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CEO Health Research Translation Newsletter - December 2013

Health and medical research provides new knowledge at an ever growing rate. This knowledge is aimed at improving health; sometimes in the short term, often with a longer time frame. 

The catch is of course that peoples’ health is improved only when the findings of research are taken up and implemented by decision makers, health professionals, policy makers and consumers.

Sometimes the research needs to be developed commercially; to support the development of new products for better diagnoses and better treatments. Research can also support improvement in the care provided to patients, or to better target preventive polices and measures. Importantly, research shows the way that whole health systems and systems of care could be improved to benefit the outcomes for people.

Since the dawn of the introduction of science into medicine and health care, the failure to take up research findings in a timely way, or at all, has been a constant refrain.

The aim of the NHMRC Research Translation Faculty is to provide NHMRC with a powerful method of changing this; to use Australia’s strength and expertise in health and medical research to drive improvements more effectively. 

Valley of Death cartoon - highlights gap between research and research translation

We included this cartoon in our current Strategic Plan to indicate the gap between discovery and, in this case, patient care.  Our aim with the Faculty is to strengthen that rickety bridge, and have it reinforce  not only evidence-based and high-quality patient care, but generally to underpin policy and practices in the health system, and economic development.

The Faculty members will develop a well-argued, Case for Action, for our Council that is supported by strong evidence. This will be scrutinised and reviewed by NHMRC’s new Community and Consumer Advisory Group, Prevention and Community Health Committee, Health Care Committee, and by international peer reviewers. If the Case for Action is accepted by Council, then depending on the action to be taken, there will also be further consultation.

I am confident that the Faculty, through this process, will provide NHMRC with transformative ideas; ideas that will challenge many of the ways we do things in Australia regarding health, where there is evidence of a crucial gap between what we do, and what we should do.

I want to thank all who have agreed to be part of this unique initiative internationally, where our funded researchers have volunteered to contribute their knowledge and energy to this transformative endeavour.

The Research Translation Faculty

Research Translation Faculty: an initiative to accelerate the translation and use of research

In addition to being Australia’s peak funding body for health and medical research in Australia, NHMRC has a parallel role in ensuring our citizens benefit from research investment and outcomes. The CEO is required under the NHMRC Act to issue guidelines and advice to the public. These make research findings available in a form that can be readily used by policy and decision makers, and those responsible for delivering high-quality health care.

The value of NHMRC’s strategy to accelerate the translation of research outcomes in Australia is even more widely recognised since the launch of our Research Translation Faculty (the Faculty) initiative in October 2012. Twelve months on, the Faculty membership has grown to almost 2,900 members with 14 Steering Groups driving the development of Cases for Action that are relevant to both National Health Priority Areas and NHMRC’s strategic Major Health Issues.

Each Case for Action must set out a well-argued case for where there is a significant gap between the best available existing evidence and what is actually happening in practice and policy. This will then allow NHMRC to do what it does best – provide the evidence-base to support policy-makers and clinicians in delivering high-quality health services. We may do this, for example, by issuing a public position statement about an important health issue. I am assured by the high-calibre of Faculty leaders and members that the Faculty will rise to this challenge and provide recommendations for action that will see benefits relevant to a range of stakeholders, disciplines, professions and systems.

I encourage readers to stay abreast of this NHMRC initiative and I look forward to updating you again on the progress of the Faculty in 2014.

For more information, visit the Research Translation Faculty page on our website.

The Research Translation Faculty in numbers:

2,866

Members of the Research Translation Faculty
Faculty members represent approximately one third of NHMRC funded Chief Investigators and Fellows.

340

Delegates that attended the 2nd Faculty Symposium in Sydney, 2-3 October 2013
Delegates were engaged by 80 speakers across 10 parallel sessions, eight master classes and three plenary sessions.

118

Faculty Steering Group Members
Steering Group members are leading the development of Cases for Action (CFA) and will be seeking input from the broader Faculty membership, consumers and other relevant stakeholders.

115

Big ideas received for the Cases for Action
While Steering Groups are at different stages of the process, most Groups are reviewing ideas and selecting one to develop. It is anticipated that most CFAs will be drafted by mid-2014.

14

Faculty Steering Groups
Steering Groups were established through a competitive process and include representation from NHMRC Principal Committees.

2

Workshops – Big Ideas for Action
Two workshops were held in April and May 2013. Steering Group members were briefed by NHMRC CEO Professor Warwick Anderson, who explained the Case for Action concept.

2

Symposia
The first Symposium in October 2012 was held in Melbourne and was the official launch of the Faculty.
The second Symposium in Sydney in October 2013 was a two-day event that facilitated discussion around research translation across clinical, public health and innovation domains. Planning has already commenced for the next Symposium in 2014.


2nd Annual NHMRC Research Translation Faculty Symposium

From Bench to Bourke: improving practice, policy and commercialisation

The 2nd annual Research Translation Symposium, held in Sydney in early October this year, was a huge success with over 340 delegates attending over the two days.

The Symposium was a showcase for Australia’s talent and creativity across the entire spectrum of research translation: including advances from innovation and industry, through to clinical and public health practice and health policy.

Over 80 speakers across 10 parallel sessions, 8 master classes and 3 plenary sessions offered practical insights into research translation; we are very grateful to the speakers and presenters for their participation and support. The program explored different models for research translation, as well as how we build capacity in research translation in order to enable us to accelerate the benefits of research.  The plenary sessions and all other presentations can be viewed on the NHMRC website.

The first plenary session was about ‘building bridges to translate research into policy and practice’. Professor Alan Cass discussed the journey towards evidence-informed delivery of renal services and its challenges. We also heard from Professor Melissa Wake on the curious case of translation in children’s health and Professor Steve Webb on translation of evidence into practice – pushing or pulling.

Plenary session two saw international guest Professor Holger Schunemann, Professor Sally Redman and Professor Cindy Shannon present on the theme of the ‘long and winding road to research translation’ with a focus on public/population health.

The final plenary session provided an excellent opportunity to wind up the Symposium with speakers including Professor Suzanne Cory, Professor Mark Cook, and another international guest, Professor Tikki Pang who described translation with an innovation focus and discussed how creativity and discovery start the journey.

The survey conducted after the Symposium confirmed that a large number of attendees found that the program fulfilled their expectations and that they would attend the Research Translation Symposium next year. Singled out for especial praise was the calibre of the plenary session speakers. Suggestions for the next Symposium included deeper engagement with policy makers, public health and primary care.

I now look forward to next year’s Symposium where we hope to continue the journey of research translation and the positive outcomes on the health of Australians.

NHMRC Committee News

The following outlines some of the projects being undertaken by the Principal Committees of NHMRC that are involved in translational research and ethics.  For further information on each of the committees and their membership, go to http://www.nhmrc.gov.au/about/committees-nhmrc

AHEC - Australian Health Ethics Committee

Survey on the National Statement on Ethical Conduct in Human Research, 2007 (the National Statement)

AHEC has developed a survey for users of the National Statement on Ethical Conduct in Human Research, 2007 (the National Statement) to inform the ongoing review of the National Statement.  This is an online survey that will be sent out to HRECs, researchers and interested people from 28 November 2013 – 7 February 2014. It is formally supported by NHMRC, Australian Research Council (ARC) and Universities Australia (UA), the three authors of the National Statement.

Informed by the results of this survey, AHEC will develop a plan of priority areas for review of the National Statement.

AHEC Activities in 2014

In 2014, the following areas will be the focus of activity for AHEC:

  • Development of a plan for the rolling review of the National Statement
  • Development of ethical guidelines for organ transplantation and allocation from deceased donors;
  • The return of results, including incidental findings, from genetic and genomic testing to patients tested in the research, clinical trial and clinical practice settings (a joint project with HGAC);
  • Review of part B of the Ethical guidelines for the use of Assisted Reproductive Technology in Clinical Practice and Research, 2007 and
  • Development of guidance for clinical ethics capacity building.

HGAC - Human Genetics Advisory Committee

Direct-to-Consumer (DTC) Genetic Testing

The Council of the NHMRC recently recommended the release of a guide for health professionals, to assist them in discussing direct to consumer (DTC) genetic testing with their patients. DTC genetic testing is usually marketed on-line, with consumers sending a sample to a laboratory that is usually based overseas.  The consumer receives the results directly, without the involvement of their medical practitioner. The DTC resource discusses some of the issues that may arise if patients undergo DTC testing. 

HGAC Activities in 2014

In 2014, the following will be a focus of activity for HGAC:

  • A Position Statement on Direct to Consumer Testing;
  • A Framework for the Evidential Standards for genetic and genomic testing, a principles based document to guide the transition of tests from research to clinical practice; and
  • A workshop on the Evidential Standards Framework to be held in March 2014.

HCC - Health Care Committee

Homeopathy

NHMRC’s draft Position Statement and Information Paper on the effectiveness of homeopathy will be ready to be released for public consultation in early 2014.  

The draft position was developed by the Homeopathy Working Committee, chaired by Professor Paul Glaziou, and  is based on a systematic review of systematic reviews, consideration of submitted literature as well as an analysis of existing government reports and guidelines on the effectiveness of homeopathy to treat various clinical conditions. The draft Information Paper details how the published literature was identified and assessed in regards to study design, quality, relevance and strength of evidence.

Further details are available on the NHMRC website under Complementary and alternative medicines.

Stem Cell Treatment Information

The NHMRC, under the guidance of HCC, have developed two resources on stem cell treatments titled:

The resources provide medical practitioners and patients with information on the stem cell treatments that are available, and the risks involved in undergoing unproven treatments. Unproven stem cell treatments can result in serious health complications such as infection, allergic reaction or immune system rejection and the development of cancer. Stem Cells Australia, the Australasian Society for Stem Cell Research, National Stem Cell Foundation of Australia has assisted in the development of these resources.

HCC Activities in 2014

In 2014, the following areas will be the focus of activity for HCC:

  • Assessing the Faculty’s Cases for Action on the most significant gaps between research and health policy and practice in each of the major health issues identified in the Strategic Plan 2013-15;
  • Data collection to drive quality improvement;
  • Shared decision making;
  • Complementary and Alternative Medicines - resource for general practitioners in communicating with patients.

PCHC - Prevention and Community Health Committee

PSA Testing

PSA Testing for Prostate Cancer in Asymptomatic Men: Information for Health Practitioners aims to assist General Practitioners and other health practitioners to provide consistent, evidence-based advice to asymptomatic men who are considering undergoing a PSA test. An expert group, chaired by Professor Adele Green was appointed to oversee the development process of this resource. 

The document was released for public consultation in July and August 2013 and was subsequently considered by Council on 28 November 2013. It is anticipated that the final information resource will be released by the CEO in early 2014.

Wind Farms

In 2012, NHMRC commissioned a systematic review of the scientific literature to examine the possible impacts of wind farms emission (i.e. audible and inaudible noise, shadow flicker and electromagnetic radiation) on human health. The Wind Farm and Human Health Reference Group, chaired by Professor Bruce Armstrong, is overseeing the development of NHMRC’s draft Position Statement. The draft Position Statement and supporting Information Paper, which outlines how the published literature was identified and assessed, will be ready for release for public consultation in early 2014.

Further details are available on the NHMRC website under Wind Farms and Human Health.

Public Health Data

A key interest for PCHC this triennium is population health and health services data, and the means by which researchers may best access this data for research purposes. This would include data from multiple and dispersed sources and where required, access to linked/integrated data. With multiple jurisdictions and administrations involved, PCHC is looking at principles to maximise the benefits of data to the community through research, while minimising the burden on data custodian organisations and researchers. NHMRC will be establishing a committee representing researchers (from PCHC), data custodians and consumers to advise on several projects around the use of data for research purposes for the remainder of the triennium.

Obesity

NHMRC identified obesity as one of our Major Health Issues for this triennium and PCHC has been advising on opportunities for research activities aimed at preventing obesity in the 15-35 year old cohort.

As part of NHMRC’s wider approach to this health issues, I have invited a small number of NHMRC funded researchers to a roundtable focused on new scientific approaches to understanding the biological basis of obesity and its resistance so far to effective population based policies.

PCHC Activities in 2014

In 2014, the following areas will be the focus of activity for PCHC:

  • Developing a National Best Practice Guide for Data Access for Research;
  • Undertaking the drafting of a National Data Strategy;
  • Considering a Targeted Call for Research for Obesity to address the 15-35 year cohort;
  • Advising on the development of an Information Document on PSA Testing for health and medical practitioners;
  • Considering an evidence based approach to improve mental wellbeing through positive early parenting;
  • Assessing the Faculty’s Cases for Action on the most significant gaps between research and health policy and practice in each of the major health issues identified in the Strategic plan 2013-15;
  • Working with these new Steering Groups of the Research Translation Faculty and the new Partnership Centres to improve the case for prevention on a number of issues, and
  • Advising on numerous environmental health issues such as wind farms, fluoridation, water quality, lead and coal seam gas.

Guidelines

The following section provides information on guidelines that have been developed and released by NHMRC in 2013: guidelines that have been developed by other institutions that have received the NHMRC ‘tick of approval’ and guidelines that are in development. 

Guidelines developed and released by NHMRC in 2013

Staying Healthy: Preventing infectious diseases in early childhood education and care services (5th Edition).

The development of Staying Healthy in Childcare involved extensive consultation with the childhood and education sector, public health experts and the public. This 5th edition replaces Staying Healthy in Child Care - Preventing infectious diseases in child care (4th edition), and represents an increased focus on a risk-management approach to infection prevention and control principles in daily care activities.  The document provides educators and other staff working in education and care services with simple and effective methods for minimizing the spread of disease.

The ‘Eat for Health’ Guidelines: Infant Feeding Guidelines and Australian Dietary Guidelines

  • The Eat for Health Program, including the Infant Feeding Guidelines (2012) and Australian Dietary Guidelines (2013), was released in February 2013. This Program aims to provide health professionals and consumers with healthy eating information which is based on strong scientific evidence, meets nutritional requirements, and reduces the risk of diet-related conditions and chronic diseases.
  • A range of companion resources for educators and consumers including summary booklets, brochures, posters and an interactive website (www.eatforhealth.gov.au) were also released as part of this Program. These include the Australian Guide to Healthy Eating (2013), and recommendations on quantities of food for different age and gender groups.
  • The Eat for Health Program is a joint initiative of NHMRC and the Australian Government Department of Health and Ageing.

Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia

  • Intended for use by clinicians including general practitioners, primary health care nurses, primary health care professionals and allied health professionals, the Guidelines follow the primary care ‘5As’ framework: ask and assess, advise, assist, arrange. A range of health benefits are promoted in the guidelines including healthy eating plans, increased physical activity and behavioural modification to help patients manage obesity.
  • The Guidelines make recommendations regarding the management of individuals who have a body mass index (BMI) greater than 25.0 kg/m2 and are at risk or currently have obesity related comorbidity.

Clinical Practice Guideline for the Management of Borderline Personality Disorder

  • The Guidelines will assist health professionals to diagnose, treat and manage Borderline Personality Disorder (BPD) in adolescents and adults. This guideline will also improve understanding and recognition of BPD in health services and the community
  • Developed by a multi-disciplinary Guideline Development Committee of clinical, consumer and carer representatives with BPD expertise, the guideline discusses a range of treatment options, including 63 recommendations covering diagnosis, management, treatment and information for supporting carers and families

Amended paragraph 4.1.11 (the human fetus, or fetal tissue, after separation) of the National Statement on Ethical Conduct in Human Research, 2007.

  • The National Statement on Ethical Conduct in Human Research (2007) (National Statement (2007)) consists of a series of Guidelines made in accordance with the National Health and Medical Research Council Act 1992 (the Act). The National Statement (2007) is subject to rolling review. This means that parts of the National Statement will be updated as needed, rather than reviewing the entire document every five years.

Australian Code for the care and use of animals for scientific purposes, 8th edition.

  • The Code outlines the ethical framework and governing principles for the care and use of animals for scientific purposes. It applies to all aspects of the care and use of animals in all areas of science where the aim is to acquire, develop or demonstrate knowledge or techniques. It applies to all types of live non-human vertebrate animals, and cephalopods (for example, octopus).

Rolling review of the Australian Drinking Water Guidelines 2011

The recent update of the ADWG includes:

  • New Information Sheets for Water Treatment Operators, which replaces Information Sheets on Disinfection;
  • An update of the 1996 Chemical Fact Sheets on benzene, toluene, ethylbenzene and xylenes; and
  • A new resource – Guidance for issuing and lifting boil water advisories.

Revised Chapter 3.4 Human Biospecimens in Laboratory Based Research
(revised chapter 3.4 of the National Statement on Ethical Conduct in Human Research, 2007).

  • The revised Chapter 3.4: Human biospecimens in laboratory based research brings together the guidance in the current Chapters 3.4 and 3.6 and addresses concerns about inconsistencies between the two chapters, and perceived gaps in the ethical guidance.

The following guidelines are scheduled to be released in 2014

  • Revised Chapter 2.3 Qualifying or waiving conditions for consent (revised chapter 2.3 of the National Statement on Ethical Conduct in Human Research, 2007).
  • Ethical Considerations in Quality Assuranceand Evaluation Activities

The following guidelines have been approved by NHMRC in 2013

The Australian Immunisation Handbook 10th edition.

  • Developed by the Australian Technical Advisory Group on Immunisation (ATAGI).

Best Practice Guidelines for the Safe Restraint of Children Travelling in Motor Vehicles (PDF, 448KB)

  • Developed by Neuroscience Research Australia (NeuRA) and Kidsafe

Guidelines for the Diagnosis and Treatment of Malignant Pleural Mesothelioma

  • Developed by Asbestos Diseases Research Institute

Australian Guidelines for the Treatment of Acute Stress Disorder and Posttraumatic Stress Disorder

  • Developed by Australian Centre for Posttraumatic Mental Health

The following guidelines and information are in development by NHMRC

NHMRC Prostate Testing Information Document

  • NHMRC Prostate Testing Information Document underwent public consultation in July and August 2013, and was considered by Council at the November 2013 session.

Complementary and Alternative Medicines Clinician Resource

  • The Complementary and Alternative Medicines Clinician Resource opened for public consultation between 31st July and 13th September.

National clinical practice guidelines portal

Recent notices

Minor amendments to the Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia (2013).

For your interest


Professor Warwick Anderson AM
Chief Executive Officer
National Health and Medical Research Council

 

Page reviewed: 20 December, 2013