Developing A Skin Test For Early Diagnosis Of Alzheimer's Disease And For Monitoring Effectiveness Of Treatment
Funder
National Health and Medical Research Council
Funding Amount
$285,000.00
Summary
Approximately 140,000 Australians suffer from Alzheimer's disease (AD). As the ageing population continues to grow, this number will double by the middle of the next century unless a cure or prevention is found. Scientists are continuously seeking new, more effective diagnostic tests in an effort to make it easier to diagnose AD in its early stages. Being able to recognize symptoms early and obtain an accurate diagnosis would give affected individuals a greater chance of benefiting from putative ....Approximately 140,000 Australians suffer from Alzheimer's disease (AD). As the ageing population continues to grow, this number will double by the middle of the next century unless a cure or prevention is found. Scientists are continuously seeking new, more effective diagnostic tests in an effort to make it easier to diagnose AD in its early stages. Being able to recognize symptoms early and obtain an accurate diagnosis would give affected individuals a greater chance of benefiting from putative treatments. However, there is no single, comprehensive diagnostic test for AD. Diagnostic tests (including peripheral markers) that can help to reliably diagnose AD at an early stage are needed as are tests that can help in monitoring the progression of AD, including response to therapy. The accuracy and clinical utility of previously proposed peripheral markers (platelets and pupil dilation test) is questionable. The only way to confirm a diagnosis of AD is through autopsy. We have obtained a provisional patent application for the use of a skin test for early diagnosis of AD (Patent No: PQ2881-99). This test is based on our extensive research over the past decade to understand the biochemical mechanisms underlying the txic vascular actions of beta amyloid protein. This protein has been implicated in the pathology of AD and it accumulates in the brain, peripheral tissues and is present in circulating blood of AD patients. The test is based on our discovery that vascular effects of Ab could be detected in the peripheral microcirculation .We now wish to further examine the utility of this novel skin test. If the test is sensitive, it could be used for screening; if it is specific it would be useful for confirmation of suspected AD. If the test is sensitive to change in clinical status it would help select treatments that might cure or improve the symptoms of AD.Read moreRead less
As a researcher in evidence-based medicine Prof Glasziou is principally concerned with developing a greater understanding among clinicians and researchers of the causes of, and solutions to, gaps between research evidence and the application of this research to practice. Specific research interests include:understanding the applicability of treatments;the effectiveness of diagnostic and disease monitoring processes; and the cognitive processes underpinning clinicians decisions to use or not use ....As a researcher in evidence-based medicine Prof Glasziou is principally concerned with developing a greater understanding among clinicians and researchers of the causes of, and solutions to, gaps between research evidence and the application of this research to practice. Specific research interests include:understanding the applicability of treatments;the effectiveness of diagnostic and disease monitoring processes; and the cognitive processes underpinning clinicians decisions to use or not use specific treatmentsRead moreRead less
A Trial Of Surgery Versus Surgery Plus Adjuvant Radiotherapy In Patients With Resected Nodal Metastatic Melanoma.
Funder
National Health and Medical Research Council
Funding Amount
$305,000.00
Summary
Skin cancer is extremely common in Australia but usually presents early and is highly curable. Malignant melanoma is the third commonest skin cancer, however is the most lethal. When melanoma spreads away from its primary site on the skin it most frequently presents as a lump in the regional node basin (lymph node metastases). The region containing malignant lymph nodes (or glands) is dependent on where the primary melanoma occurred on the skin. Thus a primary melanoma on the arm or chest would ....Skin cancer is extremely common in Australia but usually presents early and is highly curable. Malignant melanoma is the third commonest skin cancer, however is the most lethal. When melanoma spreads away from its primary site on the skin it most frequently presents as a lump in the regional node basin (lymph node metastases). The region containing malignant lymph nodes (or glands) is dependent on where the primary melanoma occurred on the skin. Thus a primary melanoma on the arm or chest would be expected to spread to nodes in the axilla (armpit) or on the leg to the groin, or on the face to the neck. The standard treatment is surgery (lymphadenectomy, therapeutic lymph node dissection) to remove the malignant nodes, and is usually very effective treatment. However some patients suffer recurrence of the melanoma in the region of the lymph node surgery which can become difficult to control. Early radiotherapy has been variably used soon after the lymph node surgery (called adjuvant radiotherapy as all the known cancer has been removed by surgery) to try and reduce the risk of the melanoma regrowing in the region of the surgically removed (completely resected) nodes. This trial is designed to answer the question as to whether the addition of radiotherapy to the region of lymph node surgery does improve outcomes for patients with this diagnosis. These outcomes include potentially reducing the rate of recurrence of melanoma in the region of the lymph node surgery, finding out the difference in the frequency and severity of side effects for each of the treatments (surgery versus surgery plus radiotherapy) and as a result whether patients on the whole have any difference in their quality of life. The trial will also study what signs in the pathology specimen taken at the time of the operation might indicate when radiotherapy would be best employed. The trial aims to accrue 270 patients over 4 years from multiple centres around Australia and New Zealand.Read moreRead less
PROTEIN PROFILING FOR THE IDENTIFICATION AND MONITORING OF LYSOSOMAL STORAGE DISORDERS AND OTHER NEUROLOGICAL DISEASES
Funder
National Health and Medical Research Council
Funding Amount
$469,500.00
Summary
Lysosomal storage disorders (LSD) are a group of more than 45 progressive genetic diseases, that result from the absence or impaired function of a specific enzyme in each of the body's cells. Lysosomes rid the cell of excess waste. Impaired enzyme function halts this process and waste begins to accumulate (or 'store') in the cell. Disease severity and patient longevity is variable, but severely affected patients often die by their mid-teens. LSD can affect the skeleton and joints, respiratory an ....Lysosomal storage disorders (LSD) are a group of more than 45 progressive genetic diseases, that result from the absence or impaired function of a specific enzyme in each of the body's cells. Lysosomes rid the cell of excess waste. Impaired enzyme function halts this process and waste begins to accumulate (or 'store') in the cell. Disease severity and patient longevity is variable, but severely affected patients often die by their mid-teens. LSD can affect the skeleton and joints, respiratory and cardiovascular systems, the brain, the eyes, the ears and the airways. As affected children become older, symptoms worsen. Patients often require frequent hospitalisation, and medical and surgical intervention. Approximately 10 to 15% of the general population are affected or carriers of an LSD. In Australia, one LSD child is born in every 5,000 live births. Diagnosis often takes several years, and families often have other children before their affected child is diagnosed. LSD are, therefore, a considerable burden to not only the families but also to the health care system. The goal of the Lysosomal Diseases Research Unit is Diagnosis at birth and effective therapy for lysosomal storage disorders. To this end we have been working toward the development of a newborn screening program for LSD and improved methods for the diagnosis and monitoring of therapy in this group of diseases. In this project we propose to develop and evaluate the use of protein profiling (looking at many diagnostic markers at the same time) to achieve these goals. The technology developed in this project will have potential application beyond LSD. Lysosomal dysfunction has been implicated in Alzheimer's disease and Parkinson's disease; in addition lysosomal proteins are reported to be involved in the spread of some cancers and may be useful markers for early detection. We will collaborate with other research groups to further develop protein profiling in these areas.Read moreRead less
A SYSTEMS BIOLOGY APPROACH TO SCREENING, DIAGNOSIS AND PROGNOSIS FOR LYSOSOMAL STORAGE DISORDERS
Funder
National Health and Medical Research Council
Funding Amount
$900,781.00
Summary
Lysosomal storage disorders (LSD) are inherited and, at present, can only be detected in children after symptoms are obvious. We are developing newborn screening for LSD to detect affected babies before the onset of irreversible symptoms. As most LSD babies appear normal at birth it is important to be able to predict disease severity or rate of disease progression; this will help doctors know when to give therapy, which therapy is best and provide families with appropriate genetic counseling.
Improving Outcomes For People With Depression In Community Settings: A Cluster RCT
Funder
National Health and Medical Research Council
Funding Amount
$803,554.00
Summary
Depression affects 350 million people worldwide. Given the pivotal role of primary care in the management of depression, effective strategies are needed to assist GPs in the delivery of patient-centred depression care. This study will test the effectiveness of providing GPs with education; as well as feedback about patients’ self-reported depressive scores using a standardised instrument and perceived need and preferences for help. This cluster RCT will be the first Australian trial of its kind.
Therapeutic Treatment Pathways And Their Impact On Medicine Safety And Effectiveness
Funder
National Health and Medical Research Council
Funding Amount
$336,070.00
Summary
In clinical trials medicines are assumed to be used regularly with a set dose over the duration of the study. However, in real life medicines are used in different doses, over different durations and together with other medicines, which affect the effectiveness and safety of the treatment. The aim of this proposed research is to evaluate how different treatment pathways impact medicine safety and effectiveness. This project will provide new information on safety and effectiveness of treatment pa ....In clinical trials medicines are assumed to be used regularly with a set dose over the duration of the study. However, in real life medicines are used in different doses, over different durations and together with other medicines, which affect the effectiveness and safety of the treatment. The aim of this proposed research is to evaluate how different treatment pathways impact medicine safety and effectiveness. This project will provide new information on safety and effectiveness of treatment pathways.Read moreRead less
Comparing The Effectiveness Of Selective Laser Trabeculoplasty With Topical Medication For The Treatment Of Primary Angle Closure Glaucoma: A Multicentred, Prospective, Randomized Controlled Clinical Trial.
Funder
National Health and Medical Research Council
Funding Amount
$639,888.00
Summary
The main treatment of glaucoma, an eye condition which causes peripheral vision loss and blindness, involves the use of eye drops. However, these are expensive, have considerable side effects, and impact negatively on daily living. Laser has recently been proposed as an alternative treatment and, in this project, we will investigate the effectiveness of laser compared to medication. We anticipate laser will be more cost effective, safer, and have a positive impact on quality of life compared to ....The main treatment of glaucoma, an eye condition which causes peripheral vision loss and blindness, involves the use of eye drops. However, these are expensive, have considerable side effects, and impact negatively on daily living. Laser has recently been proposed as an alternative treatment and, in this project, we will investigate the effectiveness of laser compared to medication. We anticipate laser will be more cost effective, safer, and have a positive impact on quality of life compared to eye drops.Read moreRead less
Using Clinical And Economic Evidence To Infrom Local Decision Making In Cancer Care
Funder
National Health and Medical Research Council
Funding Amount
$1,836,745.00
Summary
Medicines used to treat cancer often come with a high price tag. Many countries, including Australia, are no longer able to provide free access to all medicines. For this reason, patients and their families, public hospitals and private health insurers are often asked to pay for these treatments. Currently, health professionals and patients are ill-equipped to make informed treatment choices, since both cost and efficacy must be considered. Our proposed research will address this important gap i ....Medicines used to treat cancer often come with a high price tag. Many countries, including Australia, are no longer able to provide free access to all medicines. For this reason, patients and their families, public hospitals and private health insurers are often asked to pay for these treatments. Currently, health professionals and patients are ill-equipped to make informed treatment choices, since both cost and efficacy must be considered. Our proposed research will address this important gap in current knowledge. We will use a unique web-based resource (Cancer Institute NSW Standard Cancer Treatment Program; CI-SCaT) to communicate the economic evidence needed to make informed decisions about cancer treatments. Our project will provide public access to information about the effectiveness and costs of cancer drugs. This is a world first. CI-SCaT is already the main vehicle of communication about cancer drug treatments in NSW and is widely used by cancer health professionals and patients to inform point-of-care decisions. Our project we will also identify the factors which influence the ability of cancer treatment centres to make best use of their drug budgets. By achieving this goal, we hope to demonstrate how to best use scarce resources for the benefit of all cancer patients.Read moreRead less
Evaluation Of A Financial Incentive To Improve The Use Of Preventive Medicines By People With Asthma
Funder
National Health and Medical Research Council
Funding Amount
$137,860.00
Summary
Rising costs are threatening the future viability of the Pharmaceutical Benefits Scheme. New approaches are needed to address this challenge, including developing financial incentives for consumers to use effective low cost medicines in preference to higher cost alternatives. This study will develop a consumer incentive for use of low cost asthma preventer medicines, model the economic effects of this and bring together stakeholders to examine the policy and practice changes needed to implement ....Rising costs are threatening the future viability of the Pharmaceutical Benefits Scheme. New approaches are needed to address this challenge, including developing financial incentives for consumers to use effective low cost medicines in preference to higher cost alternatives. This study will develop a consumer incentive for use of low cost asthma preventer medicines, model the economic effects of this and bring together stakeholders to examine the policy and practice changes needed to implement the incentive.Read moreRead less