VITATOPS - A Randomised Controlled Trial Of Vitamins To Prevent Stroke
Funder
National Health and Medical Research Council
Funding Amount
$391,364.00
Summary
A high level of a normal protein component in the blood (homocysteine) is fast becoming recognised as a new risk factor for premature stroke and heart disease, although it remains uncertain whether treatment with vitamins can prevent these diseases from occurring. VITATOPS is a multi-centre, double-blind, placebo-controlled trial designed to examine the efficacy and safety of multi-vitamin therapy (folate, B6 and B12) in the prevention of stroke and other types of vascular disease. The VITATOPS ....A high level of a normal protein component in the blood (homocysteine) is fast becoming recognised as a new risk factor for premature stroke and heart disease, although it remains uncertain whether treatment with vitamins can prevent these diseases from occurring. VITATOPS is a multi-centre, double-blind, placebo-controlled trial designed to examine the efficacy and safety of multi-vitamin therapy (folate, B6 and B12) in the prevention of stroke and other types of vascular disease. The VITATOPS study arises from a large body of consistent, biologically plausible evidence linking homocysteine in a dose-dependent fashion to stroke and other types of vascular disease. A simple, non-toxic, and inexpensive intervention in the form of multivitamins (folate, B6 and B12) has been shown to be highly effective at reducing homocysteine levels, irrespective of the underlying cause. All patients who are referred to a neurologist or general physician in one of the collaborating centres within six months of a stroke or transient ischaemic attack are eligible for the trial. In total, treatment will continue for a period of between 1 and 5 years. During this time, patients will be closely monitored in order to record the occurrence of any vascular events (particularly strokes and heart attacks). Neither the study investigator nor the patient will know which treatment they are receiving (i.e. it is 'double blind'). The number of vascular events in the treatment groups will be compared at the end of the study in order to determine whether vitamin treatment is beneficial. This application is for five years of support to allow the investigators to move from the pilot phase of VITATOPS in Perth to begin recruitment to the definitive trial in other centres across Australia and New Zealand. This study may have a major impact on patient management. If vitamins prove to be effective, we may recommend vitamin supplementation to all of our stroke patients in the future.Read moreRead less
A Lifestyle Intervention Program For The Prevention Of Type 2 Diabetes Mellitus Among South Asian Women With Gestational Diabetes Mellitus
Funder
National Health and Medical Research Council
Funding Amount
$1,256,499.00
Summary
Gestational diabetes mellitus (GDM) is common in South Asian women, and many develop lifelong type 2 diabetes (T2DM) soon after delivery. Lifestyle change helps prevent T2DM, but we do not know how to introduce a sustainable service that will change lifestyles of young, busy and often poor women. We will test a unique intervention embedded within local health systems in 1414 women with GDM from 24 hospitals in South Asia, hoping to show that this intervention will prevent T2DM.
Should Australia Introduce A National Chlamydia Testing Program? Evaluation Of A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$518,510.00
Summary
Chlamydia is a very common sexually transmissible infection that can lead to infertility in women. About 4% of young adults have it, yet most are unaware they have it. Chlamydia is easy to diagnose and treat, but it is not known whether annual testing can reduce its spread. Over1 million tests are conducted each year in general practice, costing the government $30 million. This evaluation of a well-established trial of chlamydia testing in young adults will resolve the debate of whether annual t ....Chlamydia is a very common sexually transmissible infection that can lead to infertility in women. About 4% of young adults have it, yet most are unaware they have it. Chlamydia is easy to diagnose and treat, but it is not known whether annual testing can reduce its spread. Over1 million tests are conducted each year in general practice, costing the government $30 million. This evaluation of a well-established trial of chlamydia testing in young adults will resolve the debate of whether annual testing works and is a good use of money.Read moreRead less
Improving Health Outcomes With Ageing And Diabetes: A Focus On Prevention And Management Of Cardiovascular Disease
Funder
National Health and Medical Research Council
Funding Amount
$638,517.00
Summary
My research combines interventional trials, epidemiology and health services implementation research with a focus on prevention of cardiovascular disease, disability and dementia, including in the elderly and those with diabetes. With direct impact on the routine care of people who succumb to disabling vascular complications, it will evaluate treatment strategies but also influence change in health care and policy through the provision of trial evidence and evidence-based health services.
D-Health: A Randomised Trial Of Vitamin D For Prevention Of Cancer And Mortality
Funder
National Health and Medical Research Council
Funding Amount
$2,930,705.00
Summary
There is good evidence that vitamin D is important for maintaining healthy bones. There is now a body of work suggesting that it may play a role in other diseases such as cancer, but there is not yet sufficient information to warrant screening the population to determine their vitamin D levels or recommending routine supplementation. We plan to conduct a large-scale randomised placebo-controlled trial in which we will assess the effect of vitamin D supplementation on mortality, cancer incidence ....There is good evidence that vitamin D is important for maintaining healthy bones. There is now a body of work suggesting that it may play a role in other diseases such as cancer, but there is not yet sufficient information to warrant screening the population to determine their vitamin D levels or recommending routine supplementation. We plan to conduct a large-scale randomised placebo-controlled trial in which we will assess the effect of vitamin D supplementation on mortality, cancer incidence and many other common diseases such as diabetes.Read moreRead less
Generating Credible Evidence For Health Care Decision Making: Advancing Methods For Evidence Synthesis And Meta-analysis
Funder
National Health and Medical Research Council
Funding Amount
$360,476.00
Summary
Systematic reviews often underpin recommendations in guidelines and are therefore critical to the translation of research evidence into practice. However, weaknesses in the conduct of reviews can yield biased results, which may lead to patients receiving ineffective or harmful treatments. During my fellowship I will develop and evaluate novel methods to assess and adjust for bias in reviews, to improve the credibility of evidence needed to make well-informed choices about health care.
Optimising The Management Of Patients With Atrial Fibrillation - The Standard Vs Atrial Fibrillation SpEcific ManagemenT StudY (SAFETY)
Funder
National Health and Medical Research Council
Funding Amount
$65,040.00
Summary
To optimise the management of patients with AF, we will conduct an intervention clinical trial, the goal of which is to develop and implement a care program that aims to improve the health of patients with AF. This will be done by comparing the usual care that patients would normally receive in hospital and in the community with a specialised and individualised health care program - the Standard vs Atrial Fibrillation spEcific managemenT studY (SAFETY).
The FREEDOM Study: A RCT Of Sunlight And Calcium To Reduce Vitamin D Deficiency In Older People In Residential Care
Funder
National Health and Medical Research Council
Funding Amount
$838,972.00
Summary
The proposed study emanates from a large ongoing epidemiological study on falls and fractures in the elderly (the FREE study). Falls and fractures are major problems in the elderly. This is the genesis for the FREEDOM (Falls Risk Epidemiology: Effect of vitamin D on skeletal Outcomes and other Measures) intervention study. The FREEDOM study will evaluate the effect of a public health strategy to reduce falls and fractures in older people living in residential care (namely appropriate sun light e ....The proposed study emanates from a large ongoing epidemiological study on falls and fractures in the elderly (the FREE study). Falls and fractures are major problems in the elderly. This is the genesis for the FREEDOM (Falls Risk Epidemiology: Effect of vitamin D on skeletal Outcomes and other Measures) intervention study. The FREEDOM study will evaluate the effect of a public health strategy to reduce falls and fractures in older people living in residential care (namely appropriate sun light exposure and calcium supplementation) in a randomised trial. The primary endpoints of this study will be reduction in falls and change in vitamin D levels. Other endpoints will be change in motor function, mood, bone turnover and fracture incidence. The proposed public health strategy to be examined is readily transferable to routine practice and would have very good feasibility for easy implementation and are generally applicable to the residential care setting, where the study will be conducted. Moreover the proposed approach would be low in cost and does not depend on other health system input. Potentially large numbers of people would benefit from the better understanding of simple methods of securing improved vitamin D status.Read moreRead less
The D-Health Trial: A Large-scale Population-based Trial Of Vitamin D Supplementation For Improving The Health Of Older Adults
Funder
National Health and Medical Research Council
Funding Amount
$2,591,860.00
Summary
The D-Health Trial is a randomised placebo-controlled trial of vitamin D supplementation for improving the health of older Australian adults. Over 21,000 people were recruited and randomised to monthly doses of vitamin D or placebo. This grant will enable completion of the planned 5 years of supplementation and long-term follow-up of mortality and cancer. The results of the trial will inform decisions about food fortification and/or supplementation with vitamin D.