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https://www.readbyqxmd.com/read/28827414/coder-perspectives-on-physician-related-barriers-to-producing-high-quality-administrative-data-a-qualitative-study
#1
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
#2
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
#3
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
https://www.readbyqxmd.com/read/28811281/multimorbidity-dementia-and-health-care-in-older-people-a-population-based-cohort-study
#4
Marcello Tonelli, Natasha Wiebe, Sharon Straus, Martin Fortin, Bruce Guthrie, Matthew T James, Scott W Klarenbach, Helen Tam-Tham, Richard Lewanczuk, Braden J Manns, Hude Quan, Paul E Ronksley, Peter Sargious, Brenda Hemmelgarn
BACKGROUND: Little is known about how multimorbidity, dementia and increasing age combine to influence health outcomes or utilization. Our objective was to examine the joint associations between age, dementia and burden of morbidity with mortality and other clinical outcomes. METHODS: We did a retrospective population-based cohort study of all adults aged 65 years and older residing in Alberta, Canada, between 2002 and 2013. We used validated algorithms applied to administrative and laboratory data from the provincial health ministry to assess the presence/absence of dementia and 29 other morbidities, and their associations with mortality (our primary outcome), other clinical outcomes (emergency department visits, all-cause hospital admissions) and a proxy for loss of independent living (discharge to long-term care)...
August 14, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28807924/thyroid-cancer-incidence-in-canada-a-national-cancer-registry-analysis
#5
Dawnelle Topstad, James A Dickinson
BACKGROUND: Thyroid cancer incidence rates are increasing in many developed countries while mortality rates remain stable. International evidence shows that the increase in incidence rates is mostly caused by overdiagnosis of small papillary cancers. We sought to describe how thyroid cancer incidence has changed and how it varies between provinces in Canada. METHODS: Data were obtained from the National Cancer Incidence Reporting System, causes of death tables and the Canadian Cancer Registry using the 1991 census population structure...
August 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28800568/causes-and-consequences-of-gestational-diabetes-in-south-asians-living-in-canada-results-from-a-prospective-cohort-study
#6
Sonia S Anand, Milan Gupta, Koon K Teo, Karleen M Schulze, Dipika Desai, Nora Abdalla, Michael Zulyniak, Russell de Souza, Gita Wahi, Mateen Shaikh, Joseph Beyene, Eileen de Villa, Katherine Morrison, Sarah D McDonald, Hertzel Gerstein
BACKGROUND: The reasons for the increased risk of gestational diabetes among South Asian women are not well understood. We sought to identify the determinants of gestational diabetes and its impact on newborn health in a prospective birth cohort of South Asian women and their babies. METHODS: As part of the South Asian Birth Cohort (START) prospective birth cohort study in Ontario, we recruited 1012 South Asian women with singleton pregnancies in the second trimester of pregnancy between July 11, 2011, and Nov...
August 9, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28747349/outcomes-associated-with-a-pediatric-clinical-diabetes-network-in-ontario-a-population-based-time-trend-analysis
#7
Meranda Nakhla, Elham Rahme, Marc Simard, Astrid Guttmann
BACKGROUND: The Network of Ontario Pediatric Diabetes Programs was implemented in 2001. The objective of this study was to determine whether implementation of the network was associated with a decrease in the risk of acute diabetes-related complications and a reduction in the socioeconomic and geographic disparities in these outcomes. METHODS: We conducted a population-based time trend analysis of children (< 18 yr) with diabetes using health administrative databases in Ontario from 1996 to 2011...
July 24, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28724726/costs-of-services-for-homeless-people-with-mental-illness-in-5-canadian-cities-a-large-prospective-follow-up-study
#8
Eric A Latimer, Daniel Rabouin, Zhirong Cao, Angela Ly, Guido Powell, Tim Aubry, Jino Distasio, Stephen W Hwang, Julian M Somers, Vicky Stergiopoulos, Scott Veldhuizen, Erica E M Moodie, Alain Lesage, Paula N Goering
BACKGROUND: Limited evidence on the costs of homelessness in Canada is available. We estimated the average annual costs, in total and by cost category, that homeless people with mental illness engender from the perspective of society. We also identified individual characteristics associated with higher costs. METHODS: As part of the At Home/Chez Soi trial of Housing First for homeless people with mental illness, 990 participants were assigned to the usual-treatment (control) group in 5 Canadian cities (Vancouver, Winnipeg, Toronto, Montréal and Moncton) between October 2009 and June 2011...
July 18, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28720597/accuracy-of-administrative-claims-data-for-cerebral-palsy-diagnosis-a-retrospective-cohort-study
#9
Maryam Oskoui, Pamela Ng, Marc Dorais, Nicole Pigeon, Louise Koclas, Céline Lamarre, Francine Malouin, Carol L Richards, Michael Shevell, Lawrence Joseph
BACKGROUND: Cerebral palsy is the most common cause of childhood physical disability, with multiple associated comorbidities. Administrative claims data provide population-level prevalence estimates for cerebral palsy surveillance; however, their diagnostic accuracy has never been validated in Quebec. This study aimed to assess the accuracy of administrative claims data for the diagnosis of cerebral palsy. METHODS: We conducted a retrospective cohort study of children with cerebral palsy born between 1999 and 2002 within 6 health administrative regions of Quebec...
July 18, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28743102/incidence-of-delirium-after-cardiac-surgery-protocol-for-the-delirium-cs-canada-cross-sectional-cohort-study
#10
(no author information available yet)
BACKGROUND: Delirium is a recognized complication of cardiac surgery and is the focus of increasing attention owing to its negative effect on postoperative outcomes. However, little is known about the actual incidence of delirium following cardiac surgery, with published rates ranging widely, from 3%-78%. We describe the protocol for the DELIRIUM-CS Canada study, which will use validated and easily implementable bedside tools to determine the incidence of postoperative delirium in a contemporary cardiac surgery population...
July 13, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28701374/hospital-admission-rates-and-emergency-department-use-in-relation-to-glycated-hemoglobin-in-people-with-diabetes-mellitus-a-linkage-study-using-electronic-medical-record-and-administrative-data-in-ontario
#11
Richard Birtwhistle, Michael E Green, Eliot Frymire, Simone Dahrouge, Marlo Whitehead, Shahriar Khan, Michelle Greiver, Richard H Glazier
BACKGROUND: The Canadian Primary Care Sentinel Surveillance Network (CPCSSN) collects extensive data on primary care patients but it currently does not gather reliable information on outcomes in other settings. The objectives of this study were to link electronic medical record (EMR) data from Ontario patients in the CPCSSN with administrative data from the Institute for Clinical Evaluative Sciences (ICES), to assess the representativeness of the CPCSSN population, and to identify people with diabetes in the CPCSSN data and describe their emergency department (ED) visits and hospital admissions over a 2-year period (2010-2012) by HbA1c level...
July 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28698181/risk-factors-for-surgical-site-infection-following-cesarean-delivery-a-retrospective-cohort-study
#12
Felicia Ketcheson, Christy Woolcott, Victoria Allen, Joanne M Langley
BACKGROUND: The rate of cesarean delivery is increasing in North America. Surgical site infection following this operation can make it difficult to recover, care for a baby and return home. We aimed to determine the incidence of surgical site infection to 30 days following cesarean delivery, associated risk factors and whether risk factors differed for predischarge versus postdischarge infection. METHODS: We identified a retrospective cohort in Nova Scotia by linking the provincial perinatal database to hospital admissions and physician billings databases to follow women for 30 days after they had given birth by cesarean delivery between Jan...
July 11, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28687643/cancer-incidence-attributable-to-lifestyle-and-environmental-factors-in-alberta-in-2012-summary-of-results
#13
Anne Grundy, Abbey E Poirier, Farah Khandwala, Xin Grevers, Christine M Friedenreich, Darren R Brenner
BACKGROUND: Estimates of the proportion of cancer cases that can be attributed to modifiable risk factors are not available for Canada and, more specifically, Alberta. The purpose of this study was to estimate the total proportion of cancer cases in Alberta in 2012 that could be attributed to a set of 24 modifiable lifestyle and environmental risk factors. METHODS: We estimated summary population attributable risk estimates for 24 risk factors (smoking [both passive and active], overweight and obesity, inadequate physical activity, diet [inadequate fruit and vegetable consumption, inadequate fibre intake, excess red and processed meat consumption, salt consumption, inadequate calcium and vitamin D intake], alcohol, hormones [oral contraceptives and hormone therapy], infections [Epstein-Barr virus, hepatitis B and C viruses, human papillomavirus, Helicobacter pylori], air pollution, natural and artificial ultraviolet radiation, radon and water disinfection by-products) by combining population attributable risk estimates for each of the 24 factors that had been previously estimated...
July 7, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28676535/outcomes-in-a-nurse-led-peripherally-inserted-central-catheter-program-a-retrospective-cohort-study
#14
Sheryl McDiarmid, Nicholas Scrivens, Marc Carrier, Elham Sabri, Baldwin Toye, Lothar Huebsch, Dean Fergusson
BACKGROUND: Peripherally inserted central catheters (PICCs) provide enormous benefit to patients. However, recent publications have highlighted relatively high PICC-associated complication rates. We report on patient and device outcomes from a nurse-led program. METHODS: We performed a retrospective analysis of a prospective cohort of consecutive patients undergoing PICC insertion at The Ottawa Hospital between Jan. 1, 2013 and Dec. 31, 2014. Of the 8314 BioFlo PASV PICCs inserted, we randomly selected a sample of 700 and obtained a complete data set for 656...
June 30, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28663187/lung-cancer-incidence-attributable-to-residential-radon-exposure-in-alberta-in-2012
#15
Anne Grundy, Kevin Brand, Farah Khandwala, Abbey Poirier, Sierra Tamminen, Christine M Friedenreich, Darren R Brenner
BACKGROUND: Radon is carcinogenic, and exposure to radon has been shown to increase the risk of lung cancer. The objective of this study was to quantify the proportion and number of lung cancer cases in Alberta in 2012 that could be attributed to residential radon exposure. METHODS: We estimated the population attributable risk of lung cancer for residential radon using radon exposure data from the Cross-Canada Survey of Radon Concentrations in Homes from 2009-2011 and data on all-cause and lung cancer mortality from Statistics Canada from 2008-2012...
June 28, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28659352/cancer-incidence-attributable-to-air-pollution-in-alberta-in-2012
#16
Abbey E Poirier, Anne Grundy, Farah Khandwala, Christine M Friedenreich, Darren R Brenner
BACKGROUND: The International Agency for Research on Cancer has classified outdoor air pollution (fine particulate matter [PM2.5]) as a Group 1 lung carcinogen in humans. We aimed to estimate the proportion of lung cancer cases attributable to PM2.5 exposure in Alberta in 2012. METHODS: Annual average concentrations of PM2.5 in 2011 for 22 communities across Alberta were extracted from the Clean Air Strategic Alliance Data Warehouse and were population-weighted across the province...
June 28, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28655728/opioid-use-during-pregnancy-a-population-based-cohort-study
#17
Jamie Falk, Matthew Dahl, Colette B Raymond, Dan Chateau, Alan Katz, Christine Leong, Shawn Bugden
BACKGROUND: Opioid use has increased dramatically in North America. The safety of opioids in pregnancy is uncertain, but they are associated with several fetal abnormalities and contribute to rising rates of neonatal abstinence syndrome. We examined opioid use before and during pregnancy in a complete population-based cohort. METHODS: We examined opioid use in a cohort of all pregnant women in Manitoba, Canada, from 2001 to 2013. Opioid use was defined by prescriptions for opioids, converted to oral morphine equivalents (MEQ), during the 3 months before pregnancy and for each trimester...
June 26, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28646095/estimated-reductions-in-provider-initiated-preterm-births-and-hospital-length-of-stay-under-a-universal-acetylsalicylic-acid-prophylaxis-strategy-a-retrospective-cohort-study
#18
Joel G Ray, Emily Bartsch, Alison L Park, Prakesh S Shah, Susie Dzakpasu
BACKGROUND: Hypertensive disorders, especially preeclampsia, are the leading reason for provider-initiated preterm birth. We estimated how universal acetylsalicylic acid (ASA) prophylaxis might reduce rates of provider-initiated preterm birth associated with preeclampsia and intrauterine growth restriction, which are related conditions. METHODS: We performed a cohort study of singleton hospital births in 2013 in Canada, excluding Quebec. We estimated the proportion of term births and provider-initiated preterm births affected by preeclampsia and/or intrauterine growth restriction, and the corresponding mean maternal and newborn hospital length of stay...
June 23, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28642253/military-related-sexual-assault-in-canada-a-cross-sectional-survey
#19
Kimberley Watkins, Rachel Bennett, Mark A Zamorski, Isabelle Richer
BACKGROUND: Most research on military-related sexual assault is based on the United States military and has important limitations, such as low response rates. We sought to estimate the lifetime prevalence of sexual assault, assess its relation to military service and identify the circumstances, correlates and associations with mental disorders of military-related sexual assault among Canadian military personnel. METHODS: We used the 2013 Canadian Forces Mental Health Survey, a cross-sectional representative survey of Canadian Regular Force personnel (n = 6696)...
June 22, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28637683/an-environmental-scan-of-quality-indicators-in-critical-care
#20
Sabira Valiani, Romain Rigal, Henry T Stelfox, John Muscedere, Claudio M Martin, Peter Dodek, François Lamontagne, Robert Fowler, Afshan Gheshmy, Deborah J Cook, Alan J Forster, Paul C Hébert
BACKGROUND: We performed a directed environmental scan to identify and categorize quality indicators unique to critical care that are reported by key stakeholder organizations. METHODS: We convened a panel of experts (n = 9) to identify key organizations that are focused on quality improvement or critical care, and reviewed their online publications and website content for quality indicators. We identified quality indicators specific to the care of critically ill adult patients and then categorized them according to the Donabedian and the Institute of Medicine frameworks...
June 21, 2017: CMAJ Open
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