A Trial Of Prehospital Rapid Sequence Intubation In Patients With Severe Head Injury
Funder
National Health and Medical Research Council
Funding Amount
$311,000.00
Summary
In Australia, major trauma is a leading cause of death in people between the ages of one and 44 years. In addition to mortality, there is a high morbidity rate and quality adjusted life-years lost from injury is vast. In broad terms, major trauma is defined as those injuries with the highest severity, requiring time critical medical care. Over 10% of major trauma patients have a severe head injury and approximately 40% of these patients die and another 40% have significant long-term morbidity. F ....In Australia, major trauma is a leading cause of death in people between the ages of one and 44 years. In addition to mortality, there is a high morbidity rate and quality adjusted life-years lost from injury is vast. In broad terms, major trauma is defined as those injuries with the highest severity, requiring time critical medical care. Over 10% of major trauma patients have a severe head injury and approximately 40% of these patients die and another 40% have significant long-term morbidity. Following severe head injury, it is common for patients to have decreased oxygen levels and this is associated with a significant increase in brain damage. To prevent or treat this, patients with severe head injury require endotracheal intubation (a tube is placed in the airway to provide oxygen to the patient) as soon as possible following injury. However, in most patients with severe head injury, endotracheal intubation requires the use of drugs to facilitate placement of the endotracheal tube. The usual technique involves the administration of both a sedative drug and an appropriate muscle-relaxant. This technique is known as rapid sequence intubation (RSI). However, it is unknown whether RSI should be undertaken by paramedics early after injury or be delayed until arrival at the hospital. Since better evidence of improved outcome is required to justify the possible risk and considerable expense of training ambulance paramedics in the skill of RSI, it is proposed that a randomized, controlled trial of RSI in adults with severe head injury be conducted. This trial will compare rapid sequence intubation with standard airway management (no intubation) by ambulance paramedics for major trauma patients with severe head injury. This study will assess differences in patient outcome at 6-months post injury. The study will involve head injury patients treated by paramedics in Victoria.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.
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.