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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| Christopher Cotton, Christopher McCabe, Esllyt Jones, Evelyn Forget, Fabien Large, Lindsay Tedds, Nathalie de Marcellis-Warren, Richard Gold, Robin Boadway, Stewart Elgie, Stuart Peacock, Vic Adamowicz
The Royal Society of Canada Task Force on COVID-19 was established early in 2020 to equip Canadians with accurate information about Canadian response and recovery. A number of Working Groups were established included one on COVID-19 and Economic Recovery which is chaired by the Institute of Health Economics’ CEO, Dr. Chris McCabe. Their report, "Renewing the Social Contract:…
| Lindsey Warkentin, Erica Wright, Bing Guo, Ken Bond
This Rapid Review assesses the evidence on the rate of COVID-19 transmission from children to children or adults compared with the rate of transmission from adults to others, and the rate of COVID-19 infection in children compared with the rate in adults, to support return-to-school decision making. Twenty-two articles were included in the review. Based on a rapid assessment of…
| Lindsey Warkentin, Erica Wright, Bing Guo, Ken Bond
Face mask use within schools has been suggested as a COVID-19 risk mitigation strategy, but the effectiveness of mask use as protection against COVID-19 transmission and infection in a school setting is currently unknown. This Rapid Review assesses the evidence on the impact of community mask use on the susceptibility to and transmission of COVID-19, and how mask use compliance…
The Institute of Health Economics is proud to be a founding partner of the international Univants of Healthcare Excellence Program https://www.univantshce.com/int/en/program along with 7 other health care organizations. The following article from the September 2020 Journal of Applied Laboratory Medicine outlines twelve diverse best practices which were recognized by the program…
| Sean M. Bagshaw, Dat Tran, Dawn Opgenorth, Xiaoming Wang, Danny Zuege, Armann Ingolfsson, Henry T. Stelfox, Thanh Nguyen
Delay in transfer from intensive care unit (ICU) may contribute to strained capacity. Using a population-based patient cohort in 17 ICUs in Alberta between 2012 and 2016, this paper describes the epidemiologic features and healthcare costs attributable to potentially avoidable delays in ICU discharge. Potentially avoidable discharge delay occurred in approximately 70% of ICU patients…
Summary: Deliberative processes are a well-established part of health technology assessment (HTA) programs in a number of high- and middle-income countries, and serve to combine complex sets of evidence, perspectives, and values to support open, transparent, and accountable decision making. Nevertheless, there is little documentation and research to inform the development…
Primary care services after hours in Alberta are limited, and, as a result, emergency departments have long wait times and overcrowding as they accommodate a greater number of low-acuity conditions. In recent decades, various urgent care models have been established to fill the gap between emergency and primary care, with the aim of providing unscheduled services for urgent but…
This study examined the temporal trends of healthcare service and medicine utilization and explored the care quality of patients with chronic low back pain (CLBP) by assessing inappropriate use of medicine, using Alberta's administrative health data from 1 April 2011 to 31 March 2018. The prevalence of CLBP in Alberta increased from 1.8% FY 2011/12 to 3.0% in FY 2017/18, and the…
There have been few epidemiological studies of dysphagia and associated outcomes using administrative datasets. In this study we estimate the proportion of patients with either stroke or head and neck cancer who are additionally diagnosed with dysphagia or aspiration pneumonia, or that have a feeding tube placed. Our analysis is based on a cohort of patients identified in administrative…
Summary: We examined the association between optimal control of dyslipidemia and mortality and healthcare costs in patients with high risk for cardiovascular disease (HRCVD) between 2012-2016 in Alberta, Canada. HRCVD patients who were optimally controlled had lower mortality and incurred modestly higher costs, compared to those who were not. Secondary prevention patients with…
Abstract: The cost of drug development is commonly cited between US$800 and US$1.8 billion. A similar statistic for vaccines is yet to be estimated, and it is unclear whether the cost of vaccines is similar to drug development. Financial and regulatory policy significantly impacts the extent and cost of pharmaceutical development, and as such it is important that…
| Thanh Nguyen, Anderson Chuck, Arto Ohinmaa, Philip Jacobs
Objectives: To estimate the monetary benefits of ramipril and its distribution over time among four beneficiaries in Canada: the drug developing manufacturer, generic manufacturers, the healthcare sector and employment sectors.
| Christa Harstall, Paul Taenzer, Nancy Zuck, Donna Angus, Carmen Moga, Ann Scott
Rationale, Aims, and Objectives: The Alberta Ambassador Program (AAP) adapted seven clinical practice guidelines on low back pain (LBP) into a single guideline spanning the continuum of care from prevention and diagnosis through to treatment. The Ambassador adaptation process was evaluated to 1 Identify the major challenges encountered and successful strategies utilized;…
INTRODUCTION: Varicella vaccine was introduced to the infant immunization schedule in each province or territory between 2000 and 2007 as a result of the Canadian ImmunizationStrategy. The impact of vaccinating children against this disease is potentially far reaching, asimmunization may also benefit those segments of the population not immunized. The objective of this paper…
This report is an analysis of the theoretical basis for value-based pricing, relevant international developments, and areas for improvement within Canada’s current patented drug pricing system. This report intends to inform future policy research, advice, and Canadian drug policy discussions regarding the feasibility and implementation of value-based pricing approaches.
This consensus statement on Legal Issues of Fetal Alcohol Spectrum Disorder (FASD) is the product of a unique IHE Consensus Development Conference held in September 2013. The event was a three-day juried hearing of evidence and scientific findings that allowed for the engagement and collaboration of citizens and decision makers in government and the justice system in addressing…
| Angus Thompson, Philip Jacobs, Jessica Moffatt, Arianna Waye
This service and evaluation project originated from the Alberta courts via the collaboration of two Alberta Ministries; (1) Alberta Justice & Soliciter General and (2) Alberta Environment and Sustainable Resource Development. The impetus arose when a judge in an environmental protection case observed a need for additional attention to the mental health of workers. An Alberta…
| Thanh Nguyen, Jessica Moffatt, Philip Jacobs, Anderson Chuck, Egon Jonsson
Objectives: To estimate the break-even effectiveness of the Alberta Fetal Alcohol Spectrum Disorder (FASD) Service Networks in reducing occurrences of secondary disabilities associated with FASD.
Abstract: Medical wait time is a top health policy issue in Canada. Reliable data on the referral wait time from primary to specialty care are limited. Existing data on referral wait times are generally self-reported by specialists. In 2008, the Edmonton North Primary Care Network (PCN) developed a Centralized Referral Program, including a specialist database that contains…
The Provincial Industry Payer Agreements in an Era of National Purchasing Strategies half-day invitational roundtable was part of the IHE's ongoing Methodology Forum series supported by the Institute of Health Economics, the Alberta government, and industry partners, AstraZeneca, Merck, and Eli Lilly. The event brought together academic experts, industry leaders and senior decision…
This health technology assessment report has been produced in response to a request from Alberta Health (AH) as part of the Alberta Health Technologies Decision Process (AHTDP) to perform an evaluation of the scientific evidence on the safety and effectiveness of TMJ Concepts® and Biomet® Microfixation TMJ prostheses for adults who are indicated for total TMJ replacement.…
Transcutaneous Bilirubinometry for the Screening of Hyperbilirubinemia in Neonates ≥35 Weeks’ Gestation This report was prepared for Alberta Health Services (AHS) and focuses on the published evidence about the safety, test accuracy, and clinical impact of the use of transcutaneous bilirubin (TcB) test for the screening of significant hyperbilirubinemia in term or late…
The review summarizes the current evidence on the safety, efficacy, effectiveness, and potential cost-effectiveness on the use of the BridgePoint Medical System (consisting of the CrossBoss™ catheter, Stingray™ catheter, and Stingray™ guidewire) for the recanalization of refractory coronary chronic total occlusions (CTOs). The report also describes the relevant…
| Thanh Nguyen, Egon Jonsson, Jessica Moffatt, Liz Dennett
From the Introduction: In this paper, we report a discussion of available evidence regarding the association between poverty and FASD, and regarding the economic consequences of FASD on individuals and families which may materialize an FASD - poverty trap.
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an update of the 2008 report on islet transplantation (IT) for Type 1 diabetes (T1DM). Section One of this analysis was intended to describe the profile of T1DM (definition, progression, epidemiology, and population dynamics of affected adults in Alberta, in Canada,…
| Ian Colman, Yasmin Garad, Yiye Zeng, Kiyuri Naicker, Murray Weeks, Scott Patten, Peter Jones, Angus Thompson, T. Cameron Wild
Purpose: Studies suggest that childhood trauma is linked to both depression and heavy drinking in adulthood, and may create a lifelong vulnerability to stress. Few studies have explored the effects of stress sensitization on the development of depression or heavy drinking among those who have experienced traumatic childhood events. This study aimed to determine the effect…
| Philip Jacobs, Jessica Moffatt, Arto Ohinmaa, Egon Jonsson
Background: To address public health risk factors, governments conduct interventions in many different ministries, including non-health ministries. In order to understand the scope and cost of public health in Alberta, we developed a survey of government public health interventions. We included any government ministry or public organization, which includes health as a stated…
OBJECTIVE: About one-third of the annual $51 billion cost of mental illnesses is related to productivity losses. However, few studies have examined the association of treatment and productivity. The purpose of our research is to examine the association of depression and its treatment and work productivity.
The Institute of Health Economics organized the November 17 roundtable, with funding from Merck and in-kind support from the Canadian Health Services Research Foundation. The roundtable served as an initial gathering of the original partners and invited delegates (see Appendix I for full participant list) to further develop the HCiC partnership and begin planning…
Abstract: In the 1980s, drug prices began rising considerably worldwide, and in the 1990s, countries began incorporating health economics into the scientific review process. Rising prices in vaccines began around the year 2000 and national bodies began to use health economics to review vaccines in the next decade. Health economics is a discipline that evaluates alternative…
The Alberta Diabetes Surveillance System (ADSS) was created in 2006 in partnership with 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…
Purpose: The concept of the suicidal process implies a progression from behaviour of relatively low intent to completed suicide. Evidence from the literature has given rise to the speculation that the age of onset of an early form of the suicidal process may be associated with the ultimate seriousness of suicidal behaviour. This study was designed to test the hypothesis…
| Philip Jacobs, Jessica Moffatt, Egon Jonsson, Arto Ohinmaa, Cathy Gladwin
The Institute of Health Economics (IHE) has completed a scan to determine what public health-related costs are borne by government departments, ministries, and agencies. The final report, Everybody’s Business: The Cost of Multi-Department Involvement in Public Health in Alberta, was funded by Alberta Health Services (AHS) as part of the Project 2030 initiative that saw the…
| Christa Harstall, Paul Taenzer, Donna Angus, Carmen Moga, Ann Scott, Tara Schuller
Rationale, Aims, and Objectives: A collaborative, multidisciplinary guideline adaptation process was developed to construct a single overarching, evidence-based clinical practice guideline (CPG) for all primary care practitioners responsible for the management of low back pain (LBP) to curb the use of ineffective treatments and improve patient outcomes. Note: This is an…
The Alberta Survey of Addictive Behaviours and Mental Health in the Workforce: 2009 is the third such study conducted since 1992. It provides an interesting, comprehensive picture of many issues related to the mental health of workers across all sectors in Alberta. Introduction IHE is pleased to release the final report of The Alberta Survey of Addictive Behaviours and Mental Health…
This report describes the outcomes of a two day workshop that explored options for improving quality and access to diagnostic imaging services for low back pain (LBP) in Alberta through the engagement of stakeholders that are involved in the assessment, diagnosis, treatment, and management of this condition. These include health professionals, health service managers, administrators,…
As part of Alberta Health Services (AHS) Strategic Health Needs Assessment and Service Design 2030 project, “Becoming the Best: Building Sustainability” the Institute of Health Economics (IHE) was commissioned to conduct three Knowledge Exchange events between February and May 2011. These single-day conferences assembled leading international thinkers and experts in…
This one-day, invitational event engaged community experts and senior decision-makers involved in First Nations, Inuit, and Métis health policy in Canada in round-table discussions. Integrated Knowledge Exchange in health requires communities, researchers, and policy-makers utilize evidence from all sources in a culturally relevant way.
This in-depth book contains an introduction to prevention of FASD and to the different methods that are used. There is also a systematic review of the effectiveness of prevention approaches and an overview of reviews on FASD. The book ends with a chapter called “Five perspectives on prevention of FASD” written by professionals in the field who are working to prevent…
| Bing Guo, Christa Harstall, Thanh Nguyen, Arto Ohinmaa
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). Fecal transplantation for the treatment of Clostridium difficile-associated disease or ulcerative colitis examines the clinical research evidence on the safety and effects of fecal transplantation in the treatment of patients with Clostridium difficile-associated disease…
This article is an overview of systematic reviews reporting on the efficacy/effectiveness of psychotherapy and/or pharmacotherapy interventions delivered within Sex Offender Treatment (SOT) programs to reduce the risk of re-offending in convicted adult male sex offenders.
Related Report:
Treatment for Convicted Adult Male Sex Offenders
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…
The objective of this statement was to develop a consensus statement on the benefits and costs of testing supplies for self-monitoring of blood glucose in diabetes, to inform patients, health policy and practice.
This Mental Health Economic Statistics booklet brings together information that demonstrates the burden of mental illness and where Canada’s mental health system ranks among other developed countries. Mental Health Economic Statistics provides important consolidated information on key indicators that depict the state of our mental health system. NOTE: In 2006 the Alberta…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Initiative #24. Health technology assessments (HTAs) routinely identify questions or research ‘gaps’ that are not adequately addressed by the primary research. The unique situation of having an HTA unit housed within a provincial research funding organization provided an ideal setting for linking research…
Institute of Health Economics Working Paper WP 06-02. The purpose of this report is to examine the economic implications for the province if a supplement to the fee schedule were allowed for vacuum-assisted biopsies. NOTE: In 2006 the Alberta Heritage Foundation for Medical Research HTA unit moved to IHE. Documents produced in and prior to 2006 have different formats; the format…
| Philip Jacobs, Arto Ohinmaa, Scott Klarenbach, Anderson Chuck, Raj Padwal, Janice Varney, Doug Lier
Institute of Health Economics Working Paper WP 06-01. The purpose of this report is to examine the economic issues associated with LGB. The following analyses were conducted: a systematic review of the economic literature on obesity-related interventions, with special attention to the differences between gastric bypass and gastric banding; an estimate of the Alberta population…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Initiative #20. Health Technology Assessment (HTA) is the systematic evaluation of properties, effects and/or other impacts of health care technology. Its primary purpose is to provide objective information to support health care decisions and policy making at the local, regional, national and international levels. NOTE:…
| Saifee Rashiq, Pamela Barton, Christa Harstall, Don Schopflocher, Paul Taenzer
Background: The purpose of Health Technology Assessment (HTA) is to make the best possible summary of the evidence regarding specific health interventions in order to influence health care and policy decisions. The need for decision makers to find relevant HTA data when it is needed is a barrier to its usefulness. These barriers are highest in rural areas and amongst isolated…
| Sheri Pohar, Sumit Majumdar, Philip Jacobs, Jeffrey Johnson
Institute of Health Economics Working Paper WP 06-04. The purpose of this analysis was to compare health care utilization as well as costs and mortality of individuals with diabetes in the province of Saskatchewan from 1999 to 2001, according to residential location. NOTE: In 2006 the Alberta Heritage Foundation for Medical Research HTA unit moved to IHE. Documents produced in…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #38. This report aims to identify strategies that have been evaluated and reported in the literature and to assess their effectiveness in reducing emergency department overcrowding. Information Specialists: Seana Collins, Liz Dennett NOTE: In 2006 the Alberta Heritage Foundation for Medical Research HTA unit moved…
| Margaret Wanke, Don Juzwishin, Richard Thornley, Liza Chan
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Initiative #16. The objectives of this review were: To propose a generic evaluation framework for HTA agencies to strengthen their evaluation capacity. To conduct a review of HTA agencies to understand what aspects of HTA agencies have been evaluated, approaches/methods used, outcomes of hte evaluations and to understand…
This is the first edition of IHE In Your Pocket. This chart book is designed to be an easy reference guide to indicators of Canadian health care economic performance. Economic is broadly defined to include both means (personal and formal resources) and ends (health outcomes). The chart book is intended to provide the user with a concise, accessible, and reasonably comprehensive…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #37. The aim of this paper is to present the current evidence on the efficacy/effectiveness, safety, and efficiency of gastric electrical stimulation (EnterraTM Therapy System) used for the treatment of patients with severe gastroparesis (GP). Information Specialist: Liz Dennett NOTE: In 2006 the Alberta Heritage…
| David Cooke, Meina Dubetz, Rahim Heshmati, Sandra Iftody, Erin McKimmon, Jodi Powers, Robert Lee, Peter Dunscombe
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Initiative #22. We present a model process that will assist health care organizations in developing and implementing a formal management system for learning from incidens. Developed specifically for the Radiation Treatment (RT) Program at the Tom Baker Cancer Centre, a major cancer treatment centre in Calgary, Alberta,…