The George Institute For Global Health
United Kingdom

Changing Health Practice

The George Institute is committed to producing high-quality, high-impact research evidence to inform policy, guidelines and practices across the world. Many of the programs conducted by The Institute have had an impact on chronic disease and injury treatment and prevention globally.

A number of cross-sectional surveys into vascular risk assessment and management in Australian primary care settings were undertaken by staff at the Institute, which has resulted in changes made to the 2009 Absolute Risk Assessment Guidelines.

Results of the landmark intensive care research study, SAFE TBI, showed that the choice of resuscitation fluids affects the chance of patients with brain injury surviving.

A review by a major blood pressure collaboration conducted in 2005 helped inform the UK National Health Service, US Food and Drug Administration, European Society of Hypertension for new blood pressure treatment recommendations made by the National Collaborating Centre for Chronic Conditions and Royal College of Physicians guidelines for the management of type 2 diabetes. The US FDA also moved to change blood pressure drug pricing policy following this research, and the findings continue to be widely cited by the European Society of Hypertension guidelines.

Results of a systematic review of acute low back pain by the Musculoskeletal Division were incorporated into the National Institute of Clinical Studies guidelines - 'Lumbar imaging in acute non-specific low back pain'. Further studies by these and collaborating researchers have also resulted in whiplash guidelines endorsed by the National Health and Medical Council and Chartered Society of Physiotherapy.

Results, published in The New England Journal of Medicine of the large intensive care study NICE-SUGAR showed intensively lowering blood glucose levels in critically ill patients increases the risk of death by 10%. These results call for an urgent review of international guidelines for blood pressure lowering, and will form the basis of recommendations for the review of clinical guidelines and management strategies in 2010 for several specialist groups, including the International Brain Trauma Foundation.

In Australia, the Institute is working with the Baker IDI Heart and Diabetes Institute on the National Health and Medical Research Council guidelines for type 2 diabetes. Drawing from the extensive work in of the largest study of type 2 diabetes treatments, the ADVANCE study, this will include a review of the latest evidence to inform guidelines on lipid and blood pressure management, macrovascular and foot disease. The new guidelines were released in 2010.

After establishing the frequency and predictors of depression following stroke, researchers at the Institute have contributed to three Cochrane reviews on the management of depression and emotionalism following stroke. Demonstrating the lack of effective strategies for the treatment and prevention of this condition, this evidence has informed several stroke management guidelines including in Australia, New Zealand, the United Kingdom and Unites States of America.

Extensive research by the Musculoskeletal Division has seen many changes in clinical guidelines for the management of chronic back pain, including those by the American Society of Interventional Pain Physicians, the Institute of Health Economics Alberta, Canada, the 2009 UK National Institute for Health and Clinical Excellence, the Finnish Low Back Pain Guideline, the Canadian clinical practice guideline, American Pain Society/American College of Physicians and the European Union Guidelines.