Changing Decision-making Behaviour In General Practice By Providing Access To Online Evidence.
Funder
National Health and Medical Research Council
Funding Amount
$206,375.00
Summary
The case for a shift to evidence-based practice, and the substantial economic and health outcome benefits of that shift, have been repeatedly made. Despite the vision, significant barriers to evidence-based practice remain, and the demonstration of a positive role for on-line systems would result in a significant change in strategies for clinician behaviour change. This study will make a specific and significant contribution to our understanding of the efficacy and effectiveness of online eviden ....The case for a shift to evidence-based practice, and the substantial economic and health outcome benefits of that shift, have been repeatedly made. Despite the vision, significant barriers to evidence-based practice remain, and the demonstration of a positive role for on-line systems would result in a significant change in strategies for clinician behaviour change. This study will make a specific and significant contribution to our understanding of the efficacy and effectiveness of online evidence retrieval systems as a component in any evidence-based strategy, through a rigorous and controlled approach to the study of clinical behaviour change. It will also provide a powerful test of the value of search filters as a specific technology in support of evidence retrieval. The focus on prescribing patterns in NHMRC priority areas as an outcome measure will also provide a significant data set reflecting current practice in primary care.Read moreRead less
Reconceptualising Health Promotion: The Role Of Values, Ethics And Evidence In Obesity Intervention.
Funder
National Health and Medical Research Council
Funding Amount
$485,103.00
Summary
Obesity and overweight are public health priorities. Population-level programs, campaigns and regulations are required to prevent and reduce obesity. How should these interventions proceed? What is effective? What is ethical? How can we avoid doing harm? At present, we do not know. By studying current interventions in detail, and working with experts and practitioners in health promotion and ethics, this project will develop a new framework to guide overweight and obesity intervention in future.
Methods For Evaluating The Therapeutic Impact Of Diagnostic Tests - Development Of Guidelines
Funder
National Health and Medical Research Council
Funding Amount
$132,325.00
Summary
New diagnostic tests are frequently adopted in clinical practice without any evidence that they improve patient outcomes. This project will produce the first guidelines about the role and optimal design of studies assessing the impact of a new test on therapeutic decisions for conclusions about its clinical value. This work will inform researchers and clinicians to improve evidence-based diagnostic practice and promote the more efficient use of limited health care resources.
Efficacy And Cost-effectiveness Of Physiotherapy For Chronic Rotator Cuff Pathology
Funder
National Health and Medical Research Council
Funding Amount
$384,675.00
Summary
Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and accounting for 10% of all physiotherapy referrals. The painful shoulder affects up to 2-5% of the general population, being more common in middle to older age. One of the most common shoulder disorders is chronic rotator cuff pathology. This causes significant pain and disability that restricts activities of daily living as well as work, sleep and leisure. Forty per ....Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and accounting for 10% of all physiotherapy referrals. The painful shoulder affects up to 2-5% of the general population, being more common in middle to older age. One of the most common shoulder disorders is chronic rotator cuff pathology. This causes significant pain and disability that restricts activities of daily living as well as work, sleep and leisure. Forty percent of sufferers will continue to have symptoms beyond 3 years and 15% will have persistent disability which may require surgical intervention. Because this disorder is prevalent, it imposes a considerable burden on the Australian health care system. Physiotherapy is a common conservative treatment option but its efficacy has not been well established. A recent Cochrane review of the literature revealed several problems with many of the existing studies: (i) the populations have included a mix of shoulder diagnostic categories; (ii) the research designs have major flaws and (iii) a single physiotherapy modality has been evaluated rather than a combined program as is current clinical practice. Thus, this novel research project involving 200 participants will answer important questions about the efficacy of a physiotherapy program for chronic rotator cuff pathology and whether benefits can be maintained. In addition it will determine whether the costs of physiotherapy represent good value for money which is important in today's economic climate. The results of this project can be easily and immediately translated into clinical practice as recommendations can be made about the usefulness of physiotherapy for this patient population. The results will be of major benefit not just to the physiotherapy profession but to the medical profession who must justify patient referral to physiotherapy and to funding and compensable bodies.Read moreRead less
Efficacy Of Physiotherapy After Hydrodilatation For The Painful Stiff Shoulder: A Randomised Placebo-controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$269,020.00
Summary
Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and they account for 10% of all physiotherapy referrals. The stiff painful shoulder affects up to 2-5% of the general population, being more common in middle age and diabetes. It causes significant pain and disability that restricts activities of daily living as well as work and leisure. Forty percent of sufferers will continue to have symptoms and restricted movements ....Shoulder disorders are common, being third only to back and neck complaints as musculoskeletal reasons for medical consultation and they account for 10% of all physiotherapy referrals. The stiff painful shoulder affects up to 2-5% of the general population, being more common in middle age and diabetes. It causes significant pain and disability that restricts activities of daily living as well as work and leisure. Forty percent of sufferers will continue to have symptoms and restricted movements beyond 3 years and 15% will have persistent disability. Because this disease is prevalent, it imposes a considerable burden on the Australian health care system. Shoulder hydrodilatation is a common conservative treatment option that has been shown by our research group to have short-term but not long-term benefits. Physiotherapy may be prescribed following hydrodilatation on the basis that it may maintain the initial benefits seen with hydrodilatation. However, there are no studies to either support or refute this hypothesis. Thus, this novel research project will answer important questions about the efficacy of a physiotherapy program in addition to hydrodilatation for the stiff painful shoulder. We will determine whether physiotherapy offers a benefit over hydrodilatation alone and if so, whether this benefit is sustained. In addition we will determine whether the additional costs of physiotherapy represent good value for money. The results of this project can then be easily and immediately translated into clinical practice as recommendations can be made about the usefulness of physiotherapy for this patient population. The results will be of major benefit not just to the physiotherapy profession but to the medical profession who must justify patient referral to physiotherapy.Read moreRead less
A Randomised Controlled Trial Of Caseload Midwifery Care
Funder
National Health and Medical Research Council
Funding Amount
$761,311.00
Summary
There is concern about the rising levels of caesarean section in Australia and some evidence that women may benefit from caseload midwifery care. This randomised control trial will determine whether caseload midwifery care can reduce interventions and is as safe as usual hospital maternity care. A Cochrane systematic review of midwifery led care versus routine care was designed to answer these questions.This will be the first randomised controlled trial to contribute to this review
Increasing Appropriate Screening For Colorectal Cancer Patients And First Degree Relatives. A RCT.
Funder
National Health and Medical Research Council
Funding Amount
$1,372,866.00
Summary
Adoption of guideline recommendations is difficult to achieve. This research aims to improve adherence to guideline recommendations for surveillance for people with colorectal cancer and screening in their first degree relatives using an educational intervention. People with colorectal cancer and their first degree relatives will be randomly assigned to an educational intervention or to usual care, and adherence to guideline recommendations will be compared between groups.
Are Cardiac Conditions In Older Women Managed Appropriately?
Funder
National Health and Medical Research Council
Funding Amount
$289,492.00
Summary
Cardiac conditions, including heart attach, heart failure, angina and high blood pressure are very common among older Australians. They account for large proportions of deaths, morbidity and health care costs. For most of these conditions there are highly effective treatments, however there is evidence that these are not as well used as they should be. Also, for women, diagnosis may be delayed due to perceptions that heart disease is a problem mainly among men. The project is based on the Austra ....Cardiac conditions, including heart attach, heart failure, angina and high blood pressure are very common among older Australians. They account for large proportions of deaths, morbidity and health care costs. For most of these conditions there are highly effective treatments, however there is evidence that these are not as well used as they should be. Also, for women, diagnosis may be delayed due to perceptions that heart disease is a problem mainly among men. The project is based on the Australian Longitudinal Study on Women's Health which includes more than 10,000 women, over half living in rural and remote areas. Women with cardiac conditions will be surveyed about their medical care. This information, together with data they have provided over the last 6 years (and Medicare data if the women have given their consent), will be compared with best practice guidelines established by NHMRC and the Heart Foundation. In this way the project will examine the adequacy of medical care among older women in sufficient detail to make actionable recommendations to health authorities for where improvements are needed.Read moreRead less