Medical Education - Research Publications

Permanent URI for this collection

Search Results

Now showing 1 - 10 of 1686
  • Item
    Thumbnail Image
    Efficacy and safety of oral immunotherapy for peanut, cow's milk, and hen's egg allergy: A systematic review of randomized controlled trials
    Lodge, CJ ; Waidyatillake, N ; Peters, RL ; Netting, M ; Dai, X ; Burgess, J ; Hornung, CJ ; Perrett, KP ; Tang, MLK ; Koplin, JJ ; Dharmage, SC (WILEY, 2023-07)
    BACKGROUND: Oral immunotherapy (OIT) is a promising treatment for food allergies; however, safety is a concern. We synthesized evidence from the best randomized controlled trials (RCTs) on efficacy/safety of OIT for desensitization (DS) and remission (sustained unresponsiveness (SU)) in IgE mediated allergy to peanut, hen's eggs, and cow's milk. BODY: We searched Pubmed, EMBASE, and Cochrane databases (Until Oct 22) identifying 16 eligible RCTs published in English measuring food allergy by food challenge at the beginning and at the end of the study. The Cochrane Risk of Bias tool was used to assess study quality. We found 18 eligible studies. There was evidence of efficacy for DS for all allergens: peanut (RR 11.32; 95% CI 5.93, 21.60, I2 49%, 8 studies); hen's egg (RR 4.67; 2.66, 8.21, I2 0%, 5 studies); cow's milk (RR 13.98; 3.51, 55.65, I2 0%, 4 studies) and evidence for SU for peanut (RR 7.74; 2.90, 20.69, I2 0%, 3 studies) and hen's egg (RR 6.91; 1.67, 28.57, I2 0%, 2 studies). Allergic events were increased with intervention, and risk of adrenaline use increased for peanut RR 2.96; 1.63, 5.35, I2 0%, 8 studies; egg RR 1.71; 0.42, 6.92, I2 0%, 6 studies; and milk RR 8.45; 2.02, 35.27, I2 0%, 4 studies. CONCLUSION: We found strong evidence that peanut, hen's egg, and cow's milk OIT can induce DS and some evidence for remission. There was a high risk of allergic reactions. Generalizability to the entire food allergic population is not known.
  • Item
    Thumbnail Image
    Systematic reviews of osteopathic care: protocol for an umbrella review
    Vaughan, B ; Fleischmann, M ; Cerritelli, F ; Draper-Rodi, J ; Feehan, J ; Ferreira, AP ; McLeod, G ; Morin, C ; Muddle, L ; Sampath, K ; Thomson, OP ; Tripodi, N ; Steel, A ; Adams, J (Taylor and Francis Group, 2024)
    Background: The practice of osteopathy differs around the world. However, the dominant practice is that of manual therapy interventions guided by assessment of the neuromusculoskeletal system. Patient populations treated by osteopaths vary across the lifespan and include groups with more-nuanced care requirements such as those who are pregnant. The volume of evidence for osteopathy care is increasing. Objectives: This umbrella review seeks to identify systematic reviews of osteopathic care with the purpose of highlighting current knowledge about the high-level evidence underpinning the profession. Methods: The umbrella review will be conducted consistent with the Joanna Briggs Institute umbrella review methodology. Articles will be limited to those describing osteopathic care. An initial search did not identify a similar study and nor is one registered. A search of MEDLINE and CINAHL informed the search syntax. A full search will be performed across MEDLINE (PubMed), CINAHL (EBSCO), Scopus, Web of Science, PEDro, Osteopathic Research Web, AMED, Index to Chiropractic Literature, Cochrane Database of Systematic Reviews, and the Osteopathic Medicine Digital Repository (OSTMED.DR). The reference lists of included articles will be reviewed to identify potentially relevant systematic reviews. Data will be extracted from each systematic review and presented in tabular format. Conclusion: The umbrella review will synthesise what is known about osteopathic care as described in systematic reviews. The review will inform stakeholders about the role of osteopathic care in the health system and provide recommendations for future research. The findings will be submitted for peer-review publication.
  • Item
    No Preview Available
    Recommendations from the Medical Education Editor
    Lavercombe, M (WILEY, 2023-04)
  • Item
    No Preview Available
    Recommendations from The Medical Education Editor
    Lavercombe, M (WILEY, 2023-07)
  • Item
    No Preview Available
    Recommendations from the Medical Education Editor
    Lavercombe, M (WILEY, 2023-10)
  • Item
    No Preview Available
    Recommendations from The Medical Education Editor
    Lavercombe, M (WILEY, 2024-01)
  • Item
    No Preview Available
    Utility of the stop and stop-bang questionnaires in a pre-screened population presenting for overnight polysomnography
    Lavercombe, M ; Hocking, V ; Clarence, M ; Thien, F (Wiley, 2009)
    Obstructive Sleep Apnoea (OSA) is a common condition, the diagnosis of which is often delayed by prolonged waiting lists at the point of referral or in the sleep laboratory. Clinical prediction tools may become useful in triaging assessment and management of this condition.Recent publications have proposed and validated two new pre-opera-tive screening tools for Obstructive Sleep Apnoea (OSA) in surgical patients (STOP and STOP-BANG). These screening tools have not been examined in a general sleep population.Methods: All patients attending for in-laboratory polysomnography at Box Hill Hospital during the study period were asked to complete the STOP questionnaire, and sleep scientists recorded the biometric data required for the BANG component. Polysomnography proceeded with sleep staging and event scoring performed according to the Chicago Criteria.Risk stratification by the STOP and STOP-BANG tools was combined with total Respiratory Disturbance Index from polysomnogram reports.Results: 69 patients have been recruited, although data continues to be collected. As expected, there is a predominance of moderate and severe OSA in this cohort (45/69, 65%).The STOP-BANG tool maintains higher sensitivity, negative predic-tive value and odds ratios than the STOP tool at each degree of OSA severity examined. Receiver operating characteristic curves demonstrate superiority of the STOP-BANG tool for RDI > 15, when compared with STOP-BANG for RDI > 30 and STOP at both RDI cut-offs.Conclusions: With ongoing data collection we hope to confirm trends seen in predictive values with these tools. Removal of less discrimina-tory criteria may improve their statistical usefulness, perhaps allowing development into risk stratification tools that will assist in triaging investigation and management of patients with suspected OSA.
  • Item
    Thumbnail Image
    Recommendations from The Medical Education Editor
    Lavercombe, M (Wiley, 2023-01)
    This quarterly editorial discussing Respirology articles of continuing educational value is the fourth in a series and the final covering publications from 2022.
  • Item
    Thumbnail Image
    Prevalence of type 2 diabetes risk factors, including overweight and obesity, among youth attending hospital-based paediatric care in Western Melbourne.
    Angley, E ; Matejin, E ; Gul, S ; Rodda, C ; Longmore, DK (Wiley, 2023-02)
    AIM: To determine the prevalence of risk factors for type 2 diabetes in overweight and obese adolescents attending hospital-based paediatric care in Western Melbourne. METHODS: One hundred overweight and obese adolescents (aged 10-17 years) who attended an outpatient clinic at Sunshine Hospital between May 2019 and May 2020 were randomly selected following a retrospective chart review of 10-17 years old for whom a height and weight had been documented. Additional risk factors for type 2 diabetes were ascertained via structured telephone interview. Data were analysed to determine the overall prevalence of risk factors for type 2 diabetes, and to evaluate for associations between each parameter with body mass index and the number of risk factors. RESULTS: Of the 487 adolescents who had height and weight data recorded, 45% were overweight or obese. 77% of those who were interviewed had an additional risk factor for type 2 diabetes. No association between the number of risk factors and body mass index standard deviation score was found. Additionally, there was no association between the number of risk factors for type 2 diabetes and either family history of type 2 diabetes or ethnicity. CONCLUSIONS: This paediatric subpopulation had a high rate of risk factors for type 2 diabetes in addition to overweight and obesity, and are at risk of premature mortality and chronic morbidity should they develop type 2 diabetes.
  • Item
    Thumbnail Image
    Real-world adjuvant chemotherapy treatment patterns and outcomes over time for resected stage II and III colorectal cancer
    To, YH ; Degeling, K ; McCoy, M ; Wong, R ; Jones, I ; Dunn, C ; Hong, W ; Loft, M ; Gibbs, P ; Tie, J (Wiley, 2023-06)
    BACKGROUND: The administration of adjuvant chemotherapy (AC) to colorectal cancer (CRC) patients in Australia and impact of recent trial data has not been well reported. We aim to evaluate temporal trends in AC treatment and outcomes in real-world Australian patients. METHODS: CRC patients were analyzed from 13 hospitals, stratified by stage (II or III) and three 5-year time periods (A: 2005-2009, B: 2010-2014, C: 2015-2019). Stage III was further stratified as pre- and post publication of the International Duration Evaluation of Adjuvant Therapy (IDEA) collaboration (March 2018). AC prescription, time-to-recurrence (TTR), and overall survival (OS) was compared across the time periods. RESULTS: Of 3977 identified patients, 1148 (stage II: 640, stage III: 508), 1525 (856 vs. 669), and 1304 (669 vs. 635) were diagnosed in Period A, B, and C, respectively. Fewer patients in Period C received AC compared to Period B in stage II (10% vs. 15%, p <.01) and III (70% vs. 79%, p <.01). Post-IDEA, the proportion of patients receiving ≤3 months of oxaliplatin-based AC increased (45% vs. 13%, p <.01). The proportion of patients who remained recurrence free at 3 years was similar between time periods in stage II (A: 89% vs. B: 88% vs. C: 90%, p = .53) and stage III (72% vs. 76% vs. 72%, p = .08). OS significantly improved for stage II (80%-85%, p = .04) and stage III (69%-77%, <.01) from period A to B. CONCLUSION: AC use has moderately decreased over time with no impact on recurrence rates. Improved survival in more recent years despite similar recurrence rates may be related to improved baseline staging, better postrecurrence treatment, and reduced noncancer-related mortality.