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IEBH Newsletter: December 2022

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Our impact in 2022 

In 2022, the impact of the Institute's research has been steadily increasing in part enabled by the contract research being done for organisations such as WHO (report on COVID19 platform trials), the National Heart Foundation (CVD absolute risk), the Department of Health (MBS health assessment items review), and the NSW Agency for Clinical Innovation (methods to prioritize and implement work on evidence practice gaps). Other notable impacts are the support for Gold Coast Health with Journal Clubs during the pandemic with strong endorsement from Queensland Medical Officer, John Gerard, and the growing usage of the Systematic Review Accelerator tools. Finally, we recently published the results of a factorial randomised controlled trial involving audit and feedback letters to 3,819 high-requestion GPs. The reduction in imaging represents an estimated 36,158 fewer diagnostic imaging tests at 12 months ($3-4Million saving). O'Connor DA, Glasziou P, Maher C, Albarqouni L, et al. Effect of an individualized audit and feedback intervention on rates of musculoskeletal diagnostic imaging requests by Australian general practitioners: A cluster randomized clinical trial. JAMA 2022; Sept 6;850-860.

IEBH 2022 snapshot

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World EBHC Day 2022

2022_WorldEBHCDay

World Evidence-Based Healthcare (EBHC) Day is a global initiative that raises awareness of the need for better evidence to inform healthcare policy, practice and decision making in order to improve health outcomes globally. It is an opportunity to participate in debate about global trends and challenges, but also to celebrate the impact of individuals and organisations worldwide, recognising the work of dedicated researchers, policymakers and health professionals in improving health outcomes.

The 3rd World EBHC Day's theme was "Partnerships for Purpose". It launched on 20 June 2022 and was held on 20 October 2022. It saw 919 organisations across 123 countries publicly recognise World EBHC Day via varied social media platforms, blogs, websites, podcasts and video. 

Blogs
41 blogs from 20 countries were published in 2022. Read our blog, describing our consumer-clinician-researcher partnership to prepare a scoping review on involving consumers in co-design of nutrition interventions, here.

Vlogs
30 vlogs were published from 17 Countries in nine languages. 

More info 

Bond HDR student gives Plenary at NHMRC Symposium

From the 17th to the 22nd of November the National Health and Medical Research Council (NHMRC) held their Research Translation Symposium. The symposium covered the evolving nature of research evidence needs for clear, consistent and concise communication, and living evidence models which acknowledge the constantly evolving evidence-base. 

Justin Clark, who is a PhD student with the Faculty of Health Sciences and Medicine as well as working at the Institute for Evidence-Based Healthcare (IEBH) was invited to present as part of the Plenary Panel on day three of the conference.

The topic of the Plenary Panel was: Transforming how research is generated, valued and used. Justin presented about using the automation tools built at Bond to improve the speed of conducting systematic reviews.

The full plenary session is available online as well as Justin's presentation.

Magnolia_Congress2022

2nd LatinAmerican Congress of Nephrogeriatrics

A/Prof Magnolia Cardona represented IEBH at the congress on 29 September 2022, following an invitation from the organisers, At a plenary session she presented an overview of her research on the extent of low-value care among older people, with a focus on end-stage chronic kidney disease. Dr Cardona took the opportunity to highlight proactive ways of identifying, measuring and reducing overtreatment practices, and emphasised the importance of discussing options for dying well, a concept that elicited interesting and positive reactions from the audience. 

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Recent publications

The burden of treatment for CKD

Dialysis photo

Members of the IEBH team: Associate Professor Magnolia Cardona, Associate Professor Rae Thomas and Assistant Professor Zoe Michaleff, led by Associate Professor Claudia Dobler conducted consultations with patients and nephrologists on the burden of treatment for chronic kidney disease. Poor healthcare coordination was nominated as the top burden for patients while physicians perceived psychosocial impacts as the most important patient burdens. 

Objectives: The treatment workload associated with end-stage kidney disease (ESKD) is high. The treatment burdens experienced by patients with ESKD are not well understood. In this study, we aimed to elucidate the most important areas of treatment burden for discussion in a clinical encounter from the perspectives of patients with ESKD and nephrologists. We sought to explore possible solutions to these high priority treatment burden challenges. Results: Every patient group ranked health system issues as the most important treatment burden priority. This encompassed lack of continuity and coordination of care, dissatisfaction with frequent healthcare encounters and challenges around healthcare access. Psychosocial burdens on patients and families were perceived to be the most important area of treatment burden by physicians, and were ranked the second highest priority by patients. Conclusions: Discussing treatment burden in a clinical encounter may lead to a better understanding of patients’ capacity to cope with their treatment workload. This could facilitate tailored care, improve health outcomes, treatment sustainability and patients’ overall quality of life.

Read the full article here.

Overuse and underuse of interventions for primary and secondary prevention of cardiovascular diseases

Medication

Our IEBH team (Oyuka, Mark, Justin, Tammy, Paul and Magnolia) collaborated with Gold Coast Hospital and Central QLD University in the synthesis of two decades of overuse and underuse of cardiovascular medicines and procedures. An important topic for the prevention and management of the world's leading causes of death and disability. The authors already received requests for more information from NHS physicians.  

Abstract: Quality use of anti-hypertensives and cholesterol-lowering medications is crucial for successful cardiovascular disease management. This systematic review aimed to estimate levels of over and underuse of services for primary and secondary prevention of cardiovascular diseases from 2000 to 2020: overprescribing/underprescribing, overtesting/undertesting and overutilisation/ underutilisation of procedures compared to clinical practice guideline recommendations. Thirteen studies from USA, Europe, Asia and Australia were included. Wide practice variation was identified. Six studies reported overuse (e.g. perioperative cardiac consultations, anti-hypertensive overprescribing for normotensive or pre-hypertensive people); and ten studies reported underuse (e.g. under-prescribing of statins when indicated and under-screening for familial hypercholesterolemia). Lifestyle recommendations for cardiovascular disease prevention were largely underused. In summary, lack of adherence to published guidelines was prevalent over the past two decades for both primary and secondary prevention across settings. Further investigation of potentially justifiable deviations from guidelines are warranted to verify the estimates and identify points for intervention. 

Read the full article here.

 

Systematic Review Accelerator

SRA 2022

2022 was a very successful year for the Systematic Review Accelerator and our team. We added new features to many of our existing tools while also improving their usability and performance. A lot of these improvements were due to the feedback we received from our users, so please keep the feedback coming. 

We piloted our online workshop program to great success, with great numbers of people attending from all over the world. Due to this success, we will continue this program into 2023. 

We have also undertaken some evaluations of the SRA, which we are hoping to publish in 2023. These evaluations are an important part of any research software and its development. 

 

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Lastly, and most importantly, our small team has grown with a new software developer joining us.

Tian Liang
Tian Liang

Tian is the Software Support/Development Officer. Her work focuses on improving the speed of conducting a systematic review (SR) by automating and streamlining the tasks involved in a SR.

Tian graduated from Queensland University with a Master's degree in Computer Science and is currently doing a further Research Master at the Queensland University of Technology.

 

 

Evidence-Based Practice Professorial Unit (EBPPU)

The EBPPU located at the GCUH runs regular EBP workshops that are customised to the departments needs and can be hold in a variety of different formats to suit the departments schedule.

In 2022 we trained several clinicians from the Medical Oncology departments as well as from Midwifery and Rheumatology.

For more information, please contact: [email protected] as we are currently planning next year’s workshop schedule.

Journal clubs

The EBPPU offers online journal clubs to all GCUH clinicians to help accelerate translation of evidence into practice. In 2022 we held journal clubs on emerging covid-related evidence, early antibiotic switch, and research methods more broadly.

Assistant Professor Paulina Stehlik is involved with the WE-TREAT knowledge translation program which provides evidence-based approach for departments at setting up their own journal clubs and encourages capacity building within the Gold Coast University Hospital and beyond.

If you are interested in attending the online journal clubs, please join the EBPPU channeland you will receive an invitation as soon as a new journal club is scheduled and access to all the resources from previously discussed articles.

Gold Coast Health Research Showcase

The Gold Coast Health and partners Research Showcase 2022 took place on 8-9 November 2022. Assistant Professor Paulina Stehlik from the EBPPU chaired the Research Showcase Committee and supported the organisation and delivery of the showcase which attracted >200 guests and showcased 14 presentations, 21 lightning talks and 20 poster presentations. Assistant Professor Paulina Stehlik won the Lightning Talk with her presentation:  Findings from the ENHANCE survey: Medical specialty training research requirements may result in “poor quality unsupervised box ticking research”

More information about the Research Showcase can be found here.

GoldNet Research

GoldNet Research Logo

GoldNet Research was established in 2019 to support practice-based primary care research in our region. The practice-based research network (PBRN) offers opportunities to learn about and be involved in research with the support of Bond University, Griffith University, General Practice Gold Coast (GPGC) and the Gold Coast PHN. Information about upcoming events and research opportunities are available on the website. 

Since the PBRN was established, we have supported 15 research projects, and hold two research networking events, and two virtual journal clubs annually. In the latter half of 2022, GoldNet hosted a collaborative networking event and a virtual journal club:

Research Event: “Long COVID Era”

“Long COVID Era: long COVID and recurring waves” was a collaboration with General Practice Gold Coast (GPGC), on Oct 27 at the RACV Royal Pines Resort.

GoldNet has collaborated with GPGC since the PBRN was first established. The connection between general practice and research is vital to understand the practical implications and opportunities of research in primary care. 

Key messages from the collaborative event: 

Journal Club: “Weight Loss Interventions in Primary Care”

On Oct 12, Assistant Prof Loai Albarqouni led our virtual journal club, joined by an expert panel: author on the article, Dr Liz Sturgiss (Monash Uni), Assistant Prof Kieran Le Plastrier (Bond Uni), and Prof Nick Zwar, (GoldNet Steering Committee chair). The article discussed: “Effectiveness of weight management interventions for adults delivered in primary care: systematic review and meta-analysis of randomised controlled trials.”

Key messages for primary care:

  • Over 12 months, intervention groups lost ~2.3kg, and clinicians discussed how this amount of weight loss may not be significant to those who may wish to lose greater amounts of weight
  • Longer term (>12 month) interventions were not included
  • A team approach to weight loss should be implemented 
  • We should be cautious of weight loss interventions in those at risk of disordered eating and body dysmorphia
  • A statement from Assistant Prof Le Plastrier highlights the complexity to body weight and autonomy: “Your body is not yours; it is actually in a social-cultural context. It represents and reflects its connection to the world around it.”

The article, journal club recording, and slides can be fond on the GoldNet website.
 

Events

  • POD Conference 2023

    The 2023 International Preventing Overdiagnosis conference will be held at the Hotel Scandic, Copenhagen, Denmark 14 – 16 August.

    Hosted by The Danish College General Practitioners we promise to bring you a number of lively plenary debates about controversial and timely issues involving high-profile players from across the healthcare landscape.

    Registration OPEN

    We are accepting abstracts on the following themes

    • Clinical solutions and decision making during consultation to mitigate Overdiagnosis
    • Overdefinition: pre-disease a driver for overdiagnosis and expanding disease definition
    • Incentives, drivers and causes of Overdiagnosis
    • Overdiagnosis and sustainability of healthcare for patients, clinicians, communities and the planet
    • Communicating about overdiagnosis including the role of mainstream journalism & social media
    • How does consumer testing and self-screening contribute to Overdiagnosis
    • The Lisa M Schwartz Scholarship
    •  Other

    More information

  • HTAi 2023

    June 24-28, 2023

    HTAi invites you to join the leading minds in Health Technology Assessment (HTA) from around the world to discuss and debate the role of HTA in leading health innovation.

    THEME: "The Road to Policy and Clinical Integration"

    The road to policy and clinical integration for health technologies is filled with diverse and complex challenges to overcome, often made more arduous by the intricate and nuanced processes and rules relative to jurisdictions, agencies, policymakers, and systems. Subjugating these challenges requires a harmonized framework to examine and evaluate health technologies, and alignment of processes throughout the health technology lifecycle is crucial.

    More information

     

  • Wonca 2023

    The Royal Australian College of General Practitioners (RACGP) is excited to be the official host of the Wonca 2023 world conference to be held in Sydney, Australia from 26-29 October 2023.

    Call for submissions
    The Conference Scientific Committee (CSC) invite you to submit to present at WONCA 2023. Family doctors, GPs and primary healthcare specialists from around the world will come together for the largest global gathering of primary care to share research and discuss best practice, keeping communities healthy on an international level.

    The program will be curated to inform, engage, and provoke discussion around the core themes and align with the conference theme; 'Recovery, reconnection and revival. A celebration of primary care'.

    Presenters from diverse backgrounds, experience and perspectives are encouraged to apply to present on a broad range of primary care issues. We aim to bring together industry experts and colleagues from across the family medicine sphere to share evidence-based practice, projects and innovations that shape our primary care community. 

    For more information:https://wonca.racgp.org.au/wonca-2023/program/call-for-submissions 

POD Conference 2023

The 2023 International Preventing Overdiagnosis conference will be held at the Hotel Scandic, Copenhagen, Denmark 14 – 16 August.

Hosted by The Danish College General Practitioners we promise to bring you a number of lively plenary debates about controversial and timely issues involving high-profile players from across the healthcare landscape.

Registration OPEN

We are accepting abstracts on the following themes

  • Clinical solutions and decision making during consultation to mitigate Overdiagnosis
  • Overdefinition: pre-disease a driver for overdiagnosis and expanding disease definition
  • Incentives, drivers and causes of Overdiagnosis
  • Overdiagnosis and sustainability of healthcare for patients, clinicians, communities and the planet
  • Communicating about overdiagnosis including the role of mainstream journalism & social media
  • How does consumer testing and self-screening contribute to Overdiagnosis
  • The Lisa M Schwartz Scholarship
  •  Other

More information

HDR students and opportunities

The Institute currently has 13 HDR students completing their PhDs and Masters of Science by Research. 

To find out more about our current students, opportunities and projects, please click on the link below.

More information

Contact us

Bond University
Building 5, Level 4
14 University Drive, Robina QLD 4226

+61 7 5595 4482

[email protected] 

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