New Evidence To Guide Decisions About The Prevention And Treatment Of Common Cardiovascular Diseases.
Funder
National Health and Medical Research Council
Funding Amount
$7,309,675.00
Summary
The Program brings together clinicians, epidemiologists and statisticians in a unique endeavour designed to improve the prevention and treatment of heart attack and stroke. For the foreseeable future, these conditions will remain leading causes of death and disease in Australia and most other countries in the region. While there are many established treatment and prevention strategies for these conditions there remains great potential for further advances to be made, which might avert very large ....The Program brings together clinicians, epidemiologists and statisticians in a unique endeavour designed to improve the prevention and treatment of heart attack and stroke. For the foreseeable future, these conditions will remain leading causes of death and disease in Australia and most other countries in the region. While there are many established treatment and prevention strategies for these conditions there remains great potential for further advances to be made, which might avert very large numbers of premature deaths and serious disabling outcomes. This Program of research seeks to provide new information that will give patients, doctors and policy makers innovative options for the treatment and prevention of heart attack and stroke. The Program will incorporate two main elements: observational studies and randomised controlled trials. The observational studies will establish the precise importance of each of the main causes of cardiovascular diseases (such as diabetes, blood pressure, smoking and cholesterol) at different ages, in different ethnic groups and in different geographic regions. Furthermore, these studies will also define the relative importance of established and novel risk factors for cardiovascular disease, providing important new information about how resources for prevention should be directed. The large-scale trials will provide evidence about the effectiveness and safety of a range of new cardiovascular disease prevention and treatment strategies. The work will build on the team�s very successful approach of evaluating the effects of established interventions in high-risk groups for whom those particular treatments are not currently indicated.The Program will also include studies that address the critical issue of translating health research findings into practice _ in terms of health policy, clinical practice and consumer behaviour. A particular focus involves the application and evaluation of novel Internet technologies for promoting best practice. The methodologies used by the team will ensure that the evidence generated by the Program is as precise and reliable as possible, in order to provide a sound base to guide decisions about changes in health care policy and practice. The research findings will have direct relevance to the healthcare needs of millions of Australians within the next five years, and the impact of the work will be assured by the development of implementation and dissemination plans for each major component of the Program.Read moreRead less
Practical Tools For Robust Analysis Of Large Epidemiological Studies With Incomplete Data
Funder
National Health and Medical Research Council
Funding Amount
$358,492.00
Summary
Studies of the causes and consequences of health outcomes follow large cohorts of individuals for long time periods. A major challenge in analysing data from these studies is that information is often incomplete. Participants rarely complete all waves of data collection, or provide all requested information. Statistical research has led to increased use of a statistical method (multiple imputation) that recovers information from incomplete cases. This project will develop and improve this method
Characterisation Of A New Localisation For Susceptibility To Inflammatory Bowel Disease On Chromosome 12
Funder
National Health and Medical Research Council
Funding Amount
$76,125.00
Summary
One of the greatest challenges facing contemporary gastroenterology is to understand the causes of the inflammatory bowel diseases in order to develop more effective therapies. Although there have been advances in treatment over the last few years, the causes of IBD are still not known. The existence of a genetic predisposition to IBD is now well established, and there is strong evidence that the disease is the result of the interaction of a number of different genes. To date, two genetic locali ....One of the greatest challenges facing contemporary gastroenterology is to understand the causes of the inflammatory bowel diseases in order to develop more effective therapies. Although there have been advances in treatment over the last few years, the causes of IBD are still not known. The existence of a genetic predisposition to IBD is now well established, and there is strong evidence that the disease is the result of the interaction of a number of different genes. To date, two genetic localisations (one on chromosome 16 and a second on chromosome 12) have been confirmed in multicentre studies. We have identified a novel localisation for disease susceptibility on chromosome 12 in the Australian population during the course of a genome scan on 73 multiplex inflammatory bowel disease families. (The importance of this localisation has been confirmed in English and American families.) This localisation is quite separate from that originally described and many genes separate the two localisations. We will refine the new localisation by fine scale mapping in the region of the localisation that we originally identified in pure Crohn's disease families. At this stage, the localisation appears not to be important in families suffering from ulcerative colitis or in families in which both CD and UC occurs (known as mixed families), though this finding will be tested. Using state of the art molecular genetics, we will then identify and characterise the gene involved. The significance of this project lies in the importance of this localisation to the understanding of underlying biochemistry and genetics of a complex disease in which multiple genes are segregating and interacting in, some as yet undefined manner.Read moreRead less
Measuring The Productive Efficiency Of Hospitals - A Comparison Of Parametric And Non-parametric Approaches
Funder
National Health and Medical Research Council
Funding Amount
$61,815.00
Summary
In the face of rising health service costs, an ageing population, and falling private health insurance rates, the efficient use of scarce health service resources has become a central theme in health system reform. Productive (or technical) efficiency is a key aspect of health system reform - that given health services are produced with the minimum feasible amount of resources. Despite the importance of technical efficiency there have been few published studies in Australia which measure technic ....In the face of rising health service costs, an ageing population, and falling private health insurance rates, the efficient use of scarce health service resources has become a central theme in health system reform. Productive (or technical) efficiency is a key aspect of health system reform - that given health services are produced with the minimum feasible amount of resources. Despite the importance of technical efficiency there have been few published studies in Australia which measure technical efficiency in the health sector. This study will develop theoretical and empirical approaches to measuring technical efficiency in the production of hospital services using data from Victoria. Measures of hospital technical efficiency will be developed using two quantitative modelling approaches: stochastic frontier modelling and data envelopment analysis. Results will be used to investigate the impact of patient and hospital characteristics on efficiency, and to identify economies of scale and scope in the provision of hospital services. The robustness of results to changes in variables, the sample of hospitals studied, and model assumptions will be tested, and two techniques will be compared to assess their appropriateness in the health services context which has not previously been done. Criteria for assessing the approaches include the degree to which: assumptions affect the robustness of results; the techniques capture the salient features of health services production; and the techniques produce similar rankings and estimates of inefficiency. The methods used will represent a significant contribution to international knowledge of hospital efficiency measurement, and the relationships between hospital characteristics, casemix, and efficiency. The study wil provide improved measures of hospital efficiency in Victoria, and will inform debate on hospital funding policy.Read moreRead less