ACTA Awards haul
Congratulations are in order for several of our research teams who were recognised at the annual Australian Clinical Trials Alliance’s Trial of the Year Awards last night. The ACTA Awards recognise remarkable Australians who advance our health system by designing, conducting or participating in ground-breaking clinical trials, and promote the importance of clinical trials and the expertise and complexity of work involved.
Trial of the Year Award: TEAM Study
Critical care researcher Professor Carol Hodgson accepted the prestigious Trial of the Year Award on behalf of the TEAM study researchers. This study, published in the prestigious journal NEJM, investigated how best to achieve safe and effective early mobilisation among patients in intensive care wards, finding that compared to standard care (which includes some early rehabilitation and mobilization), additional early mobilization did not affect the number of days alive and out of hospital, but was associated with increased adverse events.
Professor Hodgson says, “The adverse events seen were short-term and certainly aren’t deal-breakers for the concept of early mobilization. However, they help us understand more precisely how early, and how vigorously we should be engaging patients, and the warning signs staff should be watching for when conducting early mobilization.”
The concept of early mobilization has recently been embraced by the medical community as a way to improve rehabilitation in ICU patients, but has been deployed with a lack of evidence around timing and dosage. The findings fill that knowledge gap, and will change international practice for the 13–20 million people receive treatment in intensive care units (ICUs) annually.
The study team randomly assigned 750 adult ICU patients receiving invasive mechanical ventilation to an early mobilization group, or usual care. The early mobilization intervention aimed to get patients mobile to the highest activity level possible from the start.
Read more about the TEAM trial here.
ACTA-HEAT Excellence in Trial-based Health Economics Award: Target-D economic evaluation
Our Health Economics Group were delighted to scoop up this inaugural award, new in 2023.
Professor Cathy Mihalopoulos accepted the award on behalf of the team, saying “Having worked in this field for some time, it’s gratifying to see the addition of this prize to ACTA’s stable of awards, reflecting a growing acknowledgement of the importance of health economics in research and practice.
“I’m very proud of my team’s work with this study, and their continuing dedication to expanding the field and making important advancements to health knowledge and practice.”
This economic evaluation was a part of a larger trial run by the University of Melbourne’s Department of General Practice, called “Matching depression management to severity prognosis in primary care: the Target-D randomised controlled trial.”
Depression is a leading cause of disease burden globally and nationally with an increasing trajectory, and most care is delivered via General Practitioners. Matching the most appropriate care to depression severity can be difficult.
The researchers evaluated the efficacy and cost-effectiveness of a unique clinical prediction tool aiming to match primary care patients with the most appropriate depression treatment(s) based on their predicted severity of depressive symptoms. This was the first economic evaluation of an e-health platform designed to personally tailor depression management in primary care.
The economic evaluation examined the value-for-money credentials of the Target-D platform by: (1) costing the actual provision of the tool and measuring changes across a range of costs (including health professional visits, hospitalisations, productivity impacts, etc.) using a self-reported resource use questionnaire; and (2) measuring changes in quality of life.
The results suggest that, over 12 months, the screening and intervention program is likely to be cost-effective, providing indicative support for further development of digitally supported mental health care.
Access the Target-D economic evaluation paper here.
Runner-up ACTA Trial of the Year Award: Audit and feedback for reducing musculoskeletal diagnostic imaging requests in general practice – A cluster randomised trial
Finally, congratulations are also in order to Professor Denise O’Connor, along with her colleagues from Wiser Healthcare and the Australia and New Zealand Musculoskeletal Clinical Trials Network, and in collaboration with the Australian Government Department of Health and Aged Care, on taking out the runner-up position for this prestigious prize.
Regional musculoskeletal conditions such as low back, neck, shoulder, hip, knee and foot pain are common, and contribute significantly to global disability. Evidence-based primary care guidelines for many of these conditions recommend against early diagnostic imaging, unless features suggest serious or specific underlying causes, or unexplained worsening or prolonged symptoms are observed.
Unwarranted imaging may lead to unnecessary treatment, waste patient and health system money and time, and is responsible for a sizeable and avoidable carbon footprint. Yet one in five diagnostic imaging requests in Australia is considered low-value.
The team used Medicare Benefits Schedule data to identify GPs who request musculoskeletal imaging much more frequently than their peers, and trialled a nationwide audit and feedback mechanism with them. They found the process to successfully reduce musculoskeletal imaging requests, opening the door to a national strategy that might strengthen health system sustainability.
Read more about the Audit and feedback trial here.
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