Hazel Thornton

Honorary Visiting Fellow


31 Regent Street
Colchester, CO5 7EA

Email: hazelcagct@keme.co.uk

In July 2002 Hazel was awarded an honorary Doctor of Science degree by the University of Leicester for her contribution to medicine and patient care. The award followed her trail-blazing work – as a cancer survivor herself - in championing patients’ causes and changing perceptions within the medical research and healthcare community.


Resource material: Patient and public involvement in research

This collection of resource material has been assembled to be used as a guide for anyone wishing to find out more about active patient and public involvement in the research process - what it is and how to do it. It is not comprehensive, but it should provide sufficient information for anyone who wants to find out more about this way of collaborative working.

The Spirit of Medicine



  1. Ray Moynihan, Lisa Bero, Sue Hill, Minna Johansson, Joel Lexchin, Helen Macdonald, Barbara Mintzes, Cynthia Pearson, Anna Stavdal, Jacob Stegenga, Brett Thombs, Hazel Thornton, Per Olav Vandvik, Beate Wieseler, Fi Godlee. Pathways to Independence: towards trustworthy evidence. Building an evidence-base and decision-support we can trust, to inform our health decisions free of commercial influences. BMJ 2019;367:l6576 https://doi.org/10.1136/bmj.l6576


  1. Thornton H. Yet another risk score – will it really help decision making? BMJ 2018.362:k3847 https://www.bmj.com/content/362/bmj.k3847


  1. Hersch J, Barratt A; Irwig L; McGeechan K; Jacklyn G; Thornton H; Dhillon H; Houssami N; McCaffery K. The importance of enabling informed decision making for women considering breast cancer screeningJ Med Screen 2016; 23(1): 55. DOI: 10.1177/0969141315612818.
  2. McCaffery K, Jansen J, Scherer L, Thornton H, Hersch J, Carter S, Barratt A, Moynihan R, Waller J, Sheridan S, Brodersen J, Pickles K, Edwards A. Walking the tightrope: communicating overdiagnosis in modern healthcare.   https://www.bmj.com/content/352/bmj.i348
  1. Hersch J, Barratt A, Jansen J, Irwig L, McGeechan K, Jacklyn G, Thornton H, Dhillon H, Houssami N, McCaffery K. Use of a decision aid including information on overdetection to support informed choice about breast cancer screening: a randomised controlled trial. Lancet 2015; 385(9978): 1642-1652.  Published online February 18, 2015
  2. Thornton H. NHS health checks are totally unscientific. BMJ 2015;3501:h990
  3. Abramson J, Angell M, Brownlee S, Saini V, Thornton H, Jefferson T and 55 other signatories. An open letter to all US Presidential Candidates. BMJ rapid response 9th November 2015.


  1. Thornton H. Bringing an end to mandatory breast cancer screening in Uruguay. BMJ 2014;348:g390
  2. Thornton H. Public consent for neonatal studies: putting values and virtues back into the practice of Medicine. Journal of the Royal Society of Medicine. Vol. 107(2) 82–83
  3. Jolyn Hersch, Alexandra Barratt, Jesse Jansen, Nehmat Houssami, Les Irwig, Gemma Jacklyn, Haryana Dhillon, Hazel Thornton, Kevin McGeechan, Kirsten Howard, Kirsten McCaffery. The effect of information about overdetection of breast cancer on women’s decision making about mammography screening: study protocol for a randomised controlled trial. BMJ Open
  4. Jolyn Hersch, Jesse Jansen, Alexandra Barratt, Les Irwig, Nehmat Houssami, Gemma Jacklyn, Hazel Thornton, Haryana Dhillon, Kirsten McCaffery. Overdetection in breast cancer screening: development and preliminary evaluation of a decision aid . BMJ Open


  1. Thornton H. Book chapter. Informed consent in the management and research of breast cancer. In: Benson JR, Gui G, Tuttle TM. Early Breast Cancer: from screening to multidisciplinary management. Third edition, CRC Press, Taylor and Francis Group, Boca Raton, USA. pp 328-340.
  2. Lucie Rychetnik, Stacy M Carter, Julia Abelson, Hazel Thornton, Alexandra Barratt, Vikki A Entwistle, Geraldine Mackenzie, Glenn Salkeld, Paul Glasziou, Enhancing citizen engagement in cancer screening through deliberative democracy. JNCI Online
  3. Thornton, H.  Book Chapter: Lightness, defining virtues of the past – to shape values of the future. In: La sanita tra ragione e passione. Publishers: Il Pensiero Scientifico Editore, Rome. ISBN 978-88-490-0466-3
  4. Thornton H. Empowerment is inappropriate for equal citizens. Letter: BMJ 2013;346:f3573 doi: 101136/bmj.f3573 4th June 2013
  5. Thornton Hazel. Bias in reporting of randomized controlled trials in breast cancer. Comment piece for NICE website Eyes on Evidence. November 2013.
  6. Thornton H. We need to ask “what is the purpose of research?” Letter. BMJ 2013:347-16165
  1. Thornton, H. Case Study. Service user involvement in clinical trials for breast cancer treatment. In: Morrow E, Boaz A, Brearley S, Ross F. Handbook of service user involvement in nursing and healthcare research. Wiley-Blackwell, Chichester, UK. 2012
  2. Thornton H. Effect of population-based screening on breast cancer mortality. Lancet 2012; 379:1296-1297
  3. Thornton H. Chapter in: Early Breast Cancer - from screening to multidisciplinary management, Third Edition. Informa Healthcare, London. Editors: Benson JR, Tuttle T, Gui G. Informed consent in the management and research of breast cancer. In press
  4. Thornton H. Doctors` numeracy and communication skills need to improve. BMJ 2012;344:e3069
  5. Thornton H. Invited comment piece on Editorial. `Multidisciplinary team working: the emperor without clothes?` Thornton S, Dodwell D. British Journal of Hospital Medicine July 2012.; 73(7):414
  1. Thornton H. Patient and Public Involvement. Brief History of Patient and Public Involvement in research (PPI). Annex 6 in European Science Foundation `Forward Look`: Implementation of Medical Research in Clinical Practice
  2. Hersch J. Jansen J, Irwig L, Barratt A, Thornton H, Howard K, McCaffery K. How do we achieve informed choice for women considering breast screening? Preventive Medicine. 2011; 53(3) 144-146
  3. Thornton, H. `We are all in this together`: resolving uncertainty through research. Invited short article for General Medical Council`s website stimulating debate and contribution to a consultation about the review of Good Medical Practice
  4. Baum M, Vaidya J, Goetzsche P, Jorgensen KJ, Thornton H, Bewley S. Exposing the fallacy of breast cancer screening. The Sunday Times, page 26, 30th July 2011
  5. Evans I, Thornton H, Chalmers I, Glasziou P. Testing treatments: better research for better healthcare – Second Edition. Pinter and Martin, London. 2011. ISBN 978-1-905177-48-6
  1. Baum M, Thornton H, Goetzsche P. Breast cancer awareness month. Still awaiting screening facts. BMJ 2010;341:c6152
  2. Thornton H. Shared decision making: personal, professional and political. International Journal of Surgery. 2010. In press, November 2010.
  3. Invited Editorial: Communicating to citizens the benefits, harms and risks of preventive interventions. Journal of Epidemiology and Community Health, (2010) 64;2:101-102  DOI number: 10.1136/jech.2009.090829

  4. Helen Saul: Hazel Thornton PODIUM: `The tide is turning` in the breast screening debate. European Journal of Cancer 46(2010)261-265 February 2010

  5. Editorial: Case Reports: “Explaining the phenomena of clinical experience” “A cornerstone of medical progress” International Journal of Surgery. 8 (2010) 333-335.


  1. Editorial: Communicating the benefits, harms and risks of medical interventions: in journals; to patients and public. International Journal of Surgery, 2009; 7:1:3-6
  2. Baum M, McCartney M, Thornton H. et al. Breast cancer screening peril. Negative consequences of the breast screening programme . The Times 19th February 2009. http://www.timesonline.co.uk/tol/comment/letters/article5761650.ece?print=yes&randnum
  3. Editorial: The `truth` about mammography screening? Nearing the end of a long and arduous Damascus Road. International Journal of Surgery. 2009; 7:177-179 http://dx.doi.org/10.1016/j.ijsu.2009.04.006
  4. Editorial: Statistical illiteracy is damaging our health. Doctors and patients need to understand numbers if meaningful dialogues are to occur. International Journal of Surgery. 2009; 7:279-284

  5. Editorial: Imogen Evans, Hazel Thornton. Transparency in numbers. The dangers of statistical illiteracy. Journal of the Royal Society of Medicine. 2009; 102(9):354-356; doi101258/jrsm.2009.090214.

  6. Paper: What research means to patients, and the importance of partnership with practitioners in research. Journal of Radiotherapy Practice. Special Issue. (2009) 8:02:79-85

  7. Comment on editorial: The UK Biobank Project: trust and altruism are alive and well. A model for achieving public support for research using personal data.  International Journal of Surgery, 7(2009) 501-502;


  1. Thornton, H. (in press) Clinical trials - a brave new partnership: a new doctor-patient working relationship in research. International Journal of Surgery 6(4):289-292.
  2. Thornton, H. Patient and public involvement in clinical trials - Is established worldwide, but encouragement is needed to promote institutional collaboration and to avoid duplication of effort. BMJ 336(7650):903-904
  3. Edwards, A. Gray, J. Clarke, A. Dundon, J. Elwyn, G. Gaff, C. Hood, K. Iredale, R. Sivell, S. Shaw, C. and Thornton, H. Interventions to improve risk communications in clinical genetics: Systematic review. Patient Education and Counseling 71(1):4-25

  4. Sivell S, Elwyn G, Gaff C, Clarke A, Iredale R, Shaw C, Dundon J, Thornton H, Edwards A. How risk is perceived, constructed and interpreted by clients in clinical genetics, and the effects on decision making: systematic review. Journal of Genetic Counselling 17(1): 31-63

  5. Thornton, H. An end user perspective of screening mammography. Mammology 3(1):12-19


  1. Thornton, H. Reporting quality - The weakest link? International Journal of Surgery 5(6): 374-375
  2. Gaff, C.L. Clarke, A. J. Atkinson, P. Sivell, S. Elwyn, G. Iredale, R. Thornton, H. Dundon, J. Shaw, C. Edwards, A. Process and outcome in communication of genetic information within families: a systematic review. European Journal of Human Genetics 15:999-1011
  3. Thornton, H. Patient decisions about management of the axilla. Mammology 3(1): 43-46


  1. Book Chapter: Informed consent. In: Early Breast Cancer, from screening to multidisciplinary management. (Second Edition). Edited by G. Querci della Rovere, R. Warren and John R.Benson. Publishers Taylor & Francis Medical Books.(2006)
  2. Book: Imogen Evans, Hazel Thornton, Iain Chalmers. Testing Treatments – better research for better healthcare.  The British Library, 2006. ISBN 0-7123-4909-X
  3. Paper: Patients and health professionals working together to improve clinical research: where are we going? European Journal of Cancer. 2006; 42:2454-2458, plus Appendix A. online at doi:10.1016/j.ejca.2006.05.022
  4. Editorial: Should obese patients be denied knee surgery? A patient perspective: Maintenance of the machine – measurement and values. International Journal of Surgery. 2006; Vol.4; Issue 3; 150-152
  5. Good doctors: safer patients – the Chief Medical Officer`s prescription for regulating doctors. Co-authored with Mr. G.Querci della Rovere and Dr. Margaret McCartney. Journal of the Royal Society of Medicine. 2006. 99:545
  6. Open letter: Mr. G.Querci della Rovere and Dr. Margaret McCartney, Hazel Thornton, plus 15 other signatories and 958 doctors and patients. The Times.   “New check ups of doctors” 17th October 2006
  7. Patient decisions about management of the axilla. Mammology 2007; 3:1:43-46
  8. Balancing perspectives on the sentinel node. The Breast. (2007) 16: 7-8
  9. Editorial: Publish, or not publish? More regulation or better motivation? The enemy is apathy. International Journal of Surgery. 2006; Volume 5, Issue 1:1-2  Doi: 10.1016/j.ijsu.2006.07.010


  1. Letter: Reduction in mortality from breast cancer: Presentation of benefits and harms needs to be balanced. Peter C. Goetzsche, Karsten J. Jorgensen, Hazel Thornton. BMJ 2005; 330:1024
  2. Book chapter (pp.62-66): Identifying patients` and clinicians` priorities in cancer clinical trials. In: Delivering Quality in the NHS 2005.  Eds: Professor Michael Rawlins & Professor Peter Littlejohns. 2005 National Institute for Health and Clinical Excellence. Radcliffe Publishing Ltd. Oxford. (2005)
  3. Hazel Thornton, Michael Baum. Single anecdote versus a mountain of data: tamoxifen and the singing voice. HealthWatch Newsletter 59. October 2005
  4. Editorial: Hazel Thornton. Viewing the pyramid – through a glass, darkly? International Journal of Surgery, 2005 Vol 3/ 4 pp.240-242
  5. Letter: Adjuvant trastuzumab for breast cancer. Advent of pharmacogenetics raises many issues. BMJ (2005) 331:1202


  1. Author as Steering Group Member in: Edwards A, Elwyn G, Hood K, Atwell C, Robling M, Houston H, Kinnersley P, Russell I and the Study Steering Group. Patient-based outcome results from a cluster randomised trial of shared decision making skill development and use of risk communication aids in general practice. Family Practice 2004; 21(4):347-54.
  2. Author as Steering Group Member in: Elwyn G, Edwards A, Hood K, Robling M, Atwell C, Russell I, Wensing M, Grol R and the Study Steering Group. Achieving involvement: process outcomes from a cluster randomised controlled trial of shared decision making skill development and use of risk communication aids in general practice. Family Practice 2004; 21(4):337-46.
  3. Paper: The ethics of trial recruitment: The ethical implications of the PROCESS of identifying, capturing and obtaining consent for trial participation from women diagnosed with screen-detected DCIS in the NHS Breast Screening Programme. CERES NEWS Issue 34, Winter 2003/4. February 2004.
  4. `Comment` page: A right to know. Chemistry and Industry. 2004. 6:15
  5. Paper: “The informed patient”.  Journal of Royal College of Physicians of Edinburgh. 2004; 34:124-129.


  1. Paper: “Mammographic screening: give us the facts.” Journal of the Royal Society of Medicine. 2003; 96:409-410
  2. Paper: Hazel Thornton, Adrian Edwards, Michael Baum: “Women need better information about routine mammography.” BMJ 2003. 327:101-3.
  3. `Viewpoint` Paper, co-authored with Dr. Adrian Edwards and Professor Glyn Elwyn. “Evolving the multiple rôles of `patients` in healthcare research: reflections after involvement in a trial of shared decision-making.” Health Expectations, 2003; 6:3:189-197
  4. Paper: Burnet K, (lead) Benson J, Earl H, Thornton H, Cox K,  Purushotham AD. A survey of breast cancer patients` views on entry into several clinical studies. European Journal of Cancer Care.  2003. (Engl). 2004 Mar;13 (1):32-5.
  5. Book review for the Journal of the Royal Society of Medicine on “The Breast Cancer Wars. Fear, Hope and the Pursuit of a Cure in Twentieth Century America” by Barron H. Lerner MD. Oxford University Press – paperback, 2003. 96:10; 516.
  6. Paper: Women should receive better quality information about breast screening. GP. 6th October 2003. Clinical section, page 67.
  7. Editorial: Patients` understanding of risk: understanding must not lead to manipulation. BMJ 2003; 327:693-4


  1. Joint letter with Dr. Mary Dixon-Woods. Recruitment of women into trials.  Lancet 12th January 2002. 359:164
  2. Book Review: “The Breast Cancer Wars” by Barron H. Lerner M.D. Oxford University Press 2001.  Oncoserve Online (European Journal of Cancer) Accessed 23rd January 2002. http://www.oncoserve.com/oncoserve/show/Products/ONCOSERVE/bookreviews.htt
  3. Paper: “Patient perspectives on involvement in cancer research in the UK”. European Journal of Cancer Care. (2002) Volume 11, Issue 3, 205-209.. Also published in HSRC (Health Services Research Collaboration Report,  July 2002. pp. 85-93.
  4. Editorial: Hazel Thornton, Mary Dixon-Woods: Prostate specific antigen testing for prostate cancer: new approaches to risk management. BMJ 2002; 325:725-6
  5. Letter. Questions about anastrozole for early breast cancer.  Lancet. (2002) 360:1890. Published together with `author`s reply` by Michael Baum on behalf of the ATAC Steering Committee.
  6. Editorial. Robert K. McKinley, Mary Dixon-Woods, Hazel Thornton. Participating in primary care research. British Journal of General Practice.  2002. 52:485. 971-2.


  1. Paper: Information and Involvement. Health Expectations. (2001) Vol.4 Issue 1. 71-74.
  2. Letter: Consequences of breast screening. Lancet. 2000; 356:1033
  3. Joint paper:  Clinical Trials in Cancer: What Makes for a Successful Study? Jeffrey Tobias, Michael Baum, Hazel Thornton.  Annals of Oncology. (2000) 11:1371-1373
  4. Book chapter: “ “Empowering” patient choice about participation in trials?” in Clinical Trials: into the new millennium Ed. Lelia Duley and Barbara Farrell BMJ Books. (2002)
  5. Invited joint paper: Michael Baum, Hazel Thornton: “Women`s Advocacy Groups and Research in Breast Cancer” (2001) The Breast. Vol.10 (Supplement 3) 19-22
  6. Paper: `Pairing accountability with responsibility – the consequences of screening   `promotion`.` In Medical Science Monitor.  2001; 7(3): 531-533
  7. Lees N, Dixon-Woods M, Young B, Heney D, Thornton H CaTLET: Evaluation of information leaflets for patients entering cancer trials. . PSYCHO-ONCOL 10 (3): 266-266 MAY-JUN 2001
  8. “Pilgrim`s Progress”. My experiences in connection with what has happened to the role of consumers since the beginning of my involvement. Newsletter of the Instituto Italiano di Cultura. (2001) December 2001.
  9. Joint paper: Consumers` views of quality in the consultation and their relevance to `shared decision-making` approaches. A. Edwards, G. Elwyn,  C.Smith, S. Williams and H. Thornton. Health Expectations Volume 4 No. 3.  September 2001.
  10. An Open Letter to the Chief Medical Officer: Mammographic Screening (Copy to the British Medical Journal). (4.11.01) Co-author with Professor Michael Baum.