Burden Of Disease&cost Effectiveness Of Intervention Options:informing Policy Choices & Health System Reform In Thailand
Funder
National Health and Medical Research Council
Funding Amount
$787,978.00
Summary
This research project aims to improve the scientific basis for health services provision in Thailand by filling important gaps in knowledge about the causes of disease and the possibility of effectively intervening to reduce them. Since the accuracy of the routine death registration system in Thailand is unknown, it cannot be confidently used to guide policy. The team will evaluate how accurately causes of death are being recorded, both in urban and rural areas. It will also calculate how much d ....This research project aims to improve the scientific basis for health services provision in Thailand by filling important gaps in knowledge about the causes of disease and the possibility of effectively intervening to reduce them. Since the accuracy of the routine death registration system in Thailand is unknown, it cannot be confidently used to guide policy. The team will evaluate how accurately causes of death are being recorded, both in urban and rural areas. It will also calculate how much disease and injury in Thailand is being caused by major risk factors, such as tobacco and unsafe sex. Using this information the team will evaluate the effectiveness of the major interventions to reduces diseases and injuries from risk factors that are affordable and applicable in the Thai context.Read moreRead less
Improving Research Evidence Quality Using Individual Patient Data, Prospective Meta-analysis And Trial Registration
Funder
National Health and Medical Research Council
Funding Amount
$387,489.00
Summary
The quality of evidence we use to make health care decisions can be improved if we use systematic reviews that are planned ahead, that use raw data from each participant and include all the trials that have looked at the clinical problem. This research program will utilise these three ways of obtaining better quality data and will thus make research results more reliable. In particular, we will use these techniques to address health problems in mothers and babies.
Why Do Some Breast Cancers Present At An Advanced Stage In Women In Australia?
Funder
National Health and Medical Research Council
Funding Amount
$682,950.00
Summary
Each year since 1994, some 10,000 Australian women have been diagnosed with breast cancer and 2,500 have died from it; these deaths have led to loss of some 31,000 years of life before 75 years of age. There is no effective way to prevent breast cancer in most women at risk of it, the only possible intervention is early detection and treatment to reduce the impact of being diagnosed with the disease. The smaller the cancer at treatment, the better the outcome. The national mammographic screening ....Each year since 1994, some 10,000 Australian women have been diagnosed with breast cancer and 2,500 have died from it; these deaths have led to loss of some 31,000 years of life before 75 years of age. There is no effective way to prevent breast cancer in most women at risk of it, the only possible intervention is early detection and treatment to reduce the impact of being diagnosed with the disease. The smaller the cancer at treatment, the better the outcome. The national mammographic screening program, BreastScreen Australia, began in 1991. We expect that screening, through early detection, would reduce the numbers of women who die of breast cancer. Death rates from breast cancer have been falling in Australia since 1994. Despite this program, however, rates of larger breast cancers, more likely to have spread beyond the breast, are not falling. In 1997-98, the woman or her doctor detected nearly half of all breast cancers diagnosed outside of screening by detecting a change in the breast. Given that screening can detect cancers when they are small and that women themselves are also able to detect symptoms that may be small breast cancers and seek medical advice, we must ask why so many cancers are not diagnosed and treated until they are 2cm or larger and threaten life. This project aims to examine reasons in three broad areas: the woman herself, the cancer, and the wider health system, including the medical practitioner to whom symptoms or signs are first presented. Our study aims to understand the factors that contribute the most to the occurrence of larger breast cancers so that public health campaigns can be designed to increase the numbers detected at an early stage.Read moreRead less
ENDOPHTHALMITIS IN WESTERN AUSTRALIA (1980-2002): INCIDENCE, MANAGEMENT AND EFFECTIVENESS OF CHEMOPROPHYLAXIS
Funder
National Health and Medical Research Council
Funding Amount
$348,942.00
Summary
Endophthalmitis is a serious sight threatening infection of the internal cavities of the eye. Although endophthalmitis is not a common post-operative complication of eye surgery, 200 cases of this serious sight threatening infection occur each year in Australia following cataract surgery. Not only is this condition extremely distressing to the patients and surgeons alike, around A$4 million per year is spent each year treating the infection. Also, there is significant expenditure on methods to p ....Endophthalmitis is a serious sight threatening infection of the internal cavities of the eye. Although endophthalmitis is not a common post-operative complication of eye surgery, 200 cases of this serious sight threatening infection occur each year in Australia following cataract surgery. Not only is this condition extremely distressing to the patients and surgeons alike, around A$4 million per year is spent each year treating the infection. Also, there is significant expenditure on methods to prevent the infection that have not, as yet, been demonstrated beneficial. Our study will use a multidisciplinary team consisting of consultant ophthalmologists, public health researchers, a biostatistician and health economist to assess the impact of endophthalmitis in WA from 1980-2002 (around 480 cases). The population-based WA Linked Database provides a unique opportunity to produce what will be the largest population study of endophthalmitis. Data from the study will provide important information to develop best-practice treatment guidelines to prevent endophthalmitis following cataract surgery. The significance of this study will be that accurate information on the clinical epidemiology and true cost of endophthalmitis will be obtained for WA. By studying the records of patients with endophthalmitis and comparing them with matched patients, who did not have post-operative endophthalmitis following cataract surgery, we will characterise the risks for this severe complication by identifying the underlying factors that are responsible for the infection. We will also better understand the effect of methods used to prevent the infection. The use of a whole population-based study to assess methods of endophthalmitis prevention has not been done before and will have a significant beneficial impact on health policy and best-practice, not only in Australia, but also internationally.Read moreRead less
Determinants Of Area-level Inequalities In Colorectal Cancer Survival: A Multilevel Study
Funder
National Health and Medical Research Council
Funding Amount
$387,191.00
Summary
Survival times for people diagnosed with colorectal cancer depend on where people live; typically lower in rural and socio-economically disadvantaged areas. However we know very little about why these inequalities exist. This study, the first of its type in Australia, examines how much of the survival inequalities are due to the characteristics of individuals, and how much is due to the characteristics of the area itself. This will increase our capacity to intervene to reduce these inequalities
Genes And Environment In Late AMD: Pooling A State And Population Resource
Funder
National Health and Medical Research Council
Funding Amount
$701,642.00
Summary
This study will pool cases from the West Australian Macular Degeneration database with the Blue Mountains Eye Study (NSW), to investigate the interplay of genes and environmental factors on risk of age-related macular degeneration (AMD), in particular the late, vision threatening stage. It will provide insights into the underlying causes of AMD, and could allow us to target people with AMD susceptibility genes for preventive approaches, which could reduce the burden of this disease.
Maternal Health After Childbirth: A Prospective Cohort Study Of 1900 Nulliparous Women Recruited In Early Pregnancy
Funder
National Health and Medical Research Council
Funding Amount
$697,150.00
Summary
Recent research highlights a concerning burden of ill health in recent mothers. Common health problems in the year after birth are chronic exhaustion, persisting pain, urinary incontinence, bowel problems, sexual problems and depression. This study will investigate the incidence, onset, severity and duration of health problems in the first 18 months after childbirth. A major focus of the study will be on the extent to which common health problems affecting women after childbirth occur as new pro ....Recent research highlights a concerning burden of ill health in recent mothers. Common health problems in the year after birth are chronic exhaustion, persisting pain, urinary incontinence, bowel problems, sexual problems and depression. This study will investigate the incidence, onset, severity and duration of health problems in the first 18 months after childbirth. A major focus of the study will be on the extent to which common health problems affecting women after childbirth occur as new problems in pregnancy, or after childbirth. This involves following women having a first child and measuring their health in pregnancy and the first year after birth. 1900 women having a first birth will be recruited to the study in early pregnancy, and followed up until 18 months after the birth. A major aim of the study is to provide stronger evidence about the role of pregnancy and birth factors in physical health problems after birth. In particular, the study will examine the contribution of method of delivery to pelvic floor disorders (urinary and anal incontinence, perineal pain and sexual problems). The study will also examine reasons why many women choose not to discuss physical and emotional health problems with health professionals in the postnatal period. The influence of cultural, social and economic factors on health service use and disclosure of maternal health problems will be explored. The study will provide the first Australian data on new health problems experienced for the first time after childbirth, and the extent to which pregnancy, labour and birth contribute to subsequent ill-health. The findings will provide stronger evidence on which to base the care of women during childbirth,development and evaluation of primary and secondary prevention strategies, and information to women and their families regarding the risks of obstetric procedures, such as caesarean section and vaginal birth assisted with forceps.Read moreRead less