University of Sydney shares NHMRC research grant to tackle overdiagnosis and overtreatment

The University of Sydney is among four universities to share in a $9.5m NHMRC Program Grant to help reduce unnecessary health testing and treatment in areas such as cancer, musculoskeletal diseases, and cardiovascular disease to help support a more sustainable healthcare future.

The grant comes as Federal Health Minister, The Hon Sussan Ley MP awarded $129.4m in grants this week to Australia’s preeminent researchers to foster the best and brightest in health and medical research.

The chief investigators who will co-lead the study are Professor Kirsten McCaffery from University of Sydney,  Professor Chris Maher from the George Institute for Global Health and University of Sydney, Professor Paul Glasziou from Bond University, and Professor Rachelle Buchbinder from Monash University and Cabrini Institute.

Professor McCaffery, a leading expert in over-diagnosis in healthcare, said “Inappropriate use of health care is a growing problem in Australia and internationally, causing harm to patients, wasting resources, and threatening the sustainability of health services.

“As a health psychologist working principally in the areas of cancer and cardiovascular disease, my interest is how to communicate the problem of inappropriate tests and treatments to patients, the community, and clinicians, and develop solutions which change the way people think, feel and behave towards this.

“At the moment both public and health professional’s understanding of the issue is very limited and this needs to change,” she said.

The NHMRC grant will fund a series of national research projects across all states staggered over a five year period from January 2017. The team will partner with relevant organisations engaged in diagnostic and screening policy making to translate and disseminate its findings.

Professor Glasziou said the research program was a natural evolution of work the team had done previously in screening and diagnosis.

“The capabilities of technology have outgrown our abilities to interpret its results, which creates an issue both for the individual patient, and for the healthcare system,” he said.

“Many ‘lesions’ that technologies like MRIs are now identifying would never cause a problem for patients, but our over-testing leads to their discovery, in turn leading to their over-treatment.

Professor Buchbinder said: “We know that one-off strategies aimed at changing clinician behaviour are ineffective and an all-of-systems approach involving clinicians, policy makers and consumers is needed to identify and test sustainable, multifaceted solutions.

“However a strength of our planned program of research is that it will cross professional boundaries and mean that we can learn from successes in other disciplines,” she said.

Professor Maher said: “My interest is in improving healthcare for common musculoskeletal conditions such as low back pain. 

"Back pain affects millions of Australians and it is the leading health reason forcing older Australians to retire prematurely,” he said.

Professor McCaffery’s research Walking the tightrope: communicating overdiagnosis in modern healthcare is featured on the cover of this month’s BMJ.