TRANSFER THEME (5) RESEARCH OUTCOMES INTO HEALTH POLICY

Project Details

Promoting effective transfer of research into practice


Quality of the plan for research translation

Testing implementation models to develop new knowledge of effective approaches

Working with the Stakeholder Advisory Council, and led by our implementation expert (Prof Gunn) and Quali-expert (Dr Ayton), the Centre’s framework for implementation will be informed by PRISM (Practical, Robust Implementation and Sustainability Model). This approach recognises the complexity of working across multidisciplinary groups and will facilitate more effective implementation and the use of knowledge translation strategies through systematic testing and shared learning.

Synergies achieved by a Centre wide approach to implementation activity

Each Workplan aims to implement new knowledge while maintaining clinical relevance and focus by ensuring shared participation between expert clinicians and specialist researchers. Our strategy of early development of translation plans, including clarity and agreement over the desired impact will help to overcome the difficulties with amalgamation of knowledge that may arise from different disciplines and stakeholder groups.

Health economics and modelling

A key component of centre is the integration of health economics into medical decision-making. This economic method will be incorporated into all stages from assisting in the design of RCTs to the evaluation and translation research findings. The centre will benefit from having access to patient level data and will use health economic modelling to extrapolate our findings to the wider Australian population so that gains in cost-effectiveness can be spread across the sector. Our health economic team is strong with a proven policy translation record supported by experienced outcomes modellers, their networks, and the experience within our Stake Holder Advisory Council. The health economic program will aim to build capacity in the health economic evaluation of TJR in Australia and to strengthen ongoing international links such as with Health Economics Research Centre at University of Oxford.

Plans for promoting the Centre’s activities to the wider community

We shall capitalise on our team’s extensive experience in networking to build a strongly connected translation community to ensure high impact interventions. This will be supported by a Stakeholder Advisory Council (SAC) who will foster a two-way exchange of information between end-users and researchers. The Centre will also engage with other CREs (TRIUMPH, MABEL, NCAS) through direct CI involvement (as CIs/AIs on these CREs) to share in translational expertise, learn from others’ experiences and to extend the reach of this Centre.

Involvement of end-users and the wider community

Orthopaedic Surgeons

Practice change in TJR must be led by orthopaedic surgeons. The Centre will leverage it’s networks with various internal and external critical players and associated existing stakeholder programs to reach surgeons and trainees.

Primary Care

As past-President, Professor Jane Gunn will facilitate the transfer of knowledge from this Centre to the primary care community through Australian Association for Academic Primary Care. Using her role as foundation Chair of Victorian Primary Care Research Network, Professor Gunn will engage general practitioners in a broad spectrum of clinical settings to test the useability of the nomogram from Workplan#1.

The Community

Community Advocacy Groups: Among others, the CEO of Arthritis & Osteoporosis Victoria (AOV) is on the Centre’s Stakeholder Advisory Council and has had considerable experience driving funding and policy changes that impact those with chronic diseases including OA.

Private Health Sector

With over 50% of TJRs performed in the private sector, it is critical to include the input of private sector funders. Dr. Linda Swan is the Chief Medical Officer of Medibank Private LTD (MPL), Australia’s largest private health fund and sits on this Centre’s Stakeholder Advisory Council. This Centre will work closely with MPL to develop methods to access, analyse and interpret private hospital data that will inform our research and evaluate the impact of interventions in that sector.

Health authorities

The Victorian Department of Health and Human Services (DHHS) has auspiced a strategic advisory group, the Musculoskeletal Clinician Leadership Group: a multidisciplinary group of medical, nursing and allied health leaders whose mandate is to identify problems and solutions to assist DHHS focus its strategic efforts when dealing with MSK issues. Professor Peter Choong through his position as inaugural chair of this group and Chair of the OA Model of Care group, is in an ideal position to engage a broad range of stakeholders at the highest levels to evaluate needs, garner support and to drive change.

Broader research world through journal editorships

All Researchers will leverage their positions on the editorial boards of 17 top ranked international journals in the fields of orthopaedics and surgery (3), physiotherapy and rehabilitation (6), speciality medicine (3) primary care (3) and health economics (2) to profile the Centre’s work and also to promote further research and dialogue in this arena.

Development of the Health and Medical Research Workforce

We are strongly committed to capacity building both for the benefit of the program itself and to that of Australian medical research now and in future generations. Future leaders in the musculoskeletal field will require strong research translational capabilities and this centre with its multidisciplinary approach is ideally placed to provide the platform and networks which will help facilitate training and advancement opportunities to new researchers, particularly those with a capacity for independent research and future leadership roles

This centre will target a broad-range of key professional groups with a specific focus on orthopaedic surgeons and early/mid-career researchers from a variety of backgrounds including universities, hospitals and community clinics. Our key trans-disciplinary hub in Melbourne interacts strongly with collaborators interstate and internationally, offering graduate students, post-doctoral early/mid-career researchers unique opportunities to extend their research experiences.

We will generate a strategy for new researcher capability, mentoring and encouragement of further career development, targeting and supporting new researchers and provide mentoring strategies to integrating new researchers into the teams. We will also help facilitate collaboration with other groups in the field of research by building smart collaborations and team cohesion.

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References

Cobos R, et al. Variability of indication criteria in knee and hip replacement: an observational study. BMC Musculoskelet Disord. 2010;11.

Dowsey MM, et al. Associations between pre-operative radiographic changes and outcomes after total knee joint replacement for osteoarthritis. Osteoarthritis Cartilage. 2012;20.

Baker PN, et al. The role of pain and function in determining patient satisfaction after total knee replacement. Data from the National Joint Registry for England and Wales. J Bone Joint Surg Br. 2007;89.

Hoffmann TC, et al. Patients' expectations of the benefits and harms of treatments, screening, and tests: a systematic review. JAMA Intern Med. 2015;175.

Wylde V, et al. Patient-reported outcomes after total hip and knee arthroplasty: comparison of midterm results. J Arthroplasty. 2009;24.

Wylde V, et al. Persistent pain after joint replacement: prevalence, sensory qualities, and postoperative determinants. Pain. 2011;152.

Riddle DL, et al. Use of a validated algorithm to judge the appropriateness of total knee arthroplasty in the United States: a multicenter longitudinal cohort study. Arthritis Rheumatol. 2014;66.

Strategic Review of Health and Medical Research in Australia. Consultation Paper Summary. Canberra: Department of health and Ageing, Australian Government, 2012.

Escobar A, et al. Patient acceptable symptom state and OMERACT-OARSI set of responder criteria in joint replacement. Identification of cut-off values. Osteoarthritis Cartilage. 2012;20.

Dowsey MM, et al. Associations between pre-operative radiographic osteoarthritis severity and pain and function after total hip replacement : Radiographic OA severity predicts function after THR. Clin Rheumatol. 2014.

Choong PF, et al. Obesity in total hip replacement. J Bone Joint Surg Br. 2009;91.

Dowsey MM, et al. The impact of obesity on weight change and outcomes at 12 months in patients undergoing total hip arthroplasty. Med J Aust. 2010;193.

Dowsey MM, et al. The impact of pre-operative obesity on weight change and outcome in total knee replacement: a prospective study of 529 consecutive patients. J Bone Joint Surg Br. 2010;92.

Paulsen MG, et al. Preoperative psychological distress and functional outcome after knee replacement. ANZ J Surg. 2011;81.

Escobar A, et al. Patient acceptable symptom state and OMERACT-OARSI set of responder criteria in joint replacement. Identification of cut-off values. Osteoarthritis Cartilage. 2012;20.

Dowsey MM, et al. Latent Class Growth Analysis predicts long term pain and function trajectories in total knee arthroplasty: a study of 689 patients. Osteoarthritis Cartilage. 2015.

Davies P, et al. A systematic review of the use of theory in the design of guideline dissemination and implementation strategies and interpretation of the results of rigorous evaluations. Implement Sci. 2010;5.

Ivers N, et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012;6.

John OP, Donahue, E.M., Kentle, R.L. The Big Five Inventory-Versions 4a and 54. University of California, Berkeley, Institute of Peronality and Social Research. 1991;Berkeley, CA.

Pearlin LI, et al. The structure of coping. J Health Soc Behav. 1978;19.

Scheier MF, et al. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): a reevaluation of the Life Orientation Test. J Pers Soc Psychol. 1994;67.

Scott IA, et al. Foregoing low-value care: how much evidence is needed to change beliefs? Intern Med J. 2013;43.

Hill JC, et al. Comparison of stratified primary care management for low back pain with current best practice (STarT Back): a randomised controlled trial. Lancet. 2011;378.

CI Vibe Fersum K, et al. Efficacy of classification-based cognitive functional therapy in patients with non-specific chronic low back pain: a randomized controlled trial. Eur J Pain. 2013;17.

Kittelson AJ, et al. Future directions in painful knee osteoarthritis: harnessing complexity in a heterogeneous population. Phys Ther. 2014;94.

Dimitroulas T, et al. Neuropathic pain in osteoarthritis: a review of pathophysiological mechanisms and implications for treatment. Semin Arthritis Rheum. 2014;44.

Holla JF, et al. Predictors and outcome of pain-related avoidance of activities in persons with early symptomatic knee osteoarthritis: a five-year followup study. Arthritis Care Res (Hoboken). 2015;67.

Lluch Girbes E, et al. Pain treatment for patients with osteoarthritis and central sensitization. Phys Ther. 2013;93.

Riddle DL, et al. Preoperative pain catastrophizing predicts pain outcome after knee arthroplasty. Clin Orthop Relat Res. 2010;468.

Skou ST, et al. Knee Confidence as It Relates to Self-reported and Objective Correlates of Knee Osteoarthritis: A Cross-sectional Study of 220 Patients. J Orthop Sports Phys Ther. 2015;45.

Caneiro JP, et al. Cognitive functional therapy for the management of low back pain in an adolescent male rower: a case report. J Orthop Sports Phys Ther. 2013;43

O'Sullivan K, et al. Cognitive Functional Therapy for Disabling Nonspecific Chronic Low Back Pain: Multiple Case-Cohort Study. Phys Ther. 2015;95.

Smith AJ, et al. Pre-surgery knee joint loading patterns during walking predict the presence and severity of anterior knee pain after total knee arthroplasty. J Orthop Res. 2004;22.

Smith AJ, et al. A kinematic and kinetic analysis of walking after total knee arthroplasty with and without patellar resurfacing. Clin Biomech (Bristol, Avon). 2006;21.

Smith AJ, et al. Total knee replacement with and without patellar resurfacing: a prospective, randomised trial using the profix total knee system. J Bone Joint Surg Br. 2008;90.

unzli S, et al. Beliefs underlying pain-related fear and how they evolve: a qualitative investigation in people with chronic back pain and high pain-related fear. BMJ Open. 2015;5.

Bunzli S, et al. Lives on hold: a qualitative synthesis exploring the experience of chronic low-back pain. Clin J Pain. 2013;29.

Feldstein AC, et al. A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. Jt Comm J Qual Patient Saf. 2008;34.



Faculty Research Themes

Cancer, Child Health, Infection and Immunology

School Research Themes

Cancer in Medicine, Child Health in Medicine



Key Contact

For further information about this research, please contact the research group leader.