%0 Journal Article %~ PubMed %A Flitcroft, Kathy L %A Irwig, Les M %A Carter, Stacy M %A Salkeld, Glenn P %A Gillespie, James A %T Colorectal cancer screening: Why immunochemical fecal occult blood tests may be the best option. %B BMC Gastroenterology %D 2012 %C United Kingdom %I BioMed Central Ltd. %V 12 %N 1 %P 183 %@ 1471-230X %X %Z FOR Codes: 1117 %0 Journal Article %~ PubMed %A Wong, Germaine %A Howard, Kirsten %A Chapman, Jeremy %A Pollock, Carol %A Chadban, Steven %A Salkeld, Glenn %A Tong, Allison %A Williams, Narelle %A Webster, Angela %A Craig, Jonathan C %T How do people with chronic kidney disease value cancer-related quality of life? %B Nephrology %D 2012 %C Australia %I Wiley-Blackwell Publishing Asia %V 17 %N 1 %P 32-41 %@ 1440-1797 %X Objectives:??? To estimate the utility-based QOL of people with CKD and to estimate the QOL associated with two hypothetical colorectal cancer health states. Methods:??? A cross-sectional study was conducted in people with CKD (stages 3-5, transplant recipients and those on dialysis) from three centres in Sydney, Australia. We measured participants'' own QOL and that of two hypothetical colorectal cancer health states using a rating scale, and a utility based QOL measure, the time-trade off, with extremes of 0 (death) and 1 (full health). Results:??? Recipients of kidney transplants (n = 79) had the highest mean QOL weights of 0.79 (standard deviation (SD) = 0.34) compared to participants with CKD 3-5 (n = 53) with mean QOL weights of 0.70 (SD = 0.39), and those on dialysis (n = 89), who had the lowest mean QOL weights of 0.62 (SD = 0.41) (p = 0.02). Having early and advanced stage colorectal cancers were valued at mean QOL weights of 0.44 (SD = 0.41) and 0.12 (SD = 0.25) among people with moderate stage CKD; 0.45 (SD = 0.39) and 0.11 (SD = 0.24) among dialysis patients; 0.62 (SD = 0.36) and 0.18 (SD = 0.29) among kidney transplant recipients. Conclusions:??? People with CKD have poor QOL. Having co-existent illnesses such as cancer further reduces the overall well-being of individuals with kidney disease. In addition to the development of effective screening and treatment programs to improve cancer outcomes in people with CKD, our study also highlights the need for effective interventions to improve the QOL in people with CKD, particularly those with major co-morbidities like cancer. %Z FOR Codes: 1402 1103 %0 Journal Article %A Yin, J K %A Salkeld, Glenn %A Heron, Leon %A Booy, Robert %T How to better inform the decision making about universal influenza vaccination in children %B Journal of Pediatric Infectious Diseases %D 2012 %C Netherlands %I IOS Press %V 7 %N 2 %P 69-73 %@ 1305-7707 %X %Z FOR Codes: 111403 110309 %0 Journal Article %~ PubMed %A Wales, Kylie %A Clemson, Lindy %A Lannin, Natasha A %A Cameron, Ian D %A Salked, Glenn %A Gitlin, Laura %A Rubenstein, Laurance %A Barras, Sarah %A Mackenzie, Lynette %A Davies, Collette %T Occupational therapy discharge planning for older adults: A protocol for a randomised trial and economic evaluation. %B BMC Geriatrics %D 2012 %C United Kingdom %I BioMed Central Ltd. %V 12 %N %P 34 %@ 1471-2318 %X ABSTRACT: %Z FOR Codes: 110321 %0 Journal Article %~ PubMed %A Howard, Kirsten %A Salkeld, Glenn P %A Mann, Graham J %A Patel, Manish I %A Cunich, Michelle %A Pignone, Michael P %T The COMPASs Study: Community Preferences for Prostate cAncer Screening. Protocol for a quantitative preference study. %B BMJ Open %D 2012 %C United Kingdom %I BMJ Group %V 2 %N 1 %P e000587 %@ 2044-6055 %X Background Prostate cancer screening using prostate-specific antigen (PSA) testing remains controversial. Trade-offs between the potential benefits and downsides of screening must be weighed by men deciding whether to participate in prostate cancer screening; little is known about benefit:harm trade-offs men are willing to accept. Methods/Design The Community Preferences for Prostate Cancer Screening (COMPASs) Study examines Australian men''s preferences for prostate cancer screening using PSA testing. The aims are to (1) determine which factors influence men''s decision to participate in prostate cancer screening or not and (2) determine the extent of trade-offs between benefits and harms that men are willing to accept in making these decisions. Quantitative methods will be used to assess men''s preferences for PSA screening. Using data on the quantitative outcomes of PSA testing from the published literature, a discrete choice study will be designed to quantitatively assess men''s preferences. A web-based survey will be conducted in approximately 1000 community respondents aged 40-69 years, stratified by family history of prostate cancer, to assess men''s preferences for PSA testing. A mixed logit model will be used; model results will be expressed as parameter estimates (?) and the odds of choosing screening over no screening. Trade-offs between attributes will also be calculated. Ethics and Dissemination The COMPASs study has been approved by the University of Sydney, Human Research Ethics committee (Protocol number 13186). The results will be published in internal reports, in peer-reviewed scientific journals as well as via conference presentations. %Z FOR Codes: 111716 %0 Journal Article %~ PubMed %A Flitcroft, K L %A St John, D J B %A Howard, K %A Carter, S M %A Pignone, M P %A Salkeld, G P %A Trevena, L J %T A comparative case study of bowel cancer screening in the UK and Australia: evidence lost in translation? %B Journal of Medical Screening %D 2011 %C United Kingdom %I Royal Society of Medicine Press Ltd. %V 18 %N 4 %P 193-203 %@ 1475-5793 %X (i) To document the current state of the English, Scottish, Welsh, Northern Irish and Australian bowel cancer screening programmes, according to seven key characteristics, and (ii) to explore the policy trade-offs resulting from inadequate funding. %Z FOR Codes: 1117 %0 Journal Article %~ PubMed %A Yin, J Kevin %A Wang, Han %A Skinner, S Rachel %A Salkeld, Glenn %A Booy, Robert %T Assessing seasonal vaccine-related cross-protection from 2009 pandemic H1N1 influenza through teacher absenteeism. %B Australian and New Zealand Journal of Public Health %D 2011 %C Australia %I Wiley-Blackwell Publishing Asia %V 35 %N 4 %P 393-394 %@ 1326-0200 %X %Z FOR Codes: 111706 %0 Journal Article %~ PubMed %A Pignone, Michael P %A Flitcroft, Kathy L %A Howard, Kirsten %A Trevena, Lyndal J %A Salkeld, Glenn P %A St John, D James B %T Costs and cost-effectiveness of full implementation of a biennial faecal occult blood test screening program for bowel cancer in Australia. %B The Medical Journal of Australia %D 2011 %C Australia %I Australasian Medical Publishing Company Pty. Ltd. %V 194 %N 4 %P 180-185 %@ 1326-5377 %X To examine the costs and cost-effectiveness of full implementation of biennial bowel cancer screening for Australian residents aged 50-74 years. %Z FOR Codes: 111799 %0 Journal Article %~ PubMed %A Flitcroft, Kathy %A Gillespie, James %A Salkeld, Glenn %A Carter, Stacy %A Trevena, Lyndal %T Getting evidence into policy: The need for deliberative strategies? %B Social science & medicine %D 2011 %C United Kingdom %I Pergamon %V 72 %N 7 %P 1039-0146 %@ 1873-5347 %X Getting evidence into policy is notoriously difficult. In this empirical case study we used document analysis and key informant interviews to explore the Australian federal government''s policy to implement a national bowel cancer screening programme, and the role of evidence in this policy. Our analysis revealed a range of institutional limitations at three levels of national government: within the health department, between government departments, and across the whole of government. These limitations were amplified by the pressures of the 2004 Australian federal election campaign. Traditional knowledge utilisation approaches, which rely principally on voluntarist strategies and focus on the individual, rather than the institutional level, are often insufficient to ensure evidence-based implementation. We propose three alternative models, based on deliberative strategies which have been shown to work in other settings: review of the evidence by a select group of experts whose independence is enshrined in legislation and whose imprimatur is required before policy can proceed; use of an advisory group of experts who consult widely with stakeholders and publish their review findings; or public discussion of the evidence by the media and community groups who act as more direct conduits to the decision-makers than researchers. Such deliberative models could help overcome the limitations on the use of evidence by embedding public review of evidence as the first step in the institutional decision-making processes. %Z FOR Codes: 111799 %0 Journal Article %~ PubMed %A Cunich, Michelle %A Salkeld, Glenn %A Dowie, Jack %A Henderson, Joan %A Bayram, Clare %A Britt, Helena %A Howard, Kirsten %T Integrating evidence and individual preferences using a web-based multi-criteria decision analytic tool: an application to prostate cancer screening. %B The Patient %D 2011 %C New Zealand %I Adis International Ltd. %V 4 %N 3 %P 153-162 %@ 1178-1653 %X Annalisa?? (AL) is a web-based decision-support template grounded in multi-criteria decision analysis (MCDA). It uses a simple expected value algorithm to calculate a score for each option by taking into account the individual''s preferences for different criteria (as importance weights) and the evidence of the performance of each option on each criterion. Given the uncertainty surrounding the trade offs between benefits and harms for prostate cancer screening, this topic was chosen as the vehicle to introduce this new decision-support template. %Z FOR Codes: 111717 %0 Journal Article %~ PubMed %A Doran, Evan %A Robertson, Jane %A Salkeld, Glenn %T Pharmaceutical Benefits Scheme cost sharing, patient cost consciousness and prescription affordability. %B Australian Health Review %D 2011 %C Australia %I CSIRO Publishing %V 35 %N 1 %P 37-44 %@ 0156-5788 %X To assess patients'' prescription medicine cost consciousness and explore the implications of further cost sharing increases for affordability. %Z FOR Codes: 111709 %0 Journal Article %~ PubMed %A Howard, Kirsten %A Salkeld, Glenn %A Pignone, Michael %A Hewett, Peter %A Cheung, Peter %A Olsen, Julie %A Clapton, Wayne %A Roberts-Thomson, Ian C %T Preferences for CT Colonography and Colonoscopy as Diagnostic Tests for Colorectal Cancer: A Discrete Choice Experiment. %B Value in Health %D 2011 %C United States %I Elsevier Inc. %V 14 %N 8 %P 1146-1152 %@ 1524-4733 %X OBJECTIVE: Computed tomography colonography (CTC) is an alternative diagnostic test to colonoscopy for colorectal cancer and polyps. The aim of this study was to determine test characteristics important to patients and to examine trade-offs in attributes that patients are willing to accept in the context of the diagnosis of colorectal cancer. METHODS: A discrete choice study was used to assess preferences of patients with clinical indications suspicious of colorectal cancer who experienced both CTC and colonoscopy as part of a diagnostic accuracy study in South Australia. Results were analyzed by using a mixed logit model and presented as odds ratios (ORs) for preferring CTC over colonoscopy. RESULTS: Colonoscopy was preferred over CTC as the need for a second procedure after CTC increased (OR of preferring CTC to colonoscopy = 0.013), as the likelihood of missing cancers or polyps increased (OR of preferring CTC to colonoscopy = 0.62), and as CTC test cost increased (OR of preferring CTC to colonoscopy = 0.65-0.80). CTC would be preferred to colonoscopy if a minimal bowel preparation was available (OR = 1.7). Some patients were prepared to trade off the diagnostic and therapeutic advantage of colonoscopy for a CTC study with a less intensive bowel preparation. Preferences also varied significantly with sociodemographic characteristics. CONCLUSIONS: Despite CTC''s often being perceived as a preferred test, this may not always be the case. Informed decision making for diagnostic tests for colorectal cancer should include discussion of the benefits, downsides, and uncertainties associated with alternative tests, as patients are willing and able to make trade-offs between what they perceive as the advantages and disadvantages of these diagnostic tests. %Z FOR Codes: 1117 %0 Journal Article %A Flitcroft, Kathy %A Gillespie, James %A Carter, Stacy %A Trevena, Lyndal %A Salkeld, Glenn %T When good evidence is not enough: the role of context in bowel cancer screening policy in New Zealand %B Evidence & Policy: A Journal of Research, Debate and Practice %D 2011 %C United Kingdom %I The Policy Press %V 7 %N 3 %P 307-326 %@ 1744-2656 %X %Z FOR Codes: 111202 111716 %0 Journal Article %~ PubMed %A Chim, Lesley %A Kelly, Patrick J %A Salkeld, Glenn %A Stockler, Martin R %T Are Cancer Drugs Less Likely to be Recommended for Listing by the Pharmaceutical Benefits Advisory Committee in Australia? %B PharmacoEconomics %D 2010 %C New Zealand %I Adis International Ltd. %V 28 %N 6 %P 463-75 %@ 1179-2027 %X The hurdle of cost effectiveness for the selection and reimbursement of drugs in Australia limits access to new medicines based on an assessment of cost relative to clinical benefit. Those drugs that are expensive and provide modest benefits will be less likely to receive a government price subsidy. There is concern that the cost-effectiveness hurdle will limit access to new cancer treatments because of their high costs and modest benefits. %Z FOR Codes: 104 608 %0 Journal Article %~ PubMed %A Flitcroft, Kathy L %A Salkeld, Glenn P %A Gillespie, James A %A Trevena, Lyndal J %A Irwig, Les M %T Fifteen years of bowel cancer screening policy in Australia: putting evidence into practice? %B Medical Journal of Australia %D 2010 %C Australia %I Australasian Medical Publishing Company Pty. Ltd. %V 193 %N 1 %P 37-42 %@ 0025-729X %X Bowel cancer kills over 4000 Australians each year. From the late 1980s to October 2005, research evidence guided the development of bowel cancer screening policy proposals, but political, financial and institutional constraints restricted implementation options. Since 2006, the Australian Government has provided a limited bowel cancer screening program, based on what the government deems it can afford, rather than on evidence of what is required to implement a successful population-based screening program. Even a partial program can be implemented in an evidence-based way, and failure to do so threatens to undermine the potential public health gains of a national bowel cancer screening program. To realise the expected public health gains from a national bowel cancer screening program, bowel cancer screening policy should return to its evidence-based beginnings, starting with an analysis of Australian age-specific cost-effectiveness data. %Z FOR Codes: 111799 %0 Journal Article %~ PubMed %A Howard, Kirsten %A White, Sarah %A Salkeld, Glenn %A McDonald, Stephen %A Craig, Jonathan C %A Chadban, Steven %A Cass, Alan %T Cost-Effectiveness of Screening and Optimal Management for Diabetes, Hypertension, and Chronic Kidney Disease: A Modeled Analysis. %B Value in Health %D 2009 %C United States %I Wiley-Blackwell Publishing, Inc. %V 13 %N 2 %P 196-208 %@ 1524-4733 %X Chronic kidney disease is, increasingly, both a contributor to premature deaths and a financial burden to the health system, and is estimated to affect between 10% and 15% of the adult population in Western countries. Hypertension and, in particular diabetes, are significant contributors to the global burden of chronic kidney disease. Although it might increase costs, screening for, and improved management of, persons at increased risk of progressive kidney disease could improve health outcomes. We therefore sought to estimate the costs and health outcomes of alternative strategies to prevent end-stage kidney disease, compared with usual care. %Z FOR Codes: 110312 111716 %0 Journal Article %~ PubMed %A Howard, Kirsten %A Salkeld, Glenn %T Does Attribute Framing in Discrete Choice Experiments Influence Willingness to Pay? Results from a Discrete Choice Experiment in Screening for Colorectal Cancer. %B Value in Health %D 2009 %C United States %I Wiley-Blackwell %V 12 %N 2 %P 354-363 %@ 1524-4733 %X Recent reviews of discrete choice methodology identified methodological issues warranting further exploration, including the issue of "framing." The objective of this study was to conduct a methodological exploration of the effect of attribute framing on marginal rates of substitution (MRS), including willingness to pay (WTP) from a discrete choice experiment (DCE), within the context of colorectal cancer screening preferences. %Z FOR Codes: 1117 %0 Journal Article %~ PubMed %A Harrison, James D %A Masya, Lindy %A Butow, Phyllis %A Solomon, Michael %A Young, Jane %A Salkeld, Glenn %A Whelan, Tim %T Implementing patient decision support tools: moving beyond academia? %B Patient education and counseling %D 2009 %C Ireland %I Elsevier %V 76 %N 1 %P 120-125 %@ 1873-5134 %X OBJECTIVE: To ascertain the feasibility of implementing three decision support tools (DSTs) for people with rectal cancer within the surgical consultation. METHODS: Twenty colorectal surgeons participated in a focus group or individual interviews. Colorectal surgeons were also asked to complete a self-administered questionnaire. RESULTS: All surgeons responded encouragingly to the concept of DSTs. However, for every positive statement an accompanying caveat was made and these were either a criticism of each tool or a barrier to their implementation. Surgeons stated DSTs should be used by patients and surgeons together (80%). The majority (70-75%) thought each tool was ''useful'' or ''extremely useful''. However, there were strong views that in their current form the DSTs would not feasible to be used within the surgical consultation. Time restraints, personal and clinical characteristics of the patient, the content of each tool, the potential negative impact on the doctor-patient relationship were noted as real barriers to their implementation. CONCLUSION: Surgeons have identified a number of barriers that may limit implementation of DSTs into routine clinical practice. PRACTICE IMPLICATIONS: Feasibility and implementation studies have the potential to provide important information to help guide development, evaluation and implementation of DSTs. %Z FOR Codes: 111799 %0 Journal Article %~ PubMed %A Masya, Lindy M %A Young, Jane M %A Solomon, Michael J %A Harrison, James D %A Dennis, Rebecca J %A Salkeld, Glenn P %T Preferences for outcomes of treatment for rectal cancer: patient and clinician utilities and their application in an interactive computer-based decision aid. %B Diseases of the Colon and Rectum %D 2009 %C United States %I Lippincott Williams & Wilkins %V 52 %N 12 %P 1994-2002 %@ 0012-3706 %X PURPOSE:: To quantify the importance that patients and clinicians assign to specific quality-of-life outcomes associated with the treatment of rectal cancer and to demonstrate a clinical application of these data in a computer-based multidimension decision aid (Annalisa(c)). METHODS:: For patients, a researcher-administered questionnaire using the time trade-off method was used to quantify the importance of nine outcomes. Information was ascertained from clinicians by use of a self-administered questionnaire. Responses were ranked and compared between groups. Mean values for each outcome were entered into Annalisa(c). RESULTS:: Overall, 103 patients, 87 colorectal surgeons, 97 medical oncologists, and 80 radiation oncologists participated. For all groups, local cancer recurrence in the pelvis and fecal incontinence (mean utility scores 0.53 and 0.57, respectively) were the two outcomes to most avoid. In Annalisa(c), the "best fit" treatment for patients and surgeons was a low anterior resection with postoperative chemotherapy, whereas for medical and radiation oncologists the best-fit treatment was surgery alone. CONCLUSION:: Local recurrence and fecal incontinence are considered the worst outcomes by patients and clinicians alike, but values for other outcomes vary. Decision aids that incorporate patients'' individual values with evidence-based data hold considerable potential to optimize treatment decision-making. %Z FOR Codes: 111799 %0 Journal Article %~ PubMed %A Howard, Kirsten %A Salkeld, Glenn %A White, Sarah %A McDonald, Stephen %A Chadban, Steve %A Craig, Jonathan C %A Cass, Alan %T The cost-effectiveness of increasing kidney transplantation and home-based dialysis. %B Nephrology %D 2009 %C Australia %I Blackwell Publishing Asia %V 14 %N 1 %P 123-132 %@ 1320-5358 %X Renal replacement therapy (RRT) consumes sizable proportions of health budgets internationally, but there is considerable variability in choice of RRT modality among and within countries with major implications for health outcomes and costs. We aimed to quantify these implications for increasing kidney transplantation and improving the rate of home-based dialysis. %Z FOR Codes: 110312 111799 %0 Journal Article %~ PubMed %A Entwistle, Vikki A %A Carter, Stacy M %A Trevena, Lyndal %A Flitcroft, Kathy %A Irwig, Les %A McCaffery, Kirsten %A Salkeld, Glenn %T Communicating about screening. %B BMJ %D 2008 %C United Kingdom %I BMJ Publishing Group %V 337 %N 0 %P a1591 %@ 1468-5833 %X %Z FOR Codes: 111716 %0 Journal Article %~ PubMed %A Young, Jane M %A Solomon, Michael J %A Harrison, James D %A Salkeld, Glenn %A Butow, Phyllis %T Measuring patient preference and surgeon choice. %B Surgery %D 2008 %C United States %I Mosby, Inc %V 143 %N 5 %P 582-588 %@ 0039-6060 %X One of the major barriers to randomized trials in the field of surgery is the presence of strong preferences for one of the treatment options. Patients and surgeons who favor strongly a particular treatment approach are usually reluctant to participate in trials where operative intervention is determined on the basis of randomization. This then affects both the feasibility of the trial in terms of achieving the required sample size as well as the generalizability of the study''s findings. Therefore, measurement of patient and surgeon preference is a crucial component of the feasibility assessment for surgery trials. In this article, we introduce the Prospective Measure of Preference, which is a novel method to measure preferences that has been designed to accommodate the complexity of surgical decision-making. We also present a simple method to measure individual and community equipoise among expert clinicians to assess the feasibility of future randomized trials in surgery. %Z FOR Codes: 110399 %0 Journal Article %~ PubMed %A Mackenzie, Ross %A Chapman, Simon %A Salkeld, Glenn %A Holding, Simon %T Media influence on Herceptin subsidization in Australia: application of the rule of rescue? %B Journal of the Royal Society of Medicine %D 2008 %C United Kingdom %I Royal Society of Medicine Press Ltd. %V 101 %N 6 %P 305-312 %@ 0141-0768 %X Background In August 2006, the Australian government announced that Herceptin (Trastuzumab) would be added to the national Pharmaceutical Benefits Scheme (PBS) of government-subsidized drugs, for treatment with adjuvant chemotherapy of HER2 breast cancer. Following initial reticence, the health minister responded to a campaign by patients and patient advocacy groups by announcing PBS subsidization which lowered the cost of a weekly dose from A$1000 to A$30. The cost to the government would be A$470 million over three years for treatment of an estimated 2100 women annually. Design We analysed the news frames used in all direct and attributed statements (n=239) in television news coverage of the discourse preceding the Herceptin decision by the Australian government. Setting Five Sydney free-to-air channels between October 2005 and August 2006. Main outcome measures News frames or themes. Results Of five news frames identified, one (''desperate, sick women in double jeopardy because of callous government/incompetent bureaucracy'') accounted for 54% of all reported statements. Government financial parsimony was framed as responsible for the women''s plight, with drug industry pricing never mentioned. Claimed benefits of Herceptin often conflated cancer non-recurrence and survival and favoured quantification rhetoric which emphasized percentage increases in improvement rather than the more modest increases in absolute survival. Conclusions News frames invoking key tenets of the ''rule of rescue'' dominated television discourse on Herceptin. Clinicians, patients, their families and patient advocacy groups invoking the rule of rescue can increase the likelihood of achieving their objective of gaining access to expensive healthcare such as pharmaceuticals. Rational, criteria-based public health policy will find it hard to resist the rule of rescue imperative. %Z FOR Codes: 1117 %0 Journal Article %~ PubMed %A Harrison, James D %A Solomon, Michael J %A Young, Jane M %A Meagher, Alan %A Butow, Phyllis %A Salkeld, Glenn %A Hruby, George %A Clarke, Stephen %T Patient and physician preferences for surgical and adjuvant treatment options for rectal cancer. %B Archives of Surgery %D 2008 %C United States %I American Medical Association %V 143 %N 4 %P 389-394 %@ 1538-3644 %X HYPOTHESIS: Patients and their clinicians hold varying preferences for surgical and adjuvant treatment therapies for rectal cancer. DESIGN: Preferences were determined using the Prospective Measure of Preference. SETTING: Royal Prince Alfred and St Vincent''s hospitals in Sydney, Australia. PARTICIPANTS: Patients with colorectal cancer were interviewed during their postoperative hospital stay, and physicians were asked to complete a mailed survey. MAIN OUTCOME MEASURES: The Prospective Measure of Preference method produces 2 outcome measures of preference: willingness to trade and prospective measure of preference time trade-off. RESULTS: Patients'' strongest preference was to avoid a stoma: more than 60% would give up a mean of 34% of their life expectancy to avoid this surgical option. This was followed by treatment options involving chemoradiotherapy, where more than 50% would give up a mean of almost 25% of their life to avoid treatment. Surgeons held stronger preferences against all adjuvant options compared with oncologists (P