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The first-line standard treatment for diffuse large B-cell lymphoma (DLBCL) is the R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, prednisone). It is associated with cardiotoxicity, which is why new treatment strategies are needed. Liposomial doxorubicin has been proven to reduce these side-effects, but until now a direct comparison regarding efficacy has not yet been published. We retrospectively assessed 364 consecutive DLBCL patients who underwent either R-CHOP (218; 60%) or R-COMP (doxorubicin replaced by non-pegylated liposomal doxorubicin; 146; 40%) in first line and compared outcome and survival. We provide evidence that both regimens induce a high and comparable number of complete remissions and that both are able to cure patients with DLBCL. Confirmatory data are needed. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has significantly impacted the delivery of mental health services globally. Within Australia, the COVID-19 pandemic and subsequent containment measures have led to reduced face-to-face attendances. To maintain access to mental health consultations, new telehealth services were introduced by the Australian Government in late March 2020. Objectives: We aimed to quantify the impact of the COVID-19 pandemic on patterns of mental health attendances in Australia using an interrupted time series model. Methods: To characterise patterns of mental health service utilisation, monthly mental health attendances between January 2016 and June 2020 were extracted from the Medicare database, stratified by clinician type: general practitioner (GP), psychiatrist, and allied health. We used triple exponential smoothing to model attendances between January 2017 and December 2019. Observed and predicted attendances between January and June 2020 were compared with 95% confidence (p<0.05). Results: Ourmodels showed decreasedmental health attendances in March and April, consistent with all healthcare services during this time. While uptake of telehealth was significant, it only partially covered the reduction in mental health attendances. Conclusions: Our modelling highlights the significant impacts of the COVID-19 pandemic on mental health services in Australia, with telehealth only partially compensating for the reduction in face-to-face attendances. These results suggest that telehealth services may not be suitable for all individuals (e.g. those without reliable internet access). Given that telehealth will likely remain a feature of mental health service provision, outreach and face-toface services should be considered for vulnerable groups. [ABSTRACT FROM AUTHOR]

Introduction: The use of diagnostic imaging services is increasing worldwide. This has important impacts on healthcare resource allocation and potential risks to the population. This study aimed to quantify trends in medical imaging in Australia over the past two decades., Methods: Data were extracted from the Australian Medicare Benefits Schedule (MBS) between 2000 and 2021. Simple linear regression analyses were performed to assess changes in absolute utilisation and utilisation rate per 100,000 population of total imaging services as well as by each imaging modality. Logistic regression analysis was performed to assess changes in total imaging services as a proportion of total Medicare services over time. Chi-squared test was used to assess for change in modality composition of imaging services., Results: There were 436,255,500 imaging studies performed between 2000 and 2021. The absolute utilisation of total imaging services increased annually by an average of 864,404 (95% CI: 808,235-920,573, p < 0.001). For each consecutive year, the proportion of total Medicare services attributed to total imaging services increased by 0.01% (95% CI: 0.01-0.01, p < 0.01). There was also a statistically significant increase in the utilisation rates of imaging services per 100,000 population for each imaging modality. The number of imaging services per radiologist increased on average by 74 (95% CI: 26-122, p < 0.05) annually., Conclusion: The utilisation of diagnostic imaging services has increased in Australia between 2000 and 2021, outpacing the population growth, total healthcare services, and the radiologist workforce., (© 2023 Royal Australian and New Zealand College of Radiologists.)

Introduction: The COVID-19 pandemic is driving unprecedented changes in healthcare services worldwide. This study aimed to quantify the impact of the first wave of the COVID-19 pandemic on diagnostic imaging services in Australia using an interrupted time series model., Methods: Monthly data were extracted from the Australian Medicare Benefits Schedule for all diagnostic imaging services performed between January 2016 and December 2019. Holt-Winters forecasting models were developed for total imaging services as well as for each imaging modality. The models were used to predict monthly data between January 2020 and June 2020 with a 95% confidence interval (P < 0.05). Absolute and percentage residual differences (RD) between observed and predicted services for this time period were calculated., Results: There were statistically significant reductions in total imaging services performed in March 2020 (RD: -332260, -13.1%, 95% CI: -17.5% to -8.4%), April 2020 (RD: -716957, -32.4%, 95% CI: -36.2% to -28.1%) and May 2020 (RD: -571634, -21.4%, 95% CI: -25.1% to -17.3%). Nuclear medicine and CT services were relatively less impacted than general radiography, ultrasound, and MRI services. There was also a statistically significant increase in nuclear medicine and CT services performed in June 2020 compared to predicted values., Conclusions: During the first wave of COVID-19 in Australia, there was a significant reduction in total diagnostic imaging services, with variable impacts on different imaging modalities. These findings may have significant public health implications and can be used to inform evidence-based strategies in the recovery phase of the pandemic., (© 2021 The Royal Australian and New Zealand College of Radiologists.)

The COVID-19 (coronavirus disease 2019) pandemic has the potential to worsen existing health inequalities faced by Aboriginal and Torres Strait Islander peoples in Australia. We aimed to assess the impact of the pandemic on First Nations people health assessments using an interrupted time series model utilizing data extracted from the Australian Medicare Benefits Schedule database. Additive triple exponential smoothing was used to model health assessments undertaken between January 2017 and December 2019. The model was used to predict health assessments between January 2020 and June 2020 with 95% confidence ( P < .05). There was no significant difference between observed and predicted First Nations people health assessments in January, February, and June 2020. However, we found a statistically significant decrease in health assessments in March (16.5%), April (23.1%), and May (17.2%) 2020. The proportion of total health assessments delivered via telehealth was 0.5%, 23.6%, 17.6%, and 10.0% for March, April, May, and June 2020, respectively. The decrease in total First Nations people health assessments compounds the risk of poorer health outcomes in this population already vulnerable due to a high burden of chronic disease and considerable social, economic, and health inequalities. Strategies to improve the delivery of telehealth for First Nations people must be considered.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic and subsequent restrictions on dental services have had a significant impact on the provision of dental care in Australia and around the world., Objectives: To investigate the impact of COVID-19 on medications prescribed by dentists under the Australian Pharmaceutical Benefits Scheme (PBS)., Methods: Data on the number of dental prescriptions dispensed for all medications listed on the PBS Dental Schedule, from January 2019 to June 2020, were extracted from publicly available data sets. Analysis of prescription trends was performed for 1) total medications, 2) each major medication class, and 3) individual medications. The number of prescriptions dispensed in each month from January 2020 to June 2020 was compared to the same month in 2019 to determine the relative (percentage) change, and z statistics were used to determine whether changes were statistically significant., Results: There was a significant decrease in dental prescriptions in April 2020 compared to April 2019 (14,785, 18%; P < 0.05). Decreases in prescriptions for antibiotics (10,512, 16%; P < 0.05) and opioid analgesics (3,129, 18%; P < 0.05) were smaller compared to other major medication classes. There was a significant increase in June 2020, compared with June 2019, for prescriptions of amoxicillin with clavulanic acid (4,903, 20%; P < 0.05), tramadol (89, 46%; P < 0.05), and oxycodone (381, 73%; P < 0.05)., Conclusion: Dental service restrictions during COVID-19 likely drove an unmet need for routine dental treatment, which had significant implications for public oral health following easing of restrictions. During the initial surge and subsequent lockdown, antibiotics and opioid analgesics may have been used an as alternative to routine operative treatment. Continued professional guidance is required to ensure dental prescribing remains evidence based during the pandemic period., Knowledge Transfer Statement: The COVID-19 pandemic and subsequent restrictions on dental practice have had a profound impact on the provision of dental care in Australia and elsewhere in the world. In this context, population-level medication surveillance is important to identify and respond to changes in prescribing patterns that have arisen due to COVID-19 and restrictions on the provision of dental care. This research is particularly important for governments, regulators, and professional associations to ensure therapeutic guidelines and recommendations during the pandemic period remain relevant and evidence based.