Professor Nadine Foster

NHMRC Leadership Fellow

Faculty of Health and Behavioural Sciences

Director, UQ Clinical Trials Center

Pro-Vice-Chancellor (Research Infrastructure)

Director, UQ Clinical Trials Unit

Pro-Vice-Chancellor (Research Infrastructure)

Overview

Nadine is a physiotherapist, NHMRC Leadership Fellow (leadership level 2) focused on musculoskeletal pain and orthopaedic research, particularly clinical trials, and Academic Director of the University of Queensland's Clinical Trials Centre. Nadine is also the program lead for the Health Research Accelerator (HERA 2) program focused on innovation in clinical trials (ULTRA - UQ's Clinical Trial Capability). She is passionate about supporting multidisciplinary groups to work together, with critical mass, to design, conduct, analyse and translate the results of high quality clinical trials, in ways that improve patient and service outcomes.

Nadine is a lifetime Fellow of the Chartered Society of Physiotherapy in the UK, and has held previous National Institute for Health Research (NIHR) Senior Investigator awards and is the only physiotherapist to have held an NIHR Research Professorship in the UK. Having moved to Australia in January 2021, she was the inaugural Director of the STARS Research and Education Alliance between the University of Queensland and Metro North Health in Queensland (STARS is the Surgical, Treatment and Rehabilitation Service, the newest public hospital in Brisbane). Nadine is part of the STARS Alliance multidisciplinary team including conjoint appointments between the University and hospital, across the disciplines of physiotherapy, nursing, occupational therapy, psychology, consumer involvement in research, interdisciplinary collaborative practice in education and practice, and research management.

Nadine's 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 $145 million in research funding from, for example, the National Institute for Health Research (NIHR), Versus Arthritis, and the Medical Research Council in the UK, PCORI in the USA and the NHMRC and MRFF in Australia. Current 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. She has supervised 15 PhD students to completion, and 19 Masters research project students (nearly all were healthcare professionals), with 5 PhDs currently in progress in the UK, Europe and Australia. Nadine has led or contributed to over 287 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 and stepped care) that has widely influenced health policy and practice.

Her program of research has led to paradigm-changing discoveries, producing 287 peer reviewed full papers cited widely in >129 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 sets and set the international bar for stratified care trials in musculoskeletal pain, leading to >12 trials globally including in other fields (eg. arthritis, whiplash).

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 and 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. the STarTBack tool, with >42 language translations).

Qualifications

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

Publications

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Supervision

  • Doctor Philosophy

View all Supervision

Publications

Book Chapter

  • 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

  • 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.

  • 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