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Projects approved by the AIHW Ethics Committee during 2017

IMPROVE – Investigating Medication re-Purposing to Reduce risk of OVarian cancer and Extend survival (EO 2016/3/276)

Applicant: QIMR Berghofer Medical Research Institute
Approval valid until: 01 February 2020

Ovarian cancer is a prominent cause of mortality, with five-year survival rates less than 50 per cent.

This study investigates whether chemo-preventive medications (e.g., beta-blockers, bisphosphonates and raloxifene) are effective in treating, and even preventing, ovarian cancer.

A specific objective is to investigate the association between chemo-preventive medication use and ovarian cancer incidence, and survival rates.

State health administrative datasets will be linked with the National Death Index, Australian Cancer Database, and the Pharmaceutical Benefits Schedule.

Study findings will inform additional investigations to establish further ovarian cancer treatments, while also identifying potential prevention strategies.

Assessing risk and predicting harms of prescribed opioids (EO 2016/4/314)

Applicant: University of New South Wales
Approval valid until: 31 December 2022

Opioid-use disorders place considerable demands on the healthcare system. Moreover, these disorders are linked to high mortality rates.

Of the available treatments, pharmaceutical interventions are most commonly used to treat opioid-use disorders.

This study investigates risk factors for adverse outcomes following prescription opioid use, and aims to identify patients at most risk of adverse outcomes.

A cohort of adult, opioid-dependent patients will be linked with the following datasets: the National Death Index, the Australian Cancer Database, the Medicare Benefits Schedule, and the Pharmaceutical Benefits Schedule. Data will also be linked with state and territory hospital and emergency datasets.

Findings will enable healthcare practitioners to identify patients at risk of adverse outcomes, following prescription opioid use, leading to better targeted interventions and a reduction in mortality rates.

Colorectal cancer – Early detection, clinical management and survival outcomes at a population level (EO 2016/4/317)

Applicant: South Australian Health and Medical Research Institute (SAHMRI)/University of South Australia
Approval valid until: 31 December 2025

Colorectal cancer prevalence continues to increase, posing a significant burden of disease. It is also a major cause of mortality.

There is a demand for ongoing research to inform procedures that enhance colorectal cancer patients’ quality of life, and survival rates.

This study will establish a linked, de-identified dataset of South Australian colorectal cancer patients. It will examine screening behaviour patterns, service use and adverse outcomes, and differences in these variables across time and socio-demographic group.

A cohort of South Australian residents diagnosed with colorectal cancer from 2003 onwards will be linked with the following Commonwealth datasets: the National Bowel Screening Register, the Medicare Benefits Schedule, and the Pharmaceutical Benefits Schedule. Data will also be linked with several South Australian health datasets.

Study findings will facilitate early detection of colorectal cancer. Healthcare practitioners can target interventions to enhance quality of life and increase survival rates.

Colorectal Cancer Database (EO 2017/1/285)

Applicant: Concord Hospital and University of Sydney
Approval valid until: 30 December 2024

Colorectal cancer is highly prevalent in Australia. It is the second, most commonly diagnosed cancer, and generally has a poor prognosis.

The Colorectal Cancer Database contains information about colorectal cancer patients treated at Concord Hospital, NSW.

Healthcare practitioners have used the database to improve their understanding of the natural history of colorectal cancer, evaluate the effectiveness of surgical options and oncological treatments, and investigate the probability of relapse.

The AIHW previously linked the colorectal cancer database with the National Death Index (NDI). In the current study, the colorectal cancer database will be linked with the NDI to update patient information. An updated database will enable healthcare professionals to enhance the management of colorectal cancer patients.

Differences in absolute and relative risks for CVD mortality among various low and high risk groups: Exploring the phenomenon (EO 2017/1/334)

Applicant: Baker IDI Heart and Diabetes Institute
Approval valid until: 01 March 2020

While much is known about cardiovascular disease risk factors, little is known about differences in the incidence and magnitude across various demographic groups.

Women have historically displayed a lower risk of cardiovascular mortality than men. This difference is due to a multitude of factors. The hypothesis of this study is that, the addition of one risk factor, in this case diabetes, among a group of people who have a lower absolute risk for cardiovascular mortality (e.g., women) will have a greater relative impact than the addition of the same risk factor among a group of people already at higher risk for cardiovascular mortality (e.g., men).

This study investigates sex differences in cardiovascular mortality rates. It will use the results of a previous project—The Australian and New Zealand Diabetes and Cancer Collaboration¬—where several patient cohorts were linked with the National

Death Index and the Australian Cancer Database to examine relationships between obesity, diabetes, cancer incidence, and mortality.

Findings will lead to a better understanding of sex differences in cardiovascular mortality rates and have implications for improving cardiovascular mortality risk assessment. This will enable healthcare practitioners to implement early, targeted interventions to reduce mortality rates.

Exploring the Natural History of Adverse eND-points in Cardiovascular disease and co-morbid Depression (ENHANCeD) (EO 2017/1/339)

Applicant: South Australian Health and Medical Research Institute (SAHMRI)
Approval valid until: 31 December 2020

Indigenous Australians display a significantly higher incidence of cardiovascular disease than non-Indigenous Australians. There is also a discrepancy in the risk of cardiovascular-related mortality.

This study—the ENHANCeD project—will investigate the effects of depression and other psychosocial risk factors on cardiovascular disease among Indigenous Australians. Data from two studies (Men, Hearts and Minds, and Heart of the Heart) will be linked with the National Death Index to obtain important outcome measures: death status, date of death, and cause/s of death.

Findings will enable healthcare professionals to obtain a better understanding of psychosocial risk factors for cardiovascular disease among Indigenous Australians. This information will have implications for indigenous health policy development, enhancing the availability and accessibility of targeted interventions.

International Spinal Cord Injury (InSCI) Community Survey (EO 2017/1/341)

Applicant: University of Sydney
Approval valid until: 01 February 2018

The InSCI Community Survey examines factors that influence activity levels, health and well-being among spinal cord patients.

This study will utilise InSCI survey data to inform health policy to improve the development and implementation of healthcare services.

Study investigators will establish a cohort by recruiting patients from various healthcare databases, managed by state spinal cord injury units, and other sources such as spinal cord injury associations, care and support agencies, and third party insurers.

The data will be linked with the National Death Index in order to exclude deceased individuals from the study cohort.

Healthcare practitioners can use InSCI survey results to improve treatment and support services for spinal cord patients.

Mothers and their Children’s Health Study (MatCH) Phase 1 (data linkage project) (EO 2017/1/342)

Applicant: University of Queensland
Approval valid until: 31 August 2018

The family environment is critical in shaping a child’s psychosocial development. Most studies investigating child development are limited in their ability to investigate the various effects among children within each family unit because they focus on individual children.

The Mothers and their Children’s Health (MatCH) study is an extension of the Australian Longitudinal Study on Women’s Health, and builds on the current knowledge base of the impact of familial factors on psychosocial development. This study examines the contributions of maternal health and well-being and family environment characteristics towards a child’s development, and whether there is any variation in developmental outcomes across children in the same family.

MatCH study data will be linked with the Australian Early Development Census to obtain important information about children who commenced school during any of the census years: 2009, 2012 or 2015.
Findings will provide further information about the contribution of familial factors towards psychosocial developmental outcomes, informing policy and enhancing existing initiatives.

Quantifying cancer patient’s health service use and costs in Queensland (EO 2017/1/343)

Applicant: James Cook University
Approval valid until: 31 December 2020

This study examines cancer patients’ out-of-pocket expenditure on healthcare services. It also quantifies the distribution of the cost of cancer, while identifying any inequalities between demographic groups.

Specific objectives include:

  • Determine any inequalities (according to income group, Indigenous status, and geographic location) in cancer incidence
  • Quantify any inequalities (according to income group, Indigenous status, and geographic location) in healthcare use and healthcare expenditure
  • Quantify healthcare, out-of-pocket expenditure and any inequalities (according to income group, Indigenous status, and geographic location)

Another objective is to investigate relationships among health system use, health system expenditure, out-of-pocket expenditure, and clinical outcomes.

A cohort from the Queensland Cancer Registry will be linked with state hospital and emergency care datasets, the Medicare Benefits Schedule and the Pharmaceutical Benefits Schedule.

Findings will provide information about cancer patients’ expenditure on healthcare utilisation, and any demographic discrepancies. This will have implications for improving the availability and accessibility of healthcare services.

Identifying gaps and inequalities in access to General Practitioner coordinated care for survivors of stroke (EO 2017/1/346)

Applicant: Monash University
Approval valid until: 01 July 2019

Stroke survivors present unique healthcare needs. General practitioners have historically been a primary source of care, through Medicare-funded Chronic Disease Management Programs and other coordinated care models.

This project examines the care of stroke survivors under Medicare-funded programs and other models of General Practitioner coordinated care to identify inequalities in availability and accessibility of care.

Australian Stroke Clinical Registry data will be linked with the Medicare Benefits Schedule and the Pharmaceutical Benefits Schedule to obtain information about services and prescriptions related to the prevention and treatment of stroke and related conditions.

Findings will inform policy to reduce any inequalities in the availability and accessibility of interventions for stroke survivors.

A comprehensive approach to international cancer survival benchmarking (EO 2017/1/347)

Applicant: NSW Cancer Institute
Approval valid until: 30 September 2019

The International Cancer Benchmarking Project (ICBP) examined survival among breast, colorectal, lung, and ovarian cancer patients diagnosed between 1995 and 2007. The ICBP also compared survival rates between six, high-income countries.

Findings demonstrated improvements in overall survival rates. However, there were differences in survival rates across countries. Another large, international study—the CONCORD-2—investigated survival among cervical, liver, prostate, and stomach cancer patients, in addition to the cancers studied in the ICBP, and obtained similar findings.

The current investigation, SurvMark-2 will build on the ICBP by investigating cancer incidence, mortality, cancer coding, registration practices, and death registration practices. The SurvMark-2 will also examine eight cancers of public health importance: colon, liver, lung, oesophagus, ovarian, pancreatic, rectum, and stomach.

Cancer incidence data and survival and mortality data will be supplied to the International Agency for Research on Cancer (IARC; Lyon, France) by the cancer registries of five high-income countries.

Data will be drawn from the NSW Cancer Institute, and linked with the National Death Index to obtain date and all causes of death. The linked dataset will be sent to the IARC for analysis.

Findings will provide important information about variations in cancer survival rates between countries, and across different cancer types. Furthermore, the cancers included in this study have considerable public health significance in Australia.

Healthcare professionals and policymakers can utilise study findings to enhance the care and management of cancer patients and increase survival rates.