Clinical research into the effect of weight loss on health is at the centre of CORE's mission. Our research seeks evidence to inform clinical decisions, using the most appropriate study design. We conduct a range of studies to achieve this, including randomised control trials, cohort studies and community based studies.
We currently have studies addressing the important healthcare issues of:
- Gastro-oesophageal reflux disease and
- Diabetes in a low BMI range.
Randomised Controlled Trials
RCTs are the most important methods for clinical research to uncover new information in a scientific robust manner. The Australian healthcare system provides an environment that is conducive to running clinical trials with a high quality medical system, good training in scientific method, a vigorous but supportive human ethics approval process and a population who are generally pleased to act as participants. Two of the RCT's we have conducted have become landmark studies in the medical literature - The BMI 30-35 trial, the first to compare medical and surgical treatment for obesity, and the Diabetes trial, another comparison of the best medical and surgical treatments for this particular group.
We are well underway in the planning of a randomised controlled trials into the impact of weight loss on:
- Asthma and
- Osteoarthritis of the weight bearing joints.
Whilst LAGB is very effective, there is always potential for improvement of outcomes. We are constantly striving to improve the laparoscopic adjustable gastric banding (LAGB) process in a cost-effective way.
Studies that are currently underway include:
- Intensive care study of LAGB patients who have not achieved good weight loss;
- Cost-effectiveness study looking at LAGB follow-up;
- Frequency of LAGB follow-up vs. efficacy study;
- Preoperative assessment of psychological factors that may impact on outcomes;
- Dietary content and weight loss post LAGB and
- Exercise and its impact on weight loss post LAGB.
LAGB in Special Communities
We also look at the impact of LAGB in special communities. We have shown clearly that weight loss will lead to a high rate of resolution of type 2 diabetes in an ideal Caucasian population. However diabetes is a common and severe disease for Indigenous Australians. Our study of the efficacy of LAGB in an indigenous community tests if the LAGB approach to treating this problem is an acceptable option for Indigenous Australians and if they will be able to follow the compliance needs to achieve a good result. We need to understand the important cultural differences which exist with sensitivity to the socio-cultural profile which emphasizes the links between the person, the family and the community and establishes close collaboration with the communities, sharing ownership and decision making. The approach to illness and treatments is modified by these cultural differences with issues of communication, understanding and trust influencing behaviour. Furthermore, the extremely disadvantaged state of many of the Indigenous community with regard to health, education, social and economic measures is relevant. There is lower income, less education, increased unemployment, and greater levels of violence and self-harm. This study will be completed in mid to late 2012 and will give us a valuable information about how the LAGB process can be modified to different environments.
For a full list of our current studies, please click here.