A Randomised Controlled Trial Of A Decision Aid For Prenatal Screening And Diagnosis
Funder
National Health and Medical Research Council
Funding Amount
$269,625.00
Summary
Prenatal screening is becoming increasingly available to pregnant women in many countries, including Australia, to test for Down syndrome and other chromosomal disorders as well as neural tube defects. Almost half the pregnant women in Victoria are now undergoing prenatal screening. Inherent in all screening tests is the possibility of false positive or false negative results. More than 5% of all women undergoing prenatal screening are likely to receive false positive results and must decide whe ....Prenatal screening is becoming increasingly available to pregnant women in many countries, including Australia, to test for Down syndrome and other chromosomal disorders as well as neural tube defects. Almost half the pregnant women in Victoria are now undergoing prenatal screening. Inherent in all screening tests is the possibility of false positive or false negative results. More than 5% of all women undergoing prenatal screening are likely to receive false positive results and must decide whether to put the pregnancy at risk of miscarriage, or a possible pregnancy termination, as a result of the necessary follow-up invasive diagnostic test. Many women do not realise they may have to face this decision. Others are not aware that their baby may be born with undiagnosed problems even if they have the screening test. One aspect of care that is likely to have a crucial influence on women's experience of screening is how much they are informed about a test prior to undergoing it. Most women visit a GP early in the first trimester of pregnancy. This visit provides an opportunity for information provision about prenatal screening. Decision aids have been developed as adjuncts to practitioners' counselling to prepare patients for decision-making. In this project we will be developing a decision aid for women considering their prenatal screening options. A randomised controlled trial will compare the efficacy of a general educational pamphlet to that of a tailored decision aid in preparing women for decision-making about prenatal screening. A total of 500 women who are less than 11 weeks pregnant and are attending one of 50 GPs will be included. Self-report questionnaires will be used to assess women immediately after use of the educational materials and then again at 24 weeks of pregnancy. The impact of the educational materials on informed choice, decisional conflict, anxiety, depression and uptake of prenatal screening tests will be compared.Read moreRead less
BEST-Australia: A Phase II Study Of Non-Endoscopic Screening For Barretts Oesophagus In Primary Care
Funder
National Health and Medical Research Council
Funding Amount
$513,481.00
Summary
Barrett's oesophagus is common in people with heartburn and may progress to oesophageal cancer. Most cases of oesophageal cancer are diagnosed at a late stage when chances of survival are poor. Currently Barrett's is only diagnosed by endoscopy. We will test how effective and acceptable a non-endoscopic sponge capsule and novel laboratory test is at detecting Barrett's oesophagus early. This could potentially enable early detection of this pre-cancerous condition in general practice.
THE DETECTION AND MANAGEMENT OF DEMENTIA IN GENERAL PRACTICE.
Funder
National Health and Medical Research Council
Funding Amount
$499,977.00
Summary
This research aims to examine a new method and practice guidelines for detection of early dementia. General practitioners will be screened on their ability to diagnose and manage dementia and to distinguish it from other diseases. Patient outcomes - including quality of life, depression, and satisfaction with care and referral indicators - will be examined.
Using Healthcare Wisely: Reducing Inappropriate Use Of Tests And Treatments
Funder
National Health and Medical Research Council
Funding Amount
$9,578,895.00
Summary
Overdiagnosis and overtreatment as unintended consequences of modern healthcare due to expanded disease definitions labelling people with mild problems or at low risk of illness, diagnostic tests identifying inconsequential abnormalities and screening programs detecting disease that won’t progress. The result is much harm and unsustainable overuse. We will research the prevalence, causes and consequences of overdiagnosis and overtreatment, evaluate solutions and widely disseminate findings.
Systematic Diabetic Retinopathy Screening And Monitoring Of Early Stage Disease In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$260,569.00
Summary
The project will assess the accuracy, acceptability and relative cost effectiveness of general practice based diabetic retinopathy (DR) screening and monitoring, with ophthalmic support and education via videoconferencing. Accredited GPs will screen for DR using non-mydriatic cameras as part of the Diabetes Annual Cycle of Care and monitor patients with minimal to moderate levels of DR but no sight threatening signs, with virtual ophthalmology support. Positive project outcomes have the capacity ....The project will assess the accuracy, acceptability and relative cost effectiveness of general practice based diabetic retinopathy (DR) screening and monitoring, with ophthalmic support and education via videoconferencing. Accredited GPs will screen for DR using non-mydriatic cameras as part of the Diabetes Annual Cycle of Care and monitor patients with minimal to moderate levels of DR but no sight threatening signs, with virtual ophthalmology support. Positive project outcomes have the capacity to effect policyRead moreRead less
The CRISP Trial: An RCT Of Risk Assessment And Decision Support To Implement Risk-stratified Colorectal Cancer Screening In Primary Care.
Funder
National Health and Medical Research Council
Funding Amount
$936,641.00
Summary
There is a mismatch between people’s use of bowel cancer screening tests through faecal occult blood testing or colonoscopy and their individual risk of bowel cancer. Building on the work of our NHMRC Centre for Research Excellence (CRE) on Optimising Colorectal Cancer Screening, this trial will test the effect of an electronic risk assessment tool, implemented in general practice, on use of the most appropriate screening test for bowel cancer based on a person’s risk of developing the condition
Improving Implementation Of Guideline Recommendations For Early Detection And Prevention Of Cancer In General Practice
Funder
National Health and Medical Research Council
Funding Amount
$277,205.00
Summary
An intervention targeting key barriers to preventive care will be implemented in 3 general practices. A multiple baseline design will be used to evaluate the success of the intervention. Key outcomes will include the proportion of eligible patients within each practice for whom 3 or more health risk behaviours have been assessed in accordance with guidelines recommendations; and the proportion of eligible patients who have been screened appropriately for breast, cervical and bowel cancer.
A Randomised Controlled Trial To Evaluate The Effectiveness And Cost-effectiveness Of Chlamydia Testing In General Practice.
Funder
National Health and Medical Research Council
Funding Amount
$1,377,557.00
Summary
Chlamydia is a very common sexually transmissible infection in Australia that can lead to infertility in women. About 4% of young adults have it. Most people with chlamydia do not have any symptoms and will be unaware they have it. Chlamydia is easy to diagnose and treat, but it is not known whether regular testing can reduce its spread. We propose to conduct a trial to evaluate whether annual testing for 16 to 29 year olds works and whether it would be a good use of public health funds.
The FaXeS Study. Offering Fragile X Carrier Testing To Women: Comparing Prenatal And Preconception Screening.
Funder
National Health and Medical Research Council
Funding Amount
$432,883.00
Summary
Fragile X syndrome is the leading cause of inherited intellectual disability. A genetic screening test is available to detect carriers of this condition. Using questionnaires and interviews we will directly compare carrier screening in pregnant and non-pregnant women in the general community, looking at issues such as informed decision-making, test uptake and its predictors and cost-effectiveness. This will be critical to inform policy and guidelines for genetic screening programs.
FAST-Australia: A Phase II Study Of Family History Screening For Chronic Disease Prevention In Primary Care.
Funder
National Health and Medical Research Council
Funding Amount
$343,429.00
Summary
Risk of developing certain cancers, heart disease and diabetes is increased by having an affected family member. People found to be at risk can be offered ways to prevent or detect these diseases early through lifestyle advice or disease screening. This project will develop and evaluate a family history questionnaire in preparation for a trial of family history screening and its impact on disease prevention.