MJA
MJA

    Access to abortion services in Australia: we must do better

    Andrew F Pesce and Gayathri Jayasinghe
    Med J Aust 2022; 216 (9): . || doi: 10.5694/mja2.51509
    Published online: 16 May 2022

    Clinicians should be mindful of the importance of post‐abortion contraception counselling for preventing further unintended pregnancies

    Unintended pregnancy has significant adverse effects on both mother and child,1,2 as well as social and financial costs.3 As South Australia is the only Australian state to collect abortion data, we rely on secondary sources for national information. For example, the most recent estimated national annual abortion rate — 17.3 per 1000 Australian women aged 15–44 years — was derived from Pharmaceutical Benefits Scheme (PBS) and National Hospital Morbidity Database (NHMD) data.4

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      Achieving continuity of care in general practice: the impact of patient enrolment on health outcomes

      Mark F Harris and Joel Rhee
      Med J Aust 2022; 216 (9): . || doi: 10.5694/mja2.51508
      Published online: 16 May 2022

      The search for a cost‐effective Australian model of comprehensive, coordinated patient‐centred care that improves outcomes continues

      Continuity of care has long been regarded as a core characteristic of general practice.1 It is thought important because it encourages more appropriate and proactive use of health care services (including hospital care), improves communication between doctors and patients, reduces inconsistency of care, and increases the chances of early diagnosis and effective management of long term conditions. Continuity of care is also associated with greater patient satisfaction, self‐management, and chronic disease management, as well as with fewer hospitalisations and lower mortality.2,3


      • 1 Centre for Primary Health Care and Equity, University of New South Wales, Sydney, NSW
      • 2 University of New South Wales, Sydney, NSW


      Correspondence: m.f.harris@unsw.edu.au
      Competing interests:

      No relevant disclosures.

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        Poor achievement of lipid targets after acute coronary syndrome: what can we improve?

        Sher May Ng, Jiliu Pan and Ajay K Gupta
        Med J Aust 2022; 216 (9): . || doi: 10.5694/mja2.51507
        Published online: 16 May 2022

        Overcoming problems that impede the delivery of evidence‐based care is needed to bridge gaps between science and improving health

        The benefits of lipid‐lowering therapy for the secondary prevention of atherosclerotic cardiovascular disease, including its effect on mortality, have been recognised since the publication of the seminal 4S trial in 1994.1 Recent clinical trials of novel lipid‐lowering therapies in people taking statins have found that the lower the low‐density lipoprotein cholesterol (LDL‐C) level achieved, the lower the risk of adverse cardiovascular events.2 It is beyond doubt that people at high risk of adverse cardiovascular events, including those with a history of acute coronary syndrome, benefit most from aggressive lipid‐lowering therapy. Accordingly, the recommended LDL‐C targets are lowest for such people, and have been continually reduced in international guidelines over time.3


        • 1 Barts Health NHS Trust, London, United Kingdom
        • 2 Harefield Hospital, Harefield, United Kingdom
        • 3 Centre for Clinical Pharmacology, Queen Mary University of London, London, United Kingdom


        Correspondence: ajay.gupta@qmul.ac.uk
        Competing interests:

        No relevant disclosures.

        • 1. Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344: 1383‐1389.
        • 2. Sabatine MS, Giugliano RP, Keech AC, et al; FOURIER Steering Committee and Investigators. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Eng J Med 2017; 376: 1713‐1722.
        • 3. The task force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS). 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk. Eur Heart J 2020; 41: 111‐188.
        • 4. Alsadat N, Hyun K, Boroumand F, et al. Achieving lipid targets within 12 months of an acute coronary syndrome: an observational analysis. Med J Aust 2022; 216: 463‐468.
        • 5. Gitt AK, Lautsch D, Ferrières J, et al. Cholesterol target value attainment and lipid‐lowering therapy in patients with stable or acute coronary heart disease: results from the Dyslipidemia International Study II. Atherosclerosis 2017; 266: 158‐166.
        • 6. Gupta A, Thompson D, Whitehouse A, et al; ASCOT Investigators. Adverse events associated with unblinded, but not with blinded, statin therapy in the Anglo‐Scandinavian Cardiac Outcomes Trial – Lipid‐Lowering Arm (ASCOT‐LLA): a randomised double‐blind placebo‐controlled trial and its non‐randomised non‐blind extension phase. Lancet 2017; 389: 2473‐2481.
        • 7. Harris DE, Lacey A, Akbari A, et al. Achievement of European guideline‐recommended lipid levels post‐percutaneous coronary intervention: a population‐level observational cohort study. Eur J Prev Cardiol 2021; 28: 854‐861.
        • 8. Billimek J, Malik S, Sorkin DH, et al. Understanding disparities in lipid management among patients with type 2 diabetes: gender differences in medication nonadherence following treatment intensification. Womens Health Issues 2015; 25: 6‐12.
        • 9. Zhang Y, Cui Y, Shen M, et al; the medical team from Xiangya Hospital to support Hubei, China. Association of diabetes mellitus with disease severity and prognosis in COVID‐19: a retrospective cohort study. Diabetes Res Clin Pract 2020; 165: 108227.
        • 10. Rodriguez F, Olufade TO, Ramey DR, et al. Gender disparities in lipid‐lowering therapy in cardiovascular disease: insights from a managed care population. J Womens Health (Larchmt) 2016; 25: 697‐706.
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          Hip fracture surgery: the importance of evidence‐based practice

          Peter FM Choong
          Med J Aust 2022; 216 (8): . || doi: 10.5694/mja2.51493
          Published online: 2 May 2022

          Registries are invaluable assets that not only benefit medical research, but also health care for all

          During 2015–16, almost 18 700 hip fractures were recorded in Australia; the incidence rate was nearly 200 times as high among people aged 45 years or more than among younger people, and 1.7 times as high for women as men.1 As longevity increases and the prevalence of osteoporosis, sarcopaenia, obesity, and dementia rise in Western countries,2 the numbers of people at risk of fractures will continue to climb.


          • 1 University of Melbourne, Melbourne, VIC
          • 2 St Vincent's Hospital, Melbourne, VIC


          Correspondence: pchoong@unimelb.edu.au
          Acknowledgements: 

          I am supported by a National Health and Medical Research Council Practitioner Fellowship.

          Competing interests:

          I have received consultancy fees and support for travel to designer surgeon meetings related to tumour prostheses from Stryker and Johnson & Johnson.

          • 1. Australian Institute of Health and Welfare. Hip fracture incidence and hospitalisations in Australia (Cat. no. PHE 226). Canberra: AIHW, 2018. https://www.aihw.gov.au/getmedia/296b5bb1‐0816‐44c6‐bdce‐b56e10fd6c0f/aihw‐phe‐226.pdf.aspx?inline=true (viewed Mar 2022).
          • 2. Gandham A, Zengin A, Bonham MP, et al. Incidence and predictors of fractures in older adults with and without obesity defined by body mass index versus body fat percentage. Bone 2020; 140: 115546.
          • 3. Australian Institute for Health and Welfare. Hospitals at a glance 2017–18. Updated 23 Aug 2019. https://www.aihw.gov.au/reports/hospitals/hospitals‐at‐a‐glance‐2017‐18/contents/surgery‐in‐australias‐hospitals (viewed Mar 2022).
          • 4. van Staa TP, Dennison EM, Leufkens HG, Cooper C. Epidemiology of fractures in England and Wales. Bone 2001; 29: 517‐522.
          • 5. Pasco JA, Sanders KM, Hoekstra FM, et al. The human cost of fracture. Osteoporos Int 2005; 16: 2046‐2052.
          • 6. Lystad RP, Cameron CM, Mitchell RJ. Mortality risk among older Australians hospitalised with hip fracture: a population‐based matched cohort study. Arch Osteoporos 2017; 12: 67.
          • 7. Turesson E, Ivarsson K, Thorngren KG, Hommel A. The impact of care process development and comorbidity on time to surgery, mortality rate and functional outcome for hip fracture patients: a retrospective analysis over 19 years with data from the Swedish National Registry for hip fracture patients, RIKSHÖFT. BMC Musculoskelet Disord 2019; 20: 616.
          • 8. Johansen A, Golding D, Brent L, et al. Using national hip fracture registries and audit databases to develop an international perspective. Injury 2017; 48: 2174‐2179.
          • 9. Sambrook PN, Seeman E, Phillips SR, Ebeling PR. Preventing osteoporosis: outcomes of the Australian Fracture Prevention Summit. Med J Aust 2002; 176 (8 Suppl): S1‐S16. https://www.mja.com.au/journal/2002/176/8/preventing‐osteoporosis‐outcomes‐australian‐fracture‐prevention‐summit
          • 10. Tan AC, Armstrong E, Close J, Harris IA. Data quality audit of a clinical quality registry: a generic framework and case study of the Australian and New Zealand Hip Fracture Registry. BMJ Open Qual 2019; 8: e000490.
          • 11. Harvey L, Harris IA, Mitchell RJ, et al. Improved survival rates after hip fracture surgery in New South Wales, 2011–2018. Med J Aust 2022; 216: 420‐421.
          • 12. Australian and New Zealand Hip Fracture Registry Steering Group. Australian and New Zealand guideline for hip fracture care: improving outcomes in hip fracture management of adults. Sept 2014. https://anzhfr.org/wp‐content/uploads/sites/1164/2021/12/ANZ‐Guideline‐for‐Hip‐Fracture‐Care.pdf (viewed Mar 2022).
          • 13. Baroni M, Serra R, Boccardi V, et al. The orthogeriatric comanagement improves clinical outcomes of hip fracture in older adults. Osteoporos Int 2019; 30: 907‐916.
          • 14. Porter ME. Value‐based health care delivery. Ann Surg 2008; 248: 503‐509.
          • 15. Australian Orthopaedic Association National Joint Replacement Registry. 2019 Annual Report: hip, knee, shoulder arthroplasty, September 1999 – December 2018. 2019. https://aoanjrr.sahmri.com/documents/10180/668596/Hip%2C+Knee+&+Shoulder+Arthroplasty/c287d2a3‐22df‐a3bb‐37a2‐91e6c00bfcf0 (viewed Mar 2022).
          • 16. de Steiger RN, Hang JR, Miller LN, et al. Five‐year results of the ASR XL Acetabular System and the ASR hip resurfacing system: an analysis from the Australian Orthopaedic Association National Joint Replacement Registry. J Bone Joint Surg Am 2011; 93: 2287‐2293.
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            The need for improved Australian data on social determinants of health inequities

            Joanne Flavel, Martin McKee, Toby Freeman, Connie Musolino, Helen Eyk, Fisaha H Tesfay and Fran Baum
            Med J Aust 2022; 216 (8): . || doi: 10.5694/mja2.51495
            Published online: 2 May 2022

            Australia needs better data on health inequities to support building back fairer from the pandemic

            The coronavirus disease 2019 (COVID‐19) pandemic has shone a light on longstanding inequities in societies.1 Yet, too often, these inequities are effectively invisible,1 and we can only know if we are tackling them if we can measure them. A lack of appropriate data is an important reason why research that has helped our understanding of health inequities is unevenly distributed internationally, with much concentrated in Europe and North America. Although Australia has some leading global centres for population health research, a lack of appropriate data creates a barrier to undertaking such research here. However, the available evidence indicates that socio‐economic health inequities have increased since the 1980s.2

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            • 1 Stretton Institute, University of Adelaide, Adelaide, SA
            • 2 London School of Hygiene and Tropical Medicine, London, UK
            • 3 Institute for Health Transformation, Deakin University, Melbourne, VIC


            Acknowledgements: 

            This work was supported by a Flinders Foundation Health Seed Grant. The funder had no role in the conduct of any aspect of producing this article.

            Competing interests:

            No relevant disclosures.

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              Emerging evidence for the use of colchicine for secondary prevention of coronary heart disease

              Stefan M Nidorf, Jamie Layland, Philip C Robinson, Sanjay Patel, Peter J Psaltis and Peter L Thompson
              Med J Aust 2022; 216 (8): . || doi: 10.5694/mja2.51488
              Published online: 2 May 2022

              Colchicine is an inexpensive new treatment for coronary heart disease that is both safe and effective in select patients

              Cardiovascular disease imposes a major burden on Australians and the Australian health care system. Due to campaigns to reduce smoking and the widespread use of effective lipid‐lowering therapy, there has been a significant decline in the death rate from cardiovascular disease over several decades.1 However, nearly 600 000 patients are hospitalised each year with cardiovascular disease, at a cost to the community of over $4 billion in 2018–19.1 Patients with coronary heart disease face an ongoing risk of cardiovascular events even when their lipid‐lowering and antithrombotic therapy is optimal. Thus, to reduce morbidity in these patients, there is a need for doctors to employ additional therapies that are effective, safe, readily available and cost‐efficient for this purpose. In the past decade, increasing evidence has accrued suggesting that there are cardiovascular benefits associated with adding colchicine 0.5 mg daily to lipid‐lowering and antithrombotic therapy for secondary prevention of coronary heart disease.2

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              • 1 Genesis Care, Perth, WA
              • 2 Heart and Vascular Research Institute, Harry Perkins Institute of Medical Research, Perth, WA
              • 3 Monash University, Melbourne, VIC
              • 4 University of Queensland, Brisbane, QLD
              • 5 Royal Brisbane Hospital, Brisbane, QLD
              • 6 Royal Prince Alfred Hospital, Sydney, NSW
              • 7 University of Sydney, Sydney, NSW
              • 8 Royal Adelaide Hospital, Adelaide, SA
              • 9 Vascular Research Centre, Heart Health Theme, South Australian Health and Medical Research Institute, Adelaide, SA
              • 10 Sir Charles Gairdner Hospital, Perth, WA
              • 11 University of Western Australia, Perth, WA


              Acknowledgements: 

              We have received funding from the Australian Government Department of Health, the National Health and Medical Research Council (GNT0211980, GNT0353669, GNT1088455, GNT1127159, GNT1187193), and the Sir Charles Gairdner Hospital Research Advisory Committee (NM 2014). Open access publishing facilitated by The University of Western Australia, as part of the Wiley ‐ The University of Western Australia agreement via the Council of Australian University Librarians.

              Competing interests:

              Aspen Pharmacare Australia provided colchicine and matching placebo for the Australian arm of the LoDoCo2 trial.

              • 1. Australian Institute of Health and Welfare. Heart, stroke and vascular disease — Australian facts, 2021. https://www.aihw.gov.au/reports/heart‐stroke‐vascular‐diseases/hsvd‐facts/contents/about (viewed Jan 2021).
              • 2. Imazio M, Nidorf M. Colchicine and the heart. Eur Heart J 2021; 42: 2745–2760.
              • 3. Nidorf SM, Thompson PL. Why colchicine should be considered for secondary prevention of atherosclerosis: an overview. Clin Ther 2019; 41: 41–48.
              • 4. Nidorf SM, Foilet AT, Abela GS. Viewing atherosclerosis through a crystal lens: How the evolving structure of cholesterol crystals in atherosclerotic plaque alters its stability. J Clin Lipidol 2020; 14: 619–630.
              • 5. Ridker PM, Everett BM, Thuren T, et al. Antiinflammatory therapy with canakinumab for atherosclerotic disease. N Engl J Med 2017; 377: 1119–1131.
              • 6. Miller J. FDA snubs Novartis bid to repurpose inflammation drug for heart attacks. Reuters 2018; 19 Oct. https://www.reuters.com/article/us‐novartis‐heart‐disease‐idUSKCN1MS2QY (viewed Mar 2022).
              • 7. O’Riordan M. Hopes fade for a CV indication for canakinumab: what’s next for the inflammatory hypothesis? TCTMD 2019; 1 Feb. https://www.tctmd.com/news/hopes‐fade‐cv‐indication‐canakinumab‐whats‐next‐inflammatory‐hypothesis (viewed Nov 2021).
              • 8. Dalbeth N, Lauterio TJ, Wolfe HR. Mechanism of action of colchicine in the treatment of gout. Clin Ther 2014; 36: 1465–1479.
              • 9. US Food and Drug Administration. Colchicine (marketed as Colcrys) information. https://www.fda.gov/drugs/postmarket‐drug‐safety‐information‐patients‐and‐providers/colchicine‐marketed‐colcrys‐information (viewed June 2021).
              • 10. Nidorf SM, Fiolet ATL, Mosterd A, et al; LoDoCo2 Trial Investigators. Colchicine in patients with chronic coronary disease. N Engl J Med 2020; 383: 1838–1847.
              • 11. Tardif JC, Kouz S, Waters DD, et al. Efficacy and safety of low‐dose colchicine after myocardial infarction. N Engl J Med 2019; 381: 2497–2505.
              • 12. Tong DC, Bloom JE, Quinn S, et al. Colchicine in patients with acute coronary syndrome: two‐year follow‐up of the Australian COPS randomized clinical trial. Circulation 2021; 144: 1584–1586.
              • 13. Toth PT, Banach M. Statins: then and now. Methodist Debakey Cardiovasc J 2019; 15: 23–31.
              • 14. Fiolet ATL, Opstal TSJ, Mosterd A, et al. Efficacy and safety of low‐dose colchicine in patients with coronary disease: a systematic review and meta‐analysis of randomized trials. Eur Heart J 2021; 42: 2765–2775.
              • 15. Robinson PC, Terkeltaub R, Pillinger MH, et al. Consensus statement regarding the efficacy and safety of long‐term low‐dose colchicine in gout and cardiovascular disease. Am J Med 2022; 135: 32–38.
              • 16. Stewart S, Yang KCK, Atkins K, et al. Adverse events during oral colchicine use: a systematic review and meta‐analysis of randomised controlled trials. Arthritis Res Ther 2020; 22: 28.
              • 17. NPS MedicineWise. Consumer medicine information: colchicine. https://www.nps.org.au/medicine‐finder/colgout‐tablets#full‐pi (viewed Mar 2022).
              • 18. Ponte‐Negretti CI, Wyss FS, Piskorz D, et al. Latin American Consensus on management of residual cardiometabolic risk. A consensus paper prepared by the Latin American Academy for the Study of Lipids and Cardiometabolic Risk (ALALIP) endorsed by the Inter‐American Society of Cardiology (IASC), the International Atherosclerosis Society (IAS), and the Pan‐American College of Endothelium (PACE). Arch Cardiol Mex 2022; 92: 99–112.
              • 19. Visseren FLJ, Mach F, Smulders YM, et al; ESC Scientific Document Group. Eur Heart J 2021; 42: 3227–3337.
              • 20. Health Canada. Product information: PMS‐COLCHICINE ER; approved 2021‐09‐10. https://health‐products.canada.ca/dpd‐bdpp/info.do?lang=en&code=100936 (viewed Jan 2022).
              • 21. BMJ Best Practice. What is GRADE? https://bestpractice.bmj.com/info/toolkit/learn‐ebm/what‐is‐grade/ (viewed Mar 2022).
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                The influence of socio‐economic conditions on the epidemiology of COVID‐19 in Australia

                Joanne Flavel and Fran Baum
                Med J Aust 2022; 216 (7): . || doi: 10.5694/mja2.51470
                Published online: 18 April 2022

                Supporting people with COVID‐19 should look beyond medical management and take into account their social and economic situation

                Coronavirus disease 2019 (COVID‐19) has exposed socio‐economic inequalities in many countries; people living with disadvantage are more susceptible to infection, hospitalisation, and death.1,2 Until recently, COVID‐19 infection and death rates in Australia were relatively low, but the ecological study by Roder and colleagues in this issue of the MJA suggests that social and economic factors also influenced the distribution of infections here.3 A socio‐economic gradient in COVID‐19 cases was predicted early in the pandemic.4,5 Ecological studies provide some evidence of this gradient, and are vital for informing disease prevention policy and clinical practice.

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                • 1 Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, SA
                • 2 Stretton Institute, University of Adelaide, Adelaide, SA


                Competing interests:

                No relevant disclosures.

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                  Lung cancer: progress with prognosis and the changing state of play

                  Fraser J Brims, Annette McWilliams, Susan V Harden and Ken O'Byrne
                  Med J Aust 2022; 216 (7): . || doi: 10.5694/mja2.51474
                  Published online: 18 April 2022

                  Lung cancer treatments and outcomes are changing, but survival remains a challenge

                  Lung cancer is the second most common cancer in the world, accounting for 11.4% of all cancers, but with 18.0% of total cancer‐related deaths, it is the leading cause of cancer death.1 In Australasia, the incidence of lung cancer varies between 19.1 and 42.1 per 100 000 population, with the strongest risk factors historically being increasing age and tobacco smoke exposure.2,3 However, the proportion of (predominantly) female never smokers with lung cancer is increasing in many countries, particularly across South‐East Asia, together with an enlarging proportion of adenocarcinomas and molecular mutations, especially of the epidermal growth factor receptor (EGFR).2,4 Lung cancer in never smokers is increasingly being recognised as biologically distinct from smoking‐related lung cancers, although there is overlap with other risk factors such as environmental and genetic interactions, biofuel and occupational exposures, and indoor and outdoor pollution.2,4 The incidence of lung cancer in several developed countries (eg, the United Kingdom and the United States) has started to fall. However, despite a projected fall in age‐standardised lung cancer rates in Australia over the next two decades, the number of deaths from lung cancer is expected to continue to increase due to population growth and ageing.2,5

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                  • 1 Sir Charles Gairdner Hospital, Perth, WA
                  • 2 Curtin University, Perth, WA
                  • 3 Fiona Stanley Hospital, Perth, WA
                  • 4 Peter MacCallum Cancer Centre, Melbourne, VIC
                  • 5 Queensland University of Technology, Brisbane, QLD
                  • 6 Princess Alexandra Hospital, Brisbane, QLD


                  Correspondence: fraser.brims@curtin.edu.au
                  Acknowledgements: 

                  Open access publishing facilitated by Curtin University, as part of the Wiley ‐ Curtin University agreement via the Council of Australian University Librarians.

                  Competing interests:

                  No relevant disclosures.

                  • 1. Sung H, Ferlay J, Siegel RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71: 209‐249.
                  • 2. Barta JA, Powell CA, Wisnivesky JP. Global epidemiology of lung cancer. Ann Glob Health 2019; 85: 8.
                  • 3. Brims F, Leong T, Stone E, et al. Variations in lung cancer care and outcomes: how best to identify and improve standards of care? Respirology 2021; 26: 1103‐1105.
                  • 4. Kerpel‐Fronius A, Tammemägi M, Cavic M, et al. Screening for lung cancer in individuals who never smoked: an International Association for the Study of Lung Cancer Early Detection and Screening Committee Report. J Thorac Oncol 2021; 17: 56‐66.
                  • 5. Luo Q, Yu XQ, Wade S, et al. Lung cancer mortality in Australia: projected outcomes to 2040. Lung Cancer 2018; 125: 68‐76.
                  • 6. Cancer Australia. National cancer stage at diagnosis data. https://ncci.canceraustralia.gov.au/features/national‐cancer‐stage‐diagnosis‐data (viewed Sept 2021).
                  • 7. Cancer Australia. Lung cancer in Australia statistics. https://lung‐cancer.canceraustralia.gov.au/statistics (viewed Sept 2021).
                  • 8. Brims FJH, Kumarasamy C, Nash J, et al. Hospital‐based multidisciplinary lung cancer care in Australia: a survey of the landscape in 2021. BMJ Open Respir Res 2022; 9: e001157.
                  • 9. Imyanitov EN, Iyevleva AG, Levchenko EV. Molecular testing and targeted therapy for non‐small cell lung cancer: Current status and perspectives. Crit Rev Oncol Hematol 2021; 157: 103194.
                  • 10. Lam S, Tammemagi M. Contemporary issues in the implementation of lung cancer screening. Eur Respir Rev 2021; 30: 200288.
                  • 11. Cancer Australia. Report on the Lung Cancer Screening enquiry. https://www.canceraustralia.gov.au/publications‐and‐resources/cancer‐australia‐publications/report‐lung‐cancer‐screening‐enquiry (viewed Sept 2021).
                  • 12. Department of Health. Budget 2021–22: preventative health — cancer screening. https://www.health.gov.au/sites/default/files/documents/2021/05/preventive‐health‐cancer‐screening_0.pdf (viewed Jan 2022).
                  • 13. Tammemägi MC, Ruparel M, Tremblay A, et al. USPSTF2013 versus PLCOm2012 lung cancer screening eligibility criteria (International Lung Screening Trial): interim analysis of a prospective cohort study. Lancet Oncol 2022; 23: 138‐148.
                  • 14. Lim E, Batchelor TJP, Dunning J, et al. Video‐assisted thoracoscopic versus open lobectomy in patients with early‐stage lung cancer: One‐year results from a randomized controlled trial (VIOLET). J Clin Oncol 2021; 39: 8504.
                  • 15. Ren XC, Liu YE, Li J, Lin Q. Progress in image‐guided radiotherapy for the treatment of non‐small cell lung cancer. World J Radiol 2019; 11: 46‐54.
                  • 16. Chun SG, Hu C, Choy H, et al. Impact of intensity‐modulated radiation therapy technique for locally advanced non‐small‐cell lung cancer: a secondary analysis of the NRG Oncology RTOG 0617 randomized clinical trial. J Clin Oncol 2017; 35: 56‐62.
                  • 17. Tian Y, Zhai X, Yan W, et al. Clinical outcomes of immune checkpoint blockades and the underlying immune escape mechanisms in squamous and adenocarcinoma NSCLC. Cancer Med 2021; 10: 3‐14.
                  • 18. Ball D, Mai GT, Vinod S, et al. Stereotactic ablative radiotherapy versus standard radiotherapy in stage 1 non‐small‐cell lung cancer (TROG 09.02 CHISEL): a phase 3, open‐label, randomised controlled trial. Lancet Oncol 2019; 20: 494‐503.
                  • 19. Suazo‐Zepeda E, Bokern M, Vinke PC, et al. Risk factors for adverse events induced by immune checkpoint inhibitors in patients with non‐small‐cell lung cancer: a systematic review and meta‐analysis. Cancer Immunol Immunother 2021; 70: 3069‐3080.
                  • 20. Reck M, Rodríguez‐Abreu D, Robinson AG, et al. Pembrolizumab versus chemotherapy for PD‐L1‐positive non‐small‐cell lung cancer. N Engl J Med 2016; 375: 1823‐1833.
                  • 21. Antonia SJ, Villegas A, Daniel D, et al. Overall survival with durvalumab after chemoradiotherapy in stage III NSCLC. N Engl J Med 2018; 379: 2342‐2350.
                  • 22. Bradley JD, Paulus R, Komaki R, et al. Standard‐dose versus high‐dose conformal radiotherapy with concurrent and consolidation carboplatin plus paclitaxel with or without cetuximab for patients with stage IIIA or IIIB non‐small‐cell lung cancer (RTOG 0617): a randomised, two‐by‐two factorial phase 3 study. Lancet Oncol 2015; 16: 187‐199.
                  • 23. Hong DS, Fakih MG, Strickler JH, et al. KRASG12C inhibition with sotorasib in advanced solid tumors. N Engl J Med 2020; 383: 1207‐1217.
                  • 24. Gomez DR, Blumenschein GR, Lee JJ, et al. Local consolidative therapy versus maintenance therapy or observation for patients with oligometastatic non‐small‐cell lung cancer without progression after first‐line systemic therapy: a multicentre, randomised, controlled, phase 2 study. Lancet Oncol 2016; 17: 1672‐1682.
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                    Treatable traits in asthma: moving beyond diagnostic labels

                    Vanessa M McDonald and Peter G Gibson
                    Med J Aust 2022; 216 (7): . || doi: 10.5694/mja2.51464
                    Published online: 18 April 2022

                    A precision medicine approach to asthma places the patient at the centre of their care

                    Asthma is a common inflammatory disease, affecting over 300 million people worldwide,1 including one in nine Australian adults.2 Asthma imposes a major burden on the health care system, on patients, and within society.3 In the late 20th century and the early 2000s, there were major improvements in asthma outcomes, largely because of the introduction of inhaled corticosteroids to treat eosinophilic airway inflammation, and asthma self‐management education initiatives.4 These improvements in asthma outcomes are now being lost. Hospitalisations and mortality from asthma have begun to rise as adoption of new assessment techniques and biomarkers into practice stagnates, and we experience sluggish development of new drug discovery in comparison to other diseases.4 Asthma deaths have risen in Australia, the United Kingdom and the United States,4 with at least one person in Australia dying every day from asthma.2

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                    • 1 Priority Research Centre for Healthy Lungs, University of Newcastle, Newcastle, NSW
                    • 2 Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW


                    Acknowledgements: 

                    Open access publishing facilitated by The University of Newcastle, as part of the Wiley ‐ The University of Newcastle agreement via the Council of Australian University Librarians.

                    Competing interests:

                    Peter Gibson has received grants from the National Health and Medical Research Council, Medical Research Future Fund and GlaxoSmithKline. He reports honoraria from AstraZeneca, GlaxoSmithKline, Novartis, Chiesi and Sanofi for educational activities. Vanessa McDonald has received grants from the National Health and Medical Research Council, Medical Research Future Fund, GlaxoSmithKline and Ramaciotti. She reports honoraria from GlaxoSmithKline, AstraZeneca and Novartis for educational activities.

                    • 1. Global Asthma Network. The global asthma report 2018. Auckland: Global Asthma Network, 2018. http://globalasthmareport.org/resources/Global_Asthma_Report_2018.pdf (viewed Mar 2022).
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                      The Virtual Inpatient Diabetes Management Service: COVID‐19 brings the future to inpatient diabetes management

                      N Wah Cheung, Amanda Hor and Tien‐Ming Hng
                      Med J Aust 2022; 216 (6): . || doi: 10.5694/mja2.51456
                      Published online: 4 April 2022

                      To the Editor: The coronavirus disease 2019 (COVID‐19) pandemic has strained health systems in New South Wales, and hospitals have rapidly adapted to care for inpatients with COVID‐19. In the 4 weeks leading up to 9 September 2021, 9330 locally acquired cases were diagnosed in Western Sydney alone.1

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                      • 1 Westmead Hospital, Sydney, NSW
                      • 2 University of Sydney, Sydney, NSW
                      • 3 Blacktown and Mount Druitt Hospital, Sydney, NSW


                      Correspondence: wah.cheung@sydney.edu.au
                      Acknowledgements: 

                      We thank Associate Professor David Chipps for his contribution to the virtual Inpatient Diabetes Management Service and review of the manuscript.

                      Competing interests:

                      No relevant disclosures.

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