Publications by authors named "Alison Pearce"
By 2030, it is anticipated that poor mental health will cost the global economy approximately $6 trillion per year, primarily due to productivity loss. It is crucial to understand how psychological distress contributes to productivity loss in the workplace. We aim to investigate the relationship between psychological distress and productivity loss in the Australian working population.
View Article and Find Full Text PDFBackground: Artificial intelligence (AI) could improve accuracy and efficiency of breast cancer screening. However, many women distrust AI in health care, potentially jeopardizing breast cancer screening participation rates. The aim was to quantify community preferences for models of AI implementation within breast cancer screening.
View Article and Find Full Text PDFBackground: Oesophagogastric (OG) cancer-associated symptoms are common in primary care, but most research has focused on patients with a confirmed OG cancer diagnosis, rather than those presenting with symptoms for the first time.
Aim: To examine diagnostic testing patterns for upper gastrointestinal (GI) symptoms linked to OG cancer.
Design And Setting: A retrospective cohort study was undertaken, which used a linked primary care database.
Assessing the impact of a self-guided digital intervention for fear of cancer recurrence (iConquerFear) in ovarian cancer survivors: a pilot randomised waitlist-controlled trial.
BMC Cancer
March 2025
Background: Approximately 50% of ovarian cancer (OC) survivors report fear of cancer recurrence/progression (FCR/P) as the most challenging aspect of living with cancer. This pilot, randomised waitlist-controlled trial aimed to evaluate the feasibility, acceptability, and safety of iConquerFear, a self-guided online FCR intervention for OC survivors.
Methods: Stage I-III OC survivors were recruited via Ovarian Cancer Australia (OCA) between October-December 2022.
Background: The widespread and rapid adoption of private payments for non-invasive prenatal testing (NIPT) in Australia has introduced complexities to the decision-making process for the public regarding prenatal screening. NIPT has the potential to be a useful screening tool, but concerns have been raised about its cost, the psychological consequences of testing and the information available to support informed decision-making.
Objective: To explore the attitudes, values and beliefs around prenatal screening in Australia, and how perspectives may differ between people living in metropolitan locations versus rural/regional locations.
Australian Preferences for Prenatal Screening: A Discrete Choice Experiment Comparing Metropolitan and Rural/Regional Areas.
Appl Health Econ Health Policy
May 2025
Background: Non-invasive prenatal testing has the potential to be a useful genetic screening tool in Australia. However, concerns have been raised about its cost, commercial provision, the psychological impacts of the screening process, and disparities in access experienced by rural and regional communities.
Aims: The aims of this study are (1) to estimate Australian preferences for features of prenatal screening; (2) to explore potential variations in preferences between metropolitan and rural/regional communities; (3) to estimate the extent to which respondents are willing to trade-off between attributes, using willingness to pay (WTP) and willingness to wait estimates.
Article Synopsis
- Many cancer survivors worry about their cancer coming back, but healthcare providers often don’t help them with this fear.
- A group of Australian health experts worked together to create a plan for doctors to better understand and manage this fear in patients who had early-stage cancer.
- They found that most items in their plan were agreed upon by the majority, suggesting that regular screenings and conversations about this fear should be part of cancer care.
Access to medical and supportive care services is important for the health and quality of life of cancer survivors; however, services are not always available or accessible to all survivors equally. This study aims to explore the experiences of cancer services among cancer survivors in urban and rural settings to inform social work practice. Authors conducted interviews with 25 cancer survivors (colorectal, n = 13; hematological, n = 12) in the West of Ireland, using a narrative inquiry approach.
View Article and Find Full Text PDFImpact of Structural Differences on the Modeled Cost-Effectiveness of Noninvasive Prenatal Testing.
Med Decis Making
October 2024
Article Synopsis
- The study reviews how different economic models impact the cost-effectiveness of noninvasive prenatal testing (NIPT) for detecting Down syndrome (trisomy 21).
- It finds significant variations in incremental cost-effectiveness ratios (ICERs) across 34 different models, indicating that the structure of the models can significantly influence economic outcomes.
- The conclusion suggests that consistent reference models could lead to more uniform health policy decisions regarding NIPT funding.
Introduction: It is now widely recognised that engaging consumers in research activities can enhance the quality, equity and relevance of the research. Much of the commentary about consumer engagement in research focuses on research processes and implementation, rather than dissemination in conference settings. This article offers reflections and learnings from consumers, researchers and conference organisers on the 12th Health Services Research Conference, a biennial conference hosted by the Health Services Research Association of Australia and New Zealand (HSRAANZ).
View Article and Find Full Text PDFArticle Synopsis
- The study aimed to investigate self-reported out-of-pocket health care expenses among Australians aged 45 and older, focusing on differences based on cancer status and various socio-demographic factors.
- It involved a cross-sectional design, utilizing data from the 45 and Up Study participants in New South Wales who completed a follow-up questionnaire in 2020, linked to cancer registry data.
- Results showed that 42.7% of respondents reported out-of-pocket expenses over $1000 in the previous year, with higher rates among those diagnosed with cancer, particularly in the last two years, and those with higher socioeconomic status or private health insurance.
Article Synopsis
- This study evaluates how preferences for genetic and genomic risk-tailored chronic disease screening affect public acceptance and participation in these programs.
- A systematic review found 12 studies, primarily focusing on cancer screening and preferences for rare genetic variants, identifying 26 program attributes that influence decisions, with survival rates and test accuracy being the most critical factors.
- The conclusion suggests that effective communication about potential benefits and test reliability can significantly enhance the willingness of individuals to engage in these screening programs.
Article Synopsis
- Finding the right balance between early cancer diagnoses and the risk of too much testing is really important, especially when considering what patients prefer.
- The study looked at what Australians aged 40 and over think about tests for symptoms linked to three types of cancer: oesophagogastric, bowel, and lung.
- Results showed that people care most about how long they have to wait for tests and how much those tests cost, and they often prefer invasive tests, but will less likely want to test for very low-risk symptoms.
A systematic review of discrete choice experiments in stroke rehabilitation.
Top Stroke Rehabil
September 2024
Article Synopsis
- - The study investigates consumer preferences in stroke rehabilitation using Discrete Choice Experiments (DCEs) to better understand which intervention characteristics are most valued by patients.
- - A systematic review analyzed five qualifying DCE studies, revealing a preference for individualized therapy, moderate exercise intensity, and professional delivery over volunteer-led services.
- - The research highlights a scarcity of DCEs in stroke rehabilitation, indicating a need for broader exploration of consumer preferences to inform practice and policy effectively.
Purpose: To increase the number of constraint-induced movement therapy (CIMT) programs provided by rehabilitation services.
Methods: A before-and-after implementation study involving nine rehabilitation services. The implementation package to help change practice included file audit-feedback cycles, 2-day workshops, poster reminders, a community-of-practice and drop-in support.
Women's Preferences for Hypofractionated Radiation Therapy for Treatment of Early-Stage Breast Cancer: A Discrete Choice Experiment.
Int J Radiat Oncol Biol Phys
May 2024
Purpose: The primary treatment recommended for early-stage breast cancer is breast conserving surgery followed by external beam radiation therapy of the whole breast. Previously, radiation therapy for early-stage breast cancer was given using more fractions over longer durations. Guidelines support treatments with fewer fractions over a shorter time (hypofractionated radiation therapy).
View Article and Find Full Text PDFHealth preference research (HPR) is being increasingly conducted to better understand patient preferences for medical decisions. However, patients vary in their desire to play an active role in medical decisions. Until now, few studies have considered patients' preferred roles in decision making.
View Article and Find Full Text PDFArticle Synopsis
- - Tobacco smoking during pregnancy leads to serious complications and higher healthcare costs, making smoking cessation support for pregnant women crucial but often inconsistent.
- - The MOHMQuit intervention in NSW, Australia aims to enhance systems and clinician support for smoking cessation, and this study evaluates its cost-effectiveness compared to usual care through a pragmatic randomised trial.
- - The evaluation includes two main analyses: one comparing immediate costs and quit rates, and another assessing long-term cost-utility using a Markov model to gauge the overall impact on mother and child health outcomes.
The economic impact of cancer mortality among working-age individuals in Brazil from 2001 to 2030.
Cancer Epidemiol
October 2023
Background: About half of cancer deaths in Brazil occur among individuals of working-age (under 65 years for men, under 60 for women), resulting in a substantial economic impact for the country. We aimed to estimate the years of potential productive life lost (YPPLL) and value the productivity lost due to premature deaths from cancer between 2001 and 2015 and the projected to 2030.
Methods: We used the Human Capital Approach to estimate the productivity losses corresponding to YPPLL for cancer deaths in working age people (15-64 years).
Projected Impact on Labour Productivity Costs of Cancer-Related Premature Mortality in Europe 2018-2040.
Appl Health Econ Health Policy
November 2023
Article Synopsis
- The study aims to estimate the costs associated with lost labor productivity due to premature cancer deaths in Europe from 2018 to 2040, involving 23 types of cancer across 31 countries.
- It's projected that around 8 million premature cancer deaths will occur, leading to total productivity costs of €1.3 trillion, with the highest impacts in Western Europe, particularly Germany and France.
- The findings can inform policymakers on potential cost-saving strategies through disease prevention and improving cancer care, particularly for high-cost cancers like Hodgkin lymphoma and melanoma.
Article Synopsis
- - The centralization of head and neck surgical services in Australia forces patients in remote areas to travel long distances for treatment, which increases costs for both patients and the healthcare system.
- - A study at three outreach clinics in New South Wales found that patients saved a median of $285 per trip by traveling to local clinics instead of major cities like Sydney, where travel costs ranged from $379 to $739 per visit.
- - Despite the benefits of telehealth, outreach services are vital for improving access to care in regional areas, though the overall financial advantages may be underestimated since indirect costs were not considered.
Article Synopsis
- The study investigated out-of-pocket costs for families dealing with cerebral palsy (CP) in Australia, emphasizing the need to understand financial burdens not covered by previous estimates.
- A total of 271 surveys were completed across different age groups, revealing that 94% of participants incurred additional expenses, with an annual median cost of $4,460 AUD, particularly high for those with more severe motor function impairments (GMFCS III-V).
- Findings indicated that financial distress was significant, affecting 36% of participants, but was not correlated with the age or severity of motor function, suggesting a broader issue related to disability costs.
Background: The friction cost approach (FCA) offers an alternative to the dominant human capital approach to value productivity losses. Application of the FCA in practice is limited largely due to data availability. Recent attempts have tried to standardise the estimation of friction periods across Europe, but to date, this has not been attempted elsewhere.
View Article and Find Full Text PDFArticle Synopsis
- Patients often worry that their symptoms could indicate cancer, leading them to seek investigations from their general practitioners (GPs), but little is known about what factors influence these decisions.
- * This study involved in-depth interviews with 15 patients over 40 years old from both rural and urban areas in Victoria, Australia, focusing on their thoughts and feelings about cancer testing.
- * Key findings highlight that concerns about cancer motivate patients to ask for tests, but barriers such as costs and time affect their willingness to pursue investigations; fostering a trusting relationship and shared decision-making with their GP can help address these issues.
Article Synopsis
- The study investigates premature cancer mortality in Brazil from 2001 to 2015 and predicts trends up to 2030 to assess progress toward a United Nations Sustainable Development Goal aiming to reduce early deaths from noncommunicable diseases by one-third.
- Results indicate a 12% reduction in premature cancer mortality for males and 4.6% for females predicted nationally, with regional disparities ranging from a 2.8% increase to a 14.7% decrease.
- While lung cancer mortality in males is expected to decrease significantly, cervical cancer rates in the North are projected to remain high, and the overall trends suggest that Brazil will fall short of the SDG 3.4 targets by 2030.