ISCRR research examines the effectiveness of various clinical approaches to treatment in areas including trauma, persistent pain and mental health.

Silica exposure

Treatment options for occupationally-acquired silica-related disease

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Medicinal cannabis

Reviews of evidence for the use of medicinal cannabis for workplace injuries and illnesses

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Pain therapies

Persistent pain (often referred to as "chronic pain") is pain that continues for three months or more, and does not respond to usual medical treatment. ISCRR researchers have evaluated several existing treatment options for persistent pain. The objective of this work is to help compensation bodies maximise the health outcomes of claimants with persistent pain.

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Psychosocial health

Mental health conditions such as anxiety, depression, and post-traumatic stress disorder affect many Australians, often impacting on their health, quality of life and return to work. To optimise the support received by claimants with mental health conditions, compensation bodies rely on research into mental health treatment approaches and strategies. Through its Evidence Review program, ISCRR provides insights from research in this area.

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Analysing Service Trajectory of Claims to investigate compensation outcomes of claims with elective surgeries 2015 Research Report

The aim of this study was to investigate the effectiveness of elected surgeries on the outcomes of WorkSafe claims in terms of return to work, physical and mental health and management of pain. Evidence from this project shows the impact of elective surgeries on the claim journey is mixed; some surgeries are followed by significant improvement in the client’s health, while some others have limited or no impact across different compensation health service use categories.

Authors: Hassani-Mahmooei, B; Barker, B

Keywords: persistent pain; pain relief; mental health; claim outcomes; best practice ; return to work; RTW

Date published: June 2015

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Best evidence for measuring spinal surgical outcomes: A snapshot evidence review Evidence Review

This evidence review analysed best-practice methods for measuring patient outcomes post-spinal surgery. The review considered both clinical outcomes and patient-reported outcomes. Secondly, the Health and Disability Strategy Group (HDSG) is interested in having surgeons use the electronic Persistent Pain Outcome Collaboration (ePPOC), so that surgical outcomes can be benchmarked nationally. This review assessed the most effective tools for measuring surgical outcomes and patient-reported pain.

Authors: O'Hare, M

Keywords: persistent pain; best practice ; rehabilitation

Date published: May 2015

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Clinical effectiveness of Platelet Rich Plasma injections for Epicondylalgia Evidence Review

Epicondylalgia, or epicondylitis, is commonly known as tennis elbow or golfers’ elbow, and results in significant loss of work days and reduced work capacity. Recently, platelet rich plasma (PRP) has been the focus of treatment in the field of musculoskeletal medicine, however, a 2014 evidence review conducted by ISCRR concluded there was insufficient evidence to validate the use of PRP in clinical practice in patients with epicondylitis. This evidence review was commissioned by WorkSafe to provide an updated review of the clinical effectiveness of PRP injections on epicondylagia. The report aimed to evaluate the effectiveness of PRP on epicondylalgia, and identify potential risk or harms from the PRP injections when used in epicondylagia. Overall, there is insufficient evidence to confirm the effectiveness of PRP injections for epicondylalgia compared with placebo. More research is needed to demonstrate the effectiveness of PRP injections.

Authors: Arora, R; Bywood, P; McMillan, J

Keywords: persistent pain; pain relief

Date published: May 2019

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Autologous platelet rich plasma or whole blood injections for epicondylitis Evidence Review

Epicondylitis or epicondylalgia is commonly known as tennis or golfers elbow. It is a painful condition. The pain can extend from one or both sides of the elbow and into the forearm and wrist. The condition is often easily fixed. When it does not get better, there are not many proven treatments. One treatment that has been suggested is platelet-rich plasma (PRP) injections and autologous whole blood (AWB) injections. This review of the evidence sought to determine whether PRP or AWB is an effective treatment compared to placebo in patients with epicondylitis.

Authors: Clavisi, O; Pattuwage, L; Chee, M

Keywords: persistent pain; pain relief

Date published: August 2014

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Body weight supported treadmill training for spinal cord injury: Evidence service Evidence Review

Body Weight Supported Treadmills are used to train patients to walk by harnessing them above the machine and using different methods to move their legs (electronic or manual). They are often used with spinal cord injury patients, a major client group of the TAC. This project analysed the most comprehensive, up-to-date, high quality systematic reviews and identified four randomised controlled trials investigating the effectiveness of body weight supported treadmill training in improving walking function for people with spinal cord injury. There was insufficient evidence available to determine if bodyweight supported treadmills are better, worse, or the same as other types of walking training.

Authors: Ait Ouakrim, D; Donoghue, E

Keywords: spinal cord injury; rehabilitation

Date published: May 2011

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Summary of the implant data record provided by the Victorian orthopaedic trauma outcomes registry participating hospitals Research Report

The Victorian Orthopaedic Trauma Outcomes Registry (VOTOR) began in 2003 as a pilot collaborative project between The Alfred Hospital, the Royal Melbourne Hospital (RMH), and the Department of Epidemiology and Preventive Medicine (DEPM) at Monash University. The registry is a comprehensive database of orthopaedic injuries, treatment, complications and outcomes based on admissions to the participating hospitals. The aim of this report is to provide a summary of the current implant data collected by VOTOR and determine the utility of the data for potential research uses. The implant data collected routinely as part of VOTOR provides a unique and useful means of identifying the type and frequency of implants used across participating VOTOR sites. There is the potential to improve the utility and validity of the data to allow meaningful comparisons of implant types across hospital sites, procedure types, injury sites and the multi- and isolated injured patient. The recommendations outlined will be addressed by the VOTOR team in the short to medium term. This work will enable long term outcomes from orthopaedic implants to be compared and tracked over time.

Authors: Gosling,C; Gabbe, B; Hannaford, A; Hart, M; Cameron, P

Keywords: orthopedic trauma; health care; best practice ; evidence base

Date published: October 2010

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Non-established, new or experimental treatments (NENET): Evidence summary Evidence Review

When evidence is lacking or inadequate, decision makers need to weigh up the potential risk of providing coverage for ineffective or harmful treatments (Type I error) against denying coverage for treatments that are beneficial and efficient (Type II error). Factors such as Australia’s history with thalidomide, and potential ‘cost blowouts’ associated with new technologies could make decision-makers more likely to lean towards ‘no’ decisions that avoid Type I error, which has the potential to create a system with an unacceptable level of denying access to medical procedures that are beneficial and efficient (Type II errors). As an alternative to strict ‘yes’ or ‘no’ decision-making, where evidence may be inadequate, the TAC has developed a policy for Non-Established, New or Experimental Treatments (NENET). Currently there seems to be debate and uncertainty around the best way to make decisions around the use or reimbursement of treatments for which there is little or no evidence. Other organisations have policies for making decisions about funding for clinical interventions with a limited or non-existent evidence base. This evidence summary reviews current policies and decision-making processes/outcomes.

Authors: Donoghue, E

Keywords: decision-making; evidence base; problem-solving

Date published: April 2010

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N_of_1 trial model investigation Evidence Review

This ISCRR report examines the utility and methodology of N-of-1 trials to determine whether a treatment with insufficient evidence of effectiveness may be of benefit to an individual in specific circumstances.

Authors: Bywood, P; McMillan, M

Keywords: Evidence review; Treatment; Evidence-based

Date published: February 2022

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