Topics
General medicine
Medicinal cannabis for chemotherapy-induced nausea and vomiting: prescribing with limited evidence
Although medicinal cannabis can now be prescribed for CINV, high quality clinical trial evidence is required to determine its efficacy and safety
Antony J Mersiades · Martin R Stockler · Ian N Olver · Peter Grimison
Clinical supervision in rural Australia: challenges and opportunities
To provide high quality patient care in rural and remote health settings, it is essential to invest in clinical supervision and explore models that enhance team building and improve recruitment and retention
Priya Martin · Tarun Sen Gupta · John M Douyere
The ecology of survival for new medical graduates
The most effective strategies for preparing young doctors will operate outside the closed public hospital system
Simon M Willcock
Preventing ovarian failure associated with chemotherapy
A new PBS indication for goserelin aims to reduce infertility and other health issues for young Australian women who receive chemotherapy
Wanyuan Cui · Catharyn Stern · Martha Hickey · Fiona Goldblatt · Antoinette Anazodo · William S Stevenson · Kelly-Anne Phillips
Revised Australian national guidelines for colorectal cancer screening: family history
The revised colorectal cancer screening guidelines recommend screening modality based on risk according to age and family history
Mark A Jenkins · Driss Ait Ouakrim · Alex Boussioutas · John L Hopper · Hooi C Ee · Jon D Emery · Finlay A Macrae · Albert Chetcuti · Laura Wuellner · D James B St John
Australia is responding to the complex challenge of overdiagnosis
Effective responses in policy and practice are essential to manage overdiagnosis and the sustainability of the health system
Ray Moynihan · Alexandra L Barratt · Rachelle Buchbinder · Stacy M Carter · Thomas Dakin · Jan Donovan · Adam G Elshaug · Paul P Glasziou · Christopher G Maher · Kirsten J McCaffery · Ian A Scott
Subclavian vein thrombosis with internal jugular vein extension in an Australian rules football player
A 40-year-old female Australian rules football player presented to a rural emergency department with a 3-hour history of swelling and pain in her right upper limb
John WP Wong · Fiona WY Lai · Ian Wilson
Redefining the physician’s role in the era of online health information
Clinicians are no longer gatekeepers to privileged information, but rather interpreters, problem solvers, and advisers
Susan Ieraci
Translation and implementation of the Australian-led PCOS guideline: clinical summary and translation resources from the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome
We have developed the first international evidence-based guideline for the diagnosis and management of polycystic ovary syndrome (PCOS), with an integrated translation program incorporating resources for health professionals and consumers
on behalf of the International PCOS Network
Medical assistance in dying: a disruption of therapeutic relationships
Medical assistance in dying may disrupt therapeutic relationships and will challenge beliefs
Leeroy William
An overview of the GRADE approach and a peek at the future
Worldwide, over 100 organisations are using the Grading of Recommendations Assessment, Development and Evaluation approach; it is thus essential that clinicians using formal guidelines become familiar with the GRADE approach
Waleed Alhazzani · Gordon Guyatt
Patient-centred care for cirrhosis: a key role for chronic disease management
Early diagnosis and coordinated care are critical for achieving the best outcomes for patients with liver disease
Timothy Papaluca · Alexander JV Thompson
A new evidence-based guideline for assessment and management of polycystic ovary syndrome
An Australian-led international and multidisciplinary collaboration has developed new recommendations to improve the care, health outcomes and quality of life of women with PCOS
Robert J Norman · Helena J Teede
Coordinated care for patients with cirrhosis: fewer liver-related emergency admissions and improved survival
Multicentre randomised controlled trials examining the efficacy of the chronic liver failure program are warranted
Jeyamani Ramachandran · Monowar Hossain · Chris Hrycek · Edmund Tse · Kate R Muller · Richard J Woodman · Billingsley Kaambwa · Alan J Wigg
Automatic reporting of estimated glomerular filtration rate in Australia turns 13: re-examining the impact
Evidence shows that eGFR automated reporting in Australia is associated with improvements in awareness, early detection, management and referral of patients with chronic kidney disease
Marie Ludlow · Shilpa Jesudason · David W Johnson
Homeless health care: meeting the challenges of providing primary care
We need to reduce the barriers to primary care access for people experiencing homelessness to stop the costly revolving door between homelessness and the hospital system
Andrew Davies · Lisa J Wood
Primary care management of non-specific low back pain: key messages from recent clinical guidelines
To the Editor: The recent guideline review by Almeida and colleagues1 coincides with an international call for action to address the burden of low back pain.2 Low back pain is a major societal problem and the number one cause of disability internationally. Recent guidelines prioritise advice, reassurance and self-management as first line care. Implementing these simple, high value interventions is important in populations, such as Aboriginal Australians, where there has been limited previous recognition of low back pain as a problem. A recent systematic review of musculoskeletal pain among Aboriginal Australians3 summarised that the prevalence of low back pain is higher among Aboriginal Australians and has disproportional impacts. Qualitatively, low back pain has multidimensional effects, including functional, cultural and emotional. Access to both primary and specialist level care is lower for some musculoskeletal pain conditions such as osteoarthritis, and there may be parallels for low back pain. Worryingly, there is evidence that the health care that Aboriginal people receive for low back pain is worse than that received by non-Aboriginal Australians, including care with the potential to cause iatrogenic harm. These include higher rates of opioid prescribing and unhelpful low back pain information. Low back pain is associated with a higher number of comorbid health issues, psychological stress and income poverty, and may contribute to the complex milieu of health burden and disadvantage for some Aboriginal communities. The implementation of effective, high value, first line care described by Almeida and colleagues1 is critical for Aboriginal people with low back pain; however, it needs to be adapted so that it is acceptable, accessible and appropriate. For example, advice and education to reassure patients and encourage self-management may need to be supported by culturally appropriate low back pain information. This could include visual, story-based information that has been developed with input from Aboriginal people.4 Implementing successful self-management requires doctors to develop trusting relationships with patients in services that are culturally secure for Aboriginal people. Effective communication is critical.5 The provision of evidence-informed low back pain care to Aboriginal patients requires better recognition of low back pain as a health issue affecting Aboriginal Australians, and a greater understanding of how such care can be best implemented in Aboriginal communities.
Ivan Lin · Donna B Mak · Juli Coffin · Peter O'Sullivan
Primary care management of non-specific low back pain: key messages from recent clinical guidelines
In reply
Matheus Almeida · Bruno Saragiotto · Chris G Maher
Network meta-analysis in health care decision making
Network meta-analysis helps determine which treatments are viable options and which are not, but its interpretation to inform clinical decision making remains a challenge
Bram Rochwerg · Romina Brignardello-Petersen · Gordon Guyatt
Inequity amplified: climate change, the Australian farmer, and mental health
We need to train our rural medical workforce in deeper mental health care skills
Molly Shorthouse · Louise Stone
Dr Google in the ED: searching for online health information by adult emergency department patients
The doctor–patient relationship can benefit from discussing health-related internet searches by adult patients
Anthony M Cocco · Rachel Zordan · David McD Taylor · Tracey J Weiland · Stuart J Dilley · Joyce Kant · Mahesha Dombagolla · Andreas Hendarto · Fiona Lai · Jennie Hutton
National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the diagnosis and management of atrial fibrillation 2018
Atrial fibrillation is increasing in prevalence and associated with significant morbidity and mortality
David Brieger · John Amerena · John R Attia · Beata Bajorek · Kim H Chan · Cia Connell · Ben Freedman · Caleb Ferguson · Tanya Hall · Haris M Haqqani · Jeroen Hendriks · Charlotte M Hespe · Joseph Hung · Jonathan M Kalman · Prashanthan Sanders · John Worthington · Tristan Yan · Nicholas A Zwar
Diagnosis of severe asthma
We describe three key steps in the diagnostic evaluation process for severe asthma
Tunn Ren Tay · Joy W-Y Lee · Mark Hew
Models of care for severe asthma: the role of primary care
There are a number of barriers in primary, secondary and tertiary settings which compromise optimal care for severe asthma in Australia
Li Ping Chung · Paula Johnson · Quentin Summers
Care of patients with chronic disease: achievements in Australia over the past decade
Despite progress made in chronic disease management in Australia, there is an ongoing need for better quality of care and services integration, as rates of chronic disease and multimorbidity continue to rise
Mark F Harris · Ben Harris-Roxas · Andrew W Knight
