Topics

Abstract

Introduction: There is a paradigm shift in our understanding of white matter hyperintensities (WMH) found on brain imaging. They were once thought to be a normal phenomenon of ageing and, therefore, warranted no further investigation. However, evidence now suggests these lesions are markers of poor brain and cardiovascular health, portending an increased risk of stroke, cognitive decline, depression and death. Nevertheless, no specific guidelines exist for the management of incidentally found WMH for general medical practitioners and other clinicians ordering brain magnetic resonance imaging scans for diverse clinical indications. Informed by a literature review and expert opinion gleaned from stroke neurologists, medical and imaging specialists, and general practitioners, we present our consensus statement to guide the management of incidentally found WMH in adults.

Main recommendations: When incidental WMH are found on brain imaging:

Perform a detailed history and examination to screen for neurological events.
Investigate for potential undiagnosed or undertreated cardiovascular risk factors, especially hypertension and diabetes mellitus.
Commence intensive and individualised cardiovascular risk management when risk factors are uncovered.
Treat underlying risk factors via accepted guidelines but note that antiplatelet and anticoagulant medications should not be prescribed for incidental WMH in the absence of an alternative indication.

Changes to management as a result of this consensus statement: A brain health opportunity. We consider the discovery of incidental WMH on brain imaging to represent an opportunity to investigate for common cardiovascular risk factors and to optimise brain health. This can be commenced and monitored by the general practitioner or physician without delay in waiting for an outpatient neurology review.

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1 John Hunter Hospital, Newcastle, NSW
2 Monash University, Melbourne, VIC

Correspondence: thomas.ottavi@health.nsw.gov.au

Open access:

Open access publishing facilitated by Monash University, as part of the Wiley ‐ Monash University agreement via the Council of Australian University Librarians.

Acknowledgements:

We thank and acknowledge Darshan Ghia, Bernard Yan, Mark Parsons, Andrew Wong, Neil Spratt, Ben Clissold, Anna Holwell, Henry Ma, Claire Muller, Kenneth Butcher, Candice Delcourt, Teddy Wu, and Anna Ranta for their contributions as the expert panel and their review of the manuscript. We also thank and acknowledge Andrew Lee, Rebecca Moore, Gregory Carter, and Kichu Nair for reviewing the manuscript.

Competing interests:

No relevant disclosures.

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Research letter

Financial support provided to male and female physicians by pharmaceutical companies in New Zealand: a cross‐sectional study

Leah Jones

Med J Aust 2023; 219 (6): . || doi: 10.5694/mja2.52057
Published online: 18 September 2023

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Social determinants of health

Despite progress, gender differences persist in many areas of medicine. In the United States, female physicians are paid less, are promoted more slowly, and fewer hold leadership or senior academic positions than male physicians.1

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Te Whatu Ora Health New Zealand Te Toka Tumai, Auckland, New Zealand

Correspondence: leahjones@adhb.govt.nz

Correspondence: lkjones@hotmail.co.nz

Competing interests:

No relevant disclosures.

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Perspectives

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Lung cancer screening for Aboriginal and Torres Strait Islander peoples: an opportunity to address health inequities

Alison Brown, Gail Garvey, Nicole M Rankin, Claire Nightingale and Lisa J Whop

Med J Aust || doi: 10.5694/mja2.52084
Published online: 11 September 2023

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Topics

Neoplasms

Diagnostic techniques and procedures

Respiratory tract diseases

Social determinants of health

Indigenous health

The implementation of a national Lung Cancer Screening Program (LCSP), commencing in July 2025, presents a significant opportunity to have an impact on an intractable health problem for Aboriginal and Torres Strait Islander communities.1 Lung cancer is the most common cancer and the leading cause of cancer death for Aboriginal and Torres Strait Islander peoples.2 The Aboriginal and Torres Strait Islander age‐standardised incidence rate was 85.2 cases per 100 000 for 2009–2013 and the mortality rate was 56.8 deaths per 100 000, which are double the rates found in non‐Indigenous populations.2 Lung cancer mortality rates for Aboriginal and Torres Strait Islander peoples are increasing, in contrast to falling rates in non‐Indigenous Australians.2 These diverging trends are expected to increase disparities for many years to come and clearly demonstrate the health system is failing Aboriginal and Torres Strait Islander peoples. The disproportionate lung cancer burden means that an LCSP could deliver greater benefits to Aboriginal and Torres Strait Islander communities and reduce the disparity with non‐Indigenous Australians.

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1 University of Melbourne, Melbourne, VIC
2 University of Queensland, Brisbane, QLD
3 National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT

Correspondence: alison.brown@unimelb.edu.au

Open access:

Open access publishing facilitated by The University of Melbourne, as part of the Wiley – The University of Melbourne agreement via the Council of Australian University Librarians.

Acknowledgements:

Lisa Whop is supported by a National Health and Medical Research Council (NHMRC) Investigator Grant (2009380). Gail Garvey is funded by an NHMRC Investigator Grant (1176651). Claire Nightingale is supported by a Mid‐Career Research Fellowship (MCRF21039) from the Victorian Government acting through the Victorian Cancer Agency. Nicole Rankin is funded by an NHMRC Ideas Grant (2019/GA65812) and a Medical Research Future Fund Grant (2019/MRF2008603). The funding sources had no role in the content of this article.

Competing interests:

We received funding from Cancer Australia for conducting consultations with Aboriginal and Torres Strait Islander workforce around lung cancer screening but we were not directly funded for the publication of this article.

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Research letter

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Prevalence, patterns of use, and socio‐demographic features of e‐cigarette use by Australian adolescents: a survey

Lauren A Gardner, Siobhan O'Dean, Katrina E Champion, Emily Stockings, Amy‐Leigh Rowe, Maree Teesson, Nicola C Newton, Lauren A Gardner, Siobhan O'Dean, Katrina E Champion, Emily Stockings, Amy‐Leigh Rowe, Maree Teesson and Nicola C Newton

Med J Aust || doi: 10.5694/mja2.52075
Published online: 11 September 2023

ARTICLE
AUTHORS
REFERENCES

Topics

Environment and public health

Mental disorders

Adolescent e‐cigarette use (vaping) and its harms are public health concerns.1 A national survey in 2019 found that 10% of 14–17‐year‐old Australians had used e‐cigarettes.2 More recent studies, smaller or non‐representative, have suggested that the rate is rapidly increasing.3,4 Little is known about how e‐cigarette use varies by socio‐demographic factors, such as gender, socio‐economic status, and residential remoteness.

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1 The Matilda Centre for Research in Mental Health and Substance Use, the University of Sydney, Sydney, NSW
1 The Matilda Centre for Research in Mental Health and Substance Use, the University of Sydney, Sydney, NSW

Correspondence: lauren.gardner@sydney.edu.au

Open access:

Open access publishing facilitated by The University of Sydney, as part of the Wiley – The University of Sydney agreement via the Council of Australian University Librarians.

Acknowledgements:

The Health4Life study was funded by the Paul Ramsay Foundation and the National Health and Medical Research Council (NHMRC; Centre of Research Excellence in the Prevention and Early Intervention in Mental Illness and Substance Use [PREMISE]: APP11349009). Katrina Champion (APP1120641), Maree Teesson (APP1078407), and Nicola Newton (APP1166377) are supported by NHMRC fellowships. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

The Health4Life study was led by researchers at the Matilda Centre at the University of Sydney, Curtin University, the University of Queensland, the University of Newcastle, Northwestern University, and UNSW Sydney. We acknowledge all the investigators and research staff who have worked on the study, as well as the participating schools, students, and teachers. The research team also acknowledges the assistance of the New South Wales Department of Education, the Catholic Education Diocese of Bathurst, the Catholic Schools Office Diocese of Maitland–Newcastle, Edmund Rice Education Australia, the Brisbane Catholic Education Committee, and Catholic Education Western Australia for access to their schools.

Competing interests:

No relevant disclosures.

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2. Australian Institute of Health and Welfare. National Drug Strategy Household Survey 2019 (Cat. no. PHE 270). 16 July 2020. https://www.aihw.gov.au/reports/illicit‐use‐of‐drugs/national‐drug‐strategy‐household‐survey‐2019/contents/summary (viewed Mar 2023).
3. Watts C, Egger S, Dessaix A, et al. Vaping product access and use among 14–17‐year‐olds in New South Wales: a cross‐sectional study. Aust N Z J Public Health 2022; 46: 814‐820.
4. Wakefield M, Haynes A, Tabbakh T, et al. Current vaping and current smoking in the Australian population aged 14+ years: February 2018 – March 2023. Report for the Australian Department of Health and Aged Care. May 2023; updated June 2023. https://www.health.gov.au/resources/publications/current‐vaping‐and‐smoking‐in‐the‐australian‐population‐aged‐14‐years‐or‐older‐february‐2018‐to‐march‐2023?language=en (viewed June 2023).
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7. Australian Bureau of Statistics. Australian Statistical Geography Standard (ASGS), volume 5: remoteness structure (1270.0.55.005), July 2016. Updated 16 Mar 2018. https://www.abs.gov.au/ausstats/abs@.nsf/mf/1270.0.55.005 (viewed June 2023).
1. Banks E, Yazidjoglou A, Brown S, et al. Electronic cigarettes and health outcomes: umbrella and systematic review of the global evidence. Med J Aust 2023; 218: 267‐275. https://www.mja.com.au/journal/2023/218/6/electronic‐cigarettes‐and‐health‐outcomes‐umbrella‐and‐systematic‐review‐global
2. Australian Institute of Health and Welfare. National Drug Strategy Household Survey 2019 (Cat. no. PHE 270). 16 July 2020. https://www.aihw.gov.au/reports/illicit‐use‐of‐drugs/national‐drug‐strategy‐household‐survey‐2019/contents/summary (viewed Mar 2023).
3. Watts C, Egger S, Dessaix A, et al. Vaping product access and use among 14–17‐year‐olds in New South Wales: a cross‐sectional study. Aust N Z J Public Health 2022; 46: 814‐820.
4. Wakefield M, Haynes A, Tabbakh T, et al. Current vaping and current smoking in the Australian population aged 14+ years: February 2018 – March 2023. Report for the Australian Department of Health and Aged Care. May 2023; updated June 2023. https://www.health.gov.au/resources/publications/current‐vaping‐and‐smoking‐in‐the‐australian‐population‐aged‐14‐years‐or‐older‐february‐2018‐to‐march‐2023?language=en (viewed June 2023).
5. Teesson M, Champion KE, Newton NC, et al; Health4Life Team. Study protocol of the Health4Life Initiative: a cluster randomised controlled trial of an eHealth school‐based program targeting multiple lifestyle risk behaviours among young Australians. BMJ Open 2020; 10: e035662.
6. Torsheim T, Currie C, Boyce W, et al. Material deprivation and self‐rated health: a multilevel study of adolescents from 22 European and North American countries. Soc Sci Med 2004; 59: 1‐12.
7. Australian Bureau of Statistics. Australian Statistical Geography Standard (ASGS), volume 5: remoteness structure (1270.0.55.005), July 2016. Updated 16 Mar 2018. https://www.abs.gov.au/ausstats/abs@.nsf/mf/1270.0.55.005 (viewed June 2023).

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Editorials

Online first

The MJA supports an Aboriginal and Torres Strait Islander Voice to Parliament

Virginia Barbour

Med J Aust || doi: 10.5694/mja2.52074
Published online: 28 August 2023

ARTICLE
AUTHORS
REFERENCES

Topics

Indigenous health

Global health

We are at a time when there have never been better opportunities to translate health policies, practices and medical research into improvements for Aboriginal and Torres Strait Islander health. Critical to these efforts is a health and research system — including in the publishing sector — that recognises the importance of Indigenous leadership in producing and implementing health care and research in order to magnify research benefits across the communities it serves.1 However, as noted by Michelle Kennedy and Janine Mohamed from the Lowitja Institute, research requires appropriate Aboriginal and Torres Strait Islander ethical governance: “All research involving Aboriginal and Torres Strait Islander peoples should be deemed safe and respectful by Aboriginal and Torres Strait Islander peoples.”2

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Editor‐in‐Chief, the Medical Journal of Australia

Correspondence: vbarbour@mja.com.au

Competing interests:

No relevant disclosures.

1. Laird P, Chang AB, Jacky J, et al. Conducting decolonizing research and practice with Australian First Nations to close the health gap. Health Res Policy Syst 2021; 19: 127.
2. Kennedy M, Mohamed J. Upholding our rights in research: calling for urgent investment in Aboriginal and Torres Strait Islander health research ethics. Med J Aust 2023; 219: 9‐11. https://www.mja.com.au/journal/2023/219/1/upholding‐our‐rights‐research‐calling‐urgent‐investment‐aboriginal‐and‐torres
3. Stanley F, Langton M, Ward J, et al. Australian First Nations response to the pandemic: a dramatic reversal of the ‘gap’. J Paediatr Child Health 2021, 57: 1853‐1856.
4. Stanley F, Langton M. In the early days of Covid‐19, Indigenous leaders used their voice and averted a catastrophe. The Guardian 2023; 31 Mar. https://www.theguardian.com/commentisfree/2023/mar/31/in‐the‐early‐days‐of‐covid‐19‐indigenous‐leaders‐used‐their‐voice‐and‐averted‐a‐catastrophe (viewed July 2023).
5. Hudson M, Milne M, Russell K, et al. The development of guidelines for indigenous research ethics in Aotearoa/New Zealand. In: Drugge A‐L, editor. Ethics in indigenous research, past experiences – future challenges. Umea, Sweden: Vaartoe Centre for Sami Research, Umea University: pp 157‐174.
6. Baldwin L. Transformative decade ahead for First Nations and climate action. 2022 Charles Perkins Oration. https://www.sydney.edu.au/news‐opinion/news/2022/10/27/transformative‐decade‐ahead‐for‐first‐nations‐and‐climate‐action.html (viewed July 2023).
7. The Hon Linda Burney MP. National Press Club address. 5 July 2023. https://ministers.pmc.gov.au/burney/2023/national‐press‐club‐address (viewed July 2023).
8. Productivity Commission. Closing the Gap: annual data compilation report. July 2023. https://www.pc.gov.au/closing‐the‐gap‐data/annual‐data‐report/report/closing‐the‐gap‐annual‐data‐compilation‐report‐july2023.pdf (viewed July 2023).
9. Devakumar D, Selvarajah S, Abubakar I, et al. Racism, xenophobia, discrimination, and the determination of health. Lancet 2022; 400: 2097‐2108.
10. Dudgeon P, Bray A, Walker R. Mitigating the impacts of racism on Indigenous wellbeing through human rights, legislative and health policy reform. Med J Aust 2023; 218: 203‐205. https://www.mja.com.au/journal/2023/218/5/mitigating‐impacts‐racism‐indigenous‐wellbeing‐through‐human‐rights‐legislative
11. Closing the Gap. National Agreement on Closing the Gap. July 2020. https://www.closingthegap.gov.au/national‐agreement/national‐agreement‐closing‐the‐gap/4‐new‐approach (viewed July 2023).
12. Productivity Commission. Review of the National Agreement on Closing the Gap. Draft report. 2023. https://www.pc.gov.au/inquiries/current/closing‐the‐gap‐review/draft/closing‐the‐gap‐review‐draft.pdf (viewed July 2023).
13. Lowitja Institute. Enshrining a Voice to Parliament: towards improving health and wellbeing outcomes for our peoples [media release]. 21 Feb 2023. https://www.lowitja.org.au/content/Document/LI_MediaRelease‐VoicetoParliament‐REG‐Feb2023.pdf (viewed July 2023).
14. Australian Indigenous Doctors’ Association. AIDA supports the Voice to Parliament [media release]. 1 June 2023. https://aida.org.au/media‐release/aida‐supports‐the‐voice‐to‐parliament/ (viewed July 2023).
15. Kong K. Ability to make a difference for Australia's future. Surgical News 2023, Vol 4, Issue 5. https://www.surgeons.org/en/surgicalnews/Articles/2023/Volume‐24/Issue‐5/Voice‐to‐Parliament (viewed July 2023).
16. Australasian College for Emergency Medicine. ACEM supports the Voice to Parliament. https://acem.org.au/News/May‐2023/ACEM‐Supports‐the‐Voice‐to‐Parliament (viewed July 2023).
17. Royal Australasian College of Physicians. The RACP supports an Aboriginal and Torres Strait Islander Voice to Parliament, in pursuit of health equity for all First Nations people. 4 Aug 2023. https://www.racp.edu.au/news‐and‐events/media‐releases/the‐racp‐supports‐an‐aboriginal‐and‐torres‐strait‐islander‐voice‐to‐parliament‐in‐pursuit‐of‐health‐equity‐for‐all‐first‐nations‐people (viewed Aug 2023).
18. Australian Medical Association. AMA statement on the Voice to Parliament. Position statement, 14 June 2023. https://www.ama.com.au/articles/ama‐statement‐voice‐parliament (viewed July 2023).
19. Australian Academy of Health and Medical Sciences. AAHMS statement supporting the Voice to Parliament. 3 May 2023. https://aahms.org/news/statement‐supporting‐the‐voice‐to‐parliament/ (viewed Aug 2023).

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Research

Clinical outcomes and health care costs of transferring rural Western Australians for invasive coronary angiography, and a cost‐effective alternative care model: a retrospective cross‐sectional study

Mikhail Alexander, Nick S R Lan, Michael J Dallo, Tom G Briffa, Frank M Sanfilippo, Andrew Hooper, Helen Bartholomew, Loletta Hii, Graham S Hillis, Brendan M McQuillan, Girish Dwivedi, James M Rankin and Abdul Rahman Ihdayhid

Med J Aust 2023; 219 (4): . || doi: 10.5694/mja2.52018
Published online: 21 August 2023

ARTICLE
AUTHORS
REFERENCES

Topics

Cardiovascular diseases

Diagnostic techniques and procedures

General medicine

Abstract

Objectives: To examine the severity of coronary artery disease (CAD) in people from rural or remote Western Australia referred for invasive coronary angiography (ICA) in Perth and their subsequent management; to estimate the cost savings were computed tomography coronary angiography (CTCA) offered in rural centres as a first line investigation for people with suspected CAD.

Design: Retrospective cohort study.

Setting, participants: Adults with stable symptoms in rural and remote WA referred to Perth public tertiary hospitals for ICA evaluation during the 2019 calendar year.

Main outcome measures: Severity and management of CAD (medical management or revascularisation); health care costs by care model (standard care or a proposed alternative model with local CTCA assessment).

Results: The mean age of the 1017 people from rural and remote WA who underwent ICA in Perth was 62 years (standard deviation, 13 years); 680 were men (66.9%), 245 were Indigenous people (24.1%). Indications for referral were non‐ST elevation myocardial infarction (438, 43.1%), chest pain with normal troponin level (394, 38.7%), and other (185, 18.2%). After ICA assessment, 619 people were medically managed (60.9%) and 398 underwent revascularisation (39.1%). None of the 365 patients (35.9%) without obstructed coronaries (< 50% stenosis) underwent revascularisation; nine patients with moderate CAD (50–69% stenosis; 7%) and 389 with severe CAD (≥ 70% stenosis or occluded vessel; 75.5%) underwent revascularisation. Were CTCA used locally to determine the need for referral, 527 referrals could have been averted (53%), the ICA:revascularisation ratio would have improved from 2.6 to 1.6, and 1757 metropolitan hospital bed‐days (43% reduction) and $7.3 million in health care costs (36% reduction) would have been saved.

Conclusion: Many rural and remote Western Australians transferred for ICA in Perth have non‐obstructive CAD and are medically managed. Providing CTCA as a first line investigation in rural centres could avert half of these transfers and be a cost‐effective strategy for risk stratification of people with suspected CAD.

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1 Fiona Stanley Hospital, Perth, WA
2 Royal Perth Hospital, Perth, WA
3 The University of Western Australia, Perth, WA
4 Medical Royal Flying Doctor Service Western Australia, Perth, WA
5 Sir Charles Gairdner Hospital, Perth, WA
6 Harry Perkins Institute of Medical Research, Perth, WA
7 Curtin Medical School, Curtin University, Perth, WA

Correspondence: abdul.ihdayhid@perkins.org.au, abdul.ihdayhid@curtin.edu.au

Open access:

Open access publishing facilitated by Curtin University, as part of the Wiley – Curtin University agreement via the Council of Australian University Librarians.

Acknowledgements:

Abdul Rahman Ihdayhid is supported by a National Heart Foundation postdoctoral scholarship.

Competing interests:

Nick S R Lan has received research funding from Sanofi as part of a clinical fellowship in endocrinology and diabetes, education support from Amgen, Bayer, Boehringer Ingelheim, Eli Lilly, and Novartis, and speaker honoraria from Boehringer Ingelheim, Eli Lilly, and Sanofi, and has participated in advisory boards for Eli Lilly. Girish Dwivedi has received lecture fees from AstraZeneca, Pfizer, and Amgen (not related to the topic of this study), and provides consultancy services and has equity interest in Artrya. Abdul Rahman Ihdayhid is a consultant for Abbott Medical, Boston Scientific, and Artrya (including equity interest).

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2. Alston L, Allender S, Peterson K, et al. Rural inequalities in the Australian burden of ischaemic heart disease: a systematic review. Heart Lung Circ 2017; 26: 122‐133.
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Perspectives

Coronary stenting for stable coronary ischaemia: ain't misbehaving, just misunderstood

Derek P Chew and Sarah Zaman

Med J Aust 2023; 219 (4): . || doi: 10.5694/mja2.52050
Published online: 21 August 2023

ARTICLE
AUTHORS
REFERENCES

Topics

Cardiovascular diseases

Diagnostic techniques and procedures

In the management of coronary artery disease, trepidation associated with the risk of future myocardial infarction weighs heavily on the minds of patients and physicians alike, given the well recognised and often publicly highlighted association with premature cardiovascular mortality. In the context of high risk acute coronary syndromes, the practice of early invasive coronary angiography with percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is a Level IA (Grading of Recommendations Assessment, Development and Evaluation [GRADE]: Strong) indication for the reduction of recurrent myocardial infarction and cardiovascular mortality.1

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1 Victorian Heart Hospital, Monash University, Melbourne, VIC
2 Westmead Applied Research Centre, University of Sydney, Sydney, NSW

Correspondence: derek.chew@monash.edu

Open access:

Open access publishing facilitated by Monash University, as part of the Wiley – Monash University agreement via the Council of Australian University Librarians.

Competing interests:

No relevant disclosures.

1. Chew DP, Scott IA, Cullen L, et al. National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian clinical guidelines for the management of acute coronary syndromes 2016. Med J Aust 2016; 205: 128‐133. https://www.mja.com.au/journal/2016/205/3/national‐heart‐foundation‐australia‐and‐cardiac‐society‐australia‐and‐new
2. Velazquez EJ, Lee KL, Jones RH, et al. Coronary‐artery bypass surgery in patients with ischemic cardiomyopathy. N Engl J Med 2016; 374: 1511‐1520.
3. Maron DJ, Hochman JS, Reynolds HR, et al. Initial invasive or conservative strategy for stable coronary disease. N Engl J Med 2020; 382: 1395‐1407.
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10. White HD, Chew DP. Acute myocardial infarction. Lancet 2008; 372: 570‐584.

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The changing landscape of clinical trials in Australia

Anna Lene Seidler, Melina L Willson, Mason Aberoumand, Jonathan G Williams, Kylie E Hunter, Angie Barba, R John Simes and Angela Webster

Med J Aust || doi: 10.5694/mja2.52059
Published online: 14 August 2023

ARTICLE
AUTHORS
REFERENCES

Topics

Statistics, epidemiology and research design

Information science

Examining the clinical trials landscape in Australia is important for governance and to expand knowledge about trial activity to health professionals, the public and funders. There is a strong history of Australian trials addressing important health care questions by covering a range of diseases, patient groups, prevention and treatment modalities.1 Trial results can drive change by informing best practice in health care and future research.

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NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW

Correspondence: lene.seidler@sydney.edu.au

Open access:

Open access publishing facilitated by The University of Sydney, as part of the Wiley ‐ The University of Sydney agreement via the Council of Australian University Librarians.

Acknowledgements:

We acknowledge funding from the Australian Government National Collaborative Research Infrastructure Strategy program, administered via Therapeutic Innovation Australia. Anna Lene Seidler, John Simes and Angela Webster are supported by NHMRC investigator grants (1177117, 2009432, 2009800). The funding sources had no role in the planning, writing or publication of the work. We also acknowledge contributions from Lisa Askie, Peta Skeers, Sherrie Liu and Ava Tan.

Competing interests:

No relevant disclosures.

1. Askie LM, Hunter KE, Berber S, et al. The clinical trials landscape in Australia 2006–2015. Sydney: Australian New Zealand Clinical Trials Registry, 2017. https://www.anzctr.org.au/docs/ClinicalTrialsInAustralia2006‐2015.pdf (viewed May 2023).
2. Willson ML, Seidler AL, Aberoumand M, et al. Latest update of the clinical trials landscape in Australia 2006 – 2020. Sydney: Australian New Zealand Clinical Trials Registry, 2022. https://ses.library.usyd.edu.au/handle/2123/29703.2 (viewed May 2023).
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Consensus statement for the management of incidentally found brain white matter hyperintensities in general medical practice

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Financial support provided to male and female physicians by pharmaceutical companies in New Zealand: a cross‐sectional study

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Lung cancer screening for Aboriginal and Torres Strait Islander peoples: an opportunity to address health inequities

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Prevalence, patterns of use, and socio‐demographic features of e‐cigarette use by Australian adolescents: a survey

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The MJA supports an Aboriginal and Torres Strait Islander Voice to Parliament

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Clinical outcomes and health care costs of transferring rural Western Australians for invasive coronary angiography, and a cost‐effective alternative care model: a retrospective cross‐sectional study

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Coronary stenting for stable coronary ischaemia: ain't misbehaving, just misunderstood

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The changing landscape of clinical trials in Australia

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Elective spinal surgery in New South Wales adults, 2001–20, by procedure funding type: a cross‐sectional study

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Building a rural and remote health workforce: an overview of effective interventions

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Consensus statement for the management of incidentally found brain white matter hyperintensities in general medical practice

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Financial support provided to male and female physicians by pharmaceutical companies in New Zealand: a cross‐sectional study

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Lung cancer screening for Aboriginal and Torres Strait Islander peoples: an opportunity to address health inequities

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Prevalence, patterns of use, and socio‐demographic features of e‐cigarette use by Australian adolescents: a survey

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The MJA supports an Aboriginal and Torres Strait Islander Voice to Parliament

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Clinical outcomes and health care costs of transferring rural Western Australians for invasive coronary angiography, and a cost‐effective alternative care model: a retrospective cross‐sectional study

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Coronary stenting for stable coronary ischaemia: ain't misbehaving, just misunderstood

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The changing landscape of clinical trials in Australia

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Elective spinal surgery in New South Wales adults, 2001–20, by procedure funding type: a cross‐sectional study

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Abstract

Author

Comment

Do you have any competing interests to declare? *

Building a rural and remote health workforce: an overview of effective interventions

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