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  • Publication
    Journal Article
    How comparable are patient outcomes in the "real-world" with populations studied in pivotal AML trials?
    (2024-03-25T13:00:00Z)
    Tiong, Ing Soo
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    Wall, Meaghan
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    Bajel, Ashish
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    Kalro, Akash
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    Fleming, Shaun
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    Roberts, Andrew W
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    Thiagarajah, Nisha
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    Chua, Chong Chyn
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    Latimer, Maya
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    Yeung, David
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    Marlton, Paula
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    Johnston, Amanda
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    Enjeti, Anoop
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    Fong, Chun Yew
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    Cull, Gavin
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    Larsen, Stephen
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    Kennedy, Glen
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    Schwarer, Anthony
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    Kipp, David
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    Ramanathan, Sundra
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    Verner, Emma
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    Tiley, Campbell
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    Morris, Edward
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    Hahn, Uwe
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    Moore, John
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    Taper, John
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    Purtill, Duncan
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    Warburton, Pauline
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    Stevenson, William
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    Murphy, Nicholas
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    Tan, Peter
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    Beligaswatte, Ashanka
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    Mutsando, Howard
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    Hertzberg, Mark
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    Shortt, Jake
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    Dunne, Karin
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    Wei, Andrew H
    Despite an increasing desire to use historical cohorts as "synthetic" controls for new drug evaluation, limited data exist regarding the comparability of real-world outcomes to those in clinical trials. Governmental cancer data often lacks details on treatment, response, and molecular characterization of disease sub-groups. The Australasian Leukaemia and Lymphoma Group National Blood Cancer Registry (ALLG NBCR) includes source information on morphology, cytogenetics, flow cytometry, and molecular features linked to treatment received (including transplantation), response to treatment, relapse, and survival outcome. Using data from 942 AML patients enrolled between 2012-2018, we assessed age and disease-matched control and interventional populations from published randomized trials that led to the registration of midostaurin, gemtuzumab ozogamicin, CPX-351, oral azacitidine, and venetoclax. Our analyses highlight important differences in real-world outcomes compared to clinical trial populations, including variations in anthracycline type, cytarabine intensity and scheduling during consolidation, and the frequency of allogeneic hematopoietic cell transplantation in first remission. Although real-world outcomes were comparable to some published studies, notable differences were apparent in others. If historical datasets were used to assess the impact of novel therapies, this work underscores the need to assess diverse datasets to enable geographic differences in treatment outcomes to be accounted for.
  • Publication
    Journal Article
    Melioidosis Knowledge Awareness in Three Distinct Groups in the Tropical Northern Territory of Australia.
    (2024-03-27T13:00:00Z) ;
    Mayo, Mark
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    Kaestli, Mirjam
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    Melioidosis is a potentially life-threatening infection. This study aimed to assess the melioidosis knowledge among distinct participant groups in the tropical Top End of the Northern Territory (NT) of Australia. Participants were categorised into three groups: NT medical students and health research staff (Group 1: Hi-Ed), Aboriginal Rangers and Aboriginal Healthcare Workers (Group 2: Rangers/AHWs), and patients with a history of melioidosis infection (Group 3: Patients). A questionnaire was developed to collect data on demographics, risk and protective factor awareness, and knowledge acquisition sources. We used responses to calculate indices for risk knowledge (RKI), protective knowledge (PKI), overall melioidosis knowledge (MKI), and information sources (ISI). We found that 93.6% of participants in Group 1 (Hi-Ed) said that they had heard of melioidosis, followed by 81.5% in Group 3 (Patients), and 72.0% in Group 2 (Rangers/AHWs). Group 1 (Hi-Ed) participants demonstrated greater knowledge of risk-increasing behaviours but had gaps in knowledge of clinical risks like diabetes. Multiple regression revealed that the number of resources used was the only significant predictor of MKI. There are varying melioidosis knowledge levels across different NT participant groups. Targeted educational interventions are needed to enhance melioidosis awareness. A weblink with an interactive summary of our analysis can be found under Results part.
  • Person
  • Publication
    Journal Article
    Establishing a telehealth model addressing paediatric sleep health in remote and rural Northern Territory Australia: Overcoming the distance barrier.
    (2024-05-09T14:00:00Z)
    Gentin, Natalie
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    Howarth, Timothy P
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    Jonas, Catherine
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    Blecher, Gregory
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    Widger, John
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    This study examined the outcomes of a telehealth model for sleep health assessment among Indigenous and non-Indigenous children residing in remote and regional communities at the Top End Northern Territory (NT) of Australia.Video telehealth consultation, that included clinical history and relevant physical findings assessed virtually with an interstate paediatric sleep physician was conducted remotely. Polysomnography (PSG) and therapeutic interventions were carried out locally at Darwin, NT. The study participants were children referred between 2015 and 2020.Of the total 812 children referred for sleep assessment, 699 underwent a diagnostic PSG. The majority of patients were female (63%), non-Indigenous (81%) and resided in outer regional areas (88%). Indigenous children were significantly older and resided in remote or very remote locations (22% vs. 10%). Referral patterns differed according to locality and Indigenous status - (non-Indigenous via private (53%), Indigenous via public system (35%)). Receipt of referrals to initial consultation was a median of 16 days and 4 weeks from consult to PSG. Remote children had slightly longer time delay between the referral and initial consult (32 vs. 15 days). Fifty one percent were diagnosed to have OSA, 27% underwent adenotonsillectomy and 2% were prescribed with CPAP therapy.This study has demonstrated that a telehealth model can be an effective way in overcoming logistical barriers and in providing sleep health services to children in remote and regional Australia. Further innovative efforts are needed to improve the service model and expand the reach for vulnerable children in very remote communities.
  • Person
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