The Clinical Research Institute
Research inspired by clinical care. Designed to improve it.
The Clinical Research Institute brings together clinicians, researchers, universities, hospitals and scientific organisations to investigate important questions arising directly from patient care.
Where it came from
Some research questions
begin in the consulting room
Established in 2012, the Institute grew from a simple idea: some of the most important research questions begin in the consulting room, hospital ward, rehabilitation gym or operating theatre. Our research is therefore closely connected with clinical practice.
We work across physiotherapy, medicine, surgery, rehabilitation and laboratory science to better understand recovery, improve clinical assessment, evaluate treatments and develop new approaches to healthcare.
Today, our research spans orthopaedics and osteoarthritis, men’s health and urology, microplastics and human health, cardiothoracic and respiratory medicine, rehabilitation, clinical measurement and high-performance sport.
A major focus of our current research is undertaken within St Vincent’s Private Hospital Sydney, where clinicians, research fellows, surgeons, students and external scientific collaborators work together within clinically embedded research programs.
1993
Practice-based research begins
Clinicians in the practice start asking measurable questions about recovery, outcomes and treatment effectiveness.
2012
The Clinical Research Institute established
A formal structure created within the practice group to support collaborative clinical research, postgraduate supervision and publication.
2020
St Vincent's Private Hospital Sydney
The practice group begins delivering allied health services at St Vincent’s Private Hospital Sydney, extending research capability into a major hospital environment.
2021
Orthopaedic Clinical Research Program
A multidisciplinary program develops at St Vincent’s Private Hospital Sydney, co-led by Professor Sean Mungovan and Associate Professor Nick Vertzyas. The Cunningham Fellowship is established in the same year.
Now
Translational collaborations
Major collaborations with the Garvan Institute of Medical Research and The University of Queensland extend the work into immunogenomics and microplastics research.
How the work starts
From patient care to
research — and back again
Research at The Clinical Research Institute starts with questions that matter in everyday clinical care.
Why do some patients recover more quickly than others?
How can we measure recovery more accurately?
Can we identify patients who may need additional rehabilitation?
Why does osteoarthritis affect people so differently?
What happens to blood pressure when patients first mobilise after joint replacement?
Can medical devices and treatments expose patients to microplastics?
Can better assessment before prostate cancer surgery improve rehabilitation afterwards?
Rather than separating research from clinical practice, we seek to build research into clinical services wherever possible. This creates a continuous cycle.
1
Clinical problem
2
Research question
3
Investigation
4
New knowledge
5
Better clinical care
and back to the clinic
It is an approach that allows clinicians to investigate problems they encounter in practice while ensuring that research remains connected to the needs of patients.
Our research programs
What we are working on
Orthopaedics and joint replacement
Understanding recovery after hip and knee surgery
The Orthopaedic Clinical Research Program at St Vincent’s Private Hospital Sydney was established in 2021 and brings together physiotherapists, orthopaedic surgeons, research fellows, medical students and scientific collaborators. Our aim is to better understand what happens before, during and after hip and knee replacement — and to use that knowledge to improve recovery.
Research includes
Recovery of physical function after hip and knee replacement
Safe mobilisation after surgery
Blood pressure and orthostatic intolerance during early mobilisation
Functional assessments that reflect everyday activities
Rehabilitation decision-making
Urinary function following joint replacement
Osteoarthritis biology
Human tissue and biospecimen research
Microplastics associated with medical treatment and implanted devices
Research alongside clinical care. Patients can contribute to carefully governed prospective studies while receiving treatment within an established hospital service.
In practice
Researching the things patients actually need to do
Traditional measures such as walking tests and joint range of movement provide important information, but they do not always tell us whether someone can perform the activities that matter to them. Our researchers have therefore investigated practical activities such as getting into and out of a car after joint replacement.
This work led to the development and validation of a standardised Car-Seat Transfer Test and the construction of a purpose-designed car-seat simulator that can be used in both research and rehabilitation.
It is an example of a recurring theme within our work: identify an everyday patient problem, develop a way of measuring it, investigate it scientifically and then apply what we learn back to clinical care.
Osteoarthritis
Connecting the patient with the laboratory
Osteoarthritis is often described simply as “wear and tear”, but the biological processes underlying the disease are considerably more complex. Two people with apparently similar arthritis on an X-ray can experience very different levels of pain, disability and recovery.
To investigate these differences, researchers from the Orthopaedic Clinical Research Program at St Vincent’s Private Hospital Sydney have established a translational research collaboration with the Garvan Institute of Medical Research. Patients undergoing hip and knee replacement can contribute detailed information about their symptoms, physical function, imaging and recovery together with blood samples and, where appropriate, tissue obtained during surgery.
Samples can include
Synovium
Synovial fluid
Cartilage
Bone
Bone marrow
These carefully characterised clinical samples can then be studied using advanced immunological, genomic and single-cell research techniques. The objective is to connect what we see in the patient with what we discover in their tissues and cells.
Why it matters. Research of this kind may help us understand different biological forms of osteoarthritis and contribute to more individualised approaches to assessment and treatment in the future.
Microplastics and human health
Investigating an emerging question in clinical medicine
Plastic is used throughout modern healthcare. It is present in medical devices, pharmaceutical packaging, implanted materials, intravenous equipment and many other products that are essential to contemporary medicine. An important emerging question is whether some of these materials can result in human exposure to microplastics, nanoplastics or plastic-associated chemicals.
The Clinical Research Institute and the Orthopaedic Clinical Research Program at St Vincent’s Private Hospital Sydney are contributing to this developing field through collaboration with the Minderoo Centre – Plastics and Human Health and the Queensland Alliance for Environmental Health Sciences at The University of Queensland. The collaboration brings together clinical research and patient biospecimen collection with specialist expertise in environmental exposure science and analytical chemistry.
Our initial work has included patients undergoing knee replacement, with carefully controlled collection of blood and surgical tissue samples before and after surgery.
The program is expanding to investigate potential exposure associated with
Joint replacement
Injectable medicines and pharmaceutical packaging
Ureteric stents
Surgical mesh
Other implanted and clinical medical products
An emerging field. Our objective is to establish rigorous clinical methods that allow questions about plastics and human health to be investigated prospectively in real patient populations.
Men's health and prostate cancer
Improving recovery after radical prostatectomy
Our men’s health research program developed from clinical work with men undergoing surgery for prostate cancer. Urinary incontinence can be one of the most significant consequences of radical prostatectomy, yet recovery varies considerably between individuals. Over more than two decades, our clinical and research work has examined how men can be better assessed, prepared and supported before and after surgery.
The program has included research into
Pelvic floor muscle function
Urinary continence mechanisms
Preoperative assessment and prehabilitation
Pelvic floor muscle training
Transperineal ultrasound
Urethral anatomy
Objective measurement of urinary continence
Predictors of continence recovery
Postoperative rehabilitation
Long-term recovery
A particular focus has been moving beyond a model in which men are simply provided with pelvic floor exercises. Our approach integrates individual assessment, education, measurement, imaging where appropriate, pelvic floor muscle training and systematic evaluation of recovery.
Research arising from this program has involved collaborations with organisations including The University of Sydney, Macquarie University, Memorial Sloan Kettering Cancer Center in New York and the University of Jamestown in the United States. The clinical pathway developed through this work has also been translated internationally, including implementation of a structured physiotherapy model for men undergoing radical prostatectomy in the United States.
Related service: Men’s Pelvic Health
Cardiothoracic and respiratory
Recovery after major cardiac and respiratory illness
The program has included research into
Physical activity following cardiac surgery
Functional exercise capacity
Six-minute walk performance
Exercise rehabilitation
Recovery following median sternotomy
Exercise in heart failure
Respiratory recovery following tuberculosis
Post-COVID rehabilitation
Telerehabilitation
Across these areas, our focus has remained strongly clinical: identifying measurements and interventions that can help clinicians understand recovery and provide effective rehabilitation.
Measurement
Better measurement. Better decisions.
Good clinical decisions depend on good information. A recurring theme throughout our research has therefore been the development and evaluation of measurements that are both scientifically robust and practical enough to use in real clinical environments.
Objective urinary continence measurement
Validated patient-reported outcome measures
Transperineal ultrasound assessment
Pelvic floor and urethral measurement
Physical activity measurement
Six-minute walk testing
Functional assessment after joint replacement
Car-seat transfer assessment
Performance assessment in elite sport
Prospective clinical research cohorts
The question is always the same
Does this measurement tell clinicians something meaningful about the person in front of them?
Research infrastructure
Research at St Vincent's
Private Hospital Sydney
A major focus of The Clinical Research Institute is the development of research that can operate alongside high-quality clinical services. At St Vincent’s Private Hospital Sydney, this approach has enabled the establishment of research infrastructure supporting orthopaedics, osteoarthritis, rehabilitation and emerging translational research.
Prospective clinical research cohorts
Research fellows
Clinical research databases
Intraoperative human tissue collection
Opportunities for clinicians and students to participate in research
Standardised clinical and functional assessments
Ethics and governance pathways
Secure sample-transfer pathways
Longitudinal follow-up
Specialised physiological and functional measurement equipment
Patient recruitment and informed consent
Biospecimen collection
University and laboratory collaborations
This infrastructure allows physiotherapists, surgeons, research fellows, students and laboratory scientists to contribute to a common research program while maintaining a direct connection between research and patient care.
Developing the next generation of clinician-researchers
The Cunningham Orthopaedic
Clinical Research Fellowship
Research does not grow through projects alone. It requires people, mentorship, infrastructure and protected opportunities to develop research skills.
The JW & M Cunningham Orthopaedic Clinical Research Fellowship Program was established at St Vincent’s Private Hospital Sydney in 2021 to provide dedicated research capacity within the Orthopaedic Clinical Research Program.
Research Fellows work across the full research pathway
Identifying important clinical questions
Designing research studies
Obtaining ethics and governance approval
Recruiting patients
Undertaking clinical and functional assessments
Managing research databases
Contributing to biospecimen and human tissue studies
Analysing and interpreting research findings
Presenting research at scientific meetings
Preparing manuscripts for publication
Translating research findings into clinical practice
Continuity, not one-off projects. Fellows work within a multidisciplinary environment alongside physiotherapists, surgeons, medical students, scientists and university researchers. The Fellowship has created continuity from one research project to the next — research cohorts, datasets, assessment methods, collaborations and governance pathways are strengthened over successive years rather than disappearing when an individual project finishes. Former Fellows have subsequently progressed into research and university academic appointments.
Building researchers, not just research
Helping clinicians get involved in research
Research can sometimes appear inaccessible to clinicians whose primary role is patient care. We believe it should not be. Clinicians frequently identify important questions because they see the same problems repeatedly in practice — our role is to help turn those observations into research that can be investigated properly.
Mentorship can include
Developing a clinical observation into a research question
Reviewing the scientific literature
Choosing appropriate outcome measures
Research methodology
Protocol development
Ethics and governance
Data collection
Research database development
Interpretation of findings
Conference abstracts and presentations
Manuscript development
Scientific writing
Translating findings back into clinical practice
The goal is to create an environment in which research becomes part of clinical practice rather than something that happens somewhere else.
Student research
Introducing students to research early
The Clinical Research Institute and associated programs have supported postgraduate and medical student research involving Australian and international universities. Students have worked alongside clinicians, research fellows, surgeons and academic collaborators, and have contributed to areas including orthopaedic surgery, joint replacement and men’s health — from development of the research question and data collection through to interpretation, conference presentation and publication.
This multidisciplinary environment provides students with something that cannot easily be learned from a textbook: an understanding of how research is actually conducted within clinical healthcare.
Our research collaborations
Complex healthcare questions rarely sit within a single discipline
Our research is therefore built on collaboration. Current and longstanding collaborators have included:
St Vincent's Private Hospital Sydney
Clinically embedded research in orthopaedics, joint replacement, rehabilitation, osteoarthritis and translational clinical medicine.
Garvan Institute of Medical Research
Osteoarthritis immunology, genomics, single-cell research and human tissue investigation.
The University of Queensland
Microplastics, nanoplastics, analytical chemistry and environmental exposure science.
The University of Sydney
Urological oncology, prostate cancer recovery and multidisciplinary clinical research.
Macquarie University
Biostatistics, research methodology and outcomes research.
Memorial Sloan Kettering Cancer Center
New York, United States. Male continence, urological imaging and anatomical assessment following radical prostatectomy.
University of Jamestown
North Dakota, United States. Men’s health, orthopaedics, clinical measurement and international translation of physiotherapy models of care.
These collaborations allow clinical questions arising in Australian healthcare to be investigated using expertise extending from physiotherapy and surgery to biostatistics, imaging, genomics, immunology and analytical chemistry.
Beyond academic journals
Publication alone does not change healthcare
Publishing scientific research is important, but research also needs to reach the clinicians who provide care, the patients who may benefit from it and the community that supports medical research.
Developing a clinical observation into a research question
Reviewing the scientific literature
Choosing appropriate outcome measures
Research methodology
Protocol development
Ethics and governance
Data collection
Research database development
Interpretation of findings
Conference abstracts and presentations
Manuscript development
Scientific writing
Translating findings back into clinical practice
The objective is to make complex research understandable without losing its scientific meaning.
Our research philosophy
Six things we hold to
Clinically embedded research
Research should address questions that matter to patients and clinicians.
Collaboration
The most important healthcare problems increasingly require expertise from multiple disciplines.
Measurement
We seek to measure outcomes that are scientifically valid but also meaningful in the real world.
Translation
Research should ultimately contribute to better assessment, better decisions and better healthcare.
Capacity
Sustainable research requires investment in clinicians, fellows, students, infrastructure and partnerships.
Curiosity
Some of the most valuable research begins with a clinician asking: “Why does this happen – and can we do something better?”
The Clinical Research Institute
Connecting clinical practice, research and discovery
From rehabilitation clinics and hospital wards to operating theatres and research laboratories, our aim is to connect the questions that emerge from patient care with the researchers and methods capable of answering them.
Because research has the greatest value when it finds its way back to the patient.
Explore our research
The research team and collaborators, our partnerships, and a complete archive of publications and presentations.