Predictive Models And Interventions For Coronary Heart Disease In Aboriginal And Torres Strait Islander People
Funder
National Health and Medical Research Council
Funding Amount
$203,125.00
Summary
The main causes of heart disease in western countries are smoking, high blood pressure and high cholesterol. However, in indigenous populations, other factors may be more important. We propose to look at these conventional risk factors and others like diabetes, blood clotting disorders and inflammation to see which are best for predicting heart attack in Aboriginal and Torres Strait Islander people . We will also examine the effect of heart disease prevention programs run by communities, to see ....The main causes of heart disease in western countries are smoking, high blood pressure and high cholesterol. However, in indigenous populations, other factors may be more important. We propose to look at these conventional risk factors and others like diabetes, blood clotting disorders and inflammation to see which are best for predicting heart attack in Aboriginal and Torres Strait Islander people . We will also examine the effect of heart disease prevention programs run by communities, to see if they can improve these risk factors. Finally, we will use this information to produce educational materials and clinical tools for health services.Read moreRead less
Risk Stratification Of Older People In Hospital: Validation And Influence On Clinical Decision Making
Funder
National Health and Medical Research Council
Funding Amount
$291,067.00
Summary
Older people in hospital are at high risk of adverse outcomes, a vulnerability commonly referred to as frailty. In community-dwelling older people, frailty status can be measured precisely with a Frailty Index score. This research aims to develop a Frailty Index from a standardised comprehensive geriatric assessment instrument used in the routine care of many patients in hospital. This would assist clinicians to identify vulnerable older inpatients, improving their care in the acute setting.
Risk prediction models incorporating multiple risk factors (including genetic markers) are a recognised method to identify individuals at high risk of developing breast or colorectal cancer, but it is uncertain which model(s) currently perform best in a population setting. We aim to compare the predictive ability of each available model. Knowing which model performs best will facilitate early diagnosis, reduce overall costs by better targeting interventions and improve cancer survival.
Increased Mortality Risk Following Osteoporotic Fractures: Data From Dubbo Epidemiology Study And A Consortium Of International Epidemiological Studies
Funder
National Health and Medical Research Council
Funding Amount
$316,449.00
Summary
Osteoporotic fractures affect 1 in 2 women and 1 in 3 men over 60 and result in significant disability and premature mortality. Yet, less than 20% of those affected are treated. One of the reasons for this neglect is an uncertainty surrounding the fracture mortality association. This study will explore the magnitude and causes of this association and the effect of treatment on its prevention in a large multinational study. If positive, this evidence will boost osteoporosis treatment.
AusCAN Risk Assessment For Sitting Acquired Pressure Ulcers
Funder
National Health and Medical Research Council
Funding Amount
$1,707,297.00
Summary
Sitting acquired pressure ulcers are one of the major complications that occur after spinal cord injury. This project will determine factors that are associated with the development of sitting acquired pressure ulcers after spinal cord injury; and will develop a risk assessment tool that can identify those at high risk of pressure ulcer development. The cost of treating a pressure ulcer will also be assessed. This will enable cost-effective preventive treatment to be used in these individuals.
The Validity Of ‘8 Instruments’ Used To Include Quality Of Life In Economic Evaluation In 8 Disease Areas And 6 Countries
Funder
National Health and Medical Research Council
Funding Amount
$856,212.00
Summary
The Quality of Life is incorporated in the economic evaluation of health services using different ‘utility instruments’. Small scale comparative studies reveal large discrepancies between measurements. Very few studies combine multiple utility and disease specific instruments and to date no studies have compared utility instruments with scales measuring subjective wellbeing (happiness) or human capabilities. This project will mount the largest cross national survey to date of these questions.
Predicting The Individual Risk Of Prostate Cancer In Australian Men
Funder
National Health and Medical Research Council
Funding Amount
$348,656.00
Summary
Prostate cancer is a major cause of disability and death in Australian men. A number of factors, particularly age and family history, influence the risk of prostate cancer but, in contrast to breast cancer, we don't know what is the risk of developing prostate cancer over a period of time for a man with a specific set of risk factors. In fact, while a number of statistical models have been developed that use a woman's risk factor profile to estimate her risk of breast cancer, none is currently a ....Prostate cancer is a major cause of disability and death in Australian men. A number of factors, particularly age and family history, influence the risk of prostate cancer but, in contrast to breast cancer, we don't know what is the risk of developing prostate cancer over a period of time for a man with a specific set of risk factors. In fact, while a number of statistical models have been developed that use a woman's risk factor profile to estimate her risk of breast cancer, none is currently available for prostate cancer. We will apply standard statistical methods to existing data from the Australian Risk Factors for Prostate Cancer study and from the Australian Institute of Health and Welfare to develop a prostate cancer risk prediction model. We will test how factor like age, detailed family history, diet, baldness status and possibly previous PSA tests and prostate biopsies predict the risk. After developing the model, we will test the accuracy of the predictions in three ways. First, using existing data from the Australian Prostate Cancer Family Study, we will see whether the number of cases in a group of men is close to the number predicted by the model (calibration). Second, to test whether the model discriminate well men who develop prostate cancer from those who do not, we will collect family trees in a sample from the Melbourne Collaborative Cohort Study. We will use these data also to estimate the optimal cut point: men above this level of risk will be considered at high risk. Third, we will apply the model to existing data from the Dutch Prostate Cancer Family Study (DPCFS) to test whether the optimal cut point identify high-risk men and to validate the model in a non-Australian population. Finally, we will prepare a computer package that health professionals will use as decision-making tool in different scenarios including individual cancer risk assessment, design of prevention trials and targeting prevention programs to high-risk men.Read moreRead less
Risk Factors For Compliance With Command Hallucinations In Psychotic Disorders
Funder
National Health and Medical Research Council
Funding Amount
$180,290.00
Summary
There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the community. Whilst a number of violence risk factors such as being male, exhibiting hostility, and having a prior history of violence are well established, they are of limited use to clinicians in making management decisions. Our study will investigate a different approach to identify individuals and occasions when a sufferer might require more intensive care or ob ....There is widespread public concern about the danger individuals with schizophrenia or related disorders pose to themselves and to the community. Whilst a number of violence risk factors such as being male, exhibiting hostility, and having a prior history of violence are well established, they are of limited use to clinicians in making management decisions. Our study will investigate a different approach to identify individuals and occasions when a sufferer might require more intensive care or observation. Most individuals with schizophrenia experience auditory hallucinations. Amongst these hallucinations, voices that command the individual to undertake a particular action are common; many of these involve significant potential harm to the hallucinator or to other persons. We will attempt to identify those factors that are associated with an individual obeying command hallucinations. Variables to be examined include the characteristics of the hallucinated voices, and the beliefs of the subject about the power of the voices. Subjects will be interviewed to find out whether they have delusions that are consistent with their hallucinations, whether they suffer from Antisocial Personality Disorder, or are dependent on alcohol or drugs. We will also determine whether subjects who report being raised by authoritarian parents, who are dependent on the approval of others, or who see external factors as determining the occurrence of major events in their lives, are more likely to act on their hallucinations. Two groups of 100 patients will be studied. One group will be representative of people living in the community with schizophrenia. The other group will be people with schizophrenia who have been treated by the State Forensic Psychiatric Services. Statistical models will be developed in order to determine the accuracy with which compliance with command hallucinations can be predicted. These models with also reveal which risk factors are the most important.Read moreRead less