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https://www.readbyqxmd.com/read/29042408/impact-of-restricting-diagnostic-imaging-reimbursement-for-uncomplicated-low-back-pain-in-ontario-a-population-based-interrupted-time-series-analysis
#1
Benjamin Fine, Susan E Schultz, Lawrence White, David Henry
BACKGROUND: In 2012, the Ontario government withdrew public insurance coverage of imaging tests for uncomplicated low back pain. We studied the impact of this restriction on test ordering by physicians. METHODS: We compared the numbers of lumbar spine radiography, computed tomography (CT) and single-segment magnetic resonance imaging (MRI) studies ordered by physicians in the 3 years before and after the policy change. We linked claims data from the Ontario Health Insurance Program with physician details to calculate rates per test-ordering physician...
October 13, 2017: CMAJ Open
https://www.readbyqxmd.com/read/29025737/use-of-hospital-related-health-care-among-health-links-enrollees-in-the-central-ontario-health-region-a-propensity-matched-difference-in-differences-study
#2
Luke Mondor, Kevin Walker, Yu Qing Bai, Walter P Wodchis
BACKGROUND: Health Links are a new model of providing care coordination for high-cost, high-needs patients in Ontario. We evaluated use of hospital-related health care services among Health Links patients in the Central Local Health Integration Network (LHIN) of Ontario in the year before versus after program enrolment and compared rates of use with those among similar patients with complex needs not enrolled in the program (comparator group). METHODS: We identified all patients who received a Health Links coordinated care plan before Jan...
October 12, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28986347/relation-between-family-physician-retention-and-avoidable-hospital-admission-in-newfoundland-and-labrador-a-population-based-cross-sectional-study
#3
John C Knight, Maria Mathews, Kris Aubrey-Bassler
BACKGROUND: Physician turnover, involving physicians' leaving clinical practice in a specific area, may disrupt continuity of care, leading to poorer health outcomes and greater use of health care services. The purpose of this study was to investigate the relation between family physician retention and avoidable hospital admission for ambulatory-care-sensitive conditions. METHODS: We conducted a population-based cross-sectional study using provincial health administrative data for residents of Newfoundland and Labrador who held a provincial health card between 2001 and 2009...
October 6, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28974533/enhancing-access-to-cervical-and-colorectal-cancer-screening-for-women-in-rural-and-remote-northern-alberta-a-pilot-study
#4
Silvina C Mema, Huiming Yang, Sherry Elnitsky, Zhichang Jiang, Marcus Vaska, Linan Xu
BACKGROUND: Women in rural and remote northern Alberta access breast cancer screening through a mobile mammogram program (Screen Test). The Enhanced Access to Cervical and Colorectal Cancer Screening (EACS) project was a 2-year pilot that aimed to integrate cervical and colorectal cancer screening with the Screen Test program. This study compares cervical and colorectal cancer screening uptake among women screened through the pilot (Screen Test-EACS) versus Screen Test. METHODS: Screen Test-EACS was offered between 2013 and 2015 in selected rural and remote sites, with a focus on hard-to-reach women living in First Nations, Métis and Hutterite communities...
October 3, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28951445/breast-cancer-survival-by-molecular-subtype-a-population-based-analysis-of-cancer-registry-data
#5
Saber Fallahpour, Tanya Navaneelan, Prithwish De, Alessia Borgo
BACKGROUND: The relation between breast cancer molecular subtype and survival has been studied in several jurisdictions, but limited information is available for Ontario. The aim of this study was to determine breast cancer survival by molecular subtype and to assess the effect on survival of selected demographic and tumour-based characteristics. METHODS: We extracted 29 833 breast cancer cases (in 26 538 girls and women aged ≥ 15 yr) diagnosed between 2010 and 2012 from the Ontario Cancer Registry...
September 25, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28947426/self-reported-versus-health-administrative-data-implications-for-assessing-chronic-illness-burden-in-populations-a-cross-sectional-study
#6
Martin Fortin, Jeannie Haggerty, Steven Sanche, José Almirall
BACKGROUND: Various data sources may be used to document the presence of chronic medical conditions. This study examined the agreement between self-reported and health administrative data. METHODS: A randomly selected cohort of participants aged 25-75 years recruited by telephone from the general population of Quebec reported on the presence of 1 or more chronic conditions from a candidate list of 12 conditions: diabetes, hypertension, thyroid disorder, any cardiac disease, cancer diagnosis in the previous 5 years (including melanoma but excluding other skin cancers), asthma, osteoarthritis, rheumatoid arthritis or lupus, osteoporosis, chronic obstructive pulmonary disease, intestinal disease and hypercholesterolemia...
September 25, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28928168/factors-that-support-successful-transition-to-the-community-among-women-leaving-prison-in-british-columbia-a-prospective-cohort-study-using-participatory-action-research
#7
Patricia A Janssen, Mo Korchinski, Sarah L Desmarais, Arianne Y K Albert, Lara-Lisa Condello, Marla Buchanan, Alison Granger-Brown, Vivian R Ramsden, Lynn Fels, Jane A Buxton, Carl Leggo, Ruth Elwood Martin
BACKGROUND: In Canada, the number of women sentenced to prison has almost doubled since 1995. In British Columbia, the rate of reincarceration is 70% within 2 years. Our aim was to identify factors associated with recidivism among women in British Columbia. METHODS: We prospectively followed women after discharge from provincial corrections centres in British Columbia. We defined recidivism as participation in criminal activity disclosed by participants during the year following release...
September 13, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28912143/the-relation-between-promotional-spending-on-drugs-and-their-therapeutic-gain-a-cohort-analysis
#8
Joel Lexchin
BACKGROUND: Whether drug promotion helps or hinders appropriate prescribing by physicians is debated. This study examines the most heavily promoted drugs and the therapeutic value of those drugs to help determine whether doctors should be using promotional material to inform themselves about drugs. METHODS: Lists were constructed of the 50 most heavily promoted drugs (amount of money spent on journal advertisements and visits by sales representatives) and the 50 top-selling drugs (by dollar value) for 2013, 2014 and 2015...
September 13, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28903976/working-hard-but-working-differently-a-qualitative-study-of-the-impact-of-generational-change-on-rural-health-care
#9
David Snadden, Mark Alexander Kunzli
BACKGROUND: There is limited literature evaluating generational change in the physician workforce and the adjustments required of practices, practitioners and the health care system as a whole. The purpose of this study was to explore rural practitioners' experiences of their current contexts relevant to recruitment and retention and to determine how practices are responding to changing aspirations of new practitioners. METHODS: We used qualitative methods. Participants were selected to ensure diversity of career stage...
September 12, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28899946/secondary-prevention-treatment-after-acute-stroke-in-older-south-asian-chinese-and-other-canadians-a-retrospective-data-analysis
#10
Nadia A Khan, Finlay A McAlister, Louise Pilote, Anita Palepu, Hude Quan, Michael D Hill, Jiming Fang, Moira K Kapral
BACKGROUND: Little is known about whether there are differences in medication use between older patients of Chinese descent, those of South Asian descent and other Canadian patients after acute ischemic or primary intracerebral hemorrhagic stroke. The aim of this population-based study was to evaluate potential ethnic differences in secondary prevention pharmacotherapy after acute stroke. METHODS: Using health administrative data, we conducted a retrospective analysis of all patients aged 66 years or more admitted to hospital with acute stroke in Ontario (1997-2011) and British Columbia (1997-2009)...
September 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28893844/accuracy-and-predictive-value-of-incarcerated-adults-accounts-of-their-self-harm-histories-findings-froman-australian-prospective-data-linkage-study
#11
Rohan Borschmann, Jesse T Young, Paul Moran, Matthew J Spittal, Kathryn Snow, Katherine Mok, Stuart A Kinner
BACKGROUND: Self-harm is prevalent in prison populations and is a well-established risk factor for suicide. Researchers typically rely on self-report to measure self-harm, yet the accuracy and predictive value of self-report in prison populations is unclear. Using a large, representative sample of incarcerated men and women, we aimed to examine the level of agreement between self-reported self-harm history and historical medical records, and investigate the association between self-harm history and medically verified self-harm after release from prison...
September 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28882852/human-seroprevalence-of-borrelia-miyamotoi-in-manitoba-canada-in-2011-2014-a-cross-sectional-study
#12
Kamran Kadkhoda, Cecilia Dumouchel, Janna Brancato, Ainsley Gretchen, Peter J Krause
BACKGROUND: Hard tick-borne relapsing fever caused by Borrelia miyamotoi has been reported in Russia, the Netherlands, Germany, Japan and the northeastern and upper midwestern United States. We sought to investigate the presence of B. miyamotoi infection in humans in Manitoba, Canada. METHODS: Two hundred fifty sera collected from residents of Manitoba with suspected Lyme disease between 2011 and 2014 were tested for Borrelia burgdorferi antibody using a C6 peptide enzyme-linked immunosorbent assay (ELISA) followed by Western blot...
September 6, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28877916/temporal-trends-in-the-association-between-socioeconomic-status-and-cancer-survival-in-ontario-a-population-based-retrospective-study
#13
Andrew Dabbikeh, Yingwei Peng, William J Mackillop, Christopher M Booth, Jina Zhang-Salomons
BACKGROUND: Cancer survival is known to be associated with socioeconomic status. The income gap between the richer and poorer segments of the population has widened over the last 20 years in Canada. The purpose of this study was to investigate temporal trends in disparities in cancer-specific survival related to socioeconomic status in Ontario. METHODS: There were 920 334 cancer cases between 1993 and 2009 in the Ontario Cancer Registry. We linked median household income from the Canadian census to the registry...
September 6, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28855308/a-cross-sectional-population-based-study-of-breast-cancer-screening-among-women-with-hiv-in-ontario-canada
#14
Claire E Kendall, Sharon Walmsley, Cindy Lau, Nathaniel Jembere, Ann N Burchell, Mona Loutfy, Janet Raboud, Ron Rosenes, Sean B Rourke, Tony Antoniou
BACKGROUND: As women with HIV live longer, the need for age-appropriate breast cancer screening will increase. We compared rates of screening mammography among women with and without HIV. METHODS: We used administrative health databases to identify all women in Ontario, Canada, who were eligible for screening mammography (aged 50 to 74 yr and no history of breast cancer) as of Apr. 1, 2011. We used multivariable log-binomial regression to compare the 2-year period prevalence of screening mammography in 2011 to 2013 among women with and without HIV and to examine the correlates of screening among women with HIV...
August 30, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28851700/model-based-projection-of-health-and-economic-effects-of-screening-for-hepatitis-c-in-canada
#15
William W L Wong, Aysegul Erman, Jordan J Feld, Murray Krahn
BACKGROUND: Because most hepatitis C virus (HCV) infections are asymptomatic and often unrecognized, screening for hepatitis C has been proposed as a plausible public health strategy. We examined the health and economic consequences of a selective one-time hepatitis C screening program for specific populations in the context of current treatment patterns. METHODS: We used a state-transition model to evaluate 2 general strategies: no screening, and screen and treat with direct-acting antiviral agents...
August 25, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28835370/screening-for-atrial-fibrillation-in-canadian-pharmacies-an-economic-evaluation
#16
Jean-Eric Tarride, Lisa Dolovich, Gordon Blackhouse, Jason Robert Guertin, Natasha Burke, Veena Manja, Alex Grinvalds, Ting Lim, Jeff S Healey, Roopinder K Sandhu
BACKGROUND: Screening for undiagnosed atrial fibrillation may lead to treatment with oral anticoagulation therapy, which can decrease the risk of ischemic stroke. The objective of this study was to conduct an economic evaluation of the Program for the Identification of 'Actionable' Atrial Fibrillation in the Pharmacy Setting (PIAAF-Pharmacy), which screened 1145 participants aged 65 years or more at 30 community pharmacies in Ontario and Alberta between October 2014 and April 2015. METHODS: We used a 2-part decision model to evaluate the short- and long-term costs and quality-adjusted life-years (QALYs) of a pharmacy screening program for atrial fibrillation compared to no screening...
August 22, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28830865/suicide-and-suicide-attempts-among-women-in-the-manitoba-mothers-and-fetal-alcohol-spectrum-disorder-cohort-a-retrospective-matched-analysis-using-linked-administrative-data
#17
Deepa Singal, Marni Brownell, Dan Chateau, Elizabeth Wall-Wieler, Sally Longstaffe, Ana Hanlon-Dearman, Leslie L Roos
BACKGROUND: Women who give birth to children with fetal alcohol spectrum disorder (FASD) may be at increased risk for suicide; however, there are few data in this area. The objective of this study was to compare rates of suicide between women who had given birth to children with FASD and women who had not given birth to children with FASD during critical periods in their lives, including before pregnancy, during pregnancy, during the postpartum period (maternal death) and until the end of the study period...
August 17, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28827414/coder-perspectives-on-physician-related-barriers-to-producing-high-quality-administrative-data-a-qualitative-study
#18
Karen L Tang, Kelsey Lucyk, Hude Quan
BACKGROUND: Professional coding specialists ("coders") are experts at translating patient chart information into alphanumerical codes, which are then widely used in research and health policy decision-making. Coders rely solely on documentation by health care providers to complete this task. We aimed to explore physician-related barriers to coding that results in high-quality administrative data. METHODS: In a qualitative study conducted from December 2015 to March 2016, we recruited 28 coders who worked in health care facilities in Alberta using purposive and snowball sampling...
August 15, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28819065/effects-of-the-fort-mcmurray-wildfires-on-the-health-of-evacuated-workers-follow-up-of-2-cohorts
#19
Nicola Cherry, Whitney Haynes
BACKGROUND: Wildfire engulfed Fort McMurray, Alberta on May 3, 2016, leading to a total evacuation. Access to 2 active cohorts allowed us to rapidly assess health effects in those evacuated. METHODS: People working in Fort McMurray who had been recruited before the fire for 2 occupational health cohort studies completed a questionnaire (online or via telephone) 3-26 weeks after evacuation. The questionnaire asked about respiratory and mental health and experiences since the fire...
August 15, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28814382/predictive-utility-of-swab-screening-for-vancomycin-resistant-enterococcus-in-selection-of-empiric-antibiotics-for-enterococcus-sterile-site-infections-a-retrospective-cohort-study
#20
Ian Brasg, Marion Elligsen, Derek MacFadden, Nick Daneman
BACKGROUND: Swab screening for vancomycin-resistant Enterococcus (VRE) is used to identify VRE carriers and thus prevent transmission of this organism. We tested whether screening results could have unintended benefits in predicting the vancomycin susceptibility of subsequent Enterococcus infections experienced by these patients. METHODS: We conducted a retrospective cohort study of all patients admitted to a large tertiary care hospital between 2010 and 2015 who underwent swab screening for VRE before experiencing an Enterococcus sterile-site infection...
August 15, 2017: CMAJ Open
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