NEW! PC4 Current Research Update 12 December 2011
The PC4 Research Portfolio has been themed into three priority areas:
The PC4 Research Portfolio has been themed into three priority areas:
This project is on the role of single nucleotide polymorphisms (SNP) testing to rationalise prostate specific antigen (PSA) screening for prostate cancer. A meta-analysis of six trials on PSA screening showed that screening resulted in a 46% increased likelihood of men being diagnosed; however, this diagnosis had no significant impact on all-cause or disease-specific mortality. The aim of this study is to determine the potential clinical utility of SNP testing to inform PSA screening.
Unfunded
In development
Chief Investigator Jon Emery, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia (jon.emery@uwa.edu.au, +61 8 9346 7508)
Randomised trial of consumer-led familial cancer risk tool & GP triage on risk-appropriate colorectal cancer screening (Phase 1). The aim of the main project is to develop a consumer-driven risk tool that allows people to build their bowel cancer family history, verify details with their relatives and then discuss their risk with their GP. By learning of their own risk they can have the best screening for them. Phase 1 of this study will evaluate the acceptability and feasibility of the online family history colorectal cancer risk tool for adults aged 25-74 years.
Funded
Pilot study complete; main study open to recruitment December 2011
Study coordinator Sundresan Naicker, Sydney Medical School, The University of Sydney (snai2338@uni.sydney.edu.au, +61 2 9036 6303)
This project will develop an evidence-based decision tool for women aged 19-26, and evaluate its effect on Pap test consultation length, HPV knowledge, uptake of tests and vaccine and provider communication. The tool will be delivered online prior to the consultation, and will be a one-stop source of information for cervical cancer prevention. Women will ideally learn to access the tool before their Pap test every two years, and they can be made aware in advance of their consultation of new technologies and options available to them. The preparation of patients before the consultation is an important model that will be tested in this study and could be transferable to other aspects of general practice.
Funded
Open to recruitment
Study coordinator Mbathio Dieng, Sydney School of Public Health, The University of Sydney (mdieng@health.usyd.edu.au, +61 2 9351 3137)
Collaborators from UWA and The University of Melbourne are currently working with the University of Cambridge on studies of a sponge capsule and novel assay for mini chromosome maintenance (Mcm) proteins to screen high risk populations for Barrett’s oesophagus (BO), the pre-cursor lesion of oesophageal cancer. They aim to determine the feasibility of developing the assay in Australia and will examine the acceptability of the screening test to inform a future international multisite screening trial.
Funded
Open to recruitment
Study coordinator Ann-Marie Power, The Royal Melbourne Hospital, The University of Melbourne (apower@unimelb.edu.au, +61 3 8344 6729)
This project will develop and test a web-based ‘meta-decision aid’ for tailoring and prioritising preventive activities recommended by the RACGP guidelines for individuals. It will include modelling for cancer screening and other preventive behaviours, cardiovascular risk reduction and mental health activities in a ‘whole-patient’ approach. The aid will calculate personal benefit-risk ratios for individuals aged 20-69 years and elicit patient values for these, producing a prioritised preventive activity list. The effect of the aid on translating evidence into practice will be measured via a randomised controlled trial. We hypothesise that compared with standard information, the ‘meta-decision-aid’ will result in more patients adopting preventive health behaviours that will maximise their health.
Funded
Recruitment complete; in follow up.
Study coordinator Camille Raynes-Greenow, Sydney Medical School, The University of Sydney (camille.raynes-greenow@sydney.edu.au, +61 2 9351 6591)
Working in collaboration with the University of Cambridge we have conducted a validation study in a primary care setting of the Molemate system in Western Australia. The feasibility study in Australia of a pragmatic trial of Molemate will inform a funding application for the full trial.
Funding submissions on hold until UK trial completes follow-up
Validation study in follow-up; full trial in development
Chief Investigator Jon Emery, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia (jon.emery@uwa.edu.au, +61 8 9346 7508)
This study investigates a hypothesis that an early approach to rehabilitation of cancer patients in the early shared care setting can lead to earlier and more successful return to work (both paid and upaid) and better health outcomes of cancer survivors. The study would also explore the feasibility of delivering shared care at the early stage of cancer care as this approach would potentially impact on the overall model of shared care between specialists and general practitioners.
Funding application submitted
In development pending funding
Chief Investigator Bogda Koczwara, Dept. of Medical Oncology, Flinders Medical Centre (bogda.koczwara@flinders.edu.au, +61 8 8204 8997)
The University of Queensland in collaboration with the Queensland Cancer Control Analysis Team (QCCAT) of Queensland Health plan to more effectively utilise a Queensland Health web-based data sharing system with data entered from hospital oncology departments to develop tailored and individualized survivorship care plans for Breast and Colorectal cancer survivors. A needs assessment tool will also be developed for post-acute survivors of breast and colorectal cancers. In addition, a complementary Meeting Colorectal and Breast Cancer Survivors Needs resource kit for GPs will outlining the types of problems that might arise and link GPs to evidence based strategies and resources that might help address the problems.
Pending QCCAT study (see below)
Development pending QCCAT study
Researcher Hugh Senior, School of Medicine, The University of Queensland (h.senior@uq.edu.au, +61 7 3381 1577)
The study will utilise the Queensland Cancer Control Analysis Team (QCCAT)’s internet-based applications that allow for the linking and sharing of patient information between clinicians and facilities. In order to enhance communication between health professionals and facilitate cancer surveillance we propose the development of SCPs for the GP (and patient), which uses Queensland Oncology Online (QOOL) data entered by the oncology multidisciplinary team, an automated email (or mail) reminder to GP and/or patient of surveillance test appointments, and an electronic-report from the GP to the consulting oncologist on cancer-specific patient care tailored to the oncologist’s requirements.
Funded
In development
Researcher Hugh Senior, School of Medicine, The University of Queensland (h.senior@uq.edu.au, +61 7 3381 1577)
This phase I/II study is set within the Medical Research Council (MRC) framework for the development and evaluation of complex interventions. Its aims are to: Develop a shared-care model of follow-up for men with potentially cured prostate cancer. Operationalise and optimise the intervention, establish acceptability of the intervention and randomisation, confirm the suitability of outcome measures and inform final design of a future phase III trial. Estimate the potential effect size and coefficient of variation on which to base power calculations for a national, adequately powered phase III trial, for which further funding will be sought.
Funded
Pilot open to recruitment
Study coordinator Juanita Doorey, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia (juanita.doorey@uwa.edu.au, 08 9346 7251)
The exercise intervention will comprise an 8-week program of 16 structured exercise sessions with a personal trainer to focus on low-intensity aerobic training, low-impact muscle strengthening and endurance training. In addition, women will be prescribed a home-based "lifestyle" walking program with feedback derived from a pedometer for the days of the week when not seeing the trainer, but where the trainer will follow-up and motivate the "lifestyle" component.
Funded
Open to recruitment
Study coordinator Jasmine Yee, Breast Cancer Research Group, The University of Sydney (jasmine.yee@sydney.edu.au, +61 2 9036 7309)
Experts believe that the optimal time for intervention is prior to the development of moderate-severe lymphoedema. Severe lymphoedema cannot be cured and the associated sequelae, such as infection and cellulitis, are both serious and costly to treat. This research aims to validate criteria that will then be used in novel screening tools to clearly flag early changes indicative of lymphoedema.
Funded
Open to recruitment
Study coordinator Liz Dylke, Breast Cancer Research Group, Faculty of Health Sciences, The University of Sydney (elizabeth.dylke@sydney.edu.au, +61 2 9036 7309)
To date, the studies on exercise in women with lymphoedema provide evidence that exercise does not increase the limb’s volume. However, there has not been an exploration of the physiological effects of exercise to the person and specifically to the lymphoedematous limb. The study we are proposing is novel as we are exploring specifically what occurs to the lymphatic system as well as the composition of the lymphoedematous limb as a consequence of exercise.
Funding application to be submitted once pilot data is gathered
Pilot open to recruitment
Study coordinator Jasmine Yee, Research Assistant, Breast Cancer Research Group, Faculty of Health Sciences, University of Sydney (jasmine.yee@sydney.edu.au, +61 2 9036 7309)
This three-phase study aims to provide a preliminary evaluation of how the CNC role contributes to meeting the objectives of the Western Australian Cancer Services Framework, provide benchmarks for future role evaluation and a foundation for a rigorous ongoing evaluation framework.
Funded
In follow up
Chief Investigator Leanne Monterosso (leanne.monterosso@nd.edu.au, +61 8 9333 9765)
This pilot project used qualitative research methods to explore the experiences of rural people with cancer. Specifically, it explored the reasons why people living in rural areas may delay diagnosis and what issues affected the decisions they made regarding their cancer treatment.
Funded
In follow up
Chief Investigator Leanne Monterosso (leanne.monterosso@nd.edu.au, +61 8 9333 9765)
Our over-arching goals are to quantify the health and support needs of patients with advanced cancer and their primary informal carers in the 6 months before death and to map patients’ movements within and between health and care services during this time. This is the first prospective study conducted in Australia to determine how patients with advanced cancer and their primary informal carers use and experience health services towards the end of life. By linking patient reported data with data from a range of administrative sources, this study will provide the evidence base needed to enable planning and delivery of appropriate and accessible health services for people with advanced cancer at end of life.
Funding application submitted
In development pending funding application outcome
Chief Investigator Patsy Yates, School of Nursing and Midwifery; Queensland University of Technology (p.yates@qut.edu.au, +61 7 3138 3835)
This trial examines the feasibility of aggregating multiple SPTs to gain a population estimate of the efficacy of methylphenidate in the management of fatigue in patients with advanced cancer.
Funded
Open to recruitment
Study manager Sue Ann Carmont, School of Medicine, University of Queensland (s.carmont@uq.edu.au; +61 7 3365 5014)
This trial examines the feasibility of aggregating multiple SPTs to gain a population estimate of the efficacy of paracetamol in pain where the patient is on regular opioids.
Funded
Open to recruitment
Study manager Sue Ann Carmont, School of Medicine, University of Queensland (s.carmont@uq.edu.au; +61 7 3365 5014)
This trial tests an intervention to address the needs of caregivers in advanced cancer, aiming to support carers and reduce hospital admissions due to carer fatigue.
Funded
In follow up
Study manager Letitia Burridge, School of Medicine, University of Queensland, (l.burridge@uq.edu.au, +61 7 3365 5403)
This study aimed to explore the factors contributing to the variation in lengths of time patients and families spend in the unstable phase in Western Australian palliative care services that participate in the National Palliative Care Outcomes Collaboration (PCOC). This project aimed to understand what factors contributed to the variability between Western Australian services, both in proportion and time spent in an unstable phase. Findings will make a significant contribution to understanding and minimising these differences at the state and national levels, and thus contribute to improved clinical outcomes.
Funded
Project complete; in follow up
Chief Investigator Leanne Monterosso (Leanne.monterosso@nd.edu.au, +61 8 9333 9765)