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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| Stefanie Tan, Julie Farmer, Monika Roerig, Sara Allin
Internationally and across Canada, governments have explored varied approaches to reforming the governance and financing of primary care with the aim of improving access, efficiency, effectiveness, and patient experiences in the health system. This rapid review prepared for the Institute of Health Economics by the North American Observatory on Health Systems and Policies presents…
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…
| 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…
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.
| 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…
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…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is an update of the “Technological efficacy/effectiveness analysis” (T) section of the 2014 Alberta STE report, which was an evidence assessment of the clinical effectiveness and safety of endovenous ablation interventions for symptomatic varicose veins…
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…
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 is an evidence assessment of the best available research evidence on the safety and effectiveness, cost effectiveness and budget impact of using Endovenous Laser Ablation (EVLA) or Endovenous Radiofrequency Ablation (RFA) in the management of symptomatic varicose…
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,…
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 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…
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,…
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…
| Bach Tran, Arto Ohinmaa, Anh Duong, Nhan Do, Long Nguyen, Quoc Nguyen, Steve Mills, Philip Jacobs, Stan Houston
PURPOSE: This longitudinal study assessed the changes in drug use patterns and health-related quality of life (HRQL) among HIV-positive drug users in the first methadonemaintenance treatment (MMT) cohort in Vietnam.
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report summarizes available key information on the use of bariatric treatments for adult obesity in Alberta and North America (mainly Canada). This analysis was intended to describe the profile of adult obesity (definition, progression, epidemiology, and population dynamics…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report examines the research evidence on the safety and efficacy of insulin pump therapy, as compared to multiple daily insulin injections, in the treatment of children, adults, and pregnant women diagnosed with type 1 diabetes. The report also analyses the economic impact…
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…
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.
Part of the successful Institute of Health Economics (IHE) book series, this handbook and ready reference adopts a unique approach in combining policy recommendations with specific treatment options for Parkinson patients. The first part of the book deals with the clinical medical, social and economical aspects of Parkinson Disease. These ten chapters include the latest diagnosis…
PURPOSE: A study was undertaken to evaluate the utilization rates of routine preoperativeelectrocardiogram (ECG) and chest x-ray (CXR) by sex, age, and most frequent surgery type, and to estimate the total cost of these screening tests.
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…
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 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,…
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…
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…
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.
| Anderson Chuck, Philip Jacobs, Thanh Nguyen, Arto Ohinmaa, Janice Varney
Evaluation of enzyme immunoassay and immunoblot testing for the diagnosis of syphilis in Alberta. A new protocol for testing and diagnosing syphilis has been proposed in Alberta. The protocol proposes replacing rapid plasma reagin (RPR) with enzyme immunoassay (EIA) as the standard initial test and replacing Treponema pallidum (T. pallidum) particle agglutination assay (TPPA) and…
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…
Institute of Health Economics Working Paper WP 05-07. The aim of this paper is to compare health in Canada and the United States using a preference-based measure. 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 was determined by the agency for which the document…
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…
Institute of Health Economics Working Paper WP 05-03. Missing data is a common problem in studies that collect data on patient-reported outcomes data. This paper reports the methods, results, and an evaluation of one method for imputing missince Centre for Epidemiological Studies-Depression (CES-D) data in a study of health-related quality of life (HRQL) in a cohort of patients…
| Sheri Maddigan, David Feeny, Sumit Majumdar, Karen Farris, Jeffrey Johnson
Institute of Health Economics Working Paper WP 05-02. The purpose of this report was to assess the cross-sectional construct validity of the Health Utilities Mark 3 (HUI3) in type 2 diabetes using population-health survey data. 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;…
| Sheri Maddigan, David Feeny, Sumit Majumdar, Karen Farris, Jeffrey Johnson
Institute of Health Economics Working Paper WP 05-01. The objective of this paper is to assess a broad range of determinants of health to determine which are most strongly associated with health-related quality of life (HRQL) in people with type 2 diabetes. NOTE: In 2006 the Alberta Heritage Foundation for Medical Research HTA unit moved to IHE. Documents produced in and prior…
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 #16. This report has been prepared in view of the continuing interest in positron emission tomography and other functional diagnostic imaging (FDI) methods within the Alberta health care system. It also continues the work at the Alberta Heritage Foundation for Medical Research in developing approaches to assessment…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #16. This is the second volume of an assessment of functional diagnostic imaging methods in imaging of the myocardium. Volume 1 included an overview of the assessment findings and provided comments on the place of the FDI techniques in this application. In this volume, further details are given of the assessment…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #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 #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…