Research Action Awards

Up until very recently, people with advanced carotid stenosis (narrowing of the main arteries supplying blood to the brain) and without related stroke symptoms were routinely recommended procedural treatment. This typically involves either surgery designed to clear the blockage, or stenting, which involves inserting a metal or other device to prop open the artery and keep the blood circulating. However, like all invasive procedures, both these interventions come with a significant risk of harm. Associate Professor Abbott’s key discovery was that medical intervention (appropriate medication and lifestyle changes) alone can reduce the risk of stroke in these people by at least 65%, compared with previous practice.

Associate Professor Abbott’s research and advocacy have had a powerful effect on both prevention practice and policy. It is now recognised by many that medical intervention alone is the best option for advanced asymptomatic carotid stenosis, and trials now incorporate medical intervention as well as procedural arms. Associate Professor Abbott’s efforts to alert the medical community to the significance of her findings led to her being invited to address US experts conducting a review of US Medicare’s reimbursement policy for treatment of carotid artery disease. Her work was instrumental in their decision not to fund widespread stenting, helping to reduce harmful and wasteful procedures in many thousands of people each year.

“The message I’d like the public to take home from my research is that they have the most power to prevent their own stroke by adopting healthy lifestyle habits and using medication appropriately for things like high blood pressure and cholesterol. Combining all these things is very effective in stroke prevention,” said Associate Professor Abbott.

Although major trauma from falls, road accidents or violence is the leading cause of death and disability in Australian children, injury rates have not changed in the past decade and there has been surprisingly little research into the incidence of childhood injury in Australia, causes of injury, or the most effective treatments. Professor Curtis heads up a major program of research that aims to fill the gaps in paediatric trauma knowledge and reduce the incidence and impact of childhood injury.

Her research has for the first time described the incidence and causes of paediatric injury in Australia, using data from over half a million hospitalisation and mortality records. Professor Curtis and her team have also assessed processes of care and associated outcomes for 535 severely injured children in NSW, as well as conducting a two-year study to determine what aspects of care patients feel could improve their experience and wellbeing. This research is already having a significant impact on national prevention policy.

“We’ve been able to bring our research into rates of childhood injury to the attention of the federal government through meetings with child commissioners and health ministers,” said Professor Curtis.

“Just this month Health Minister Greg Hunt signed off on a national injury prevention plan. Until then, we didn’t have one, which just seems crazy, given that it’s such a huge cause of death and disability.”

There is a revolving door between homelessness and health, with high rates of emergency department presentations and hospitalisations making this not just a moral but a fiscal issue as well. But homelessness charities and agencies on the ground rarely have the time or resources to do the research and build the real-world evidence needed to make headway.

Having started out working pro bono in this area, Associate Professor Lisa Wood now leads a rapidly growing program of research and collaboration with homelessness organisations across WA and Victoria. Her team has developed the largest database of linked homelessness and health data in Australia. This innovative project has involved linking hospital records for 3400 homeless patients to other homeless, housing and police data to glean new insights into predictors of homelessness, the effectiveness of interventions and the barriers to delivering policies and services that work.

One of the focuses of Associate Professor Wood’s research program has been the use of evidence to advocate for services. A recent example was a street health service that was providing healthcare to rough sleepers, which was about to close due to lack of funding.

“We quickly generated some case studies and a report that showed the benefits of that service,” said Associate Professor Wood. “It got some media coverage which led to a philanthropist coming forward and offering $100,000 to continue that service. She’s just put in another $100,000, and one of her comments was how much she valued the evaluation that we undertook of that service.”