About Dr Gustavo Machado

My aim is to improve healthcare for musculoskeletal conditions. I am interested in clinical research evaluating interventions for low back pain, implementation of models of care into routine clinical practice, and in the use of digital technology in health.

Much of my research projects has focussed on clinical research evaluating healthcare for low back pain. Examples include meta-analysis of pain medicines for back pain and sciatica, large cohort studies identifying risk and prognostic factors for back pain, and data linkage of big datasets for lumbar spinal stenosis. More recently I have become interested in translational research and in the use of digital technology in health. I am currently leading a multi-centre stepped wedge cluster randomised controlled trial implementing a new model of care for low back pain into emergency departments. The trial involves training for emergency clinicians which is sequentially rolled out across participating sites. We hope that this trial will reduce inappropriate tests and treatments for back pain and improve health outcomes of patients when visiting an emergency department. I have also been involved in the development of an innovative and award-winning data analytics application using Qlik Sense that harness routinely collected measures in electronic medical records for back pain. This application currently contains data for more than 7,500 patients visiting the emergency departments of the Sydney Local Health District and is automatically updated every week. It provides a unique opportunity for front-line clinicians to interact with real-time data, identify and interrogate unwarranted clinical variation, evaluate healthcare practices and optimise patient outcomes. For researchers, it facilitates efforts to drive practice change, and conduct low cost, high-quality, real world patient- centred research in this area.

Dr Machado is an NHMRC Early Career Fellow at the Institute for Musculoskeletal Health, a research partnership between Sydney Local Health District and The University of Sydney. He is based at the King George V Building, Royal Prince Alfred Hospital. The work Dr Machado led has been published in top ranking general medical (eg BMJ) and specialist journals (eg Annals of the Rheumatic Diseases). He has a strong track record in the design and conduct of meta-analyses (eg Cochrane reviews) investigating healthcare interventions for back pain. His papers have been published with invited editorials and summarised in leading medical journals, including the NEJM Journal Watch and the ACP Journal Club. Dr Machado's work has been cited in over 10 clinical guidelines and was featured in major media (eg The New York Times, The Times UK). As a recognition of his teaching excellence, Dr Machado was awarded the Dean's Citation for Learning & Teaching from the Faculty of Health Sciences, The University of Sydney.Dr Machado is an associate member of the Australia & New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network and an invited member of the low back pain guideline development committee within the European Pain Federation (EFIC).

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Selected publications

• Machado G.C., Richards B., Needs C., Buchbinder R., Harris I., Howard K., McCaffery K., Billot L., Edwards J., Rogan E., Maher C., et al (2018). Implementation of an evidence-based model of care for low back pain in emergency departments: protocol for the Sydney Health Partners Emergency Department (SHaPED) trial. BMJ Open, 8(4), 1-7.
• Machado G.C., Rogan E., Maher C. (2018). Managing non-serious low back pain in the emergency department: Time for a change? EMA - Emergency Medicine Australasia, 30(2), 279-282.• Pinheiro M.B., Machado G.C. (2018). Lower back pain app: An exercise programme for the management of low back pain. British Journal of Sports Medicine, 52(8), 536-537.
• Machado G.C., Maher C., Ferreira P., Latimer J., Koes B., Steffens D., Ferreira M. (2017). Can recurrence after an acute episode of low back pain be predicted? Physical Therapy, 97(9), 889-895.
• Machado G.C., Maher C., Ferreira P., Day R., Pinheiro M.B., Ferreira M. (2017). Non-steroidal anti-inflammatory drugs for spinal pain: A systematic review and meta-analysis. Annals of the Rheumatic Diseases, 76(7), 1269-1278.
• Machado G.C., Maher C., Ferreira P., Harris I., Deyo R., McKay D., Li Q., Ferreira M. (2017). Trends, complications, and costs for hospital admission and surgery for lumbar spinal stenosis. Spine, 42(22), 1737-1743.
• Machado G.C., Pinheiro M.B., Lee H., Ahmed O., Hendrick P., Williams C., Kamper S. (2016). Smartphone apps for the self-management of low back pain: A systematic review. Best Practice and Research: Clinical Rheumatology, 30(6), 1098-1109.
• Machado G.C., Ferreira P., Yoo R., Harris I., Pinheiro M.B., Koes B., van Tulder M., Rzewuska M., Maher C., Ferreira M. (2016). Surgical options for lumbar spinal stenosis. Cochrane Database of Systematic Reviews, 2016 (11), 1-88.
• Machado G.C., Ferreira P., Maher C., Latimer J., Steffens D., Koes B., Li Q., Ferreira M. (2016). Transient physical and psychosocial activities increase the risk of nonpersistent and persistent low back pain: a case-crossover study with 12 months follow-up. Spine Journal, 16(12), 1445-1452.

• Machado G.C., Maher C., Ferreira P., Pinheiro M.B., Lin, C., Day R., McLachlan A., Ferreira M. (2015). Efficacy and safety of paracetamol for spinal pain and osteoarthritis: systematic review and meta-analysis of randomised placebo controlled trials. BMJ, 350, 1-13.