ESTIMATION OF INDIGENOUS MORTALITY WHERE DESIGNATION OF INDIGENOUS STATUS ON DEATH CERTIFICATES IS UNRELIABLE
Funder
National Health and Medical Research Council
Funding Amount
$158,840.00
Summary
Mortality of indigenous Australians is regarded as unacceptably high compared to other Australians and compared to indigenous minorities in other similar countries. Indigenous mortality is based on data from WA, SA and NT, although some of the data are unreliable. There are few reliable data available in Qld, NSW, Vic or Tas because Indigenous status is significantly under-recorded on the death certificate. The objective of the research is to devise and validate indirect methods for estimating i ....Mortality of indigenous Australians is regarded as unacceptably high compared to other Australians and compared to indigenous minorities in other similar countries. Indigenous mortality is based on data from WA, SA and NT, although some of the data are unreliable. There are few reliable data available in Qld, NSW, Vic or Tas because Indigenous status is significantly under-recorded on the death certificate. The objective of the research is to devise and validate indirect methods for estimating indigenous mortality in sub-populations where there are significant proportions of indigenous people, and where designation of indigenous status on death certificate is unreliable. This would permit assessment of mortality differentials and trends in a significant number of Aboriginal and Torres Strait Islander communities in Qld, NSW, Vic and possibly Tas and provide new perspectives in the study of determinants of mortality in indigenous populations through comparisons of communities with relatively high and relatively low mortality, and allow population-based evaluation of the effectiveness of services and programs through surveillence of mortality trends and differentials. The methods rely on the basic premise that the total mortality of a population is contributed to by the mortality of its components in relation to their proportion of the total population. The units of analyses will be mainly municipalities. Mortality and proportion indigenous will be used in the comparison of municipalities with similar socio-economic and geographic characteristics, and mortality by municipality will be statistically modelled using various characteristics of these populations, including proportion indigenous (using ABS data). Methods will be validated by employing them on selected WA, SA and NT mortality data where designation of indigenous staus is considered reliable. Mortality estimates will then be made for indigenous communities in NSW, Qld, and other states.Read moreRead less
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
Goodness-of-fit Testing Of Log-link Models For Categorical Outcome Data
Funder
National Health and Medical Research Council
Funding Amount
$260,863.00
Summary
Information about the health consequences of exposure to causal factors is obtained from mathematical models of observed data. Incorrect inferences are possible if the model does not adequately represent the data. Relative risk models are recommended for observations over time on a cohort of subjects, but it is not known how best to assess the adequacy of such models. This project will assess the performance of summary measures of goodness-of-fit when applied to relative risk models.
Design And Analysis Of Interrupted Time Series Studies In Health Care Research: Resolution Of Methodological Issues
Funder
National Health and Medical Research Council
Funding Amount
$307,125.00
Summary
An interrupted time series (ITS) study involves a population observed on multiple occasions before and after the implementation of an intervention program. However, methods for statistical analysis and designing such studies have not been well developed and many statistical analyses of such studies are flawed. This proposal will investigate appropriate methods for design and analysis, and develop guidelines and software for its implementation by health researchers.
Population Monitoring Of Coronary Heart Disease In The Modern Era
Funder
National Health and Medical Research Council
Funding Amount
$636,375.00
Summary
Despite major reductions in mortality from heart attack over the past three decades, coronary heart disease (CHD) remains the leading cause of death and disability in Australia. It generates very large health costs and is one of five National priority areas for disease prevention and control. The most important manifestations of CHD are heart attacks, which require urgent hospital treatment, or sudden death, generally outside hospital. Accurate information to monitor trends in the incidence and ....Despite major reductions in mortality from heart attack over the past three decades, coronary heart disease (CHD) remains the leading cause of death and disability in Australia. It generates very large health costs and is one of five National priority areas for disease prevention and control. The most important manifestations of CHD are heart attacks, which require urgent hospital treatment, or sudden death, generally outside hospital. Accurate information to monitor trends in the incidence and outcomes of heart attack that can be used to assess the effectiveness for public health programs, establish requirements for clinical services, improve quality of care, and support studies of costs of health care, is essential. This study will use the unique capacity for medical record linkage in Western Australia (WA) to establish a comprehensive system to monitor the incidence, outcomes and emergency treatment of heart attack. It will combine information from a number of data sources including the hospital statistical system, emergency departments, ambulance services, laboratories and departments of cardiology. It will also obtain information from Commonwealth Department of Health and Aged care about the prescribing of selected medications, such as cholesterol lowering drugs, used in for the prevention of heart disease. Within this framework, it will undertake a number of sub-studies to improve the accuracy of information about heart attacks in the hospital statistical system to ensure consistency in measuring future trends, provide clinicians with state-wide information about outcomes of hospital care and the uptake of proven therapies, provide health administrators with information for planning services, and policy makers about the most cost-effective options for the preventions and control of heart disease.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.
Exploring The Contributions Of Individual-, Area- And Service- Level Factors To Indigenous Health Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$486,919.00
Summary
We will use linked hospital and death data, and multilevel models, to estimate the contributions of individual-, area- and service-level factors to inequalities in the outcomes of hospital care between Indigenous and non-Indigenous people. Factors investigated will include socioeconomic status, remoteness, access to primary care services, and hospital characteristics. Conditions explored will include heart disease, stroke, diabetes, chronic obstructive pulmonary disease and asthma.
Is Infection An Acute Trigger For Preeclampsia? A Case-crossover Study.
Funder
National Health and Medical Research Council
Funding Amount
$207,761.00
Summary
Preeclampsia is a multisystem hypertensive disease affecting up to 10% of pregnancies. It puts both mother and baby at increased risk of major illness and death. The cause is unknown but inflammation appears to play a key role. We will use an innovative design to determine whether recent maternal infection triggers the onset of preeclampsia. If preeclampsia is associated with infection, preventative strategies can be developed.