After completing his doctorate at Trinity College Dublin he worked at the Health Services Research Unit of the London School of Hygiene and Tropical Medicine (LSHTM) from 1998 to 2008, where he oversaw the development of the NHS Patient Reported Outcome Measures (PROMs) programme.
He is currently exploring the value of PROMs as a tool for engineering quality improvement in a variety of clinical areas including breast cancer surgery and joint replacement.
He joined the Department of Epidemiology and Public Health at University College Cork in January 2009 and continues to hold an honorary position at LSHTM.
His research interests include: quality of care achieved by healthcare providers (particularly with respect to surgical outcomes); comparison of case-mix and outcomes achieved by public versus privately funded hospital care models; impact of clinical guidelines on care practices and outcomes; psychometric development of new measures of health-related quality of life; calibration of outcome tools to improve interpretability (e.g. understanding minimally important differences); prognostic modelling of risk factors associated with negative outcomes after hospital care; systematic review and meta-analysis methods.