Evidence check
A rapid review outlining the available evidence on a discrete topic or question. Evidence includes grey and peer review literature. View all Evidence Checks by date of publication.
Same day joint replacement
Added: 23 Jan 2026
What is the evidence on outcomes for same-day joint replacement surgery compared with inpatient joint replacement surgery?
- This check includes 29 systematic reviews, published from 2021 onwards. Most of the studies were on knee, hip and shoulder joint replacement surgeries, with a few on ankle and elbow joints.
- Individual study types included in the review articles were mostly retrospective and prospective cohort studies from single centres, and larger database or registry studies. There were few randomised controlled trials. Authors often described the included studies as having a high risk of bias.
- Overall, studies generally found that same-day joint replacement surgery compared to inpatient joint surgery had: similar or lower complication rates, readmission rates, reoperation rates, mortality, transfusion rates and emergency department admissions, mixed evidence on surgical site infection rate and pain, with some studies favouring inpatient and some outpatient, similar favourable functional outcomes, similar patient satisfaction and reduced cost.
Whole of health suicide prevention
Added: 4 Sep 2025
Updated: 16 Dec 2025
What do people who have experienced suicidality and their families report as helpful or unhelpful (health) service responses in managing their suicidality and distress?
What are the approaches used by non-mental health services, clinicians and general health staff to identify or assess someone at risk of suicide?
What whole of system approaches (health, whole of government, public health) have been implemented to manage suicide prevention and suicidality?
What are the approaches used by non-mental health services, clinicians and general health staff to identify or assess someone at risk of suicide?
What whole of system approaches (health, whole of government, public health) have been implemented to manage suicide prevention and suicidality?
- A review of qualitative studies shows helpful and unhelpful responses are themed around genuine empathy and understanding communication and information professionalism and competence practical support and environment and trust and collaboration.
- The U.S. Preventive Services Task Force concludes that the current evidence is insufficient to assess the benefits and harms of screening for suicide risk in children, adolescents and all adults, including pregnant and postpartum people and older adults.
- Countries such as Ireland, Scotland and New Zealand, along with every Australian state and territory, have published suicide prevention plans or frameworks. However, no formal evaluation of their effectiveness has been conducted.
Family-focused recovery
Added: 11 Dec 2025
What is the scope and nature of the available literature on policies, programs and interventions that have incorporated parenting as a focus of the recovery practice of mental health services, including adult, youth, Child and Adolescent Mental Health Services (CAMHS), and Perinatal Infant Mental Health Services (PIMHS), both community and inpatient?
Within the literature identified above, what is the evidence that including parenting as a focus of recovery planning and practice is effective in improving parental or child mental health and wellbeing?
Within the literature identified above, is there any focus on sub-populations, or any evidence of varying levels of effectiveness for such populations?
What are the national and state initiatives, and policies for subsequent recommendations for vulnerable families?
Within the literature identified above, what is the evidence that including parenting as a focus of recovery planning and practice is effective in improving parental or child mental health and wellbeing?
Within the literature identified above, is there any focus on sub-populations, or any evidence of varying levels of effectiveness for such populations?
What are the national and state initiatives, and policies for subsequent recommendations for vulnerable families?
- This evidence check provides an overview of systematic reviews, randomised controlled trials (RCTs) and grey literature sources describing or evaluating national or statewide initiatives and policies to improve parental and child mental health and wellbeing outcomes in families where a parent has a mental illness.
- Most primary studies included in systematic reviews are from high-income countries, with interventions targeting either the parent (mostly mothers) receiving care at mental health services or experiencing mental health symptoms, or the family (at least one parent and one child). The interventions were mostly delivered by mental health professionals, trained clinicians or social workers, with a minority delivered online. Most interventions were highly manualised with a structured format, conversation guides or logbooks. Interventions are often multicomponent.
- Most systematic reviews and randomised controlled trials examining the effectiveness of the family-focused recovery or practices within the context of parental mental health issues report positive impacts of such interventions in improving parent, child and/or family outcomes in at least one area such as parenting skills, mental health symptoms or risk, or family functioning and high acceptability to parents.
Integrated service hubs
Added: 11 Dec 2025
What are the evidence-informed frameworks or enablers or barriers for designing, implementing, governing, and evaluating integrated service hubs within a primary health and community care context?
- There is a very large volume of literature on integration of care, reflecting the broad and heterogeneous definitions, conceptualisations and configurations, as well as the combinations of sectors, level of services, or disciplines integrated.
- Five systematic reviews published since 2020 provided a comprehensive review of the literature on integrated care models and have proposed frameworks to guide the future design and implementation. Domains that were represented across multiple frameworks and their corresponding enabling factors or strategies derived from systematic reviews and grey literature reports were summarised.
- An in-depth comparison of 5 select integrated models that focused on mental health demonstrated some commonalities and differences shared across models. They aimed to provide a range of both clinical and social support services, with 2 of the models using a stepped care approach. The remaining 3 models specifically sought to also reduce unscheduled healthcare use.
Multiple chemical sensitivity
Added: 3 Dec 2025
How is multiple chemical sensitivity (MCS) defined?
What are the diagnostic criteria?
What are the management options?
What resources are available for clinicians and patients?
What are the diagnostic criteria?
What are the management options?
What resources are available for clinicians and patients?
- Overall, MCS (also known as idiopathic environmental intolerance) is not a well understood illness. The evidence available on the condition and its treatment is limited.
- MCS is a chronic condition that can be caused by low-level exposure to a range of everyday chemicals in the environment. These can include perfumes, detergents and artificial colours, and preservatives.
- MCS can have many different triggers and symptoms which can vary from mild to severe. In severe cases, it can affect a person’s social life, daily activities or ability to work.
Geriatric models of care
Added: 3 Nov 2025
Updated: 13 Nov 2025
What evidence-based geriatric care models are available, both within Australia and internationally?
What is the evidence for their effectiveness at improving outcomes, including clinical outcomes and cost-effectiveness, but with a focus on healthcare resource use and staffing pressures?
What is the evidence for their effectiveness at improving outcomes, including clinical outcomes and cost-effectiveness, but with a focus on healthcare resource use and staffing pressures?
- Geriatric services can be delivered in several ways across individual sites and districts.
- Traditionally, geriatric models of care have centred around a geriatrician as the key leader, with their design and evolution inherently multidisciplinary from the outset.
- Recently, more practices are pivoting toward alternate models, such as providing care out of hospital where possible, nurse and allied health-led models, co-management by geriatrics and another team, or upskilling other medical staff and wards in geriatric competencies.
Pregnancy beyond 39 weeks
Added: 29 Sep 2025
In women with singleton pregnancies at 39+0 weeks or beyond gestation, what are the risks and benefits of induction of labour, with a focus on maternal and neonatal outcomes?
In women with singleton pregnancies at 39+0 weeks or beyond, what are the risks and benefits of non-medical options like acupuncture and herbal in terms of maternal and neonatal outcomes?
What are the experiences of women who undergo induction of labour for post-date pregnancies?
In women with singleton pregnancies at 39+0 weeks or beyond, what are the risks and benefits of non-medical options like acupuncture and herbal in terms of maternal and neonatal outcomes?
What are the experiences of women who undergo induction of labour for post-date pregnancies?
- The timing of labour plays an important role in maternal and neonatal health, requiring careful consideration of the associated risks and benefits.
- The evidence reviewed for this check was primarily based on randomised controlled trials (RCTs), including key RCTs such as ARRIVE, SWEPIS, INDEX, systematic reviews and meta-analyses, and cohort studies alongside RCTs, all published since 2018.
- Most studies provided a direct comparison of outcomes between elective induction of labour at around 39–40 weeks versus expectant management
- or induction of labour at different timepoints near or at post-term, mostly among women with low-risk or uncomplicated pregnancies.
Paediatric and mental health service collaborative
Added: 8 Sep 2025
What is the evidence for improving the capability of paediatric clinicians or emergency care clinicians in psychiatry or vice versa and associated outcomes for children and adolescents who have mental health, behavioural and neuro-developmental problems?
What is the evidence for different models of collaborative care between paediatric services or emergency department clinicians and Child and Adolescent Mental Health Services (CAMHS), hospital and other mental health services for children and adolescents who have mental health, behavioural and neuro-developmental problems?
What are the specific roles of paediatric or emergency services and CAMHS, hospital and other mental health services in relation to children and adolescents who have mental health, behavioural and neuro-developmental problems in jurisdictions with similar health system to Australia, such as the United Kingdom and New Zealand?
What is the evidence for different models of collaborative care between paediatric services or emergency department clinicians and Child and Adolescent Mental Health Services (CAMHS), hospital and other mental health services for children and adolescents who have mental health, behavioural and neuro-developmental problems?
What are the specific roles of paediatric or emergency services and CAMHS, hospital and other mental health services in relation to children and adolescents who have mental health, behavioural and neuro-developmental problems in jurisdictions with similar health system to Australia, such as the United Kingdom and New Zealand?
- Most of the literature on collaborative care for children and adolescents originates from the United States (US). Available evidence published since 2018 comprises 11 systematic reviews of various collaborative care models, and 20 implementation studies with pre-post evaluations or retrospective cohort studies tracking outcomes of children enrolled in various models.
- Improving the capability and skills of paediatric or emergency clinicians through education and training is often embedded within collaborative care models. Studies focused on the educational component demonstrate benefits in improving the confidence and skills of participating clinicians in communication, assessment, non-pharmacological and pharmacological management of common mental health and neurodevelopmental conditions, follow-up and making appropriate referrals. There is also evidence that such education and training are associated with improved care outcomes, such as shorter time to evaluations, high diagnostic accuracy, and cost savings due to emergency or inpatient admission deferrals.
- Most collaborative care models were associated with improved outcomes, such as increased access to care and treatment, improved symptoms and behaviour change, and a reduction in hospital visits, compared to usual care or pre-implementation. Integrated or co-located models, especially with those high levels of integration between services, have the strongest evidence base to support their effectiveness in improving outcomes.
Rapid evidence checks are based on a simplified review method and may not be entirely exhaustive, but aim to provide a balanced assessment of what is already known about a specific problem or issue. This brief has not been peer-reviewed and should not be a substitute for individual clinical judgement, nor is it an endorsed position of NSW Health. Evidence checks are archived a year after the date of publication.