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Sonya Osborne

Publications and source records attributed to Sonya Osborne.

10 recordsLinked to original sources
PubMed2025

Cost-Effectiveness Analysis of 3D Total-Body Photography for People at High Risk of Melanoma.

IMPORTANCE: Greater use of novel digital technologies could be associated with improved health outcomes and save health care costs by detecting smaller melanomas earlier (needing less treatment) or benign tumors (needing no treatment). OBJECTIVE: To compare costs and health effects of 3-dimensional (3D) total-body photography (TBP) and sequential digital dermoscopy imaging (SDDI) vs usual care for early detection of melanoma. DESIGN, SETTING, AND PARTICIPANTS: This prespecified cost-effectiveness analysis using randomized clinical trial (n = 309) data with 2 years of follow-up was conducted at a research hospital in Brisbane, Australia, and took a health system perspective. It included adults 18 years or older at high risk of developing a primary or subsequent melanoma. INTERVENTION: The intervention group received usual care plus clinical skin examinations by junior clinicians at baseline and 6, 12, 18, and 24 months with 3D TBP-SDDI reviewed by a teledermatologist. The control group continued to receive usual care and completed online surveys every 6 months. MAIN OUTCOMES AND MEASURES: Government health care costs, patient out-of-pocket costs, numbers of benign and malignant skin tumor excisions, and quality-adjusted life-years. Skin biopsy, excisions, pathology, and their costs were collected using administrative claims data. Quality of life was collected using the EuroQol-5D-5L. RESULTS: The trial included 314 participants (mean [SD] age, 51.6 [12.8] years; 194 female individuals [62%]) who completed all of the study procedures (158 in the intervention and 156 in the control groups). Compared with controls, intervention group participants had fewer melanoma excisions, more keratinocyte carcinomas and benign excisions, and more biopsy specimens. Over 24 months, mean per-person costs (analyzed in Australian dollars and converted to US$) for the intervention group were $1708 (95% CI, $1455-$1961) vs $763 (95% CI, $655-$870) for controls, an incremental cost of $945 (95% CI, $738-$1157) to provide the intervention. Total quality-adjusted life-years per person were similar for the intervention (1.84; 95% CI, 1.82-1.86) and control groups (1.84; 95% CI, 1.83-1.86). The incremental cost per additional malignant skin tumor excised was $40 (95% CI, $34-$48). CONCLUSIONS AND RELEVANCE: Over 2 years of the trial, the 3D TBP-SDDI model by junior clinicians and teledermatologist review generated higher costs and detected similar numbers of malignant tumors than usual care in a high-risk melanoma cohort. Cost-effectiveness is a necessary but not sufficient consideration for implementation. Other benefits of 3D TBP-SDDI may arise once artificial intelligence clinician support systems are integrated, and more research is needed to understand factors associated with costs and whether there are other benefits of 3D TBP-SDDI.

Adult↗
PubMed2006

Developing a Research base for Intravenous Peripheral cannula re-sites (DRIP trial). A randomised controlled trial of hospital in-patients.

BACKGROUND: There is currently no high grade evidence on which to base decisions about the frequency of intravenous cannula re-sites. OBJECTIVE: To assess the safety of changing peripheral venous cannulas when clinically indicated. DESIGN: Randomised controlled trial. SETTING: A tertiary referral hospital in Brisbane, Australia. PARTICIPANTS: Two hundred and six hospitalised patients from surgical, medical and orthopaedic wards. INTERVENTIONS: Peripheral intravenous cannulas were re-sited only when complications occurred (intervention group) or every 3 days (control group). MAIN OUTCOME MEASURES: The primary endpoint was any unplanned cannula removal, the secondary outcome was cost. RESULTS: Forty six patients had unplanned removals in the intervention group compared with 41 in the control group [relative risk 1.12, 95% confidence interval 0.81-1.55 (p=0.286)], a non-significant difference. Total duration of peripheral cannulation was similar in both groups (mean 123.3h in the intervention group and 125.9h in the control group: P=0.82) but significantly more re-sites occurred in the control group (167 in intervention group, 202 in the control group: p=0.022). Cost of cannula replacements in the intervention group was AUD$3,183.62 and in the control group AUD$3,837.56 (p=0.006). CONCLUSION: Re-siting peripheral venous cannulas when clinically indicated compared with changing them routinely every 3 days does not lead to more complications and reduces costs.

Catheterization, Peripheral↗
PubMed2006

Using a monitored test to assess risk of aspiration in postoperative patients.

Pulmonary aspiration is associated with high morbidity and mortality rates. Older adult patients have been shown to be particularly at risk for aspiration. A randomized controlled trial was conducted to investigate the efficacy of a simple, noninvasive screening test-the monitored sip test-in identifying patients at risk for aspiration, including "silent aspirators." Based on clinical judgment using the study's outcome measures, incidence of aspiration-related lung injury was high (ie, 37.5%); however, no identification of patients at risk for aspiration occurred after either the use of the monitored sip test or routine cautious introduction of fluids during the data collection phase of the study.

Aged↗
PubMed2003

Perceptions that influence occupational exposure reporting.

Statistics on health care workers' occupational exposures to bloodborne pathogens underestimate the true extent of the problem because of a tendency for underreporting. A descriptive correlational design was used to investigate compliance with standard precautions and occupational exposure reporting practices among perioperative nurses in Australia. The study found that although intention to report both percutaneous and mucocutaneous exposures was relatively high, mean compliance rates for actually reporting exposures incurred were considerably lower. The perception of barriers to reporting significantly influenced compliance.

Attitude of Health Personnel↗
PubMed2003

Reconceptualising the objectives of a pilot study for clinical research.

This is a methodological study in which a case report is used to retrospectively analyse the link between a successful pilot study and stalled main study to identify potential methodological weaknesses in the planning process. The analysis identified unanticipated influences related to hospital processes and discipline boundaries that adversely influenced participant recruitment and retention for a clinical trial. The findings of the study demonstrate that, whilst the pilot is an important step in research planning to confirm the design and operational processes for a study, a thorough analysis of the relevant health service environment is an important additional objective for the pilot study.

Biomedical Research↗
PubMed2003

Influences on compliance with standard precautions among operating room nurses.

BACKGROUND: Occupational exposures of health care workers occur because of inconsistent compliance with standard precautions. The purpose of this study was to develop national estimates of compliance with standard precautions and occupational exposure reporting among operating room nurses (specifically, scrub nurses) in Australia and to assess variables that influence compliance. METHODS: A descriptive correlation design was used to investigate relationships between variables and compliance, using a theoretical framework, the Health Belief Model, to give meaning to the variables. Data collection was done through mail-out surveys to members of the Australian College of Operating Room Nurses. RESULTS: This article reports the results of compliance with the following 2 specific self-protective behaviors: double-gloving and wearing adequate eye protection. Mean compliance rates were 55.6% with always double-gloving during surgical procedures and 92% with always wearing adequate eye protection. In addition, the variable that had the most influence on compliance was the perception of barriers to compliance, specifically, that adhering to standard precautions interfered with duties. CONCLUSION: These results have implications for the development of multifaceted perioperative infection control programs, including strategies for prevention, education, and policy development, to improve practices aimed at reducing occupational exposures among this high-risk group.

Adult↗
PubMedDate not supplied

Does evening removal of urinary catheters shorten hospital stay among general hospital patients? A randomized controlled trial.

OBJECTIVE: Literature indicates that removing urinary catheters at midnight facilitates earlier discharge among urology patients, but the effect of evening removal on the general patient population is unknown. The objective of this study was to investigate whether removing a urinary catheter at 22.00 hours compared to 06.00 hours among a general hospital population would lead to earlier hospital discharge. DESIGN: Randomized controlled trial. SETTING AND SUBJECTS: The study was conducted in a large tertiary hospital in Brisbane, Australia. Two hundred and ten general surgical and medical patients who had an indwelling catheter as part of their routine care were included. RESULTS: Length of hospital stay after catheter removal was not significantly affected by the timing of its removal among general hospital patients: mean hours morning 186.1; mean evening 209.3, (P = .309). In a cohort of surgical patients, the hospital stay was shorter in the evening removal group (mean hours morning 186.1; mean evening 209.3), but this result was not statistically significant (P = .127). Patients in the evening group were more likely to have a longer time period between catheter removal and the first postcatheter void, mean hours morning, 3.76 vs evening, 4.89 (t = -2.59, CI - 1.99 to -0.27). Timing of removal of the urinary catheter had no effect on the volume of the first void, mean volume morning, 214.7 mL vs evening, 221.4 mL. Twenty-five (12.1%) patients were recatheterized, but the rate of recatheterization between groups was similar. There were no differences in postdischarge problems between groups. CONCLUSION: Among general hospital patients, removing an indwelling urinary catheter at 22:00 hours does not shorten the length of stay and is effective in increasing the time to first void.

Australia↗