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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| Wendy Sligl, Justin Chen, Xiaoming Wang, Cheyanne Boehm, Karen Fong, Katelynn Crick, Míriam Clua, Cassidy Codan, Tanis Dingle, Daniel Gregson, Connie Prosser, Hossein Sadrzadeh, Charles Yan, Guanmin Chen, Alena Tse-Chang, Daniel Garros, Christopher Doig, David Zygun, Dawn Opgenorth, John Conly, Sean Bagshaw
Sepsis is a leading cause of hospital mortality, particularly in the intensive care unit (ICU) , and the related financial costs to healthcare systems are substantial. Antimicrobial use in ICUs is considerable; early, and effective antimicrobial therapy has been associated with improved sepsis outcomes. However, up to 50% of antimicrobials are sub-optimally prescribed,…
| 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…
| 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…
| Anderson Chuck, Thanh Nguyen, James Wesenberg, Rhada Chari, Robert Wilson, Selikke Janes-Kelley
Objectives: In 2006, the Alberta Ministry of Health issued a policy to implement fetal fibronectin (fFN) testing as a publicly funded service for pregnant women. The goals were to reduce maternity health care utilization and unnecessary treatment, which would result in cost-savings for the health system by more accurately diagnosing false preterm labour. We conducted a post-policy…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This STE report examines the safety, screening accuracy, therapeutic efficacy/effectiveness, cost-effectiveness, budget impact, and health system readiness of newborn screening for seven conditions (galactosemia, tyrosinemia type I, homocystinuria, sickle cell anemia, sickle…
Objectives: To estimate the life expectancy and specify the causes of death among people with fetal alcohol syndrome (FAS). Methods: Included were all patients recorded in Alberta provincial databases of inpatients, outpatients, or practitioner claims from 2003 to 2012. People with FAS were identified by ICD-9 code 760.71 and ICD-10 codes Q86.0 and P04.3, and were linked…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This rapid report has been produced in response to a request from Alberta Health to provide an update on the new published research evidence on the efficacy/effectiveness, efficiency, and safety of hysteroscopic tubal sterilization (HTS) using the Essure® system for permanent…
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,…
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…
| 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…
Objectives: To estimate the annual health services utilization (HSU) cost per person with FASD by sex and age; the lifetime HSU cost per person with FASD by sex, and the annual HSU cost of FASD for Alberta by sex.
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an evidence assessment of the clinical effectiveness and safety of hysteroscopic tubal sterilization, and the value for money associated with adopting hysteroscopic tubal sterilization in Alberta. Section Authors: Section One – Background and Context: Carmen…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report examines the safety, screening accuracy, therapeutic efficacy, patient outcomes and cost effectiveness of first trimester Quad (1T-Quad) +/- NT and NIPT screening for fetal trisomies. Section Authors: Section One – Technology Effectiveness and Safety: Ken Bond,…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior staff of…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior staff of…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior staff of…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior staff of…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior staff of…
The International Charter on Prevention of FASD has been published in The Lancet Global Health, one of the world’s most influential public-health journals. The Charter – also known as the “Edmonton Charter” – was endorsed at the First International Conference on Prevention of FASD in September 2013.The Edmonton Charter was drafted by senior staff of…
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 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…
| 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.
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…
| 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 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…
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…
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…
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…
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…
The IHE has produced a book of the proceedings from the Consensus Development Conference: FASD - Across the Lifespan. Hardcover copies are available for purchase at a unit cost of $25.00 CAD plus $2.50 shipping and handling. Click on the Add to Cart button at the bottom of this page to proceed with your purchase. In followup to the conference, the Institute has produced two…
Reflecting the recent increased public awareness of the topic, this is the first and most comprehensive resource for over a decade on the molecular basis, prevalence, treatment options, socioeconomic impact, and prevention strategies of FASD. Edited by world-renowned experts, this compendium includes the latest research results to provide new insights and realistic estimations…
| Thanh Nguyen, Philip Jacobs, Margaret Wanke, Ann Hense, Reg Sauve
OBJECTIVE: In 2004, the three-module, three-year long patient safety program, Managing Obstetrical Risk Efficiently (MOREOB), was introduced to all clinicians providing obstetrical services in Alberta. We report on an outcomes evaluation of this initiative.
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…
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.
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…
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…
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.
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…
This consensus statement on how to prevent low birth weight was developed to inform patients, health policy, and practice. It is a product of the IHE Consensus Development Conference on Healthy Mothers - Healthy Babies: How to Prevent Low Birth Weight held April 23 to 25, 2007
| Philip Jacobs, Rita Yim, Arto Ohinmaa, Janice Varney, Anita Hanrahan, Joy Loewen, Laura Mashinter, Bev Baptiste, Margaret Russell
This booklet is a compendium of existing statistics related to the economic aspect of childhood immunizations in Canada. It brings together, in one document, data obtained from a wide range of sources. It covers topics related to the economic and epidemiological burden of childhood diseases, resources used, and system performance from provincial, national, and international viewpoints.
A successful screening program for cystic fibrosis (CF) refers to the ability of the program to appropriately identify and refer for care those with CF, while meeting the needs of those who do not have CF, particularly those infants identified by the screening program as carriers (individuals unaffected by CF but have a mutation in one of their CFTR genes). Some measures of success…
The use of the automated auditory brainstem response and otoacoustic emissions tests for newborn hearing screening. Permanent congenital hearing impairment/loss (PCHI) is one of the most common congenital anomalies found at birth which can be expected to lead to delays and deficits in the development of speech, language, cognition and learning, as well as secondary effects on the…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #36. The objective of this report is to identify the most appropriate investigative protocol, or component of a protocol, for determining the cause(s) of stillbirth and to identify protocols that have been recommended by health authorities and professional associations both within Canada and worldwide. Information…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #33. This report is a systematic review and critical appraisal of the evidence on the use of ovulation induction (OI) drug therapy to manage anovulatory infertility associated with polycystic ovary syndrome (PCOS) in women of reproductive age. The aim was to provide the current published scientific evidence about…
| Sue Ludwig, Patricia Leggett Tait, Christa Harstall
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #22. This review was requested to determine whether conductive education as a learning approach or therapeutic intervention is safe and efficacious for children with disabilities such as cerebral palsy that impact neuromotor functioning. The review also addresses the profile of the child who would benefit from…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #3. The intent of this report is to inform medical practitioners and the public on the current status of in vitro fertilization and embryo transfer (IVF-ET) as a treatment for various types of infertility, and on its use and coverage in Canada. The report has been prepared because of the interest and debate regarding…