The Impact Of Insurance On Use Of Dental Services And Oral Health
Funder
National Health and Medical Research Council
Funding Amount
$203,616.00
Summary
Dental problems are very common in the Australian population, and health expenditure on dental services is large. This project addresses the impact of dental insurance on use of dental services and oral health outcomes to investigate the effect of insurance on dental visit patterns and mix of dental services provided, and examine how the cost of dental care is related to outcomes such as tooth loss and quality of life.
Measuring Patient Preferences For Treatment Of Colorectal Cancer Using Discrete Choice Modelling
Funder
National Health and Medical Research Council
Funding Amount
$188,912.00
Summary
Around the world, governments, medical professional bodies, individual clinicians and patients are trying to make decisions in health care more rationally. More of these decisions are 'informed' by evidence-based medicine, which depends on a systematic review of all relevant evidence of acceptable scientific rigour. This kind of systematic review has been conducted for the management of colorectal cancer. Patients making choices about possible treatment for colorectal cancer will then have the b ....Around the world, governments, medical professional bodies, individual clinicians and patients are trying to make decisions in health care more rationally. More of these decisions are 'informed' by evidence-based medicine, which depends on a systematic review of all relevant evidence of acceptable scientific rigour. This kind of systematic review has been conducted for the management of colorectal cancer. Patients making choices about possible treatment for colorectal cancer will then have the best 'evidence-based' information to hand. But not enough is known about what aspects of the treatment options matter most to patients. Choosing between different treatment options involves weighing up or trading-off different factors associated with each therapy. Depending on the clinical stage of their cancer, patients may have to choose between the type and size of surgical operation, whether or not to have chemotherapy and-or radiotherapy, the side effects of treatment, the chance of a recurrence of the disease and an early death as well as their quality of life. This research project will ask patients who have already been treated for their colorectal cancer what kind of tradeoffs they make between factors such as disease-free survival, toxicity of treatment and longer term quality of life. This will be done using hypothetical clinical scenarios comparing one type of treatment to another. In this way, the hypothetical choices will be informed by the patient's experience with treatment without asking them to reflect or dwell directly on their own treatment choices. The answers to the hypothetical choice questions can be used to assess what factors in treatment are most important to patients and by how much. This information can then be used by clinicians when presenting evidence-based information on treatment for patients newly diagnosed colorectal cancer.Read moreRead less
Application Of Discrete Choice Experiments To Value Multi-attribute Health States For Use In Economic Evaluation
Funder
National Health and Medical Research Council
Funding Amount
$450,369.00
Summary
Economic evaluation is used increasingly by health care decision makers to decide which health care programs provide the best value for money, in terms of improving health and quality of life outcomes for the population. It is used by the Australian government in deciding which medical services and pharmaceuticals should be funded. This requires measurement of quality of life in a way that allows comparison across treatments, and a means of quantifying community preferences for different health ....Economic evaluation is used increasingly by health care decision makers to decide which health care programs provide the best value for money, in terms of improving health and quality of life outcomes for the population. It is used by the Australian government in deciding which medical services and pharmaceuticals should be funded. This requires measurement of quality of life in a way that allows comparison across treatments, and a means of quantifying community preferences for different health states (that is, how we value health outcomes). Health outcomes are often valued using the quality adjusted life year (QALY) which combines length and quality of life in a single measure. To compare across diseases and treatments, quality of life must be measured in the same way. This can be done by using a standard set of questions that cover the different aspects of quality of life (eg pain, mobility, emotional state). In this way, a single survey instrument can be used for any disease or outcome of treatment. We can also use the same instrument to ask members of the public to provide information about their preferences for different health states (that is how they value health outcomes). However, obtaining this information from respondents is complex, and there is debate about which are the best instruments, and the best methods to value health outcomes. In this research, we propose a new approach to valuing health states, which is easier to administer and which allows for more detailed and rigorous analysis of the responses people give, to provide better models of how the different aspects of quality of life are combined in valuing health outcomes. We will compare the new method with the main existing methods. We will compare these methods for two standard quality of life instruments that are widely used in health care research. The research will also provide valuations of health states from the Australian population that can then be used in economic evaluation.Read moreRead less
Prediction Of Clinical Radiosensitivity Caused By Ionising Radiation During Radiotherapy.
Funder
National Health and Medical Research Council
Funding Amount
$447,750.00
Summary
Around one to five percent of cancer patients suffer from significant side effects in normal tissue exposed to ionizing radiation during radiotherapy. Although radiotherapy is an effective therapy for cancer treatment, the amount of radiation is generally restricted to minimize the incidence of these severe side effects (radiosensitivity). This means that individuals who don't have radiosensitivity are not getting the dose of radiation that would be most beneficial. A major goal of radiation bio ....Around one to five percent of cancer patients suffer from significant side effects in normal tissue exposed to ionizing radiation during radiotherapy. Although radiotherapy is an effective therapy for cancer treatment, the amount of radiation is generally restricted to minimize the incidence of these severe side effects (radiosensitivity). This means that individuals who don't have radiosensitivity are not getting the dose of radiation that would be most beneficial. A major goal of radiation biology research is to develop efficient predictive measures that could identify radiosensitive individuals prior to treatment. This predictive ability would enable the individualisation of radiotherapy radiation doses, which should result in improvement of tumour control rates and a reduction in the incidence of side effects associated with radiotherapy. We aim to understand radiosensitivity at the molecular level using the powerful technology of microarrays. Using microarray technology, thousands of genes can be tested for expression activity simultaneously. We have a unique tissue bank established from many radiosensitive and non-sensitive control radiotherapy patients. The use of microarray technology on samples from this unique tissue bank may enable the gene expression pattern of individuals that display radiosensitivity to be distinguished from the rest of the population. In conjunction, two additional tests will be used to determine who is susceptible to radiosensitive reactions which include assessment of a DNA repair pathway and assessment of the length of the telomeres (Caps on the ends of the chromosomes), both of which have been shown to be involved with radiosensitivy. This experimentation will hopefully lead to the development of a predictive assay for use in the clinic for cancer patients prior to receiving radiotherapy.Read moreRead less