Professor Les Irwig

MBBCh, PhD, FFPHM

Professor
Screening and Test Evaluation Program

Room 301B
Edward Ford Building (A27)
The University of Sydney
NSW 2006

Phone: +61 2 9351 4370
Fax: +61 2 9351-5049

http://www.health.usyd.edu.au/step/
http://www.health.usyd.edu.au/shdg/


  (Update details)

Research Interests

Epidemiological methods for screening, diagnostic test evaluation and meta-analysis.

Les is especially interested in the application of epidemiological methods to provide the evidence on which to base Public Health and Clinical decisions. His particular area of expertise is the assessment of screening and diagnostic tests through systematic review (meta-analysis) and the conduct of new studies.

Current research projects

Many projects fall within the ambit of Screening and Test Evaluation Programs (STEP) which Les Irwig convenes.

Affiliated

Until recently Les chaired the Cochrane Collaboration Methods Working Group on Screening and Diagnostic tests. The Screening and Diagnostic Tests website is located at http://som.flinders.edu.au/fusa/cochrane/cochrane/sadt.htm

Grant reviewing roles:
Agency of Health Care Policy and Research (USA) - from 1998
Clive and Vera Ramaciotti Foundation
Health Services Research Committee, Hong Kong - from 1997
Leo and Jenny Leukaemia & Cancer Foundation of Australia
Medical Research Council of Canada
National Health and Medical Research Council (NH&MRC)
NSW Cancer Council

Editorial roles:
Referee, Cochrane Collaboration publications
Member, Editorial Board, Journal of Medical Screening

Reviewer for:
American Journal of Epidemiology
American Journal of Gastroenterology
American Journal of Public Health
Australian and New Zealand Journal of Public Health
British Medical Journal
Clinical Chemistry
Cochrane Collaboration
Epidemiology
International Journal of Epidemiology
Journal of Clinical Epidemiology
Journal of Medical Screening
Medical Journal of Australia
Scandinavian Journal of Clinical and Laboratory Investigation
Statistics in Medicine

Teaching area

Les teaches courses on diagnostic test assessment, meta-analysis & guideline development, and advanced epidemiological methods. He also is heavily involved in the Faculty’s Graduate Medical Program, in particular the Evidence-Based Medicine component.

Publications

Books

Irwig L, Irwig J, Trevena L, Sweet, M. Smart Health Choices - Making sense of health advice. Hammersmith Press. 2008.

Barratt AL, Irwig L, Glasziou P, Cumming R, Raffle A, Hicks N, Gray JAM, Guyatt G. The fundamentals of screening. Oxford Handbook of Public Health. Oxford University Press. Oxford 2001.

Glasziou P, Irwig L, Bain C, Colditz G. Systematic reviews in health care. A practical guide. Cambridge University Press, UK, 2001

Irwig J, Irwig L, Sweet M. Smart Health Choices: How to Make Informal Health Decisions, Sydney, Allen & Unwin, 1999.

Peer Reviewed/Refereed Journal Articles

Leeflang MMG, Bossuyt PMM, Irwig L. Diagnostic test accuracy may vary with prevalence: implications for evidence-based diagnosis. Jnl of Clin Epidem. 2009;62:5-12

Lucas N, Macaskill P, Irwig L, Moran R, Bogduk. Reliability of physical examination for diagnosis of myofascial trigger points. Clin J Pain. 2009;25(1):80-89

Keenan K, Hayen A, Neal BC, Irwig L. Long term monitoring in patients receiving treatment to lower blood pressure: analysis of data from placebo controlled randomised controlled trial. BMJ. 2009;338

Bell KJL, Hayen A, Macaskill P, Craig JC, Neal BC, Irwig L. Mixed models showed no need for initial response monitoring after starting anti-hypertensive therapy. Journal of Clinical Epidemiology. 2009; 62(6): 650-9

Bell KJL, Hayen A, Macaskill P, Irwig L, Craig JC, Ensrud K, Bauer DC. Value of routine monitoring of bone mineral density after starting bisphosphonate treatment: secondary analysis of trial data. BMJ. 2009;338(232)

McGeechan K, Liew G, Macaskill P, Irwig L, Klein R, Klein BEK, Wang JJ, Mitchel P, Vingerling JR, deJong PTVM, Witteman JCM, Breteler MMB, Shaw J, Zimmet P, Wong TY. Meta-analysis: Retinal Vessel Caliber and Risk for Coronary Heart Disease. Annals of Internal Medicine. 2009;151:404-413

Craig JC, Simpson JM, Williams GJ, Lowe A, Reynolds GJ, McTaggart SJ, Hodson EM, Carapetis JR, Cranswick NE, Smith G, Irwig LM, Caldwell PHY, Hamilton S, Roy LP. Antibiotic Prophylaxis and Recurrent Urinary Tract Infection in Children. NEJM. 2009;Volume 361(18):1748-1759

Lord Sj, Irwig L, Bossuyt PM. Using the Principles of Randomized Controlled Trial Design to Guide Test Evaluation. Medical Decision Making. 2009;29:E1 - E12.

Bell K, Irwig L, Craig J, Macaskill P. Use of randomised trials to decide when to monitor response to new treatment. BMJ 2008:336;361-365.

Adelstein B.A, Irwig L, Macaskill P, Katelaris P.H, Jones D.B, Bokey L. A self administered reliable questionnaire to assess lower bowel symptons. BMC Gastroenterology 2008;8:8.

Turner, M.J., Van Schalkwyk, J.M., Irwig, L.B. Lax sphygmomanometer standard causes overdetection and underdetection of hypertension: a computer simulation study. Blood Pressure Monitoring 2008;13:(2)91-99.

Glasziou, P.P., Irwig, L., Heritier, S., Simes, J., Tonkin, A. Monitoring Choloestrol Levels: Measurement Error or True Change. Annuals of Internal Medicine 2008;148:(9), 656-661.

Houssami N,Ciatto S, Macaskill P, Lord S.J, Warren R, Dixon J.M, Irwig L. Accuracy and surgical impact of MRI in breast cancer staging: Systematic review and meta-analysis in detection of multifocal and multicentric cancer. Journal of Clinical Oncology 2008;26:(19)3248-3258.

Howard, K., Salkeld, G., McCaffery, K., Irwig, L. HPV triage testing or repeat PAP smear for the management of atypical squamous cells (ASCUS) on PAP smear: Is there evidence of process utility? Health Economics 2008;17:593-605.

Trevena, L.J., Irwig, L., Barratt, A. Randomized trial of a self-administered decision aid for colorectal cancer screening. J Med Screen 2008;15:76-82.

Craig, J.C., Webster, A.C., Mitchell, A., Irwig, L. Expanding the Evidence Base in Transplantation: More and Better Randomized Trials, and Extending the Value of Observational Data. Transplantaton 2008;86(1):32-35.

McGeechan, K. Liew, G., Macaskill, P., Irwig, L, Klein, R., Sharrett, A.R., Klein, B.E., Wang, J.J., Chambless, L.E., Wong, T.Y. Risk prediction of coronary heart disease based on retinal vascular caliber (from the Atherosclerosis Risk In Communities [ARIC]Study). American Journal of Cardiology 2008;102(1):58-63.

Chan, S., Deeks, J., Macaskill, P., Irwig, L.. Three methods to construct predictive models using logistic regression and likelihood ratios to facilitate adjustment for pretest probability give similar results. Journal of Clinical Epidemiology. 2008; 61(1):52-63.

Hewitson P, Glasziou P, Watson E, Towler B, Irwig L. Cochrane Systematic Review of Colorectal Cancer Screening Using the Fecal Occult Blood Test (Hemoccult): An Update. American Journal of Gastroenterology 2008;103(6):1541-1549.

Entwistle VA, Carter SM, Flitcroft KL, Irwig L, McCaffery K, Salkeld G. Communicating about screening: a proposed new direction. BMJ 2008;337:a1591.

McGeechan K, Macaskill P, Irwig L, Liew G, Wong TY. Assessing new biomarkers and predictive models for use in clinical practice. Archives Internal Medicine 2008;168(21):2304-2310

Davey E, D`Assuncao J, Irwig L, Macaskill P, Chan SF, Richards A, Farnsworth A. More histological high-grade cervical disease is detected by the ThinPrep Imager than by conventional cytology: a prospective study. BMJ 2007;335(7609):31.

Davey E, Irwig L, Macaskill P, Chan SF, D`Assuncao J, Richards A, Farnsworth A. Cervical cytology reading times: A comparison between thinprep imager and conventional methods. Diagnostic Cytopathology 2007;35(9):550-554.

Trevena L, Irwig L, Barratt A. GP`s want tailored, user friendly evidence summaries - A cross sectional study in NSW. Australian Family Physician 2007;36(12):1056-1069.

McCaffery KJ, Irwig L, Bossuyt P. Patient decision aids to support clinical decision making: evaluating the decision or the outcomes of the decision. Special Issue: Decision Aids. Medical Decision Making. Sep-Oct;27(5):619-25

Biesheuvel, C., Barratt, A., Howard, K., Houssami, N., Irwig, L. Estimates of invasive breast cancer overdectection by mammography screening are affected by study methods and biases: A systematic review. Lancet Oncology 2007;8(12):1129-1138.

Biesheuvel C, Irwig L, Bossuyt P. Observed differences in diagnostic test accuracy between patient subgroups: is it real or due to reference standard misclassification? Clinical Chemistry. 2007;53(10): 1725-1729

Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Lijmer JG, Moher D, Rennie D, de Vet HC; STARD Group. Towards complete and accurate reporting of studies of diagnostic accuracy: the STARD initiative. Vet Clin Pathol. 2007;36(1):8-12.

Houssami N, Irwig L, Ciatto S. Radiological surveillance of interval breast cancers in screening. Lancet Oncology 2006;7:259-265.

Lord S, Simes J, Irwig L. Assessment of new diagnostic tests when can studies of test accuracy suffice and when do we need randomized trials? Annals of Internal Medicine 2006;144(11):850-5.

Trevena L, Irwig L, Barratt A. The impact of privacy legislation on the number and characteristics of people who are recruited for research: a randomised controlled trial. Journal of Medical Ethics 2006;32:473-477.

Turner MJ, Irwig L, Bune AJ, Kam PC, Baker AB. Lack of sphygmomanometer calibration causes over - and under-detection of hypertension - a computer simulation study. Journal of Hypertension 2006;24:1931-1938.

Jabbour J, Irwig L, Macaskill P. Intraocular lens power in bilateral cataract surgery: Whether adjusting for error of predicted refraction in the first eye improves prediction in the second eye. Journal of Cataract & Refractive Surgery. 2006; 32: 2091-2097

Glasziou P.P, Hewitson P, Irwig L. Updated colorectal cancer screening systematic review. The Cochrane Database ,.November 2006.

Lord SJ, Irwig L, Simes RJ. Assessment of new diagnostic tests: when can studies of test accuracy suffice and when do we need randomized trials? Annals of Internal Medicine, 144:850-855, 2006 June 6.

Bossuyt PMM, Irwig L, Craig J, Glasziou P. Comparative Accuracy: Assessing new tests against existing diagnostic pathways. BMJ 2006;332:1089-1092.

Irwig L, Macaskill P, Walter SD, Houssami N. New methods give better estimates of changes in diagnostic accuracy when prior information is provided. Journal of Clinical Epidemiology 2006;59(3):299-307.

Irwig L, McCaffery K, Salkeld G. and Bossuyt P. Informed choice for screening: implications for evaluation. BMJ 2006;332:1148-50.

Davey E, Barratt A, Irwig L, Chan Siew F, Macaskill P, Mannes P. and Saville AM. Effect of study design and quality on unsatisfactory rates, cytology calssifications, and accuracy in liquid-based versus conventional cervical cytology: a systematic review. The Lancet 2006;367:122-132.(Editorial comments by Obwegeser J & Schneider Von pages 88-89)

Houssami N, Irwig L, Ung O. Review of complex breast cysts: Implications of cancer detection and clinical practice. ANZ J Surg 2005; 75: 1080-85

Howard K, Salkeld G, Irwig L, Adelstein B. High participation rates are not necessary for cost-effective colorectal cancer screening. J Med Screen 2005;12:96-102.

Houssami N, Ciatto S, Ambrogetti D, Catarzi S, Risso G, Bonardi R. and Irwig L. Florence-Sydney Breast Biopsy Study: sensitivity of ultrasound-guided versus freehand fine needle biopsy of palpable breast cancer. Breast Cancer Research and Treatment 2005;89:55-59.

Houssami N, Irwig L, Simpson JM, McKessar M, Blome S, Noakes J. The influence of knowledge of mammograph findings on the accuracy of breast ultrasound in symptomatic women. The Breast Journal 2005;11:167-172.

Glasziou P, Irwig L, Mant D. Monitoring in chronic disease: a rational approach. BMJ 2005;330:644-8.

Deeks JJ, Macaskill P, Irwig L. The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. Journal of Clinical Epidemiology 2005;58(9):882-893.

Tew K, Irwig L, Matthews A, Crowe P, Macaskill P. Review article: Meta-analysis of sentinel node imprint cytology in breast cancer. British Journal of Surgery 2005;92:1068-1080.

Tew K, Irwig L, Matthews A, Crowe P. and Macaskill P. Meta-analysis of sentinel node imprint cytology in breast cancer. British Journal of Surgery 2005;92:1068-1080.

McCaffery K and Irwig L. Australian women's needs and preference for information about human papillomavirus in cervical screening. J Med Screen 2005;12(3):134-141.

Barratt A, Howard K, Irwig L, Salkeld G, Houssami N. Model of outcomes of screening mammography: information to support informed choices. BMJ 2005;330(7497):936.

Bakis S, Irwig L, Wood G and Wong D. Exfoliative Cytology as a Diagnostic Test for Basal Cell Carcinomas: A Meta-analysis. British Journal of Dermatology 2004;150:829-836.

Irwig L, Houssami N and Van Vliet C. New technologies in screening for breast cancer: a systematic review of their accuracy. British Journal of Cancer 2004;90:2118-2122.

Loy CT and Irwig L. Accuracy of Diagnostic Tests Read With and Without Clinical Information: A Systematic Review. JAMA 2004;292(13):1602-1609.

Loy C, Irwig L. Accuracy of diagnostic tests read with and without clinical information. A systematic review. JAMA 2004;292:1602-9.

Houssami N, Irwig L, Simpson JM, McKessar M, Blome S. and Noakes J. The influence of clinical information on the accuracy of diagnostic mammorgraphy. Breast Cancer Research and Treatment 2004;85:223-228.

Irwig L, Macaskill P, Farnsworth A, Wright RG, McCool J, Barratt A, Simpson JM. A randomized crossover trial of PAPNET for primary cervical screening. Journal of Clinical Epidemiology. 2004;57:75-81.

Irwig L, Houssami N. and van Vliet C. New technologies in screening for breast cancer: a systematic review of their accuracy. British Journal of Cancer 2004;90:2118-2122.

Bakis S, Irwig L, Wood G. and Wong D. Exfoliative cytology as a diagnostic test for basal cell carcinoma: a meta-analysis. British Journal of Dermatology 2004;150:829-836.

Chan SF, Macaskill P, Irwig L, Walter SD. Adjustment for baseline measurement error in randomized controlled trials induces bias. Controlled Clinical Trials 2004;25(4):408-416.

Askie LM, Henderson-Smart DJ, Irwig L, Simpson JM. Oxygen-Saturation Targets and Outcomes in Extremely Preterm Infants. New England Journal of Medicine, 2003;349:10.

Chen J, Conigrave KM, Macaskill P, Whitfield JB. and Irwig L. Combining Carbohydrate-Deficient Transferrin and Gamma-Glutamyltransferase to Increase Diagnostic Accuracy for Problem Drinking. Alcohol & Alcoholism 2003;38(6):574-582

Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Lijmer JG, Moher D, Rennie D, de Vet HCW, for the STARD Group. Towards Complete and Accurate Reporting of Studies of Diagnostic Accuracy. The STARD Initiative. British Medical Journal 2003;326:41.

Houssami N, Irwig L, Simpson JM, McKessar M, Blome S, Noakes J. The contribution of work-up or additional views to the accuracy of diagnostic mammography. Breast 2003; 12: 270-5.

Houssami N, Irwig L, Blome S, Noakes J, McKessar M, Simpson J. Sydney breast imaging accuracy study: comparative sensitivity and specificity of mammography and sonography in young women with symptoms. Am J Roentgenol 2003; 180: 935-940.

Irwig L. This added to my multiple myopia. BMJ 2003; 326: 1336.

Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Lijmer JG, Moher D, Rennie D, de Vet HCW, for the STARD Group. Towards Complete and Accurate Reporting of Studies of Diagnostic Accuracy. The STARD Initiative. Annals of Internal Medicine 2003;138:40.

Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Lijmer JG, Moher D, Rennie D, de Vet HCW, for the STARD Group. Towards Complete and Accurate Reporting of Studies of Diagnostic Accuracy. The STARD Initiative. clinical Biochemistry 2003;36:1

Chen J, Conigrave KM, Macaskill P, Whitfield JB, Irwig L on behalf of the World Health Organization and the International Society for Biomedical Research on Alcoholism Collaborative Group. Combining carbohydrate-deficient transferrin and gamma-glutamyltransferase to increase diagnostic accuracy for problem drinking. Alcohol and Alcoholism 2003;38(6):574-582.

Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Lijmer JG, Moher D, Rennie D, de Vet HCW, for the STARD Group. Toward Complete and Accurate Reporting of Studies of Diagnostic Accuracy. The STARD Initiative. Am Journal of Clinical Pathology 2003: 119:18-22

Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Moher D, Rennie D, de Vet HCW. and Lijmer JG. The STARD Statement for Reporting Studies of Diagnostic Accuracy: Explanation and Elaboration. Clinical Chemistry 2003;49(1):7-18

Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Lijmer JG, Moher D, Rennie D, de Vet HCW For the STARD Group. Towards Complete and Accurate Reporting of Studies of Diagnostic Accuracy: The STARD Initiative. Radiology 2003;226(1):24-28

Bossuyt PM, Reitsma JB, Bruns DE, Gatsonis CA, Glasziou PP, Irwig LM, Moher D, Rennie D, de Vet HCW. and Lijmer JG. The STARD Statement for Reporting Studies of Diagnostic Accuracy: Explanation and Elaboration. Annals of Internal Medicine 2003;138(1):W1-W12. (http://www.annals.org)

Macaskill P, Walter SD, Irwig L. and Franco EL. Assessing the Gain in Diagnostic Performance when Combining Two Diagnostic Tests. Statistics in Medicine 2002;21:2527-2546.

Craig J, Barratt A, Cumming R, Irwig L, Salkeld G. A feasibility study of the early detection and treatment of renal disease by mass screening. Internal Medicine Journal. 2002;32:6-14.

Houssami N, Ciatto S, Irwig L, Simpson JM. and Macaskill P. The comparitive sensitivity of mammography and ultrasound in women with breast symptoms: an age-specific analysis. The Breast 2002;11:125-130.

Barratt AL, Mannes P, Irwig L, Trevena L, Craig J, Rychetnik L. A glossary of cancer screening terms. J Epidemiol & Comm Health. 2002; 56: 899-902

Askie LM, Henderson-Smart DJ, Irwig L, Simpson JM. The effect of differing oxygen saturation targeting ranges on long term growth and development of extremely preterm, oxygen dependent infants: the BOOST Trial. Pediatric Research. 2002;51(4):378A.

Houssami N, Irwig L. and Loy C. Accuracy of combined breast imaging in young women. The Breast 2002;11:36-40.

Irwig L, Bossuyt P, Glasziou P, Gatsonis C, Lijmer J. Evidence base of clinical diagnosis - Designing studies to ensure that estimates of test accuracy are transferable. British Medical Journal 2002;324(7338):669-671.

Irwig L, Macaskill P. and Houssami N. Evidence relevant to the investigation of breast symptoms: the triple test. The Breast 2002;11:215-220

Irwig L, Bossuyt P, Glasziou P, Gatsonis C, Lijmer J. Designing studies to ensure that estimates of test accuracy are transferable. BMJ 2002;324:669-671

Berry G, Smith CL, Macaskill P. and Irwig L. Analytic methods for comparing two dichotomous screening or diagnostic tests applied to two populations of differing disease prevalence when individuals negative on both tests are unverified. Statistics in Medicine 2002;21:853-862

Barratt A, Irwig L, Salkeld G, Houssami N, Glasziou P. Benefits, harms and costs of screening mammography in women over 70 years of age: a systematic review". Medical Journal of Australia. 2002;176:266-272

Macaskill P, Walter SD and Irwig L. A comparison of methods to detect publication bias in meta-analysis. Statistics in Medicine 2001;20(4):641-654.

Goyder E, Barratt AL, Irwig LM. Telling people about screening programmes and screening test results: how can we do it better? Journal of Medical Screening. 2000;7:123-26.

Goyder EC, Irwig LM. Screening for Type 2 diabetes mellitus: a decision analytic approach. Diabetic Medicine 2000;17:469-77.

Irwig L, Glasziou P. Informed consent for screening by community sampling. Effective Clinical Practice 2000;3:47-50.

Scouller K, Conigrave KM, Macaskill P, Irwig L, Whitfield JB. Should we use carbohydrate-deficient transferrin instead of y-glutamyltransferase for detecting problem drinkers? A systematic review and metaanalysis. Clinical Chemistry 2000;46(12):1894-1902.

Askie L, Irwig L, Henderson-Smart D, Simpson J. Novel design and implementation features of an Australian randomised controlled trial. Pediatric and Perinatal Epidemiology 2000;14:A2

Craig JC, Irwig LM, Knight JF, Roy LP. Does treatment of vesicoureteric reflux in childhood prevent end-stage renal disease attributable to reflux nephropathy. Pediatrics 2000;105(6):1236-41.

Craig JC, Irwig L, Ford M, Willis NS, Howman-Giles RB, Uren RF, Rossleigh MA, Grunewald S. Reliability of DMSA for the diagnosis of renal parenchymal abnormality in children. European Journal of Nuclear Medicine 2000;27(11):1610-1616.

Craig JC, Wheeler DM, Irwig L, Howman-Giles RB. How accurate is dimercaptosuccinic acid scintigraphy for the diagnosis of acute pyelonephritis? A meta-analysis of experimental studies. Journal of Nuclear Medicine, 2000;41(6):986-993.

Waters DL, Wilcken B, Irwig L, Van Asperen P, Mellis C, Simpson JM, Brown J and Gaskin KJ. Clinical outcomes of newborn screening for cystic fibrosis. Archives of Disease in Childhood 1999;80(1):F1-F7 Sp. Iss. SI January.

Walter SD, Irwig L, Glasziou PP. Meta-analysis of diagnostic tests with imperfect reference standards. Journal of Clinical Epidemiology 1999;52(10):943-951.

Barratt AL, Irwig L, Glasziou P, Cumming R, Raffle A, Hicks N, Gray JAM, Guyatt GH. Users' guides to the medical literature. XVIII How to use guidelines and recommendations about screening. JAMA. 1999; 281: 2029-2034.

Mackerras D, Irwig L, Simpson JM, Weisberg E, Cardona M, Webster F, Walton L and Ghersi D. Randomized double-blind trial of beta-carotene and vitamin C in women with minor cervical abnormalities. British Journal of Cancer 1999;79(9-10):1448-1453.

Caplehorn J, Lumley T. and Irwig L. Staff attitudes and retention of patients in methadone maintenance programs. Drug and Alcohol Dependence 1998;52:57-61.

Caplehorn J, Lumley T, Irwig L. and Saunders J. Changing attitudes and beliefs of staff working in methadone maintenance programs. Australian and New Zealand Journal of Public Health 1998;22(4):505-8.

Craig JC, Irwig LM, Knight JF, Sureshkumar P. and Roy LP. Symptomatic urinary tract infection in preschool Australian children. Journal of Paediatrics and Child Health 1998;34:154-59.

Craig J, Irwig L, Howman-Giles R, Uren R, Bernard E, Knight J, Sureshkumar P. and Roy LP. Variability in the interpretation of dimercaptosuccinic acid scintigraphy after urinary tract infection in children. The Journal of Nuclear Medicine 1998;39(8):1428-32.

Fisher CM, Appleberg M, Irwig L, Macaskill P. A systematic review of the accuracy of diagnosis of 70% carotid artery stenosis by duplex scanning. Journal of Vascular Investigation 1998;4:91-98.

Goyder E. and Irwig L. Screening for diabetes: what are we really doing? British Medical Journa 1998;l(317):1644-46.

Houssami N. and Irwig L. Likelihood ratios for clinical examination, mammography, ultrasound and fine needle biopsy in women with breast problems. The Breast 1998;7:85-9.

Jordens C, Hawe P, Irwig L, Henderson-Smart D, Ryan M, Donoghue D, Gabb R. and Fraser I. Use of systematic reviews of randomised trials by Australian neonatologists and obstetricians. Medical Journal of Australia 1998;168:267-70.

Katz I, Irwig L, Vinen J, March L, Wyndham L, Luu T. and Nelson G. Biochemical markers of acute myocardial infarction: strategies for improving their clinical usefulness. Annals of Clinical Biochemistry 1998;35:393-99.

Towler B, Irwig L, Glasziou P, Weller D, Kewenter J, Screening for colorectal cancer using the faecal occult blood test, Hemoccult. In the Cochrane Library, Issue 3, 1998, Oxford; Update Software.

Towler B, Irwig L, Glasziou P, Kewenter J, Weller D. and Silagy C. A systematic review of the effects of screening for colorectal cancer using the faecal occult blood test, Hemoccult. British Medical Journal 1998;317:559-65.

Irwig L, Macaskill P. and Berry G. Graphical test is itself biased. British Medical Journal 1998;316:470.

Other publications

Houssami N, Irwig L, Simpson JM, McKessar M, Blome S, Noakes J. Sydney Breast Imaging Accuracy Study: Coimparative Sensitivity and Specificity of Mammography and Sonography in Young Women with Symptoms. AJR 2003;180

Trevena LJ, Barratt A, Irwig L. New approaches to preference elicitation, estimation and representation of probabilistic screening information within a home-based decision aid for colorectal cancer screening in general practice. 2nd International Shared Decision Making Conference. Swansea, UK September 2003.

Askie LM, Henderson-Smart DJ, Irwig L, Simpson JM. The effect of differing oxygen saturation targeting ranges on long term growth and development of extremely preterm, oxygen dependent infants: the BOOST Trial. Proceedings of the 6th Annual Congress of Perinatal Society of Australia & New Zealand and the Federation of the Asia and Oceania Perinatal Societies 12th Congress, 2002, Christchurch, New Zealand, oral presentation A133/134

Barratt AL, Irwig L, Glasziou P, Cumming R, Raffle A, Hicks N, Gray JAM, Guyatt G. Moving from Evidence to Action: Recommendations about screening. Users Guides to the Medical Literature. A Manual for Evidence-Based Clinical Practice. American Medical Association. Chicago 2002.

Ragg, M. Barratt, A. Irwig, L. Chapman, S. Cockburn, J. Swinburne, L. How to present the evidence for consumers: preparation of consumer publications. NHMRC, 1999.

Glasziou P. and Irwig L. "Meta-Analysis of Diagnostic Tests". In Peter Armitage and Theodore Colton, eds. Encyclopaedia of Biostatistics, Vol 4, John Wiley & Sons, Chichester, 1998:2579-85.

Goyder E. and Irwig L. Screening for Type 2 Diabetes: A Decision Analysis Approach. A report for the New South Wales Health Department, 1998.

Irwig L, Zwarenstein M, Zwi A, and Chalmers I, A flow diagram to facilitate selection of interventions and research for health care, Bulletin of the World Health Organisation, 76 (1), 1998: 17-24.

Irwig L. Unit 70, Systematic Review (Meta-analyses). In C Kerr, R Taylor and G Heard, eds. A Handbook of Public Health Methods, McGraw Hill, Sydney, 1998: 443-48.

Book chapters

Irwig LM, Bossuyt PM, Glasziou PP, Gatsonis C, Lijmer JG. Chapter 6; Designing studies to ensure that estimates of test accuracy will travel. The Evidence Base of Clinical Diagnosis. Theory and Methods of Diagnostic Research. Knottnerus JA and Buntinx F (eds). 2nd Edition. BMJ books. A John Wiley & Sons Ltd. 2009; 96-117.

Barratt, A., Irwig, L., Glasziou, P., Cumming R., Raffle, A., Hicks, N., Muir Gray, J.A., Guyatt, G. Moving From Evidence to Action:Recommendations About Screening.(2nd ed) Users Guides to the Medical Literature A Manual for Evidence-Based Clinical Practice. Guyatt, G., Rennie, D., O`Meade, M., Cook, D.J. (eds). AMA, Chicago, 2008;663-678.

Bell K, Craig J.C, Irwig L. Chapter 6, "Monitoring the initial response to treatment". Evidence-Based Medical Monitoring: from Principles to Practice. Glaxziou P, Aronson J, Irwig L. (eds). Massachusetts, Blackwell Publishing, 2008:75-89.

Barratt A, Irwig L, Glasziou P, Cumming R, Raffle A, Hicks N, Murir Gray JA, Guyatt G. 2F. Moving from evidence to action. Recommendations about screening. Pages 583-597 in Users' Guides to The Medical Literature. A Manual for Evidence-Based Clinical Practice. Guyatt G, Rennie D (eds). AMA Press, Chicago 2002:583-597.

Irwig LM, Bossuyt PM, Glasziou PP, Gatsonis C, Lijmer JG. Designing studies to ensure that estimates of test accuracy will travel. Pages 95-116 in The Evidence Base of Clinical Diagnosis edited by Knottnerus JA. BMJ Books, London, 2002.

Les M. Irwig, Patrick M Bossuyt, Paul P Glasziou, Constantine Gatsonis and Jeroen G Lijmer, The Evidence Base of Clinical Diagnosis Chapter 6, BMJ Books 2002

Commissioned reports

Barratt Alexandra, Ragg Mark, Cockburn Jill, Irwig Les, Swinburne Lyn, Chapman Simon, 1999 literature review of the evidence about how to prepare and present evidence-based information for consumers of health services, National Health and Medical Research Council, Commonwealth of Australia, 2000.

Editorials

Irwig L, Houssami N, Armstrong B, Glasziou P. Evaluating new screening tests for breast cancer. BMJ 2006;332:678-9.

Elwood M, Campbell D, de Campo M on behalf of the National Cancer Control Initiative (NCCI) Working Group on Lung Cancer Screening, comprising also Fong K, Irwig L, Manser R, Pedersen K, Peters M, St John J. Helical computer tomography for lung cancer screening (Editorial). MJA.2003; 179: 125-6

Irwig L, Armstrong B. EUROCARE-2: Relevance for assessment of quality of cancer services? (Editorial) Lancet 2000; 355: 427-428.

News Reports/Feature Articles

Irwig L. Bone density monitoring/blood pressure monitoring. The Health Report - ABC National. 20 July 2009.

Letters to Editor

Walter S, Guyatt G, Haynes B, Irwig L. (Letter) Dual vision method for analysis of agreement data. Scandinavian Journal of Clinical and Laboratory Investigation. Accepted Sept 2003

Trevena LJ, Barratt A, McCaffery KJ, Irwig L. (Letter) More haste, less speed in the implementation of screening decision aids. BMJ. 2003; 327: 869

Projects

Antibiotics for the Prevention of Recurrent Urinary Tract Infection in Children

Craig J, Irwig L, Simpson J, Knight J, Roy L.
This NH&MRC funded study (PRIVENT) is a randomised controlled trial to determine children with urinary tract infection given long-term antibiotics have a lower risk of further infection than children given placebo. Participants are reviewed over a one-year follow up period and 700 children are to be enrolled.


 

Diagnostic Test Evaluation of Tests used in Children with Suspected Kidney Disease

Craig J, Irwig L.
A number of studies are being done which evaluate the test performance and reproducibility of diagnostic tests used in children. These include studies of the inter-observer variability of radionuclide tests, and systematic reviews of radionuclide tests for kidney damage, and urinalysis for the diagnosis of urinary tract infection.


 

Combining Test Information: The febrile child

Craig J, Irwig L, Macaskill P, Glasziou, Hanson.
The study will involve ascertaining primary diagnoses of a random sample of children presenting with fever to the Emergency Department by prospective follow up and microbiological confirmation. The test performances of the clinical signs and symptoms and laboratory tests routinely used to assess children with fever will be analysed, singly and in combination, against the reference standards for four common and important diagnoses - urinary tract infection, occult bacteraemia, pneumonia, and meningitis. We will investigate statistical methods to assess incremental gain when combining the results of two or more tests that take into account correlation in tests errors and missing test results for some individuals. The results of this study will be used in further work as outlined in informed decision-making.


 

Informed Decisions in Diagnosis for Clinicians: The febrile child

Craig J, Macaskill P, Irwig L, Hanson.
Once the combined accuracy of the clinical and laboratory tests used to evaluate febrile children to diagnose bacterial disease has been determined (Accuracy Theme), data on pre-test probabilities of the possible diagnoses and the likelihood ratios for each diagnostic test will be developed into computer-based diagnostic algorithms. Interactive software will be developed so that when individual patient clinical and laboratory data are entered into the Emergency-Department based computer terminals, the probability of each relevant diagnosis will be provided to the clinician. Children randomly chosen during the third year of the study will be randomly allocated to the conventional diagnostic decision-making process or our new computerised evidence-based process. The primary outcome will be the number of incorrect diagnoses made on the day of presentation (missed diagnoses and false positive diagnoses). Secondary outcome measures will be the time from presentation to reach a correct diagnosis, duration of symptoms until recovery, process of care measures (number of tests arranged, number of admission) and staff satisfaction.

We plan to determine whether giving explicit probabilities of disease in individual patients based on the best available local and published research information and given to the clinician in real time using interactive software, results in improved diagnostic accuracy and improved outcomes compared with the traditional diagnostic decision-making model.


 

Comparison of accuracy of liquid-based cervical cytology evaluated using the ThinPrep Imager (TPI) with conventional cytology evaluated manually

Davey E, Macaskill P, Irwig L, Chan SF, D'Assuncao J

The relative performance of manually-read LBC and conventional cytology (CC) has been evaluated in several studies, and substantial evidence suggests that LBC slides are faster to read than CC slides. However, the introduction of computer-assisted reading of LBC slides, such as with the TPI, may affect the accuracy of LBC relative to CC, may affect laboratory performance if timing alters, and may therefore change the cost-effectiveness of LBC relative to CC. This is important in countries such as Australia and NZ that have not already adopted LBC into screening programs. Our study, in collaboration with a large pathology laboratory, compares the accuracy of more than 50,000 pairs of TPI-read LBC slides with that of manually read CC slides, using re-reading of histology and Pap Test Register reports as the reference standard.

A substudy examines the time required to read TPI-processed LBC slides and CC slides amongst 41 cytolgists under normal laboratory conditions over 5-7 months, and analyses these times according to years of cytologists' experience.


 

Measuring Individual Preferences for Preventive Goods: the Application of Conjoint Analysis to Colorectal Cancer Screening

Salkeld G, Ward J, Solomon M, Short L, Irwig L and Macaskill P.
Discrete choice modelling (DCM) is a technique relatively new to the evaluation of health care services in Australia. This NHMRC-funded project uses DCM in a survey of men and women aged 50-70 years and living in the Central Sydney Health Area to find out whether they would choose to be screened for colorectal cancer and, if so, what attributes of screening matter most to them. The study is also exploring the reliability of the DCM technique in a group of people who have not been screened for colorectal cancer.


 

Developing Methods for the Evaluation of Screening Programs and Diagnostic Tests

L.Irwig.
Improving design and analysis of studies

  • The design and analysis of primary studies and meta-analyses to compare performance characteristics of two or more tests
  • The detection of and correction for publication bias in meta-analyses of test performance
  • Correcting for misclassification of the reference (gold) standard when assessing test performance.


 

HPV testing Decision Aid for women with Minor Atypia on Pap smear (The IMAP Study)

McCaffery K, Irwig L, Howard K, Davey E, Barratt A, Salkeld G, Lewicka M, Weisberg E.

This study will compare the psychosocial outcomes of different management strategies for women with a mildly abnormal Pap smear: (a) usual care (repeat Pap smear), (b) HPV testing, a new management proposed for this group, and (c) the choice of either management using a decision aid to support women to make their preferred choice. The study will assess psychosocial and quality of life outcomes and will model the effectiveness of each management strategy.


 

Development and evaluation of a literacy sensitive decision aid for colorectal cancer screening

McCaffery K, Smith S, Trevena L, Barratt A, Simpson J, Nutbeam D.

Associate investigators:Butow P, Irwig L

This project is funded by the Sydney Cancer Research Fund and the NHMRC. The project will develop and evaluate by randomised trial a FOBT screening decision aid for adults with limited literacy. The project also includes a substudy investigating optimal graphic formats for presenting risk information to adults with limited literacy and numeracy skills. The findings from this will inform the prsentation of quantitative risk information included in the decision aid.

Sydney Cancer Research Fund. $100,000.


 

Evaluation of cervical cytology accuracy according to different strategies of providing information to cytologists

Davey E, Macaskill P, Irwig L This study, in collaboration with a large pathology laboratory, examines how the accuracy of cervical cytology reading varies according to whether cytologists have no information on client details or previous cytology and histology results when they evaluate slides, read slides with these details available or read slides initially with no access to information and again after provision of such information. Cytology slides from over 600 women will be used amongst 9 cytologists, with all cytologists examining all slides blind to others' results and blind to histology. Histology will be used as a reference standard in all cases.


 

Testing graphical risk presentation format among adults with low literacy

McCaffery K, Dixon A, Smith S, Trevana L, Hayen A, Barratt A, Irwig L, Nutbeam D, Simpson J.

This study is a sub study of the above listed project. The aim is to the determine optimal graphic format to present risk information to adults with low literacy and education. 120 adults will be recruited from adult education classes in NSW for testing of different graph formats. The results of this study will inform the design of the decision aid described above.