Registration of clinical trials: Is it just lip service?

Project code:  MHS025

Department

Obstetrics and Gynaecology

Location

Auckland

Supervisor

Dr Vanessa Jordan

In order to combat publication bias the research world introduced trial registration. The purpose of trial registrations is in the first part to make sure that all clinical trials are documented and therefore not lost if they are eventually unpublished. The second purpose is to prevent researchers from altering their outcomes or methods in order to manipulate trial data. However, it is possible to register a trial at any point along the research pathway and many researchers register their trials just prior to publication. This fulfils the medical journals mandate that a trial must be registered. Registering a trial after the fact completely negates the intended purpose of trial registration. The aim of this project would be to determine what percentage of trials are retrospectively registered. We would also like to look at whether this is influenced by the clinical field of study or the country in which the research is undertaken and time allowing we may compare if this has changed over time.

Skills

Publication bias is a great concern for researchers and the general public alike. The student will be taught about this area of research and learn what it is like to work in a research group. In order to carry out the project they will learn about trial registration and how to search the international trial registries. They will collect and analyse the data by establishing a database and prepare a manuscript for publication with the results of this work.

Quality of New Zealand Clinical Practice Guidelines

Project code:  MHS037

Department

Obstetrics and Gynaecology

Location

Auckland

Supervisor

Dr Julie Brown

We do not currently know the quality of the clinical practice guidelines in New Zealand.

This project will focus on clinical practice guidelines developed in New Zealand or with New Zealand representation on the Guideline Development Panel.

The project will involve identification of relevant guidelines, extraction of data regarding various aspects of the guideline development process, critical appraisal of the guidelines and an evaluation of the implementation resources available.

This project is aligned with the Quality of New Zealand public health guidelines Summer Student Project and students from both projects will be expected to work closely together to provide duplicate data extraction for quality assurance.

Skills

  • Systematic searching of multiple databases
  • Accuracy
  • Critical appraisal
  • Data handling, analysis and report writing

Quality of New Zealand Public Health Guidelines

Project code:  MHS038

Department

Obstetrics and Gynaecology

Location

Auckland

Supervisor

Dr Julie Brown

We do not currently know the quality of the public health guidelines in New Zealand.

This project will focus on public health guidelines developed in New Zealand or with New Zealand representation on the Guideline Development Panel.

The project will involve identification of relevant guidelines, extraction of data regarding various aspects of the guideline development process, critical appraisal of the guidelines and an evaluation of the implementation resources available.

This project is aligned with the Quality of New Zealand clinical practice guidelines Summer Student Project and students from both projects will be expected to work closely together to provide duplicate data extraction for quality assurance.

Skills

  • Systematic searching of multiple databases
  • Accuracy
  • Critical appraisal
  • Data handling, analysis and report writing

The Pipelle for Pregnancy (PIP) trial

Project code:  MHS048

Department

Obstetrics and Gynaecology

Location

Auckland

Supervisor

Cindy Farquhar

Endometrial scratching has been suggested as a possible fertility treatment in women undergoing embryo transfer as part of an IVF cycle. Endometrial scratching is similar to a smear test, and can be achieved using a thin plastic catheter called a pipelle. The pipelle procedure takes 1-2 minutes and involves inserting the pipelle through the cervix into the womb and gently moving the pipelle back and forth to obtain a sample of the endometrium (lining of the womb).

More recently some research suggests this procedure can also be beneficial in couples who are trying to conceive from simpler fertility treatments and even in couples trying to get pregnant from intercourse alone.

However, the evidence for the benefit of pipelle scratching is limited and more research is needed. If this procedure is found to be beneficial, it will provide a cost-effective method of helping subfertile women and couples to conceive.

The Pipelle for Pregnancy (PIP) studies are three RCTs investigating endometrial scratching in different subfertile populations.

Skills

The PIP trials have been underway for over a year and are ongoing. The summer student would be assisting with the day to day coordination of the trial.

Skills taught include:

  • experience in assisting with a clinical trial including: eligibility assessment, randomisation, liaising with patients, scheduling procedures, outcome follow-up, data entry, auditing,
  • using Concerto and understanding health records
  • experience working within the fertility clinic and exposure to the different types of fertility conditions, diagnosis, investigations, treatments and public funding

Does calreticulin activate endothelial cells in preeclampsia, as one of the most important damage-associated molecular patterns (DAMPs)?

Project code:  MHS090

Department

Obstetrics and Gynaecology

Location

Auckland

Supervisor

Qi Chen

Preeclampsia, a human pregnancy-specific hypertensive disease, kills 60,000 young women and their babies each year globally. It is characterised by maternal endothelial cell dysfunction.  Although the exact causes of this disease are unclear, it is well-known that toxin from placenta triggers the maternal disease in preeclampsia by inducing endothelial cell dysfunction. Placental extracellular vesicles are membrane enclose packages of proteins and nucleic acids which are shed from the placenta into the maternal blood, as early as six weeks of gestation. Placental extracellular vesicles are categorised into nano-, micro- and macro-vesicles by size. Placental extracellular vesicles are hypothesised to be one placental toxin that may trigger preeclampsia and previous work from our laboratory supports this hypothesis.
There is growing evidence that calreticulin, an important damage-associated molecular patterns (DAMPs) is involved in inducing apoptosis and inhibiting invasion in several cell types. Calreticulin is a multifunctional protein that functions as a major calcium-binding (storage) protein in the lumen of the endoplasmic reticulum. It also promotes phagocytosis of cancer cells. Calreticulin is overexpressed in preeclamptic placentae and is increased in the maternal circulation in preeclampsia. We have shown that calreticulin is expressed in all three categories of placental extracellular vesicles. However, whether calreticulin contained in preeclamptic extracellular vesicles contributes to the endothelial cell dysfunction seen in preeclampsia is unknown. Therefore the aim of this project is to investigate whether calreticulin in placental extracellular vesicles is involved in endothelial cell dysfunction.
Objective (1): Whether the levels of calreticulin are altered in placental extracellular vesicles from preeclamptic compared to normal placentae.
Objective (2): whether blocking calreticulin can prevent the endothelial cell dysfunction induced by placental extracellular vesicles from preeclamptic placentae.
 

Skills

  • Cell and tissue culture
  • Western blotting
  • Immunohistochemistry
  • General laboratory skill

Development of a new test for embryo toxicity

Project code:  MHS116

Department

Obstetrics and Gynaecology

Location

Auckland

Supervisor

Dr Lynsey Cree

One in six New Zealand couples suffer from infertility and many of these may need to be treated using vitro fertilisation (IVF) in order to have a family. During IVF, the successful in vitro culture of human embryos relies on a meticulous environment created by the media, temperature, gas composition and pH of the culture system.

The mineral oil overlay is an important component of this system, acting as a buffer to prevent the embryo from experiencing environmental fluctuations which may compromise development. Following manufacture, mineral oil can vary in quality however, and this poses a risk to the developing embryo.

This project is aimed at developing a sensitive, cost-effective and practical test for embryo toxicity in mineral oil during the in vitro culture of human embryos. This novel, translational research project has the potential to offer a reliable method to screen mineral oil, which can be implemented in IVF laboratories both in New Zealand and internationally.

 

Skills

  • Cell culture
  • Embryology
  • Data analysis
  • Literature review

The use of recombinant hyaluronidase in IVF

Project code:  MHS120

Department

Obstetrics and Gynaecology

Location

Auckland

Supervisor

Dr Lynsey Cree

One in six New Zealand couples suffer from infertility and many of these may need to be treated using vitro fertilisation (IVF) in order to have a family. ICSI is the most successful form of treatment for men who are infertile and is used in nearly half of all IVF treatment. ICSI only requires one sperm, which is injected directly into the egg.

Prior to ICSI, eggs are stripped of their cumulus cells using hyase in order to effectively visualise the egg. In this study we wish to examine whether the use of a recombinant hyaluronidase results in gene expression changes in the cumulus cells.

Skills

  • Molecular biology techniques including real-time PCR
  • Embryology
  • Data analysis
  • Literature review

Develop A Regional Situation And Response Analysis On Cervical Cancer In The Pacific

Project code:  MHS167

Department

Obstetrics and Gynaecology

Location

South Auckland Clinical Campus

Supervisor

Dr Alec Ekeroma

Phase 1

Conduct situation and response analysis:

Collate available policies, studies, reports and information on cervical cancer in the Pacific region

Phase 2

Develop mapping tools in coordination with regional taskforce on cervical cancer initiatives in 14 PICs

Application of  mapping tools/questionnaires to collect information on existing policies and available services (screening, vaccination, treatment/management)  for cervical cancer

Phase 3

Formulate policy options and specific recommendations based on the situation and response analysis

Develop an advocacy pitch using existing cost benefit analysis for cervical cancer programmes from other countries (looking at cost of neglect versus cost of providing appropriate services)