorouracil plasma monitoring : the My5-FU assay for guiding dose adjustment in patients receiving fluorouracil chemotherapy by continuous infusion. NICE, NICE (National Institute for Health and Care Excellence)
- Freeman, Karoline, Szczepura, Ala, Osipenko, Leeza, 2007. Quality of Rh genotyping studies and diagnostic accuracy estimation. American Journal of Obstetrics and Gynecology, Mosby-Elsevier, pp. 116-117
- Freeman, Karoline, Osipenko, Leeza, Clay, Diane, Hyde, Julia, Szczepura, Ala, 2007. A review of evidence on non-invasive prenatal diagnosis (NIPD) : tests for fetal RHD genotype. University of Warwick
- Szczepura, Ala, Freeman, Karoline, Osipenko, Leeza, Hyde, Julia, 2005. Emerging prenatal genetic tests : developing a health technology assessment (HTA) frameworkfor informed decision-making. University of Warwick
Title | Funder | Award start | Award end |
---|---|---|---|
TAR 3 - Production of Technology Assessment Reviews (TAR) | National Institute for Health Research (NIHR DoH) | 01 Apr 2022 | 31 Mar 2027 |
SLOANE atypia | National Institute for Health Research (NIHR DoH) | 01 Dec 2021 | 31 Dec 2023 |
NIHR HS&DR Stage 2: Adapting Breast Cancer Screening to MAximise Mortality Benefit and Minimise Overdiagnosis harm (Adapt-MAMMO) | National Institute for Health Research (NIHR DoH) | 01 Jan 2021 | 31 Dec 2023 |
NIHR DRF 2016 - Karoline Freeman: What is the role of faecal calprotectin testing for the differentiation between IBS and IBD in primary care? | National Institute for Health Research (DoH) | 01 Oct 2016 | 30 Sep 2020 |
UKNSC Tender | Public Health England | 01 Oct 2015 | 30 Sep 2018 |
Tyrosinemia Review (part of NSC framework agreement) | Public Health England | 01 Oct 2015 | 31 Dec 2016 |
Therapeutic communication in black and minority ethnic populations: a synthesis of the evidence base: Via QMUL | The Human Tissue Authority (HTA) | 01 Jan 2012 | 30 Jun 2013 |
Extension to: Health econometrics study to inform the Detection & Identification of Infectious Agents (DIIA) Innovation Platform. | Technology Strategy Board | 01 Dec 2010 | 01 Mar 2012 |
Improvement of Medication use in Older Residents (IMOR) Project | BUPA Foundation | 01 Jan 2010 | 31 Dec 2010 |
Extension to Health Econometrics Study to inform the Detection and Identification of Infectious Agents (DIIA) innnovation platform | Technology Strategy Board | 01 Apr 2010 | 31 Jul 2010 |