Academic literature on the topic 'Records Australia Management'

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Journal articles on the topic "Records Australia Management"

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REED, BARBARA. "Electronic records management in Australia." Records Management Journal 7, no. 3 (March 1997): 191–204. http://dx.doi.org/10.1108/eb027111.

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SCHAUDER, CHERRYL, and JAY KENNEDY. "Records Management in Australia: An Overview." Records Management Journal 6, no. 3 (March 1996): 161–72. http://dx.doi.org/10.1108/eb027094.

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Ville, Simon, and Grant Fleming. "Locating Australian Corporate Memory." Business History Review 73, no. 2 (1999): 256–64. http://dx.doi.org/10.2307/3116242.

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This research note reports on the quantity of business records available in Australia as indicated by a recent survey of the top one hundred firms operating during the twentieth century. The archival work was undertaken as part of a large study investigating aspects of corporate leadership in Australia, conducted Jointly at the Australian National University and the University of Melbourne. We found that the surviving records of Australian businesses cover a wide selection of firm types, and that the comprehensiveness of many archives places business history on a sound foundation for the future.
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Stuart, Katharine. "Methods, methodology and madness." Records Management Journal 27, no. 2 (July 17, 2017): 223–32. http://dx.doi.org/10.1108/rmj-05-2017-0012.

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Purpose This paper aims to present findings from a recent study examining current records management as fit for digital government in Australia. Design/methodology/approach This paper draws on findings from the first phase of research for a postdoctoral degree. This research was collected through an online quantitative survey of government records management professionals in Australia. The survey’s purpose was to understand whether the profession has kept pace with advances in, and expectations of, digital government. Building on the findings of the survey, this paper explores the concepts of methodology and methods and applies them to current digital records management in the Australian Government. Methodology for Australian Government digital records management is contained in the 2015 Digital Continuity 2020 policy. However, measuring method proved more difficult. The researcher supplemented data published by the National Archives of Australia and the Department of Finance with data from her own research to measure the validity of methods by examining suitability of current requirements. Findings Australian Government records management professionals overwhelmingly feel requirements, organisational culture and behaviour form a barrier to implementing successful records management programs. This paper finds that the Australian Government is buying ten times more digital storage per year than the sum of all of the digital Australian Government records known. This suggests perhaps not all records are recognised. While there will always be more storage than records, the ratio should not be so inflated. Further problems are found with requirements for records management being seen as mostly paper-based and too resource intensive to be of use. This research, combined with a contemporary literature review, shows that there is an imbalance with the current methodology and methods and asks the question: Has a methodology (Digital Continuity 2020) been created without suitable and known methods being in place? Research limitations/implications The method for collecting survey data was based on self-reporting, which can lead to limitations in that the population sample may exaggerate their response or demonstrate bias. However, responses to the survey were common enough to eliminate bias. The study is based on the Australian Government; however, findings may translate to other governments. This paper presents findings from the first phase of research of a postdoctoral degree. Not all findings are presented, only those relevant to the topic. Originality/value As the Australian Government moves to become a true digital government, records management is still required to ensure accountability of government actions and decisions. However, while the government transitions to digital, and information stores continue to grow, the question of whether records management has kept up with the rapid pace of digital information flow and expansion does not need to be asked. Instead, the time has come to ask, “What can we do to keep up?”
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Joseph, Pauline. "A case study of records management practices in historic motor sport." Records Management Journal 26, no. 3 (November 21, 2016): 314–36. http://dx.doi.org/10.1108/rmj-08-2015-0031.

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Purpose This paper aims to report on empirical research that investigated the records management practices of two motor sport community-based organisations in Australia. Design/methodology/approach This multi-method case study was conducted on the regulator of motor sport, the Confederation of Australian Motor Sport Ltd (CAMS) and one affiliated historic car club, the Vintage Sports Car Club (VSCC), in Western Australia. Data were gathered using an online audit tool and by interviewing selected stakeholders in these organisations about their organisation’s records management practices. Findings The findings confirm that these organisations experience significant information management challenges, including difficulty in capturing, organising, managing, searching, accessing and preserving their records and archives. Hence, highlighting their inability to manage records advocated in the best practice Standard ISO 15489. It reveals the assumption of records management roles by unskilled members of the group. It emphasises that community-based organisations require assistance in managing their information management assets. Research limitations/implications This research focused on the historic car clubs; hence, it did not include other Australian car clubs in motor sport. Although four historical car clubs, one in each Australian state, were invited to participate, only the VSCC participated. This reduced the sample size to only one CAMS-affiliated historical car club in the study. Hence, further research is required to investigate the records management practices of other CAMS affiliated car clubs in all race disciplines and to confirm whether they experienced similar information management challenges. Comments from key informants in this project indicated that this is likely the case. Practical implications The research highlights risks to the motor sport community’s records and archives. It signals that without leadership by the sport’s governing body, current records and community archives of CAMS and its affiliated car clubs are in danger of being inaccessible, hence lost. Social implications The research highlights the risks in preserving the continuing memory of records and archives in leisure-based community organisations and showcases the threats in preserving its cultural identity and history. Originality/value It is the first study examining records management practices in the serious leisure sector using the motor sport community.
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Pember, Margaret. "The rise of the ‘new age’ records management professional: records management education and training in Australia." Records Management Journal 8, no. 3 (December 1998): 63–75. http://dx.doi.org/10.1108/eum0000000007238.

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Patrickson, Margaret, and Leonie Hallo. "Female Immigrant Entrepreneurship: The Experience of Chinese Migrants to Australia." Administrative Sciences 11, no. 4 (December 3, 2021): 145. http://dx.doi.org/10.3390/admsci11040145.

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This article reports on findings from interviews with a small group of Chinese female immigrants to Australia who have started up their own business since their arrival. Unlike most publications concerning immigration that focus upon financial factors, we have instead concentrated on their personal journeys, why they started their businesses and the benefits they sought. We interviewed thirteen participants in Adelaide who had recently arrived from China with the aim of immigrating permanently to Australia. Immigration records indicate that by 2020 this figure had risen to over 160,000 per annum. However, it dropped again quickly in 2020 following the beginning of COVID-19. Nonetheless, according to recent Australian government records, over 866,200 current Australian residents have Chinese ancestry and 74% are first-generation migrants. The primary motivators for respondents were independence and control as well as income and skill development. Respondents were also satisfied by the personal development they gained.
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Michael, Robin. "Paperless Medical Records." Australian Medical Record Journal 19, no. 4 (December 1989): 149–54. http://dx.doi.org/10.1177/183335838901900404.

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Flinders Medical Centre (FMC) in South Australia has a storage problem. The space available for filing existing medical records is full, while the demand for additional storage continues its linear growth. The hospital plans to use this “crisis” as an opportunity to review the entire basis for the management of the medical record and pilot an optical disk system as a precursor to paperless medical records. There are many constraints to this objective, but many advantages if the scheme proves successful. Michael describes the events which precipitated this project and outlines the steps in FMC's planned progression to a paperless record. (AMRJ, 1989, 19(4), 149–154).
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Woinarski, J. C. Z., S. M. Legge, L. A. Woolley, R. Palmer, C. R. Dickman, J. Augusteyn, T. S. Doherty, et al. "Predation by introduced cats Felis catus on Australian frogs: compilation of species records and estimation of numbers killed." Wildlife Research 47, no. 8 (2020): 580. http://dx.doi.org/10.1071/wr19182.

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Abstract ContextWe recently estimated the numbers of reptiles, birds and mammals killed by cats (Felis catus) in Australia, with these assessments providing further evidence that cats have significant impacts on Australian wildlife. No previous studies have estimated the numbers of frogs killed by cats in Australia and there is limited comparable information from elsewhere in the world. AimsWe sought to (1) estimate the numbers of frogs killed by cats in Australia and (2) compile a list of Australian frog species known to be killed by cats. MethodsFor feral cats, we estimated the number of frogs killed from information on their frequency of occurrence in 53 cat dietary studies (that examined stomach contents), the mean number of frogs in dietary samples that contained frogs, and the numbers of cats in Australia. We collated comparable information for take of frogs by pet cats, but the information base was far sparser. Key resultsFrogs were far more likely to be reported in studies that sampled cat stomachs than cat scats. The mean frequency of occurrence of frogs in cat stomachs was 1.5%. The estimated annual per capita consumption by feral cats in Australia’s natural environments is 44 frogs, and, hence, the annual total take is estimated at 92 million frogs. The estimated annual per capita consumption by pet cats is 0.26 frogs, for a total annual kill of one million frogs by pet cats. Thirty native frog species (13% of the Australian frog fauna) are known to be killed by cats: this tally does not include any of the 51 threatened frog species, but this may simply be because no cat dietary studies have occurred within the small ranges typical of threatened frog species. ConclusionsThe present study indicated that cats in Australia kill nearly 100 million frogs annually, but further research is required to understand the conservation significance of such predation rates. ImplicationsThe present study completed a set of reviews of the impacts of cats on Australian terrestrial vertebrates. Cat predation on Australian frogs is substantial, but is likely to be markedly less than that on Australian reptiles, birds and mammals.
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Wilkins, Julia. "The Royal Flying Doctor Service Flies to New Heights: The Journey of Health Information Management." Health Information Management Journal 38, no. 3 (October 2009): 51–55. http://dx.doi.org/10.1177/183335830903800308.

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The Royal Flying Doctor Service (RFDS) of Australia was founded in 1928 by the Reverend John Flynn to deliver health services to the people of the Australian Outback. In this unique environment the RFDS Queensland Section provides both Primary Health Care and Aeromedical services to rural and remote communities throughout Queensland. It provides health services from a hub and spoke model and its clinicians work very closely with other health service providers, such as Queensland Heath, within the communities it visits. Currently, the RFDS' health records are both paper and electronic and clinicians duplicate much of patient information and data between RFDS and non-RFDS health records. Introduction of an off-the-shelf electronic medical record (EMR) would not meet the RFDS' clinical and organisational needs because of complexity, the multidisciplinary nature of the teams and the lack of communication technology in the communities the RFDS visits. This article defines the vision for a health information system designed to meet the requirements of the RFDS, and describes its implementation throughout RFDS Queensland using the PRINCE2 project management methodology.
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Dissertations / Theses on the topic "Records Australia Management"

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Druitt, Denise, and n/a. "The role of records management for overcoming excessive quantity, poor quality and storage media problems in computer-based information systems." University of Canberra. Communication, 1990. http://erl.canberra.edu.au./public/adt-AUC20060705.151052.

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Organizations are experiencing problems with the control of information in computer-based information systems. Records management is a system that consists of a number of elements to control recorded information over its life cycle. Previous studies have ranked various records management activities. However, these studies were not conducted in Australia, were not specifically related to computerbased information systems, and were based on the frequency with which records management tasks, or duties and responsibilities were being performed by records management personnel rather than the perceived importance of records management elements for overcoming problems. This study is conducted in Australia on the role of records management within the context of computer-based information systems. It has two purposes: to determine whether there is an appreciable difference in the perceived importance of the various records management elements for overcoming excessive quantity, poor quality and storage media problems in computer-based information systems by RMAA individual members; and to determine whether regardless of professional involvement and level of education of RMAA individual members, there is no statistically significant difference in the perceived importance of the various records management elements in computer-based information systems for overcoming these three problems. To carry out the research a questionnaire was devised and distributed to individual members of the Records Management Association of Australia. The survey obtained a usable response rate of 53.1 percent from a population of 399 individual members of the Association. The study indicated that there is a difference in the perceived importance of the various records management elements for overcoming excessive quantity, poor quality and storage media problems in computer-based information systems. There was evidence to suggest that respondents frequently involved in professional activities are more likely to consider certain records management elements more important than respondents not frequently involved in these activities. The study also found that level of education is associated with the selection of certain records management elements. In particular, those respondents with no tertiary qualifications are more likely to consider the records management elements mail management and a records retention and disposition schedule important than respondents with tertiary qualifications.
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Larkin, Devitt. "Aligning with the rapidly shifting technological goalposts : the review and update of the RIMPA technology survey." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2012. https://ro.ecu.edu.au/theses/516.

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In 2008 the Records and Information Management Professionals Australasia (RIMPA) organisation (then known as the Records Management Association of Australasia – RMAA) launched its Technology Survey. The survey attempted to capture a snapshot, predominantly but not exclusively in Australia and New Zealand, and gain empirical evidence about the use of technology adoption trends, RIM capabilities in host organisations and the role of RIM personnel in technology selection and adoption. The survey had a particular focus on Records Management (RM) and Enterprise Content Management (ECM) systems and processes, but also featured questions on the demographics of the participants, organisational policies and processes around these technologies and peripheral devices. In 2010 the survey was repeated. Consequently, the survey became more than a one-off cross-sectional snapshot and could lay claim to being a longitudinal study, however as a longitudinal study instrument the current survey is lacking validity and reliability. A consensus exists, however, that changes are required going forward if the survey is to continue. This consensus is based on issues that have emerged from analysis of the two iterations of the current instrument. The issues that need to be addressed are: • Low participation rate • The relatively high number of questions skipped • The overall length of the survey • Ensuring the survey has a clear and distinct aim • Ensuring what is captured is core to the survey’s aim • Ensuring what is captured is relevant to the RIM profession • The ambiguity of questions • Misunderstanding of questions • Scope – expansion of the instrument to encompass technology learning, knowledge and skills of RIM professions These issues were identified by Brogan and Roberts in their analyses of the 2008 and 2010 data (2009, 2011 and 2012). This study is an examination and revision of the current technology survey instrument, aimed at ensuring that issues of relevancy, currency, usability, design and clarity of terms and definitions are all addressed, resulting in a valid and reliable longitudinal study instrument. The research design employed involved: a) investigation of the peer reviewed literature on survey participation and instrument design; b) investigation of peer reviewed and non-peer reviewed literature on technology in the RIM space; c) Convening of a panel of experts (focus group) to provide feedback on the existing instrument; d) Re-design of the existing instrument taking into account outcomes from a-c; and e) Validation of the re-designed instrument via the Focus Group The Focus Group review involved six highly regarded and knowledgeable participants pro-active in the RIM profession who trialled the instrument in a subsequent Pilot Test. The Focus Group provided additional feedback on scope and usability from a user perspective. The final survey produced will enable RIMPA to be informed on the technology education and training needs of its members, as well as continuing to track technology adoption and RIM program trends in the workplace.
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Mount, Christopher. "An Australian integrated health record and information system (IHRIS)." Phd thesis, 2000. http://hdl.handle.net/1885/148140.

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Bassett, Cameron. "Cloud computing and innovation: its viability, benefits, challenges and records management capabilities." Diss., 2015. http://hdl.handle.net/10500/20149.

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This research investigated the potential benefits, risks and challenges, innovation properties and viability of cloud computing for records management on an Australian organisation within the mining software development sector. This research involved the use of a case study results analysis as well as a literature analysis. The literature analysis identified the ten potential benefits of cloud computing, as well as the ten risks and challenges associated with cloud computing. It further identified aspects, which needed to be addressed when adopting cloud computing in order to promote innovation within an organisation. The case study analysis was compared against a literature review of ten potential benefits of cloud computing, as well as the ten risks and challenges associated with cloud computing. This was done in order to determine cloud computing’s viability for records management for Company X (The company in the case study). Cloud computing was found to be viable for Company X. However, there were certain aspects, which need to be discussed and clarified with the cloud service provider beforehand in order to mitigate possible risks and compliance issues. It is also recommended that a cloud service provider who complies with international standards, such as ISO 15489, be selected. The viability of cloud computing for organisations similar to Company X (mining software development) followed a related path. These organisations need to ensure that the service provider is compliant with laws in their local jurisdiction, such as Electronic Transactions Act 1999 (Australia, 2011:14-15), as well as laws where their data (in the cloud) may be hosted. The benefits, risks and challenges of records management and cloud computing are applicable to these similar organisations. However, mitigation of these risks needs to be discussed with a cloud service provider beforehand. From an innovation perspective, cloud computing is able to promote innovation within an organisation, if certain antecedents are dealt with. Furthermore, if cloud computing is successfully adopted then it should promote innovation within organisations.
Information Science
M. Inf.
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"Comparative analysis of construction project management in specified Asian countries." Chinese University of Hong Kong, 1988. http://library.cuhk.edu.hk/record=b5885862.

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Books on the topic "Records Australia Management"

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Officers, Western Australia Royal Commission into Whether There Has Been Any Corrupt or Criminal Conduct by Western Australian Police. Western Australia Police Service: Information management and security. Perth]: Royal Commission into Whether There Has Been Any Corrupt or Criminal Conduct by Western Australian Police Officers, 2003.

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Charles Sturt University. Centre for Information Studies., ed. Disaster recovery for archives, libraries and records management systems in Australia and New Zealand. Wagga Wagga, N. S. W: Centre for Information Studies. Charles Sturt University - Riverina, 1997.

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Western Australia. Royal Commission into Whether There Has Been Any Corrupt or Criminal Conduct by Western Australian Police Officers. Western Australia Police Service: Corruption prevention strategies. Perth]: Royal Commission into Whether There Has Been Any Corrupt or Criminal Conduct by Western Australian Police Officers, 2003.

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Western Australia. Royal Commission into Whether There Has Been Any Corrupt or Criminal Conduct by Western Australian Police Officers. Western Australia Police Service: Internal investigations and disciplinary processes. Perth]: Royal Commission into Whether There Has Been Any Corrupt or Criminal Conduct by Any Western Australian Police Officer, 2003.

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Hone, Jim. Applied population and community ecology: A case study of terrestrial vertebrates. Hoboken, NJ: Wiley, 2012.

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Takeda, Hiroshi. E-Health: First IMIA/IFIP Joint Symposium, E-Health 2010, Held as Part of WCC 2010, Brisbane, Australia, September 20-23, 2010. Proceedings. Berlin, Heidelberg: IFIP International Federation for Information Processing, 2010.

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Playing for keeps: The proceedings of an electronic records management conference hosted by the Australian Archives, Canberra, Australia, 8-10 November 1994. Dickson, ACT: Australian Archives, 1995.

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A, Ellis Judith, and Australian Society of Archivists, eds. Selected essays in electronic recordkeeping in Australia. O'Connor, ACT: Australian Society of Archivists, 2000.

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Dagmar, Parer, Terry Ron, Australian Council of Archives, and Australian Society of Archivists, eds. Managing electronic records: Papers from a workshop on managing electronic records of archival value held on 30 October 1992 in Sydney Central ... New South Wales, Australia, and organised by the Electronic Records Committee of the Australian Council of Archives and jointly sponsored by that Council and the Australian Society of Archivists with assistance from the Australian Archives. [Sydney]: Australian Council of Archives, 1993.

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Dagmar, Parer, Terry Ron, Australian Council of Archives, Australian Society of Archivists, and Australian Council of Archives. Electronic Records Committee., eds. Managing electronic records: Papers from a workshop on Managing Electronic Records of Archival Value held on 30 October 1992 in Sydney Central, Pitt Street, Sydney, New South Wales, Australia and. O'Connor, ACT, Australia: Australian Council of Archives, 1993.

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Book chapters on the topic "Records Australia Management"

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Tarvey, Lance. "First nesting records for the Leatherback Turtle Dermochelys coriacea in northern New South Wales Australia, and field management of nest sites." In Herpetology in Australia, 233–38. P.O. Box 20, Mosman NSW 2088, Australia: Royal Zoological Society of New South Wales, 1993. http://dx.doi.org/10.7882/rzsnsw.1993.036.

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Cleary, GV. "Financial Management Records." In Pig Production in Australia, 310–15. Elsevier, 1990. http://dx.doi.org/10.1016/b978-0-409-32525-6.50057-8.

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Roese, GJ. "Using Production Records in Unit Management." In Pig Production in Australia, 300–306. Elsevier, 1990. http://dx.doi.org/10.1016/b978-0-409-32525-6.50055-4.

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Doig, Judith. "Management Issues in Disaster Recovery Planning." In Disaster Recovery for Archives, Libraries and Records Management Systems in Australia and New Zealand, 35–70. Elsevier, 1997. http://dx.doi.org/10.1016/b978-0-949060-35-8.50007-6.

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Ervin, Karen. "Legal and Ethical Considerations in the Implementation of Electronic Health Records." In Cases on Electronic Records and Resource Management Implementation in Diverse Environments, 193–210. IGI Global, 2014. http://dx.doi.org/10.4018/978-1-4666-4466-3.ch012.

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This chapter examines the literature of healthcare in the United States during the transitioning to electronic records. Key government legislation, such as the Health Insurance Portability and Accountability Act (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH), which were part of the American Recovery and Reinvestment Act (ARRA) and the Affordable Health Care Act, are reviewed. The review concentrates on patient privacy issues, how they have been addressed in these acts, and what recommendations for improvement have been found in the literature. A comparison of the adoption of electronic health records on a nationwide scale in three countries is included. England, Australia, and the United States are all embarking in and are at different stages of implementing nationwide electronic health database systems. The resources used in locating relevant literature were PubMed, Medline, Highwire Press, State Library of Pennsylvania, and Google Scholar databases.
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Medhekar, Anita, and Julie Nguyen. "My Digital Healthcare Record." In Research Anthology on Improving Health Literacy Through Patient Communication and Mass Media, 538–57. IGI Global, 2022. http://dx.doi.org/10.4018/978-1-6684-2414-8.ch030.

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In the 21st century, the digital revolution is disrupting every sector of the economy. Australia has adopted the digital healthcare technological revolution such as My Health Record (MyHRC) to improve healthcare practice for clinicians/medical professionals and empower consumers to provide positive health management experience with a patient-centred approach to digital health revolution and digital literacy. My Health Record has its benefits, but it has been a challenge for the healthcare practitioners, hospital staff, as well as patients as consumers to accept, embrace, and uptake digital technologies and manage their healthcare records amidst concerns of slow adoption by the patient, data privacy, and implications of the secondary use of their personal data by non-government entities.
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Medhekar, Anita, and Julie Nguyen. "My Digital Healthcare Record." In Opportunities and Challenges in Digital Healthcare Innovation, 131–50. IGI Global, 2020. http://dx.doi.org/10.4018/978-1-7998-3274-4.ch008.

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In the 21st century, the digital revolution is disrupting every sector of the economy. Australia has adopted the digital healthcare technological revolution such as My Health Record (MyHRC) to improve healthcare practice for clinicians/medical professionals and empower consumers to provide positive health management experience with a patient-centred approach to digital health revolution and digital literacy. My Health Record has its benefits, but it has been a challenge for the healthcare practitioners, hospital staff, as well as patients as consumers to accept, embrace, and uptake digital technologies and manage their healthcare records amidst concerns of slow adoption by the patient, data privacy, and implications of the secondary use of their personal data by non-government entities.
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"CENTRE FOR INFORMATION STUDIES." In Disaster Recovery for Archives, Libraries and Records Management Systems in Australia and New Zealand, ii. Elsevier, 1997. http://dx.doi.org/10.1016/b978-0-949060-35-8.50001-5.

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"Front Matter." In Disaster Recovery for Archives, Libraries and Records Management Systems in Australia and New Zealand, iii. Elsevier, 1997. http://dx.doi.org/10.1016/b978-0-949060-35-8.50002-7.

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"Copyright." In Disaster Recovery for Archives, Libraries and Records Management Systems in Australia and New Zealand, iv. Elsevier, 1997. http://dx.doi.org/10.1016/b978-0-949060-35-8.50003-9.

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Conference papers on the topic "Records Australia Management"

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Viney, Christopher. "Informing IT Managers - Why the Bank for International Settlements is Establishing a Capital Charge Guideline for Operational Risk: the Australian Evidence." In 2002 Informing Science + IT Education Conference. Informing Science Institute, 2002. http://dx.doi.org/10.28945/2585.

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IT managers within financial institutions must understand and be able to respond to the operational, financial and regulatory impacts that will result from a loss of critical business functions. The Basel Committee on Banking Supervision, through the Bank for International Settlements (BIS) has circulated a consultative paper which, if eventually adopted by nation-state bank supervisors, will impose an operational risk capital charge on banks as part of the new Capital Accord. Banks will also be required to record and report operational risk occurrences or events. This paper presents data on aspects of the disaster risk management practices of banks operating within the Australian financial system. The data indicate that banks, as a group, do not maintain effective disaster risk management practices and are not adequately prepared to recover a loss of critical business functions. The results clearly support the necessity of the BIS initiatives.
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Reports on the topic "Records Australia Management"

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Rankin, Nicole, Deborah McGregor, Candice Donnelly, Bethany Van Dort, Richard De Abreu Lourenco, Anne Cust, and Emily Stone. Lung cancer screening using low-dose computed tomography for high risk populations: Investigating effectiveness and screening program implementation considerations: An Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Cancer Institute NSW. The Sax Institute, October 2019. http://dx.doi.org/10.57022/clzt5093.

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Background Lung cancer is the number one cause of cancer death worldwide.(1) It is the fifth most commonly diagnosed cancer in Australia (12,741 cases diagnosed in 2018) and the leading cause of cancer death.(2) The number of years of potential life lost to lung cancer in Australia is estimated to be 58,450, similar to that of colorectal and breast cancer combined.(3) While tobacco control strategies are most effective for disease prevention in the general population, early detection via low dose computed tomography (LDCT) screening in high-risk populations is a viable option for detecting asymptomatic disease in current (13%) and former (24%) Australian smokers.(4) The purpose of this Evidence Check review is to identify and analyse existing and emerging evidence for LDCT lung cancer screening in high-risk individuals to guide future program and policy planning. Evidence Check questions This review aimed to address the following questions: 1. What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? 2. What is the evidence of potential harms from lung cancer screening for higher-risk individuals? 3. What are the main components of recent major lung cancer screening programs or trials? 4. What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Summary of methods The authors searched the peer-reviewed literature across three databases (MEDLINE, PsycINFO and Embase) for existing systematic reviews and original studies published between 1 January 2009 and 8 August 2019. Fifteen systematic reviews (of which 8 were contemporary) and 64 original publications met the inclusion criteria set across the four questions. Key findings Question 1: What is the evidence for the effectiveness of lung cancer screening for higher-risk individuals? There is sufficient evidence from systematic reviews and meta-analyses of combined (pooled) data from screening trials (of high-risk individuals) to indicate that LDCT examination is clinically effective in reducing lung cancer mortality. In 2011, the landmark National Lung Cancer Screening Trial (NLST, a large-scale randomised controlled trial [RCT] conducted in the US) reported a 20% (95% CI 6.8% – 26.7%; P=0.004) relative reduction in mortality among long-term heavy smokers over three rounds of annual screening. High-risk eligibility criteria was defined as people aged 55–74 years with a smoking history of ≥30 pack-years (years in which a smoker has consumed 20-plus cigarettes each day) and, for former smokers, ≥30 pack-years and have quit within the past 15 years.(5) All-cause mortality was reduced by 6.7% (95% CI, 1.2% – 13.6%; P=0.02). Initial data from the second landmark RCT, the NEderlands-Leuvens Longkanker Screenings ONderzoek (known as the NELSON trial), have found an even greater reduction of 26% (95% CI, 9% – 41%) in lung cancer mortality, with full trial results yet to be published.(6, 7) Pooled analyses, including several smaller-scale European LDCT screening trials insufficiently powered in their own right, collectively demonstrate a statistically significant reduction in lung cancer mortality (RR 0.82, 95% CI 0.73–0.91).(8) Despite the reduction in all-cause mortality found in the NLST, pooled analyses of seven trials found no statistically significant difference in all-cause mortality (RR 0.95, 95% CI 0.90–1.00).(8) However, cancer-specific mortality is currently the most relevant outcome in cancer screening trials. These seven trials demonstrated a significantly greater proportion of early stage cancers in LDCT groups compared with controls (RR 2.08, 95% CI 1.43–3.03). Thus, when considering results across mortality outcomes and early stage cancers diagnosed, LDCT screening is considered to be clinically effective. Question 2: What is the evidence of potential harms from lung cancer screening for higher-risk individuals? The harms of LDCT lung cancer screening include false positive tests and the consequences of unnecessary invasive follow-up procedures for conditions that are eventually diagnosed as benign. While LDCT screening leads to an increased frequency of invasive procedures, it does not result in greater mortality soon after an invasive procedure (in trial settings when compared with the control arm).(8) Overdiagnosis, exposure to radiation, psychological distress and an impact on quality of life are other known harms. Systematic review evidence indicates the benefits of LDCT screening are likely to outweigh the harms. The potential harms are likely to be reduced as refinements are made to LDCT screening protocols through: i) the application of risk predication models (e.g. the PLCOm2012), which enable a more accurate selection of the high-risk population through the use of specific criteria (beyond age and smoking history); ii) the use of nodule management algorithms (e.g. Lung-RADS, PanCan), which assist in the diagnostic evaluation of screen-detected nodules and cancers (e.g. more precise volumetric assessment of nodules); and, iii) more judicious selection of patients for invasive procedures. Recent evidence suggests a positive LDCT result may transiently increase psychological distress but does not have long-term adverse effects on psychological distress or health-related quality of life (HRQoL). With regards to smoking cessation, there is no evidence to suggest screening participation invokes a false sense of assurance in smokers, nor a reduction in motivation to quit. The NELSON and Danish trials found no difference in smoking cessation rates between LDCT screening and control groups. Higher net cessation rates, compared with general population, suggest those who participate in screening trials may already be motivated to quit. Question 3: What are the main components of recent major lung cancer screening programs or trials? There are no systematic reviews that capture the main components of recent major lung cancer screening trials and programs. We extracted evidence from original studies and clinical guidance documents and organised this into key groups to form a concise set of components for potential implementation of a national lung cancer screening program in Australia: 1. Identifying the high-risk population: recruitment, eligibility, selection and referral 2. Educating the public, people at high risk and healthcare providers; this includes creating awareness of lung cancer, the benefits and harms of LDCT screening, and shared decision-making 3. Components necessary for health services to deliver a screening program: a. Planning phase: e.g. human resources to coordinate the program, electronic data systems that integrate medical records information and link to an established national registry b. Implementation phase: e.g. human and technological resources required to conduct LDCT examinations, interpretation of reports and communication of results to participants c. Monitoring and evaluation phase: e.g. monitoring outcomes across patients, radiological reporting, compliance with established standards and a quality assurance program 4. Data reporting and research, e.g. audit and feedback to multidisciplinary teams, reporting outcomes to enhance international research into LDCT screening 5. Incorporation of smoking cessation interventions, e.g. specific programs designed for LDCT screening or referral to existing community or hospital-based services that deliver cessation interventions. Most original studies are single-institution evaluations that contain descriptive data about the processes required to establish and implement a high-risk population-based screening program. Across all studies there is a consistent message as to the challenges and complexities of establishing LDCT screening programs to attract people at high risk who will receive the greatest benefits from participation. With regards to smoking cessation, evidence from one systematic review indicates the optimal strategy for incorporating smoking cessation interventions into a LDCT screening program is unclear. There is widespread agreement that LDCT screening attendance presents a ‘teachable moment’ for cessation advice, especially among those people who receive a positive scan result. Smoking cessation is an area of significant research investment; for instance, eight US-based clinical trials are now underway that aim to address how best to design and deliver cessation programs within large-scale LDCT screening programs.(9) Question 4: What is the cost-effectiveness of lung cancer screening programs (include studies of cost–utility)? Assessing the value or cost-effectiveness of LDCT screening involves a complex interplay of factors including data on effectiveness and costs, and institutional context. A key input is data about the effectiveness of potential and current screening programs with respect to case detection, and the likely outcomes of treating those cases sooner (in the presence of LDCT screening) as opposed to later (in the absence of LDCT screening). Evidence about the cost-effectiveness of LDCT screening programs has been summarised in two systematic reviews. We identified a further 13 studies—five modelling studies, one discrete choice experiment and seven articles—that used a variety of methods to assess cost-effectiveness. Three modelling studies indicated LDCT screening was cost-effective in the settings of the US and Europe. Two studies—one from Australia and one from New Zealand—reported LDCT screening would not be cost-effective using NLST-like protocols. We anticipate that, following the full publication of the NELSON trial, cost-effectiveness studies will likely be updated with new data that reduce uncertainty about factors that influence modelling outcomes, including the findings of indeterminate nodules. Gaps in the evidence There is a large and accessible body of evidence as to the effectiveness (Q1) and harms (Q2) of LDCT screening for lung cancer. Nevertheless, there are significant gaps in the evidence about the program components that are required to implement an effective LDCT screening program (Q3). Questions about LDCT screening acceptability and feasibility were not explicitly included in the scope. However, as the evidence is based primarily on US programs and UK pilot studies, the relevance to the local setting requires careful consideration. The Queensland Lung Cancer Screening Study provides feasibility data about clinical aspects of LDCT screening but little about program design. The International Lung Screening Trial is still in the recruitment phase and findings are not yet available for inclusion in this Evidence Check. The Australian Population Based Screening Framework was developed to “inform decision-makers on the key issues to be considered when assessing potential screening programs in Australia”.(10) As the Framework is specific to population-based, rather than high-risk, screening programs, there is a lack of clarity about transferability of criteria. However, the Framework criteria do stipulate that a screening program must be acceptable to “important subgroups such as target participants who are from culturally and linguistically diverse backgrounds, Aboriginal and Torres Strait Islander people, people from disadvantaged groups and people with a disability”.(10) An extensive search of the literature highlighted that there is very little information about the acceptability of LDCT screening to these population groups in Australia. Yet they are part of the high-risk population.(10) There are also considerable gaps in the evidence about the cost-effectiveness of LDCT screening in different settings, including Australia. The evidence base in this area is rapidly evolving and is likely to include new data from the NELSON trial and incorporate data about the costs of targeted- and immuno-therapies as these treatments become more widely available in Australia.
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