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Dianna Wang, Abdool S Yasseen, Laetitia Marchand-Martin, Ann E Sprague, Erin Graves, François Goffinet, Mark Walker, Pierre-Yves Ancel, Thierry Lacaze-Masmonteil
BACKGROUND: The management and outcomes of preterm births can vary greatly even among developed nations with the same access to medicine, technology and expertise. We aimed to compare aspects of obstetrical management and mortality for preterm infants in France and Ontario, Canada. METHODS: The Better Outcomes Registry & Network (BORN) Information System in Ontario and Épidémiologique sur les petits âges gestationnels (EPIPAGE-2) in France collected information on maternal demographics, obstetrical characteristics, obstetrical interventions and neonatal outcomes for infants born between 22 and 34 weeks gestation...
January 2019: CMAJ Open
Moin Khan, Bashar Alolabi, Nolan Horner, Asheesh Bedi, Olufemi R Ayeni, Mohit Bhandari
BACKGROUND: Shoulder impingement is one of the most common nontraumatic upper limb causes of disability in adults. Our aim was to evaluate the efficacy of surgical intervention in comparison with nonoperative or sham treatments in patients with shoulder impingement in terms of both pain and functional outcomes. METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials. Two reviewers independently screened MEDLINE, Embase, PubMed and Cochrane databases for randomized controlled trials published from 1946 to July 19, 2018...
January 2019: CMAJ Open
Samiah Alam, Justin J Lang, Aaron M Drucker, Carolyn Gotay, Nicole Kozloff, Kedar Mate, Scott B Patten, Heather M Orpana, Ashkan Afshin, Leah E Cahill
BACKGROUND: An understanding of the risk factors contributing to disease burden is critical for determining research priorities and informing national health policy. We aimed to identify the risk factor trends in Canada. METHODS: As part of the Global Burden of Disease (GBD) study (1990-2016), we conducted an analysis of country-level estimates for Canada to assess the burden of diseases and injuries attributable to risk factors. For both 1990 and 2016, metabolic, environmental and behavioural risk factors were ranked according to their contribution to disability-adjusted life years (healthy years of life lost), total deaths and years lived with disability...
January 2019: CMAJ Open
Yuan Xu, Sue Steckle, Arthur Lui, Elijah Dixon, Chad G Ball, Francis R Sutherland, Jennifer Spratlin, Oliver F Bathe
BACKGROUND: The management of biliary cancers is complex and requires a multidisciplinary approach. Because it is unknown how access to specialty care affects resource use and survival in patients with biliary cancer, we conducted a population-based study to understand the needs of these patients and the relation of geography to care delivery and clinical outcomes for biliary cancer in Alberta. METHODS: All patients with biliary cancer diagnosed in Alberta from Sept...
January 2019: CMAJ Open
M Ruth Lavergne, Ian Scott, Goldis Mitra, David Snadden, Doug Blackie, Laurie J Goldsmith, David Rudoler, Lindsay Hedden, Agnes Grudniewicz, Megan A Ahuja, Emily Gard Marshall
BACKGROUND: Family medicine residents choose among a range of practice options as they enter the physician workforce. We describe the demographic and personal characteristics of Canadian family medicine residents and examine differences in the intentions of residents from Ontario, Quebec, Western Canada and Atlantic Canada at the completion of their training, in terms of practice comprehensiveness, organizational model, clinical domains, practice settings and populations served. METHODS: We analyzed national survey data collected by the College of Family Physicians of Canada and 16 university-based family medicine residency programs...
January 2019: CMAJ Open
Aamir Suhail, Candice E Crocker, Bijon Das, Jennifer I Payne, Daria Manos
BACKGROUND: Guidelines aimed at improving care for lung cancer, the leading cause of cancer-related death in Canada and worldwide, require accurate knowledge of the diagnostic setting or pathway. We sought to determine how often lung cancer is initially diagnosed through the emergency department. METHODS: We performed a descriptive study that included all cases of primary lung cancer diagnosed in residents of Nova Scotia in 2014. Cancer registry data included diagnostic data and date of death to Aug...
January 2019: CMAJ Open
Amity E Quinn, Alun Edwards, Peter Senior, Kerry A McBrien, Brenda R Hemmelgarn, Marcello Tonelli, Flora Au, Zhihai Ma, Robert G Weaver, Braden J Manns
BACKGROUND: As the number of people with chronic diseases increases, understanding the impact of payment model on the types of patients seen by specialists has implications for improving the quality and value of care. We sought to determine if there is an association between specialist physician payment model and the types of patients seen. METHODS: In this descriptive study, we used administrative data to compare demographic characteristics, illness severity and visit indication of patients with diabetes seen by fee-for-service and salary-based internal medicine and diabetes specialists in Calgary and Edmonton between April 2011 and September 2014...
January 2019: CMAJ Open
Lisa Barbera, Faith Lee, Rinku Sutradhar
BACKGROUND: Since 2007, Cancer Care Ontario has been collecting data using the Edmonton Symptom Assessment System as a patient-reported outcome measure for use in routine care. The purpose of this project was to evaluate the factors associated with Edmonton Symptom Assessment System uptake among cancer patients seen at regional cancer centres and to examine if these associations have changed over time. METHODS: This was a retrospective cohort study among cancer patients eligible to complete Edmonton Symptom Assessment System assessments who were seen at regional cancer centres in Ontario between 2007 and 2015...
January 2019: CMAJ Open
Alexandrea Peel, Iris Gutmanis, Trevor Bon
BACKGROUND: The relationship between having a family physician and in-hospital and postdischarge health outcomes among older adults is unclear. We ascertained the proportion of seniors who did not have a family physician and were admitted to an Ontario tertiary care centre, and we determined the association between having/not having a family physician and in-hospital mortality, 1-year mortality and readmission after live discharge. METHODS: This was a retrospective cohort study of community-dwelling seniors who were admitted to a medical service at Thunder Bay Regional Health Sciences Centre...
January 2019: CMAJ Open
Jennifer Claydon, Constantin R Popescu, Lana Shaiba, Cheryl Christopherson, Derek Human, Richard Taylor, Alfonso Solimano, Pascal M Lavoie
BACKGROUND: It has been hypothesized that 4 doses of palivizumab, a neutralizing monoclonal antibody against respiratory syncytial virus (RSV), administered during a fixed-date RSV season may reduce hospital admissions comparably to the standard 5-dose schedule. We report outcomes in children with congenital heart disease approved to receive this 4-dose palivizumab schedule in British Columbia. METHODS: We performed a population-based descriptive cohort analysis of all 406 approved palivizumab courses over 4 seasons (2012/13 to 2015/16) in 325 children with hemodynamically significant congenital heart disease enrolled in the British Columbia RSV Immunoprophylaxis Program...
January 2019: CMAJ Open
Ilona Hale, Shazhan Amed, Shelly Keidar, Megan Purcell, Donna Lee, Daniel Farhadi
BACKGROUND: Infancy appears to be a critical period for establishing a person's weight set point. It remains unclear which interventions during infancy may be most effective in preventing later obesity and which ones are most acceptable to parents. The aim of this study was to examine the attitudes of parents of children aged 2 years and under toward different obesity prevention messages and their preferences with regard to these messages. METHODS: Using a qualitative research design, we conducted semistructured interviews followed by a focus group...
January 2019: CMAJ Open
Hsien Seow, Lialoma Salam-White, Daryl Bainbridge
BACKGROUND: Access to community-based specialist palliative care teams has been shown to improve patients' quality of life; however, the impact on health system expenditures is unclear. This study aimed to determine whether exposure to these teams reduces health system costs compared with usual care. METHODS: We conducted a retrospective matched cohort study in Ontario, Canada, using linked administrative data. Decedents treated by 1 of 11 community-based specialist palliative care teams in 2009/10 and 2010/11 (the exposed group) were propensity score matched (comorbidity, extent of home care, etc...
January 2019: CMAJ Open
Deepa Singal, Marni Brownell, Elizabeth Wall-Wieler, Dan Chateau, Ana Hanlon-Dearman, Sally Longstaffe, Leslie L Roos
BACKGROUND: Few studies have investigated prenatal care use among women who use alcohol during pregnancy. The objective of this study was to investigate rates of prenatal care usage of women who have given birth to children with fetal alcohol spectrum disorder (FASD). METHODS: We conducted a case-control study of women with children born in Manitoba between Apr. 1, 1984, and Mar. 31, 2012, with follow-up until 2013, using linkable administrative data. The study group included women whose child(ren) was (were) diagnosed with FASD ( n = 702) between Apr...
January 2019: CMAJ Open
Peter Cram, Lisa M Lix, Eric Bohm, Lin Yan, Leslie Roos, John Matelski, Rajiv Gandhi, Bruce Landon, William D Leslie
BACKGROUND: Nearly 30 years ago, a series of studies showed increased hip fracture mortality in Manitoba compared to the United States, but these data have not been updated. Our objective was to compare the organization of hip fracture care and short-term outcomes in Manitoba and New York State using contemporary data. METHODS: This was a retrospective cohort study of administrative data for all adults aged 50 years or more admitted to hospital with hip fracture between Jan...
January 2019: CMAJ Open
P Alison Paprica, Magda Nunes de Melo, Michael J Schull
BACKGROUND: Both the research literature and headline news stories indicate that the public cares about how their health data are used. The objective of this study was to learn more about the general public's attitudes toward users and uses of linked administrative health data held by ICES in Ontario, Canada. METHODS: Eight focus groups, with a total of 65 members of the general public, were conducted in urban and northern settings in Ontario, Canada, in 2015 and 2017 using qualitative market research panels established by a market research/public opinion research firm...
January 2019: CMAJ Open
Kimberly A Mc Cord, Hannah Ewald, Aviv Ladanie, Matthias Briel, Benjamin Speich, Heiner C Bucher, Lars G Hemkens
BACKGROUND: Electronic health records (EHRs) may support randomized controlled trials (RCTs). We aimed to describe the current use and costs of EHRs in RCTs, with a focus on recruitment and outcome assessment. METHODS: This descriptive study was based on a PubMed search of RCTs published since 2000 that evaluated any medical intervention with the use of EHRs. Cost information was obtained from RCT investigators who used EHR infrastructures for recruitment or outcome measurement but did not explore EHR technology itself...
January 2019: CMAJ Open
Amol A Verma, Yishan Guo, Janice L Kwan, Lauren Lapointe-Shaw, Shail Rawal, Terence Tang, Adina Weinerman, Fahad Razak
BACKGROUND: Short hospital stays may represent opportunities to avert unnecessary admissions or expedite inpatient care. To inform the design of interventions that target patients with potentially avoidable hospital admissions or brief stays, we examined the patient, physician and situational characteristics associated with short stays among patients admitted to general internal medicine wards and describe the use of hospital resources by these patients. METHODS: This was a multicentre cross-sectional study conducted between Apr...
January 2019: CMAJ Open
Daniel Fuller, Joshua Neudorf, Stuart Lockhart, Charles Plante, Hazel Roberts, Thilina Bandara, Cory Neudorf
BACKGROUND: Improving our understanding of social inequalities may improve prevention and treatment efforts for diabetes mellitus. We examined the association between individual- and area-level socioeconomic measures and physician-diagnosed diabetes in Saskatchewan over time. METHODS: In this cross-sectional study, we linked health administrative data with individual-level socioeconomic data from the Canadian Community Health Survey and area-level data from the 2006 Canadian census...
January 2019: CMAJ Open
Fiona K I Chan, Kimberlyn McGrail, Sumit R Majumdar, Michael R Law
BACKGROUND: Employer-sponsored health insurance, particularly for retirees with limited incomes, plays a major funding role in Canadian health care, including prescription drugs and dental services. We aimed to investigate the changes in retiree health insurance availability over time. METHODS: We performed a secondary analysis of data from the 2005 and 2013-2014 cycles of the Canadian Community Health Survey using multivariate logistic regression to study changes in retiree coverage availability over time in Ontario...
January 2019: CMAJ Open
Richard Buote, Shabnam Asghari, Kris Aubrey-Bassler, John C Knight, Julia Lukewich
BACKGROUND: Newfoundland and Labrador has a rapidly aging population, much of which is rural, with poor health behaviours and high rates of chronic disease. These factors contribute to a unique challenge in health care delivery. Our aim was to describe the availability of publicly funded primary health care programs and services delivered by regional health authorities across the province. METHODS: We performed a descriptive analysis using data from a cross-sectional provincial primary health care survey deployed across Newfoundland and Labrador...
January 2019: CMAJ Open
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