Medical Journal of Australia最新文献

{"title":"Equity first: mapping who gets what is essential to re-designing the NDIS","authors":"Jennifer Smith-Merry, Kyo-yi J Chang","doi":"10.5694/mja2.52587","DOIUrl":"https://doi.org/10.5694/mja2.52587","url":null,"abstract":"<p>Recent media commentary on the operation of the National Disability Insurance Scheme (NDIS) has focused on costs, fraud, and preventing dubious provider practices. This discussion obscures the broader importance of the NDIS for overcoming the entrenched disadvantages that prevent people with disability fully participating in Australian society.<span><sup>1</sup></span> However, disability support in Australia, provided by the NDIS or otherwise, is not equitable. Access to and the use of disability support varies widely for a variety of reasons, and people who need considerable support but are ineligible for the NDIS are left with a sparse array of uncoordinated support.<span><sup>2, 3</sup></span> We hear about inequity time and time again from service providers and people with disability, but quantifying inequity is often difficult.<span><sup>4</sup></span></p><p>The article by Disney and colleagues<span><sup>5</sup></span> in this issue of the <i>MJA</i> provides much needed insights into the operation of the NDIS for different groups. The authors quantified socio-demographic differences in NDIS eligibility and resource allocation by analysing NDIS unit record data. These data are essential for understanding who is granted support by the NDIS, how much of the allocated support they use, and whether these outcomes differ by socio-demographic characteristics. Disney and his colleagues found that, in certain disability categories, applicants aged 55 years or older, women and girls, and people living in socio-economically disadvantaged areas were more likely to be found ineligible for the NDIS, as were people with psychosocial disability. The authors noted possible structural reasons, including the use of diagnosis-based eligibility lists that include, for example, autism, for which the eligibility rate is high, but not psychosocial disability-related diagnoses. People with conditions not included in these lists may have to provide more evidence to prove they are eligible for support.<span><sup>5</sup></span></p><p>People with psychosocial disability or living in lower socio-economic status areas can find it more difficult to gather the evidence required because they cannot afford the private care providers who could provide the required information in formats more acceptable to the National Disability Insurance Agency (NDIA).<span><sup>6</sup></span> We need qualitative research into decision making by the NDIA and how it assesses evidence, and to learn from NDIS participants about barriers to gathering the required information. Rural and remote regions are often also lower socio-economic status areas, and access in this areas to specialist assessments that would help people provide evidence of disability in an appropriate manner is more limited.<span><sup>7</sup></span> Inequality of access is therefore linked to social inequities.<span><sup>8</sup></span> NDIS eligibility criteria that disadvantage people who cannot afford the right type of e","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"222 3","pages":"131-132"},"PeriodicalIF":6.7,"publicationDate":"2025-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52587","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143423602","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is it time to retire the label “CALD” in public health research and practice?","authors":"Ikram Abdi, Adeline Tinessia, Abela Mahimbo, Meru Sheel, Julie Leask","doi":"10.5694/mja2.52608","DOIUrl":"10.5694/mja2.52608","url":null,"abstract":"<p>In Australian public health research and practice, the label “culturally and linguistically diverse” (CALD) is used to encompass a diversity of birth countries, languages and cultures. This term is routinely used in public health to address diversity, to guide equitable access to health resources, and inform inclusive policies and programs. It influences how health research and services are designed and implemented. However, the label has inherent limitations, and its broad application simplifies and masks disparities within these diverse communities. As researchers, like many others, we have also used the label “CALD” as a form of acknowledgement of diversity in Australia. This perspective article challenges the use of the label, recognising its use in current research and practice, while also exploring the need for a more nuanced approach.</p><p>Before 1996, “non-English speaking background” (NESB) was used as a measure of needs and disadvantages tied to cultural factors.<span><sup>1</sup></span> In 1996, a meeting of the Council of Ministers of Immigration and Multicultural Affairs agreed to drop NESB from official communications due to its inability to capture the nuances and diverse experiences in these communities, including the inability to differentiate between disadvantaged and non-disadvantaged groups.<span><sup>1</sup></span> In 1999, the Australian Bureau of Statistics (ABS) developed the standards on “cultural and language diversity” to identify multicultural populations. The ABS uses a minimum set of primary indicators to describe CALD populations, which include country of birth, main language spoken at home, proficiency in spoken English, and Indigenous status. This is the minimum set and some variables can be omitted if not relevant; for example, Indigenous status can be omitted when focusing on migrant communities.<span><sup>1</sup></span> These primary indicators aim to provide a standardised and systematic approach to demographic analysis, allowing for a better understanding of Australia's multicultural population. However, despite this standardisation, the label “CALD” also faces the same criticisms as NESB regarding its effectiveness and relevance in accurately representing diverse cultural and linguistic communities.</p><p>Studies apply and interpret CALD indicators variably, hindering the comparability of research findings. A systematic review exploring the definitions of “CALD” used in epidemiological research found variations in how it was defined.<span><sup>2</sup></span> Included studies defined “CALD” using different ABS indicators, with some using country of birth whereas others used language spoken at home.<span><sup>2</sup></span> This variability can affect policy recommendations, as inconsistent definitions make it challenging to identify which groups require targeted interventions or resources. For instance, researchers have noted that Australian dementia research is not sufficiently inclusive of multicultural","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"222 5","pages":"220-222"},"PeriodicalIF":6.7,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52608","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management challenges and prognostic uncertainties in heat-induced acute liver failure","authors":"Nicholas Smith, Richard Skoien, Melita Andelkovic","doi":"10.5694/mja2.52606","DOIUrl":"10.5694/mja2.52606","url":null,"abstract":"","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"222 5","pages":"226-228"},"PeriodicalIF":6.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responding to reports of nitazene toxicity in Australia","authors":"Brendan Clifford, Amy Peacock, Krista J Siefried, John Gobeil, Jennifer L Smith, Nadine Ezard","doi":"10.5694/mja2.52605","DOIUrl":"10.5694/mja2.52605","url":null,"abstract":"<p>Nitazenes are a class of synthetic 2-benyzl-benzimidazole opioid receptor agonists that can be several hundred times the potency of morphine.<span><sup>1</sup></span> Clonitazene and etonitazene were initially developed in the 1950s as potential analgesics, but were never approved for therapeutic purposes due to their high potency.<span><sup>1</sup></span> Isotonitazene was first notified as a drug of concern to the United Nations Office on Drugs and Crime (UNODC) in 2019. By the beginning of 2024, 13 different nitazene analogues across six global regions had been reported, highlighting the potential for continued proliferation of chemically modified structures into the drug market.<span><sup>2</sup></span> Nitazene-associated harms and deaths have been reported in North America and Europe, with toxicity symptoms being similar to those from other opioids, including respiratory depression and decreased level of consciousness.<span><sup>1</sup></span></p><p>Nitazenes are now an established feature of the Australian illicit drug market,<span><sup>3</sup></span> with 11 nitazenes classified as Schedule 9 (prohibited substance) by the Therapeutic Goods Administration.<span><sup>4</sup></span> The first confirmed nitazene detections in Australia were in 2021, including reports in New South Wales<span><sup>5</sup></span> and Victoria.<span><sup>6</sup></span> Sentinel toxico-surveillance of Australian and Victorian emergency department presentations analytically confirmed the protonitazene, metonitazene, isotonitazene, butonitazene, etodesnitazene and etonitazepyne across 32 cases between July 2020 and February 2024.<span><sup>7</sup></span> Wastewater analysis has not detected nitazenes in Australia, but routine monitoring by this method for new psychoactive substances is limited.<span><sup>8</sup></span> A recent retrospective study of national coronial data identified 17 deaths due to nitazene (etodesnitazene, metonitazene and protonitazene) toxicity, with the first in 2021.<span><sup>9</sup></span> Nitazenes have also been identified in police and customs seizures in multiple jurisdictions, including the Northern Territory and NSW.<span><sup>3</sup></span> Analysis of cryptomarkets has indicated an increase in availability of nitazenes for sale online in Australia between February 2023 and January 2024.<span><sup>10</sup></span></p><p>Government-issued public drug alerts are intended to raise awareness of new risks in the drug market and are issued by health departments in some, but not all, Australian jurisdictions. A list of alerts related to nitazenes is provided in the Box, with the relevant harms reported in the alert, where available. Criteria for the issuing of drug alerts vary between jurisdictions, so the box is indicative of the types of harms that may be caused by nitazenes, rather than a comprehensive list. Public drug alerts related to nitazenes have been issued in the Australian Capital Territory,<span><sup>11</sup></span> NSW,<span","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"222 5","pages":"216-219"},"PeriodicalIF":6.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus recommendations on multiple sclerosis management in Australia and New Zealand: part 1.","authors":"Jessica Shipley, James Beharry, Wei Yeh, Nabil Seery, Yi Chao Foong, Darshini Ayton, Pakeeran Siriratnam, Tracie Tan, Heidi Beadnall, Joshua Barton, Francesca Bridge, Robb Wesselingh, Lisa Taylor, Louise Rath, Jodi Haartsen, Mohammad Gadi, Cassie Nesbitt, Michael Zhong, Victoria Cushing, Fiona McKay, Julia Morahan, Benjamin Peter Trewin, Izanne Roos, Mark Marriott, Ai-Lan Nguyen, Emma Downey, Joanne Crosby, Julian Bosco, Jennifer Taylor, Lauren Giles, Nevin John, Ernest Butler, Anneke van der Walt, Helmut Butzkueven, Stefan Blum, Marion Simpson, Mark Slee, Sudarshini Ramanathan, Todd Hardy, Richard A L Macdonell, Katherine Buzzard, Deborah F Mason, Jeannette Lechner-Scott, Trevor J Kilpatrick, Tomas Kalincik, Bruce V Taylor, Simon A Broadley, Stephen Reddel, Douglas Johnson, Mastura Monif","doi":"10.5694/mja2.52578","DOIUrl":"https://doi.org/10.5694/mja2.52578","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple sclerosis (MS) is a chronic inflammatory demyelinating and degenerative disease of the central nervous system. There were 33 335 people with MS in Australia in 2021 and 2917 in New Zealand in 2006 and the prevalence and incidence are increasing with time. Although new treatments have substantially improved outcomes in recent decades, the treatment landscape has become increasingly complex due to the expanding number of disease-modifying therapies (DMTs) and associated safety considerations.</p><p><strong>Main recommendations: </strong>A total of 80 consensus recommendations were developed on the current best-practice management of MS in Australia and New Zealand. Part 1 of these guidelines outlines the consensus recommendations covering domains including DMT counselling and selection, pre-DMT assessments, monitoring disease activity on DMT, switching DMT, and discontinuing DMT. The remaining recommendations are outlined in Part 2, encompassing risk mitigation strategies during treatment with DMT, managing DMT in special situations (including pregnancy, postpartum, breastfeeding, active infection including COVID-19, and malignancy), general lifestyle measures, acute MS relapses, and symptomatic treatments for MS.</p><p><strong>Changes in management as a result of the guidelines: </strong>This two-part position statement provides a practical resource for clinicians on current best-practice consensus recommendations for managing adults (≥ 18 years old) with MS in the Australian and New Zealand health care settings. It outlines the 14 DMTs currently available through the Australian Pharmaceutical Benefits Scheme and eight through the New Zealand Pharmaceutical Schedule, including the unique efficacy, safety and monitoring considerations of each. Through these guidelines, we aim to support safe, timely and effective management of patients with MS in Australia and New Zealand.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consideration of sex and gender: an analysis of Australian clinical guidelines","authors":"Maggie Kirkman,&nbsp;Tomoko Honda,&nbsp;Steve J McDonald,&nbsp;Sally Green,&nbsp;Karen Walker-Bone,&nbsp;Ingrid Winship,&nbsp;Jane R W Fisher","doi":"10.5694/mja2.52602","DOIUrl":"10.5694/mja2.52602","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess Australian clinical guidelines for their inclusion of sex and gender.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design, setting</h3>\u0000 \u0000 <p>Survey of all clinical guidelines published in Australia from 1 January 2014 to 31 April 2024 that employed methods such as Grading of Recommendations, Assessment, Development, and Evaluations, or were endorsed, approved or acknowledged by the National Health and Medical Research Council or another major national body, or concerned marginalised groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main outcome measures</h3>\u0000 \u0000 <p>Use of the terms “sex”, “gender”, “female”, “male”, “women”, “men”, “girl” and “boy”; definitions of “sex” and “gender”; and incorporation of sex- and gender-relevant guidance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 80 eligible guidelines were from 51 organisations and covered 27 areas of practice. No sex- or gender-related terms were found in 12 of the guidelines. Of the remaining 68 guidelines, most used some of these terms only a few times, with 34 of them using “gender” to mean “sex”. “Sex” and “gender” were defined to some extent in four guidelines. There was no reference to clinical practice concerning sex in 15 of the guidelines. A total of 46 guidelines made no mention of clinical practice concerning gender, only 12 included gender-relevant practice in any detail, and the remaining 22 either implied aspects of gender awareness without stating this or mentioned “psychosocial” or “cultural” considerations. Guidelines drew on heterogeneous research, some of which provided no sex-disaggregated data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Guideline development bodies should be encouraged to assess evidence for its treatment of sex and gender, to enable strategies to counter inequity and discrimination.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"222 4","pages":"205-209"},"PeriodicalIF":6.7,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52602","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consensus recommendations on multiple sclerosis management in Australia and New Zealand: part 2.","authors":"Jessica Shipley, James Beharry, Wei Yeh, Nabil Seery, Yi Chao Foong, Darshini Ayton, Pakeeran Siriratnam, Tracie Tan, Heidi Beadnall, Joshua Barton, Francesca Bridge, Robb Wesselingh, Lisa Taylor, Louise Rath, Jodi Haartsen, Mohammad Gadi, Cassie Nesbitt, Michael Zhong, Victoria Cushing, Fiona McKay, Julia Morahan, Benjamin Peter Trewin, Izanne Roos, Mark Marriott, Ai-Lan Nguyen, Emma Downey, Joanne Crosby, Julian Bosco, Jennifer Taylor, Lauren Giles, Nevin John, Ernest Butler, Anneke van der Walt, Helmut Butzkueven, Stefan Blum, Marion Simpson, Mark Slee, Sudarshini Ramanathan, Todd Hardy, Richard A L Macdonell, Katherine Buzzard, Deborah F Mason, Jeannette Lechner-Scott, Trevor J Kilpatrick, Tomas Kalincik, Bruce V Taylor, Simon A Broadley, Stephen Reddel, Douglas Johnson, Mastura Monif","doi":"10.5694/mja2.52577","DOIUrl":"https://doi.org/10.5694/mja2.52577","url":null,"abstract":"<p><strong>Introduction: </strong>Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative disease of the central nervous system with rapidly evolving treatment options and strategies. An iterative modified Delphi process was used to develop 80 consensus recommendations for the management of MS in Australia and New Zealand. Part 1 of these guidelines includes recommendations related to selection of initial disease-modifying therapy (DMT) for MS, assessments before commencing DMT, monitoring disease activity on DMT, switching DMT, and discontinuing DMT.</p><p><strong>Main recommendations: </strong>This article, Part 2, covers recommendations related to risk mitigation during treatment with DMT, managing DMT in special situations (including pregnancy, postpartum, breastfeeding, active infection including COVID-19, and malignancy), general lifestyle measures for MS, acute MS relapses, and symptomatic treatments.</p><p><strong>Changes in management as a result of the guidelines: </strong>Together with Part 1, this consensus statement provides practical guidance for clinicians involved in the care of adults (≥ 18 years old) with MS in Australia and New Zealand. A safe, effective and comprehensive approach to managing MS is crucial for improving long term outcomes and quality of life in individuals affected by MS.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":" ","pages":""},"PeriodicalIF":6.7,"publicationDate":"2025-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potentially preventable medication-related hospitalisations with cardiovascular disease of Aboriginal and Torres Strait Islander people, Queensland, 2013–2017: a retrospective cohort study","authors":"Jean Spinks,&nbsp;Gabor Mihala,&nbsp;Warren Jennings,&nbsp;Robert S Ware,&nbsp;Lisa M Kalisch Ellett,&nbsp;Elizabeth E Roughead,&nbsp;Daniel Williamson","doi":"10.5694/mja2.52600","DOIUrl":"10.5694/mja2.52600","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To identify the proportion of hospitalisations (inpatient admissions and emergency department presentations) of Aboriginal and Torres Strait Islander people in Queensland that were medication-related and potentially preventable for nine clinical indicators of cardiovascular disease (CVD).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Study design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Retrospective cohort study; analysis of linked hospitalisations and emergency department presentations data and administrative records of medical services, pharmaceuticals, and deaths.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting, participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Aboriginal or Torres Strait Islander adults (18 years or older) admitted to Queensland public and private hospitals, 1 January 2013 – 31 December 2017.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main outcome measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Potentially preventable medication-related hospitalisations (PPMRHs), defined by a set of clinical indicators describing CVD; deaths within 30 days of PPMRHs; hospital costs.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We identified 31 472 CVD-related hospitalisations, of which 11 469 were of people with medical histories suggesting harm that was foreseeable and preventable with appropriate treatment. Of the 7886 hospitalisations with congestive heart failure, 4350 (55%) were of people with prior CVD diagnoses; 681 (16%) were associated with use of medicines known to exacerbate congestive heart failure, and 1488 (34%) were associated with underuse of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or angiotensin receptor–neprilysin inhibitors. Of the 1089 hospitalisations with myocardial infarction of people who had previously experienced myocardial infarction or acute coronary syndrome events, 809 (74%) were not receiving recommended treatment at the time of hospitalisation. Of the 5417 hospitalisations with ischaemic events of people with histories including diabetes and earlier ischaemic events, 3343 (62%) were not receiving antiplatelet or lipid-lowering therapy. The median cost associated with PPMRHs for the time period (2013–2017) was $4352 (interquartile range, $8742), and 136 (3%) of CVD-related deaths within 30 days of hospital discharge followed PPMRH events.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Interventions supporting targeted and timely medication safety services for Aborigin","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"222 4","pages":"198-204"},"PeriodicalIF":6.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52600","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of ChatGPT to obtain health information in Australia, 2024: insights from a nationally representative survey","authors":"Julie Ayre,&nbsp;Erin Cvejic,&nbsp;Kirsten J McCaffery","doi":"10.5694/mja2.52598","DOIUrl":"10.5694/mja2.52598","url":null,"abstract":"&lt;p&gt;Since the launch of ChatGPT in 2022,&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; people have had easy access to a generative artificial intelligence (AI) application that can provide answers to most health-related questions. Although ChatGPT could massively increase access to tailored health information, the risk of inaccurate information is also recognised, particularly with early ChatGPT versions, and its accuracy varies by task and topic.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Generative AI tools could be a further problem for health services and clinicians, adding to the already large volume of medical misinformation.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Discussions of the benefits and risks of the new technology for health equity, patient engagement, and safety need reliable information about who is using ChatGPT, and the types of health information they are seeking.&lt;/p&gt;&lt;p&gt;To examine the use of ChatGPT in Australia for obtaining health information, we surveyed a nationally representative sample of adults (18 years or older) drawn from the June 2024 wave of the Life in Australia panel.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Participants who completed the Life in Australia survey online or by telephone were asked how often they used ChatGPT for health information purposes during the preceding six months, the type of questions they asked, and their trust in the responses. Participants who were aware of ChatGPT but had not used it for health information purposes were asked about their intentions to do so in the following six months. Health literacy was assessed using a validated single-item screener: “If you need to go to the doctor, clinic or hospital, how confident are you filling out medical forms by yourself?“&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; Demographic information was derived from previously collected panel data. Residential postcode-based socio-economic standing was classified according to the Index of Relative Socio-economic Advantage and Disadvantage (IRSAD; by quintile).&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; Participant responses were weighted to the Australian population using propensity scores. Associations between respondent characteristics and survey responses were assessed using simple logistic regression; we report odds ratios (ORs) with 95% confidence intervals (CIs). Analyses were conducted in SPSS 26. Unless otherwise stated, we report unweighted results (further study details: Supporting Information, part 1). Our study was approved by the University of Sydney Human Research Ethics Committee (2024/HE000247).&lt;/p&gt;&lt;p&gt;Of 2951 invited panellists, 2034 completed the three ChatGPT and the health literacy survey items (68.9%). The demographic characteristics of the sample were similar to those of the Australian population (data not shown). The weighted proportion of participants who had heard of ChatGPT was 84.7% (95% CI, 83.0–86.3%). The weighted proportion of participants who had used ChatGPT to obtain health-related information during the preceding six months was 9.9% (95% CI, 8.5–11.4%). The proportion of ","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"222 4","pages":"210-212"},"PeriodicalIF":6.7,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52598","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aboriginal and Torres Strait Islander community experiences and recommendations for health and medical research: a mixed methods study","authors":"Felicity Collis,&nbsp;Kade Booth,&nbsp;Jamie Bryant,&nbsp;Tanika Ridgeway,&nbsp;Catherine Chamberlain,&nbsp;Jaquelyne Hughes,&nbsp;Kalinda E Griffiths,&nbsp;Mark Wenitong,&nbsp;Peter O'Mara,&nbsp;Alex Brown,&nbsp;Sandra J Eades,&nbsp;Kelvin M Kong,&nbsp;Michelle Kennedy","doi":"10.5694/mja2.52571","DOIUrl":"10.5694/mja2.52571","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To describe Aboriginal and Torres Strait Islander communities’ processes, positioning and experiences of health and medical research and their recommendations.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A cross-sectional online and paper-based survey.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting, participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Representatives from Aboriginal and Torres Strait Islander health services and community-controlled organisations in Australia.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main outcome measures&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Responses to a 33-item mixed methods survey that explored communities’ positioning and processes relating to health and medical research and their experiences of health and medical research in the previous 5 years. Recommendations for improving health and medical research were elicited via two open-ended questions.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Fifty-one community representatives nationally responded to the survey. Most representatives reported feeling slightly or very positive about research (37, 73%). More than half (33, 65%) reported having formal governance processes, and two-thirds of those without governance processes were interested in establishing such processes (12, 67%). Almost half reported that research has sometimes or never had benefit (25, 49%). Ethical principles that were most often reported as essential included those relating to sharing results back with community (45, 88%), translating research into policy and practice (37, 73%), employing Aboriginal and Torres Strait Islander staff (37, 73%), Indigenous data sovereignty and governance (36, 71%) and research agreements (35, 69%). Community representatives reported being approached frequently and in the later stages of research, with little input during the development and design stages of research. Most representatives reported that their communities had participated in Indigenous-led research (39, 76%). Community representatives highlighted the need for appropriate resourcing and funding to drive and lead their own research agendas.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Aboriginal and Torres Strait Islander communities continue to have negative experiences of research despite four decades of advocating for control, ownership and leadership of health and medical research. Researchers, funding bodies and institutions must ","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"222 S2","pages":"S6-S15"},"PeriodicalIF":6.7,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52571","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}