Testing Treatments
When patients seek treatment, they want an intervention that helps them get better (effective), has minimal or manageable side effects (safe), and justifies the money they spend (cost-effective). Providing effective, safe and cost-effective treatments is important to clinicians, health funders and patients. In the Intervention Testing theme, we rigorously evaluate whether treatments are effective, safe and cost-effective to continuously improve the care that patients receive.
Our research has improved the management of musculoskeletal conditions. For example, we have found that for people with certain injuries (chronic whiplash or ankle fracture), simple advice from the physiotherapist is just as effective as a structured exercise program. We have also found that some medicines – such as pregabalin – are not effective and may be harmful in back pain conditions, and this has changed the way these medicines are being recommended in practice.
The Testing Treatments theme includes research staff, research students and professional staff from a variety of backgrounds including physiotherapy and pharmacy.
Theme Leader:
Prof Chris Maher
Current research projects & trials
OASIS
This project aims to investigate the effects of oral glucocorticoids in people with acute sciatica. There is currently no simple, effective treatment to relieve the pain in acute sciatica. Acute sciatica is a prevalent, debilitating pain condition. Preliminary evidence suggests that taking oral glucocorticoids may relieve pain and improve function in acute sciatica. The OASIS clinical trial will evaluate whether oral glucocorticoids are effective and safe compared to placebo. The medication will be taken for up to 2 weeks. Participants will be followed up for one year to measure leg pain intensity and other important outcomes. We will also assess drug safety and evaluate cost-effectiveness. This trial is now recruiting. The research team is also looking for General Practitioners who are interested in research to be involved with the recruitment of patients with sciatica into the OASIS study. For more information, please contact: Giovanni Ferreira e: giovanni.ferreira@sydney.edu.au The sponsor of this trial is The University of Sydney. OASIS is funded by the National Health and Medical Research Council. Principal Investigator: Professor Christine Lin (IMH) Chief Investigators: Professor Andrew McLachlan (University of Sydney), Professor Jane Latimer (IMH), Dr Christina Abdel Shaheed (IMH), Qiang Li (The George Institute) Associate Investigators: Dr Bethan Richards (IMH), Professor Rachelle Buchbinder (Monash University), Professor Chris Maher (IMH), Professor Ric Day (University of NSW).
WALKBACK - Effectiveness and cost-effectiveness of a progressive individualised walking and education program for the prevention of a recurrence of low back pain
The intention of the trial is to prevent recurrences of low back pain through determining if a progressive individualised walking and education program is more effective when compared to usual care, in preventing recurrence of low back pain in people recently recovered from an episode of non-specific low back pain. Participants will be randomly allocated to one of two groups. One group will receive a walking and advice intervention delivered by a physiotherapist (3 face to face/video conferencing and 3 over the phone consultations, at no cost) and the other group will receive usual care which does not involve any intervention as part of the trial. This project is currently recruiting. You may be eligible to participate in this study if you live in Australia and have had an episode of low back pain in the last 6 months Principal Investigator: Professor Mark Hancock Institute for Musculoskeletal Health Investigators: Professor Jane Latimer, Professor Chris Lin, Professor Chris Maher, Associate Professor Anne Tiedemann. For more information on this Macquarie University Trial, please visit the WALKBACK website. This NHMRC funded project has received ethics approval from Macquarie University Human Research Ethics Committee. Trial registered on ANZCTR: ACTRN12619001134112
Previous research & resources
OPAL - The first placebo-controlled trial of opioid analgesia for acute spinal pain
This project will provide the first robust evidence on the effectiveness of opioids in the treatment of acute low back pain and neck pain. The trial results will improve care for patients suffering acute spinal pain. Low back pain and neck pain place an enormous burden on patients and health services, both nationally and internationally. Despite the widespread use and recommendations in clinical guidelines, there are no randomised controlled trials that have assessed the effectiveness of opioids for acute low back and neck pain. OPAL is a clinical trial to find out whether opioid analgesics are effective in reducing low back or neck pain, compared to placebo. The opioid analgesic medication– oxycodone – will be taken for up to six weeks. During these six weeks, the participant will be reviewed weekly by a treating physician. This study is currently recruiting. You may be eligible to participate if you have experienced low back pain and/or neck pain of at least moderate severity within the last 12 weeks, and are considered by your treating doctor as appropriate for opioid analgesia. Principal Investigator: Professor Christine Lin Chief Investigators: Professor Chris Maher, Professor Jane Latimer, Associate Professor Laurent Billot, Professor Andrew McLachlan, Professor Ric Day and Professor Bart Koes. The sponsor of this trial is the George Institute. The study has received ethics approval from the University of Sydney Human Research Ethics Committee. For more information, please contact the OPAL team. e: sph.opal@sydney.edu.au Trial registered on ANZCTR: ACTRN12615000775516
TOPS - Trial Of Prevention Strategies for low back pain in patients recently recovered from low back pain
We hope the findings of this project provide strategies to prevent the recurrence of low back pain. The TOPS Trial aims to assess the effectiveness and the cost-effectiveness of exercise and educational classes compared with a back care booklet, for reducing recurrence of low back pain. Participants are randomly allocated to one of two groups: participants allocated to the exercise and education group attend a group-based exercise and education program for 12 weeks, and participants allocated to the booklet group receive a self-management and prevention booklet. You may be eligible to participate in this study if you have recently (within the last three months) recovered from an episode of low back pain. Principal Investigator: Professor Chris Maher Co-Investigators: Associate Professor Mark Hancock, Dr Charles New, Professor Jane Latimer and Dr Giovanni Ferreira. Associate Investigators: Professor Rachelle Buchbinder, Professor Mauritis van Tulder, Professor Christine Lin and Professor Margareth Grotle. The study has received ethics approval from the University of Sydney Human Research Ethics Committee and is funded by WorkCover NSW. For more information, please contact the TOPS team. e: sph.tops@sydney.edu.au Trial registered on ANZCTR: ACTRN12615000939594
The RESOLVE Trial - Retraining the brain to reduce pain intensity of chronic low back pain
The RESOLVE Trial - Retraining the brain to reduce pain intensity of chronic low back pain The intention of the trial is to validate a new treatment approach for chronic low back pain leading to clinically meaningful reduction in pain intensity at six weeks post treatment. The RESOLVE Trial aims to test two interventions targeting the brain to treat chronic low back pain. New research shows that it may be possible to retrain the brain to reduce chronic low back pain. Participants are allocated to one of two intervention groups, both attending 12 one-hour treatment sessions. The first intervention program will include: discussion of your low back pain; laser therapy and pulsed electromagnetic energy for your lower back, non-invasive brain stimulation; mental movement training; physical movement training; and training to improve your sense of touch. The second intervention program will include: low back pain experience, transcranial direct current stimulation, cranial electrical stimulation, low-intensity laser therapy and pulsed electromagnetic energy. This project is currently recruiting. You may be eligible to participate in this study if you have low back pain for longer than three months, between 18 – 70 years old and live in the Sydney metropolitan area. Principal Investigator: Associate Professor James McAuley (NeuRA) Institute for Musculoskeletal Health Investigator: Professor Chris Maher For more information on this NeuRA trial, please contact the RESOLVE team on 02 9399 1627. This NHMRC Project Grant has received ethics approval from University of New South Wales Human Research Ethics Committee. Trial registered on ANZCTR: ACTRN12615000610538