Research Supervisor Connect
A PhD opportunity exists for a student interested in implementation and evaluation of e-resources for people with musculoskeletal (MSK) disorders and their primary healthcare professionals. Our team have developed three key resources, rigorously following research translation frameworks. The resources (mywhiplash.com.au, mypainhub.com.au, clinical outcome measures) are unique in that they address key gaps in health service delivery for MSK disorders. First, they contain prognostic risk assessment tools that stratify people into low risk (likely to recover) or high risk (less likely to recover) and customise resources accordingly. Resources for patients are structured around key messages for implementation (exercise and advice). Resources for primary healthcare professionals are structured around assessment, prognosis and management of people targeted to their risk profile. The resources have been developed and are in various stages of implementation.
MyWhiplashNavigator has been developed, implemented and evaluated and is now in the monitoring phase. MyPainHub has been developed and now requires implementation and evaluation. The aim of both resources is to assist recovery of MSK disorders by providing consistent, targeted information to both patients and their treating primary healthcare professionals. This PhD opportunity therefore, is for the interested student to evaluate implementation and monitoring of these resources. The PhD student will work with a multidisciplinary, national and motivated team in implementing these resources. The researchers involved in these programs of research include Trudy Rebbeck, Kerrie Evans, Milena Simic, Marnee McKay, Paulo Ferreira, Darren Beales, Michele Sterling, Kim Bennell, Ian Cameron, Michael Nicholas, Carrie Ritchie, Gwendolen Jull, Julia Treleaven, Lyndal Trevena, Kathryn Refshauge, Luke Connelly, Nadine Foster, Deborah Black, Paul Hodges, Manuela Ferreira, Timothy Shaw. The projects have funding (MyPainHub, $25k; MyWhiplashNavigator, $75k).
Dr Trudy Rebbeck, Dr Kerrie Evans, Dr Marnee McKay, Dr Milena Simic.
BACKGROUND: Musculoskeletal (MSK) disorders including LBP, neck pain or whiplash, and OA of the knee are ranked as the highest contributors to years lost to disease, above mental, respiratory and cardiovascular diseases. [1] Despite the disease burden, guideline-based care is poorly implemented amongst these groups. [2-5] Whilst many resources exist, low credibility standards, inaccurate information, lack of cultural diversity,[6] and the sheer volume of resources all contribute to poor implementation. [7]
MYWHIPLASH NAVIGATOR as a SOLUTION: To initially address this gap in people with whiplash, our team developed, implemented and evaluated an online resource, MyWhiplashNavigator (www.mywhiplash.com.au>). The website contains resources for patients that include online assessment of prognostic risk. Resources are then customised to risk but structured around advice, exercises and care pathways. Resources for primary HCPs are structured around assessment, prognosis and management again with different pathways suggested based on prognostic risk. MyWhiplashNavigator was received well by patients, allied health students, primary HCPs and the insurance industry. Three government regulators (SIRA, MAIC, SA-CTP) now use the resource and are keen for broader uptake of the resource, hence have funded future implementation and monitoring.
MYPAINHUB as a SOLUTION: Following from MyWhiplashNavigator, it became apparent that similar messages for implementation were required to address the gap for MSK conditions more broadly. To address this gap, our team then developed a convenient one-stop location where patients with, and clinicians managing, MSK conditions can access relevant, up to date and high-quality evidence-informed information. We followed a translation framework,[8] (Figure 1) to develop this website (mypainhub.com) which functions as an online hub. During the first stage of development, we consulted key stakeholders (including primary health care professionals, consumer organisations, industry and patients with MSK conditions) to identify key messages and resources. Subsequent iterative workshops resulted in the resource containing information for patients structured under risk-based recovery pathways, condition-specific health information, exercise and imaging. Content for clinicians includes links to over 200 evidence-based resources organised under assessment, management, and prognosis for each condition. Videos of key opinion leaders in MSK health are embedded to assist implementation. Mypainhub aims to assist implementation of efficient clinical pathways by providing information targeted to prognostic risk.
OPPORTUNITY: The next phase in our research translation programme is implementation and monitoring of these resources amongst key target markets.
IMPLEMENTATION OF MY PAIN HUB: Our team is implementing mypainhub to support a randomised controlled trial in primary care at the moment (PACE MSK TRIAL - funded $1.5m). We aim to further evaluate implementation of this resource in several settings:
MONITORING OF MYWHIPLASH NAVIGATOR:
MyWhiplashNavigator is now available as a public resource. As part of the final part of research translation, we aim to continue to monitor how this is used by people with whiplash, allied health students and primary health care professionals. The monitoring phase of MyWhiplashNavigator is funded ($73k over 3 years 2022-2024).
A/Prof Trudy Rebbeck | PhD, FACP, MHealthSc(ManipPhty), BAppSc(Phty)
Trudy Rebbeck is an A/Prof at The University of Sydney and a Specialist Musculoskeletal Physiotherapist. At the University of Sydney, she leads a national program of research in implementation of clinical pathways for MSK pain conditions. This includes risk stratification and implementation of clinical pathways matched to risk. She led the development and implementation of Mywhiplash.com.au and the PACE-MSK trial which underpin this work. She has >60 publications, 2200 citations and h-index of 20. In specialist clinical practice, she specialises in assessment and management of complex upper cervical spine and head conditions including whiplash, neck pain, headache, concussion and dizziness. Trudy also runs national and international education courses on the above (for Physiotherapy and multi-disciplinary organisations).
Dr. Kerrie Evans | PhD, FACP, MHealthSc(ManipPhty), BAppSc(Phty), GAICD
Kerrie Evans is a Senior Research Fellow and a Specialist Musculoskeletal Physiotherapist. She is currently managing a large national NHMRC-funded project grant (PACE MSK, APP1141377 $1.5m 2018-2022), part of which involved the development of mypainhub. She co-supervises 5 research assistants, 4 PhD students and 1 Honours student. Prior to her post-doctoral appointment, she was a Senior Lecturer at Griffith University for 18 years and was program director of the Masters in Musculoskeletal and Sports Physiotherapy program. She has 36 publications in peer-reviewed journals and has presented at numerous international and national conferences. Dr. Evans is also the Group Education and Research Officer for a large national allied health organisation and maintains a clinical caseload, consulting to national sporting teams and providing second opinions on patients with complex MSK presentations.
Dr. Marnee McKay | PhD, MHlthSc(Sports Physio), BAppSc(Phty).
Marnee McKay is an early career researcher and Sports Physiotherapist with over 25 years of clinical experience. She is a Senior Lecturer, Musculoskeletal Physiotherapy team leader and Co-Chair of the Faculty of Medicine and Health Early and Mid-Career Research network at The University of Sydney. Her research focuses on developing and validating outcome measures with enhanced precision and responsiveness to be used in clinical trials to facilitate the development of targeted personalised therapies. During her doctoral studies she generated the generated the largest normative reference database of measures of physical and self-reported health, known as the 1000 Norms Project. Dr McKay has developed the Clinical Outcome Measures website to freely disseminate outcome measure assessment calculators for neuromusculoskeletal disorders. The 1000 Norms Project and Dr McKay now leads the 1000 Norms Project Consortium, a global group of interdisciplinary academics, researchers, clinicians and higher degree research students governing the implementation of the 1000 Norms Project reference values.
A/Prof Milena Simic| PhD, BPhysio(Hons)
Milena Simic is the Director of the Sydney Biomechanics Laboratory at The University of Sydney and Associate Professor in Physiotherapy. She leads a team of researchers, students, and early career academics in knee osteoarthritis research, with a particular focus on exercise therapy, e-health, and development of novel interventions for offloading diseased joints. She has strong international collaborations and leads knee OA studies of various designs including systematic reviews, experimental biomechanical studies (including reliability and validity of clinical gait measures), as well as clinical trials studies involving gait retraining, telehealth, and implementation research. She has attracted >$4.2M of competitive research funding and publishes in top-ranking peer-reviewed journals. A/Prof Simic has a strong track record of successful PhD supervision with her students regularly winning awards.
The opportunity ID for this research opportunity is 3004