Development Of A Health-related Quality Of Life Instrument For Children With Cerebral Palsy
Funder
National Health and Medical Research Council
Funding Amount
$114,000.00
Summary
This project aims to develop and test a measure of quality of life for children with cerebral palsy (CP). This is a new project of international significance that has been recommended as the highest research priority of the United Cerebral Palsy Association with the strong support of CP researchers and clinicians internationally. CP remains the most common cause of physical disability in childhood, with an incidence of 2-2.0-2.5 per 1,000 live births. Described as a 'non-progressive motor impair ....This project aims to develop and test a measure of quality of life for children with cerebral palsy (CP). This is a new project of international significance that has been recommended as the highest research priority of the United Cerebral Palsy Association with the strong support of CP researchers and clinicians internationally. CP remains the most common cause of physical disability in childhood, with an incidence of 2-2.0-2.5 per 1,000 live births. Described as a 'non-progressive motor impairment of central origin recognised in infancy or childhood', CP presents as a static lesion on the brain characterised by progressive muscoskeletal deformity. Its impact on children and families is profound, resulting in extensive and life-long burden of care for families, and significant limitations to children's development and wellbeing. The management of the neuromuscular sequelae and health problems is a considerable cost to the health system because children require frequent visits for medical management, surgical procedures and rehabilitation. Trials of CP management effectiveness are hampered by the absence of patient outcome measures. Whilst new treatment options aim to provide substantial improvements in impairment and functioning they have disadvantages. For example, spasticity management includes Botulinum toxin A and intrathecal baclofen, both may improve function but are costly and invasive; treatments for ambulation (multi-level orthopaedic surgery) offer improved gait and mobility but require extensive rehabilitation; treatments for severe eating difficulties and poor growth (gastrostomy) may improve survival but result in aggravation of gastro-oesophageal reflux; and surgery for intractable epilepsy may improve seizure disorder but result in functional deficits. Quality of life is now a mandatory component of clinical trial research; valid and reliable tools sensitive to detecting change are urgently required.Read moreRead less
Improving Outcomes For People With Depression In Community Settings: A Cluster RCT
Funder
National Health and Medical Research Council
Funding Amount
$803,554.00
Summary
Depression affects 350 million people worldwide. Given the pivotal role of primary care in the management of depression, effective strategies are needed to assist GPs in the delivery of patient-centred depression care. This study will test the effectiveness of providing GPs with education; as well as feedback about patients’ self-reported depressive scores using a standardised instrument and perceived need and preferences for help. This cluster RCT will be the first Australian trial of its kind.
As a researcher in evidence-based medicine Prof Glasziou is principally concerned with developing a greater understanding among clinicians and researchers of the causes of, and solutions to, gaps between research evidence and the application of this research to practice. Specific research interests include:understanding the applicability of treatments;the effectiveness of diagnostic and disease monitoring processes; and the cognitive processes underpinning clinicians decisions to use or not use ....As a researcher in evidence-based medicine Prof Glasziou is principally concerned with developing a greater understanding among clinicians and researchers of the causes of, and solutions to, gaps between research evidence and the application of this research to practice. Specific research interests include:understanding the applicability of treatments;the effectiveness of diagnostic and disease monitoring processes; and the cognitive processes underpinning clinicians decisions to use or not use specific treatmentsRead moreRead less
Developing A Skin Test For Early Diagnosis Of Alzheimer's Disease And For Monitoring Effectiveness Of Treatment
Funder
National Health and Medical Research Council
Funding Amount
$285,000.00
Summary
Approximately 140,000 Australians suffer from Alzheimer's disease (AD). As the ageing population continues to grow, this number will double by the middle of the next century unless a cure or prevention is found. Scientists are continuously seeking new, more effective diagnostic tests in an effort to make it easier to diagnose AD in its early stages. Being able to recognize symptoms early and obtain an accurate diagnosis would give affected individuals a greater chance of benefiting from putative ....Approximately 140,000 Australians suffer from Alzheimer's disease (AD). As the ageing population continues to grow, this number will double by the middle of the next century unless a cure or prevention is found. Scientists are continuously seeking new, more effective diagnostic tests in an effort to make it easier to diagnose AD in its early stages. Being able to recognize symptoms early and obtain an accurate diagnosis would give affected individuals a greater chance of benefiting from putative treatments. However, there is no single, comprehensive diagnostic test for AD. Diagnostic tests (including peripheral markers) that can help to reliably diagnose AD at an early stage are needed as are tests that can help in monitoring the progression of AD, including response to therapy. The accuracy and clinical utility of previously proposed peripheral markers (platelets and pupil dilation test) is questionable. The only way to confirm a diagnosis of AD is through autopsy. We have obtained a provisional patent application for the use of a skin test for early diagnosis of AD (Patent No: PQ2881-99). This test is based on our extensive research over the past decade to understand the biochemical mechanisms underlying the txic vascular actions of beta amyloid protein. This protein has been implicated in the pathology of AD and it accumulates in the brain, peripheral tissues and is present in circulating blood of AD patients. The test is based on our discovery that vascular effects of Ab could be detected in the peripheral microcirculation .We now wish to further examine the utility of this novel skin test. If the test is sensitive, it could be used for screening; if it is specific it would be useful for confirmation of suspected AD. If the test is sensitive to change in clinical status it would help select treatments that might cure or improve the symptoms of AD.Read moreRead less
Therapeutic Treatment Pathways And Their Impact On Medicine Safety And Effectiveness
Funder
National Health and Medical Research Council
Funding Amount
$336,070.00
Summary
In clinical trials medicines are assumed to be used regularly with a set dose over the duration of the study. However, in real life medicines are used in different doses, over different durations and together with other medicines, which affect the effectiveness and safety of the treatment. The aim of this proposed research is to evaluate how different treatment pathways impact medicine safety and effectiveness. This project will provide new information on safety and effectiveness of treatment pa ....In clinical trials medicines are assumed to be used regularly with a set dose over the duration of the study. However, in real life medicines are used in different doses, over different durations and together with other medicines, which affect the effectiveness and safety of the treatment. The aim of this proposed research is to evaluate how different treatment pathways impact medicine safety and effectiveness. This project will provide new information on safety and effectiveness of treatment pathways.Read moreRead less
Comparing The Effectiveness Of Selective Laser Trabeculoplasty With Topical Medication For The Treatment Of Primary Angle Closure Glaucoma: A Multicentred, Prospective, Randomized Controlled Clinical Trial.
Funder
National Health and Medical Research Council
Funding Amount
$639,888.00
Summary
The main treatment of glaucoma, an eye condition which causes peripheral vision loss and blindness, involves the use of eye drops. However, these are expensive, have considerable side effects, and impact negatively on daily living. Laser has recently been proposed as an alternative treatment and, in this project, we will investigate the effectiveness of laser compared to medication. We anticipate laser will be more cost effective, safer, and have a positive impact on quality of life compared to ....The main treatment of glaucoma, an eye condition which causes peripheral vision loss and blindness, involves the use of eye drops. However, these are expensive, have considerable side effects, and impact negatively on daily living. Laser has recently been proposed as an alternative treatment and, in this project, we will investigate the effectiveness of laser compared to medication. We anticipate laser will be more cost effective, safer, and have a positive impact on quality of life compared to eye drops.Read moreRead less
Using Clinical And Economic Evidence To Infrom Local Decision Making In Cancer Care
Funder
National Health and Medical Research Council
Funding Amount
$1,836,745.00
Summary
Medicines used to treat cancer often come with a high price tag. Many countries, including Australia, are no longer able to provide free access to all medicines. For this reason, patients and their families, public hospitals and private health insurers are often asked to pay for these treatments. Currently, health professionals and patients are ill-equipped to make informed treatment choices, since both cost and efficacy must be considered. Our proposed research will address this important gap i ....Medicines used to treat cancer often come with a high price tag. Many countries, including Australia, are no longer able to provide free access to all medicines. For this reason, patients and their families, public hospitals and private health insurers are often asked to pay for these treatments. Currently, health professionals and patients are ill-equipped to make informed treatment choices, since both cost and efficacy must be considered. Our proposed research will address this important gap in current knowledge. We will use a unique web-based resource (Cancer Institute NSW Standard Cancer Treatment Program; CI-SCaT) to communicate the economic evidence needed to make informed decisions about cancer treatments. Our project will provide public access to information about the effectiveness and costs of cancer drugs. This is a world first. CI-SCaT is already the main vehicle of communication about cancer drug treatments in NSW and is widely used by cancer health professionals and patients to inform point-of-care decisions. Our project we will also identify the factors which influence the ability of cancer treatment centres to make best use of their drug budgets. By achieving this goal, we hope to demonstrate how to best use scarce resources for the benefit of all cancer patients.Read moreRead less
Evaluation Of A Financial Incentive To Improve The Use Of Preventive Medicines By People With Asthma
Funder
National Health and Medical Research Council
Funding Amount
$137,860.00
Summary
Rising costs are threatening the future viability of the Pharmaceutical Benefits Scheme. New approaches are needed to address this challenge, including developing financial incentives for consumers to use effective low cost medicines in preference to higher cost alternatives. This study will develop a consumer incentive for use of low cost asthma preventer medicines, model the economic effects of this and bring together stakeholders to examine the policy and practice changes needed to implement ....Rising costs are threatening the future viability of the Pharmaceutical Benefits Scheme. New approaches are needed to address this challenge, including developing financial incentives for consumers to use effective low cost medicines in preference to higher cost alternatives. This study will develop a consumer incentive for use of low cost asthma preventer medicines, model the economic effects of this and bring together stakeholders to examine the policy and practice changes needed to implement the incentive.Read moreRead less
Enhanced Control Of Hypertension And Thrombolysis In Stroke Study (STAY ENCHANTED)
Funder
National Health and Medical Research Council
Funding Amount
$2,437,384.00
Summary
"Clot busting" treatment is the only approved medical treatment for the commonest type of stroke, ischaemic stroke. However, uptake of treatment remains poor, mainly due to the known major risk of bleeding in the brain. STAY ENCHANTED is an international clinical trial to investigate whether "clot-busting" can be made safer using a lower dose and/or immediate blood pressure lowering. A safer more effective regime could have a major global health impact.
Mechanisms Of Pharyngeal Collapse In Obstructive Sleep Apnoea Defined By Optical Coherence Tomography
Funder
National Health and Medical Research Council
Funding Amount
$476,764.00
Summary
Obstructive sleep apnoea is characterised by intermittent collapse of the upper airway (throat) resulting in episodes of decreased blood oxygen levels, increased blood pressure and sleep disruption. Obstructive sleep apnoea is common, affecting 5% of middle-aged adults, and is associated with worsening health, increased motor vehicle accidents and increased risk of heart disease. However the mechanisms responsible for obstructive sleep apnoea are not well understood. One reason for this lack of ....Obstructive sleep apnoea is characterised by intermittent collapse of the upper airway (throat) resulting in episodes of decreased blood oxygen levels, increased blood pressure and sleep disruption. Obstructive sleep apnoea is common, affecting 5% of middle-aged adults, and is associated with worsening health, increased motor vehicle accidents and increased risk of heart disease. However the mechanisms responsible for obstructive sleep apnoea are not well understood. One reason for this lack of understanding is that current diagnostic techniques can not accurately measure changes in the size and shape of the upper airway during sleep. Such information is vital for the accurate diagnosis and treatment of obstructive sleep apnoea. This project proposes to use a technique called endoscopic optical coherence tomography (eOCT), recently developed by ourselves, to measure the changes in upper airway size and shape in patients with obstructive sleep apnoea during wakefulness and, importantly, during sleep. A prototype of the system has been developed. Preliminary in vivo studies have been performed in the human upper airway and the results from these preliminary trials have been published. To our knowledge, world-wide, this is the only such system capable of making these measurements. The studies proposed in this application will provide a better understanding of the mechanisms underlying obstructive sleep apnoea and may lead to the development of greatly improved and more specific treatments that are tailored to the exact needs of the individual patient.Read moreRead less