Adverse event following immunisation (AEFI) is ‘an unwanted or unexpected event following the administration of a vaccine(s). AEFIs may be caused by a vaccine(s) or may occur by coincidence: that is, it would have occurred regardless of vaccination’. AEFIs also include conditions that may occur following the incorrect handling and/or administration of a vaccine.

SAEFVIC aims to provide increased early detection and appropriate rapid response to AEFI in adults and children, integrated with clinical support for reporting health care workers and patients/families within Victoria. The intention is to enhance the passive surveillance of all significant or rare AEFI, regardless of causality. The surveillance information is used to detect vaccine safety ‘signals’, prompt action and maintain confidence in immunisation programs. This collaboration aims to deliver a system with world-leading sensitivity for Victorian health authorities to rapidly detect and research vaccine safety concerns, whether they are new trends or just temporally associated events.

Purpose: Ambulance Victoria (AV) is the state-wide emergency medical service for almost 6.6 million Victorian residents. Historically paramedic collected electronic patient care records are uploaded and stored in the AV clinical data warehouse and data are used to report on clinical quality improvement and audit, operational improvement, and for research and evaluation. ST-elevation myocardial infarction (STEMI) represents an important cohort needing additional time-critical monitoring, assessment and management to ensure optimal patient outcomes. AV has established the Victorian Ambulance STEMI Quality Initiative (VASQI) for this purpose.

Aims: AV STEMI management has grown in complexity in recent years, including the service-wide rollout of pre-hospital 12-lead ECG, administration of aspirin and heparin, and pre-hospital thrombolysis in selected rural/remote patients. Assessing the quality and safety of these complex interventions is vital and it is the aim of VASQI to undertake these assessments, monitor safety and progress, provide vital feedback to the paramedic workforce and measure patient outcomes.

Population: Eligible patients are those attended by AV and treated for a paramedic suspected STEMI.

Outcomes: Monitor the quality and safety of treatment and procedures performed by paramedics on patients presenting with cardiovascular symptoms consistent with STEMI. This includes linkage with hospital treatment and outcome data which will form part of a feedback circle to assess accuracy of diagnosis.

Degenerative cervical Myelopathy (DCM) is the commonest cause of spinal cord dysfunction worldwide. Clinical features include localised neck pain, impairment of motor functions in the upper and lower limbs, loss of bladder function that can eventually lead to paralysis and even death if treatment is not sought. Although surgical decompression of the spinal cord remains the mainstay of treatment, very few patients achieve complete recovery, and the majority of patients are left with life-long disability. Due to lack of a diagnostic criteria and many mimicking conditions, DCM is widely underdiagnosed and hence its true incidence and prevalence remains unknown.

The MYNAH (MYelopathy NAtural History) registry is a multi-centre, prospective, observational cohort study enrolling patients with Degenerative Cervical Myelopathy (DCM) across Australia. MYNAH Registry is the world's first registry to understand the natural history of DCM in a systematic manner. The purpose is to determine the natural history of DCM, to describe the influence of age, gender, smoking and BMI on outcome of DCM, to describe the demographics, comorbidities, genetic predisposition, disease severity and prognosis of DCM and to compare the outcomes between the operative and non-operative cases of DCM. Patients with a diagnosis of DCM by a spine surgeon or neurosurgeon from various participating clinical sites are included in the registry.

The outcome measures are Neck Disability Index (NDI), modified Japanese Orthopaedic Association Score (mJOA), EQ-5D-5L questionnaire and Nurick grade. Follow-up for all participants is conducted biannually, which includes completion of mJOA score, Nurick grade and clinical examination at their respective study site and completion of NDI and EQ-5D-5L questionnaires.