Clomiphene citrate medication for infertility and risk of stillbirth or neonatal death: a population-based cohort study.

Context: Women achieving pregnancy with infertility treatment may be at increased risk of stillbirth and neonatal death.

Objective: To assess associations between clomiphene citrate (CC) use and perinatal death.

Design: Whole of population data linkage cohort.

Dispensing of clomiphene citrate to treat infertility: medication supplied and population prevalence of assisted pregnancies and multiple births.

Objective: To determine the proportion of pregnancies resulting in birth that were conceived with the use of clomiphene citrate (CC) and the frequency of multiple pregnancy.

Design: Whole-of-population cohort study, constructed through data linkage. Comprehensive Australian Government records of dispensed medications were linked to state Perinatal Registry records for all births of at least 20 weeks' gestation.

Comparison of the effect of lemborexant and other insomnia treatments on driving performance: a systematic review and meta-analysis.

Study Objectives: This systematic literature review and meta-analysis explored the impact of lemborexant and other insomnia treatments on next-day driving performance.

Methods: Searches were conducted in MEDLINE and Embase on May 16, 2019, supplemented by clinical trial registries. Randomized controlled trials in healthy volunteers or people with insomnia were included if they reported a standardized on-road driving test, were published in English and included ≥1 group receiving a recommended dose of flunitrazepam, estazolam, triazolam, temazepam, brotizolam, etizolam, alprazolam, lorazepam, zolpidem, eszopiclone, zaleplon, zopiclone, trazodone, ramelteon, lemborexant, or suvorexant.

Comparative efficacy of lemborexant and other insomnia treatments: a network meta-analysis.

Insomnia is a common disorder associated with a substantial burden of illness, particularly in older adults. To compare the efficacy and safety of lemborexant with specified other insomnia treatments through a systematic literature review and network meta-analysis (NMA). Medline and Embase were systematically searched from inception to February 2019 and updated with a targeted search of PubMed for pivotal trials in March 2021.

Indirect treatment comparisons including network meta-analysis: Lenvatinib plus everolimus for the second-line treatment of advanced/metastatic renal cell carcinoma.

Background: In the absence of clinical trials providing direct efficacy results, this study compares different methods of indirect treatment comparison (ITC), and their respective impacts on efficacy estimates for lenvatinib (LEN) plus everolimus (EVE) combination therapy compared to other second-line treatments for advanced/metastatic renal cell carcinoma (a/mRCC).

Methods: Using EVE alone as the common comparator, the Bucher method for ITC compared LEN + EVE with cabozantinib (CAB), nivolumab (NIV), placebo (PBO) and axitinib (AXI). Hazard ratios (HR) for overall survival (OS) and progression-free survival (PFS) estimated the impact of applying three versions of the LEN+EVE trial data in separate ITCs.

Risk factors for Pseudomonas aeruginosa infections in Asia-Pacific and consequences of inappropriate initial antimicrobial therapy: A systematic literature review and meta-analysis.

Objectives: Treating infections of Gram-negative pathogens, in particular Pseudomonas aeruginosa, is a challenge for clinicians in the Asia-Pacific region owing to inherent and acquired antimicrobial resistance. This systematic review and meta-analysis provides updated information on risk factors for P. aeruginosa infection in Asia-Pacific as well as the consequences (e.

Fibromyalgia Outcomes Over Time: Results from a Prospective Observational Study in the United States.

Background: Longitudinal research on outcomes of patients with fibromyalgia is limited.

Objective: To assess clinician and patient-reported outcomes over time among fibromyalgia patients.

Methods: At enrollment (Baseline) and follow-up (approximately 2 years later), consented patients were screened for chronic widespread pain (CWP), attended a physician site visit to determine fibromyalgia status, and completed an online questionnaire assessing pain, sleep, function, health status, productivity, medications, and healthcare resource use.

Assessment of in silico protein sequence analysis in the clinical classification of variants in cancer risk genes.

Missense variants represent a significant proportion of variants identified in clinical genetic testing. In the absence of strong clinical or functional evidence, the American College of Medical Genetics recommends that these findings be classified as variants of uncertain significance (VUS). VUSs may be reclassified to better inform patient care when new evidence is available.

Medical resource utilization and costs among Australian patients with genotype 1 chronic hepatitis C: results of a retrospective observational study.

Objective: To evaluate medical resource utilization (MRU) and associated costs among Australian patients with genotype 1 chronic hepatitis C (GT1 CHC), including both untreated patients and those receiving treatment with first-generation protease inhibitor-based regimens (telaprevir, boceprevir with pegylated interferon and ribavirin).

Methods: Medical records were reviewed for a stratified random sample of GT1 CHC patients first attending two liver clinics between 2011-2013 (principal population; PP), supplemented by all GT1 CHC patients attending one transplant clinic in the same period (transplant population; TP). CHC-related MRU and associated costs are reported for the PP by treatment status (treated/not treated) stratified by baseline fibrosis grade; and for the TP for the pre-transplant, year of transplant and post-transplant periods.

Progression of fibromyalgia: results from a 2-year observational fibromyalgia and chronic pain study in the US.

Background: A previous fibromyalgia (FM) research reports that 20%-47% of diagnosed patients may not meet the study definition of FM 1-2 years after diagnosis. The aim of this study was to gain a better understanding of the progression of FM in a geographically diverse cohort over a 2-year time period.

Methods: This cohort study followed 226 subjects recruited online to assess FM and chronic widespread pain (CWP) diagnosis stability over time.

The Comparative Burden of Chronic Widespread Pain and Fibromyalgia in the United States.

Background/purpose: Little information exists on the comparative patient and economic burden of chronic widespread pain (CWP) and fibromyalgia (FM) in the United States.

Methods: This multistage, observational study included an online screening survey of a large geographically diverse US sample to assess CWP status, a physician/site visit to determine FM diagnosis, and an online subject questionnaire to capture clinical characteristics, pain, health status, functioning, sleep, healthcare resource use (HRU), productivity, and costs. Based on the screener and physician evaluation, mutually exclusive groups of subjects without CWP (CWP-), with CWP but without FM (CWP+), and with confirmed FM were identified.

Adenocarcinoma of the oesophagus: incidence and survival rates in New South Wales, 1972-2005.

Objective: To investigate trends in the incidence of adenocarcinoma (AC) of the oesophagus in New South Wales, factors associated with a diagnosis of AC, and factors associated with survival of patients with AC.

Design And Setting: We examined all cases of invasive oesophageal cancer recorded in the NSW Central Cancer Registry from 1972 to 2005. The Accessibility/Remoteness Index of Australia was used to assess geographical remoteness and the Index of Relative Socio-Economic Disadvantage to assess socioeconomic status.

Degree-of-spread artefact in the New South Wales Central Cancer Registry.

Objective: To describe a data artefact in degree-of-spread at first presentation in the New South Wales Central Cancer Registry (NSW CCR), the only Australian cancer registry that records degree-of-spread data for all solid tumours.

Method: Trends in the proportions of cancer cases diagnosed annually over 1972-2004 by degree-of-spread categories of localised, regional, distant and unknown were calculated for each major cancer type.

Results: Excepting breast cancer and melanoma, the proportion of localised cancer cases reported from 1993-1998 was approximately 5% lower than expected, and was mirrored by an artefactual increase in unknown degree-of-spread cases.

Olanzapine versus lithium in the acute treatment of bipolar mania: a double-blind, randomized, controlled trial.

Background: This multicenter, double-blind, randomized, controlled study conducted in China examined the efficacy and safety of olanzapine versus lithium in the treatment of patients with bipolar manic/mixed episodes.

Methods: Patients with bipolar manic or mixed episode (DSM-IV criteria) and Young Mania Rating Scale (YMRS) score> or =20 at screening received olanzapine (5-20 mg/day, n=69) or lithium carbonate (600-1800 mg/day, n=71) for 4 weeks. The primary outcome was mean change from baseline in Clinical Global Impressions-Bipolar Version Overall Severity of Illness (CGI-BP) score.

Effectiveness and safety of olanzapine in the treatment of schizophrenia among Asian patients switching from conventional antipsychotics.

Objectives: The objectives of this study were: (1) to investigate, in a clinical practice setting, the effectiveness of olanzapine in the treatment of schizophrenia among partially-responding, symptomatic Asian patients who switch from conventional antipsychotic treatment, (2) to assess the safety of olanzapine and (3) to assess the change in quality of life in Asian patients with schizophrenia who switch to olanzapine.

Methods: Effectiveness, safety and quality of life were assessed in outpatients with schizophrenia (n=1267) who lacked symptomatic control with conventional antipsychotics and were switched to olanzapine therapy. Data for this prospective, observational study were collected for 12 months from Asian patients in China, Hong Kong, the Philippines, South Korea and Taiwan.

Empiric validation of the rural Australian Medical Undergraduate Scholarship 'rural background' criterion.

Objective: Rural Australian Medical Undergraduate Scholarships (RAMUS) provide 10,000 dollars per annum to selected medical students with a rural background. Eligibility criteria include having lived in a rural community for five consecutive or eight cumulative years. We sought to validate the above-specified criterion using data from the Australian National Rural Background Study.

Are socio-economically disadvantaged Australians making more or less use of the Enhanced Primary Care Medicare Benefit Schedule item numbers?

We aimed to examine the relationship between levels of socio-economic disadvantage (measured by the Socio Economic Indexes for Areas [SEIFA] used by the Australian Bureau of Statistics) and uptake of the Enhanced Primary Care (EPC) item numbers on the Medicare Benefits Schedule. Health services are often less likely to reach those that most need them and so it is important to monitor whether disadvantaged communities are accessing EPC The rates of health assessments, care plans and case conferences are similar in each SEIFA quartile (from advantaged to disadvantaged populations), favouring the more disadvantaged quartiles in some cases. These national trends are not observed in each state and territory.

Trial of nurse-run asthma clinics based in general practice versus usual medical care.

Objective: The aim of this study was to assess the ability of nurse-run asthma clinics based in general practice compared with usual medical care to produce at least a moderate improvement in the quality of life of adults with asthma.

Methodology: A randomized controlled trial involving 80 asthma clinic and 90 usual medical care asthma participants, aged 18 years and older was conducted in 11 general practices in Adelaide. The main outcome measure was the St George's respiratory questionnaire (SGRQ), from which quality-of-life scores were used to assess therapeutic benefit.

Randomized controlled trial of unflued gas heater replacement on respiratory health of asthmatic schoolchildren.

Background: Previous studies do not provide a clear picture of the relationship between nitrogen dioxide (NO(2)) exposure and asthma.

Methods: Eighteen schools using unflued gas heating in winter were randomly allocated to either retain their heaters (10 control schools) or to have replacement flued gas or electric heaters installed at the beginning of winter (8 intervention schools). Fortnightly telephone interviews were used to record daily individual asthma symptoms that occurred over 12 weeks (including winter).

Acute bronchitis in Australian general practice. A prescription too far?

Objective: To quantify how frequently general practitioners in Australia prescribe antibiotics for acute bronchitis, which antibiotics are used, and whether there are subgroups of patients who might benefit from their use.

Design And Setting: A retrospective descriptive study using 3 sets of data: Australian Sentinel Practice Research Network, the Bettering the Evaluation and Care of Health (BEACH) Program, and the General Practice Research Network (GPRN).

Results: Over 50% of all patients with 'acute bronchitis' had either chest or one or more systemic signs on physical examination.

The Australian Orthopaedic Association National Joint Replacement Registry.

In the financial year ending June 2002, 26 689 hip replacements and 26089 knee replacements (total, 52778) were performed in Australia. Hip and knee replacement procedures have increased between 5%-10% each year for the past 10 years, with a combined increase in hip and knee replacement of 13.4% in the past year.

Statin prescribing in Australia: socioeconomic and sex differences. A cross-sectional study.

Objective: To assess if there are any differences in statin prescribing across Australia by socioeconomic status or sex and to relate prescribing rates to coronary heart disease (CHD) mortality rates.

Design: Cross-sectional study using data on statin prescribing by age, sex and patient postcode for the period May to December 2002.

Setting And Participants: The Australian population, stratified by sex and quintile of Index of Relative Socio-Economic Disadvantage (IRSD).

Factors associated with rural practice among Australian-trained general practitioners.

Objective: To determine the factors associated with general practitioners' current practice location, with particular emphasis on rural location.

Design: Observational, retrospective, case-control study using a self-administered questionnaire.

Setting: Australian general practices in December 2000.

Hospital attendance prediction tool also identifies impaired quality of life in adults with asthma in general practice.

Study Objective: To assess the ability of an adult risk screening questionnaire (RSQ), previously shown to predict attendance at hospital emergency departments, to identify impaired quality of life in adult patients with asthma in general practice.

Design: Baseline data from an RCT of asthma clinics in general practice, using the St. George Respiratory Questionnaire (SGRQ) to measure quality of life.