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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This report provides a summary of a real-world evidence (RWE) design sprint workshop that took place on October 21, 2018 in Toronto, Ontario. The workshop was developed and delivered as a joint partnership between the Canadian Agency for Drugs and Technologies in Health (CADTH); Canadian Association for Population Therapeutics (CAPT), Health Canada, and the Institute of Health…
| Dat Tran, Robert Welsh, Arto Ohinmaa, Thanh Nguyen, Padma Kaul
Little is known about the resource use and cost burden of acute myocardial infarction (AMI) beyond the index event. We examined resource use and care costs during the first and each subsequent year, among patients with incident AMI.
This environmental scan describes existing initiatives that aim to accelerate the diagnostic phase of cancer care in Alberta, Canada, and internationally. Specifically, it describes their development and implementation, structure and functioning, intended outcomes and effectiveness, costs and cost savings, and enablers and barriers.
| S.P. Bisch, T. Wells, L. Gramlich, P. Faris, X. Wang, Dat Tran, Thanh Nguyen, S. Glaze, P. Chu, P. Ghatage, J. Nation, V. Capstick, H. Steed, J. Sabourin, G. Nelson
The Institute of Health Economics has contributed to a study published in the Journal Gynecologic Oncology. The study described the effects of Enhanced Recovery After Surgery (ERAS) guideline implementation in gynecologic oncology on length of stay, patient outcomes, and economic impact in Alberta. The study compared pre-and post-guideline implementation outcomes at two centers…
This study originated from discussions on how to translate research findings into conclusions regarding safety and effectiveness in systematic reviews responding to requests from a provincial mechanism for introducing and diffusing publicly funded healthcare technologies. Its objective is to identify prominent and reliable evidence grading systems used in health technology assessment…
| Jasmine Brown, Roger Bland, Egon Jonsson, Andrew Greenshaw
Objective: Fetal alcohol spectrum disorder (FASD) is a medical term used to describe a range of mental and physical disabilities caused by maternal alcohol consumption. The role of alcohol as a teratogen and its effects on the cellular growth of the embryo and the fetus were not determined on scientific grounds until the late 1960s. However, the link between alcohol use during…
| Jasmine Brown, Roger Bland, Egon Jonsson, Andrew Greenshaw
Objective: Fetal Alcohol Spectrum Disorder (FASD) is a preventable disorder caused by maternal alcohol consumption and marked by a range of physical and mental disabilities. Although recognized by the scientific and medical community as a clinical disorder, no internationally standardized diagnostic tool yet exists for FASD. Methods and Results: This review seeks to analyse the…
| Charles Yan, Yufei Zheng, Michael D. Hill, Balraj Mann, Thomas Jeerakathil, Noreen Kamal, Shy Amlani, Anderson Chuck
Abstract: We present a conceptual approach to determine the optimal solution to delivering a health technology, consistent with the objective of maximizing patient outcomes subject to resources available to a publicly funded health system. The article addresses two key policy questions: 1) adding system values through appropriate planning of health services delivery and 2) considering…
As the Federal Government contemplates introducing an element of value-based pricing to the pharmaceutical industry regulatory framework, this report provides an overview of key theoretical and empirical material, to support informed engagement by all stakeholders in this important debate.
| Rodger Craig, Carmen Moga, Bing Guo, Dagmara Chojecki
The Institute of Health Economics (IHE) was commissioned by the Canadian Cardiovascular Society to provide a rapid update of the literature, to compare the impacts of public reporting and external benchmarking on selected outcomes, and to evaluate and describe the applicability of this body of research to non- competitive health systems, emphasizing perspectives and considerations…
Objective: The aim of this study was to analyze the health care costs and savings associated with quality improvement (QI) interventions initiated and implemented utilizing the National Surgical Quality Improvement Program (NSQIP). Background: Five acute care facilities of Alberta Health Services (AHS) adopted NSQIP in 2015 for a pilot project. Methods: The cost-savings of NSQIP…
This report provides a summary of the proceedings from the IHE roundtable on diabetes care and management in Indigenous populations in Canada, held on November 1, 2017. The roundtable aimed to: discuss and share learnings and promising practices from successful community-led diabetes programs, highlighting approaches to effectively engage communities to co-develop prevention and…
Since 2000, 5 studies have been published that each purported to estimate aggregate national mental health costs in Canada. Each of these studies used a different method. Our aim was to compare the studies, and we created a framework for the different elements used to assess mental health costs (direct costs, indirect costs, transfer payments, and “human” costs). In…
This report provides a summary of the IHE/CAPT Precision Health workshop that took place on October 22, 2017 in Toronto, Ontario. The intent of the workshop was to identify gaps and opportunities in implementing precision health technologies into the Canadian health system. The workshop was supported by unrestricted grants from Merck Canada and Hoffmann-La Roche Limited.The views…
Presenteeism (reduced productivity at work) is thought to be responsible for large economic costs. Nevertheless, much of the research supporting this is based on self-report questionnaires that have not been adequately evaluated.
| Dat Tran, Ilke Akpinar, Richard Fedorak, Egon Jonsson, John Mackey, Lawrence Richer, Philip Jacobs
Purpose: In pharmaceutical clinical trials, industrial sponsors pay for study drugs and related healthcare services. We conducted a study to determine industry’s economic contribution of these trials to the Alberta healthcare system. Authors and Affiliations: Dat T. Tran1,2; Ilke Akpinar2 ; Richard N. Fedorak3 ; Egon Jonsson2 ; John R. Mackey4 ; Lawrence Richer5 ; Philip…
| Bing Guo, Paula Corabian, Charles Yan, Lisa Tjosvold
This evidence-based report examines expanding the role of paramedics in the community. It summarizes the various types of community paramedicine programs (characteristics, implementation, and funding sources in other jurisdictions) as well as the safety, effectiveness, and economic outcomes of these paramedic programs towards providing patients with alternate, non-emergency health…
L’IHE dans votre poche 2017 – Guide de statistiques sur l’économie de la santé présente et divise les données les plus récentes en sections portant sur le fardeau économique de la maladie, les ressources en soins de santé, les comportements liés à la santé, l'état de santé, les…
This paper reviews implementation of enhanced recovery after surgery (ERAS) and its financial implications. Literature on clinical outcomes and financial implications were reviewed. Reports from many different surgery types shows that implementation of ERAS reduces complications and shortens hospital stay. These improvements have major impacts on reducing the cost of care even…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This STE report examines the social and system demographics, technological safety and therapeutic efficacy/effectiveness, cost-effectiveness, and budget impact of endovascular therapy for acute ischemic stroke, contextualized to the Alberta setting. Section Authors: Section…
This report provides a summary of the IHE Real-World Evidence Roundtable, which took place on December 12, 2016. The intent of the roundtable was to capture initial thinking regarding preferences and perceptions of the use of real-world evidence for pricing and reimbursement of new medicines in Canada and what more may be needed.
This report provides a summary of the IHE Biosimilars Forum engagement exercise that took place on April 23, 2017 in Ottawa, Ontario. The intent of the forum was to identify: options to categorize and consider biosimilars; a process to engage stakeholders to identify place in therapy and further evidence development that may be required; and an approach to knowledge exchange that…
IHE In Your Pocket 2017 – A Handbook of Health Economic Statistics includes the most currently available data, presented in separate sections on the economic burden of illness, health care resources, health behaviours, health status and demographics, and health system performance. IHE In Your Pocket was designed to provide a compact, comprehensive, and comparative overview…
| Thanh Nguyen, Ilke Akpinar, Jennifer Gratrix, Sabrina Plitt, Petra Smyczek, Ron Read, Philip Jacobs, Tom Wong, Ameeta E Singh
Adding universal rectal screening to urogenital screening should positively impact rectal Chlamydia trachomatis (CT) incidence in affected populations. A dynamic Markov model was used to evaluate costs and outcomes of three rectal CT screening strategies among women attending sexually transmitted infection clinics in Alberta, Canada: universal urogenital-only screening (UG-only),…
Alberta Health Services (AHS) has 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 to provide…
This report provides a summary of recently published information (January 2015 to present) regarding the glucose monitoring technologies that are commercially available in North America, as well as those that are emerging within the next five years (up to 2021).
| Alain Lesage, Roger Bland, Ian Musgrave, Egon Jonsson, Mike Kirby, Helen-Maria Vasiliadis
The Liberal government committed to making mental health services more accessible. Housing funding was increased in the last budget, but now commitment to comprehensive home care for the severely mentally ill and access to primary care treatments for common mental disorders are needed.
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.…