Sydney School of Public Health

Problems in comparing tobacco regulatory models and excise when only two countries are considered.

Thu, 14 May 2026 00:00:00 GMT

Problems in comparing tobacco regulatory models and excise when only two countries are considered. Chapman, Simon; Egger, Sam; Freeman, Becky Preprint of a response to: Borland R, Martin J, Jegasothy E, Youdan B, Hall W. Has Australia lost control of its tobacco and nicotine markets? Addiction 2026; https://doi.org/10.1111/add.70428

Policy Analysis of the Virtual Hospital Model: A Case Study of Sydney Local Health District Virtual Hospital

Tue, 05 May 2026 00:00:00 GMT

Policy Analysis of the Virtual Hospital Model: A Case Study of Sydney Local Health District Virtual Hospital Gallo, Enrico This research study was conducted within 8 months and was part of Enrico Gallo’s PhD research. It was supported by A/Prof. Philip Haywood from the Leeder Centre for Health Policy, Economics and Data and Miranda Shaw, General Manager at Sydney Local Health District Virtual Hospital (Sydney Virtual)

Coronary calcium artery scoring for support of shared decision making in adults who do not have a history of cardiovascular disease (CACS Study) dataset

Wed, 01 Jan 2025 00:00:00 GMT

Coronary calcium artery scoring for support of shared decision making in adults who do not have a history of cardiovascular disease (CACS Study) dataset Bonner, Carissa This dataset includes 1629 participants aged 45-79; living in Australia, who never had a heart attack or stroke nor been diagnosed with a CVD. This randomised experiment aimed to test different content options amongst consumers with varying health literacy. A 2 x 2 x 2 factorial design tested how to present risk assessment and management options (basic vs detailed) and uncertainty (implicit vs explicit) to enhance understanding to different final risk outcome groups (low vs high). \r\n The data includes participants' demographics and health literacy as well as their responses to various information (either basic description of CVD risk factors management options or detailed description of the triage method and intervention effects). The file type is .XLS

MEL-SELF dataset: a randomised controlled trial of patient-led surveillance compared to clinician-led surveillance in people treated for localised melanoma

Wed, 18 Mar 2026 00:00:00 GMT

MEL-SELF dataset: a randomised controlled trial of patient-led surveillance compared to clinician-led surveillance in people treated for localised melanoma Bell, Katy The MEL-SELF trial is a randomised controlled trial comparing patient-led surveillance with clinician-led surveillance in people who have been previously treated for localised melanoma. Stage 0/I/II melanoma patients (n=500) from dermatology, surgical, or general practice clinics in Australia, will be randomised (1:1) to the intervention (patient-led surveillance, n=250) or control (usual care, n=250). The primary outcome, measured at 12-months, is the proportion of participants diagnosed with a subsequent new primary or recurrent melanoma diagnosed at an unscheduled clinic visit. Clinical secondary outcomes include time from randomisation to diagnosis of any skin cancer (melanoma or keratinocyte cancer), clinicopathological characteristics of subsequent new primary or recurrent melanomas (including AJCC stage), number of lesions surgically evaluated, and number of clinic visits attended. Patient-reported outcomes collected at baseline, 6 and 12 months, include thoroughness, confidence, beliefs, and knowledge of skin self-examination, adherence with recommended clinician SSE practice guidelines, fear of new or recurrent melanoma severity and general anxiety, stress, and depression. A nested qualitative study will include interviews with patients and clinicians, and a costing study will compare costs from a societal perspective. The data will be available in CSV format.

Better to be looked over than overlooked: 50 years of public health research and advocacy

Wed, 14 Jan 2026 00:00:00 GMT

Better to be looked over than overlooked: 50 years of public health research and advocacy Chapman, Simon Simon Chapman AO is emeritus professor of public health in the School of Public Health. He retired from the University in 2016 but has since continued his contributions publishing three books with Sydney University Press (available open access in this repository), several highly cited research papers, many articles for The Conversation, and a blog. Starting from the very earliest beginnings of his career in the 1970s, this memoir of his 50 years as a highly influential public researcher and advocate highlights work he did on four major issues to which he contributed most: • tobacco control • gun control • discrediting attacks on wind farms, mobile phones and transmission towers, and exposing the non-disease of electrosensitivity • his pioneering teaching, writing and practice of public health advocacy and a large amount of related research into the ways that public health issues are reported and framed in news media which both contribute to and diminish public and political understanding of these issues. Intersecting with these topic-focussed emphases were two enduring themes: Public health scepticism and myth-busting. A lengthy chapter looks at his sceptical contributions to public health since the earliest days of his career. These include: • challenging government messaging that ‘everyone’ was at risk of acquiring HIV • criticism of the enduring effort to convince smokers that they should not try to quit unaided, when that it is exactly how the great majority of ex-smokers have always quit • challenging the ethics of outdoor smoking bans • questioning proposals that employers should be able to not employ smokers • questioning those who want to see all movies showing smoking given R (18+) classifications • challenging argument that eliciting fear in health messaging is often unethical • questioning calls for all men to be screened for prostate cancer and • looking at the evidence for the extent to which public health intervention research is taken up in ‘real world’ settings after being shown to ‘work’ in research projects Confronting corporate, ideological and special interest disease vectors • the tobacco industry • the gun lobby • the sunbed industry • hard right libertarians ideologically opposed to state regulation Many of the interest groups Chapman spotlighted as endangering public health sought to discredit him and diminish his impact. A final chapter in the memoir Growing rhino hide, covers attacks on him and his responses.

Breast density notification trial

Tue, 07 Oct 2025 00:00:00 GMT

Breast density notification trial Nickel, Brooke; Ormiston-Smith, Nick; Cvejic, Erin; Isautier, Jennifer; Hammerton, Lisa; Baker, Karen; Legerton, Paula; Vardon, Paul; McInally, Zoe; Robertson, Sandy; McCaffery, Kirsten; Houssami, Nehmat Dataset.

What do editors of medical journals think about opportunities and barriers to advancement in the publication of plain language summaries? A qualitative analysis

Mon, 15 Sep 2025 00:00:00 GMT

What do editors of medical journals think about opportunities and barriers to advancement in the publication of plain language summaries? A qualitative analysis Gainey, Karen Deidentified transcripts from semi-structured qualitative interviews by Karen Gainey as part of her PhD.

Coaching for Healthy AGEing (CHAnGE) dataset

Tue, 29 Apr 2025 00:00:00 GMT

Coaching for Healthy AGEing (CHAnGE) dataset Anne, Tiedemann This dataset includes 605 participants (aged 60+ years, 180 males /425 females) living in the community, recruited from metropolitan Sydney and regional Orange community (NSW), Australia) via direct contact with established community-based organisations for older people. Baseline data includes demographics, physical activity, fall history, health related quality of life, mobility, BMI, affect, dietary habits. Follow-up data was collected at 3, 6 and 12 months and includes self-reported falls, wellbeing, mobility, health-related quality of life, BMI, dietary habits, falls efficacy, gait efficacy, risk taking behaviour, self-report physical activity and device-measured physical activity. The file type is .XLS.

A technology-enabled collaborative learning model (Project ECHO) to upskill primary care providers in best practice pain care

Mon, 01 Jan 2024 00:00:00 GMT

A technology-enabled collaborative learning model (Project ECHO) to upskill primary care providers in best practice pain care De Morgan, Simone; Walker, Pippy; Blyth, Fiona M.; Daly, Anne; Burke, Anne L. J.; Nicholas, Michael K. Background. The South Australian (SA) Chronic Pain Extension for Community Healthcare Outcomes (ECHO) Network was established to upskill primary care providers in best practice pain care aligned to a patient-centred, biopsychosocial approach using didactic and case-based virtual mentoring sessions. The aims of this study were to assess: (a) participation, satisfaction (relevance, satisfaction with format and content, perceptions of the mentorship environment), learning (perceived knowledge gain, change in attitudes), competence (self-confidence) and performance (intention to change practice, perceived practice change) of the ECHO Network clinician participants; and (b) self-perceived barriers at the clinical, service and system level to applying the learnings. Methods. A mixed methods, participatory evaluation approach was undertaken. Data sources included analysis of program records (learning needs assessment, enrolment survey data, program participation data and online surveys of healthcare professionals including a satisfaction survey after each ECHO session (n = 106 across the ECHO series of 10 sessions; average response rate = 46%), a case presenters survey (n = 7, response rate = 78%) and an outcome survey after all 10 ECHO sessions (n = 11, response rate = 25%). Results. Forty-four healthcare professionals participated in the ECHO Network from a range of career stages and professional disciplines (half were general practitioners). One-third of participants practised in regional SA. Participants reported that the ECHO sessions met their learning needs (average = 99% across the series), were relevant to practice (average = 99% across the series), enabled them to learn about the multidisciplinary and biopsychosocial approach to pain care (average = 97% across the series) and provided positive mentorship (average = 96% across the series). Key learnings for participants were the importance of validating the patient experience and incorporating psychological and social approaches into pain care. More than one-third of participants (average = 42% across the series) identified barriers to applying the learnings such as limited time during a consultation and difficulty in forming a multidisciplinary team. Conclusions. The ECHO Network model was found to be an acceptable and effective interdisciplinary education model for upskilling primary care providers in best practice pain care aligned to a patient-centred, biopsychosocial approach to pain managment. However, participants perceived barriers to translating this knowledge into practice at the clinical, service and system levels.

Framework for Social Media Health Communication to Young People

Fri, 22 Nov 2024 00:00:00 GMT

Framework for Social Media Health Communication to Young People Taba, Melody A framework for using social media for health communication to young people, co-designed by young people and professional health communicators.

Participation Grant Program – Round 2: National Evaluation Report

Mon, 01 Jan 2024 00:00:00 GMT

Participation Grant Program – Round 2: National Evaluation Report Foley, Bridget; Owen, Katherine; Halim, Nicole; Phongsavan, PH This national evaluation report provides an assessment of the Australian Sports Commission's (ASC) Round 2 Participation grant program. The evaluation assessed the program’s impact on the capacity of organisations in the sport and physical activity sector and the effects of funded projects on participants. The Sport Recreation Intervention and Epidemiology Research (SPRINTER) Group at the University of Sydney conducted this national evaluation, covering the period from 1st December 2021 to 28th February 2023. The findings from Round 1 and Round 2 of the ASC’s Participation grant program can inform decisions made by government policymakers, strategic thinkers, sport and recreation sector organisations, practitioners, researchers, and evaluators to ensure progress towards the Global and National target to reduce population physical inactivity by 15% by 2030. The report provides several recommendations for funding applicants, the ASC, and for the evaluation of similar programs.

Disability Inclusion Project: Evaluation Report

Tue, 06 Aug 2024 00:00:00 GMT

Disability Inclusion Project: Evaluation Report Halim, Nicole; Willing, Indigo; Owen, Katherine This evaluation report presents an independent, critical evaluation of the Sport NSW Disability Inclusion Project (DIP). The DIP aimed to create opportunities for children with disability to participate and feel included in sport and active recreation, and build capacity of State Sporting Organisations, local councils, and other providers to provide inclusive sporting and active recreation opportunities for People With Disability. This evaluation report aims to assess the process and short-term outcomes of key streams of the DIP. These include the delivery of Multi-Sport Activity Days targeted at children with disability, and training, education and networking for representative leads of sporting opportunity providers. Sport NSW engaged with the Sport and Recreation Intervention and Epidemiology Research (SPRINTER) Group at the University of Sydney in a policy-research partnership to undertake an evaluation of the DIP which covers the period of project delivery (March-December 2023). The project evaluation was conducted using a mixed-methods approach, involving surveys, semi-structured interviews, and progress-reporting metrics.

Characteristics and post-metastasis survival of recurrent metastatic breast cancer over time - An Australian population-based record linkage study, 2001-2016

Mon, 01 Jan 2024 00:00:00 GMT

Characteristics and post-metastasis survival of recurrent metastatic breast cancer over time - An Australian population-based record linkage study, 2001-2016 Lord, Sally J; Kiely, Belinda E; O'Connell, Diane L; Daniels, Benjamin; Beith, Jane; Smith, Andrea L; Pearson, Sallie-Anne; Chiew, Kim-Lin; Bulsara, Max K; Houssami, Nehmat The aim of this study was to assess population-level characteristics and post-metastasis survival of people with recurrent metastatic breast cancer (rMBC) during a period when new publicly-subsidised adjuvant and metastatic systemic therapies became available. Record linkage study of females in NSW Cancer Registry (NSWCR) diagnosed with non-metastatic breast cancer (BC) in 2001-2002 (C1) and 2006-2007 (C2). We identified first rMBC from NSWCR, administrative hospital records, dispensed medicines and radiotherapy services (2001-2016). We used death registrations to estimate cumulative incidence of BC death.

Preoperative breast MRI positively impacts surgical outcomes of needle biopsy–diagnosed pure DCIS: a patient-matched analysis from the MIPA study.

Sun, 01 Jan 2023 00:00:00 GMT

Preoperative breast MRI positively impacts surgical outcomes of needle biopsy–diagnosed pure DCIS: a patient-matched analysis from the MIPA study. Cozzi, Andrea; Di Leo, Giovanni; Houssami, Nehmat; Gilbert, Fiona J.; Helbich, Thomas H.; Álvarez Benito, Marina; Balleyguier, Corinne; Bazzocchi, Massimo; Bult, Peter; Calabrese, Massimo; Herrero, Julia; Cartia, Francesco; Cassano, Enrico; Clauser, Paola; de Lima Docema, Marcos; Depretto, Catherine; Dominelli, Valeria; Forrai, Gábor; Girometti, Rossano; Harms, Steven; Hilborne, Sarah; Ienzi, Raffaele; Lobbes, Marc; Losio, Claudio; Mann, Ritse; Montemezzi, Stefania; Obdeijn, Inge-Marie; Ozcan, Umit; Pediconi, Federica; Pinker, Katja; Preibsch, Heike; Raya Povedano, José; Saccarelli, Carolina; Sacchetto, Daniela; Scaperrotta, Gianfranco; Schlooz, Margrethe; Szabó, Botond; Taylor, Donna; Ulus, Sila; Van Goethem, Mireille; Veltman, Jeroen; Weigel, Stefanie; Wenkel, Evelyn; Zuiani, Chiara; Sardanelli, Francesco The objective of the study was to investigate the influence of preoperative breast MRI on mastectomy and reoperation rates in patients with pure ductal carcinoma in situ (DCIS). The MIPA observational study database (7245 patients) was searched for patients aged 18–80 years with pure unilateral DCIS diagnosed at core needle or vacuum-assisted biopsy (CNB/VAB) and planned for primary surgery. Patients who underwent preoperative MRI (MRI group) were matched (1:1) to those who did not receive MRI (noMRI group) according to 8 confounding covariates that drive referral to MRI (age; hormonal status; familial risk; posterior-to-nipple diameter; BI-RADS category; lesion diameter; lesion presentation; surgical planning at conventional imaging). Surgical outcomes were compared between the matched groups with nonparametric statistics after calculating odds ratios (ORs).

Communicating Heart Disease Risk: Development and testing of a health-literate decision aid for people with low health literacy dataset

Tue, 16 Jul 2024 00:00:00 GMT

Communicating Heart Disease Risk: Development and testing of a health-literate decision aid for people with low health literacy dataset Bonner, Carissa This dataset includes 859 participants aged 45-74 years (52.8% females and 47.2% males) randomised to see one of six different versions of the results page: either a version aimed at lower health literacy, a standard version, or one as the Heart Foundation present it, and each of those three either with percentage risk of having heart attack or stroke, or percentage risk plus heart age. Baseline data includes demographics (age, heart age, sex, education and health literacy), clinical characteristics (cholesterol, HDL, blood pressure, BMI), behaviour and lifestyle characteristics (dietary, exercise and smoking habits) and risk results. Outcome data includes prevention intentions and behaviours, gist and verbatim knowledge of risk, credibility, emotional response, and decisional conflict. The file type is .XLS.

Optimising COVID-19 testing intentions and behaviour with enhanced messaging dataset

Fri, 28 Jun 2024 00:00:00 GMT

Optimising COVID-19 testing intentions and behaviour with enhanced messaging dataset Bonner, Carissa This dataset includes 1314 adults (equal groups above and below the age of 40 years, equal groups for male and female and equal groups for education). Participants were recruited from New South Wales, Australia into this randomised controlled trial to test the efficacy of providing health literacy-sensitive written information (ie, adapted for people with lower health literacy) for all capability and motivation barriers, where individuals could view information to plan for their top 3 barriers to COVID-19 testing. Anonymous quantitative data on outcomes for each group including the intention to undergo testing for COVID-19 if symptomatic, intentions about other prevention behaviours (self-isolation if symptomatic, social distancing of 1.5 m, washing hands regularly, and wearing masks in crowded indoor areas), understanding of messaging, risk perceptions, social stigma, and self-efficacy (ie, confidence in overcoming perceived barriers to testing) is included in this dataset. The file type is .XLS.

The effect of enhanced messaging on COVID-19 testing intentions and behaviour dataset

Tue, 25 Jun 2024 00:00:00 GMT

The effect of enhanced messaging on COVID-19 testing intentions and behaviour dataset Bonner, Carissa This dataset includes 1527 participants (from 18 to 39 years old, both males and females) receiving 2 audio-visual interventions addressing common COVID-19 testing barriers for people with lower health literacy. Participants were recruited from New South Wales, Australia into this randomised controlled trial. Anonymous quantitative data on outcomes for each group including the intention to undergo testing for COVID-19 if symptomatic, intentions about other prevention behaviours (self-isolation if symptomatic, social distancing of 1.5 m, washing hands regularly, and wearing masks in crowded indoor areas), understanding of messaging, risk perceptions, social stigma, and self-efficacy (ie, confidence in overcoming perceived barriers to testing) is included in this dataset. The file type is .XLS.

Psychosocial outcomes and health service use after notifying women participating in population breast screening when they have dense breasts: a BreastScreen Queensland randomised controlled trial

Sun, 01 Jan 2023 00:00:00 GMT

Psychosocial outcomes and health service use after notifying women participating in population breast screening when they have dense breasts: a BreastScreen Queensland randomised controlled trial Nickel, Brooke; Ormiston-Smith, Nick; Hammerton, Lisa; Cvejic, Erin; Vardon, Paul; Mcinally, Zoe; Legerton, Paula; Baker, Karen; Isautier, Jennifer; Larsen, Emma; Giles, Michelle; Brennan, Meagan E; McCaffery, Kirsten J; Houssami, Nehmat Robust evidence regarding the benefits and harms of notifying Australian women when routine breast screening identifies that they have dense breasts is needed for informing future mammography population screening practice and policy. The objective of this study was to assess the psychosocial and health services use effects of notifying women participating in population-based breast cancer screening that they have dense breasts; to examine whether the mode of communicating this information about its implications (print, online formats) influences these effects.

Lung cancer screening program factors that influence psychosocial outcomes: A systematic review

Sun, 01 Jan 2023 00:00:00 GMT

Lung cancer screening program factors that influence psychosocial outcomes: A systematic review McFadden, Kathleen; Rankin, Nicole; Nickel, Brooke; Li, Tong; Jennett, Chloe; Sharman, Ashleigh; Quaife, Samantha; Dodd, Rachael; Houssami, Nehmat Lung cancer screening (LCS) programs are being designed and implemented globally. Early data suggests that the psychosocial impacts of LCS are influenced by program factors, but evidence synthesis is needed. This systematic review aimed to elucidate the impact of service-level factors on psychosocial outcomes to inform optimal LCS program design and future implementation. Certain program factors are reportedly associated with psychosocial impacts of LCS, but study heterogeneity and quality necessitate more real-world studies. Future work should examine (a) implementation of targeted interventions and high-value discussion during LCS, and (b) optimal methods and timing of risk and result communication, to improve psychosocial outcomes while reducing time burden for clinicians.

Artificial Intelligence-Driven Mammography-Based Future Breast Cancer Risk Prediction: A Systematic Review

Mon, 01 Jan 2024 00:00:00 GMT

Artificial Intelligence-Driven Mammography-Based Future Breast Cancer Risk Prediction: A Systematic Review Schopf, Cody; Ramwala, Ojas; Lowry, Kathryn; Hofvind, Solveig; Marinovich, Luke; Houssami, Nehmat; Elmore, Joann; Dontchos, Brian; Lee, Janie; Lee, Christoph The purpose of this review was to summarize the literature regarding the performance of mammography-image based artificial intelligence (AI) algorithms, with and without additional clinical data, for future breast cancer risk prediction. Sixteen studies met inclusion and exclusion criteria, of which 14 studies provided AUC values. The median AUC performance of AI image-only models was 0.72 (range 0.62-0.90) compared with 0.61 for breast density or clinical risk factor–based tools (range 0.54-0.69). Of the seven studies that compared AI image-only performance directly to combined image + clinical risk factor performance, six demonstrated no significant improvement, and one study demonstrated increased improvement. Early efforts for predicting future breast cancer risk based on mammography images alone demonstrate comparable or better accuracy to traditional risk tools with little or no improvement when adding clinical risk factor data. Transitioning from clinical risk factor–based to AI image-based risk models may lead to more accurate, personalized risk-based screening approaches.

Breast cancer highlights from 2023: Knowledge to guide practice and future research

Mon, 01 Jan 2024 00:00:00 GMT

Breast cancer highlights from 2023: Knowledge to guide practice and future research Cardoso, Maria-Joao; Poortman, Philip; Senkus, Elżbieta; Gentilini, Oreste D.; Houssami, Nehmat This narrative work highlights a selection of published work from 2023 with potential implications for breast cancer practice. We feature publications that have provided new knowledge immediately relevant to patient care or for future research. We also highlight guidelines that have reported evidence-based or consensus recommendations to support practice and evaluation in breast cancer diagnosis and treatment. The scope of selected highlights represents various domains and disciplines in cancer control, from prevention to treatment of early and advanced breast cancer.

iMOVE Project 3-019: Wagga Wagga Active Travel Plan Evaluation Project Final Report

Mon, 01 Jan 2024 00:00:00 GMT

iMOVE Project 3-019: Wagga Wagga Active Travel Plan Evaluation Project Final Report Thomas, Margaret; Bullock, Susan; Halar, Fiona Planning for Australia’s future requires increasing investment in sustainable transport, not only in capital cities but also in growing regional centres. Wagga Wagga is the largest inland city in NSW, with a population of 65,000 which is expected to increase to over 80,000 by 2040. Transport solutions for growing regional centres like Wagga Wagga require an integrated system of mobility options which meet current and future demand. Wagga Wagga City Council received $11.4 million in 2018 from the NSW Cycling Infrastructure Fund managed by Transport for NSW (Transport) to construct a 45 kilometre-long active travel infrastructure network in the town. Subsequently in 2020, Council received an additional $3.9 million in funding from the NSW Government to expand the project by 12 kilometres. This represents the largest network of new, high quality, safe and accessible shared walking and cycling links ever constructed within a short timeframe in regional NSW. The project comprises 57 kilometres of new or resurfaced shared path infrastructure plus interchange upgrades. This network connects cycling and walking infrastructure to education facilities and workplaces, including coming within one block of 90 per cent of schools in Wagga Wagga. To understand the impact of this infrastructure project on a range of areas such as increased community use and promotion of active travel, evaluative research was undertaken. This research aimed to provide evidence of the short to medium-term changes and benefits of the Active Travel Plans implementation and enable longer-term benefits to be estimated. This evaluation adds significantly to the evidence base on active transport planning and implementation in Australia. Specifically, the project provides critical data to inform policies for NSW regional towns and councils seeking to improve infrastructure for active travel.

Breast Cancer Stage and Size Detected with Film versus Digital Mammography in New South Wales, Australia: A Population-Based Study Using Routinely Collected Data.

Mon, 20 May 2024 00:00:00 GMT

Breast Cancer Stage and Size Detected with Film versus Digital Mammography in New South Wales, Australia: A Population-Based Study Using Routinely Collected Data. Farber, Rachel; Houssami, Nehmat; McGeechan, Kevin; Barratt, Alexandra; Bell, Katy J.L. Digital mammography has replaced film mammography in breast-screening programs globally, including Australia. This led to an increase in the rate of detection, but whether there was increased detection of clinically important cancers is uncertain. We found increased detection of in situ cancer (3.36 per 10,000 screens), localized invasive, and smaller-sized breast cancers attributable to the change in mammography technology, whereas screen-detected intermediate-sized and metastatic breast cancers decreased. Rates of early-stage and intermediate-sized interval cancers increased, and late-stage (−1.62 per 10,000 screens) and large interval cancers decreased. In unscreened women, there were small increases in the temporal trends of cancers across all stages.

Active Kids Evaluation Report (2018-2020)

Mon, 01 Jan 2024 00:00:00 GMT

Active Kids Evaluation Report (2018-2020) Reece, Lindsey; Owen, Katherine; Foley, Bridget; Bellew, William; Bauman, Adrian This report presents evaluation findings from the independent evaluation of the New South Wales (NSW) Government’s Active Kids program. Data are presented from the first 3 years of the Active Kids program delivery (2018, 2019, and 2020). Active Kids, the first universal voucher program of its kind, is an innovative approach to promoting participation in organised sport and physical activity outside-of-school among all school-enrolled children in NSW, Australia. Evaluation of the program was designed to help us understand the extent to which a universal voucher program can reach and engage children in organised sport and physical activity. The evaluation affords a unique opportunity to learn more about influencing the physical activity participation behaviours of children in NSW, the factors that affect participation and to understand health and well-being outcomes associated with participation. These population-level program evaluation data have not previously been collected throughout the sport sector. This evaluation also makes an important contribution to the evidence base on how, to effectively design, implement and evaluate complex, at-scale programs, underpinned by evidence, and reported in a way that is readily accessible and appropriate for policy makers and practitioners. The SPRINTER1 Group is a specialist academic research group within the Charles Perkins Centre and the School of Public Health at the University of Sydney. In 2016, the Prevention Research Collaboration established a policy-focused partnership with the NSW Government Office of Sport, entitled SPRINTER. SPRINTER led the pragmatic evaluation design of the Active Kids program in close collaboration with the Office of Sport. Through this collaboration, SPRINTER influenced routine data capture within the registration process for the Active Kids program led by the NSW Government - Service NSW and Office of Sport. The evaluation of Active Kids is registered with the Australian and New Zealand clinical trials registry: ACTRN12618001148268. The evaluation protocol was designed using the TIDieR (Template for Intervention Description and Replication) Checklist. A complete outline of the evaluation protocol can be accessed here: https://doi.org/10.17061/phrp301220062. This evaluation received ethics approval from the Human Research Ethics Committee at the University of Sydney (Project number: 2017/947).

OPTimising IMmunisation Using Mixed schedules (OPTIMUM): comparing allergic outcomes in infants following pertussis vaccination dataset

Fri, 15 Mar 2024 00:00:00 GMT

OPTimising IMmunisation Using Mixed schedules (OPTIMUM): comparing allergic outcomes in infants following pertussis vaccination dataset Snelling, Tom OPTIMUM is an investigator-initiated phase IV, two-stage, multisite, parallel, double-blind, adaptive, randomised controlled trial of a single dose of DTwP given at the age of 6 to <12 weeks, followed by DTaP at 4 and 6 months, versus three aP doses only, for the prevention of IgE-mediated food allergy. The primary objective of the study is to assess the allergy protective benefits of the addition of DTwP into the infant schedule. The study population will be up to 1500 Australian infants recruited at 6-10 weeks of age and randomised to receive either a combined Diphtheria-Tetanus-whole cell Pertussis, Hepatitis B, and Haemophilus influenzae type B vaccine (DTwP) OR a combined Diphtheria-Tetanus-acellular Pertussis, Hepatitis B, Inactivated Poliovirus and Haemophilus influenzae type B vaccine (DTaP) as their first vaccine dose at 6- <12 weeks of age as part of the infant vaccine schedule. The dataset includes demographics, birth history, vaccine history, allergic outcomes to 18 months, including SPT and food challenge data at 12 months of age. The file type is .CSV

Her Sport Her Way Grant Program Evaluation - 2023 Report

Sun, 01 Jan 2023 00:00:00 GMT

Her Sport Her Way Grant Program Evaluation - 2023 Report Halim, Nicole; Willing, Indigo; Foley, Bridget; Owen, Katherine This is the second evaluation report from the SPRINTER evaluation of the Her Sport Her Way Grant Program (2019-2023). This evaluation report aims to explore the capabilities and capacities of state sporting organisations (SSOs) in creating gender-inclusive environments, and identify strategies that are currently utilised by SSOs to increase the participation of women and girls in the sporting sector. The report presents interim findings of the grant projects that have been awarded and outcomes achieved by completed grant projects during the period July 2021 and April 2023. The NSW Office of Sport engaged the SPRINTER group in a policy-research partnership to conduct the evaluation of the Her Sport Her Way grant program using a mixed-methods approach, involving surveys, semi-structured interviews and case studies of funded projects.

Engaging Australian men in disease prevention - Supplementary tables

Thu, 28 Sep 2023 00:00:00 GMT

Engaging Australian men in disease prevention - Supplementary tables Smith, Ben J Supplementary tables showing the demographic and health factors associated with preventive health priorities, attitudes and information sources among Australin men.

Netball NSW Membership Study 2022 report

Sun, 01 Jan 2023 00:00:00 GMT

Netball NSW Membership Study 2022 report Foley, Bridget; Owen, Katherine The Netball NSW membership study was conducted in 2022 to gain a comprehensive understanding of involvement in Netball from the current and past members. Netball NSW partnered with researchers at the University of Sydney for this study. The study involved sending an online survey to Netball NSW members and in-depth analysis of survey responses. Responses were received from 8,461 Netball NSW members (response rate 5.3%). The following key insights were identified from the survey responses to inform how Netball NSW could strategically increase involvement in Netball. • Netball was the sport of choice for 66% of children, and 77% of adult members. • Members rated their involvement in Netball highly. The overall experience of playing Netball was rated 8.4 out of 10, and non-players rated their experience 8 out of 10. The experience in 2022 was better than the past two years, which were affected by the global COVID-19 pandemic. • There were substantial increases in the proportion of members involved in social activities and attending presentation nights in 2022. • The main reason people played Netball was for Fun/Enjoyment. Additional drivers for participation were related to social connection and improving health and fitness. Playing competitively was rated as less critical among both adults and children. • Netball provided members with about half of their annual structured physical activity participation (50% for children, and 63% for adults). • Players reported Netball had positive impacts on their lives. The most positive influences were related to social connection, and improvements in strength, coordination, and fitness. • Players who stopped playing Netball in 2022 reported that it was not fun or enjoyable, did not feel welcome in the Netball community, or had a bad experience with a coach/official. Interpersonal relationships between players within a team, across teams, and between players, and non-players should be fostered. • Although registration cost was not a major barrier to participation, reducing the costs of registration and uniforms was a primary recommendation to increase participation. • A quarter of adult players reported playing Netball at fitness centres not affiliated with Netball NSW, and played more games here than through their club/association. • About one third of Netball players reported they were also involved in non-players roles such as umpiring, coaching, and various duties. On average, people spent 3 hours per week involved in non-player roles. • The main reason people were involved in non-players roles was to be part of the Netball community – to give back. Family involvement was a stronger driver of involvement in non-player roles than athlete development. • Being involved in non-player roles had a neutral impact on people’s lives. The strongest influences from non-player roles were increased social connection and physical activity levels. • Completion of education and training for non-player roles declined compared to previous years. This may be due to many people upskilling during the lock-down and having less time to complete training during 2022. Further analysis of regional differences and qualitative responses from participants will help identify local priorities to be addressed by Netball NSW to increase involvement in Netball.

Basketball NSW 2023 Member Report

Sun, 01 Jan 2023 00:00:00 GMT

Basketball NSW 2023 Member Report Owen, Katherine Basketball NSW engaged the SPRINTER group at the University of Sydney to conduct their 2023 bi-annual membership survey. The objective of this report is to provide evidence for Basketball NSW’s strategic planning and vision; to realise the potential of everyone, strengthening the basketball community and making the sport accessible to all. • Excellent survey response from members, providing confidence in the findings and these findings are likely to represent the broader Basketball community. However, response rates are lower than 2021 (↓2%). Taking time to thank participants, feedback results and articulate how Basketball have listened to the insights will promote long term engagement with the survey. • Members recognise the health benefits of playing basketball. Two thirds of all members reported that basketball has improved their social connection, mental wellbeing, and overall health. The health benefits of basketball should be promoted to the community. • Overall, members are satisfied with their basketball experience. Over 90% of current members would recommend basketball to their friends and family. • Fun and enjoyment were the overwhelming motivator for new and loyal members. Prioritising having fun within the basketball community culture is essential to keep members engaged. • New members reported that improving skills was more important for them; whereas loyal members reported that playing competitively was more important. Providing skill development opportunities should be prioritised among new members and options for playing competitively should be maintained for loyal members. • Word of mouth is the most effective way to get new people to engage with basketball, more than half of new members hearing about basketball from friends and family. Create innovative approaches to encourage current members to invite friends and family to engage with basketball. For example, basketball could encourage existing members to post about their basketball experiences on social media. • Reducing the costs of basketball of providing discounts was the most reported recommendation to help keep members involved in basketball. The annual expenditure of basketball was lower than the state averages reported in Ausplay. Four out of five children used an Active Kids voucher to reduce the cost of basketball. Continue taking advantage of government interventions (e.g., NSW Active kids’ voucher) or alternate subsidiaries, and informing the basketball community about potential financial support is encouraged. 3 Basketball NSW 2023 Member Study • More than half of members reported that they would like to pay for their basketball membership in ways other than the current one-off annual fee. The provision of alternate and flexible pricing within the membership could provide diverse options for communities on varying financial budgets. • Females aged 15-17 years and 18-24 years were the most likely groups to drop out of basketball. Basketball NSW should develop a comprehensive approach to increasing participation and retention of women and girls, guided by evidence in this report. • The most common reasons for children leaving basketball were to try a different sport, basketball wasn’t enjoyable anymore, and other. ‘Other’ responses included providing social, less competitive opportunities. Research recommends that children aged 0-12 should be encouraged to try multiple sports and avoid specialisation in one sport. Strategies to improve retention should be focused on keeping basketball fun and enjoyable. • The most common reasons for adults leaving basketball were poor health, disability, or injury, trying a different sport, and fear of injury. Injury prevention and management information could be integrated into routine basketball communication. Members need a clear understanding of the factors that increase the risk of injury, and how to effectively manage injuries that do occur. • People taking on non-player roles were doing so to be more involved with family members interests and to give back to the community and do not feel the need for recognition. While non-players do not feel the need for recognition, they should have a clear understanding of how their work is contributing to basketball’s strategic objectives, and to broader social outcomes (such as mental health, or community cohesion). • One third of non-players have received no training. Providing volunteers with technical and emotional support will contribute to quality outcomes for the sport. • Members are generally unaware of how to engage with the upcoming FIBA Women’s Asia Cup. Basketball needs to increase awareness around ways for members to engage with the upcoming major event. • The results of this survey should be shared with the basketball community to share what was learnt. This will help member engagement with the sport and any future research conducted by Basketball NSW.

Hockey Australia Survey Report 2022

Sat, 01 Jan 2022 00:00:00 GMT

Hockey Australia Survey Report 2022 Owen, Katherine; Foley, Bridget Hockey Australia conducted their 2022 National membership survey. The SPRINTER group at the University of Sydney were engaged to analyse responses and help to inform strategic decisions within Hockey Australia that aim to achieve the organisations strategic directions; increase initiation and retention within the Hockey community. • In 2022, growth in Hockey Australia memberships was observed, from 93,923 members in 2021 to 95,798 members in 2022. • Hockey is successfully engaging new and re-engaging lapsed members, with 27,237 (28%) of their members new in 2022. • More than one in four hockey members (n=25,362; 27%) members who participated in 2021 but did not return for the 2022 hockey season. Retention was lowest for members aged 0-6 years and 18-25 years, females, Aboriginal and/or Torres Strait Islanders, and members living in regional and remote areas. Continue recruiting new members, but also develop and implement evidence-based strategies to increase retention in members aged 18-25 years, females, Aboriginal and/or Torres Strait Islanders, and members living in regional and remote areas. • Excellent survey response from members, providing confidence in the findings and these findings are likely to represent the broader Hockey community. However, response rates are lower than 2021 (Returning members ↓5.8%, new members ↓5.4%, and lost members ↓2.1%). Taking time to thank participants, feedback results and articulate how Hockey Australia have listened to the insights will promote long term engagement with the annual survey • Overall, members are satisfied with their hockey experience. Since 2020, returning member satisfaction has increased and remained high during 2021 and 2020. In 2022, 89% of returning members and 56% of lost members were satisfied with their hockey experience. • Fun was the overwhelming motivator for new, returning, and lost members. Prioritising having fun within the hockey community culture, for players and non-players, is essential to keep members engaged. • New members reported that improving skills was more important for them. Providing skill development opportunities should be prioritised among new members, 0–17-year olds, and Aboriginal and/or Torres Strait Islander members. • Maintaining opportunities for playing competitively is more important for returning members, males, and members living in major cities. • Providing opportunities to socialise at hockey is more important for older members (55+ years), Aboriginal and/or Torres Strait Islander members, and members living in the most 3 disadvantaged areas. It is important to identify the target audience for specific hockey programs and strategically design programs that align with their motivations and meets their needs. • Top reasons for lost members not returning included other, medical, injury, age, cost, and no time. The membership survey should allow members to provide more details on these ‘other’ reasons. • For groups with the highest risk of being not returning, the top reason for 0-6 years was starting another sport, for 18-25 years was no time, for females was medical, specifically injury, and for members living in regional and remote areas was medical, specifically injury. Research recommends that children aged 0-12 should be encouraged to try multiple sports and avoid specialisation in one sport. Strategies to improve retention should be targeted towards members 12 years and above. Injury prevention and management information could be integrated into routine hockey communication. Members need a clear understanding of the factors that increase the risk of injury, and how to effectively manage injuries that do occur. • Top strategies to encourage more people to engage with hockey were reducing the cost for returning and lost members, and nothing for new members. • ‘Other’ strategies revolved around engaging young children in the school environment. Continue and increase promotion through schools – i.e., Hockey school roadshows and Sporting School programs. • Word of mouth is the most effective way to get new people to engage with hockey, with two thirds of new members hearing about hockey from friends and family. Create innovative approaches to encourage current members to invite friends and family to engage with hockey. For example, Hockey could encourage existing members to post about their hockey experiences on social media. • The quality of registration data has improved, and this is the first-year survey data analysis could be done for members with a disability and members who identified as Aboriginal. Continue the high-quality evaluation and making it ‘the hockey way’ is encouraged for future strategy and program development

Strategic engagement of multicultural communities in sport and recreation: a rapid evidence review for the NSW Government Office of Sport.

Sun, 01 Jan 2023 00:00:00 GMT

Strategic engagement of multicultural communities in sport and recreation: a rapid evidence review for the NSW Government Office of Sport. O'Hara, Blythe; Halim, Nicole; McGill, Bronwyn; Phongsavan, Philayrath The Office of Sport has engaged the SPRINTER group at the University of Sydney to undertake a rapid review to inform strategic approaches to increase the involvement of multicultural communities in sport and active recreation. The purpose of the review was to identify strategic approaches that the Office could implement to increase the involvement of multicultural communities in sport in NSW. Specifically, the review seeks to answer the following research questions: 1. What strategies have been implemented by governments or organisations to involve multicultural communities in sports? 2. Which strategies are effective at increasing multicultural communities’ involvement in sports as participants, volunteers, and leaders? This review included both peer reviewed papers and grey literature and websites, in total n=59 papers / reports / website were included; n=29 were identified through the peer reviewed search and n=30 were identified through the grey literature search. The records included in the main represent examples of sports participation programs and strategies that were based in Australia, with European examples being the showcased but to a less extent.

Transplant recipients and Anal Neoplasia (TAN) study dataset

Wed, 23 Aug 2023 00:00:00 GMT

Transplant recipients and Anal Neoplasia (TAN) study dataset Rosales, Brenda; Hillman, Richard; Webster, Angela This dataset includes up to 125 kidney transplant recipients recruited from Westmead Hospital, New South Wales, Australia. Baseline data includes demographics, risk factors of HPV-associated anal squamous cell cancer, cigarette smoking, sexual behaviours, history of anogenital warts and previous abnormal cervical cytology, concurrent but unrelated anal conditions and sexual practices. Clinical data such as date of transplantation, time on waiting list and current immunosuppression treatment were obtained from patients' clinical records. Anal swab test results for HPV detection and genotyping and cytopathology were collected.

Women’s views about current and future management of Ductal Carcinoma in Situ (DCIS): a mixed-methods study

Sun, 01 Jan 2023 00:00:00 GMT

Women’s views about current and future management of Ductal Carcinoma in Situ (DCIS): a mixed-methods study Nickel, Brooke; McCaffery, Kirsten; Jansen, Jesse; Barratt, Alexandra; Houssami, Nehmat; Saunders, Christobel; Spillane, Andrew; Rutherford, Claudia; Stuart, Kristy; Robertson, Geraldine; Dixon, Ann; Hersch, Jolyn Management of low-risk ductal carcinoma in situ (DCIS) is controversial, with clinical trials currently assessing the safety of active monitoring amidst concern about overtreatment. Little is known about general community views regarding DCIS and its management. We aimed to explore women's understanding and views about low-risk DCIS and current and potential future management options. This mixed-method study involved qualitative focus groups and brief quantitative questionnaires. Participants were screening-aged (50-74 years) women, with diverse socioeconomic backgrounds and no personal history of breast cancer/DCIS, recruited from across metropolitan Sydney, Australia. Sessions incorporated an informative presentation interspersed with group discussions which were audio-recorded, transcribed and analysed thematically. Fifty-six women took part in six age-stratified focus groups. Prior awareness of DCIS was limited, however women developed reasonable understanding of DCIS and the relevant issues. Overall, women expressed substantial support for active monitoring being offered as a management approach for low-risk DCIS, and many were interested in participating in a hypothetical clinical trial. Although some women expressed concern that current management may sometimes represent overtreatment, there were mixed views about personally accepting monitoring. Women noted a number of important questions and considerations that would factor into their decision making. Our findings about women's perceptions of active monitoring for DCIS are timely while results of ongoing clinical trials of monitoring are awaited, and may inform clinicians and investigators designing future, similar trials. Exploration of offering well-informed patients the choice of non-surgical management of low-risk DCIS, even outside a clinical trial setting, may be warranted.

SHeLL Health Literacy Editor screenshot

Wed, 05 Jul 2023 00:00:00 GMT

SHeLL Health Literacy Editor screenshot Ayre, Julie This image depicts the SHeLL Health Literacy Editor. The Editor provides multiple automated health literacy assessments of a text, including readability, complex language, and passive voice.

Let’s talk about U=U: seizing a valuable opportunity to better support adolescents living with HIV

Sun, 01 Jan 2023 00:00:00 GMT

Let’s talk about U=U: seizing a valuable opportunity to better support adolescents living with HIV Bernays, Sarah; Lariat, Joni; Ameyan, Wole; Willis, Nicola The clinical knowledge that people living with HIV who maintain an undetectable viral load and therefore cannot transmit HIV sexually, known as Undetectable equals Untransmittable (U=U), has reached a critical mass of adults, but it is relatively silenced within adolescent HIV care and support. We argue that understanding the full range of opportunities enabled by viral suppression, including the elimination of transmission risk, could transform adolescents’ understanding of living with HIV, incentivise optimal treatment engagement and support and sustain their positive mental health. However, the reluctance to discuss U=U with adolescents means that we are not providing them with adequate access to the information and tools that would help them to succeed. We need to recognise, value, and invest in the mediating role of building viral load literacy, illustrated by conveying U=U in ways that are meaningful for adolescents, to accelerate viral suppression. Rather than protect, rationing access to information on U=U only increases their vulnerability and risk to poor HIV and mental health outcomes.

Towards consensus on managing high mammographic density in population breast screening?

Sun, 01 Jan 2023 00:00:00 GMT

Towards consensus on managing high mammographic density in population breast screening? Tagliafico, Alberto S; Houssami, Nehmat In Medicine and in Radiology, impact on societal and health outcomes of a diagnostic pathway or methodology should be comprehensively investigated before implementing a screening approach for disease ...

Two-year follow-up of participants in the BreastScreen Victoria pilot trial of tomosynthesis versus mammography: breast density-stratified screening outcomes

Sun, 01 Jan 2023 00:00:00 GMT

Two-year follow-up of participants in the BreastScreen Victoria pilot trial of tomosynthesis versus mammography: breast density-stratified screening outcomes Houssami, Nehmat; Lockie, Darren; Giles, Michelle; Noguchi, Naomi; Marr, Georgina; Marinovich, M Luke This follow-up study of BreastScreen Victoria’s pilot trial of digital breast tomosynthesis aimed to report interval cancer rates, screening sensitivity, and density-stratified outcomes for tomosynthesis vs mammography screening. Prospective pilot trial [ACTRN-12617000947303] in Maroondah BreastScreen recruited females ≥ 40 years presenting for screening (August 2017–November 2018) to DBT; concurrent screening participants who received mammography formed a comparison group. Follow-up of 24 months from screen date was used to ascertain interval cancers; automated breast density was measured.

Screening and diagnostic breast MRI: how do they impact surgical treatment? Insights from the MIPA study

Sun, 01 Jan 2023 00:00:00 GMT

Screening and diagnostic breast MRI: how do they impact surgical treatment? Insights from the MIPA study Cozzi, Andrea; Di Leo, Giovanni; Houssami, Nehmat; Et, al To report mastectomy and reoperation rates in women who had breast MRI for screening (S-MRI subgroup) or diagnostic (D-MRI subgroup) purposes, using multivariable analysis for investigating the role of MRI referral/non-referral and other covariates in driving surgical outcomes. The MIPA observational study enrolled women aged 18–80 years with newly diagnosed breast cancer destined to have surgery as the primary treatment, in 27 centres worldwide. Mastectomy and reoperation rates were compared using non-parametric tests and multivariable analysis.

Reply: Understanding the Impact of Blood Pressure Guidelines and Variability on Hypertension Diagnoses

Fri, 01 Jan 2021 00:00:00 GMT

Reply: Understanding the Impact of Blood Pressure Guidelines and Variability on Hypertension Diagnoses Bell, Katy J.L.; Doust, Jenny; McGeechan, Kevin; Horvath, AR; Barratt, Alexandra; Hayen, Andrew; Semsarian, Caitlin R; Irwig, Les n/a

Supporting adults with Chronic Kidney Disease to engage in shared decision making successfully (SUCCESS) dataset

Mon, 15 May 2023 00:00:00 GMT

Supporting adults with Chronic Kidney Disease to engage in shared decision making successfully (SUCCESS) dataset Muscat, Danielle This dataset will include up to 384 participants receiving in-center or home-based hemodialysis or peritoneal dialysis recruited from six local health districts in the Greater Sydney region, New South Wales, Australia. Baseline data will include demographics, dialysis history, cognitive status, health literacy and self-efficacy scores. Follow-up data will be collected at 3, 6 and 12 months and will include patient reported outcomes (quality of life, knowledge, confidence, health behaviour and self-management) and clinical outcomes (symptom burden (Palliative care Outcome Scale) and nutritional status (Patient-generated Subjective Global Assessment).

“I haven’t had that information, even though I think I’m really well-informed about most things”: a qualitative focus group study on Australian women’s understanding and views of potentially modifiable risk factors for breast cancer

Sun, 01 Jan 2023 00:00:00 GMT

“I haven’t had that information, even though I think I’m really well-informed about most things”: a qualitative focus group study on Australian women’s understanding and views of potentially modifiable risk factors for breast cancer Nickel, Brooke; Armiger, Josephine; Saunders, Christobel; Vincent, Wendy; Dodd, Rachael H; Temple, Anthea; Bhola, Nalini; Verde, Angela; Houssami, Nehmat This study aimed to explore current knowledge, understanding and experience of potentially modifiable risk factors for breast cancer, and views on current and future communication strategies for this information and related interventions.

Diagnostic accuracy and outcomes of digital breast tomosynthesis (DBT) compared to digital mammography (DM) in identifying breast cancer in women at increased risk of breast cancer due to symptoms and/or family history.

Sun, 01 Jan 2023 00:00:00 GMT

Diagnostic accuracy and outcomes of digital breast tomosynthesis (DBT) compared to digital mammography (DM) in identifying breast cancer in women at increased risk of breast cancer due to symptoms and/or family history. Houssami, Nehmat; Noguchi, Naomi; Boroumand, Farzaneh; Teixeira-Pinto, Armando; Zeng, Aileen; Bell, Katy J.L. Aims: 1. To examine the diagnostic accuracy and outcomes of DBT, in women with symptoms or signs of breast cancer and/or family history of breast cancer, in comparison with DM. 2. To examine the diagnostic accuracy and outcomes of DBT in the subgroup of women with dense breasts who have symptoms or signs of breast cancer and/or family history of breast cancer, in comparison with DM. 3. To examine the additional diagnostic value of breast ultrasound, used in addition to either DBT or DM in the above-described populations including the subgroup with dense breasts.

Low-risk prostate lesions: An evidence review to inform discussion on losing the "cancer" label

Sun, 01 Jan 2023 00:00:00 GMT

Low-risk prostate lesions: An evidence review to inform discussion on losing the "cancer" label Semsarian, Caitlin R; Ma, Tara; Nickel, Brooke; Barratt, Alexandra; Varma, Murali; Delahunt, Brett; Millar, Jeremy; Parker, Lisa; Glasziou, Paul; Bell, Katy J.L. Background: Active surveillance (AS) mitigates harms from overtreatment of low-risk prostate lesions. Recalibration of diagnostic thresholds to redefine which prostate lesions are considered "cancer" and/or adopting alternative diagnostic labels could increase AS uptake and continuation. Methods: We searched PubMed and EMBASE to October 2021 for evidence on: (1) clinical outcomes of AS, (2) subclinical prostate cancer at autopsy, (3) reproducibility of histopathological diagnosis, and (4) diagnostic drift. Evidence is presented via narrative synthesis. Results: AS: one systematic review (13 studies) of men undergoing AS found that prostate cancer-specific mortality was 0%-6% at 15 years. There was eventual termination of AS and conversion to treatment in 45%-66% of men. Four additional cohort studies reported very low rates of metastasis (0%-2.1%) and prostate cancer-specific mortality (0%-0.1%) over follow-up to 15 years. Overall, AS was terminated without medical indication in 1%-9% of men. Subclinical reservoir: 1 systematic review (29 studies) estimated that the subclinical cancer prevalence was 5% at <30 years, and increased nonlinearly to 59% by >79 years. Four additional autopsy studies (mean age: 54-72 years) reported prevalences of 12%-43%. Reproducibility: 1 recent well-conducted study found high reproducibility for low-risk prostate cancer diagnosis, but this was more variable in 7 other studies. Diagnostic drift: 4 studies provided consistent evidence of diagnostic drift, with the most recent (published 2020) reporting that 66% of cases were upgraded and 3% were downgraded when using contemporary diagnostic criteria compared to original diagnoses (1985-1995) Conclusions: Evidence collated may inform discussion of diagnostic changes for low-risk prostate lesions.

Technical aspects of breast MRI—do they affect outcomes?

Thu, 01 Jan 2009 00:00:00 GMT

Technical aspects of breast MRI—do they affect outcomes? Warren, Ruth; Ciatto, Stefano; Macaskill, Petra; Black, Richard; Houssami, Nehmat In a systematic review of breast MRI for assessing ipsilateral breast cancer to detect additional lesions, technical details were extracted from publications to assess their effect on diagnostic performance. Where technical parameters were complete, we examined their effect on summary ROC models, and the TP:FP ratio and PPV, using random-effects logistic regression. A total of 2,801 breasts in 19 publications underwent statistical analysis for year of study, slice thickness, and repetitions after contrast-medium injection. None were associated with TP/FP ratio. Summary ROC analysis provided weak evidence (P = 0.09) of an association between diagnostic performance and time period, however no trend over time. Tesla strength was reported in 2,801 cases. Other key information was omitted including whether both breasts were examined for 1683 (60%), position of the patient in 1,375 (49%), and imaging planes used in 688 (25%). Contrast agent and dose were reported for 2,646 (95%) breasts. Reporting technique was inconsistently reported. Single radiology reports were found in 1,637 (58%) cases, double in 347 (12.4%), and in 960 (34%) knowledge of mammography or ultrasound findings was not stated. Slice thickness, number of sequences after contrast medium, and year of study did not show significant performance differences. Other technical information was deficient. There is an urgent need to improve the quality of reporting of breast MRI studies.

Bigger margins are not better in breast conserving surgery

Sun, 01 Jan 2012 00:00:00 GMT

Bigger margins are not better in breast conserving surgery Dixon, Michael J; Houssami, Nehmat Letter to editor in response to Jeevan R, Cromwell DA, Trivella M, Lawrence G, Kearins O, Pereira J, et al. Reoperation rates after breast conserving surgery for breast cancer among women in England: retrospective study of hospital episode statistics. BMJ2012;345:e4505. (12 July.)

“It’s about our bodies… we have the right to know this stuff”: a qualitative focus group study on Australian women’s perspectives on breast density

Sat, 01 Jan 2022 00:00:00 GMT

“It’s about our bodies… we have the right to know this stuff”: a qualitative focus group study on Australian women’s perspectives on breast density Brooke, Nicole; Dolan, Hankiz; Carter, Stacy; Houssami, Nehmat; Brennan, Meagan; Hersch, Jolyn; Verde, Angela; Vaccaro, Lisa; McCaffery, Kirsten Objective: This study aimed to explore Australian women's current knowledge, perspectives and attitudes about breast density (BD); and information needs to inform effective evidence-based communication strategies. Methods: Fourteen online focus group sessions with a total of 78 women in New South Wales and Queensland, Australia aged 40-74 years without a personal diagnosis of breast cancer were conducted. Audio-recorded data was transcribed and analysed thematically. Results: Women had a very limited knowledge of BD. Overall, women expressed a preference for more frequent mammograms and/or supplemental screening should they be told they had dense breasts, despite being presented with information on potential downsides of additional testing. The majority of women were supportive of the notion of BD notification, often suggesting they had a 'right to know' and they would prefer to be educated and informed about it. Conclusion: The potential of being informed and notified of BD is found to be of interest and importance to Australian women of breast screening age despite lacking current knowledge.

Interval and Subsequent Round Breast Cancer in a Randomized Controlled Trial Comparing Digital Breast Tomosynthesis and Digital Mammography Screening

Fri, 01 Jan 2021 00:00:00 GMT

Interval and Subsequent Round Breast Cancer in a Randomized Controlled Trial Comparing Digital Breast Tomosynthesis and Digital Mammography Screening Hofvind, Solveig; Moshina, Nataliia; Holen, Åsne S.; Danielsen, Anders S; Lee, Christoph I; Houssami, Nehmat; Aase, Hildegunn S; Akslen, Lars A; Haldorsen, Ingfrid S Prevalent digital breast tomosynthesis (DBT) has shown higher cancer detection rates and lower recall rates compared with those of digital mammography (DM). However, data are limited on rates and histopathologic tumor characteristics of interval and subsequent round screen-detected cancers for DBT. Purpose To follow women randomized to screening with DBT or DM and to investigate rates and tumor characteristics of interval and subsequent round screen-detected cancers. Materials and Methods To-Be is a randomized controlled trial comparing the outcome of DBT and DM in organized breast cancer screening. The trial included 28 749 women, with 22 306 women returning for subsequent DBT screening 2 years later (11 201 and 11 105 originally screened with DBT and DM, respectively). Differences in rates, means, and distribution of histopathologic tumor characteristics between women prevalently screened with DBT versus DM were evaluated with Z tests, t tests, and χ2 tests. Relative risk (RR) with 95% CIs was calculated for the cancer rates. Results Interval cancer rates were 1.4 per 1000 screens (20 of 14 380; 95% CI: 0.9, 2.1) for DBT versus 2.0 per 1000 screens (29 of 14 369; 95% CI: 1.4, 2.9; P = .20) for DM. The rates of subsequent round screen-detected cancer were 8.1 per 1000 (95% CI: 6.6, 10.0) for women originally screened with DBT and 9.1 per 1000 (95% CI: 7.4, 11.0; P = .43) for women screened with DM. The distribution of tumor characteristics did not differ between groups for either interval or subsequent screen-detected cancer. The RR of interval cancer was 0.69 (95% CI: 0.39, 1.22; P = .20) for DBT versus DM, whereas RR of subsequent screen-detected cancer for women prevalently screened with DBT versus DM was 0.89 (95% CI: 0.67, 1.19; P = .43). Conclusion Rates of interval or subsequent round screen-detected cancers and their tumor characteristics did not differ between women originally screened with digital breast tomosynthesis (DBT) versus digital mammography. The analysis suggests that the benefits of prevalent DBT screening did not come at the expense of worse downstream screening performance measures in a population-based screening program.

The Effect of Supplemental Imaging on Interval Cancer Rates in Mammography Screening: Systematic Review

Sat, 01 Jan 2022 00:00:00 GMT

The Effect of Supplemental Imaging on Interval Cancer Rates in Mammography Screening: Systematic Review Zheng, Aileen; Brennan, Meagan E; Young, Sharon; Mathieu, Erin; Houssami, Nehmat Supplemental screening with MRI or ultrasound increases cancer detection rate (CDR) in women with standard screening mammography. Whether it also reduces interval cancer rate (ICR) is unclear. This study reviewed the evidence evaluating the effect of supplemental imaging on ICR in women undergoing screening mammography. This systematic review included studies that reported both CDR and ICR in women undergoing screening mammography alone compared to those undergoing screening mammography with supplemental imaging. Five studies (3 randomized trials) were eligible. These reported on 142,153 women undergoing mammography screening alone or mammography with supplemental imaging (3 ultrasound and 2 MRI studies). Two studies included a general screening population and 3 included special populations (young, high genetic risk and/or dense breasts). The incremental CDR for supplemental MRI was 14.2 to 16.5/1000 screens and for ultrasound was 0 to 4.4/1000 screens. Effect on ICR was variable but evidence of a reduced ICR was more consistent for studies using supplemental MRI (ICR 0.3 to 0.8 per 1000 screens) than those using ultrasound (ICR 0.49 to 1.9 per 1000 screens). The higher CDR and lower ICR with supplemental screening were associated with higher recall and biopsy rates particularly with supplemental MRI (9.5%-15.9%, up to 69/1000 screens). Cancers detected with supplemental imaging modalities were generally smaller and earlier stage. Mammography with supplemental MRI or ultrasound increases detection of cancers (versus mammography only) in some sub-groups but also increases recall and biopsy rates and may have a relatively modest effect in reducing ICR.

The financial implications of investigating false-positive and true-positive mammograms in a national breast cancer screening program

Sat, 01 Jan 2022 00:00:00 GMT

The financial implications of investigating false-positive and true-positive mammograms in a national breast cancer screening program Soon, Jason; Houssami, Nehmat; Clemson, Michelle; Lockie, Darren; Farber, Rachel; Barratt, Alexandra; Elshaug, Adam; Howard, Kirsten ObjectivesTo determine the total annual screening and further-investigation costs of investigating false-positive and true-positive mammograms in the Australian population breast-screening program.MethodsThis economic analysis used aggregate-level retrospective cohort data of women screened at a breast-screening clinic. Counts and frequencies of each diagnostic workup-sequence recorded were scaled up to national figures and costed by estimating per-patient costs of procedures using screening clinic cost data. Main outcomes and measures estimated were percentage share of total annual screening and further-investigation costs for the Australian population breast-screening program of investigating false-positive and true-positive mammograms. Secondary outcomes determined were average costs of investigating each false-positive and true-positive mammogram. Sensitivity analyses involved recalculating results excluding subgroups of patients below and above the screening age range of 50-74 years.ResultsOf 8235 patients, the median age was 60.35 years with interquartile range of 54.17-67.17 years. A total of 15.4% (ranging from 13.4 to 15.4% under different scenarios) of total annual screening and further-investigation costs were from investigating false-positive mammograms. This exceeded the share of costs from investigating true-positives (13%).ConclusionsWe have developed a transparent and non-onerous approach for estimating the costs of false-positive and true-positive mammograms associated with the national breast-screening program. While determining an optimal balance between false-positives and true-positive rates must rely primarily on health outcomes, costs are an important consideration. We recommend that future research adopts and refines similar approaches to facilitate better monitoring of these costs, benchmark against estimates from other screening programs, and support optimal policy development.

A survey of the use and impact of International Journal of Epidemiology's Education Corner

Sat, 01 Jan 2022 00:00:00 GMT

A survey of the use and impact of International Journal of Epidemiology's Education Corner Medcalf, Ellie; Huang, Jonathan Y; Arah, Oneybuchi A; Harhay, Michael O; Leeder, Stephen R; Bell, Katy J.L. The International Journal of Epidemiology (IJE) Education Corner was introduced in 2012, providing educational articles on epidemiological concepts and methods. We conducted a survey of the use and impact of the IJE Education Corner articles in relation to teaching, research and practice, collating suggestions on how we might increase their utility.