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Anne Grundy, Abbey E Poirier, Farah Khandwala, Alison McFadden, Christine M Friedenreich, Darren R Brenner
BACKGROUND: Consumption of red and processed meats has been associated with an increased risk of colorectal cancer. The purpose of this study was to estimate the proportion and absolute number of cancers in Alberta in 2012 that could be attributed to the consumption of red and processed meat. METHODS: The number and proportion of colorectal cancers in Alberta that were attributable to red and processed meat consumption were estimated using population attributable risk...
October 2016: CMAJ Open
Anne Grundy, Abbey E Poirier, Farah Khandwala, Alison McFadden, Christine M Friedenreich, Darren R Brenner
BACKGROUND: Sufficient fruit and vegetable consumption (≥ 5 servings/d) has been associated with a probable decreased risk for cancers of the oral cavity, pharynx, larynx, esophagus, stomach and lung (fruit only). The purpose of this study was to estimate the proportion and absolute number of cancer cases in Alberta in 2012 that were attributable to insufficient fruit and vegetable consumption. METHODS: The numbers and proportions of cancers attributable to insufficient fruit and vegetable consumption were estimated using the population attributable risk...
October 2016: CMAJ Open
Xin Grevers, Anne Grundy, Abbey E Poirier, Farah Khandwala, Matthew Feldman, Christine M Friedenreich, Darren R Brenner
BACKGROUND: Hormonal contraceptives and hormone replacement therapies are classified as carcinogenic to humans (group 1) by the International Agency for Research on Cancer. We sought to estimate the proportion and total number of cancers attributable to the use of oral contraceptives and hormone therapy in Alberta in 2012. METHODS: Population attributable risks were used to estimate the proportion of attributable cases for each associated cancer site. Relative risk estimates were obtained from the most relevant and recent epidemiologic literature...
October 2016: CMAJ Open
Kathryn E McIsaac, Andrea Moser, Rahim Moineddin, Leslie Anne Keown, Geoff Wilton, Lynn A Stewart, Angela Colantonio, Avery B Nathens, Flora I Matheson
BACKGROUND: There is recent evidence to suggest that sustaining a traumatic brain injury (TBI) increases risk of criminal justice system involvement, including incarceration. The objective of this study was to explore the association between TBI and risk of incarceration among men and women in Ontario. METHODS: We identified a cohort of 1.418 million young adults (aged 18-28 yr) on July 1, 1997, living in Ontario, Canada, from administrative health records; they were followed to Dec...
October 2016: CMAJ Open
Geneviève Cadieux, Jennifer Campbell, Nandini Dendukuri
BACKGROUND: Several expert groups, including the United States Preventive Services Task Force and the Canadian Task Force on Preventive Health Care, have recently examined or are currently examining whether primary care physicians should screen asymptomatic adults for hepatitis C virus (HCV) infection. To inform decision-making on HCV screening, we performed a systematic review of the accuracy of antibody tests compared with other immunoassays and RNA detection for screening asymptomatic adults for HCV infection in Canada...
October 2016: CMAJ Open
Sunitha V Kaiser, Vandana Sundaram, Eyal Cohen, Rayzel Shulman, Jun Guan, Lee Sanders, Astrid Guttmann
BACKGROUND: Children with diabetes mellitus in low-income families have poor outcomes, but little is known as to how this relates to healthcare system structure. Our objective was to gain insight into how best to structure health systems to serve these children by describing their health care use in 2 health system models: a Canadian model, with an organized diabetes care network that includes generalists, and an American model, with targeted support services for children from low-income families...
October 2016: CMAJ Open
Justin Thielman, Heather Manson, Maria Chiu, Ray Copes, Laura C Rosella
BACKGROUND: Research has shown that neighbourhood walkability is associated with small differences in physical activity; however, the health impacts of these small differences have been questioned. We examined the size of the association of walkability with accelerometer-measured physical activity in a large, national-level Canadian population, and compared results to physical activity levels recommended in international guidelines. Our primary objective was to investigate the direction and size of the differences in physical activity that were related to walkability, and whether these differences depended on age...
October 2016: CMAJ Open
Alison Sinclair, Xuanqian Xie, Lama Saab, Nandini Dendukuri
BACKGROUND: Recent meta-analyses of the efficacy of probiotics for preventing diarrhea associated with Clostridium difficile have concluded there is a large effect favouring probiotics. We reexamined this evidence, which contradicts the results of a more recent large randomized controlled trial that found no benefit of Lactobacillus probiotics for preventing C. difficile-associated diarrhea. METHODS: We performed a systematic review of the efficacy of treatment with Lactobacillus probiotics for preventing nosocomial C...
October 2016: CMAJ Open
Luke T Lavallée, Rodney H Breau, Dean Fergusson, Carl van Walraven
BACKGROUND: Prostate cancer is a substantial public health concern; however, in recent years, national guidelines have recommended against prostate cancer screening. We sought to determine if prostate biopsy incidence has changed over time in Ontario. We hypothesized that there has been a decrease in the incidence of prostate biopsy in recent years. METHODS: This cohort study used population-based administrative databases from Ontario, Canada. We used a diagnostic code to identify if a patient received his first prostate biopsy between 1992 and 2012 (the last year for which records in the Ontario Cancer Registry were complete)...
October 2016: CMAJ Open
David Stock, Cassandra Cowie, Vincy Chan, Angela Colantonio, Walter P Wodchis, David Alter, Nora Cullen
BACKGROUND: Delayed discharge, captured as alternate-level-of-care days, represents inefficient use of high-demand acute care resources and results in potentially poorer patient outcomes. We performed a study to determine the extent of alternate-level-of-care days among patients who survived hypoxic-ischemic brain injury in inpatient hospital care in Ontario and to identify predictors of alternate-level-of-care use in this population. METHODS: A population-based cohort of acute care survivors of hypoxic-ischemic brain injury aged 20 years or more from 2002/03 through 2011/12 was identified...
October 2016: CMAJ Open
Logan McLeod, Gioia Buckley, Arthur Sweetman
BACKGROUND: Between 2001 and 2006, the Ontario government introduced a menu of new primary care models, with elements such as patient enrolment and minimum group sizes, and various combinations of fee-for-service, capitation, pay-for-performance and salary. From the statistical perspective of physicians, as opposed to patients, we looked at the distribution of physician characteristics, group size and patient visit patterns across models to describe primary care practice in Ontario. METHODS: Using administrative data for fiscal year 2010/11 containing information on physician characteristics, patient rostering status, patient visits and other practice information, we described similarities and differences across primary care models...
October 2016: CMAJ Open
Nicola Allen, Stuart R Walker, Lawrence Liberti, Chander Sehgal, M Sam Salek
BACKGROUND: The CADTH Common Drug Review was established in 2002 to prepare national health technology assessment reports to guide listing decisions for 18 participating drug plans. The aim of this study was to compare the nonmandatory recommendations from the Common Drug Review in Canada with the listing decisions of provincial payers to determine alignment. METHODS: We identified the recommendations issued by the Common Drug Review from Jan. 1, 2009, to Jan. 1, 2015, and compared these with the listing decisions of 3 provincial public payers (Alberta, British Columbia and Ontario) that participate in the Common Drug Review and the recommendations from Quebec...
October 2016: CMAJ Open
Jennifer Telford, Laura Gentile, Lovedeep Gondara, Colleen McGahan, Andrew Coldman
BACKGROUND: British Columbia undertook a colorectal cancer screening pilot program in 3 communities. Our objective was to assess the performance of 2-specimen fecal immunochemical testing in the detection of colorectal neoplasms in this population-based screening program. METHODS: A prospective cohort of asymptomatic, average-risk people aged 50 to 74 years completed 2 quantitative fecal immunochemical tests every 2 years, with follow-up colonoscopy if the result of either test was positive...
October 2016: CMAJ Open
Claire de Oliveira, Erin M Macdonald, Diane Green, Patricia Colton, Marion Olmsted, Susan Bondy, Paul Kurdyak
BACKGROUND: Eating disorders, specifically anorexia nervosa, bulimia nervosa and eating disorder not otherwise specified, represent a substantial burden to the health care system. Our goal was to estimate the economic burden of patients who received specialized inpatient care for an eating disorder out of country. METHOD: We conducted a cost-of-illness study evaluating health care costs among patients in Ontario who received specialized inpatient care for an eating disorder out of country from 2003 to 2011, from the public third-party payer perspective...
October 2016: CMAJ Open
Christine Troskie, Judith A Soon, Arianne Y Albert, Wendy V Norman
BACKGROUND: Access to a wide range of contraceptive methods improves prevention of unintended pregnancy by ensuring the best method fit for each individual. We compared approval times of new hormonal contraceptives by Health Canada, the US Food and Drug Administration (FDA), and the UK Medicines and Healthcare Products Regulatory Agency (MHRA). METHODS: We obtained dates of applications to Health Canada, the FDA and the MHRA for contraceptive methods approved from January 2000 to January 2015...
October 2016: CMAJ Open
Jason Jiang, Danielle Southern, Cynthia A Beck, Matthew James, Mingshan Lu, Hude Quan
BACKGROUND: Surveillance using coded administrative health data has shown that the prevalence of hypertension and diabetes in Canada increased substantially between 1998 to 2008. These findings require an assumption that the validity of hypertension and diabetes coding is stable over time. We tested this assumption by examining temporal trends in the validity of coding for hypertension and diabetes in the Canadian hospital Discharge Abstract Database. METHODS: We used the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) database, a clinical registry, as the reference standard to evaluate the validity of the Discharge Abstract Database in recording hypertension and diabetes in Alberta...
October 2016: CMAJ Open
Andrew Walkty, James A Karlowsky, Heather J Adam, Philippe Lagacé-Wiens, Melanie Baxter, Michael R Mulvey, Melissa McCracken, Susan M Poutanen, Diane Roscoe, George G Zhanel
BACKGROUND: Colistin is often used as an antimicrobial of last resort for the treatment of infections caused by multidrug-resistant gram-negative bacilli. In 2015, plasmid-mediated colistin resistance in Escherichia coli due to MCR-1 was described. The purpose of this study was to evaluate the frequency of colistin resistance among E. coli clinical isolates obtained from patients in Canadian hospitals as part of the Canadian Ward Surveillance Study (CANWARD) and to determine how often the mcr-1 gene is detected among the colistin-resistant subset...
October 2016: CMAJ Open
Meta van den Heuvel, Cornelia M Borkhoff, Christine Koroshegyi, Weeda Zabih, Sijmen A Reijneveld, Jonathon Maguire, Catherine Birken, Patricia Parkin
BACKGROUND: Communication delays are often the first presenting problem in infants with a range of developmental disabilities. Our objective was to assess the validity of the 18-month Nipissing District Developmental Screen compared with the Infant Toddler Checklist, a validated tool for detecting expressive language and other communication delays. METHODS: A cross-sectional design was used. Children aged 18-20 months were recruited during scheduled health supervision visits...
October 2016: CMAJ Open
Anna Banerji, Val Panzov, Michael Young, Joan Robinson, Bonita Lee, Theo Moraes, Muhammad Mamdani, B Louise Giles, Depeng Jiang, Danny Bisson, Marguerite Dennis, Johanne Morel, Judith Hall, Charles Hui, Bosco Paes, James B Mahony
BACKGROUND: It is unknown whether this burden of disease of lower respiratory tract infections is comparable across the Canadian Arctic. The objectives of this surveillance study were to compare the rates of hospital admission for lower respiratory tract infection and the severity of infection across Arctic Canada, and to describe the responsible viruses. METHODS: We performed a prospective multicentre surveillance study of infants less than 1 year of age admitted in 2009 with lower respiratory tract infection to all hospitals (5 regional, 4 tertiary) in the Northwest Territories, Nunavut and Nunavik to assess for regional differences...
October 2016: CMAJ Open
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