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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.
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
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.
Multicentre Evaluation Of A Clinical Pathway For Chronic Cough In Children- Can Its Use Improve Clinical Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$971,362.00
Summary
Chronic cough is a common presenting symptom to doctors. It is associated with significant morbidity and may be a symptom of a serious underlying problem. This is especially pertinent to Aboriginal children. In this study we will examine the utility and efficacy of an evidence based clinical pathway for the management of chronic cough in Aboriginal and non-Aboriginal children. This study will contribute to clinical policy and improve clinical outcomes and early diagnosis of respiratory illnesses
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
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
CRCT Of A Multidisciplinary, Team Building Intervention To Manage Fever, Sugar And Swallowing (FeSS) In Acute Stroke
Funder
National Health and Medical Research Council
Funding Amount
$405,450.00
Summary
The latest acute stroke guidelines and recommendations from Ausralia's National Stroke Unit Program endorse a prompt and evidence-based treatment for fever, blood sugar and swallowing in acute stroke. This Clustered Randomised Control Trial (CRCT) will develop and rigorously evaluate a standardised, multidisciplinary team-building intervention for the management of fever, blood sugar and swallowing in patients following acute stroke. The intervention comprises: an evidence-based clinical treatme ....The latest acute stroke guidelines and recommendations from Ausralia's National Stroke Unit Program endorse a prompt and evidence-based treatment for fever, blood sugar and swallowing in acute stroke. This Clustered Randomised Control Trial (CRCT) will develop and rigorously evaluate a standardised, multidisciplinary team-building intervention for the management of fever, blood sugar and swallowing in patients following acute stroke. The intervention comprises: an evidence-based clinical treatment pathway (the FeSS Pathway) and facility-based support consisting of multidisciplinary, team building workshops, a standardised, interactive education program and engagement of local staff through support and feedback. Stroke Units allocated to the control group will receive only the FeSS Pathway with no facility-based support. Expected patient outcomes comprise decreased: disability on discharge, length of stay, 90-day disability, 90-day dependency, 90-day death and disability and higher 90-day health status for those patients allocated to receive care at intervention Stroke Units. Further, medical record audits will be undertaken to measure the integrity of the FeSS Pathway uptake. By conducting a CRCT, we will generate Level 2 evidence for the effectiveness of a standardised, multidisciplinary team-building intervention for the management of fever, blood sugar and swallowing in patients following acute stroke. Thus, this trial is highly significant both within Australia and internationally.Read moreRead less
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