Clinical Research Paid PhD Scholarship (x2)**
NHMRC Clinical Scholarship: Centre for Research Excellence (x2) **
The Chancellery Research Division at the University of Melbourne has awarded two scholarships to the Department of Surgery, St Vincent's Hospital, in recognition of their efforts in obtaining NHMRC funding for their Centre of Research Excellence for Total Joint Replacement, which has goals in optimising outcomes, equity, cost effectiveness and patient Selection (OPUS).
The funds are for the purpose of clinical healthcare research in synergy with the programs five year focus which spans clinical care, health economics, outcomes modelling, and implementation research. Applicants with a background in Medicine, Health Science, Physiotherapy, Nursing, Psychology, Statistics and Epidemiology are encouraged to apply. Specific areas of study interest include but are not limited to outcomes modelling, enhanced recovery in arthritis surgery, health behaviours, health services & support and health economics.
Three projects outlined below are now available, however the Centre is open to discussion with students to develop their own project plans in synergy with the Centre’s goals.
The scholarship awards of ~AU$27000 per year are available for 3.5 years pending approval of all major milestones and should be commenced in 2017. Contact the Centre Manager at any time to learn more: firstname.lastname@example.org, +613 9231 2553.
See below to view specific eligibility criteria
For more information on the Centre for Research Excellence in Total Joint Replacement - OPUS
Title: Evaluating the clinical and cost effectiveness of total joint replacement
Partners: The University of Melbourne Department Of Surgery and Department of Orthopaedics St Vincent’s Hospital
Supervisors: A/Prof Michelle Dowsey, Prof Peter Choong, Prof Philip Clarke
Background: Annually more than 100,000 joints are replaced in Australia, making it one of the most common elective surgical procedures in this country. Joint replacement numbers are expected to double within the next 30 years and while considered a highly successful procedure, controversies exist regarding best practice in several key areas of surgical practice. These controversies include; patella resurfacing and the use of computer navigation in total knee replacement, surgical approach and cementation techniques in total hip replacement. Despite numerous randomised controlled trials interrogating these issues, there remains little definitive evidence to preference one practice over another and as a consequence, decisions are largely based on surgeon preference.
Although joint replacement has proven to be cost-effective treatments for end-stage osteoarthritis, studies have also shown that the cost of surgery can vary between patient subgroups. Measuring value and understanding the cost of services is imperative in healthcare where providers are challenged to balance between the provision of quality care and cost containment. This study will use a unique dedicated clinical registry that includes high quality patient reported outcome measures for a group of nationally representative joint replacement patients, to interrogate the cost implications of common surgical practices.
The St. Vincent’s Melbourne Arthroplasty Outcomes Registry (SMART) is a registry which collects both clinical and patient reported outcomes in patients who have undergone elective lower limb joint replacement at St. Vincent’s Hospital. The registry has recorded information on patient demographics, surgery details and death for these patients since 1998. From 2006, the collection of patient reported HRQL was initiated and patients are followed-up at regular time intervals. Using techniques such as instrumental variable analysis, propensity score analysis and Markov modelling, the aim of this study will be to evaluate the clinical and cost effectiveness of common surgical practices and in doing so inform the evidence base for surgical decision making in total joint replacement
Preferred prerequisite studies: orthopaedics/musculoskeletal disease, epidemiology, health economics
Title: Optimal Pain Assessment in Joint Replacement Patients
Partners: The University of Melbourne & the University of South Australia
Supervisors: A/Prof Michelle Dowsey, Adjunct A/Professor Maria Inacio
Background: The lifetime risk of an Australian undergoing a knee or hip replacement is 10-12% and annually almost 100,000 joints are replaced in Australia, making it one of the most common elective surgical procedures in this country. Patients have joint replacement surgery because of severe arthritis that causes them debilitating pain and limited function. While this surgery should provide patients with substantial, if not complete, pain relief from their disease, post-surgical pain is common. Thirty eight percent of patients present to their general practitioners within 30 days post-surgery for assistance with pain management. Up to one third of patients report chronic post-operative pain and 19-42% still take opioids one year after surgery.
Opioids are strong pain relief medications associated with significant side effects, including intoxication, dependency, and abuse, with limited evidence of their long-term efficacy. Because of the accumulating evidence of the detrimental effects of opioid use and ineffectiveness for long-term pain relief, understanding post-surgical use of opioids for pain relief and rehabilitation in joint replacement patients is needed.
To determine the effect of opioids in the post-operative pain relief of joint replacement patients, this study will compare patient reported pain, function, and other patient assessments with their analgesic medication use, with great focus on opioid medication use. We will determine how opioid use is associated with patient reported pain, whether changes in pain are associated with changes in opioid use, and identify patient groups at a high risk for suboptimal opioid use. Our study’s findings will be useful to patients who have joint replacements and their providers, who struggle in balancing the risks and benefits of opioid therapy when recommending pain management treatment.
The study will use a unique dataset, which is a dedicated clinical registry that includes high quality patient reported pain assessments for a group of nationally representative joint replacement patients. Characterising the progression of pain after joint replacement and patients at risk of suboptimal opioid use will assist and aid clinicians in the identification of patients that will benefit from additional education and support for pain management as well as inform the development of opioid use protocols post-surgery.
Preferred prerequisite studies: epidemiology, phamacology or pharmacoepidemiology, orthopaedics/musculoskeletal disease.
Partners: The University of Melbourne & the Monash University
Supervisors: A/Prof Michelle Dowsey, Dr Darshini Ayton
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Further Information / Application Enquiries
Mr Dale Baum
+61 435 697 011