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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| Dat Tran, Ilke Akpinar, Irvin Mayers, Tatiana Makhinova, Philip Jacobs
The objective of this study, published in the International Journal of Chronic Obstructive Pulmonary Disease, was to describe the trends in pharmacologic treatment for patients newly diagnosed with chronic obstructive pulmonary disease (COPD) in Alberta, Canada.
| Charles Yan, Katherine Rittenbach, Sepideh Souri, Peter H. Silverstone
This analysis, published in BMC Psychiatry, aimed to determine cost-effectiveness of a stepped-care pathway for depression in adults in primary care versus standard care (SC), treatment-as-usual (TAU), and online cognitive behavioural therapy (CBT).
| Samuel N. Frempong, Andrew J. Sutton, Clare Davenport, Pelham Barton
The aim of this study, published in PharmacoEconomics – Open, was to conduct an early economic analysis of a hypothetical rapid test for typhoid fever diagnosis in Ghana and identify the necessary characteristics of the test for it to be cost effective in Ghana.
This study, published in PharmacoEconomics – Open, reports exploratory analysis of the provincial and nationwide costs of industry-sponsored drug clinical trials (CTs) in Canada. The costs of industry-sponsored drug CTs completed in 2016 were Can$2.1 billion. In addition to the creation of knowledge, these trials play an important role in alleviating the healthcare cost burden…
| Dat Tran, Thanh Nguyen, Arto Ohinmaa, Irvin Mayers, Philip Jacobs
OBJECTIVES: To examine the resource use and healthcare costs for chronic obstructive pulmonary disease (COPD) in Alberta, Canada between 2008 and 2016 and model the future costs to 2030.
Clinical research is funded by industry, governments, charities, and hospitals. It is important to know the economic commitment of the various funding bodies, but until now there has been no national source available which provides these data. We surveyed the major funders to provide such a measure. There is evidence that government and charity funding of medical research is a…
| Helena M Earl, Louise Hiller, Anne-Laure Vallier, Shrushma Loi, Karen McAdam, Luke Hughes-Davies, Adrian N Harnett, Mei-Lin Ah-See, Richard Simcock, Daniel Rea, Sanjay Raj, Pamela Woodings, Mark Harries, Donna Howe, Kerry Raynes, Helen B Higgins, Maggie Wilcox, Chris Plummer, Janine Mansi, Ioannis Gounaris, Betania Mahler–Araujo, Elena Provenzano, Anita Chhabra, Jean E Abraham, Carlos Caldas, Peter S Hall, Christopher McCabe, Claire Hulme, David Miles, Andrew M Wardley, David A Cameron
Adjuvant trastuzumab significantly improves outcomes for patients with HER2-positive early breast cancer. The standard treatment duration is 12 months but shorter treatment could provide similar efficacy while reducing toxicities and cost. We aimed to investigate whether 6-month adjuvant trastuzumab treatment is non-inferior to the standard 12-month treatment regarding disease-free…
| Michelle Pollock, Ann Scott, Jennifer Seida, Paula Corabian, Andrew J. Sutton, Mike Paulden, Christopher McCabe, Lisa Tjosvold, Bing Guo
The clinical review and economic evaluation aimed to determine how Oncotype DX and Prosigna can be optimally used to determine which patients with early-stage breast cancer will benefit from adjuvant chemotherapy. This report addresses the following research question: For patients with early-stage (I–III), ER+, HER2?, node-negative or node-positive (one to three nodes) breast…
| Timothy Caulfield, Alessandro R Marcon, Blake Murdoch, Jasmine Brown, Sarah Tinker Perrault, Jonathan Jarry, Jeremy Snyder, Samantha J Anthony, Stephanie Brooks, Zubin Master, Christen Rachul, Ubaka Ogbogu, Joshua Greenberg, Amy Zarzeczny, Robyn Hyde-Lay
Abstract: Numerous social, economic and academic pressures can have a negative impact on representations of biomedical research. We review several of the forces playing an increasingly pernicious role in how health and science information is interpreted, shared and used, drawing discussions towards the role of narrative. In turn, we explore how aspects of narrative are used in…
| Dat Tran, Thanh Nguyen, Dawn Opgenorth, Xiaoming Wang, Danny Zuege, David A. Zygun, Henry T. Stelfox, Sean M. Bagshaw
This study, published in the Journal of Critical Care, explores the association between strained ICU capacity and healthcare costs, and demonstrates the admissions to ICUs experiencing strain incur incremental costs, attributed to longer hospitalization and physician services.
| Paula Corabian, Bing Guo, Carmen Moga, Ann Scott
This article retrospectively examines the evolution of rapid assessments (RAs) produced by the Health Technology Assessment (HTA) Program at the Institute of Health Economics over its 25-year relationship with a single requester, the Alberta Health Ministry (AHM).
| Paula Corabian, Bing Guo, Carmen Moga, Ann Scott
The Health Technology Assessment Program at the Institute of Health Economics has conducted rapid assessments (RAs) since 1993. This information paper draws on this experience and describes the evolution of RA process and products over a 25-year relationship with a single requester to quantify the effects of this partnership on the RAs produced. The aim is to contribute to emergent…
| Nancy Zuck, John Sproule, Charles Cook, Rebecca Albrecht
Alberta Health initiated the Nurse Practitioner Demonstration Project(s) (NPDP) in 2016 to support access to and further integration of Nurse Practitioners (NPs) into Alberta’s primary health care system. Funding was provided (based on diverse program plans) to the Boyle McCauley Health Centre (BMHC), The Alex Community Health Centre (The Alex), the Calgary Urban Project…
Ce rapport fournit un résumé d’un atelier de sprint sur la conception de données probantes du monde réel (DPMR) qui a eu lieu le 21 octobre 2018 à Toronto, en Ontario. L’atelier a été conçu et offert dans le cadre d’un partenariat entre l’Agence canadienne des médicaments et des technologies…
| Angus Thompson, Maria Ospina, Liz Dennett, Arianna Waye, Philip Jacobs
Presenteeism, reduced productivity while working, has come into consideration as a major occupational health problem in many countries with serious consequences for both organizations and employees. Increasing evidence shows that presenteeism represents a significant source of productivity losses that can cost organizations much more than does absenteeism, and it can lead to an…
This report is from an Alberta Strategic Clinical Networks (SCN) exchange meeting with Mr. Neil Fraser. This event brought together SCNs and related health system stakeholders, and a leader in the Canadian medical technology industry, and recent member of a Federal Advisory Panel on Healthcare Innovation. The meeting had the objectives to help the SCNs to understand the Advisory…
Background: Significant gaps in the evidence base on costs in rural communities in Canada and elsewhere are reported in the literature, particularly regarding costs to families. However, it remains unclear whether the costs related to all resources used by palliative care patients in rural areas differ to those resources used in urban areas.
The Institute of Health Economics held a roundtable on June 4, 2015, entitled Innovative Funding Models: Kidney Care Policy Options for the Future, to identify and discuss key issues in kidney care policy options. Prior to the roundtable, an Innovative Funding Models: Kidney Care Policy Options for the Future Steering Committee teleconference refined project objectives, and the…
The Institute of Health Economics (IHE), in partnership with Boehringer Ingelheim (Canada) Ltd./Ltée held an invitational forum on October 3, 2015, in Edmonton, Alberta. The purpose of this discussion was to bring together multiple stakeholders from across Canada to investigate the current state of evidence and information regarding idiopathic pulmonary fibrosis (IPF) and…
Objective: In this study, we estimate the impact of the new PCV13 immunization program on the burden of disease and related healthcare costs in Alberta.
OBJECTIVES: To examine differences in health services utilization (HSU) costs in the first year of life between low birth weight (LBW) and normal birth weight (NBW) infants, identify maternal and child characteristics associated with HSU costs, and estimate annual HSU cost of LBW infants for the province of Alberta, Canada.
| Bing Guo, Carmen Moga, Christa Harstall, Don Schopflocher
Objective: Because of a lack of a control group, a case-series study is considered one of the weaker study designs from which to obtain evidence on treatment effectiveness. Under certain circumstances, however, this is the only available evidence to inform health-care decisions. This study's intent was to develop and validate a quality appraisal checklist specifically for…
| Werner J Becker, Ted Findlay, Carmen Moga, Ann Scott, Christa Harstall, Paul Taenzer
Objective: To increase the use of evidence-informed approaches to diagnosis, investigation, and treatment of headache for patients in primary care.
Note: This is an Alberta Ambassador Guideline Adaptation Program related publication.
Alberta Health Services (AHS) has recently established a number of Strategic Clinical Networks (SCNs) in the province around specific health care topics (e.g., Cardiovascular Health & Stroke) and within areas where care is delivered (e.g., Surgery). The SCNs are the engines of innovation in the health system and have a mandate to find new and innovative ways of delivering care…
| Don Husereau, Larry Arshoff, Shahira Bhimani, Nicola Allen
This document describes the entry of new medical devices into the Canadian health system. It is intended to provide an accurate description of new medical device entry in Canada, and is intended to give patients, the public, private and public sector health system researchers, medical device companies, and private and public coverage bodies a general understanding of what regulatory,…
Written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report provides an assessment of how the adoption of fFN testing in Alberta impacted the clinical management of preterm labour and healty system resources. This was also an opportunity to retroactively use the Post Policy Implementation Framework to evaluate a specific policy developed within…
We reviewed literature to estimate the costs of Fetal Alcohol Spectrum Disorder (FASD) in the Canadian Criminal Justice System (CJS), and to update the total costs of FASD in Canada. The results suggest FASD is costlier than previous estimates. The costs of FASD associated with the CJS are estimated at $3.9 billion a year, with $1.2 billion for police, $0.4 billion for court,…
| Julie Polisena, John Lavis, Don Juzwishin, Pam McLean-Veysey, Ian Graham, Christa Harstall, Janet Martin
A perceived gap exists in how well Canadian health technology assessment (HTA) producers are supporting the use of their HTAs by decision-makers. The authors propose that the newly released HTA Database Canadian search interface incorporate structured decision-relevant summaries of HTAs that would be developed by participating Canadian HTA organizations. The registry would…
| Ann Scott, Dion Pasichnyk, Christa Harstall, Dagmara Chojecki
This Information Paper is an inventory and broad summary of factors affecting the adoption and diffusion of health technologies and of available models, strategies, tools, and processes for optimizing health technology diffusion.
| Braden Manns, Anderson Chuck, Eddy Nason, Lianne Barnieh, John Sproule, Jasmine Brown
This work, conducted by the Institute for Health Economics (IHE) and the University of Calgary (Health Economics group), was performed to better understand the unmet educational needs and health economics products that could support people in the province, and to determine the current capacity for conducting health economics in Alberta. This paper seeks to understand the needs…
Objectives: Economic evaluations, although not formally used in purchasing decisions for medical devices in Canada, are still being conducted and published. The aim of this study was to examine the way that prices have been included in Canadian economic evaluations of medical devices.
Economic surveillance and economic assessments are important sources of information to help administrators and policy makers to track current trends and evaluate policies and care patterns. The Institute of Health Economics, in partnership with Alberta Health, held a two-day Costing Methods Workshop which helped to review costing practices by bringing together economists and other…
| Deborah Marshall, Egon Jonsson, Liam Martin, Diane Mosher, Karen V. MacDonald
This White Paper discusses the concept of developing a comprehensive rheumatoid arthritis registry in Alberta, and the important health, social, and economic gains such a resource would generate for Alberta.
The Federal Minister of Health, the Honourable Rona Ambrose, announced the creation of the Advisory Panel on Healthcare Innovation (Panel) on June 24, 2014, to examine innovative health care ideas and approaches that exist in Canada and internationally. The Panel’s mandate is to identify promising innovations, here and internationally, which could help Canada reduce growth…
This book includes the plenary presentations made at the first international conference on prevention of FASD, which was attended by about 700 people from 35 countries around the globe. The issues addressed are FASD as a priority in health policy making; its prevalence and incidence; strategies for prevention; current applied and basic research in the field; the role of the medical…
Fetal alcohol spectrum disorder (FASD) is of growing concern around the world. A range of disabilities caused by prenatal exposure to alcohol, FASD is estimated to affect 2% to 5% of all newborns in the industrialized countries of Europe and North America, and the rates may be significantly higher in some developing countries and certain defined populations. Epidemiological studies…
| Maria Ospina, Liz Dennett, Arianna Waye, Philip Jacobs, Angus Thompson
Objectives: To assess and compare the measurement properties (ie, validity, reliability, responsiveness) and the quality of the evidence of presenteeism instruments.
| Thanh Nguyen, Egon Jonsson, Jessica Moffatt, Liz Dennett, Anderson Chuck, Shelley Birchard
Abstract: Parent-Child Assistance Program (P-CAP) is a 3-year home visitation/harm reduction intervention to prevent alcohol exposed births, thereby births with fetal alcohol spectrum disorder, among high-risk women. This article used a decision analytic modelling technique to estimate the incremental cost-effectiveness ratio and the net monetary benefit of the P-CAP…
| Lindsay Wodinski, Kate Woodman, Margaret Wanke, Thanh Nguyen, Philip Jacobs
Abstract: Alberta's Primary Care Networks (PCNs) bring together family physicians and other health professionals to provide local, comprehensive, and readily accessible primary care services to patients. The Edmonton North PCN, one of the largest in the province, piloted the Resource in Clinic (RIC) Program with objectives to increase efficiencies in the use of physician…
The Institute of Health Economics sponsored Dr. Arne Ohlsson and Dr. Prakeshkumar Shah to write this book to inform the May 2007 Consensus Development Conference on Healthy Mothers Healthy Babies: How to Prevent Low Birth Weight. The book provides a synopsis of the research evidence on the determinants and prevention of preterm/low birth weight births. This book is a synopsis (an…
The purpose of this report is to update an earlier HTA report published in 2003. This report examines the newly published clinical research evidence on the safety and efficacy/effectiveness of islet transplantation in type 1 diabetic patients who have severe hypoglycemia episodes or hyperglycemia unawareness but are without kidney failure. The main clinical efficacy/effectiveness…
This report presents summary information on computed tomography (CT) and magnetic resonance imaging (MRI) in Alberta, with comparison to the use of these diagnostic imaging technologies in other jurisdictions. The aims of the report are to: illustrate the capacity in Alberta to diagnose and manage health problems with the help of these important technolgies compare the numbers,…
| Arto Ohinmaa, Carolyn Dewa, Trish Chatterley, Philip Jacobs
The mental health economics literature review shows that about one third of the articles found in the search did not include any or just minimal economic information. The database of 4005 references can be used to analyze the mental health economic literature e.g. by diagnosis, type of economic analysis, treatment, publication year, and targeted population.
L’honorable Michael Kirby (président de la Commission de la santé mentale du Canada) a présidé un éminent panel de citoyens et d’experts pour formuler des recommandations pratiques sur la façon d’améliorer la prévention, le diagnostic et le traitement des troubles dépressifs chez…
The Consensus Statement on Depression in Adults: How to Improve Prevention, Diagnosis and Treatment was produced by a panel of experts led by the Hon. Michael Kirby Chair, Mental Health Commission of Canada. This consensus statement was prepared by an independent panel of health professionals, academics, and public representatives based on: presentations by and questioning of experts…
How much should we spend on mental health? provides an overview of the various approaches that have been used to answer the question of health spending, applied to the mental health context. Estimates using several of the approaches are provided.
Information Specialists: Trish Chatterley, Liz Dennett
Discussing all aspects of chronic pain management, this is the second volume of the new book series on health care and disease management, published with the Institute of Health Economics (IHE) in Edmonton, Canada. The authors provide an introduction into the history, pathophysiology, ethics and epidemiology of chronic pain before covering the different aspects of treating chronic…
The Importance of Measuring Health Related Quality of Life report provides an overview of health-related quality of life (HRQL) measurement to facilitate and understanding of such measures to be used in both clinical practice and research. Health-related quality of life (HRQL) measures have been widely used in health research in recent years and have been the endpoint in many clinical…
IHE In Your Pocket (IHE IYP) presents a bird’s eye view of the economic aspects of the Canadian healthcare system with international comparisons. IHE IYP 2008 has been reorganized and expanded, and includes the most currently available data. Topics are presented related to resources first, addressing in turn economic burden of illness, expenditures, physical resources, prices,…
| David Hailey, Jeremy Grimshaw, Martin Eccles, Craig Mitton, Carol E. Adair, Emily McKenzie, Scott Patten, Brenda Waye-Perry, Leif Rentzhog, Paul Taenzer, Christa Harstall, Saifee Rashiq, Pamela Barton, Don Schopflocher, Lynda Jobin
Effective Dissemination of Findings from Research contains essays resulting from a workshop on effective dissemination of findings from research organized by the Institute of Health Economics. The publication is intended as one of the many available resources on dissemination of research findings for those interested in the subject. Chapter 3 of this report originally appeared…
| Ann Scott, Carmen Moga, Christa Harstall, Jacques Magnan
Abstract: Health technology assessments (HTAs) are an as yet unexploited source of comprehensive, systematically generated information that could be used by research funding agencies to formulate researchable questions that are relevant to decision-makers. We describe a process that was developed for distilling evidence gaps identified in HTAs into researchable questions…
This rapid assessment addressed a request to assess the published research evidence on how the Actim™ Partus test compares to the TliIQ® System in terms of diagnostic accuracy, clinical utility, and costs when added to preterm labour management in symptomatic women with intact membranes.
Air ambulance transportation with capabilities to provide advanced life support. The objective of this report is to present and synthesize the available published research evidence on the efficacy/effectiveness, safety, and efficiency of air ambulance transportation (helicopters) with on-board capabilities of advanced life support (ALS). The intent is to use this evidence to inform…
Discussing issues of health care financing, this is the first volume in a completely new public health book series, edited by the Institute of Health Economics (IHE) in Alberta, Canada. Starting with various funding methods, it also features sections on different health care payment and purchasing mechanisms, as well as equity issues. This book is of interest to medical and allied…
Risk assessment tools for predicting recidivism of spousal violence. The objective of this report is to assess the research evidence on the inter-rater reliability and predictive validity of various risk assessment instruments in predicting male-to-female spousal violence recidivism and lethality in those males who had contact with the police system. Information Specialist: Liz…
The role of rapid fetal fibronectin assay in the management of spontaneous preterm labour The objective of this report is to evaluate the added value of using fetal fibronectin (Rapid fFN for the TLi™ System, referred to here as the rapid fFN assay) to diagnose spontaneous preterm labour (PTL) in symptomatic women, which is the only fFN detection modality currently available…
| 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.…