The Royal Melbourne Hospital

International consensus guidance for general population screening for islet autoantibodies to diagnose early-stage type 1 diabetes: a nominal group technique process

Type 1 diabetes is an autoimmune disease that targets and destroys insulin-producing beta cells in the pancreatic islets. The incidence of type 1 diabetes is rising globally. At the clinical diagnosis of type 1 diabetes, between 20% and 67% of children and adolescents present wit...

A qualitative study of cancer survivors’ exercise behaviour 4 months after a telerehabilitation program

Abstract Purpose Although telerehabilitation can improve access to exercise programs for cancer survivors, it is not known if these programs lead to ongoing change in exercise habits. This study explored participant experiences of exercise 4 months after finishing specialized can...

An Updated Evidence Assessment of the Genetic Causes of Dilated Cardiomyopathy

BACKGROUND: Evidence of the diverse genetic architecture of dilated cardiomyopathy (DCM) continues to emerge and requires reassessment of the clinical relevance of implicated disease genes. Building on the 2019-2020 Clinical Genome Resource evaluation, the DCM gene curation exper...

Dynamic risk stratification using early CAR ‐T expansion in R/R LBCL treated with axicabtagene ciloleucel

The clinical utility of routine monitoring of chimeric antigen receptor (CAR) T-cell expansion post-infusion remains controversial. We conducted a retrospective analysis of a prospectively collected cohort of 176 patients with relapsed/refractory large B-cell lymphoma (LBCL) trea...

Stroke clinical documentation education program in Australia and New Zealand

Background: Accurate and complete clinical documentation underpins the assignment of International Classification of Disease codes used for epidemiological research, hospital activity based funding, and health service planning. Objective: To develop, implement, and evaluate an ed...

Efficacy and safety of canagliflozin are consistent across polypharmacy burden in CKD: the CREDENCE trial

Abstract Background Polypharmacy in chronic kidney disease (CKD) is substantial. Clinicians and patients are often reluctant to add medications to already complex regimens, partly due to concerns about diminishing efficacy and increased adverse effects. We assessed whether effica...

Implementing univerSal TeleprehabiliTation into cAnceR caRe pathwayS (STTARRS Trial): protocol for a hybrid type 1 multi-centre randomised controlled trial and nested sub study

Abstract Background Postoperative complications are common after major cancer surgeries, occurring in 25–50% of patients. They delay recovery and adversely affect both cancer-free and overall survival. Intervention to optimise patients’ physical and psychological wellbeing before...

A qualitative analysis to identify implementation strategies for a deprescribing clinical practice guideline using the CFIR-ERIC Matching Tool: perspectives from consumers and professional stakeholders

Abstract Introduction Deprescribing is the planned withdrawal or dose reduction of medicines when harms outweigh benefits or when they are no longer required. Following publication of the Clinical Practice Guideline for Deprescribing in Older People in September 2025, supporting...

Coronary Plaque Burden and Plaque Composition in Long-Term Cancer Survivors: A Comparative CCTA Study

Abstract Background The increased risk of atherosclerotic cardiovascular disease in cancer survivors is not fully elucidated. Understanding the coronary plaque burden and composition in survivors could address this gap. Objectives To determine whether cancer survivorship is assoc...

Progress and challenges in expanding access to clinical trials in pancreatic cancer

Clinical trials are essential for developing new cancer treatments and improving patient care. However, participation remains low across oncology and is particularly challenging for people with pancreatic cancer, who often experience rapid disease progression, limited treatment o...

A necroptotic-to-apoptotic signaling axis underlies inflammatory bowel disease

ABSTRACT Inflammatory bowel disease (IBD) is a chronic condition caused by altered cytokine signaling, maladaptive immunity, dysbiosis, and intestinal barrier dysfunction. Patients with IBD receive therapy to correct these imbalances and achieve remission. However, most patients...

Cooperative multi-EV aggregator strategy of V2G-enabled charging stations under shared interconnection limits

The widespread adoption of electric vehicles creates new opportunities for energy management through vehicle-to-grid participation. When multiple electric vehicle aggregators operate behind a shared point of common coupling, uncoordinated scheduling can cause congestion and ineff...

Cognitive Behavior vs Bright Light Therapy for Insomnia in Women Undergoing Chemotherapy for Breast Cancer

Importance Women receiving chemotherapy for breast cancer experience insomnia and fatigue, which impair quality of life. To date, no randomized clinical trial (RCT) has evaluated the use of cognitive behavior therapy for insomnia (CBT-I) and bright light therapy (BLT) both alone...

The effect of augmented protein intake on nitrogen balance: A nested cohort study of the TARGET protein trial

Purpose The impact of augmenting enteral protein delivery on nitrogen balance, urea generation, and kidney function in critically ill patients remains poorly defined. This study aimed to investigate these effects in a nested cohort within the TARGET Protein trial. Methods We cond...

Presymptomatic plasma biomarkers in autosomal dominant Alzheimer’s disease: sequence and timing

Abstract Background Autosomal dominant Alzheimer’s disease (ADAD) serves as a model for presymptomatic biomarker discovery. Characterising the temporal profile of plasma biomarker levels in presymptomatic individuals may enhance understanding of disease pathogenesis, inform futur...

A community-validated tool for clinical outcome calculation in multiple sclerosis: Consensus development and scenario-specific recommendations

Background: Reproducibility and comparability of disability outcomes remain major challenges in multiple sclerosis (MS) research. Definitions of disability progression vary widely across studies, and calculation criteria are often insufficiently documented to enable replication....

The Association of Umbilical Cord Blood Neurofilament Light With Nonreassuring Fetal Status: A Prospective Observational Study

( Int J Gynaecol Obstet . 2026 Mar;172(3):1491–1500. doi:10.1002/ijgo.70421) A prospective observational study explored whether neurofilament light (NfL), a marker of neuronal injury, can be reliably measured in umbilical cord blood and whether it is associated with nonreassuring...

Aorto‐Ostial Lesion Percutaneous Coronary Intervention: Clinical Characteristics, Predictors and Clinical Outcomes

ABSTRACT Background Aorto‐ostial coronary lesions represent a high‐risk subset of coronary disease because of fibrocalcific disease, elastic recoil, and difficulty achieving precise stent positioning. Percutaneous coronary intervention (PCI) of these lesions may therefore be asso...

Scaling up Genomics

Introduction: Genomic testing has substantial diagnostic and clinical value in nephrology, yet integrating testing into routine care requires service-level changes to ensure timely and equitable access. Methods: We conducted an observational cohort study at four tertiary centres,...

Intraarterial Thrombolysis: Past, Present, Future

Suboptimal clinical outcomes are common after ischemic stroke with large vessel occlusion despite current reperfusion treatment with intravenous thrombolysis and mechanical thrombectomy. Targeting residual distal arterial and microvascular occlusions with intraarterial thrombolys...