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Publications (152)
Background
While there has been widespread global acceptance of the importance of evidence-informed policy, many opportunities to inform health policy with research are missed, often because of a mismatch between when and where reliable evidence is needed, and when and where it is available. ‘Living evidence’ is an approach where systematic evidenc...
Background
Early diagnosis and prompt antibiotic treatment are crucial to reducing morbidity and mortality of early-onset sepsis (EOS) in neonates. However, this strategy remains challenging due to non-specific clinical findings and limited facilities. Inappropriate antibiotics use is associated with ineffective therapy and adverse outcomes. This s...
Introduction
The Australian National COVID-19 Clinical Evidence Taskforce is producing living, evidence-based, national guidelines for treatment of people with COVID-19 which are updated each week. To continually improve the process and outputs of the Taskforce, and inform future living guideline development, we undertook a concurrent process evalu...
Background:
Mindfulness interventions are increasingly popular as an approach to improve mental well-being. To date, no Cochrane Review examines the effectiveness of mindfulness in medical students and junior doctors. Thus, questions remain regarding the efficacy of mindfulness interventions as a preventative mechanism in this population, which is...
Introduction
The Australian National COVID-19 Clinical Evidence Taskforce is developing living, evidence-based, national guidelines for treatment of people with COVID-19. These living guidelines are updated each week. We undertook an impact evaluation to understand the extent to which health professionals providing treatment to people with COVID 19...
Background:
Living systematic reviews (LSRs) offer an approach to keeping high-quality evidence synthesis continually up to date, so the most recent, relevant and reliable evidence can be used to inform policy and practice, resulting in improved quality of care and patient health outcomes. However, they require modifications to authoring and edito...
Background
Imaging is commonly performed for people with musculoskeletal conditions and is an important aspect of the management of these conditions. However, it may be used inappropriately and there is evidence of both underutilisation and overutilisation of imaging varying by specific condition. Inappropriate imaging can lead to unnecessary treat...
Background: Many organisations in Australia undertake systematic reviews to inform development of evidence-based guidelines or would like to do so. However, the substantial resources required to produce systematic reviews limit the feasibility of evidence-based approaches to guideline development. We are working with Australian guideline developers...
Background
This paper describes the trial of a novel intervention, Supporting Policy In health with evidence from Research: an Intervention Trial (SPIRIT). It examines (1) the feasibility of delivering this kind of programme in practice; (2) its acceptability to participants; (3) the impact of the programme on the capacity of policy agencies to eng...
Background Antibiotics are commonly prescribed in neonatal intensive care units (NICUs) for suspected sepsis because of the nonspecific clinical symptoms of sepsis. The overuse of antibiotic is associated with adverse outcomes. This study aimed to determine the rate of early-onset sepsis (EOS) and antibiotic use in neonates admitted to three NICUs...
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the benefits and harms of manual therapy and exercise, alone or in combination, compared to placebo, no treatment, or another treatment, in adults with lateral elbow pain.
Background:
This is the final paper in a thematic series reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was established to explore a systematic, integrated, evidence-based organisation-wide approach to disinvestment in a large Australian health servi...
This is the first in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE). The SHARE Program is an investigation of concepts, opportunities, methods and implications for evidence-based investment and disinvestment in health technologies and clinical practices in a local healthcare setting. The paper...
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The overall objective of this review is to determine if CQI is effective for improving professional practice and ultimately healthcare outcomes. We plan to do this by conducting a systematic review of existing evidence to address the following questions: Primary...
Background
This is the tenth in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. After more than a decade of research, there is little published evidence of active and successful disinvestment. The paucity of frameworks, methods and tools is reported t...
Background
This is the ninth in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The disinvestment literature has broadened considerably over the past decade; however there is a significant gap regarding systematic, integrated, organisation-wide approa...
New approaches to evidence synthesis, which utilise human effort and machine automation in mutually reinforcing ways, can enhance the feasibility and sustainability of living systematic reviews. Human effort is a scarce and valuable resource, required when automation is impossible or undesirable, and includes contributions from online communities (...
Background
Producing high-quality, relevant systematic reviews and keeping them up to date is challenging. Cochrane is a leading provider of systematic reviews in health. For Cochrane to continue to contribute to improvements in heath, Cochrane Reviews must be rigorous, reliable and up to date. We aimed to explore existing models of Cochrane Review...
BACKGROUND At a time when research output is expanding exponentially, citizen science, the process of engaging willing volunteers in scientific research activities, has an important role to play in helping to mange the information overload. It also creates a model of contribution that enables anyone with an interest in health to contribute meaningf...
BACKGROUND At a time when research output is expanding exponentially, citizen science, the process of engaging willing volunteers in scientific research activities, has an important role to play in helping to manage the information overload. It also creates a model of contribution that enables anyone with an interest in health to contribute meaning...
Background
This is the fifth in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. This paper synthesises the findings from Phase One of the SHARE Program and presents a model to be implemented and evaluated in Phase Two. Monash Health, a large healthcare network in...
Background
Capacity building strategies are widely used to increase the use of research in policy development. However, a lack of well-validated measures for policy contexts has hampered efforts to identify priorities for capacity building and to evaluate the impact of strategies. We aimed to address this gap by developing SEER (Seeking, Engaging w...
Background:
Management of rotator cuff disease often includes manual therapy and exercise, usually delivered together as components of a physical therapy intervention. This review is one of a series of reviews that form an update of the Cochrane review, 'Physiotherapy interventions for shoulder pain'.
Objectives:
To synthesise available evidence...
Background:
Management of rotator cuff disease may include use of electrotherapy modalities (also known as electrophysical agents), which aim to reduce pain and improve function via an increase in energy (electrical, sound, light, or thermal) into the body. Examples include therapeutic ultrasound, low-level laser therapy (LLLT), transcutaneous ele...
Objective To explore whether systematic reviewers selectively include trial effect estimates in meta-analyses when multiple are available, and what impact this may have on meta-analytic effects.
Design Cross-sectional study.
Data sources We randomly selected systematic reviews of interventions from 2 clinical specialties published between January 2...
It is essential that health policies are based on the best available evidence including that from
research, to ensure their effectiveness in terms of both cost and health outcomes for the wider community.
The present study describes the development of SAGE (Staff Assessment of enGagement
with Evidence), a measure that combines an interview and docu...
Background:
The Neurotrauma Evidence Translation (NET) Trial aims to design and evaluate the effectiveness of a targeted theory-and evidence-informed intervention to increase the uptake of evidence-based recommended practices for the management of patients who present to an emergency department (ED) with mild head injuries. When designing interven...
Tables with representative quotations.
(DOCX)
Background:
Evidence-informed policymaking is more likely if organisations have cultures that promote research use and invest in resources that facilitate staff engagement with research. Measures of organisations' research use culture and capacity are needed to assess current capacity, identify opportunities for improvement, and examine the impact...
The Policy Liaison Initiative (PLI) is a long-term knowledge translation initiative designed to support the use of Cochrane systematic reviews in health policy. A joint initiative between the Australasian Cochrane Centre and Australian Government Department of Health and Ageing, the PLI includes: 1) a community of practice for evidence-informed pol...
Objective:
To determine whether physiotherapists avoid lumbar X-rays for acute non-specific low back pain and advise people to stay active.
Methods:
We conducted a cross sectional survey of Australian physiotherapists. 880 physiotherapists were randomly sampled from Victoria (495), South Australia (158), and Western Australia (227). Physiotherap...
Objectives Implementation intervention effects can only be fully realised and understood if they are faithfully delivered. However the evaluation of implementation intervention fidelity is not commonly undertaken. The IMPLEMENT intervention was designed to improve the management of low back pain by general medical practitioners. It consisted of a t...
To explore the outcome domains and measurement instruments reported in published randomised controlled trials of physical therapy interventions for shoulder pain (rotator cuff disease, adhesive capsulitis or non-specific shoulder pain).
We included trials comparing physical therapy to any other intervention for shoulder pain, indexed up to March 20...
Background:
Despite the availability of evidence-based guidelines for the management of mild traumatic brain injury in the emergency department (ED), variations in practice exist. Interventions designed to implement recommended behaviours can reduce this variation. Using theory to inform intervention development is advocated; however, there is no...
The recent proliferation of strategies designed to increase the use of research in health policy (knowledge exchange) demands better application of contemporary conceptual understandings of how research shapes policy. Predictive models, or action frameworks, are needed to organise existing knowledge and enable a more systematic approach to the sele...
To investigate how often systematic reviewers encounter multiple trial effect estimates that are available for inclusion in a particular meta-analysis (multiplicity of results) and the methods they use to select effect estimates.
We randomly sampled Cochrane and MEDLINE-indexed non-Cochrane reviews published between January 2010 and January 2012. T...
Background:
Adhesive capsulitis (also termed frozen shoulder) is a common condition characterised by spontaneous onset of pain, progressive restriction of movement of the shoulder and disability that restricts activities of daily living, work and leisure. Electrotherapy modalities, which aim to reduce pain and improve function via an increase in e...
Background:
Systematic reviews may be compromised by selective inclusion and reporting of outcomes and analyses. Selective inclusion occurs when there are multiple effect estimates in a trial report that could be included in a particular meta-analysis (e.g. from multiple measurement scales and time points) and the choice of effect estimate to incl...
Background:
Adhesive capsulitis (also termed frozen shoulder) is commonly treated by manual therapy and exercise, usually delivered together as components of a physical therapy intervention. This review is one of a series of reviews that form an update of the Cochrane review, 'Physiotherapy interventions for shoulder pain.'
Objectives:
To synthe...
Background
Mild head injuries commonly present to emergency departments. The challenges facing clinicians in emergency departments include identifying which patients have traumatic brain injury, and which patients can safely be sent home. Traumatic brain injuries may exist with subtle symptoms or signs, but can still lead to adverse outcomes. Despi...
Dementia is a growing problem, causing substantial burden for patients, their families, and society. General practitioners (GPs) play an important role in diagnosing and managing dementia; however, there are gaps between recommended and current practice. The aim of this study was to explore GPs' reported practice in diagnosing and managing dementia...
Mild traumatic brain injury is a frequent cause of presentation to emergency departments. Despite the availability of clinical practice guidelines in this area, there is variation in practice. One of the aims of the Neurotrauma Evidence Translation program is to develop and evaluate a targeted, theory- and evidence-informed intervention to improve...
Men seek advice from their general practitioner (GP) on the merits of screening for prostate cancer. This study aimed to examine how the knowledge and clinical experience of GPs influenced their position on prostate cancer screening.
A total of 13 focus groups were set up with 77 GPs. Focus group discussions were audio-taped and transcribed verbati...
The development and publication of clinical practice guidelines for acute low-back pain has resulted in evidence-based recommendations that have the potential to improve the quality and safety of care for acute low-back pain. Development and dissemination of guidelines may not, however, be sufficient to produce improvements in clinical practice; fu...
Background:
Dementia is a common and complex condition. Evidence-based guidelines for the management of people with dementia in general practice exist; however, detection, diagnosis and disclosure of dementia have been identified as potential evidence-practice gaps. Interventions to implement guidelines into practice have had varying success. The...
This cluster randomised trial evaluated an intervention to decrease x-ray referrals and increase giving advice to stay active for people with acute low back pain (LBP) in general practice.
General practices were randomised to either access to a guideline for acute LBP (control) or facilitated interactive workshops (intervention). We measured behavi...
IMPLEMENT Trial Protocol.
(PDF)
GP final questionnaire and scoring key.
(PDF)
CONSORT Checklist.
(PDF)
Background:
Lateral elbow pain, or tennis elbow, is a common condition that causes pain in the elbow and forearm. Although self-limiting, it can be associated with significant disability and often results in work absence. It is often treated with topical and oral non-steroidal anti-inflammatory drugs (NSAIDs). This is an update of a review first p...
Background
Systematic reviewers may encounter a multiplicity of outcome data in the reports of randomised controlled trials included in the review (for example, multiple measurement instruments measuring the same outcome, multiple time points, and final and change from baseline values). The primary objectives of this study are to investigate in a c...
Background
Prostate cancer is a commonly diagnosed cancer in men. Few men understand the complexities involved with prostate screening and treatment issues. The information that men seek and obtain may influence how they make decisions about prostate cancer. The objective of this study was to explore men's knowledge, information seeking and decisio...
Background
Measuring team factors in evaluations of Continuous Quality Improvement (CQI) may provide important information for enhancing CQI processes and outcomes; however, the large number of potentially relevant factors and associated measurement instruments makes inclusion of such measures challenging. This review aims to provide guidance on th...
Table summarizing the development and measurement properties of instruments included in Stage four of the review (Table S9).
Antecedentes: La imaginología se realiza habitualmente en las enfermedades musculoesqueléticas. La identificación de intervenciones que mejoren el uso apropiado de la imaginología en las enfermedades musculoesqueléticas podría mejorar los resultados de salud para los pacientes y reducir los costos de la atención sanitaria.
Objetivos: Determinar los...
Background
Continuous quality improvement (CQI) methods are widely used in healthcare; however, the effectiveness of the methods is variable, and evidence about the extent to which contextual and other factors modify effects is limited. Investigating the relationship between these factors and CQI outcomes poses challenges for those evaluating CQI,...
Glossary of terms used in the review.
Tables reporting the content of instruments (Tables S3-S6) and overview of development and assessment of measurement properties (Table S10).
Tables reporting the content of instruments (Tables S3-S6) and overview of development and assessment of measurement properties (Table S10).
Tables summarising the characteristics of instruments included for review of measurement properties (Tables S7-S9).
Tables summarising the development and measurement properties of instruments included in Stage 4 of the review (Tables S11–S13).
The format in which risk is communicated influences how patients make health care decisions. The same statistical information may be summarized differently according to relative risk reduction, absolute risk reduction, number needed to treat, or odds ratio. A total of 76 men participated in focus groups exploring their understanding of information...
The Neurotrauma Evidence Translation (NET) program was funded in 2009 to increase the uptake of research evidence in the clinical care of patients who have sustained traumatic brain injury. This paper reports the rationale and plan for this five-year knowledge translation research program. The overarching aims of the program are threefold: to impro...
There is little systematic operational guidance about how best to develop complex interventions to reduce the gap between practice and evidence. This article is one in a Series of articles documenting the development and use of the Theoretical Domains Framework (TDF) to advance the science of implementation research.
The intervention was developed...
Objectives Defining ‘best practice’ is one of the first and crucial steps in any Knowledge Translation (KT) research project. Without a sound understanding of what exactly should happen in practice, it is impossible to measure the extent of existing gaps between ‘desired’ and ‘actual’ care, set implementation goals, and monitor performance. The aim...
This is the protocol for a review and there is no abstract. The objectives are as follows:
To summarise the characteristics and synthesise the results of empirical studies that have (i) investigated the prevalence of selective inclusion or reporting in systematic reviews of RCTs, (ii) investigated the factors associated with this (e.g. statistical...
Chiropractors commonly provide care to people with acute low-back pain (LBP). The aim of this survey was to determine how chiropractors intend to support and manage people with acute LBP and if this management is in accordance with two recommendations from an Australian evidence-based acute LBP guideline. The two recommendations were directed at mi...
The objective was to provide an overview of the recommendations and quality of evidence-based clinical practice guidelines (CPGs) for the emergency management of mild traumatic brain injury (mTBI), with a view to informing best practice and improving the consistency of recommendations.
Electronic searches of health databases (MEDLINE, EMBASE, The C...