• 02 DEC 18
    • 0

    HSRAANZ 2018 Awards

    The HSR Impact Award

    This biennial award recognises health services research that has had a significant impact through translation into health policy, management, or clinical practice.   We received seven very worthy nominations that that highlight the amazing real-world impact of health services research. The submissions covered a broad range of impacts and after the judges' votes had been cast, we had a tie between two very different pieces of HSR.

    Elizabeth Lynch

    Our first joint winner is Dr Elizabeth Lynch and colleagues for a program of research around the implementation of the nationally recommended Assessment for Rehabilitation Tool.  As part of a RCT, she identified that rehab needs were being made based primarily on the services available.  Elizabeth’s subsequent engagement with stakeholders focused on supporting clinicians to use the tool to identify unmet needs, including a lead role in updating the stroke clinical guidelines with respect to the assessment of rehab needs.
    Elizabeth Lynch - “Assessing and managing rehabilitation needs of people with stroke in Australia”</span >
    Read Elizabeth's blog - Assessing and managing rehabilitation needs of people with stroke in Australia </span >

    Catherine Joyce on behalf of Anthony Scott

    Our second joint winner is Professor Tony Scott and his team involved in the development and maintenance of the Medicine in Australia: Balancing Employment and Life (MABEL) survey which is Australia's national panel survey of 10,000 doctors that has been running for over 10 annual Waves. The specific application of the project that was cited in the submission was the use of MABEL data to develop the Modified Monash Model (MMM), a new geographic classification scheme to allocate funding to medical workforce programs in rural areas. The MMM was first used by the Department of Health in 2015, and is now applied to over 15 workforce programs that allocate over $1bn to support access to medical care rural areas in Australia.
    Professor Anthony Scott - Medicine in Australia: Balancing Employment and Life (MABEL).
    Read Anthony's blog - Influencing policy through research: Medicine in Australia: Balancing Employment and Life (MABEL)

    Best Health Services and Policy Research Papers

    These awards recognise the best scientific works in the field health services and policy research.

    Overall and ECR Categories

    Seven nominations were received for the overall best paper and eight for the ECR category.  There were some very strong submissions and judging was tight.  Research types included cost-effectiveness, outcomes research, meta-analysis, predictive modelling and qualitative research.

    Overall Winner - Alison Pearce

    Freddy Sitas on behalf of Alison Pearce

    Alison's winning paper estimates the years of productive life lost and assorted costs due to adult cancer deaths.  The paper compares estimates for 5 developing countries and across cancer subtypes.  The article impressed the judges in the scope of research undertaken and the value it will contribute to the research field, including its potential to guide local prevention and treatment strategies.
    Pearce, AM, Sharp, L, Hanly, P, Barchuk, A, Bray, F, de Camargo Cancela, M, Gupta, P, Meheus, F, Qiao, YL, Sitas, F, Wang, SM & Soerjomataram, I 2018,
    ‘Productivity losses due to premature mortality from cancer in Brazil, Russia, India, China, and South Africa (BRICS): A population-based comparison’, Cancer Epidemiology, vol. 53, pp. 27-34.   Publisher's site
    Read Alison's Blog  - $46 billion in productivity lost to cancer in developing countries

    Eleven papers were submitted for the PhD Student category and all were of a good standard. All except one was quantitative and several were analyses of large data sets. The winner was of the latter type and literally just pipped some of the other papers because it had good logical flow, clear concise language and clearly explained its relevance to policy and practice.

    ECR Winner - Haitham Tuffaha

    Haitham Tuffaha

    Haitham's paper presents a Markov model to estimate the long-term benefits and costs of testing women and their relatives with breast cancer who had at least a 10% probability of BRCA mutation.  This work struck the judging panel as of high importance to guide expensive treatment decisions.
    Tuffaha, Mitchell, Ward, Connelly, Butler, Norris, Scuffham
    ‘Cost-effectiveness analysis of germ-line BRCA testing in women with breast cancer and cascade testing in family members of mutation carriers’. Genet Med. 2018 Sep;20(9):985-994. doi: 10.1038/gim.2017.231. Epub 2018 Jan 4. Publisher’s Site
    Read Haitham's blog - Cost-effectiveness analysis of germ-line BRCA testing in women with breast cancer and cascade testing in family members of mutation carriers

    PhD Student Winner - Tim Badgery-Parker

    Tim Badgery-Parker

    As the name suggests, Tim's paper is an analysis of a large dataset to examine the use of 27 low-value care procedures in Australian public Hospitals. The procedures studies varied substantially and included some very well-known and some less well-known procedures and used the perspective of the health service provider. Tim’s results show 13 of the procedures had negligible low-value care, 7 showed a decreasing trend, 4 had no clear trend and 3 showed an increasing trend for low-value care. However, there was substantial variation between hospitals.
    Badgery-Parker T, Pearson S, Chalmers K, et al
    Low-value care in Australian public hospitals: prevalence and trends over time BMJ Qual Saf Published Online First: 06 August 2018. doi: 10.1136/bmjqs-2018-008338 Publishers Site
    Read Tim's Blog - Measuring Low-Value Care

    PhD Student-Highly Commended Johnathan Brett

    Natasha Donnolley on behalf of Johnathan Brett

    Jonathan Brett, Helga Zoega, Nicholas Buckley, Benjamin Daniels, Adam Elshaug, Sallie-Anne Pearson
    Choosing Wisely? Quantifying the extent of three low value psychotropic prescribing practices in Australia

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Dr Elizabeth Lynch

Dr Elizabeth Lynch is an experienced stroke rehabilitation physiotherapist. She has been awarded state and national awards for her work implementing evidence-based practices in stroke rehabilitation settings.

Liz completed her PhD in 2015, which used mixed methods to explore and improve how rehabilitation needs are assessed after stroke. She was awarded an NHMRC Early Career Research Fellowship (commenced 2018) and she is currently investigating how to effectively implement the 2017 Stroke Clinical Guidelines and how partnerships with patients can be incorporated into implementation projects.  Liz is based at the Adelaide Nursing School, University of Adelaide and is affiliated with the NHMRC Centre of Research Excellence in Stroke Rehabilitation and Brain Recovery.

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“Assessing and managing rehabilitation needs of people with stroke in Australia”

This program of research investigated the implementation of the nationally recommended Assessment for Rehabilitation Tool that was disseminated in 2012. The Assessment for Rehabilitation Tool is a patient-centred, evidence-based decision-making tool that can help determine whether a person has rehabilitation needs and how these can best be managed. A cluster-randomised trial was conducted at 10 hospitals in South Australia and New South Wales, comparing the effectiveness of education-only to a multifaceted intervention. Data were collected from all participating sites about how the Assessment Tool was being used, and factors affecting its use. This work highlighted that judgements were being made about a person’s rehabilitation potential based primarily on whether services were available to meet a person’s needs – people whose needs fell outside the scope of the usual services (e.g. people with severe stroke, people with reduced alertness) often did not have rehabilitation needs identified and were not referred to a rehabilitation service, despite evidence that this cohort can improve independence and quality of life with rehabilitation.

Elizabeth has:

• Presented the findings to consumer, clinical and research audiences.

• Acted in a consultancy role with Australia’s peak stroke body, the Stroke Foundation, to advise on wording of the National Stroke Audit. This has enabled the collection of information about how rehabilitation needs are being identified and managed, and objective reasons why rehabilitation is not indicated or why rehabilitation is not accessed.

• Provided advice and mentoring to clinicians in three states of Australia regarding how to implement the Assessment for Rehabilitation Tool, so clinicians are empowered and confident to conduct patient-centred, evidence-based assessments, and refer to rehabilitation according to patients’ rehabilitation needs.

• Contributed to the updating the Australian Stroke Clinical Guidelines and was nominated to lead the section regarding assessment of rehabilitation needs. The Stroke Clinical Guidelines now explicitly recommend use of the Assessment for Rehabilitation Tool, and recommend that every person with rehabilitation needs be referred to a rehabilitation service. The impact of the new Stroke Clinical Guidelines has yet to be evaluated.

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Professor Anthony Scott

Anthony Scott leads the Health Economics Research Program at the Melbourne Institute of Applied Economic and Social Research at the University of Melbourne. He has a PhD in Economics from the University of Aberdeen. He is an Associate Editor of Journal of Health Economics, Health Economics, and Social Science and Medicine, President of the Australian Health Economics Society, and a member of the Board of the International Health Economics Association. He is a Fellow of the Academy of the Social Sciences in Australia. He has been an ARC Future Fellow and NHMRC Principal Research Fellow. Tony’s research interests focus on the behaviour of physicians, health workforce, incentives and performance, primary care, and hospitals. He has consulted and provided advice to the World Bank, Independent Hospital Pricing Authority, Productivity Commission, Medibank Private, and Commonwealth and State Departments of Health. He leads the Medicine in Australia: Balancing Employment and Life (MABEL) panel survey of 10,000 physicians, and is a Research Lead Investigator on the NHMRC Partnerships Centre on Health System Sustainability.   

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Medicine in Australia: Balancing Employment and Life (MABEL)

Medicine in Australia: Balancing Employment and Life (MABEL) is Australia’s national panel survey of 10,000 doctors. Now running for over 11 annual Waves, MABEL is designed to improve access to health care by influencing the geographic distribution of doctors, and understanding workforce participation, doctor’s career choices, and working patterns.   The latest Wave 11 included new questions on doctor’s health and wellbeing and use of electronic shared records and video consultations.  MABEL survey data are also linked to MBS and PBS data.

 

MABEL’s most notable impact to date was the use of MABEL data to develop the Modified Monash Model (MMM), a new geographic classification scheme to allocate funding to medical workforce programs in rural areas.  MMM was proposed by MABEL Chief Investigators Emeritus Prof. John Humphreys (Monash University) and Dr. Matthew McGrail (The University of Queensland) as part of a submission to a Senate Enquiry.  This was based on a paper published using MABEL data to describe how GP workload varied by population size.  MMM was adopted and first used by the Department of Health in 2015, and is now applied to over 15 workforce programs that allocate over $1bn to support access to medical care rural areas in Australia. The measure has continuing strong support from the rural health sector and from the Commonwealth Department of Health. In addition, MABEL data are regularly used by researchers and key medical workforce stakeholders, including medical colleges, to provide evidence and data on a range of current issues within the medical workforce, including evidence on policies to support access to medical care in rural areas.  De-identified MABEL data are provided to external researchers at minimal cost to maximise the use of the data. We have 260 external data users from across Australia, and receive 2-3 data requests per month.

 

Impact Summary

 

 

 

 

Funding acknowledgement. NHMRC (2008 to 2015), Department of Health (2018-19), The University of Melbourne (2017-18), Health Workforce Australia (2013), Medibank Private Better Health Foundation (2017), DHHS (2017-18), NSW Health (2017), Australian Digital Health Agency (2018-19).

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Dr Alison Pearce

Alison is a health economist interested in the various costs of cancer. Her research aims to use health services research and health economics to improve cancer care by providing relevant, reliable information for decision making.

Based at the Centre for Health Economics Research and Evaluation (CHERE) at UTS, she is working in the areas of productivity loss and patient preferences, including currently visiting the University of British Colombia to develop a decision aid for people choosing cancer treatments. Her research extends the work she did on the economics of cancer survivorship at the National Cancer Registry in Ireland. Alison completed her PhD on the costs of chemotherapy side effects at CHERE in 2013, before which she worked in cancer clinical trials and health services research. Her original training was in occupational therapy, and she remains interested in rehabilitation research. She also has keen interests in early career researcher development, communicating research to the public, and the use of social media in academia.

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‘Productivity losses due to premature mortality from cancer in Brazil, Russia, India, China, and South Africa (BRICS): A population-based comparison’

ABSTRACT

Background: Over two-thirds of the world’s cancer deaths occur in economically developing countries; however, the societal costs of cancer have rarely been assessed in these settings. Our aim was to estimate the value of productivity lost in 2012 due to cancer-related premature mortality in the major developing economies of Brazil, the Russian Federation, India, China and South Africa (BRICS).

Methods: We applied an incidence-based method using the human capital approach. We used annual adult cancer deaths from GLOBOCAN2012 to estimate the years of productive life lost between cancer death and pensionable age in each country, valued using national and international data for wages, and workforce statistics. Sensitivity analyses examined various methodological assumptions.

Results: The total cost of lost productivity due to premature cancer mortality in the BRICS countries in 2012 was $46·3 billion, representing 0·33% of their combined gross domestic product. The largest total productivity loss was in China ($28 billion), while South Africa had the highest cost per cancer death ($101,000). Total productivity losses were greatest for lung cancer in Brazil, the Russian Federation and South Africa; liver cancer in China; and lip and oral cavity cancers in India.

Conclusion: Locally-tailored strategies are required to reduce the economic burden of cancer in developing economies. Focussing on tobacco control, vaccination programs and cancer screening, combined with access to adequate treatment, could yield significant gains for both public health and economic performance of the BRICS countries.

Highlights

(Acknowledgement – Alison’s research was funded by an Irish Health Research Board ‘Interdisciplinary Capacity Enhancement Award’ and by the COST Action CANWON for a ‘Short Term Scientific Mission’ to the WHO International Association for Research on Cancer)

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Dr Haitham Tuffaha

Dr Haitham Tuffaha is NHMRC and Senior Research Fellow in Health Economics at Griffith University, Australia. Haitham holds an MSc degree in Clinical Pharmacy (with Distinction) from Strathclyde University in Glasgow, an MBA degree from Wollongong University in NSW and a PhD in Health Economics from Griffith University. His research encompasses the economic evaluation of health care technologies with an interest in Value of Information analysis as a systematic approach to inform reimbursement decisions, optimise trial design and prioritise research funding.

After completing his PhD in 2016, Haitham has rapidly established a high-quality track record and built a reputation as a promising leader in his field of research. He has over 50 peer-reviewed journal articles, book chapters and technical reports. He has published in leading journals including The Lancet, Nature Genetics in Medicine, Value in Health, PharmacoEconomics and the Medical Journal of Australia. His research has influenced health policy and clinical practice nationally and internationally.

Haitham is the Chair of the Clinical Oncology Society of Australia’s (COSA)-Epidemiology Group, the Co-Chair of Australian Clinical Trials Alliance (ACTA)-Research Prioritisation Group and Secretary of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR)-Australian Chapter. He is an Editorial Board Member of PharmacoEconomics-Open and a regular reviewer for leading journals.

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JohnBrett

Jonathan is a staff specialist in clinical pharmacology, toxicology and addiction at St. Vincent’s Hospital and a post-graduate fellow in clinical toxicology at NSW Poison Information Centre . He completed a PhD at the Centre for Big Data Research in Health on the use of PBS dispensing claims to measure the quality use of medicines. He is a tutor on masters courses in toxicology and health data and sits on the Drug Utilisation Sub Committee of the PBAC. 

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Tim Badgery-Parker

Tim Badgery-Parker is completing his PhD in the Menzies Centre for Health Policy, The University of Sydney. His research focuses on measuring low value care, defined by Choosing Wisely, RACP EVOLVE, or similar recommendations, in the NSW public hospital system. Tim previously worked as a biostatistician in the Centre for Epidemiology and Evidence, NSW Ministry of Health, and then in the Cancer Epidemiology and Services Research Group and the Surgical Outcomes Research Centre in the Sydney School of Public Health.

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