Publications

Bagg, MK, Wand, BM, Cashin, AG, Lee, H, Hübscher, M, Stanton, TR, O’Connell, NE, O’Hagan, ET, Rizzo, RRN, Wewege, MA, Rabey, M, Goodall, S, Saing, S, Lo, SN, Luomajoki, H, Herbert, RD, Maher, CG, Moseley, GL & McAuley, JH 2022, 'Effect of Graded Sensorimotor Retraining on Pain Intensity in Patients With Chronic Low Back Pain', JAMA, vol. 328, no. 5, pp. 430-430.
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Importance: The effects of altered neural processing, defined as altering neural networks responsible for perceptions of pain and function, on chronic pain remains unclear. Objective: To estimate the effect of a graded sensorimotor retraining intervention (RESOLVE) on pain intensity in people with chronic low back pain. Design, Setting, and Participants: This parallel, 2-group, randomized clinical trial recruited participants with chronic (>3 months) nonspecific low back pain from primary care and community settings. A total of 276 adults were randomized (in a 1:1 ratio) to the intervention or sham procedure and attention control groups delivered by clinicians at a medical research institute in Sydney, Australia. The first participant was randomized on December 10, 2015, and the last was randomized on July 25, 2019. Follow-up was completed on February 3, 2020. Interventions: Participants randomized to the intervention group (n = 138) were asked to participate in 12 weekly clinical sessions and home training designed to educate them about and assist them with movement and physical activity while experiencing lower back pain. Participants randomized to the control group (n = 138) were asked to participate in 12 weekly clinical sessions and home training that required similar time as the intervention but did not focus on education, movement, and physical activity. The control group included sham laser and shortwave diathermy applied to the back and sham noninvasive brain stimulation. Main Outcomes and Measures: The primary outcome was pain intensity at 18 weeks, measured on an 11-point numerical rating scale (range, 0 [no pain] to 10 [worst pain imaginable]) for which the between-group minimum clinically important difference is 1.0 point. Results: Among 276 randomized patients (mean [SD] age, 46 [14.3] years; 138 [50%] women), 261 (95%) completed follow-up at 18 weeks. The mean pain intensity was 5.6 at baseline and 3.1 at 18 weeks in the intervention grou...

Bahrampour, M, Devlin, N & Mulhern, B 2022, 'PCR30 An Empirical Comparison of EQ-5D-Y-5L and EQ-5D-Y 3L Questionnaires', Value in Health, vol. 25, no. 12, pp. S395-S396.
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Bahrampour, M, Jones, R, Devlin, N, Dalziel, K & Mulhern, B 2022, 'PCR263 What Does the EQ-5D-Y-5L Measure in Comparison to Other Generic Paediatric Health Related Quality of Life Instruments?', Value in Health, vol. 25, no. 12, pp. S441-S441.
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Bailey, C, Dalziel, K, Cronin, P, Devlin, N & Viney, R 2022, 'How are Child-Specific Utility Instruments Used in Decision Making in Australia? A Review of Pharmaceutical Benefits Advisory Committee Public Summary Documents', PharmacoEconomics, vol. 40, no. 2, pp. 157-182.
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Measuring and valuing health-related quality of life (HRQOL) in children can be challenging but is an important component for providing decision makers with accurate information to fund new interventions, including medicines and vaccines for public subsidy. We review funding submissions of medicines made to the Pharmaceutical Benefits Advisory Committee contained in public summary documents to examine the use of child-specific HRQOL measures in decision making in Australia. A sample frame of medicines used by children was derived from four sources. Public summary documents relating to these medicines were searched in the Pharmaceutical Benefits Advisory Committee web resources for whether they related to children (aged under 18 years) and contained HRQOL information and/or cost-utility analyses. Data about the use of utilities in decision making were extracted and analysed. Of the 1889 public summary documents available, 62 public summary documents (29 medicines) contained information pertaining to children and utilities. Of these, four public summary documents included child-specific HRQOL measures, 16 included adult HRQOL measures, 11 included direct elicitation and the HRQOL source was not defined in 31 documents. Excluding documents using child-specific HRQOL measures, we considered that in 85% of medicines, decision making uncertainty might have been reduced by using child-specific HRQOL measures. Despite the growing literature on economic analysis in paediatric populations, the use of child-specific HRQOL measures in submissions to the Pharmaceutical Benefits Advisory Committee was minimal. Submissions involved inconsistent approaches, use of adult measures and weights, and substantial gaps in evidence. We recommend the consistent use of child-specific measures to improve the evidence base for decisions about medicines for children in Australia.

Bailey, C, Dalziel, K, Cronin, P, Devlin, N & Viney, R 2022, 'POSA301 A Review of Pharmaceutical Benefits Advisory Committee (PBAC) Public Summary Documents to Investigate the Use of Child-Specific Utility Measures in Decision Making in Australia', Value in Health, vol. 25, no. 1, pp. S198-S198.
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Bailey, C, Howell, M, Raghunandan, R, Dalziel, K, Howard, K, Mulhern, B, Petrou, S, Rowen, D, Salisbury, A, Viney, R, Lancsar, E & Devlin, N 2022, 'MSR68 Development of a Checklist for Studies Reporting the Elicitation of Stated Preferences Values for Child Health Related Quality of Life', Value in Health, vol. 25, no. 12, pp. S363-S363.
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Bailey, C, Howell, M, Raghunandan, R, Salisbury, A, Chen, G, Coast, J, Craig, JC, Devlin, NJ, Huynh, E, Lancsar, E, Mulhern, BJ, Norman, R, Petrou, S, Ratcliffe, J, Street, DJ, Howard, K, Viney, R, Dalziel, K, Hiscock, H, Hayes, A, Wong, G, Donaldson, C & Carter, S 2022, 'Preference Elicitation Techniques Used in Valuing Children’s Health-Related Quality-of-Life: A Systematic Review', PharmacoEconomics, vol. 40, no. 7, pp. 663-698.
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BACKGROUND AND OBJECTIVES: Valuing children's health states for use in economic evaluations is globally relevant and is of particular relevance in jurisdictions where a cost-utility analysis is the preferred form of analysis for decision making. Despite this, the challenges with valuing child health mean that there are many remaining questions for debate about the approach to elicitation of values. The aim of this paper was to identify and describe the methods used to value children's health states and the specific issues that arise in the use of these methods. METHODS: We conducted a systematic search of electronic databases to identify studies published in English since 1990 that used preference elicitation methods to value child and adolescent (under 18 years of age) health states. Eligibility criteria comprised valuation studies concerning both child-specific patient-reported outcome measures and child health states defined in other ways, and methodological studies of valuation approaches that may or may not have yielded a value set algorithm. RESULTS: A total of 77 eligible studies were identified from which data on country setting, aims, condition (general population or clinically specific), sample size, age of respondents, the perspective that participants were asked to adopt, source of values (respondents who completed the preference elicitation tasks) and methods questions asked were extracted. Extracted data were classified and evaluated using narrative synthesis methods. The studies were classified into three groups: (1) studies comparing elicitation methods (n = 30); (2) studies comparing perspectives (n = 23); and (3) studies where no comparisons were presented (n = 26); selected studies could fall into more than one group. Overall, the studies varied considerably both in methods used and in reporting. The preference elicitation tasks included time trade-off, standard gamble, visual analogue scaling, rating/ranking, discrete choice experime...

Bailey, C, Howell, M, Raghunandan, R, Salisbury, A, Devlin, N, Howard, K & Viney, R 2022, 'EE14 A Systematic Review of Preference Elicitation Techniques Used in Valuing Children's Health-Related Quality-of-Life', Value in Health, vol. 25, no. 7, pp. S337-S337.
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Bansback, N, Trenaman, L, Mulhern, BJ, Norman, R, Metcalfe, R, Sawatzky, R, Brazier, JE, Rowen, D & Whitehurst, DGT 2022, 'Estimation of a Canadian preference-based scoring algorithm for the Veterans RAND 12-Item Health Survey: a population survey using a discrete-choice experiment', CMAJ Open, vol. 10, no. 3, pp. E589-E598.
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BACKGROUND: The Veterans RAND 12-Item Health Survey (VR-12) is a generic patient-reported outcome measure derived from the widely used 36- and 12-item Short Form Health Surveys. We aimed to estimate a Canadian preference-based scoring algorithm for the VR-12, enabling the derivation of health utility values for generating quality-adjusted life years (QALYs). METHODS: We conducted a discrete-choice experiment in a sample of the Canadian population in January and February 2019. Participants - recruited from a consumer research panel - completed an online survey, in English or French, that included 11 discrete-choice questions, each comprising 2 health profiles. We defined the health profiles using 8 VR-12 items and a duration attribute. Using conditional logit regressions, where each level of the respective VR-12 items was interacted with duration, we applied the coefficients to estimate health utility values interpretable on a scale of 0 (dead) to 1 (full health). Negative values reflect states considered worse than dead. RESULTS: A total of 3380 individuals completed the survey. Of these, 1688 (49.9%) were females, and 3101 (91.7%) completed the English version of the survey. Across all models, 'feel downhearted and blue all of the time' and 'pain interferes with your normal work extremely' were associated with the largest decrements in health utility. Excluding the 685 respondents (20.3%) who provided inconsistent responses had a negligible effect on the results. The recommended model, weighted to match population demographics, had health utility values ranging from -0.589 to 1.000. INTERPRETATION: Health utility values that reflect the preferences of the Canadian population can now be derived from responses to the VR-12. These values can be used to generate QALYs in future analyses.

Barnes, K, Hall Dykgraaf, S, de Toca, L, Wright, M & Kidd, M 2022, 'Primary care is the ideal setting to promote COVID ‐19 vaccination for children', Medical Journal of Australia, vol. 217, no. 11, pp. 575-577.
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Barnett, A, Page, K, Dyer, C & Cramb, S 2022, 'Meta-research: justifying career disruption in funding applications, a survey of Australian researchers', eLife, vol. 11.
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Background:When researchers’ careers are disrupted by life events – such as illness or childbirth – they often need to take extended time off. This creates a gap in their research output that can reduce their chances of winning funding. In Australia, applicants can disclose their career disruptions and peer reviewers are instructed to make appropriate adjustments. However, it is not clear if and how applicants use career disruption sections or how reviewers adjust and if they do it consistently.Methods:To examine career disruption, we used surveys of the Australian health and medical research community. We used both a random sample of Australian authors on PubMed and a non-random convenience sample.Results:Respondents expressed concerns that sharing information on career disruption would harm their chances of being funded, with 13% saying they have medical or social circumstances but would not include it in their application, with concerns about appearing ‘weak’. Women were more reluctant to include disruption. There was inconsistency in how disruption was adjusted for, with less time given for those with depression compared with caring responsibilities, and less time given for those who did not provide medical details of their disruption.Conclusions:The current system is likely not adequately adjusting for career disruption and this may help explain the ongoing funding gap for senior women in Australia.Funding:National Health and Medical Research Council Senior Research Fellowship (Barnett).

Bates, S, Wright, M & Harris-Roxas, B 2022, 'Strengths and risks of the Primary Health Network commissioning model', Australian Health Review, vol. 46, no. 5, pp. 586-594.
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Objective To explain how the Primary Health Network commissioning model works, and factors likely to affect its success. Methods The study focuses on the delivery of primary healthcare services by one Primary Health Network (PHN) in Australia. The qualitative case study is informed by a desk top review, interviews (n = 49) and observations with key stakeholders involved in commissioning and delivering primary healthcare services in the region. Results The study provides several insights about the PHN model. First, conceptually, the PHN commissioning model is well suited to identifying and meeting local primary healthcare priorities, bringing together a range of stakeholders involved in healthcare provision. Second, although primary healthcare services are difficult to specify and measure, PHN staff use their content knowledge and experience, and relationships with providers and the community, to design services that meet the needs of consumers. Third, the success of this model may be undermined by short funding cycles and short lead-times, a focus on national rather than local priorities, and continual reductions in operational funding. This may result in more procedural forms of contract management, which may mean that changes in service need, provision and quality go unnoticed. Conclusions This study shows that although clever in design, the PHN model may not meet its full potential. Given continual changes to the model, including funding, further independent research should be undertaken to understand how PHNs adjust and whether services continue to meet the needs of the local community.

Benger, J, Brant, H, Scantlebury, A, Anderson, H, Baxter, H, Bloor, K, Brandling, J, Cowlishaw, S, Doran, T, Gaughan, J, Gibson, A, Gutacker, N, Leggett, H, Liu, D, Morton, K, Purdy, S, Salisbury, C, Vaittinen, A, Voss, S, Watson, R & Adamson, J 2022, 'General practitioners working in or alongside the emergency department: the GPED mixed-methods study', Health and Social Care Delivery Research, vol. 10, no. 30, pp. 1-156.
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BackgroundEmergency care is facing a steadily rising demand. In response, hospitals have implemented new models of care that locate general practitioners in or alongside the emergency department.ObjectivesWe aimed to explore the effects of general practitioners working in or alongside the emergency department on patient care, the primary care and acute hospital team, and the wider system, as well as to determine the differential effects of different service models.DesignThis was a mixed-methods study in three work packages. Work package A classified current models of general practitioners working in or alongside the emergency department in England. We interviewed national and local leaders, staff and patients to identify the hypotheses underpinning these services. Work package B used a retrospective analysis of routinely available data. Outcome measures included waiting times, admission rates, reattendances, mortality and the number of patient attendances. We explored potential cost savings. Work package C was a detailed mixed-methods case study in 10 sites. We collected and synthesised qualitative and quantitative data from non-participant observations, interviews and a workforce survey. Patients and the public were involved throughout the development, delivery and dissemination of the study.ResultsHigh-level goals were shared between national policy-makers and local leads; however, there was disagreement about the anticipated effects. We identified eight domains of influence: performance against the 4-hour target, use of investigations, hospital admissions, patient outcome and experience, service access, workforce recruitment and retention, workforce behaviour and experience, ...

Brazier, J, Peasgood, T, Mukuria, C, Marten, O, Kreimeier, S, Luo, N, Mulhern, B, Pickard, AS, Augustovski, F, Greiner, W, Engel, L, Belizan, M, Yang, Z, Monteiro, A, Kuharic, M, Gibbons, L, Ludwig, K, Carlton, J, Connell, J, Rand, S, Devlin, N, Jones, K, Tsuchiya, A, Lovett, R, Naidoo, B, Rowen, D & Rejon-Parrilla, JC 2022, 'The EQ-HWB: Overview of the Development of a Measure of Health and Wellbeing and Key Results', Value in Health, vol. 25, no. 4, pp. 482-491.
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OBJECTIVES: Existing measures for estimating quality-adjusted life-years are mostly limited to health-related quality of life. This article presents an overview of the development the EQ-HWB (EQ Health and Wellbeing), which is a measure that encompasses health and wellbeing. METHODS: Stages: (1) Establishing domains through reviews of the qualitative literature informed by a conceptual framework. (2) Generation and selection of items to cover the domains. (3) Face validation of these items through qualitative interviews with 168 patients, social care users, general population, and carers across 6 countries (Argentina, Australia, China, Germany, United Kingdom, United States). (4) Extensive psychometric testing of candidate items (using classical, factor analysis, and item response theory methods) on > 4000 respondents in the 6 countries. Stakeholders were consulted throughout. RESULTS: A total of 32 subdomains grouped into 7 high-level domains were identified from the qualitative literature and 97 items generated to cover them. Face validation eliminated 36 items, modified 14, and added 3. Psychometric testing of 64 items found little difference in missing data or problems with response distribution, the conceptual model was confirmed except in China, and most items performed well in the item response theory in all countries. Evidence was presented to stakeholders in 2 rounds of consultation to inform the final selection of items for the EQ-HWB (25-item) and the short version of EQ-HWB (9-items). CONCLUSIONS: EQ-HWB measures have been developed internationally for evaluating interventions in health, public health, and social care including the impact on patients, social care users, and carers.

Broderick, L, Bjorner, JB, Lauher-Charest, M, White, MK, Kosinski, M, Mulhern, B & Brazier, J 2022, 'Deciding Between SF-6Dv2 Health States: A Think-Aloud Study of Decision-Making Strategies Used in Discrete Choice Experiments', Value in Health, vol. 25, no. 12, pp. 2034-2043.
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Broderick, L, Bjorner, JB, Lauher-Charest, M, White, MK, Kosinski, M, Mulhern, B & Brazier, J 2022, 'Development of the SF-6Dv2 health utility survey: comprehensibility and patient preference', Journal of Patient-Reported Outcomes, vol. 6, no. 1.
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Abstract Background The SF-6Dv2 classification system assesses health states in six domains—physical functioning, role function, bodily pain, vitality, social functioning, and mental health. Scores have previously been derived from the SF-36v2® Health Survey. We aimed to develop a six-item stand-alone SF-6Dv2 Health Utility Survey (SF-6Dv2 HUS) and evaluate its comprehensibility. Methods Two forms of a stand-alone SF-6Dv2 HUS were developed for evaluation. Form A had 6 questions with 5–6 response choices, while Form B used 6 headings and 5–6 statements describing the health levels within each domain. The two forms were evaluated by 40 participants, recruited from the general population. Participants were randomized to debrief one form of the stand-alone SF-6Dv2 HUS during a 75-min interview, using think-aloud techniques followed by an interviewer-led detailed review. Participants then reviewed the other form of SF-6Dv2 and determined which they preferred. Any issues or confusion with items was recorded, as was as overall preference. Data were analyzed using Microsoft Excel and NVivo Software (v12). Results Participants were able to easily complete both forms. Participant feedback supported the comprehensibility of the SF-6Dv2 HUS. When comparing forms, 25/40 participants preferred Form A, finding it clearer and easier to answer when presented in question/response format. The numbered questions and underlining of key words in Form A fostered quick and easy comprehension and completion of the survey. However, despite an overall preference for Form A, almost half of participants (n = 19) preferred the physical functioning item in Form B, with...

Broderick, L, Lauher, M, White, MK, Kosinski, M, Mulhern, B, Brazier, JE & Bjorner, JB 2022, 'PCR58 Participant Reinterpretation of Health States: A Think-Aloud Study of Decision-Making Strategies in Discrete Choice Experiments with the SF-6DV2', Value in Health, vol. 25, no. 7, pp. S551-S551.
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Brooks, C, Helson, C, McCormack, M, Baur, LA, Gill, T, Green, J, Billah, B, Cronin, P, Johar, A, Plaskett, J, Nolan, M, Latanik, M & Renzaho, AMN 2022, 'Protocol for a randomised controlled trial of a family strengthening program to prevent unhealthy weight gain among 5 to 11-year-old children from at-risk families: the Strong Families Trial', BMC Public Health, vol. 22, no. 1.
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Abstract Background Obesity is an increasing health concern in Australia among adult and child populations alike and is often associated with other serious comorbidities. While the rise in the prevalence of childhood obesity has plateaued in high-income countries, it continues to increase among children from disadvantaged and culturally diverse backgrounds. The family environment of disadvantaged populations may increase the risk of childhood obesity through unhealthy eating and lifestyle practices. The Strong Families Trial aims to assess the effectiveness of a mixed behavioural and lifestyle intervention for parents and carers of at-risk populations, i.e. families from culturally diverse and disadvantaged backgrounds, in preventing unhealthy weight gain among children aged 5 to 11 years. Methods Eight hundred families from low socio-economic areas in Greater Western Sydney, NSW, and Melbourne, VIC, will be recruited and randomised into a lifestyle intervention or control group. The intervention comprises 90-minute weekly sessions for 6 weeks (plus two-booster sessions) of an integrated, evidence-based, parenting and lifestyle program that accounts for the influences of family functioning. Primary (anthropometric data) and secondary (family functioning, feeding related parenting, physical activity, consumption of healthy foods, health literacy, family and household costs) outcome measures will be assessed at baseline, immediately following the intervention, and 12 months post-intervention. Discussion This study will elucidate methods for engaging socially disadvantaged and culturally diverse groups in parenting programs concerned with chi...

Brown, A, Pain, T, Tan, A, Anable, L, Callander, E, Watt, K, Street, D & De Abreu Lourenco, R 2022, 'Men’s preferences for image-guidance in prostate radiation therapy: A discrete choice experiment', Radiotherapy and Oncology, vol. 167, pp. 49-56.
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Brown, A, Tan, A, Anable, L, Callander, E, De Abreu Lourenco, R & Pain, T 2022, 'Perceptions and recall of treatment for prostate cancer: A survey of two populations', Technical Innovations & Patient Support in Radiation Oncology, vol. 24, pp. 78-85.
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Brugulat‐Serrat, A, Chen, Y, Demnitz, N, Ashour, A, Adrion, E, Ilinca, S, Kinchin, I, Almirall‐Sanchez, A, Öz, D, Karanja, W, Pintado, M, Rogers, N, Browning, A, Petkuté, I & Lawlor, B 2022, 'Roadmap for change in sex and gender inequities in brain health: A global perspective', International Journal of Geriatric Psychiatry, vol. 37, no. 5.
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Butow, P, Shepherd, HL, Cuddy, J, Rankin, N, Harris, M, He, S, Grimison, P, Girgis, A, Faris, M, Beale, P, Butow, P, Clayton, J, Cuddy, J, Davies, F, Dhillon, H, Faris, M, Geerligs, L, Girgis, A, Grimison, P, Hack, T, Harris, M, He, S, Kelly, B, Kelly, P, Kirsten, L, Lindsay, T, Lovell, M, Luckett, T, Masya, L, Murphy, M, Newby, J, Piro, D, Rankin, N, Shaw, J, Shaw, T, Shepherd, H, Viney, R, Yim, J & Shaw, J 2022, 'Staff perspectives on the feasibility of a clinical pathway for anxiety and depression in cancer care, and mid-implementation adaptations', BMC Health Services Research, vol. 22, no. 1.
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AbstractBackgroundClinical pathways (CPs) are intended to standardise and improve care but do not always produce positive outcomes, possibly because they were not adapted to suit the specific context in which they were enacted. This qualitative study aimed to explore staff perspectives of implementation of a CP for routine screening, assessment, referral and management of anxiety and depression (the ADAPT CP) for patients with cancer, focussing on perceived feasibility of the CP and negotiated adaptations made during the implementation phase.MethodsThe ADAPT CP was implemented in 12 urban and regional oncology services in Australia. Services were randomised to receive core versus enhanced implementation strategies. Core sites received support until implementation commencement and could access progress reports. Enhanced sites received proactive, ongoing support during the 12-month implementation. Purposively selected staff were interviewed prior to implementation (n = 88) and 6 months later, half-way through the implementation period (n = 89). Monthly meetings with lead multi-disciplinary teams at the eight enhanced sites were recorded. Data were thematically analysed.ResultsSix overarching themes were identified: ADAPT is of high value; timing for introducing the CP and screening is difficult; online screening is challenging; a burden too much; no-one to refer patients to; and micro-logistics are key. While early screening was deemed desirable, diverse barriers meant this was complex, with adaptations made to time and screening location. Online screening prompted by email, seen as time-saving and efficient, also proved unsuccessful in some services, with adaptations made to in-clinic or phone screening, or rep...

Campbell, M, Page, K, Longden, T, Kenny, P, Hossain, L, Wilmot, K, Kelly, S, Kim, Y, Haywood, P, Mulhern, B, Goodall, S, van Gool, K, Viney, R, Cumming, T & Soeberg, M 2022, 'Evaluation of the Victorian Healthy Homes Program: protocol for a randomised controlled trial', BMJ Open, vol. 12, no. 4, pp. e053828-e053828.
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IntroductionThe evaluation of the Victorian Healthy Homes Program (VHHP) will generate evidence about the efficacy and cost-effectiveness of home upgrades to improve thermal comfort, reduce energy use and produce health and economic benefits to vulnerable households in Victoria, Australia.Methods and analysisThe VHHP evaluation will use a staggered, parallel group clustered randomised controlled trial to test the home energy intervention in 1000 households. All households will receive the intervention either before (intervention group) or after (control group) winter (defined as 22 June to 21 September). The trial spans three winters with differing numbers of households in each cohort. The primary outcome is the mean difference in indoor average daily temperature between intervention and control households during the winter period. Secondary outcomes include household energy consumption and residential energy efficiency, self-reported respiratory symptoms, health-related quality of life, healthcare utilisation, absences from school/work and self-reported conditions within the home. Linear and logistic regression will be used to analyse the primary and secondary outcomes, controlling for clustering of households by area and the possible confounders of year and timing of intervention, to compare the treatment and control groups over the winter period. Economic evaluation will include a cost-effectiveness and cost-benefit analysis.Ethics and disseminationEthical approval was received from Victorian Department of Human Services Human Research Ethics Committee (reference number: 04/17), University of Technology Sydney Human Research Ethics Committee (reference number: ETH18-2273) and Australian Government Department of Veterans Affairs. Study results will be disseminated in a final report and...

Carey, KA, Farrar, MA, Kasparian, NA, Street, DJ & De Abreu Lourenco, R 2022, 'Family, healthcare professional, and societal preferences for the treatment of infantile spinal muscular atrophy: A discrete choice experiment', Developmental Medicine & Child Neurology, vol. 64, no. 6, pp. 753-761.
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AimTo understand the factors that most influence decision‐making in the treatment of infantile spinal muscular atrophy (SMA).MethodA discrete choice experiment was conducted among parents of people with SMA (parents), healthcare professionals (HCPs), and members of the Australian general population (GenPop). Respondents were asked to accept/reject treatment for an infant newly diagnosed with SMA in eight hypothetical scenarios, characterized by different combinations of the attributes of the treatment offered. The results were analyzed using probability analysis.ResultsCompleted responses were provided from 1113 individuals (1024 GenPop, 21 parents, 68 HCPs). Respondents were more likely to accept treatments that improved functioning and mobility. Treatments with higher costs, invasive delivery, and risks of adverse events were accepted less often. Cost most affected treatment choices by HCPs and GenPop, while change in mobility and mode of administration were most influential for parents.InterpretationThese results highlight the importance of understanding value for money and clinical impact in affecting treatment choice, which are crucial for effective planning of healthcare and the successful implementation of treatment programmes for SMA.What this paper addsSpinal muscular atrophy (SMA) treatments with a higher chance of improving functioning and mobility are preferred by the general population, parents, and healthcare professionals.Treatments with ...

Carlton, J, Peasgood, T, Mukuria, C, Connell, J, Brazier, J, Ludwig, K, Marten, O, Kreimeier, S, Engel, L, Belizán, M, Yang, Z, Monteiro, A, Kuharic, M, Luo, N, Mulhern, B, Greiner, W, Pickard, S & Augustovski, F 2022, 'Generation, Selection, and Face Validation of Items for a New Generic Measure of Quality of Life: The EQ-HWB', Value in Health, vol. 25, no. 4, pp. 512-524.
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Church, J, Street, D, Bateson, D & Haas, M 2022, 'POSA352 The Preferences of Australian Women for the Outcomes of Long-Acting Reversible Contraception (LARC)', Value in Health, vol. 25, no. 1, pp. S218-S218.
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Clark, J, Chang, S, Kinchin, I, Ferreira, D, Kochovska, S, Morgan, D, Poulos, LM, Johnson, MJ, Ekström, M & Currow, DC 2022, 'Lower workforce participation is associated with more severe persisting breathlessness', BMC Pulmonary Medicine, vol. 22, no. 1, p. 93.
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Abstract Background Not being able to work has negative health, social and financial consequences. Persisting breathlessness is prevalent in working-aged people. Is it associated with lower workforce participation? This study, using the South Australian Health Omnibus, aimed to explore associations between paid workforce participation and persisting breathlessness intensity, and economic impacts on income in people of working age. Methods This cross-sectional study conducted face-to-face interviews with a random sample of adults in South Australia (n = 8916). Questions included key demographic data, workforce participation and the presence and intensity of persisting breathlessness. Data from working-aged respondents (20–65 years of age) were standardised to the census for regression analyses. Work was coded to paid full- or part-time work or ‘other’. Persisting breathlessness (more than three of the last six months) used the modified Medical Research Council breathlessness scale (aggregated to 0, 1, 2–4). Opportunity cost valuations compared annual income foregone by persisting breathlessness severity. Results Of people interviewed, 6,608 were working-aged (49.9% male; 67.5% had post-secondary qualifications; 70.9% were in paid full- or part-time work; and 1.7% had mMRC score 2–4). Workforce participation dropped in working aged people with increasing breathlessness: mMRC 0, 70.6%; mMRC 1, 51.7%; mMRC 2–4, 20.3%. In the regression model, people with the most severe breathlessness were much less likely to work (OR 0.14; 95% CI 0.09, 0.22). Annual income foregone by people with persisting breathlessness was AU$10.7 billion (AU$9.1b for full...

Conduit, C, Mak, B, Qu, W, Lulio, JD, Burder, R, Bressel, M, Cusick, T, Dhillon, HM, Lourenço, RDA, Underhill, C, Torres, J, Crumbaker, M, Honeyball, F, Linton, A, Allen, R, Davis, ID, Clark, SJ, Horvath, LG & Mahon, KL 2022, 'GUIDE: a randomised non-comparative phase II trial of biomarker-driven intermittent docetaxel versus standard-of-care docetaxel in metastatic castration-resistant prostate cancer (clinical trial protocol)', Therapeutic Advances in Medical Oncology, vol. 14, pp. 175883592210924-175883592210924.
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Objective: To determine the efficacy and safety of intermittent docetaxel chemotherapy guided by circulating methylated glutathione S-transferase Pi-1 ( mGSTP1) in men with metastatic castration-resistant prostate cancer (CRPC). Patients and Methods: GUIDE (NCT04918810) is a randomised, two-arm, non-comparative phase-2 trial recruiting 120 patients at six Australian centres. Patients with Prostate Cancer Working Group-3 defined metastatic CRPC who are commencing docetaxel 75 mg/m2 q3w will be pre-screened for detectable mGSTP1 at baseline ± following two cycles of treatment. Those with detectable plasma mGSTP1 at baseline that becomes undetectable after two cycles of chemotherapy will be eligible for GUIDE. Prior to Cycle 4 of docetaxel, these patients are randomised 2:1 to one of two treatment arms: Arm A (cease docetaxel and reinstitute if mGSTP1 becomes detectable) or Arm B (continue docetaxel 75 mg/m2 q3w in accordance with clinician’s usual practice). The primary endpoint is radiographic progression-free survival. Secondary endpoints include time on treatment holidays, safety, patient-reported outcomes, overall survival, health resource use, and cost associated with treatment. Enrolment commenced November 2021. Results and Conclusion: The results of this trial will generate data on the clinical utility of mGSTP1 as a novel biomarker to guide treatment de-escalation in metastatic CRPC.

Cunich, M, Barakat-Johnson, M, Lai, M, Arora, S, Church, J, Basjarahil, S, Campbell, JL, Disher, G, Geering, S, Ko, N, Leahy, C, Leong, T, McClure, E, O'Grady, M, Walsh, J, White, K & Coyer, F 2022, 'The costs, health outcomes and cost-effectiveness of interventions for the prevention and treatment of incontinence-associated dermatitis: A systematic review', International Journal of Nursing Studies, vol. 129, pp. 104216-104216.
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BACKGROUND: Incontinence-associated dermatitis is a common, under-recognized painful skin condition associated with poorer quality of life, increased nurse workloads, and costs. OBJECTIVE: To systematically review economic evidence for the prevention and treatment of incontinence-associated dermatitis. DESIGN: Systematic review of quantitative research. DATA SOURCES: PubMed, MEDLINE, EMBASE, Cochrane Library, York Centre for Reviews and Dissemination database, Econlit, Tufts' Cost-Effectiveness Analysis Registry, and Web of Science. REVIEW METHODS: A comprehensive search for studies on resource use (costs), health outcomes, and cost-effectiveness of interventions for incontinence-associated dermatitis was conducted. Screening, data extraction, and initial quality assessment were conducted independently by two reviewers, with disagreements/queries regarding quality settled through consensus with the larger team. Quality evaluated using the Consolidated Health Economic Evaluation Reporting Standards checklist and results narratively arranged. FINDINGS: Seventeen studies (10 for prevention, one for treatment and six for both prevention and treatment) included. All studies measured resource use from a healthcare provider perspective; 14 quantified resources in monetary terms. Considerable variation existed in the resource use data primarily due to differences in the type of resources counted, selected time horizons, valuation methods, and reporting approaches. Ten studies provided evidence of their intervention to be cost saving (or at least cost avoiding). Five studies on barrier products provided evidence to be cost saving: three for prevention, one for treatment, and one for both prevention and treatment. Two studies of cleanser and barrier products provided evidence to be cost saving for the prevention and treatment of incontinence-associated dermatitis. One study found a cleanser to be a cost saving preventative intervention. One bowel management syste...

Davidoff, DF, Benn, DE, Field, M, Crook, A, Robinson, BG, Tucker, K, De Abreu Lourenco, R, Burgess, JR & Clifton-Bligh, RJ 2022, 'Surveillance Improves Outcomes for Carriers of SDHB Pathogenic Variants: A Multicenter Study', The Journal of Clinical Endocrinology & Metabolism, vol. 107, no. 5, pp. e1907-e1916.
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Abstract Context Carriers of succinate dehydrogenase type B (SDHB) pathogenic variants (PVs) are at risk of pheochromocytoma and paraganglioma (PPGL) from a young age. It is widely recommended carriers enter a surveillance program to detect tumors, but there are limited studies addressing outcomes of surveillance protocols for SDHB PV carriers. Objective The purpose of this study was to describe surveillance-detected (s-d) tumors in SDHB PV carriers enrolled in a surveillance program and to compare their outcomes to probands. Methods This was a multicenter study of SDHB PV carriers with at least 1 surveillance episode (clinical, biochemical, imaging) in Australian genetics clinics. Data were collected by both retrospective and ongoing prospective follow-up. Median duration of follow-up was 6.0 years. Results 181 SDHB PV carriers (33 probands and 148 nonprobands) were assessed. Tumors were detected in 20% of nonprobands undergoing surveillance (age range 9-76 years). Estimated 10-year metastasis-free survival was 66% for probands and 84% for nonprobands with s-d tumors (P = .027). S-d tumors were smaller than those in probands (median 27 mm vs 45 mm respectively, P = .001). Tumor size ≥40 mm was associated with progression to metastatic disease (OR 16.9, 95% CI 2.3-187.9, P = .001). Patients with s-d tumors had lower mortality compared to probands: 10-year overall survival was 79% for probands and 100% for nonprobands (P = .029). ...

Davies, F, Harris, M, Shaw, J, Butow, P, Newby, J, Murphy, M, Kirsten, L & Shepherd, HL 2022, 'Uptake of an online psychological therapy program (iCanADAPT‐Early) when implemented within a clinical pathway in cancer care centres', Psycho-Oncology, vol. 31, no. 2, pp. 338-341.
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Key pointsProviding access to an online psychological therapy program in cancer care did not result in significant uptake and engagement by patients, or referrals by cancer care professionalsDespite many opportunities for referral by cancer care professionals, only 2% resulted in a referral to the program. None of these referrals were taken upTwenty five patients self‐referred, however only seven (28%) matched the recommended criteria for the program of mild to moderate psychological distressPatient engagement in the program was low, with 11/25 (44%) patients completing at least one lessonCancer care professionals reported numerous barriers to use including patient barriers such as fatigue, and personal barriers such as forgetting to refer

Desborough, J, Wright, M, Parkinson, A, Dykgraaf, SH, Ball, L, Dut, GM, Sturgiss, E, de Toca, L & Kidd, M 2022, 'What strategies have been effective in optimising COVID-19 vaccine uptake in Australia and internationally?', Australian Journal of General Practice, vol. 51, no. 9, pp. 725-730.
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Devlin, N, Roudijk, B, Viney, R & Stolk, E 2022, 'EQ-5D-Y-3L Value Sets, Valuation Methods and Conceptual Questions', PharmacoEconomics, vol. 40, no. S2, pp. 123-127.
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Finch, AP & Mulhern, B 2022, 'Where do measures of health, social care and wellbeing fit within a wider measurement framework? Implications for the measurement of quality of life and the identification of bolt-ons', Social Science & Medicine, vol. 313, pp. 115370-115370.
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Francisco, MC, Lane, H, Luckett, T, Disalvo, D, Pond, D, Mitchell, G, Chenoweth, L, Phillips, J, Beattie, E, Luscombe, G, Goodall, S & Agar, M 2022, 'Facilitated case conferences on end-of-life care for persons with advanced dementia—a qualitative study of interactions between long-term care clinicians and family members', Age and Ageing, vol. 51, no. 2.
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Abstract Background Prognostic uncertainty and the need for proxy decision-making owing to cognitive impairment in advanced dementia, adds complexity to end-of-life care planning within the long-term care setting. Case conferences provide a structure to facilitate difficult conversations and an opportunity for family and clinicians to engage in prospective planning, and reach agreement on goals of end-of-life care. Objective To explore interactions between multidisciplinary healthcare clinicians and families during facilitated case conferences on end-of-life care for residents with advanced dementia. Methods A qualitative approach was used. Transcripts of audio-recorded case conferences facilitated by a trained registered nurse were coded by two independent researchers and analysed inductively. Transcripts were selected from an available pool until thematic saturation was reached. Emerging themes were confirmed with the wider research group. Results Thematic saturation was reached after 25 transcripts. An overarching theme concerned the ways in which clinicians and families bridged medical and person-centred perspectives. Subthemes included: details of day-to-day care versus establishing overall goals of care; expression of emotion versus retreat from emotion; and missed opportunities versus expressed cues. Successful facilitation served to ‘bridge the gap’ between family and clinicians. ...

Friedland, P, Tucker, S, Goodall, S, Julander, J, Mendenhall, M, Molloy, P, de Jong, DM, Musungaie, DB, Sikazwe, C, Panta, K, Levy, A & Smith, D 2022, 'In vivo (human) and in vitro inactivation of SARS-CoV-2 with 0.5% povidone-iodine nasal spray', Australian Journal of Otolaryngology, vol. 5, pp. 0-0.
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Background: Nasal disinfection with 0.5% povidone-iodine (PVP-I) may be a useful adjunct in the management of COVID-19. The purpose of this article is to confirm the in vitro activity of the PVP-I nasal spray against SARS-CoV-2 and whether that may translate into reduced nasal shedding in vivo. Methods: Two SARS-CoV-2 virus isolates were exposed to 0.5% PVP-nasal spray (Nasodine®) for different times in vitro, with PCR and cell culture used to assess impact on viral infectivity and RNA copies. An open label in vivo single arm pilot study of 14 subjects with positive COVID-19 PCR diagnosis was undertaken. Baseline nasal swabs were collected to quantify SARS-CoV-2 pre-treatment, followed by a single 0.5% PVP nasal spray application (1.12 mL). Nasal swabs were collected at 5, 15, and 60 minutes post-dose to assess immediate and residual impact of treatment. Results: In vitro, the nasal spray reduced infectivity by 3.5 log10 TCID50/mL (99.97%) after 15 seconds exposure and eliminated detectable viral infectivity after 60 seconds; there was no effect on viral RNA detection by PCR. In vivo, culturable virus (VOC beta/B.1.351 variant) was obtained from 6 of 14 PCRconfirmed positive subjects; in these subjects, 5 minutes after the single PVP-I dose, the mean viral titre was reduced by 65% versus baseline and by 79% versus baseline at 60 minutes post-dose. 5 of the 6 subjects (83%), had reduction or cessation of viral shedding at 5 minutes in all 6 subjects, virus titers 60 minutes post-dose were below baseline value. 0.5% PVP-I treatment didn’t interfere with the laboratory diagnosis of COVID-19 via PCR-detection of viral RNA in humans. Conclusions: 0.5% PVP-I nasal spray is rapidly virucidal to SARS-CoV-2 in vitro using exposure times consistent with nasal residence; single in vivo nasal administration reduced infectious viral titers in COVID-19 subjects with culturable virus. A single application of 0.5% PVP-I nasal spray does not interfere with PCR-mediated laboratory...

Gaughan, J, Liu, D, Gutacker, N, Bloor, K, Doran, T & Benger, JR 2022, 'Does the presence of general practitioners in emergency departments affect quality and safety in English NHS hospitals? A retrospective observational study', BMJ Open, vol. 12, no. 2, pp. e055976-e055976.
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ObjectivesEmergency departments (EDs) in NHS hospitals in England have faced considerable increases in demand over recent years. Most hospitals have developed general practitioner services in emergency departments (GPEDs) to treat non-emergency patients, aiming to relieve pressure on other staff and to improve ED efficiency and patient experience. We measured the impact of GPED services on patient flows, health outcomes and ED workload.DesignRetrospective observational study. Differences in GPED service availability across EDs and time of day were used to identify the causal effect of GPED, as patients attending the ED at the same hour of the day are quasi-randomly assigned to treatment or control groups based on their local ED’s service availability.ParticipantsAttendances to 40 EDs in English NHS hospitals from April 2018 to March 2019, 4 441 349 observations.Primary and secondary outcomes measuredOutcomes measured were volume of attendances, ‘non-urgent’ attendances, waiting times over 4 hours, patients leaving without being treated, unplanned reattendances within 7 days, inpatient admissions and 30-day mortality.ResultsWe found a small, statistically significant reduction in unplanned reattendances within 7 days (OR 0.968, 95% CI 0.948 to 0.989), equivalent to 302 fewer reattendances per year for the average ED. The clinical impact of this was judged to be negligible. There was no detectable impact on any other outcome measure.ConclusionsWe found no adverse effects on patient outcomes; neither did we find any evidence of the hypothesised benefits of placing GPs in emergency settings beyond a margin...

Goodall, S, Viney, R, Street, D, Waller, DS & Zhao, FL 2022, 'Responses to direct-to-consumer advertising in Australia: Comparing experience', Health Marketing Quarterly, vol. 39, no. 4, pp. 398-409.
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This paper examines the potential effect of Direct-to-Consumer (DTC) advertising on consumers’ behavioral intentions in relation to a medical issue. Using an online experiment, 1295 people were randomized to two information conditions. One group watched an advertisement for a hypothetical cold sore medicine, while a second (control) group did not view the advertisement, before both groups answered questions on symptoms. The responses were analyzed based on group allocation and the respondents’ experience with cold sores. Results indicate that those who viewed the advertisement were more likely to choose the product, and the advertisement had larger effects based on consumer experience.

Grycuk, E, Chen, Y, Almirall‐Sanchez, A, Higgins, D, Galvin, M, Kane, J, Kinchin, I, Lawlor, B, Rogan, C, Russell, G, O'Sullivan, R & Leroi, I 2022, 'Care burden, loneliness, and social isolation in caregivers of people with physical and brain health conditions in English‐speaking regions: Before and during the COVID‐19 pandemic', International Journal of Geriatric Psychiatry, vol. 37, no. 6.
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AbstractBackgroundPublic health restrictions due to the COVID‐19 (SARS CoV‐2) pandemic have disproportionately affected informal caregivers of people living with long term health conditions. We aimed to explore levels of care burden, loneliness, and social isolation among caregivers of people with enduring physical and brain health conditions in English‐speaking regions worldwide, by investigating outcomes before and during the COVID‐19 pandemic.MethodsA cross‐sectional anonymous online survey data from 2287 English‐speaking caregivers of people with long term health conditions from four English‐speaking regions (UK, Ireland, USA, New Zealand) included measures of care burden, loneliness, and social isolation, reported before and during the COVID‐19 pandemic. Analyses were descriptive, followed by an ordinal regression model for predictors of burden.ResultsCompared to pre‐pandemic levels, all caregivers experienced a significant increase in burden, loneliness, and isolation. Caregivers of people with both brain health and physical conditions were the most burdened and had the highest levels of loneliness and isolation compared to caregivers of people with either a brain health or physical condition only. The increase in care burden among caregivers of people with brain health challenges was associated with caregiver's gender, moderate and severe emotional loneliness, magnitude and frequency of isolation during the pandemic, and care circumstances (cohabitation with the care recipient, restrictions on the ability to provide care).ConclusionsHealth and social care interventions should target caregivers' care circumstances and psychological outcomes, particularly in women, accounting for the significant ...

Gye, A, Goodall, S & De Abreu Lourenco, R 2022, 'A Systematic Review of Health Technology Assessments of Chimeric Antigen Receptor T-Cell Therapies in Young Compared With Older Patients', Value in Health, vol. 25, no. 1, pp. 47-58.
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Haas, M, Church, J, Street, DJ, Bateson, D & Mazza, D 2022, 'How can we encourage the provision of early medical abortion in primary care? Results of a best–worst scaling survey', Australian Journal of Primary Health, vol. 29, no. 3, pp. 252-259.
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Background Almost one in four women in Australia experience an unintended pregnancy during their lifetime; of these, approximately 30% currently end in abortion. Although early medical abortion (EMA) up to 9 weeks gestation is becoming more widely available in Australia, it is still not commonly offered in primary care. The aim of this study was to investigate the barriers and facilitators to the provision of EMA in primary care. Methods A sample of 150 general practitioners (GPs) and 150 registered nurses (RNs) working in Australia responded to a best–worst scaling survey designed to answer the following question: what are the most important facilitators and barriers to the provision of EMA in primary care? Results GPs believe that the lack of clinical guidelines, the amount of information provision and counselling required, and the fact that women who are not their patients may not return for follow-up are the most important barriers. For RNs, these three barriers, together with the stigma of being known as being involved in the provision of EMA, are the most important barriers. The formation of a community of practice to support the provision of EMA was identified by both professions as the most important facilitator. Conclusions Having access to a community of practice, enhanced training and reducing stigma will encourage the provision of EMA. Although clinical guidelines are available, they need to be effectively disseminated, implemented and endorsed by peak bodies. Primary care practices should consider using task sharing and developing patient resources to facilitate the provision of information and counselling.

Haas, M, Church, J, Street, DJ, Bateson, D, Fisher, J, Taft, A, Black, KI, Lucke, J, Hussainy, SY, McGeechan, K, Norman, W & Mazza, D 2022, 'The preferences of women in Australia for the features of long-acting reversible contraception: results of a discrete choice experiment', The European Journal of Contraception & Reproductive Health Care, vol. 27, no. 5, pp. 424-430.
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PURPOSE: Long-acting reversible contraceptives (LARC), such as intrauterine devices (IUD) and implants, are highly effective. However, the uptake of LARC in Australia has been slow and the oral contraceptive pill (OC) remains the best known and most widely used contraceptive. Our aim was to investigate women's preferences for the features of LARC. METHODS: We used a discrete choice experiment (DCE) in which each respondent completed 12 choice tasks. We recruited a general population sample of 621 women in Australia aged 18-49 using an online survey panel. A mixed logit model was used to analyse DCE responses; a latent class model explored preference heterogeneity. RESULTS: Overall, 391 (63%) of women were currently using contraception; 49.3% were using an OC. About 22% of women were using a LARC. Women prefer products that are more effective in preventing pregnancy, have low levels of adverse events (including negative effects on mood), and which their general practitioner (GP) recommends or says is suitable for them. CONCLUSIONS: Women have strong preferences for contraceptive products that are effective, safe, and recommended by their GP. The results indicate which characteristics of LARCs need to be front and centre in information material and in discussions between women and healthcare professionals.

Hafiz, N, Hyun, K, Tu, Q, Knight, A, Hespe, C, Chow, CK, Briffa, T, Gallagher, R, Reid, CM, Hare, DL, Zwar, N, Woodward, M, Jan, S, Atkins, ER, Laba, T-L, Halcomb, E, Johnson, T, Usherwood, T & Redfern, J 2022, 'Data-driven quality improvement program to prevent hospitalisation and improve care of people living with coronary heart disease: Protocol for a process evaluation', Contemporary Clinical Trials, vol. 118, pp. 106794-106794.
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Hettiarachchi, RM, Kularatna, S, Byrnes, J, Chen, G, Mulhern, B & Scuffham, PA 2022, 'Development of a classification (descriptive) system for a preference‐based quality of life measure for dental caries (dental caries utility index) among adolescents', Journal of Public Health Dentistry, vol. 82, no. 3, pp. 253-261.
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AbstractObjectivesPreference‐based quality‐of‐life measures (PBMs) have been developed in many clinical areas to aid estimation of more accurate utility values for economic evaluations. Existing oral health‐related quality‐of‐life (OHRQoL) instruments are non‐PBM and hence, cannot be used to generate utility values. The objective of this study was to develop a classification system for a new PBM (dental caries utility index‐DCUI) for the most prevalent childhood oral health condition: dental caries.MethodsPossible domains and items to be included in the classification system were identified based on the reviewing available pediatric non‐PBM OHRQoL instruments, studies eliciting utility values for oral health outcomes and clinical dentistry textbooks and based on the findings, a draft classification system was developed. To refine the draft classification system, semi‐structured interviews were conducted among a convenience sample of 15 12–17‐year‐old adolescents who had experience with dental caries. The classification system was further refined and validated by a group of dental experts, using a modified Delphi technique.ResultsThe classification system comprised five items (pain/discomfort, difficulty in eating food/drinking, worried, ability to participate in activities, and appearance) and each item had a four‐level response scale.ConclusionThe classification system developed herein is considered an amenable tool for the subsequent development of a new PBM for dental caries. Once the scoring algorithm is completed, the classification system can be used to incorporate economic evaluations of dental caries health interventions.

Jones, R, Mulhern, B, Devlin, N, O’Loughlin, R, Xiong, X, Bahrampour, M, McGregor, K, Yip, S, Hiscock, H & Dalziel, K 2022, 'PCR62 The Australian Paediatric Multi-Instrument Comparison (P-MIC) Study: Data Quality, Feasibility, Acceptability, and Construct Validity of the EQ-5D-Y-3L, EQ-5D-Y5L, CHU9D, PedsQL, HUI, PROMIS-25 and AQoL-6D', Value in Health, vol. 25, no. 12, pp. S401-S402.
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Karia, A, Norman, R, Robinson, S, Lehnbom, E, Laba, T-L, Durakovic, I, Balane, C, Joshi, R & Webster, R 2022, 'Pharmacist’s time spent: Space for Pharmacy-based Interventions and Consultation TimE (SPICE)—an observational time and motion study', BMJ Open, vol. 12, no. 3, pp. e055597-e055597.
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ObjectiveTo describe the pharmacists’ workflow, including tasks and time spent, to better understand their work capacity.DesignCross-sectional, observational, time and motion study.SettingCommunity pharmacies in Western Australia and New South Wales, Australia.ParticipantsCurrently registered and practising pharmacists were approached using snowball sampling and selected using purposive techniques to obtain balance representation of metropolitan and rural pharmacies, as well as high and low script volumes where possible.ResultsTwenty-four pharmacists across 15 pharmacies participated during the 135 sessions totalling over 274 hours of observation. Dispensing (30%), indirect patient services (17%), counselling (15%) and professional management activities (15%) were the top four duties pharmacists performed, while only 2% of time was spent on professional services such as pain clinics and influenza vaccinations. Tasks were frequently interrupted and often performed simultaneously. Breaks and consumer-contact times were limited. More time was spent on professional service activities in non-metropolitan pharmacies, in pharmacies with greater daily prescription volumes and those with one or more support pharmacists.ConclusionsThis is the first study to quantify the pharmacists’ tasks in Australian community pharmacies. Much time is being spent on dispensing, supply and management activities with little time for providing additional professional services. An extra supporting pharmacist is likely necessary to increase professional services. These findings could support future research around barriers and enab...

Khadka, J, Ratcliffe, J, Hutchinson, C, Cleland, J, Mulhern, B, Lancsar, E & Milte, R 2022, 'Assessing the construct validity of the Quality-of-Life-Aged Care Consumers (QOL-ACC): an aged care-specific quality-of-life measure', Quality of Life Research, vol. 31, no. 9, pp. 2849-2865.
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Abstract Purpose To evaluate the construct (convergent and known group) validity of the Quality-of-Life-Aged Care Consumer (QOL-ACC), an older-person-specific quality-of-life measure designed for application in quality assessment and economic evaluation in aged care. Methods Convergent validity was assessed by examining relationships with other validated preference-based measures (EQ-5D-5L, ASCOT), quality of aged care experience (QCE-ACC) and life satisfaction (PWI) through an online survey. Known-group validity was assessed by testing the ability to discriminate varying levels of care needs, self-reported health and quality of life. Results Older people (aged ≥ 65 years) receiving community-aged care (N = 313) responded; 54.6% were female, 41.8% were living alone and 56.8% were receiving higher-level care. The QOL-ACC and its six dimensions were low to moderately and significantly correlated with the EQ-5D-5L (correlation co-efficient range, ρ = 0.39–0.56). The QOL-ACC demonstrated moderate and statistically significant correlations with ASCOT (ρ = 0.61), the QCE-ACC (ρ = 0.51) and the PWI (ρ = 0.70). Respondents with poorer self-reported health status, quality of life and/or higher-level care needs demonstrated lower QOL-ACC scores (P < 0.001), providing evidence of known-group validity. Conclusions The study provides evidence of the construct validity of the QOL-ACC...

Khanna, D, Khadka, J, Mpundu-Kaambwa, C, Lay, K, Russo, R, Ratcliffe, J, Devlin, N, Norman, R, Viney, R, Ratcliffe, J, Dalziel, K, Mulhern, B, Hiscock, H, Street, D, Chen, G, Peasgood, T, Bailey, C, Mpundu-Kaambwa, C, Yu, A, Bahrampour, M, Jones, R, O’Loughlin, R, Luo, Y, van Heusden, A, Xiong, X, Khanna, D & De Silva, A 2022, 'Are We Agreed? Self- Versus Proxy-Reporting of Paediatric Health-Related Quality of Life (HRQoL) Using Generic Preference-Based Measures: A Systematic Review and Meta-Analysis', PharmacoEconomics, vol. 40, no. 11, pp. 1043-1067.
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OBJECTIVE: The aim of this study was to examine the level of agreement between self- and proxy-reporting of health-related quality of life (HRQoL) in children (under 18 years of age) using generic preference-based measures. METHODS: A systematic review of primary studies that reported agreement statistics for self and proxy assessments of overall and/or dimension-level paediatric HRQoL using generic preference-based measures was conducted. Where available, data on intraclass correlation coefficients (ICCs) were extracted to summarise overall agreement levels, and Cohen's kappa was used to describe agreement across domains. A meta-analysis was also performed to synthesise studies and estimate the level of agreement between self- and proxy-reported paediatric overall and domain-level HRQoL. RESULTS: Of the 30 studies included, 25 reported inter-rater agreement for overall utilities, while 17 reported domain-specific agreement. Seven generic preference-based measures were identified as having been applied: Health Utilities Index (HUI) Mark 2 and 3, EQ-5D measures, Child Health Utility 9 Dimensions (CHU9D), and the Quality of Well-Being (QWB) scale. A total of 45 dyad samples were included, with a total pooled sample of 3084 children and 3300 proxies. Most of the identified studies reported a poor inter-rater agreement for the overall HRQoL using ICCs. In contrast to more observable HRQoL domains relating to physical health and functioning, the inter-rater agreement was low for psychosocial-related domains, e.g., 'emotion' and 'cognition' attributes of both HUI2 and HUI3, and 'feeling worried, sad, or unhappy' and 'having pain or discomfort' domains of the EQ-5D. Parents demonstrated a higher level of agreement with children relative to health professionals. Child self- and proxy-reports of HRQoL showed lower agreement in cancer-related studies than in non-cancer-related studies. The overall ICC from the meta-analysis was estimated to be 0.49 (95% confidenc...

Kim, H, Liew, D & Goodall, S 2022, 'Current Issues in Health Technology Assessment of Cancer Therapies: A Survey of Stakeholders and Opinion Leaders in Australia', International Journal of Technology Assessment in Health Care, vol. 38, no. 1.
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AbstractObjectiveThe aim of this study was to find ways of bridging the gap in opinions concerning health technology assessment (HTA) in reimbursement submission between manufacturers and payers to avoid access delays for patients of vital medicines such as oncology drugs. This was done by investigating differences and similarities of opinion among key stakeholders in Australia.MethodsThe survey comprised of nine sections: background demographics, general statements on HTA, clinical claim, extrapolations, quality of life, costs and health resource utilization, agreements, decision making, and capability/capacity. Responses to each question were summarized using descriptive statistics and comparisons were made using chi-square statistics.ResultsThere were ninety-seven respondents in total, thirty-seven from the public sector (academia/government) and sixty from the private sector (industry/consultancies). Private and public sector respondents had similar views on clinical claims. They were divided when it came to extrapolation of survival data and costs and health resource utilization. However, they generally agreed that rebates are useful, outcomes-based agreements are difficult to implement, managed entry schemes are required when data are limited, and willingness to pay is higher in cancer compared to other therapeutic areas. They also agreed that training mostly takes place through on the job training and that guideline updates were a least favored opportunity for continued training.ConclusionsPrivate sector respondents favor me...

Kim, H, Liew, D & Goodall, S 2022, 'HPR35 The Impact of Biosimilar Trastuzumab on Drug Spending in Australia', Value in Health, vol. 25, no. 7, pp. S472-S473.
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Kinchin, I, Edwards, L, Adrion, E, Chen, Y, Ashour, A, Leroi, I, Brugulat‐Serrat, A, Phillips, J, Masterson, F & Kochovska, S 2022, 'Care partner needs of people with neurodegenerative disorders: What are the needs, and how well do the current assessment tools capture these needs? A systematic meta‐review', International Journal of Geriatric Psychiatry, vol. 37, no. 7.
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AbstractObjectivesThe burden on care partners, particularly once dementia emerges, is among the greatest of all caregiving groups. This meta‐review aimed to (1) synthesis evidence on the self‐reported needs of care partners supporting people living with neurodegenerative disorders; (2) compare the needs according to care partner and care recipient characteristics; and (3) determine the face validity of existing care partner needs assessment tools.MethodsWe conducted a systematic review of reviews involving a thematic synthesis of care partner needs and differences in needs according to demographic and other characteristics. We then conducted a gap analysis by identifying the themes of needs from existing needs assessment tools specific to dementia and cross‐matching them with the needs derived from the thematic synthesis.ResultsDrawing on 17 published reviews, the identified range of needs fell into four key themes: (1) knowledge and information, (2) physical, social and emotional support, (3) care partner self‐care, and (4) care recipient needs. Needs may differ according to disease trajectory, relationship to the care recipient, and the demographic characteristics of the care partner and recipient. The ‘captured needs’ range between 8% and 66% across all the included needs assessment tools.ConclusionsCurrent tools do not fully or adequately capture the self‐identified needs of care partners of people living with neurodegenerative disorders. Given the high burden on care partners, which has been further exacerbated by the COVID‐19 (SARS CoV‐2) pandemic, the needs assessment tools should align with the self‐reported needs of care partners throughout the caregiving trajectory to better understand unmet...

Kinchin, I, Kelley, S, Meshcheriakova, E, Viney, R, Mann, J, Thompson, F & Strivens, E 2022, 'Cost-effectiveness of a community-based integrated care model compared with usual care for older adults with complex needs: a stepped-wedge cluster-randomised trial', Integrated Healthcare Journal, vol. 4, no. 1, pp. e000137-e000137.
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ObjectiveTo assess the cost of implementation, delivery and cost-effectiveness (CE) of a flagship community-based integrated care model (OPEN ARCH) against the usual primary care.DesignA 9-month stepped-wedge cluster-randomised trial.Setting and participantsCommunity-dwelling older adults with chronic conditions and complex care needs were recruited from primary care (14 general practices) in Far North Queensland, Australia.MethodsCosts and outcomes were measured at 3-month windows from the healthcare system and patient’s out-of-pocket perspectives for the analysis. Outcomes included functional status (Functional Independence Measure (FIM)) and health-related quality of life (EQ-5D-3L and AQoL-8D). Bayesian CE analysis with 10 000 Monte Carlo simulations was performed using the BCEA package in R (V.3.6.1).ResultsThe OPEN ARCH model of care had an average cost of $A1354 per participant. The average age of participants was 81, and 55% of the cohort were men. Within-trial multilevel regression models adjusted for time, general practitioner cluster and baseline confounders showed no significant differences in costs, resource use or effect measures regardless of the analytical perspective. Probabilistic sensitivity analysis with 10 000 simulations showed that OPEN ARCH could be recommended over usual care for improving functional independence at a willing to pay above $A600 (US$440) per improvement of one point on the FIM Scale and for avoiding or reducing inpatient stay for any willingness-to-pay threshold up to $A50 000 (US$36 500).Conclusions and implicationsOPEN ARCH was associated with a favourable Bayesian CE p...

Kinchin, I, Leroi, I, Kennelly, SP, Kochovska, S, Brady, C, Fitzhenry, D, McHale, C, Kinghorn, P & Coast, J 2022, 'What does a “good life” mean for people living with dementia? A protocol for a think-aloud study informing the value of care', Frontiers in Aging Neuroscience, vol. 14, p. 1061247.
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IntroductionEconomic evaluation currently focuses almost exclusively on the maximization of health, using the Quality-Adjusted Life-Year (QALY) framework with instruments such as the EQ-5D, with a limited number of health-focused dimensions providing the assessment of health benefit. This evaluative framework is likely to be insufficient for setting priorities in dementia care because of its exclusive concern with health. Data are also often collected from the perspective of a proxy, limiting the voice of those living with dementia in decision-making. This protocol describes a research project that aims to gather the perspectives of people living with dementia, their insights, and preferences for assessing their quality of life to inform economic evaluation outcome measurement and design with a goal of creating a more robust evidence base for the value of healthcare services. Specifically, this study will elucidate what a “good life” means to people living with dementia and how well instruments currently used in economic evaluation meet this description. This project will further test the acceptability of capability wellbeing instruments as self-report instruments and compare them to generic and dementia-specific preference-based instruments.Methods and analysisPeople living with dementia, diagnosed, or waiting to receive a formal diagnosis and with the capacity to participate in research, will be invited to participate in an hour “think aloud” interview. Participants will be purposefully selected to cover a range of dementia diagnoses, age, and sex, recruited through the integrated care, geriatric, and post-diagnostic clinics at St James’ and Tallaght University Hospitals and dementia support groups in the Ireland. During the interview, participants will be invited to reflect on a “good life” and “think aloud” while completing four economic quality...

Kofol, C & Naghsh Nejad, M 2022, 'Child Labour and the Arrival of Refugees: Evidence from Tanzania', Journal of African Economies, vol. 31, no. 5, pp. 467-486.
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Abstract Despite efforts to reduce the incidence of child labour, about one in three children in Sub-Saharan Africa works. Using data for the Kagera region of Tanzania, we estimate how rates of child labour were impacted by a large influx of refugees fleeing from genocide in both Rwanda and Burundi. We find that the areas most affected by this population shock initially had a lower incidence of child labour. However, 10 years later, children in these areas were more likely to work on a farm and participate in domestic chores as the demand for agricultural labour increased.

Koh, E-S, Moore, A, Francis, RJ, Ebert, MA, Gan, HK, Lee, ST, Lau, E, Rossi, A, Grose, A, Ng, SP, Barnes, EH, Moffat, BA, Scott, FE, Adda, L, Foroudi, F, Nowak, AK, Bailey, DL, Back, M, Lourenco, RDA & Scott, AM 2022, 'A prospective, multi-centre trial of FET-PET in glioblastoma patients - the TROG 18.06 FIG Study: results of the Nuclear Medicine and Radiation Oncology credentialing program', WFNOS 2022 Abstract Book.
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Kron, T, Bressel, M, Lonski, P, Hill, C, Mercieca-Bebber, R, Ahern, V, Lehman, M, Johnson, C, Latty, D, Ward, R, Miller, D, Banjade, D, Morriss, D, De Abreu Lourenco, R, Woodcock, J, Montgomery, R, Lehmann, J & Chua, BH 2022, 'TROG 14.04: Multicentre Study of Feasibility and Impact on Anxiety of DIBH in Breast Cancer Patients', Clinical Oncology, vol. 34, no. 9, pp. e410-e419.
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Kularatna, S, Chen, G, Senanayake, S, Hettiarachchi, R, Parsonage, W, Norman, R, Mulhern, B, Mukuria, C, Rowen, D & McPhail, S 2022, 'Australian Health Utility Value Set for MacNew-7D Heart Disease-Specific Measure', Heart, Lung and Circulation, vol. 31, pp. S71-S71.
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Kularatna, S, Rowen, D, Mukuria, C, McPhail, S, Chen, G, Mulhern, B, Whitty, JA, Byrnes, J, Scuffham, P, Atherton, J, Höfer, S & Parsonage, W 2022, 'Development of a preference-based heart disease-specific health state classification system using MacNew heart disease-related quality of life instrument', Quality of Life Research, vol. 31, no. 1, pp. 257-268.
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Kwon, J, Freijser, L, Huynh, E, Howell, M, Chen, G, Khan, K, Daher, S, Roberts, N, Harrison, C, Smith, S, Devlin, N, Howard, K, Lancsar, E, Bailey, C, Craig, J, Dalziel, K, Hayes, A, Mulhern, B, Wong, G, Ratcliffe, J & Petrou, S 2022, 'Correction to: Systematic Review of Conceptual, Age, Measurement and Valuation Considerations for Generic Multidimensional Childhood Patient-Reported Outcome Measures', PharmacoEconomics, vol. 40, no. 4, pp. 477-478.
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Kwon, J, Freijser, L, Huynh, E, Howell, M, Chen, G, Khan, K, Daher, S, Roberts, N, Harrison, C, Smith, S, Devlin, N, Howard, K, Lancsar, E, Bailey, C, Craig, J, Dalziel, K, Hayes, A, Mulhern, B, Wong, G, Ratcliffe, J & Petrou, S 2022, 'Systematic Review of Conceptual, Age, Measurement and Valuation Considerations for Generic Multidimensional Childhood Patient-Reported Outcome Measures', PharmacoEconomics, vol. 40, no. 4, pp. 379-431.
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BACKGROUND AND AIMS: Patient-reported outcome measures (PROMs) for children (aged ≤ 18 years) present methodological challenges. PROMs can be categorised by their diverse underlying conceptual bases, including functional, disability and health (FDH) status; quality of life (QoL); and health-related quality of life (HRQoL). Some PROMs are designed to be accompanied by preference weights. PROMs should account for childhood developmental differences by incorporating age-appropriate health/QoL domains, guidance on respondent type(s) and design. This systematic review aims to identify generic multidimensional childhood PROMs and synthesise their characteristics by conceptual basis, target age, measurement considerations, and the preference-based value sets that accompany them. METHODS: The study protocol was registered in the Prospective Register of Systematic Reviews (CRD42021230833), and reporting followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted systematic database searches for generic multidimensional childhood PROMs covering the period 2012-2020, which we combined with published PROMs identified by an earlier systematic review that covered the period 1992-2011. A second systematic database search identified preference-based value sets for generic multidimensional PROMs. The PROMs were categorised by conceptual basis (FDH status, QoL and HRQoL) and by target age (namely infants and pre-schoolers aged < 5 years, pre-adolescents aged 5-11, adolescents aged 12-18 and multi-age group coverage). Descriptive statistics assessed how PROM characteristics (domain coverage, respondent type and design) varied by conceptual basis and age categories. Involvement of children in PROM development and testing was assessed to understand content validity. Characteristics of value sets available for the childhood generic multidimensional PROMs were identified and compared. RESULTS: We identified 89 PROMs, including...

Laba, T-L, Worthington, HC, Cheng, L, Chan, FKI, Bansback, N & Law, MR 2022, 'The impact of the Choosing Wisely Canada campaign on the simultaneous use of angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers: interrupted time-series analysis', CMAJ Open, vol. 10, no. 4, pp. E1059-E1066.
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Lin, J, Islam, K, Leeder, S, Huo, Z, Hung, CT, Yeoh, EK, Gillespie, J, Dong, H, Askildsen, JE, Liu, D, Cao, Q, Castelli, A & Yip, BHK 2022, 'Integrated Care for Multimorbidity Population in Asian Countries: A Scoping Review', International Journal of Integrated Care, vol. 22, no. 1.
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Long, E, Babl, FE, Phillips, N, Craig, S, Zhang, M, Kochar, A, McCaskill, M, Borland, ML, Slavin, MA, Phillips, R, Lourenco, RDA, Michinaud, F, Thursky, KA & Haeusler, G 2022, 'Prevalence and predictors of poor outcome in children with febrile neutropaenia presenting to the emergency department', Emergency Medicine Australasia, vol. 34, no. 5, pp. 786-793.
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AbstractObjectiveChildren with acquired neutropaenia due to cancer chemotherapy are at high risk of severe infection. The present study aims to describe the prevalence and predictors of poor outcomes in children with febrile neutropaenia (FN).MethodsThis is a multicentre, prospective observational study in tertiary Australian EDs. Cancer patients with FN were included. Fever was defined as a single temperature ≥38°C, and neutropaenia was defined as an absolute neutrophil count <1000/mm3. The primary outcome was the ICU admission for organ support therapy (inotropic support, mechanical ventilation, renal replacement therapy, extracorporeal life support). Secondary outcomes were: ICU admission, ICU length of stay (LOS) ≥3 days, proven or probable bacterial infection, hospital LOS ≥7 days and 28‐day mortality. Initial vital signs, biomarkers (including lactate) and clinical sepsis scores, including Systemic Inflammatory Response Syndrome, quick Sequential Organ Failure Assessment and quick Paediatric Logistic Organ Dysfunction‐2 were evaluated as predictors of poor outcomes.ResultsBetween December 2016 and January 2018, 2124 episodes of fever in children with cancer were screened, 547 episodes in 334 children met inclusion criteria. Four episodes resulted in ICU admission for organ support therapy, nine episodes required ICU admission, ICU LOS was ≥3 days in four, hospital LOS was ≥7 days in 153 and two patients died within 28 days. Vital signs, blood tests and clinical sepsis scores, including Systemic Inflammatory Response Syndrome, quick Sequential Organ Failure Assessment and quick Paediatric Logistic Organ Dysfunction‐2, performed poorly as predictors of these outcomes (area under the receiver operating characteristic curve <0.6).

Lourenco, RDA, Khoo, T, Crothers, A, Haas, M, Montgomery, R, Ball, D, Bressel, M & Siva, S 2022, 'Cost-Effectiveness of Single Versus Multifraction SABR for Pulmonary Oligometastases: The SAFRON II Trial', International Journal of Radiation Oncology*Biology*Physics, vol. 114, no. 5, pp. 968-976.
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Macey, J, Farrar, M, O’Donoghue, C, Knight, S, Carmichael, C, Marshall, C, Yonan, C, Imel, E, Salam, M & Mulhern, B 2022, 'PCR114 The Adjunctive Therapy Preferences of Adults with Classic Congenital Adrenal Hyperplasia: A Discrete Choice Experiment', Value in Health, vol. 25, no. 7, pp. S562-S562.
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Mak, A, Delbaere, K, Refshauge, K, Henwood, T, Goodall, S, Clemson, L, Hewitt, J & Taylor, ME 2022, 'Sunbeam Program Reduces Rate of Falls in Long-Term Care Residents With Mild to Moderate Cognitive Impairment or Dementia: Subgroup Analysis of a Cluster Randomized Controlled Trial', Journal of the American Medical Directors Association, vol. 23, no. 5, pp. 743-749.e1.
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Manahan, R, Macey, J, Farrar, M, O’Donoghue, C, Knight, S, Carmichael, C, Marshall, C, Yonan, C, Imel, E, Salam, M & Mulhern, B 2022, 'PSAT097 Patient Preference Research: Preferred Adjunctive Medication Attributes of Adult Patients with Classic Congenital Adrenal Hyperplasia', Journal of the Endocrine Society, vol. 6, no. Supplement_1, pp. A118-A118.
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Abstract Background People with classic congenital adrenal hyperplasia (CAH) often require supraphysiologic doses of glucocorticoids (e.g., hydrocortisone, dexamethasone) to treat cortisol deficiency and excess androgen production. Healthcare providers and patients continually try to balance androgen control with side effects from supraphysiologic glucocorticoids. This study aimed to understand the preferences of adults with classic CAH regarding benefits of a potential new adjunctive medication that may provide better androgen control and allow for lower glucocorticoid doses. Methods Discrete choice experiment (DCE) methodology was used to calculate the relative stated preferences for the additional therapy's hypothetical benefits (attributes). Seven attributes were developed for the DCE after review of relevant data and qualitative literature, interviews with eight adults with classic CAH and input from two endocrinologists. The online DCE survey was piloted via interviews with three adults with classic CAH and a soft launch, which confirmed survey content and functioning. Preference data and subgroup differences were analyzed using conditional logit and scale assessment modelling, respectively. Results US adults with classic CAH (N=118, 75% female, age 19–69) valued avoidance of glucocorticoid-induced weight gain by twice the magnitude of other treatment attributes (all coefficients p&lt;0.001 compared to baseline levels of no avoidance/decrease/improvement): complete avoidance of weight gain from glucocorticoids (1.109); moderate decrease in risk of developing health con...

McTaggart-Cowan, H, King, MT, Norman, R, Costa, DSJ, Pickard, AS, Viney, R, Peacock, SJ, Chan, K, Hoch, J, Leighl, N, Mittmann, N & Regier, D 2022, 'The FACT-8D, a new cancer-specific utility algorithm based on the Functional Assessment of Cancer Therapies-General (FACT-G): a Canadian valuation study', Health and Quality of Life Outcomes, vol. 20, no. 1.
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Abstract Introduction Utility instruments are used to assess patients’ health-related quality of life for cost-utility analysis (CUA). However, for cancer patients, the dimensions of generic utility instruments may not capture all the information relevant to the impact of cancer. Cancer-specific utilities provide a useful alternative. Under the auspices of the Multi-Attribute Utility in Cancer Consortium, a cancer-specific utility algorithm was derived from the FACT-G. The new FACT-8D contains eight dimensions: pain, fatigue, nausea, sleep, work, support from family/friends, sadness, and worry health will get worse. The aim of the study was to obtain a Canadian value set for the FACT-8D. Methods A discrete choice experiment was administered to a Canadian general population online panel, quota sampled by age, sex, and province/territory of residence. Respondents provided responses to 16 choice sets. Each choice set consisted of two health states described by the FACT-8D dimensions plus an attribute representing survival duration. Sample weights were applied and the responses were analyzed using conditional logistic regression, parameterized to fit the quality-adjusted life year framework. The results were converted into utility weights by evaluating the marginal rate of substitution between each level of each FACT-8D dimension with respect to duration. Results 2228 individuals were recruited. The analysis dataset included n = 1582 individuals, who completed at least one choice set; of which, n = 1501 completed all choice sets. After constraining to ensure monotonicity in the utility function, the largest decrements were for the highest le...

Mulhern, BJ, Sampson, C, Haywood, P, Addo, R, Page, K, Mott, D, Shah, K, Janssen, MF & Herdman, M 2022, 'Criteria for developing, assessing and selecting candidate EQ-5D bolt-ons', Quality of Life Research, vol. 31, no. 10, pp. 3041-3048.
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Abstract Purpose ‘Bolt-on’ dimensions are additional items added to multi-attribute utility instruments (MAUIs) such as EQ-5D that measure constructs not included in the core descriptive system. The use of bolt-ons has been proposed to improve the content validity and responsiveness of the descriptive system in certain settings and health conditions. EQ-5D bolt-ons serve a particular purpose and thus satisfy a certain set of criteria. The aim of this paper is to propose a set of criteria to guide the development, assessment and selection of candidate bolt-on descriptors. Methods Criteria were developed using an iterative approach. First, existing criteria were identified from the literature including those used to guide the development of MAUIs, the COSMIN checklist and reviews of existing bolt-ons. Second, processes used to develop bolt-ons based on qualitative and quantitative approaches were considered. The information from these two stages was formalised into draft development and selection criteria. These were reviewed by the project team and iteratively refined. Results Overall, 23 criteria for the development, assessment and selection of candidate bolt-ons were formulated. Development criteria focused on issues relating to i) structure, ii) language, and iii) consistency with the existing EQ-5D dimension structure. Assessment and selection criteria focused on face and content validity and classical psychometric indicators. Conclusion The criteria generated can be used to guide the development of bolt-ons across different hea...

Naghsh Nejad, M & Schurer, S 2022, 'Cognitive and non-cognitive abilities of immigrants: New perspectives on migrant quality from a selective immigration country', Journal of Economic Behavior & Organization, vol. 203, pp. 107-124.
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Nonvignon, J, Addo, R, Wang, H & Seddoh, A 2022, 'Benefit–cost analysis of electronic claims processing under Ghana’s National Health Insurance Scheme', BMJ Open, vol. 12, no. 5, pp. e054757-e054757.
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ObjectiveThe aim of this study was to evaluate the benefit–cost of E-claims. A benefit–cost analysis was used to evaluate the efficiency of E-claims from the perspective of the providers and the purchaser.DesignA benefit–cost analysis approach was taken for this economic evaluation. Furthermore, we estimated the incremental benefit–cost ratio (IBCR) of the intervention under assessment.ParticipantsPurchasers and healthcare providers of the National Health Insurance Scheme (NHIS) of Ghana were the study population.ResultsThe analysis was stratified according to providers and purchaser. Cost incurred in processing claims electronically and manually were estimated by assessing the resource use and their corresponding costs. Sensitivity analysis was conducted to assess the robustness of the results to variations in discount rate and proportions of claims processed under E-claims compared with paper claims. The combined sample of providers and purchaser made incremental gains from processing claims electronically. The IBCR was −19.75, 25.56 and 5.10 for all (sample) providers, purchaser and both providers and purchaser, respectively. When projected for the 330 facilities submitting claims to the NHIS claims processing centre (CPC) as at December 2014, the IBCR were −35.20, 25.56 and 90.06 for all providers, purchaser and both providers and purchaser. The results were sensitive to the discount rate used and proportions of E-claims compared with paper claims.ConclusionElectronic processing of claims is more efficient compared with manual processing, hence provide an economic case for scaling it up to cover many more healthcare facilities and NHIS CPCs in the Ghana.

Pan, T, Mulhern, B, Viney, R, Norman, R, Hanmer, J & Devlin, N 2022, 'A Comparison of PROPr and EQ-5D-5L Value Sets', PharmacoEconomics, vol. 40, no. 3, pp. 297-307.
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OBJECTIVES: The EQ-5D-5L and its value sets are widely used internationally. However, in the US and elsewhere, there is growing use of PROMIS, which has a value set (PROPr) based on the stated preferences of the US population. This paper aims to compare the characteristics of EQ-5D-5L and PROPr value sets and to highlight potential implications for users. METHODS: US, Australian and English value sets were used for EQ-5D-5L. PROPr utilities were calculated based on PROMIS-29 + 2. We examined, in each case, (i) the characteristics (e.g. range of values, number of unique values) and distribution of all possible 'theoretical' utilities; (ii) dimension/domain importance ranking by the utility of corner states (i.e. health states with the worst level in one domain and the best in all others); (iii) comparisons of utilities for health states hypothesised to be comparable in terms of severity across EQ-5D-5L descriptive systems and PROMIS-29 + 2 domain scores; (iv) the changes in values of adjacent states (i.e. a one-level change in one dimension for EQ-5D-5L and a four-point change in raw scores for PROMIS-29 + 2, with the other dimensions held constant) for dimensions hypothesised to overlap conceptually or be correlated between the two instruments. RESULTS: EQ-5D-5L and PROPr utilities differ systematically. First, the US EQ-5D-5L utilities range from - 0.573 to 1, whereas PROPr values for PROMIS-29 + 2 range from - 0.022 to 0.954. Second, in the US (and English) EQ-5D-5L value sets, pain is the most important dimension whereas in PROPr pain is one of the least important (apart from sleep disturbance). Third, classified based on severity across EQ-5D-5L descriptive systems and PROMIS-29 + 2 domain scores, PROPr has substantially lower values than EQ-5D-5L values for comparable 'mild' health states, but higher values for more 'severe' health states. Last, when one dimension is considered across its best to worst levels and all other dimensions are held const...

Pan, T, Mulhern, B, Viney, R, Norman, R, Tran-Duy, A, Hanmer, J & Devlin, N 2022, 'Evidence on the relationship between PROMIS-29 and EQ-5D: a literature review', Quality of Life Research, vol. 31, no. 1, pp. 79-89.
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Purpose

EQ-5D and PROMIS-29 are both concise, generic measures of patient-reported outcomes accompanied by preference weights that allow the estimation of quality-adjusted life years (QALYs). Both instruments are candidates for use in economic evaluation. However, they have different features in terms of the domains selected to measure respondents' self-perceived health and the characteristics of (and methods used to obtain) the preference weights. It is important to understand the relationship between the instruments and the implications of choosing either for the evidence used in decision-making. This literature review aimed to synthesise existing evidence on the relationship between PROMIS-29 (and measures based on it, such as PROMIS-29+2) and EQ-5D (both EQ-5D-3L and EQ-5D-5L).

Methods

A literature review was conducted in PubMed and Web of Science to identify studies investigating the relationship between PROMIS-29 and EQ-5D-based instruments.

Results

The literature search identified 95 unique studies, of which nine studies met the inclusion criteria, i.e. compared both instruments. Six studies examined the relationship between PROMIS-29 and EQ-5D-5L. Three main types of relationship have been examined in the nine studies: (a) comparing PROMIS-29 and EQ-5D as descriptive systems; (b) mapping PROMIS-29 domains to EQ-5D utilities; and (c) comparing and transforming PROMIS-29 utilities to EQ-5D utilities.

Conclusion

This review has highlighted the lack of evidence regarding the relationship between PROMIS-29 and EQ-5D. The impact of choosing either instrument on the evidence used in cost-effectiveness analysis is currently unclear. Further research is needed to understand the relationship between the two instruments.

Parkinson, A, Matenge, S, Desborough, J, Hall Dykgraaf, S, Ball, L, Wright, M, Sturgiss, EA & Kidd, M 2022, 'The impact of COVID ‐19 on chronic disease management in primary care: lessons for Australia from the international experience', Medical Journal of Australia, vol. 216, no. 9, pp. 445-448.
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Paterson, C, Roberts, C, Kozlovskaia, M, Nahon, I, Schubach, K, Sara, S, Sayner, AM, De Abreu Lourenco, R, Turner, M, Chan, RJ, Lam, T, Woo, H & Toohey, K 2022, 'The Effects of Multimodal Prehabilitation Interventions in Men Affected by Prostate Cancer on Physical, Clinical and Patient Reported Outcome Measures: A Systematic Review', Seminars in Oncology Nursing, vol. 38, no. 5, pp. 151333-151333.
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Peasgood, T, Mukuria, C, Brazier, J, Marten, O, Kreimeier, S, Luo, N, Mulhern, B, Greiner, W, Pickard, AS, Augustovski, F, Engel, L, Gibbons, L, Yang, Z, Monteiro, AL, Kuharic, M, Belizan, M & Bjørner, J 2022, 'Developing a New Generic Health and Wellbeing Measure: Psychometric Survey Results for the EQ-HWB', Value in Health, vol. 25, no. 4, pp. 525-533.
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OBJECTIVES: The development of measures such as the EQ-HWB (EQ Health and Wellbeing) requires selection of items. This study explored the psychometric performance of candidate items, testing their validity in patients, social carer users, and carers. METHODS: Article and online surveys that included candidate items (N = 64) were conducted in Argentina, Australia, China, Germany, United Kingdom, and the United States. Psychometric assessment on missing data, response distributions, and known group differences was undertaken. Dimensionality was explored using exploratory and confirmatory factor analysis. Poorly fitting items were identified using information functions, and the function of each response category was assessed using category characteristic curves from item response theory (IRT) models. Differential item functioning was tested across key subgroups. RESULTS: There were 4879 respondents (Argentina = 508, Australia = 514, China = 497, Germany = 502, United Kingdom = 1955, United States = 903). Where missing data were allowed, it was low (UK article survey 2.3%; US survey 0.6%). Most items had responses distributed across all levels. Most items could discriminate between groups with known health conditions with moderate to large effect sizes. Items were less able to discriminate across carers. Factor analysis found positive and negative measurement factors alongside the constructs of interest. For most of the countries apart from China, the confirmatory factor analysis model had good fit with some minor modifications. IRT indicated that most items had well-functioning response categories but there was some evidence of differential item functioning in many items. CONCLUSIONS: Items performed well in classical psychometric testing and IRT. This large 6-country collaboration provided evidence to inform item selection for the EQ-HWB measure.

Pulok, MH, van Gool, K & Hall, J 2022, 'The link between out-of-pocket costs and inequality in specialist care in Australia', Australian Health Review, vol. 46, no. 6, pp. 652-659.
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Objective Out-of-pocket (OOP) costs could act as a potential barrier to accessing specialist services, particularly among low-income patients. The aim of this study is to examine the link between OOP costs and socioeconomic inequality in specialist services in Australia. Methods This study is based on population-level data from the Medicare Benefits Schedule of Australia in 2014–15. Three outcomes of specialist care were used: all visits, visits without OOP costs (bulk-billed services), and visits with OOP costs. Logistic and zero-inflated negative binomial regression models were used to examine the association between outcome variables and area-level socioeconomic status after controlling for age, sex, state of residence, and geographic remoteness. The concentration index was used to quantify the extent of inequality. Results Our results indicate that the distribution of specialist visits favoured the people living in wealthier areas of Australia. There was a pro-rich inequality in specialist visits associated with OOP costs. However, the distribution of the visits incurring zero OOP cost was slightly favourable to the people living in lower socioeconomic areas. The pro-poor distribution of visits with zero OOP cost was insufficient to offset the pro-rich distribution among the visits with OOP costs. Conclusions OOP costs for specialist care might partly undermine the equity principle of Medicare in Australia. This presents a challenge to the government on how best to influence the rate and distribution of specialists’ services.

Ratcliffe, J, Bourke, S, Li, J, Mulhern, B, Hutchinson, C, Khadka, J, Milte, R & Lancsar, E 2022, 'Valuing the Quality-of-Life Aged Care Consumers (QOL-ACC) Instrument for Quality Assessment and Economic Evaluation', PharmacoEconomics, vol. 40, no. 11, pp. 1069-1079.
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Rendas-Baum, R, Mulhern, B, Thurn, C, McCausland, KL, Brazier, JE & Bjorner, JB 2022, 'HTA163 Development of SF-6Dv2 Health Utility Weights in the United States', Value in Health, vol. 25, no. 12, pp. S328-S328.
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Saing, S, van der Linden, N, Hayward, CS & Goodall, S 2022, 'HTA190 Discrete Event Simulation Model for Real-World Restricted Treatment Policies in End-Stage Heart Failure', Value in Health, vol. 25, no. 12, pp. S333-S333.
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Schummers, L, Darling, EK, Dunn, S, McGrail, K, Gayowsky, A, Law, MR, Laba, T-L, Kaczorowski, J & Norman, WV 2022, 'Abortion Safety and Use with Normally Prescribed Mifepristone in Canada', New England Journal of Medicine, vol. 386, no. 1, pp. 57-67.
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BACKGROUND: In the United States, mifepristone is available for medical abortion (for use with misoprostol) only with Risk Evaluation and Mitigation Strategy (REMS) restrictions, despite an absence of evidence to support such restrictions. Mifepristone has been available in Canada with a normal prescription since November 2017. METHODS: Using population-based administrative data from Ontario, Canada, we examined abortion use, safety, and effectiveness using an interrupted time-series analysis comparing trends in incidence before mifepristone was available (January 2012 through December 2016) with trends after its availability without restrictions (November 7, 2017, through March 15, 2020). RESULTS: A total of 195,183 abortions were performed before mifepristone was available and 84,032 after its availability without restrictions. After the availability of mifepristone with a normal prescription, the abortion rate continued to decline, although more slowly than was expected on the basis of trends before mifepristone had been available (adjusted risk difference in time-series analysis, 1.2 per 1000 female residents between 15 and 49 years of age; 95% confidence interval [CI], 1.1 to 1.4), whereas the percentage of abortions provided as medical procedures increased from 2.2% to 31.4% (adjusted risk difference, 28.8 percentage points; 95% CI, 28.0 to 29.7). There were no material changes between the period before mifepristone was available and the nonrestricted period in the incidence of severe adverse events (0.03% vs. 0.04%; adjusted risk difference, 0.01 percentage points; 95% CI, -0.06 to 0.03), complications (0.74% vs. 0.69%; adjusted risk difference, 0.06 percentage points; 95% CI, -0.07 to 0.18), or ectopic pregnancy detected after abortion (0.15% vs. 0.22%; adjusted risk difference, -0.03 percentage points; 95% CI, -0.19 to 0.09). There was a small increase in ongoing intrauterine pregnancy continuing to delivery (adjusted risk difference, 0.08 perc...

Shaw, J, Allison, K, Cuddy, J, Lindsay, T, Grimison, P, Shepherd, H, Butow, P, Shaw, T, Baychek, K, Allison, K, Andrews, G, Baychek, K, Beale, P, Butow, P, Clayton, J, Coll, J, Cuddy, J, Davies, F, Dhillon, H, Faris, M, Geerligs, L, Girgis, A, Grimison, P, Hack, T, Harris, M, He, S, Kelly, B, Kirsten, L, Lindsay, T, Lovell, M, Luckett, T, Masya, L, Murphy, M, Newby, J, Orr, F, Pearce, A, Piro, D, Rankin, N, Shaw, J, Shaw, T, Shepherd, H, Stubbs, J, Viney, R, White, F, Yim, J & Kelly, B 2022, 'Development, acceptability and uptake of an on-line communication skills education program targeting challenging conversations for oncology health professionals related to identifying and responding to anxiety and depression', BMC Health Services Research, vol. 22, no. 1, p. 132.
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Abstract Background Anxiety and depression screening and management in cancer settings occurs inconsistently in Australia. We developed a clinical pathway (ADAPT CP) to promote standardized assessment and response to affected patients and enhance uptake of psychosocial interventions. Health professional education is a common strategy utilised to support implementation of practice change interventions. We developed an interactive on-line education program to support staff communication and confidence with anxiety/depression screening and referral prior to the ADAPT CP being implemented in 12 oncology services participating in the ADAPT CP cluster randomised controlled trial (CRCT). The aim of this research was to assess acceptability and uptake of the education program. Patient Involvement: Although the wider ADAPT Program included patient consumers on the Steering Committee, in the context of this research consumer engagement included health professionals working in oncology. These consumers contributed to resource development. Methods Development was informed by oncology and communication literature. The five online modules were pilot tested with 12 oncology nurses who participated in standardised medical simulations. Acceptability and uptake were assessed across the 12 Oncology services participating in the ADAPT CRCT. Results During pilot testing the online training was reported to be acceptable and overall communication and confidence improved for all participants post training. However, during the ADAPT CRCT uptake was low (7%; n = 20). Although those who accessed the trainin...

Taft, A, Watson, CJ, McCarthy, E, Black, KI, Lucke, J, McGeechan, K, Haas, M, McNamee, K, Peipert, JF & Mazza, D 2022, 'Sustainable and effective methods to increase long‐acting reversible contraception uptake from the ACCORd general practice trial', Australian and New Zealand Journal of Public Health, vol. 46, no. 4, pp. 540-544.
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OBJECTIVE: Most Australian women access contraception through general practitioners (GPs) but choose oral methods rather than long-acting reversible contraceptives (LARCS). The Australian Contraceptive ChOice pRoject (ACCORd) successfully tested a complex intervention for LARC uptake. We aimed to explore the critical elements of this intervention to increase LARC uptake. DESIGN: ACCORd was a cluster randomised control trial conducted in 57 GP clinics in Melbourne, Australia. To explore intervention impact, fidelity checks (n=21 GPs) and interviews with 37 GPs and 40 patients were undertaken 12 months after initial consultations. Data were inductively coded, thematically analysed and mapped to Normalization Process Theory constructs. RESULTS: Doctors understood the importance of effectiveness-based contraceptive counselling (EBCC). GPs demonstrated cognitive engagement in the promotion of LARC and some appreciated the rapid referral pathways. GPs and women valued the effectiveness approach. GPs held varying views about having a rapid referral pathway, with many already having established pathways in place. Some GPs viewed intrauterine device insertion costs or insertion training as barriers to ongoing practice. Most GPs and women saw the ACCORD model as effective and sustainable. CONCLUSIONS: GP training in EBCC and the use of rapid referral pathways were critical features of an effective sustainable model for successful uptake of LARCs in primary care. IMPLICATIONS FOR PUBLIC HEALTH: Improving Australian women's access to and use of LARCs is sustainable with EBCC training and support for general practitioners.

Tew, M, De Abreu Lourenco, R, Gordon, JR, Thursky, KA, Slavin, MA, Babl, FA, Orme, L, Bryant, PA, Teh, BW, Dalziel, K & Haeusler, GM 2022, 'Cost‐effectiveness of home‐based care of febrile neutropenia in children with cancer', Pediatric Blood & Cancer, vol. 69, no. 7.
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AbstractIntroductionHome‐based treatment of febrile neutropenia (FN) in children with cancer with oral or intravenous antibiotics is safe and effective. There are limited data on the economic impact of this model of care. We evaluated the cost‐effectiveness of implementing an FN programme, incorporating home‐based intravenous antibiotics for carefully selected patients, in a tertiary paediatric hospital.MethodsA decision analytic model was constructed to compare costs and outcomes of the home‐based FN programme, with usual in‐hospital treatment with intravenous antibiotics. The programme included a clinical decision rule to stratify patients by risk for severe infection and home‐based eligibility criteria using disease, chemotherapy and patient‐level factors. Health outcomes (quality of life) and probabilities of FN risk classification and home‐based eligibility were based on prospectively collected data between 2017 and 2019. Patient‐level costs were extracted from hospital administrative records. Cost‐effectiveness was expressed as the incremental cost per quality‐adjusted life year (QALY).FindingsThe mean health care cost of home‐based FN treatment in low‐risk patients was Australian dollars (A$) 7765 per patient compared to A$20,396 for in‐hospital treatment (mean difference A$12,632 [95% CI: 12,496–12,767]). Overall, the home‐based FN programme was the dominant strategy, being more effective (0.0011 QALY [95% CI: 0.0011–0.0012]) and less costly. Results of the model were most sensitive to proportion of children eligible for home‐based care programme.ConclusionCompared to in‐hospital FN care, the home‐based FN programme is cost‐effective, with savings arising from cheaper cost of caring for childr...

Venning, B, Saya, S, De Abreu Lourenco, R, Street, DJ & Emery, JD 2022, 'Preferences for a polygenic test to estimate cancer risk in a general Australian population', Genetics in Medicine, vol. 24, no. 10, pp. 2144-2154.
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Wise, S, Coleshill, MJ, Taylor, N, Le, M, Debono, D, Day, RO, Melocco, T, Baysari, MT, Laba, T & Carland, JE 2022, 'Australian hospital outpatient pharmacies: service adaptations during the 2020 national coronavirus disease 2019 lockdown', Journal of Pharmacy Practice and Research, vol. 52, no. 4, pp. 326-328.
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Wise, S, Duffield, C, Fry, M & Roche, M 2022, 'A team mental model approach to understanding team effectiveness in an emergency department: A qualitative study', Journal of Health Services Research & Policy, vol. 27, no. 1, pp. 14-21.
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ObjectivesTo demonstrate how the team mental model concept can broaden our understanding of team effectiveness in health care by exploring the knowledge that underpins it, and the workplace conditions that sustain it in a metropolitan emergency department (ED) in Sydney, Australia.MethodsThis study draws on accounts of 19 ED clinicians (registered nurses, doctors and nurse practitioners) of their teamwork practice and perceptions of their team’s effectiveness through semi-structured interviews. Analysis was conducted in two stages. A thematic analysis was followed by a template analysis using the a priori themes of task, team, team process and goal knowledge to specify the content of the team’s mental model.ResultsThe content of the ED team’s mental model revealed that the knowledge the team employed to coordinate their work was deeply embedded in the team’s tasks and the workplace context. Team effectiveness not only relied on how well team members coordinate, but also their ability to perform their own role effectively and efficiently. Three workplace conditions were identified as enablers to individuals acquiring the knowledge needed to work effectively in the team: stability in team membership; workplace experience; and the spatial-temporal conditions of emergency work where permanent emergency doctors and nurses executed their tasks concurrently, regularly interacted and shared a common goal.ConclusionsGetting health care teams ‘on the same page’ is a long-standing challenge. This study suggests that solutions may lay in the organisation of health care work, creating team stability and opportunities for team members to interact that allows a team mental model to emerge.

Wise, S, Duffield, C, Fry, M & Roche, M 2022, 'Nurses' role in accomplishing interprofessional coordination: Lessons in ‘almost managing’ an emergency department team', Journal of Nursing Management, vol. 30, no. 1, pp. 198-204.
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Aim: To describe how nurse coordinators accomplished day-to-day interprofessional coordination in an Australian emergency department team, drawing some lessons for the design of nurse coordinator roles in other settings. Background: Previous studies have examined leadership within nursing teams, and there are a growing number of registered nurses employed as care coordinators. There is limited literature on how the day-to-day coordination of interprofessional teams is accomplished, and by whom. Method: Nineteen semi-structured interviews with emergency department registered nurses, doctors and nurse practitioners analysed thematically. Results: Three themes describe how coordinators accomplished interprofessional coordination: task coordination and oversight, taking action to maintain patient flow and negotiating an ambiguous role. Conclusion: Better-defined nurse coordinator roles with clearer authority and associated training are essential for consistent practice. However, accomplishing interprofessional coordination will always require the situated knowledge of the complex nursing-medical division of labour in the workplace and the interpersonal relationships that are only gained through experience. Implications for Nursing Management: The design of nurse coordinator roles must include the thorny question of ‘who leads’ interprofessional teams in the day-to-day coordination of tasks. New and inexperienced nurses may not have the necessary situated knowledge or interpersonal relationships to succeed. However, such roles offer an important development opportunity for future nurse managers.

Wright, M & Versteeg, R 2022, 'Introducing general practice enrolment in Australia: the devil is in the detail', Medical Journal of Australia, vol. 216, no. 3, pp. 159-159.
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Wright, M, Hoffman, R, Petrozzi, MJ & Wise, S 2022, 'General practice experiences of Australia’s COVID-19 vaccine rollout: lessons for primary care reform', Australian Health Review, vol. 46, no. 5, pp. 595-604.
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Objective The aim of this research was to explore the experiences of general practice in delivering Australia’s coronavirus disease 2019 (COVID-19) vaccine, and the impact on practice finances and workforce. Methods Eighteen semi-structured interviews with owners and practice managers of general practices in Greater Sydney between June and August 2021 were conducted. Results Practices reported early enthusiasm for the vaccine rollout and engaged in large-scale staffing and infrastructure adaptations to manage increased vaccination workload. Although some practices reported increased income related to vaccination, nearly all reported increased costs. Lack of timely and transparent communication between primary care and policymakers was a major concern for practices. Conclusions The success of Australia’s COVID-19 vaccine rollout relied on the goodwill of general practices. Participation in the COVID-19 vaccine rollout resulted in increased stress, increased administration workload, and reduced financial viability for many practices.

Yu, A, Viney, R, Goodall, S & Street, D 2022, 'PCR113 Are Patient and General Population Samples Fundamentally Different? An Exploration Using a Discrete Choice Experiment (DCE)', Value in Health, vol. 25, no. 12, pp. S412-S412.
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Yu, A, Viney, R, Goodall, S & Street, D 2022, 'SA51 Different Ways to Present a DCE to Respondents: A Scoping Review', Value in Health, vol. 25, no. 12, pp. S493-S493.
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Yu, S, Fiebig, DG, Viney, R, Scarf, V & Homer, C 2022, 'Private provider incentives in health care: The case of caesarean births', Social Science & Medicine, vol. 294, pp. 114729-114729.
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Cumming, T, Kim, Y, Hossain, L & Page, K 1970, 'Organised Session: The Victorian Healthy Homes Program: Energy, health, and cost effectiveness outcomes from a randomised control trial', 43rd Annual Australian Health Economics Society Conference, Brisbane, Australia.

Jones, R, Mulhern, B, Devlin, N, Hiscock, H, O'Loughlin, R, Xiong, X, Bahrampour, M & Dalziel, K 1970, 'Comparing the psychometric performance of generic paediatric health-related quality of life measures: Evidence from the Australian paediatric multi-instrument comparison (P-MIC) study', QUALITY OF LIFE RESEARCH, SPRINGER, pp. S32-S32.

Koh, ES, Moore, A, Francis, RJ, Ebert, MA, Gan, HK, Lee, ST, Lau, E, Rossi, A, Grose, A, Ng, SP, Barnes, EH, Moffat, BA, Scott, FE, Adda, L, Foroudi, F, Nowak, AK, Bailey, DL, Back, M, Lourenco, RDA & Scott, AM 1970, 'A prospective, multi-centre trial of FET-PET In Glioblastoma patients - the TROG 18.06 FIG Study: results of the Nuclear Medicine and Radiation Oncology credentialing program', INTERNAL MEDICINE JOURNAL, WILEY, pp. 23-24.

Wright, M, Wise, S, Hoffman, R & Petrozzi, MJ 1970, 'The impact of COVID-19 pandemic on the financial viability of Australian general practice', AUSTRALIAN JOURNAL OF PRIMARY HEALTH, CSIRO PUBLISHING, pp. LXVIII-LXVIII.

Zissiadis, Y, Saunders, C, Wise, S, Schulz, JMR & Ives, A 1970, 'Breast cancer bundle of care: A pilot study', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, WILEY, pp. 201-202.

Aranda, S, De Abreu Lourenco, R, Thomas, M, Crothers, A, Lewandowska, M, Saing, S, Addo, R, Fagery, M, Kim, N, Cronin, P & Viney, R Centre for Health Economics Research and Evaluation, University of Technology Sydney 2022, Review of the Efficient Funding of Chemotherapy (EFC) Funding Arrangements. Interim Report. July 2022., Released online.

Aranda, S, De Abreu Lourenço, R, Webster, R, Thomas, M, Crothers, A, Saing, S, Addo, R, Fagery, M, Kim, N, Cronin, P & Viney, R Centre for Health Economics Research and Evaluation (CHERE) University of Technology Sydney (UTS) 2022, Review of the Efficient Funding of Chemotherapy (EFC) Funding Arrangements.Interim Report, Jan 2022, Sydney, Australia.

Lewis, R, Woods, M, Brown, D, Parker, D, Sutton, N & McAllister, G University of Technology Sydney 2022, Support at Home: A Commentary on the design of the proposed unified program., pp. 1-42, Sydney.
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The following Commentary on the strengths and shortcomings of the currentproposals for a unified Support at Home program and the submission of specificproposals for consideration in the next round of consultations, is offered byresearchers at the UTS Ageing Research Collaborative (UARC).

Naghsh Nejad, M, Yu, S, Van Gool, K, Hall, J & Wright, M Department of Health 2022, Health Care Homes trial final evaluation report, Volume 2: Main report, Department of Health.

Naghsh Nejad, M, Yu, S, Van Gool, K, Wright, M, Hall, J, Pearse, J, Mazevska, D, McElduff, P, Stone, C, Tuccia, J, Cho, O, Mitchell, S, McElduff, B, Tran, D, Falster, M, Pearson, S, Jorm, L, Bower, M, Dunbar, J, Henryks, J, Rosen, R & Smyth, T Department of Health 2022, Health Care Homes trial final evaluation report, Volume 1, Summary report, Department of Health.

Page, K, Hossain, L, Wilmot, K, Kim, Y, Liu, D, Kenny, P, Van Gool, K & Viney, R Sydney: University of Technology Sydney 2022, Evaluation of the Victorian Healthy Homes Program – Final Report, Sydney: University of Technology Sydney.

Sutton, N, Ma, N, Yang, J, Lewis, R, McAllister, G, Brown, D & Woods, M University of Technology Sydney 2022, Australia’s Aged Care Sector: Mid-Year Report (2021-22), pp. 1-126, Sydney.
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The Editorial Board of Australia’s Aged Care Sector welcomes you, our readers, to this first edition of what is to become a biannual report on the delivery of subsidised aged care services to senior Australians in need. The focus of this f irst edition is the Mid-year Report (2021-22). The second edition will report on the full financial year 2021-22. This series has been established to provide an independent assessment of the sector by the UTS Ageing Research Collaborative (UARC) at the University of Technology Sydney. It will have a broad policy scope and will analyse the performance of the sector from accounting, health economics and labour market perspectives. It will offer commentary on the key policy and operational issues impacting the delivery of subsidised aged care. From the second edition, it will also include the publication of policy relevant research. At the core of this report’s financial analysis will be aggregated, deidentified survey data which StewartBrown is making available to UTS as part of a broader partnership between the two organisations. As many readers will be aware, StewartBrown has been publishing its Aged Care Financial Performance Survey since 1995. Over the last two decades, the report has grown in volume and depth of coverage and is the largest benchmark data source in the aged care sector. For many years the report has also been a key public information resource for providers, government, researchers and other stakeholders across the sector. StewartBrown has now decided to focus on its benchmarking reporting to aged care providers, and it is our challenge to respectfully build on the strong foundation constructed by Grant Corderoy and his team and to provide the wider audience with an objective, evidence-based analysis of the sector. We are conscious that as the Australian population ages, the demand for care for senior Australians will continue to grow, but that it will need to evolve to better reflect the needs and p...

Viney, R, Goodall, S, De Abreu Lourenco, R, Thomas, M, Addo, R, Saing, S & Kotnala, A Australian Government Department of Health and Aged Care 2022, Review of the discount rate in the PBAC Guidelines - Report, Online.

Woods, M, Sutton, N, McAllister, G, Brown, D & Parker, D University of Technology Sydney 2022, Sustainability of the Aged Care Sector: Discussion Paper, pp. 1-84, Sydney.
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This Discussion Paper aims to support and promote an informed national policydebate on the sustainability of publicly subsidised aged care services in Australia.A sustainable aged care system is crucial to current and future senior Australians and theirfamilies. Equally, it is of fundamental importance to taxpayers, providers and the sector’sworkforce. Sustainability has several dimensions. The four addressed in this Paper are: taxpayeraffordability; community satisfaction with the care provided; workforce availability; andprovider viability.The current aged care system has been under stress for some time and the situation is worsening.Demand-side pressures are arising from demographic and health changes in Australia’s ageingpopulation and from community expectations for safer and higher quality care.On the supply side, there are already significant constraints on the sustainable availability of anappropriately skilled aged care workforce, which will likely worsen as the working-age proportionof the population declines. In addition, sector viability is under threat, given that the financialperformance of most, though not all, providers who deliver the care is generally poor, especiallyin residential care.And yet, the costs of improving the quality and safety of services will need to increase toaddress community dissatisfaction with a number of aged care services. Staff wages andconditions must rise so that the sector can compete for skilled workers. Additional investmentfunding is also needed in the sector to respond to growing demand.Government spending on aged care will need to rise. However, budgetary concerns raisequestions about the fiscal sustainability of significant increases, particularly in the contextof higher national debt in response to the COVID-19 pandemic. At the same time, consumercontributions to the cost of aged care services are low, even among senior Australians whohave the financial capacity to pay more.

Akanksha, A, Mulhern, B, Street, D & Viney, R 2022, 'EE545 Mapping Between Health and Broader Quality of Life Instruments: A Scoping Review', Value in Health.
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