Estimating the magnitude and healthcare costs of melanoma in situ and thin invasive melanoma overdiagnosis in Australia.

Background: Research suggests that a high proportion of melanoma in situ (MIS) may be overdiagnosed, potentially contributing to overtreatment, patient harm and inflated costs for individuals and healthcare systems. However, Australia-wide estimates of the magnitude of melanoma overdiagnosis are potentially outdated and there has been no estimation of the cost to the healthcare system.

Objectives: To estimate the magnitude and cost of overdiagnosed MIS and thin invasive melanomas in Australia.

Clinician and health service interventions to reduce the greenhouse gas emissions generated by healthcare: a systematic review.

Objective: To synthesise the available evidence on the effects of interventions designed to improve the delivery of healthcare that reduces the greenhouse gas (GHG) emissions of healthcare.

Design: Systematic review and structured synthesis.

Search Sources: Cochrane Central Register of Controlled Trials, PubMed, Web of Science and Embase from inception to 3 May 2023.

Low-Value Surgical Procedures in Low- and Middle-Income Countries: A Systematic Scoping Review.

Importance: Overuse of surgical procedures is increasing around the world and harms both individuals and health care systems by using resources that could otherwise be allocated to addressing the underuse of effective health care interventions. In low- and middle-income countries (LMICs), there is some limited country-specific evidence showing that overuse of surgical procedures is increasing, at least for certain procedures.

Objectives: To assess factors associated with, extent and consequences of, and potential solutions for low-value surgical procedures in LMICs.

"We're trained to trust our patients": a qualitative study on the general practitioners' trust in patients for colorectal cancer shared care.

Background: In a therapeutic partnership, physicians rely on patients to describe their health conditions, join in shared decision-making, and engage with supported self-management activities. In shared care, the patient, primary care, and specialist services partner together using agreed processes and outputs for the patient to be placed at the centre of their care. However, few empirical studies have explored physicians' trust in patients and its implications for shared care models.

Overuse of medications in low- and middle-income countries: a scoping review.

Objective: To identify and summarize the evidence about the extent of overuse of medications in low- and middle-income countries, its drivers, consequences and potential solutions.

Methods: We conducted a scoping review by searching the databases PubMed®, Embase®, APA PsycINFO® and Global Index Medicus using a combination of MeSH terms and free text words around overuse of medications and overtreatment. We included studies in any language published before 25 October 2021 that reported on the extent of overuse, its drivers, consequences and solutions.

Overdiagnosis and overuse of diagnostic and screening tests in low-income and middle-income countries: a scoping review.

Objective: Overdiagnosis and overuse of healthcare services harm individuals, take resources that could be used to address underuse, and threaten the sustainability of health systems. These problems are attracting increasing attention in low-income and middle-income countries (LMICs). Unaware of any review of relevant evidence, we conducted a scoping review of the evidence around overdiagnosis and overuse of diagnostic and screening tests in LMICs.

Including Information on Overdiagnosis in Shared Decision Making: A Review of Prostate Cancer Screening Decision Aids.

Unlabelled: Overdiagnosis is an accepted harm of cancer screening, but studies of prostate cancer screening decision aids have not examined provision of information important in communicating the risk of overdiagnosis, including overdiagnosis frequency, competing mortality risk, and the high prevalence of indolent cancers in the population. We undertook a comprehensive review of all publicly available decision aids for prostate cancer screening, published in (or translated to) the English language, without date restrictions. We included all decision aids from a recent systematic review and screened excluded studies to identify further relevant decision aids.

Trends in Prostate Specific Antigen (PSA) testing and prostate cancer incidence and mortality in Australia: A critical analysis.

Background: Population trends in PSA testing and prostate cancer incidence do not perfectly correspond. We aimed to better understand relationships between trends in PSA testing, prostate cancer incidence and mortality in Australia and factors that influence them.

Methods: We calculated and described standardised time trends in PSA tests, prostate biopsies, treatment of benign prostatic hypertrophy (BPH) and prostate cancer incidence and mortality in Australia in men aged 45-74, 75-84, and 85 + years.

Estimating the magnitude of cancer overdiagnosis in Australia.

Objectives: To estimate the proportion of cancer diagnoses in Australia that might reasonably be attributed to overdiagnosis by comparing current and past lifetime risks of cancer.

Design, Setting, And Participants: Routinely collected Australian Institute of Health and Welfare national data were analysed to estimate recent (2012) and historical (1982) lifetime risks (adjusted for competing risk of death and changes in risk factors) of diagnoses with five cancers: prostate, breast, renal, thyroid cancers, and melanoma.

Main Outcome Measure: Difference in lifetime risks of cancer diagnosis between 1982 and 2012, interpreted as probable overdiagnosis.

Is the risk of cancer in Australia overstated? The importance of competing mortality for estimating lifetime risk.

Objectives: To calculate lifetime risks of cancer diagnosis and cancer-specific death, adjusted for competing mortality, and to compare these estimates with the corresponding risks published by the Australian Institute of Health and Welfare (AIHW).

Design, Setting: Analysis of publicly available annual AIHW data on age-specific cancer incidence and mortality - for breast cancer, colorectal cancer, prostate cancer, melanoma of the skin, and lung cancer - and all-cause mortality in Australia, 1982-2013.

Outcome Measures: Lifetime risks of cancer diagnosis and mortality (to age 85), adjusted for competing mortality.

Lifetime risk of prostate cancer overdiagnosis in Australia: quantifying the risk of overdiagnosis associated with prostate cancer screening in Australia using a novel lifetime risk approach.

Objectives: To quantify the risk of overdiagnosis associated with prostate cancer screening in Australia using a novel lifetime risk approach.

Design: Modelling and validation of the lifetime risk method using publicly available population data.

Setting: Opportunistic screening for prostate cancer in the Australian population.

Impact evaluation of "Have Fun - Be Healthy" program: A community based health promotion intervention to prevent childhood obesity.

Issue Addressed: Childhood obesity is rising in prevalence in Australia. This study aimed to evaluate the impact of the "Have Fun-Be Healthy" (HFBH) intervention, delivered in the Playgroup setting, to generate short term changes in dietary, physical activity and sedentary behaviours of children under 5 years and self-efficacy of parents and primary carers.

Methods: This intervention consisted of eight structured cooking and physical play sessions delivered over a period of 8 weeks by trained facilitators.

Socioeconomic status and multimorbidity: a systematic review and meta-analysis.

Objectives: We performed a systematic review to identify, critically appraise and synthesise the existing literature on the association between SEP and multimorbidity occurrence.

Methods: We searched Medline and Embase from inception to December 2014. Where possible we performed meta-analysis to obtain summary odds ratios (ORs), exploring heterogeneity between studies through sub-group analysis.

Depression, anxiety and risk of hypertension in mid-aged women: a prospective longitudinal study.

Objectives: The evidence for an association between depression and anxiety and increased hypertension risk is inconsistent. We aimed to investigate the association between each of depression and anxiety and incident hypertension.

Methods: We included women born between 1946 and 1951 from the Australian Longitudinal Study on Women's Health, surveyed triennially from 1998 to 2013, without a history of hypertension at baseline.