Application deadline: Sunday, December 13, 2026
Funding: Competition Funded PhD Project (Students Worldwide)
About the project
Coeliac disease affects around 1% of the population, yet many people remain undiagnosed. For some, diagnosis comes only after years of symptoms or after complications have developed. Could population screening provide a better approach? If so, at what age should people be screened? The UK does not currently recommend population screening for coeliac disease. However, the evidence is changing. Previous NIHR-funded research by our team found that population screening could be cost-effective in adults, while identifying important uncertainties. Since then, Italy has introduced national paediatric screening, providing new real-world evidence about what population screening might achieve. Our previous modelling took an NHS perspective, asking whether screening represents good value for the health service. Much of the impact of delayed diagnosis, however, falls outside the NHS, including missed school or work, impaired growth and development, and long-term reproductive complications. Other broader elements of value may also be important, such as potential impacts on equity from systematic screening rather than symptomatic detection. This project will take a broader societal perspective, drawing on the “Value Flower” framework to identify and incorporate these wider elements of value.
The project will also move beyond conventional single-best-strategy decision-making. Benefits, harms and uncertainty may differ across ages, and several screening strategies may have similar expected value. The student will therefore investigate novel decision rules, including Loss-Adjusted Expected Value (LAEV), developed at Bristol, and/or the international GRACE approach, designed to support decisions when multiple strategies each have genuine merit.
This PhD will use coeliac disease to address an important health-policy question while developing new approaches to economic evaluation: Should we screen the population for coeliac disease, when should screening occur, and how should we make that decision when benefits, harms and uncertainty extend across the life course? A major strength of the project is its feasibility. The supervisory team has already developed and published an economic model of coeliac disease screening. The student will therefore begin with an established model and evidence base, allowing them to focus on answering new questions rather than building research infrastructure from scratch.
Aims and objectives
The student will:
- Update the evidence and economic model to determine whether population screening remains cost-effective using current epidemiological, clinical and cost evidence, including emerging international screening data.
- Determine when screening should occur, extending the model to compare screening at different ages and potentially at multiple points across the life course.
- Investigate the broader value of earlier diagnosis, considering outcomes insufficiently represented in conventional economic evaluations, including developmental and reproductive consequences and impacts on patients and families.
- Explore better ways of making decisions under uncertainty, particularly where several screening strategies offer similar expected value but differ in their risks, benefits or uncertainty.
Methods
The project will consist of four linked work packages.
- Updating an established screening model. The student will update the team's existing coeliac disease screening model using contemporary epidemiological, clinical and cost evidence. Relevant findings from international screening programmes, particularly Italy, will be incorporated where available.
- Identifying what matters. Evidence synthesis and patient and clinician involvement will identify outcomes and broader elements of value that should be considered when evaluating earlier diagnosis and screening. The student will investigate how these could be incorporated into economic evaluation, comparing conventional NHS/PSS analysis with a broader societal perspective.
- Screening across the life course. The model will be extended to compare alternative screening ages and strategies, allowing the student to ask not simply whether population screening is worthwhile, but when screening is likely to provide greatest value.
- Decision-making when the answer is uncertain. Our previous model considered different risk groups, tests, test combinations and thresholds, generating numerous possible screening strategies. Expected value was highly uncertain, making it difficult to identify a single robustly optimal strategy. This challenge is not unique to coeliac disease: screening decisions involving combinations of risk groups, tests and thresholds can generate large, uncertain strategy sets.
The student will investigate alternative decision-making approaches, including Loss-Adjusted Expected Value and related methods, and assess whether they produce more robust screening recommendations. Value of information analysis will further assess the potential value of reducing uncertainty and help prioritise future research.
How to apply
Before applying, please check the entry requirements.
Submit your application via the University of Bristol portal. Search for and then select ‘Population Health Sciences (PhD)’. Click ‘Apply’ for September 2027 start.
You must provide the following in your application:
- A CV
- Two referees (add to the Reference section of your application form)
- A personal statement highlighting your motivation for applying for this PhD, and any relevant experience and/or skills (maximum of one side of A4, font size 11). We are keen to support applicants from minority and under-represented backgrounds (based on protected characteristics) and those who have experienced other challenges or disadvantages. Please use your personal statement to ensure we can take these factors into account.
- Certificates and transcripts
- Enter the project title and the supervisor names as they appear on this advert in the Research section.
- A research statement/proposal is not required. You should upload a blank document in this section.
- In the funding section, choose ‘University of Bristol Scholarship’.
Incomplete applications will not be considered. Read the list above carefully and ensure you have uploaded all required documents by the deadline. If you have yet to complete your degree, please supply an interim transcript where possible.
You can find more information on how to prepare your application and what we are looking for at the “PhD Application Workshop” which will be held on Teams on Monday 23rd November at 2pm (GMT): PhD Application Workshop.
Applications will be shortlisted in January 2027 with interviews in February 2027. The anticipated start date for this scholarship is September 2027.
Please visit our website for more information on PhD opportunities in the Faculty of Health and Life Sciences.
Further enquiries
Project-specific queries: [contact details available in the full listing]
Application queries: [contact details available in the full listing]
Funding Notes
The University of Bristol is one of the most popular and successful universities in the UK, ranked 51st globally (QS 2026), top five in the UK for research (THE analysis of REF 2021), and 6th most targeted by UK employers (High Fliers 2026).
This is a four-year scholarship covering tuition fees, a UKRI-rate stipend (£21,805 in 2026/27, updated annually), and £2,100 annual research costs.
The scholarship is available to UK and International applicants. International candidates (including EU) will be required to cover the cost of their student visa, healthcare surcharge and other costs of moving to the UK.
