1,685 results match your criteria: "NHMRC Clinical Trials Centre[Affiliation]"

Introduction: This analysis aimed to investigate diabetes-specific psychological outcomes among adults with type 1 diabetes (T1D) using hybrid closed-loop (HCL) versus standard therapy.

Research Design And Methods: In this multicenter, open-label, randomized, controlled, parallel-group clinical trial, adults with T1D were allocated to 26 weeks of HCL (MiniMed™ 670G) or standard therapy (insulin pump or multiple daily injections without real-time continuous glucose monitoring). Psychological outcomes (awareness and fear of hypoglycemia; and diabetes-specific positive well-being, diabetes distress, diabetes treatment satisfaction, and diabetes-specific quality of life (QoL)) were measured at enrollment, mid-trial and end-trial.

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Therapeutic Potential of Ketogenic Interventions for Autosomal-Dominant Polycystic Kidney Disease: A Systematic Review.

Nutrients

December 2024

Centre for Diabetes, Obesity and Endocrinology Research (CDOER), Westmead Institute for Medical Research, Westmead, Sydney, NSW 2145, Australia.

Background: Recent findings have highlighted that abnormal energy metabolism is a key feature of autosomal-dominant polycystic kidney disease (ADPKD). Emerging evidence suggests that nutritional ketosis could offer therapeutic benefits, including potentially slowing or even reversing disease progression. This systematic review aims to synthesise the literature on ketogenic interventions to evaluate the impact in ADPKD.

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Objective: Large-scale mortality trials require reliable secondary assessments of impairment. We compared the Ages and Stages Questionnaire (ASQ-3), a screening tool self-administered by parents, in classifying impairment using the 'gold standard' Bayley Scales of Infant Development (Bayley-III), a diagnostic tool administered by trained assessors.

Design: Analysis of 405 children around 2 years corrected age from the Australian Placental Transfusion Study, a trial conducted over 8 years.

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Aim: SGLT2 inhibitors may be underused in older adults with type 2 diabetes due to concerns about safety and tolerability. This pooled analysis of the CANVAS Program and CREDENCE trial examined the efficacy and safety of canagliflozin according to age.

Methods: Pooled individual participant data from the CANVAS Program (n = 10 142) and CREDENCE trial (n = 4401) were analysed by baseline age (<65 years, 65 to <75 years, and ≥75 years).

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Background: Panitumumab (pan) plus chemotherapy is a preferred first-line therapy for unresectable RAS and BRAF wild type metastatic colorectal cancer (mCRC). Older patients may not be suitable for combination regimens. We investigated 2 lower intensity pan-containing regimens.

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Decompressive craniectomy for people with intracerebral haemorrhage: the SWITCH trial.

Lancet

January 2025

NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia. Electronic address:

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Background: TRK-inhibitors have demonstrated efficacy across several cancers with NTRK fusions. Their activity in cancers with NTRK overexpression remains unclear.

Methods: This trial enrolled patients with advanced cancers harboring NTRK fusions or extreme mRNA overexpression, defined as NTRK1/2/3 expression by RNA profiling >5 SDs for a given cancer type.

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Objective: We have shown that men aged 50 years+ at high risk of type 2 diabetes treated with testosterone together with a lifestyle program reduced the risk of type 2 diabetes at 2 years by 40% compared to a lifestyle program alone. To develop a personalized approach to treatment, we aimed to explore a prognostic model for incident type 2 diabetes at 2 years and investigate biomarkers predictive of the testosterone effect.

Design: Model development in 783 men with impaired glucose tolerance but not type 2 diabetes from Testosterone for Prevention of Type 2 Diabetes; a multicenter, 2-year trial of Testosterone vs placebo.

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Identifying and counteracting fraudulent responses in online recruitment for health research: a scoping review.

BMJ Evid Based Med

December 2024

Westmead Applied Research Centre, School of Medicine, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.

Objectives: This study aimed to describe how health researchers identify and counteract fraudulent responses when recruiting participants online.

Design: Scoping review.

Eligibility Criteria: Peer-reviewed studies published in English; studies that report on the online recruitment of participants for health research; and studies that specifically describe methodologies or strategies to detect and address fraudulent responses during the online recruitment of research participants.

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Introduction: Equity, diversity and inclusion (EDI) are social constructs which when used in clinical trials help generate the highest quality evidence for interventions in the populations most likely to benefit. However, the incorporation of these constructs in clinical trials is unclear and inconsistent. This scoping review sought to understand how EDI is applied in clinical trials.

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Accumulating the key proteomic signatures associated with delirium: Evidence from systematic review.

PLoS One

December 2024

NHMRC Clinical Trials Centre, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.

Article Synopsis
  • Delirium is a serious neuropsychiatric condition seen often in intensive care and post-surgery, leading to longer hospital stays and higher mortality/morbidity rates.
  • A systematic review analyzed 1746 studies on delirium biomarkers from 2000-2023, resulting in the inclusion of 78 studies emphasizing proteomic signatures related to the condition.
  • The review identified 313 proteins, with a focus on 13 key proteins (like IL-6, CRP, and TNF-a) that show a significant link to delirium, highlighting the need for more research to better understand these biomarkers for diagnosis and treatment.
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Objective: Patient reported outcome measures (PROMs) are commonly collected in melanoma research. However, they are not used to guide immediate clinical care in Australia. This study explored the views and experiences of patients with Stage III melanoma and clinic staff during implementation of an electronic Patient-Reported Outcome Measures in melanoma (ePROMs-MEL) pilot to assess distress and quality of life.

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Background: Despite advances in the treatment of metastatic castration-resistant prostate cancer (mCRPC), primary and secondary resistance to current therapies remains. Elevated circulating sphingolipids are associated with poor outcomes in patients with mCRPC, including therapeutic resistance and shorter overall survival. PCPro is a clinically accessible, regulatory compliant plasma lipid biomarker of poor prognosis in mCRPC, which incorporates prognostic sphingolipids.

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Background: Factors associated with nonadherence to guideline-recommended complete excision of suspicious cutaneous lesions are unclear.

Objective: The purpose of this study was to analyze patient, melanoma, and clinician factors associated with initial diagnostic biopsy type and determine whether unwarranted variation from guidelines occurred.

Methods: This population-based, cohort study involved the analysis of data from questionnaires completed by clinicians who managed patients with newly diagnosed, histopathologically confirmed primary invasive cutaneous melanomas reported to the New South Wales Cancer Registry between 2006 and 2007.

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Age-related macular degeneration (AMD) is a multifactorial disorder, and there is growing evidence of immunological involvement in its pathogenesis. To address this, we aimed to identify biomarker candidates related to retinal antigens in patients with neovascular AMD treated with ranibizumab and healthy subjects. This study was designed as a prospective, open, parallel-group, interventional, single-center phase IV trial.

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Objective: To investigate the effectiveness of the Melanoma Care Programme when implemented into routine clinical practice coupled with fear of cancer recurrence (FCR) screening and a stepped-care model of intervention delivery.

Methods: Using a Type-I hybrid effectiveness-implementation design, individuals with stage 0-II melanoma and a Fear of Cancer Recurrence Inventory FCR severity score of ≥ 13 were offered the Melanoma Care Programme. The programme included a psychoeducational booklet and 3 to 5 psychotherapeutic telehealth sessions with a clinical psychologist, timed around routine dermatological appointments.

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The relationship of bispectral index values to conscious state: an analysis of two volunteer cohort studies.

Br J Anaesth

December 2024

Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Department of Anaesthetics, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; Institute of Academic Surgery, Royal Prince Alfred Hospital, Sydney Local Health District, Sydney, NSW, Australia; NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia.

Background: The ability of current depth-of-anaesthesia monitors to differentiate subtle changes in the conscious state has not been well characterised. We examine the variability in bispectral index (BIS) scores associated with disconnected conscious and unconscious states as confirmed by a novel serial awakening paradigm.

Methods: Seventy adult participants, given propofol or dexmedetomidine, had a cumulative 1381 electroencephalographic (EEG) recordings across two centres.

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Article Synopsis
  • * A systematic search yielded 62 relevant trials, revealing that 87% did not factor in multiple births for sample size calculations, and almost half ignored the clustering effect of multiple births in their analyses.
  • * The findings highlight ongoing issues in trial designs that overlook the complexities of multiple births, signaling a need for trialists to better incorporate these considerations and for readers to critically assess the methodologies in neonatal research.
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Assessing long-term effectiveness and cost-effectiveness of statin therapy in the UK: a modelling study using individual participant data sets.

Health Technol Assess

December 2024

Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.

Background: Cardiovascular disease has declined but remains a major disease burden across developed countries.

Objective: To assess the effectiveness and cost-effectiveness of statin therapy across United Kingdom population categories.

Design: The cardiovascular disease microsimulation model, developed using Cholesterol Treatment Trialists' Collaboration data and the United Kingdom Biobank cohort, projected cardiovascular events, mortality, quality of life and healthcare costs using participant characteristics.

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Chemotherapy and radiotherapy for advanced pancreatic cancer.

Cochrane Database Syst Rev

December 2024

Medical Oncology, The Kinghorn Cancer Care Centre, St Vincent's Hospital, Sydney, Australia.

Article Synopsis
  • Pancreatic cancer is a highly lethal disease with limited treatment options, leading to an updated review of randomized data focused on first-line treatments for advanced cases.
  • The review examines the impact of chemotherapy, radiotherapy, or a combination of both on overall survival, severe adverse events, and quality of life for patients with unresectable or metastatic pancreatic cancer.
  • A total of 75 studies were analyzed, with 51 included in the meta-analysis, examining various treatment comparisons and finding that the studies generally had low risks for biases in methodology.
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Objectives: Research to develop early screening tools to determine an individual's risk of developing adult-onset disease is a growing field. Expectant parents may find themselves with an option in the future to undergo screening to determine not only genetic abnormalities in their child but also their risk of developing adult-onset non-communicable diseases (NCD) such as hypertension, obesity or hypercholesterolaemia. To ensure acceptability and feasibility of new screening tools researchers must work in partnership with healthcare consumers to discern consumers' current understanding and acceptance of these technologies in research and the potential for clinical applications.

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This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: Primary objectives To identify and estimate the prognostic value of molecular biomarkers as predictors of pathological complete response to neoadjuvant chemoradiotherapy in people with locally advanced rectal cancer. summarises the review question in population, index prognostic factor, comparator prognostic factor(s), outcome, timing, and setting (PICOTS) format.

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