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Professor Nadine Foster

NHMRC Leadership Fellow

Faculty of Health and Behavioural Sciences

Director, UQ Clinical Trials Unit

Pro-Vice-Chancellor (Research Infrastructure)
n.foster@uq.edu.au

Overview

Nadine is a physiotherapist, lifetime Fellow of the Chartered Society of Physiotherapy in the UK, and previous National Institute for Health Research (NIHR) Senior Investigator and NIHR Research Professor in the UK. She is a Professor and Director of the STARS Research and Education Alliance between the University of Queensland and Metro North Health in Queensland, Australia (STARS is the Surgical, Treatment and Rehabilitation Service, the newest public hospital in Brisbane). She leads the Research and Education portfolio within STARS, including a team of conjoint appointments between the University and hospital, across the disciplines of physiotherapy, nursing, occupational therapy, psychology and interdisciplinary education and research management.

Nadine is also the Academic Director of UQ Clinical Trials Unit, leading the establishment of the CTC through 2023.

Her research focuses on musculoskeletal pain, including low back pain, osteoarthritis and shoulder problems, and she has a particular interest in developing, testing and implementing treatments and health services. She has led or collaborated on more than 31 randomised trials, attracting over $115 million in research funding from, for example, the National Institute for Health Research (NIHR), Versus Arthritis, the Medical Research Council, PCORI in the USA and the NHMRC and MRFF in Australia. Examples include international collaborative RCTs funded through the NIHR-NHMRC collaborative trial scheme focused on comparative effectiveness of surgery and conservative care for persistent, severe low back pain and comparative effectiveness of different approaches to shoulder joint replacement for patients with shoulder osteoarthritis.

For 5 years (2015-2020) she was the NIHR Lead Training Advocate for Physiotherapy in the UK, and Chaired the NIHR/Health Education England Integrated Clinical Academic personal fellowship scheme in England in 2019 and 2020. Nadine also served as Chair of the NIHR Research for Patient Benefit research funding panel in the West Midlands in the UK. She was previously President of the Society for Back Pain Research, and a member of the Steering Group for the International Forum for Back and Neck Pain Research. She has supervised 15 PhD students to completion and led or contributed to over 262 peer reviewed publications, including the Lancet Series on Low Back Pain in 2018.

Examples of recognition as a national and international leader in the field include:

2024-2029 NHMRC Investigator Grant, Leadership level 2, supporting a program of research focused on new musculoskeletal RCTs and sharing existing RCT data to answer further research questions

2023 Stanley Paris Visiting Fellowship award, University of Otago, New Zealand, supporting visiting fellowship in March 2024

2022 Chief Executive's Award for Research, Metro North Health and Hospital Service Research Excellence Award

2020 Senior Investigator award from the National Institute for Health Research (NIHR) in the UK, awarded to the top 200 clinical researchers in the country.

2019 PEDro recognition for the UK FASHIoN trial - chosen by a panel of international trialists as one of the five most important physiotherapy trials published in 2014-2019. Announced on 4 November 2019.

2019 Invited member of the International Research Strategy Advisory Committee for the Health Research Board’s (Ireland) new five year research strategy development. September-October 2019

2018 Miegunyah Distinguished Visiting Fellowship 2019, University of Melbourne, Australia. February-March 2019

Research Interests

  • Musculoskeletal pain including low back pain pain, osteoarthritis, shoulder pain
  • Rehabilitation
  • Health services research
  • Interprofessional collaborative practice in health services
  • Clinical trials
  • Using routine health record data to improve care and outcomes

Research Impacts

How to get the right treatment to the right musculoskeletal (MSK) patient at the right time is a key challenge. Prof Foster's clinical research program is internationally renowned for establishing the effectiveness of interventions through randomised controlled trials (RCTs), and evidencing new models of care (eg. stratified & stepped care) that has widely influenced health policy and practice.

Her program of research has led to paradigm-changing discoveries, producing 262 peer reviewed full papers cited widely in >114 countries, >27 disciplines (eg. medicine, health professions, neuroscience, social sciences, engineering, decision sciences), and in 765 news outlets and underpinned 31 patents.

Four of Prof Foster's program interventions were recommended by Public Health England based on their return-on-investment (ROI) and included in a ROI tool used by >200 Clinical Commissioning Groups in England. Her research has developed internationally agreed and widely adopted core outcome setsand set the international bar for stratified care trials in MSK pain, leading to >12 trials globally including in other fields (eg. arthritis, whiplash). The program led to her co-leadership of the Lancet Low Back Pain Series in 2018.

Prof Foster's research has provided best evidence about treatments and challenged the 'one-size-fits-all' musculoskeletal healthcare approach, influencing 88 policy documents including NICE and the WHO, 35 guidelines in 8 countries, including the UK NICE Low Back Pain and Osteoarthritis Clinical Guidelines, and the Australian Commission on Safety & Quality in Healthcare Back Pain Standards. Her program transformed patient care pathways including the UK's National Back Pain & Sciatica Pathway. Many hospital medical centres (eg. Massachusetts General Hospital) and universities (eg. Harvard Medical School and Oxford University) cite her program of research, and collaborations with IT industry partners EMIS Health & SystmOne embedded her stratified care tools in clinical practice (eg. STarTBack with >42 language translations).

Qualifications

  • Doctor of Philosophy, University of Ulster
  • Bachelor (Honours), University of Ulster

Publications

View all Publications

Grants

View all Grants

Supervision

  • Collaborative clinical practice in healthcare

    Doctor Philosophy

View all Supervision

Available Projects

  • Towards a better conceptual understanding of Interprofessional clinical practice

    Interprofessional clinical practice is poorly defined and conceptualised, limiting our ability to measure and assess it and crucially to improve it for the benefit of health service and patient outcomes. This PhD programme will review current definitions and measures in the field, before developing a better conceptualisation of it that provides a new model to better understand interprofessional practice and from that identify preferred tools or the need for a new tool with which to measure it.

  • Rehabilitation and exercise for patients with shoulder osteoarthritis: can we do better?

    Musculoskeletal pain conditions are the largest contributer to global disability. Compared to knee or hip osteoarthritis, there is a paucity of research evidencing rehabilitation or exercise for patients with shoulder osteoarthritis. This means that most clinical practice is based on low quality evidence, and expert opinion. This programme of research will draw from recent systematic reviews to describe current practice and treatment protocols, explore the concerns and experiences of patients and clinicians about rehabilitation and exercise, develop consensus about best practice rehabilitation before specifying a rehabilitation programme including its underpinning logic model (identifying key treatment targets, components, mechanisms and outcomes).

View all Available Projects

Publications

Book Chapter

  • Prognosis research in people with low back pain

    Foster, Nadine E., van der Windt, Danielle A., Dunn, Kate M. and Croft, Peter (2019). Prognosis research in people with low back pain. Prognosis research in health care: concepts, methods, and impact. (pp. 247-257) edited by Richard D. Riley, Danielle A. van der Windt, Peter Croft and Karel G. M. Moons. Oxford, United Kingdom: Oxford University Press. doi: 10.1093/med/9780198796619.003.0011

  • Assessing rehabilitation: practical examples

    Foster, Nadine Elizabeth (2016). Assessing rehabilitation: practical examples. Randomized Clinical Trials of Nonpharmacological Treatments. (pp. 309-324) edited by Isabelle Boutron, Philippe Ravaud and David Moher. Boca Raton, FL, United States: CRC Press.

  • Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults

    Jordan, Joanne L, Foster, Nadine E, Holden, Melanie A and Mason, Elizabeth EJ (2006). Interventions to improve adherence to exercise for chronic musculoskeletal pain in adults. Cochrane Database of Systematic Reviews. edited by Jordan, Joanne L. Chichester, UK: John Wiley & Sons, Ltd. doi: 10.1002/14651858.cd005956

Journal Article

Conference Publication

Grants (Administered at UQ)

PhD and MPhil Supervision

Current Supervision

Possible Research Projects

Note for students: The possible research projects listed on this page may not be comprehensive or up to date. Always feel free to contact the staff for more information, and also with your own research ideas.

  • Towards a better conceptual understanding of Interprofessional clinical practice

    Interprofessional clinical practice is poorly defined and conceptualised, limiting our ability to measure and assess it and crucially to improve it for the benefit of health service and patient outcomes. This PhD programme will review current definitions and measures in the field, before developing a better conceptualisation of it that provides a new model to better understand interprofessional practice and from that identify preferred tools or the need for a new tool with which to measure it.

  • Rehabilitation and exercise for patients with shoulder osteoarthritis: can we do better?

    Musculoskeletal pain conditions are the largest contributer to global disability. Compared to knee or hip osteoarthritis, there is a paucity of research evidencing rehabilitation or exercise for patients with shoulder osteoarthritis. This means that most clinical practice is based on low quality evidence, and expert opinion. This programme of research will draw from recent systematic reviews to describe current practice and treatment protocols, explore the concerns and experiences of patients and clinicians about rehabilitation and exercise, develop consensus about best practice rehabilitation before specifying a rehabilitation programme including its underpinning logic model (identifying key treatment targets, components, mechanisms and outcomes).

This staff member is a UQ Expert for media in the following fields:

arthritis, back pain, physiotherapy, musculoskeletal disorders, rehabilitation, pain, joint pain, knee pain, osteoarthritis

They are happy to lend their expertise to your articles or broadcasts and share their research discoveries and insights with the community via media channels.

For additional assistance with story ideas, general advice and information or help with seeking further experts, please email the UQ Media Team or telephone (07) 3365 1120.

Links

ORCID: 0000-0003-4429-9756

Scopus ID: 55485496400

Google Scholar ID: yg30KicAAAAJ

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