George-researchers-receive-4m

George Institute researchers to receive over four million dollars in Medical Research Future Fund grants

Dapagliflozin in advanced chronic kidney disease and kidney failure: The RENAL LIFECYCLE trial

A team of researchers from The George Institute for Global Health have been awarded over $2.2 million to conduct a new trial to see if a drug used to treat diabetes can improve outcomes for people with advanced stages of kidney disease.

Currently, almost 27,000 Australians are living with kidney failure with nearly 14,000 receiving dialysis and 12,800 living with a kidney transplant. Death rates are high in patients with advanced chronic kidney disease (CKD) and in those that have progressed to kidney failure and need dialysis or transplantation, and treatment options are limited. Kidney failure rates are also high in patients with advanced stages of CKD and in those living with a kidney transplant.

A class of drugs called SGLT2 inhibitors have already been shown to improve heart, circulatory and kidney outcomes in patients with mild and moderate stages of chronic kidney disease (CKD), but they haven’t been studied in people who are in the advanced stages of the disease or in kidney failure.

The new international trial will evaluate whether the SGLT2 inhibitor dapagliflozin can also reduce risk of death, heart failure and kidney failure in people with advanced stages of the disease or in kidney failure. The Australian arm of this trial will be led by Professor Sunil Badve and Associate Professor Clare Arnott. In this world-first study, the Australian team will also study the effect of dapagliflozin on structural abnormalities of heart and if this in turn contributes to their cardiovascular benefits in people with advanced kidney disease and kidney failure.

Australia to join large multicentre Enhanced Control of Hypertension and Thrombectomy Stroke Study (ENCHANTED-MT) being conducted in China

Professor Craig Anderson, Director of Global Brain Health at The George Institute and Professor of Neurology and Epidemiology in the Faculty of Medicine at UNSW Sydney will receive just over $2m to help improve outcomes for people who have experienced an ischaemic stroke.

Mechanical removal of clots blocking large blood vessels to restore blood flow to the affected area of the brain has become standard treatment for acute ischaemic stroke. Despite this, many patients still have a poor outcome.

Blood pressure (BP) is a powerful predictor of how well patients do, but there is uncertainty around what the ideal level should be during and after this procedure, known as mechanical thrombectomy (MT). Recommendations in current treatment guidelines are not based on strong evidence and there are variations on how this is managed in clinical practice.

The George Institute established the Enhanced Control of Hypertension and Thrombectomy Stroke Study in China to compare more- or less-intensive blood pressure management on outcomes for patients after successful MT. The MRFF funding will now allow Prof Anderson and his team to enrol and conduct brain imaging analysis on 400 Australian patients as part of the larger trial.

Over 50,000 Australians are living with the effects of stroke, resulting in over $6 million in direct health care costs and $26 billion in indirect costs through loss of life and suffering.

It is estimated that over 2000 patients undergo the MT procedure at 18 hospitals across the country each year. The researchers estimate that this funding has the potential to improve the function and wellbeing of at least 150 of these patients each year, as well as many hundreds of thousands elsewhere in the world, reduce the burden on health systems, community care, and society.

Leads

Further reading

Event

Second Seminar on Evidence Synthesis for Global Health : Doing Guideline Adaptation Right

evidence synthesis for global health

The George Institute continuing its seminar series under Evidence Synthesis for Global Health is organising the second seminar on “Doing Guideline Adaptation Right”, highlighting the challenges and role of the RIGHT AD@PT checklist.

Guideline development is a complex multistage process. Proper reporting is an important step in guideline development. The Reporting Items of Practice Guidelines in Healthcare (RIGHT) statement provides guidance to the developers for the purpose. However, in the case of adapted guidelines, the RIGHT statement is inadequate. The RIGHT AD@PT checklist fills this gap. It builds on the experiences of international stakeholders in guideline adaptation and may improve the completeness of reporting adapted guidelines.

Mark your calendar for 5th May 2022 | 13:00 IST

About the seminar

Clinical Practice Guidelines are the highest quality of evidence to guide clinical practice. Adapting guidelines helps contextualize trustworthy recommendations but is a challenging process. Guidance on how to draft, and report adapted guidelines is rapidly evolving. Researchers, clinicians, and policymakers around the globe have recently published the Right AD@PT checklist for reporting adapted guidelines. The seminar will highlight the challenges in guideline adaptation and the role of the RIGHT AD@PT checklist in mitigating some of the challenges.

Register Here

Speakers

  • Lead Speaker : Dr Yang Song - Iberoamerican Cochrane Centre–Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain

    Dr Yang Song led the development of a reporting checklist for guideline adaptation (RIGHT-Ad@pt), published in the journal Annals of Internal Medicine. She is dedicated towards improving the guideline development and adaptation methodology in China. Yang is pursuing her Ph.D. in Methodology of Biomedical Research and Public Health, Universitat Autònoma de Barcelona, Barcelona, Spain. She is also a leading author of the RIGHT AD@PT checklist. Her research interests focus on the methodology of clinical guidelines development and adaptation, and biomedical research.

    To maximize the efficiency of resources and reduce redundancy, organizations and countries may decide to adapt an existing practice guideline rather than developing de novo guidelines. Although several adaptation frameworks exist, adapted guidelines are generally of low quality, poorly reported, and not based on published frameworks. Dr Yang in her presentation will be talking about the findings from her qualitative research on the challenges of guideline adaptation. She will also be discussing the RIGHT-Ad@pt checklist as a reporting guidance for adapted guidelines, covering the adaptation process and the adapted recommendations.

    Dr Yang Song

  • Welcome address : Dr Mohammad Abdul Salam - Program Head, Cardiovascular Research, The George Institute for Global Health, India

    Salam is a clinical and public health researcher interested in cardiovascular disease prevention. He is particularly interested in developing, evaluating, and implementing novel low-cost pharmacological interventions. He has experience in clinical trials, systematic reviews and qualitative health research. Abdul Salam has a Master of Pharmacy (Pharmacology) from the Jawaharlal Nehru Technological University, India, and a PhD in Medicine from The University of Sydney, Australia.

  • Fireside Chat Moderator : Dr Soumyadeep Bhaumik - Co-Head, Meta-Research & Evidence Synthesis Unit, The George Institute for Global Health, India

    Soumyadeep is an international public health specialist, working on evidence synthesis, meta-research, health policy and injury. His work in injury is focused on snakebite and drowning. He has been working on employing a diverse range of methodologies to ensure fit-for-purpose approaches to inform policy, practice, and future research. His work has informed multiple WHO guidelines, technical documents, and national policies.

    Soumyadeep Bhaumik

  • Host : Dr Manveen Kaur - Research Assistant , Meta Research and Evidence Synthesis Unit, The George Institute for Global Health, India

    Manveen leverages her clinical training in MBBS and a fellowship in geriatric medicine for her work. Prior to this, Manveen worked as a registrar and physician for a novel population-based cancer registry at Society for Education, Action and Research (SEARCH), Gadchiroli. She completed her clinical training at the Government Medical College and Hospital, Aurangabad. She also holds an MSc in Gerontology and Ageing from King’s College London.

    manveen kaur

Further reading

dementia risk

People living with dementia at risk from rising temperatures, study finds

LONDON, 7 April 2022   As climate change drives rising temperatures, the UK can expect to see increased emergency dementia admissions, find researchers from The George Institute for Global Health and Centre on Climate Change and Planetary Health at the London School of Hygiene and Tropical Medicine.

Researchers explored the association between daily temperature and counts of emergency admissions for dementia in England, and projected future health burdens in people living with dementia under two climate change scenarios (a high emissions scenario where global greenhouse gas emissions continue to rise, and a low emissions scenario where global greenhouse gas emissions are sizeably reduced through mitigation).

The results, published in Environment International, describe how every 1֯C rise in temperature above 17֯C is associated with a 4.5% increase in risk of emergency admissions for people living with dementia in England.

Jessica Gong, a PhD student at of The George Institute for Global Health, who led the research said:

“Our findings underline the association between rising temperatures and dementia-related acute admissions. How our high- and low- scenario projections play out will be determined by how robust and effective climate change mitigation is in the immediate present and future. What is clear, however, is that UK summers will get hotter, and we may see an increase in the number of people living with dementia requiring emergency admission as a result.”

Under the high emissions scenario, the projections model suggests emergency admissions may increase by 300% by 2040.

Dr Shakoor Hajat, Associate Professor, Centre on Climate Change and Planetary Health at the London School of Hygiene and Tropical Medicine said:

“It is imperative that people living with dementia are considered a high-risk group during hot weather. In this way, when hot weather is forecast, caregivers can anticipate some of the dangers of heat-exacerbated symptoms while hospital emergency departments can best plan for hot weather periods.”

Professor Kent Buse, Director of the global Healthier Societies Programme at The George Institute, said:

"Climate change and population ageing are two of the most significant global health challenges facing us in the 21st century. This timely and valuable research, which maps the impact of global warming on current and future dementia burdens, shows one of the many ways the two are linked. For me, it is all about prevention. We need more urgency & accountability to reduce global heating for the health of people and planet."

The published article is available here.

Leads

Further reading

Subscribe to