Prospective Evaluation Of A Model To Predict Outcomes Following Endovascular Aortic Aneurysm Repair
Funder
National Health and Medical Research Council
Funding Amount
$1,098,901.00
Summary
Once present, abdominal aortic aneurysms tend to enlarge over time resulting in an increased risk of death if they rupture. Endovascular aneurysm repair may be used to fix the aneurysm but this procedure can result in complications over time. We developed a model that uses pre-operative information to predict the chance of an individual having poor results.This study aims to assess whether the model is a good predictor of outcomes and whether extra information will improve its accuracy.
Ablative Therapies For Barrett's Oesophagus - Evaluation Of New Clinical And Experimental Therapies
Funder
National Health and Medical Research Council
Funding Amount
$302,310.00
Summary
Barrett's oesophagus arises when repeated episodes of gastro-oesophageal reflux lead to the oesophageal lining undergoing change to a lining more like that of the intestine. This new lining predisposes to cancer, a problem which is rapidly becoming more common. Recent research has focused on techniques which could reverse this process. Destruction (ablation) of Barrett s oesophagus can be followed by regeneration with a normal looking lining. A range of techniques have been used for this. Howeve ....Barrett's oesophagus arises when repeated episodes of gastro-oesophageal reflux lead to the oesophageal lining undergoing change to a lining more like that of the intestine. This new lining predisposes to cancer, a problem which is rapidly becoming more common. Recent research has focused on techniques which could reverse this process. Destruction (ablation) of Barrett s oesophagus can be followed by regeneration with a normal looking lining. A range of techniques have been used for this. However, the behavior of the regenerated lining is unknown, and there still remains potential for cancer. We are currently evaluating endoscopic ablation using Argon Plasma Coagulation within clinical trials. There is also scope for the development of better approaches to ablation. We hypothesize that an suitable liquid has the potential to more evenly and more easily ablate the lining. Delivery of a liquid substance to lower oesophagus can be achieved through a tube which confines liquid to the lower oesophagus. However, to make this approach acceptable it is necessary to determine the best treatment agent, and to test the delivery system. We will first do this using animal models, before future application in patients. A further key issue is whether the cells which repopulate the oesophagus are genetically normal or abnormal. After ablation it is likely that the cells which repopulate the lining are sourced from the same cells which were the source of the abnormal lining, and these cells could inherit genetic alterations. This could increase the risk of cancer. Hence, we plan to assess certain genes in biopsies taken from tissue before and after ablation to determine genetic normality. In Australia endoscopic ablative techniques are currently being introduced into clinical practice without evaluation. Hence the question of whether ablation actually reduces the risk of cancer and how to best perform ablation should be addressed before clinical application becomes widespread.Read moreRead less
The Quality Of Surgical Care Project: Quality Assurance, Clinical Audit And Outcomes Evaluation In Western Australia
Funder
National Health and Medical Research Council
Funding Amount
$346,018.00
Summary
The Quality of Surgical Care Project (QSCP) is a unique quality assurance program in Australia which promotes best practice in surgical and procedural care. The objectives of the QSCP are to evaluate the outcomes of surgical procedures in Western Australia (WA) and to compare them with international standards. The QSCP was established in 1996, as a collaborative venture among the Royal Australasian College of Surgeons (RACS), the Department of Public Health, (UWA) and the Health Department of WA ....The Quality of Surgical Care Project (QSCP) is a unique quality assurance program in Australia which promotes best practice in surgical and procedural care. The objectives of the QSCP are to evaluate the outcomes of surgical procedures in Western Australia (WA) and to compare them with international standards. The QSCP was established in 1996, as a collaborative venture among the Royal Australasian College of Surgeons (RACS), the Department of Public Health, (UWA) and the Health Department of WA. The QSCP is only possible because of the unique population-based record linkage available in this state and is consistent with priorities identified in the National Health Information Development Plan in the areas of record linkage and health outcomes, as well as with the monitoring of interventions recommended by the Taskforce on Quality in Australian Health Care. The surgical procedures reviewed are selected to include a broad range of surgical specialties on the basis of national priority, in consultation with the RACS and with input from the Australian Safety and Efficacy Register of New Interventional Procedures-Surgical (ASERNIP-S). This application proposes to continue the core program in promoting best practice in procedural care by reviewing selected procedures including the outcomes of laparoscopic and endoscopic procedures, and endoluminal stenting surgery due to their rapid proliferation during the 1990's. This second stage of the QSCP proposes the introduction of two new quality assurance themes. Firstly, to promote the clinical safety and post-implementation surveillance of new surgical interventions and other medical technology by establishing the WA Registry and Surgical Audit of New Surgical Interventions. Secondly, to comprehensively and independently audit all surgical mortality at a population level. A dissemination strategy will be established to 'complete the loop' in the evaluation and audit processes.Read moreRead less