Emma ThomasThe University of Queensland | UQ · Centre for Online Health
Emma Thomas
B.Sp.Path, MPH, PhD (Population Health)
About
72
Publications
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Introduction
Emma Thomas is a research fellow in the Centre for Online Health, Centre for Health Services Research, The University of Queensland. She holds a PhD in Population Health (University of Melbourne, NHMRC Postgraduate Scholar), Master of Public Health and has a clinical background in alllied health. Her research interests lie in the prevention and management of cardiovascular disease, implementation science and using telehealth to increase access to care.
Publications
Publications (72)
Introduction:
Cancer clinical trials have traditionally occurred in-person. However, the COVID-19 pandemic has forced adaptions of all aspects of cancer care (including clinical trials) so they can be delivered remotely. We aimed to quantify and qualify current use of telehealth and how it can be further improved and routinely integrated into canc...
Introduction
Digital health interventions can be useful for the management of chronic disease. The aim of this study was to draw out universal themes to understand how people with chronic conditions experience digital health services, programmes, and interventions, and consequently, better inform future digital health delivery.
Methods
An umbrella...
In Australia, the COVID-19 pandemic has resulted in the exponential growth in the delivery of telehealth services. Medicare data indicates that the majority of telehealth consultations have used the telephone, despite the known benefits of using video. The aim of this study was to understand the perceived quality and effectiveness of in-person, tel...
Introduction
High rates of dementia among Australian First Nations’ peoples have resulted in an increased demand for dementia knowledge and skills among the primary health care professionals in these communities. The Dementia Extension for Community Healthcare Outcomes (ECHO) program aims to be a culturally safe way of increasing local health workf...
In May 2022, Nature Reviews Cardiology published our comprehensive roadmap of strategies to support the career progression of cardiovascular researchers,¹ driven by the Australian Cardiovascular Alliance Emerging Leaders Committee. The path to this roadmap started in 2019, when we discovered only 23% of Australian cardiovascular researchers had per...
Abstract: Since the COVID-19 pandemic onset, there has been exponential growth in the uptake of telehealth, globally. However, evidence suggests that people living in lower socioeconomic areas, cultural and linguistically diverse communities, people with disabilities, and with low health literacy are less likely to receive telehealth services. Thes...
Cardiovascular disease remains the leading cause of death worldwide. Cardiovascular research has therefore never been more crucial. Cardiovascular researchers must be provided with a research environment that enables them to perform at their highest level, maximizing their opportunities to work effectively with key stakeholders to address this glob...
Background: Recent evidence indicates that high numbers of cardiovascular (CV) researchers have considered leaving the research and academic sector due to lack of job security and low funding success. Thus, there is an urgent need to develop solutions to support the retention of early- and mid-career researchers (EMCRs). Here, we aimed to explore t...
Introduction
As COVID-19 restrictions reduce globally, services will determine what components of care will continue via telehealth. We aimed to determine the clinician, service, and system level factors that influence sustained use of telehealth and develop a framework to enhance sustained use where appropriate.
Methods
This study was conducted a...
Background
To enable services to be provided at a distance during the COVID-19 pandemic, outpatient pharmacy services in Australia underwent near-immediate reform by moving to telehealth, including telephone and video consults.
Objective
To investigate how telehealth was used in a metropolitan outpatient pharmacy setting before and after the start...
The application of telestroke has matured considerably since its inception in 1999. The use of telestroke is now recommended in several published guidelines. Consequently, jurisdictions without a telestroke service are seeking practical information on the best approach to implement telestroke. French et al. (2013) reviewed the challenges of impleme...
Background:
The novel coronavirus disease of 2019 (COVID-19) pandemic significantly disrupted health care, especially outpatient services such as cardiac rehabilitation (CR). We investigated the impact of early COVID-19 waves on the delivery of Australian CR programs, comparing this time period with usual practice prior to the pandemic (2019) and...
Telehealth can effectively increase access to specialist care and reduce the need for travel. The Geri-Connect service was established in 2017 to support people living in residential aged care facilities in regional Victoria, Australia. Using the Model for the Assessment of Telemedicine, an evaluation of the Geri-Connect service identified service...
Telepalliative care services enable clinicians to provide essential palliation services to people with a life-limiting illness in or closer to home. This study aims to explore the costs, service activity and staff experiences resulting from the introduction of telehealth in a community palliative care service in Queensland, Australia. Pre- and post...
Objectives
Our recent systematic review determined that remote patient monitoring (RPM) interventions can reduce acute care use. However, effectiveness varied within and between populations. Clinicians, researchers, and policymakers require more than evidence of effect; they need guidance on how best to design and implement RPM interventions. There...
Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): Queensland Health
Background
Remote patient monitoring (RPM) is an underutilised telehealth intervention that can enhance self-management of cardiovascular and pulmonary disease and reduce acute care use. However, studies of effectiveness of RPM intervent...
Introduction
To promote telehealth implementation and uptake, it is important to assess overall clinical effectiveness to ensure any changes will not adversely affect patient outcomes. The last systematic literature review examining telehealth effectiveness was conducted in 2010. Given the increasing use of telehealth and technological developments...
Objective: The 2020 coronavirus pandemic required many psychologists to rapidly transition to telehealth services to reduce virus exposure. Telepsychology services expanded quickly in Australia. This article seeks to provide simple and practical recommendations for clinicians who are changing their practice.
Method: A narrative literature review fo...
Objective
Chronic diseases are associated with increased unplanned acute hospital use. Remote patient monitoring (RPM) can detect disease exacerbations and facilitate proactive management, possibly reducing expensive acute hospital usage. Current evidence examining RPM and acute care use mainly involves heart failure and omits automated invasive mo...
A large proportion of expected deaths do not occur at home, despite often being the dying person’s preference. Paramedics play an integral role in hospital admissions when someone is close to death. As illness worsens, paramedics are often called and ascertain whether hospitalisation is appropriate. In a 12-month period, Ambulance Victoria (Austral...
Background/Introduction
Comprehensive exercise-based cardiac rehabilitation (CR) has well-established efficacy and effectiveness for improving patients' outcomes. There is substantial variability in terms of clinical effectiveness and quality measurement of CR programs internationally which limits service improvement initiatives. In Australia in 20...
The current coronavirus pandemic (COVID-19) has resulted in tremendous growth in telehealth services in Australiaand around the world. The rapid uptake of telehealth has mainly been due to necessity – following social distancingrequirements and the need to reduce the risk of transmission. Although telehealth has been available for many decades,the...
In March 2020, the Australian Government added new temporary telehealth services to the Medicare Benefits Schedule (MBS) to reduce the risk of patient-patient and patient-clinician transmission of the 2019 coronavirus (COVID-19). Here, the MBS statistics for general practitioner activity and the associated costs are described; a small increase in b...
Background
Cardiovascular disease is the leading cause of death in Australia. Investment in research solutions has been demonstrated to yield health and a 9.8-fold return economic benefit. The sector, however, is severely challenged with success rates of traditional peer-reviewed funding in decline. Here, we aimed to understand the perceived challe...
Background
Women experience poorer health outcomes following acute coronary syndrome (ACS). Heart rate (HR) and heart rate variability (HRV) have emerged as sensitive and cost-effective markers of autonomic function and prognostic risk factors of poor cardiac outcomes. The aim of the current study was to investigate whether sex-specific differences...
The current coronavirus (COVID-19) pandemic is again reminding us of the importance of using telehealth to deliver care, especially as means of reducing the risk of cross-contamination caused by close contact. For telehealth to be effective as part of an emergency response it first needs to become a routinely used part of our health system. Hence,...
We aimed to examine whether a lifestyle intervention was effective in reducing cardiovascular disease (CVD) risk in individuals at high-risk of developing diabetes in a low- and middle-income setting. The Kerala Diabetes Prevention Program was evaluated by a cluster-randomized controlled trial (2013–2016) of 1007 individuals (aged 30–60 years) at h...
Background
To determine whether differential all-cause hospital readmission exists for men and women 2 years after percutaneous coronary intervention (PCI) treatment for acute coronary syndrome (ACS), and to identify potential pathways contributing to this association.
Methods
Four hundred and sixteen (416) patients admitted with ACS were recruite...
This study provides a new test of time-use diary methodology, comparing diaries with a pair of objective criterion measures: wearable cameras and accelerometers. A volunteer sample of respondents ( n = 148) completed conventional self-report paper time-use diaries using the standard UK Harmonised European Time Use Study (HETUS) instrument. On the d...
Objective
To develop standardised programme content for Australian phase II cardiac rehabilitation (CR) programme.
Design
Using the RAND/UCLA appropriateness method (RAM), a two-phase process including a comprehensive literature review and a two round modified Delphi process was undertaken to develop and validate content of a standardised CR progr...
![Figure 1 Clinical Quality Registries Information Model [16]. Reproduced...](profile/Emma-Thomas-23/publication/335213130/figure/fig3/AS:936993731145728@1600408122700/Clinical-Quality-Registries-Information-Model-16-Reproduced-with-permission-from_Q320.jpg)
Background: The central aim was to examine the accuracy of the full range of daily activities recorded in self-report
time-use diaries against data from two objective passive data collection devices (wearable camera and accelerometer)
serving as criterion reference instruments. This enabled systematic checks and comparisons on the timing, sequence...
Introduction: Women experience poorer clinical outcomes after Acute Coronary Syndrome (ACS). While the reason for this differential is unclear, autonomic function -indicative of vagal and sympathetic modulation directed to the sinus node- is a candidate mechanism.
Hypothesis: That sex-specific differences in heart rate variability (HRV) in the year...
![Figure 1 Clinical Quality Registries Information Model [16]. Reproduced...](profile/Adrienne-Oneil/publication/330709272/figure/fig1/AS:994925135020034@1614220045642/Clinical-Quality-Registries-Information-Model-16-Reproduced-with-permission-from_Q320.jpg)
Background:
Clinical registries are effective for monitoring clinical practice, yet manual data collection can limit their implementation and sustainability. The objective of this study was to assess the feasibility of using a data capture tool to collect cardiac rehabilitation (CR) minimum variables from electronic hospital administration databas...
Background::
Ageing populations and increasing survival following acute coronary syndrome has resulted in large numbers of people living with cardiovascular disease and at high risk of hospitalizations. Rising hospital admissions have a significant financial cost to the healthcare system.
Aim::
The purpose of this study was to determine whether...
Objective
Phobic anxiety is a risk factor for poor prognosis following Acute Coronary Syndrome (ACS). A psychophysiological marker of vagal function, autonomic dysfunction may play a critical role in this relationship. The aim of the study was two-fold: to assess whether phobic anxiety was characterised by autonomic dysfunction (heart rate variabil...
Background
The major efficacy trials on diabetes prevention have used resource-intensive approaches to identify high-risk individuals and deliver lifestyle interventions. Such strategies are not feasible for wider implementation in low- and middle-income countries (LMICs). We aimed to evaluate the effectiveness of a peer-support lifestyle intervent...
Relative risk and intervention costs in diabetes prevention lifestyle intervention trials.
(DOCX)
CONSORT 2010 checklist of information to include when reporting a CRT.
CRT, cluster randomized trial.
(DOCX)
Changes in health-related quality of life variables at 12 months by study group.
(DOCX)
Scatter plot showing the relationship between relative risk and resource intensity of lifestyle intervention in diabetes prevention trials.
(DOCX)
Changes in clinical and biochemical characteristics at 12 months by study group.
(DOCX)
Objectives and content of peer leader training sessions.
(DOCX)
Comparison of objectives and content of the group sessions in the Finnish GOAL program and the Australian GGT Diabetes Prevention Project with those of the peer group sessions in the K-DPP.
GGT, Greater Green Triangle; GOAL, Good Ageing in Lahti Region; K-DPP, Kerala Diabetes Prevention Program.
(DOCX)
Changes in behavioral characteristics at 12 months by study group.
(DOCX)
Background:
Type 2 diabetes mellitus (T2DM) is now one of the leading causes of disease-related deaths globally. India has the world's second largest number of individuals living with diabetes. Lifestyle change has been proven to be an effective means by which to reduce risk of T2DM and a number of "real world" diabetes prevention trials have been...
Although some practical tools for facilitating the use of implementation research for the prevention and
control of disease already exist, these mainly focus on communicable diseases. None exist specifically for
NCDs. The main purpose of this guide is to provide practical guidance, tools and examples for implementation
research so as to support eff...
Introduction Despite cardiac rehabilitation being recommended in clinical practice guidelines internationally these services are underutilised, programmes are not standardised and quality improvement methods and outcomes are rarely published. National registries are an important strategy to characterise service delivery, quality and outcomes, yet t...
Background: Speech pathologists work to optimise communication and reduce the emotional and social impact of communication disability in patients with aphasia but need evidence-based interventions to effectively do so.
Objective: This phase 1 study aims to evaluate an Australian speech-pathology-led intervention called the Aphasia Action, Success,...
Background:
Influenza is an infectious virus affecting both humans and animals. In humans, symptoms present as fever, cough, sore throat, runny nose, headache, muscle and joint pain, and malaise. The epidemiological profile of influenza is influenced by multiple factors, including transmissibility of the virus and the susceptibility of the populat...
Dengue is an infectious disease transmitted by mosquitoes in the Tropics. There are 2.5
billion people around the world at risk. Dengue presents as an acute febrile illness with
symptoms including headache, bone or joint and muscular pains and rash. The objective
of this study is to perform a diagnostic accuracy meta-analysis comparing the use of t...
Self-report time use diaries collect a continuous sequenced record of daily activities but the validity of the data they produce is uncertain. This study tests the feasibility of using wearable cameras to generate, through image prompted interview, reconstructed 'near-objective' data to assess their validity. 16 volunteers completed the Harmonised...
Household air pollution (HAP) resulting from the use of solid fuels presents a major public health hazard. Improved stoves have been offered as a potential tool to reduce exposure to HAP and improve health outcomes. Systematic information on stove interventions is limited.
We conducted a systematic review of the current evidence of improved stove i...
Objective To assess, in a sample of systematic reviews of non-pharmacological interventions, the completeness of intervention reporting, identify the most frequently missing elements, and assess review authors’ use of and beliefs about providing intervention information.
Design Analysis of a random sample of systematic reviews of non-pharmacologica...
This is the protocol for a review and there is no abstract. The objectives are as follows:
To assess the efficacy and safety of exercise prior to influenza vaccination to enhance influenza prevention in adults.
Exercise prior to influenza vaccination for limiting influenza incidence and its related complications in adults (Protocol)
Objectives To develop and validate a national set of best practice statements for use in post-stroke aphasia rehabilitation.
Design Literature review and statement validation using the RAND/UCLA Appropriateness Method (RAM).
Participants A national Community of Practice of over 250 speech pathologists, researchers, consumers and policymakers develo...
Questions
Question (1)
We are using Actilife software to validate the GPAQ using actigraph accelerometers. I specified that I only need PA levels for activities performed in a bout of 10 minutes continuously, so it is more comparable to GPAQ data (GPAQ considers only activities performed for 10 minutes continuously). However, Actilife software gives me the same output irrespective of whether I specify 10 min bouted or non-bouted activities. How do I get data for bouted and non-bouted activities separately in Actilife?
Projects
Projects (8)
The response to the COVID-19 is seeing massive uptake in the use of telehealth. This unprecedented change to the health system has created a unique “natural experiment”. Our research aims to harness this natural experiment to understand which telehealth models of care and implementation strategies are suitable for the sustained use of telehealth.
Excellent resources are now available for free download:
https://coh.centre.uq.edu.au/research/covid-19-and-telehealth
This project will implement DementiaECHO; a service which provides speciality case management advice and education from a multi-disciplinary team of experts to the local primary health professionals caring for people with dementia. The service hosts regular DementiaECHO sessions via multi-point videoconference. These sessions provide support on complex dementia cases. Our project responds to clear messages received from community stakeholders about the need for accessible (culturally and geographically) dementia support services. DementiaECHO will support Aboriginal and Torres Strait Islander communities facing a growing dementia burden, by simultaneously improving access to dementia expertise and increasing capacity of the local health workforce.