The outcome of IHE initiatives is providing better information for developing health policy and best medical practices. IHE disseminates information in many ways. In addition to publications in peer-reviewed journals, IHE produces books and a variety of reports synthesizing information in a particular field.
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The Institute of Health Economics conducted an environmental scan to: describe available Alberta data assets to support the identification, surveillance, and management of high-risk patients with known cardiovascular disease; identify preliminary gaps in the available information; and formulate potential strategies to address the gaps identified. This environmental scan represents…
Previous reports have examined predictors for inpatient stroke rehabilitation length of stay (LOS) and home discharge. However, none of them has provided a validation benchmark for predictability of identified risk factors. Accordingly, we examined temporal trends, geographic variations, and predicted inpatient rehabilitation LOS and home discharge for stroke patients in Alberta…
| Bing Guo, Carmen Moga, Charles Yan, Gareth Hopkin, Jeff Round, Jennifer Seida, Lisa Tjosvold, Michelle Pollock
This health evidence review assesses the clinical effectiveness and economic impact of various vascular risk reduction (VRR) initiatives that have been implemented in Alberta, and promising new initiatives, to inform priority-setting decisions regarding risk-reduction initiatives. The assessment also examines the clinical benefit that future projects would need to achieve for them…
| Susan Armijo-Olivo, Bing Guo, Nathan McClure, Carmen Moga, Negar Razavilar, Jeff Round, Lisa Tjosvold, Dat Tran, Charles Yan
This health evidence review assesses strategies for the delivery of high-quality and cost-effective stroke rehabilitation care in Alberta to inform decisions about how the province might increase care capacity for stroke rehabilitation services and maximize the benefits of effective treatment interventions. The review assesses two novel approaches to the delivery of high-quality…
| Ellen Rafferty, Laura Reifferscheid, Lawrence Svenson, Margaret Russell, Shannon Macdonald, Stephanie Booth
The impact of universal varicella vaccination on herpes zoster (HZ) risk in unvaccinated and vaccinated children, and its long-term influence on HZ epidemiology, remains unknown. This retrospective cohort study used population-based administrative health data for children born between 1993 and 2018. A universal varicella vaccination programme implementation corresponded to decreased…
| Erin Kirwin, Ellen Rafferty, Kate Harback, Jeff Round, Christopher McCabe
The objective of this study was to implement a model-based approach to identify the optimal allocation of a coronavirus disease 2019 (COVID-19) vaccine in the province of Alberta Canada. The results have three important policy implications: (i) optimal vaccine allocation will depend on the public health policies in place at the time of allocation and the impact of those policies…
The COVID Strategic Choices Group is an interdisciplinary taskforce with experience across different domains of expertise (including epidemiology, public health, public policy, economics and business) and regions of Canada. IHE CEO, Dr. Christopher McCabe is a member of the COVID Strategic Choices Group. Members serve in their individual capacity and not as representatives of any…
This special supplement of Clinical Laboratory News showcases the winning teams from the UNIVANTS Healthcare Excellence Awards. It features innovative programs in Laboratory Medicine. The Institute of Health Economics is pleased to be one of the partners and judges in this prestigious program. Approximately 180 applications were initiated and three top-performing teams were selected…
| Don Husereau, Jennifer Seida, Eddy Nason, John Sproule, Christopher McCabe
The purpose of this report is to provide a summary of current information and stakeholder perspectives regarding the current and future state of regenerative medicine (with a focus on stem cell-based research) in Canada and globally. Specifically, it assesses the strengths, potential areas for improvement, and opportunities for growth in the Canadian sector to ensure the future…
Little is currently known about the overall health service utilization and cost burden in patients with high risk for cardiovascular disease (HRCVD) who are recommended to start a statin to control dyslipidemia to prevent CVD events and mortality in short- and long-term care. We assessed the resource use and healthcare cost burden in this HRCVD patient population in Alberta, Canada,…
The Institute for Health Economics (IHE) conducted a roundtable on PF-ILD, in November 2021 and policy recommendations from the diverse stakeholder group provided some guidance on areas to focus on to improve the lives of those living with progressive fibrosing interstitial lung disease. Key actions identified at the roundtable included: increased surveillance for early identification…
| Sherilyn Houle, Finlay McAlister, Cynthia Jackevicius, Anderson Chuck, Ross Tsuyuki
BACKGROUND: Pay-for-performance (P4P) is increasingly touted as a means to improve health care quality.
PURPOSE: To evaluate the effect of P4P remuneration targeting individual health careproviders.
Value for Money in the Health System was the eighth in the series of Innovation Forums. The keynote speaker, Mr. Don Drummond, Matthews Fellow and Distinguished Visiting Scholar in the School of Policy Studies at Queens University, and a former Associate Deputy Minister of Finance in the Government of Canada, as well as a former Senior Vice President and Chief Economics at TD Financial…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report performs an evaluation of the scientific evidence on the safety, performance, and effectiveness of universal and targeted preschool hearing screening (PHS) to inform the Infant and Preschool Screening Framework being developed by the Community and Public Health (CPH)…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This review focused on the best evidence available on the use of PSVS to detect vision conditions in asymptomatic preschool children (aged from birth to 6 years; not necessarily considered at risk for developing visual impairment) to determine the safety and efficacy/effectiveness…
The EQ-5D is a standardized instrument developed by the EuroQol group for use as a measure of health outcome. It considers five dimensions of health-related quality of life: mobility, self-care, usual activities, pain/discomfort, anxiety/depression. When the need for greater collaboration around implementation and use of the EQ-5D in Alberta was recognized in eary 2012, colleagues…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an update of a 2007 report. Permanent congenital hearing impairment/loss (PCHI/PCHL) is one of the most common congenital anomalies found at birth which can lead to delays and deficits in the development of speech, language, cognition, and learning, as well as…
This project is concerned with describing a comprehensive set of HTA products, not the methods used to produce them. The report describes various products produced by HTA agencies and provides a summary of the basic elements of these products, but an in-depth analysis of, or comparison between, the various products in terms of their methodology is beyond its scope. Information…
Background: The aim of this study was to extend an earlier retrospective cohort study of schizophrenia via a prospective study to a follow-up of 34 years, with an emphasis on describing the life-course of the illness.
| Thanh Nguyen, Anderson Chuck, Arto Ohinmaa, Philip Jacobs
Background: The benefits of pharmaceutical innovations are widely diffused; they accrue to the healthcare providers, patients, employers, and manufacturers. We estimate the societal monetary benefits of simvastatin in Canada and its distribution among different beneficiaries overtime.
| Mel Slomp, Philip Jacobs, Arto Ohinmaa, Roger Bland, Ray Block, Carolyn Dewa, Carina Wang
OBJECTIVES: In Canada, most mental health services are embedded in the publichealth care system. Little is known of the cost distribution within the mental healthpopulation. Our study aims to estimate the depression care costs of patients with adepression diagnosis, ranking them by the increasing total depression health carecosts.
| Logan McLeod, JoAnn Kingston-Riechers, Egon Jonsson
Abstract: The potential risks to patient safety in a primary care setting are different than the risks to patient safety in an acute care setting. The main differences arise from the organisational structures of primary care delivery and the greater involvement of patients in their care. To account for these differences, we present the Patient Safety in Primary Care Framework…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report provides an epidemiological profile of fetal aneuploidy and open neural tube defects (ONTD); describes the patterns of care, utilization trends, and factors affecting the provision of first and second trimester screening (FASTs) services for fetal aneuploidy and…
The concept of “personalized medicine” in health is garnering increased attention. Personalized medicine can be defined as the tailoring of preventive, diagnostic, or therapeutic interventions to the characteristics of an individual or population. This may involve genetic or laboratory biomarker information. As personalized medicine promises to increasingly change the…
For which strategies of suicide prevention is there evidence of effectiveness? This report aims to synthesize research findings from existing systematic reviews to address two questions: What types of preventive interventions have been evaluated in the published literature? Which strategies have good-quality evidence to support them? Limited evidence - as well as variability by…
| Sherilyn Houle, Anderson Chuck, Finlay McAlister, Ross Tsuyuki
STUDY OBJECTIVE: To quantify the potential cost savings of a community pharmacy-basedhypertension management program based on the results of the Study of Cardiovascular Risk Intervention by Pharmacists-Hypertension (SCRIP-HTN) study in terms of avoided cardiovascular events-myocardial infarction, stroke, and heart failure hospitalization, and to compare these cost savings…
| Bach Tran, Arto Ohinmaa, Anh Duong, Nhan Do, Long Nguyen, Quoc Nguyen, Steve Mills, Philip Jacobs, Stan Houston
PURPOSE: This longitudinal study assessed the changes in drug use patterns and health-related quality of life (HRQL) among HIV-positive drug users in the first methadonemaintenance treatment (MMT) cohort in Vietnam.
| Paula Corabian, Dagmara Chojecki, Christa Harstall
This exploratory report provides a summary of some of the published information on the current status of research in and potential future sphere of activity of nanomedicine (Part I) and an inventory of resources on nanotechnology and nanomedicine (Part II). Over the next 5 to 10 years it is expected that the overall impact of nanomedicine will be multifaceted, with significant…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report summarizes available key information on the use of bariatric treatments for adult obesity in Alberta and North America (mainly Canada). This analysis was intended to describe the profile of adult obesity (definition, progression, epidemiology, and population dynamics…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report examines the research evidence on the safety and efficacy of insulin pump therapy, as compared to multiple daily insulin injections, in the treatment of children, adults, and pregnant women diagnosed with type 1 diabetes. The report also analyses the economic impact…
| Carmen Moga, Bing Guo, Don Schopflocher, Christa Harstall
This Methodology Paper summarizes the process, a modified Delphi approach, used to develop a specific checklist for the quality appraisal of case series studies. This work was supplemented with a review of other published checklists and an initial pilot test of the newly developed quality appraisal checklist. Researchers at the Institute of Health Economics with researchers from…
| Anne-Marie Boström, Susan E Slaughter, Dagmara Chojecki, Carole Estabrooks
OBJECTIVES: The recent emphasis on knowledge translation (KT) in health care is based on the premise that quality of care improves when research findings are translated into practice. This study aimed to identify the extent, nature, and settings of KT research pertaining to the care of older adults.
This report describes a framework for evaluating policies developed within the Alberta Health Technologies Decision Process (AHTDP) to strengthen the link between policy development and evidence. The framework was designed as a foundation upon which to build a more detailed and contextualized evaluative process in consultation with all stakeholders who are likely to be affected…
In February 2012, the Canadian Institute for Health Information (CIHI) in partnership with the Institute of Health Economics (IHE) sponsored a two day meeting of content, administrative and research experts to identify the breadth of diagnostic imaging studies that CIHI might feasibly undertake with its data or with data that could be easily obtained. The purpose of this report…
Sponsored by the Institute of Health Economics (IHE) – Methodology Forum Series. Presented at the Health Canada and Canadian Institutes of Health Research Personalised Medicine in Canada: A Multi-Stakeholder Workshop to Examine the Canadian Perspective, January 12, 2012. The specific objectives of this session/workshop were to: Explore issues relevant to economic evaluation…
| Bing Guo, Christa Harstall, Thomas Louie, Sander Veldhuyzen van Zanten, Levinus Dieleman
Aim: To critically appraise the clinical research evidence on the safety and effectiveness of FT compared with standard care in the treatment of patients with CDAD.
From the Introduction: Until four or five decades ago, the clinical consensus about childhood depression was that it did not, and perhaps could not, occur (Lefkowitz & Burton, 1978; Rie, 1966; Rochlin, 1965; Wolfenstein, 1966). In fact, prior to 1960, childhood depression was rarely mentioned in the literature (Cytryn, 2003; Tisher, 2007). A number of studies and conceptualizations…
| Carissa Escober-Doran, Philip Jacobs, Carolyn Dewa
This study measures the return on investment for parent training at the pre- or early childhood stage. The purpose is to prevent conduct disorders in childhood, and mental health problems in adolescence and adulthood. The program studied is the Triple P program. The context is a one year birth cohort in Alberta. The costs are for a universal parental training program. The downstream…
Rationale, aims and objectives: The Appraisal of Guidelines Research and Evaluation (AGREE) instrument is a generic tool for assessing guideline quality. This feasibility study aimed to reduce the ambiguity and subjectivity associated with AGREE item scoring, and to augment the tool's capacity to differentiate between good- and poor-quality guidelines. Note: This is an Alberta…
Emceed by Tom Feasby, the University of Calgary’s Dean of Medicine, this third session considered the following theme: Maximizing Health System Performance: Cost Containment and Improved Efficiency. Speakers from all sectors provided a range of perspectives on Cost Containment and Improved Efficiency.
The Consensus Statement on Fetal Alcohol Spectrum Disorder (FASD) - Across the Lifespan was produced by a panel of experts led by the Hon. Anne McLellan, former Deputy Prime Minister of Canada. This consensus statement on fetal alcohol spectrum disorder is the product of a unique conference: The IHE Consensus Development Conference on Fetal Alcohol Spectrum Disorder - Across the…
Le présent énoncé consensuel a été préparé par un panel indépendant de professionnels de la santé et de représentants du milieu universitaire et du public en se fondant sur: les études publiées pertinentes réunies par le Comité scientifique de la conférence pour l’établissement…
The Alberta Diabetes Surveillance System (ADSS) was created in 2006 in a partnership between Alberta Health and Wellness (AHW) and the Institute of Health Economics (IHE). The purpose of the ADSS is to provide information about diabetes within the province of Alberta. This information includes the incidence, prevalence and use of health care services for people with diabetes, along…
Written by health policy experts, the book gives a comprehensive overview of 8 different national health care systems and focuses in particular on the different approaches to maintain efficiency and to contain overall healthcare costs. Each chapter identifies the 4-5 specific policies with the highest impact for the respective country over the past 20-30 years and the current policy…
The Institute of Health Economics (IHE) Innovation Forum series reflects one of the key goals of the Institute to promote open debate and dialogue on important issues in the health care system among academia, government, health service executives and industry. The Institute believes that the significant challenges facing the health system will only be addressed if all partners…
The objective of this report is to assess research evidence on the safety and prognostic value of exercise testing (including electrocardiogram exercise testing and cardiopulmonary exercise testing) for the prediction of cardiac events in patients with chronic diseases including diabetes, chronic obstructive pulmonary disease (COPD), and arthritis. Information Specialist: Trish…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is about testing for Human Papillomavirus (HPV). HPV is one of the most common sexually transmitted infections and can also cause cervical cancer. Cervical screening aims to reduce cervical cancer incidence and mortality by detecting precancerous lesions early. Until…
Les estimations indiquent que un canadien sur trois aura un problème de santé mentale durant sa vie. Peu de canadiens réalisent l’impact que la mauvaise santé mentale a sur les familles, les communautés, les systèmes de santé et l’économie. La santé mentale est aussi importante que la santé physique…
| Charles Yan, JoAnn Kingston-Riechers, Anderson Chuck
This report provides information regarding the impact of physician reimbursement models on five dimensions specified in the Provincial Alternate Relationship Plan Program Evaluation. The impact of physician reimbursement models were assessed on the following five dimensions: Health service utilization Access to care Quality of services Patient satisfaction Physician satisfaction…
The use of the term “comparative effectiveness” (CE) has attracted considerable attention, particularly in the United States. This booklet examines the concept of CE and its relationship to other assessment frameworks.
Background: Although many programs targeting fetal alcohol spectrum disorder (FASD) are implemented, the province of Alberta is still lacking information on costs of FASD.
Objectives: To estimate the costs of FASD in Alberta based on available US and Canadian research on costs of FASD, and Alberta data.
| Lisa Bergerman, Paula Corabian, Christa Harstall
The purpose of this report is to advance the area of workplace mental health through a comprehensive synthesis of published research evidence. More specifically, this report examines the evidence on the effectiveness of organizational-level interventions for the prevention of stress in the workplace for adult employees without diagnosed mental illness. The main effectiveness outcomes…
This report on assisted reproductive technologies (ARTs) is a literature review and secondary analyses of administrative health data conducted to provide information on the direct health care costs associated with multiple pregnancies and the potential cost impact of ARTs in Alberta. It examines the impact of multiple pregnancies and Assistive Reproductive Technologies on health…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #17. The present report has been prepared as a follow up to the previous assessment because of continued interest in the technology by the health ministry and others. It considers studies that have been reported in the literature since completion of the earlier assessment (1997-1999) and focuses on the efficacy…
| Jennifer Simpson, Sandra Doze, Douglas Urness, David Hailey, Philip Jacobs
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #20. This report presents data from the telepsychiatry program subsequent to the pilot project. The assessment of telepsychiatry beyond the pilot project stage had two primary focuses: a) to develop and document information collection systems initiated during the pilot project evaluation, and b) to assess the operation…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #19. A request for information about the use of low level laser therapy (LLLT) to assist wound healing was received from the Capital Health Authority (CHA). This technology has been increasingly used within the Edmonton area, with somewhat different approaches being taken by individual operators. The concern was…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #16. This report has been prepared in view of the continuing interest in positron emission tomography and other functional diagnostic imaging (FDI) methods within the Alberta health care system. It also continues the work at the Alberta Heritage Foundation for Medical Research in developing approaches to assessment…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #16. This is the second volume of an assessment of functional diagnostic imaging methods in imaging of the myocardium. Volume 1 included an overview of the assessment findings and provided comments on the place of the FDI techniques in this application. In this volume, further details are given of the assessment…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #15. The present health technology assessment report has been prepared following a request by Alberta Health and Wellness for additional information on the use of stereotactic radiosurgery (SRS) in the treatment of acoustic neuroma, one of the applications considered in an earlier publication on SRS. Two main issues…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #14. This report has been prepared because of the interest by the Consumers' Association of Canada and the Health Ministry in the increasing use of newer types of intraocular lenses (IOLs) and in their comparative advantage. The focus of the report is on the safety, efficacy and effectiveness of the three types…
| Maureen Yunkap Kwankam, David Hailey, Philip Jacobs
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #13. This assessment has been prepared in view of the interest at the University of Alberta Hospital in developing a cord blood banking facility in the province and to provide information to decision makers on the current status of cord blood transplantation (CBT). The principal purpose of the assessment was to…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #12. This report has been prepared following a request from the provincial Clinical Practice Guidelines Program for information on the accuracy of diagnostic tests for the detection of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomoniasis in females of reproductive age. The intention of this…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #11. This report has been prepared in view of the increasing interest in ultrasound technology for diagnosis of osteoporosis. Until recently, quantitative ultrasound (QUS) was mainly being used in research settings. This procedure is still not covered by provincial fee schedules. The recent FDA pre-marketing approvals…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #10. This report has been prepared as part of a project to assess the role of high cost functional diagnostic imaging (FDI) and related methods in routine health care. In the present paper, the potential application of four FDI methods to the management of epilepsy is considered. The assessment considered the current…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #8. This report has been prepared to provide information to health authorities and others on the available evidence on effectiveness of HBOT and the possible economic impact on health care should a second HBO facility be established in the province. Issues addressed in the report include: Whether HBOT has been…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #9. The present report has been prepared following a request by Alberta Health in relation to referral of patients outside the province for treatment with stereotactic radiosurgery (SRS). There was interest by the department in the comparative effectiveness of the two main approaches to SRS (GK and LINAC) and in…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #7. This assessment was undertaken at the request of a Regional Health Authority to provide input into a funding decision on a computerized dynamic posturography (CDP) system for use by a rehabilitation department. The focus of this study was restricted to the clinical use of CDP by the rehabilitation community.…