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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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…
| 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.
| 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.
| 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),…
This report provides a summary of the IHE Biosimilars Forum engagement exercise that took place on October 6, 2016 in Edmonton. The intent of the forum was to inform Alberta biosimilar reimbursement policy by sharing international experiences in this area, and the perspectives of key stakeholders.
The Institute of Health Economics (IHE), in partnership with the Canadian Pulmonary Fibrosis Foundation (CPFF), held a forum on April 25th, 2016 in Toronto, Ontario, entitled Optimizing access to care for patients with idiopathic pulmonary fibrosis: A multi-stakeholder national forum, to discuss the need for patient-led policy recommendations and a patient charter for idiopathic…
This white paper follows on from the 2016 IHE report, Economic surveillance for chronic obstructive pulmonary disease (COPD) in Alberta. It provides a summary of main gaps in COPD care across Canada and, in the context of a broad economic framework, it surveys important examples of programs and policies designed to address these gaps.
“The Canadian Idiopathic Pulmonary Fibrosis Patient Charter is a way to call upon policymakers, health care providers and private payers to recognize IPF as a rare, rapidly lethal, chronic disease and to join in the campaign for greater awareness of this illness. The ultimate goal is to improve the overall quality and standards of care and ensure equal access to a continuum…
| 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…
| Arianna Waye, Philip Jacobs, Maria Ospina, Michael Stickland, Irvin Mayers
This report provides the results of an economic surveillance analysis on the components of the Alberta healthcare system that are devoted to COPD prevention and treatment. It focuses on epidemiology (prevalence and incidence), service use, and cost indicators, and identifies gaps in the system that presumably add to the overall economic burden of COPD. PDF of the above image: IHE…
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…
The purpose of this workshop was to examine COPD management in Canada through presentation of analyses and examples of system supports to action best practices to a select group of clinical leaders and relevant public sector decision makers. The group deliberated, and key themes and policy recommendations from discusssion were captured to form the basis of the final COPD Policy…
PDF of a PowerPoint presentation by Dr. Irvin Mayers, Professor, Division of Pulmonary Medicine, University of Alberta; Chair of the COPD Policy Framework Study Expert Advisory Committee.
Chronic Obstructive Pulmonary Disease (COPD) Care Canada Policy Workshop
PDF of a PowerPoint presentation by Dr. Arianna Waye, Health Economist, Institute of Health Economics.
Chronic Obstructive Pulmonary Disease (COPD) Care Canada Policy Workshop
PDF of a PowerPoint presentation by Mr. Michael G. Stewart, Director, Clinical Support Branch, Ontario Ministry of Health and Long-Term Care.
Chronic Obstructive Pulmonary Disease (COPD) Care Canada Policy Workshop
PDF of a PowerPoint presentation by Dr. Michael Stickland, Associate Professor, Division of Pulmonary Medicine, University of Alberta; Heart & Stroke Foundation New Investigator.
Chronic Obstructive Pulmonary Disease (COPD) Care Canada Policy Workshop
PDF of a PowerPoint presentation by Dr. Simon Lessard, Quebec Lung Association Board & Scientific Committee Member, Community Pharmacist.
Chronic Obstructive Pulmonary Disease (COPD) Care Canada Policy Workshop
PDF of a PowerPoint presentation by Dr. Cathy Clelland, Head of Department of Family Practice, Royal Columbian Hospital; Consultant, General Practitioners Services Committee, British Columbia.
Chronic Obstructive Pulmonary Disease (COPD) Care Canada Policy Workshop
PDF of a PowerPoint presentation by Mr. Stephen Samis, Vice President, Programs, Canadian Foundation for Healthcare Improvement; and Dr. Graeme Rocker, Professor of Medicine, Dalhousie University; Faculty, Canadian Foundation for Healthcare Improvement.
Chronic Obstructive Pulmonary Disease (COPD) Care Canada Policy Workshop
| 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.
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…
| 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.
| Victoria Ung, Thanh Nguyen, Karen Wong, Karen Kroeker, Thomas Lee, Haili Wang, Arto Ohinmaa, Philip Jacobs, Richard Fedorak
BACKGROUND & AIMS: Infliximab is effective for induction and maintenance of response in patients with moderate to moderately severe ulcerative colitis. Previous cost analyses of infliximab treatment for ulcerative colitis used models of colectomy vs infliximab and response rates derived from early clinical trials. In real life, therapeutic options are more complex; patients…
| Arto Ohinmaa, Thanh Nguyen, Cheryl Barnabe, Liam Martin, Anthony Russell, Susan G Barr, Walter Maksymowych
OBJECTIVE: To provide Canadian estimates of health care utilization costs associated withrheumatoid arthritis (RA)-related and non-RA-related care within 4 treatment strategies and in different physical functioning categories.
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,…
| Cheryl Barnabe, Thanh Nguyen, Arto Ohinmaa, Joanne Homik, Susan G Barr, Liam Martin, Walter Maksymowych
OBJECTIVE: Sustained remission in rheumatoid arthritis (RA) results in healthcare utilizationcost savings. We evaluated the variation in estimates of savings when different definitions ofremission [2011 American College of Rheumatology/European League Against Rheumatism Boolean Definition, Simplified Disease Activity Index (SDAI) ≤ 3.3, Clinical Disease Activity Index…
Summary of Systematic Reviews, Primary Studies, and Evidence-based Guidelines. The following research questions were addressed in this review: What are the clinical effects of a universal screening strategy for ARO carriage when compared with no screening? What are the clinical effects of a universal screening strategy for ARO carriage when compared with targeted screening (screening…
Antibiotic-Resistant Organisms (AROs) are a serious health problem, though they are more prevalent in some settings than others. We were asked to make findings and develop recommendations on how to address surveillance of and screening for AROs in acute care hospitals. This consensus statement addresses these requests. However, confining the discussion and recommendations to hospitals…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report examines the potential role of low dose computed tomography (LDCT) in screening for lung cancer in adults aged 50 years or older in Alberta. Section Authors: Section One – Social and System Demographics Analysis: Bing Guo, Dagmara Chojecki Section Two –…
| 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;…
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 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…
| 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…
| 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…
Objective: To ascertain knowledge gaps in the diagnosis and treatment of acute and chronic low back pain (LBP) in the primary care setting to prepare a scoping survey for identifying knowledge gaps in LBP management among Alberta's primary care practitioners, and to identify potential barriers to implementing a multidisciplinary LBP guideline. Note: This is an Alberta Ambassador…
This background document outlines the methods used to develop the Alberta Clinical Practice Guideline (CPG) for the Evidence-Informed Primary Care Management of Low Back Pain, which was produced as part of the second phase of the Alberta Health Technology Assessment (HTA) Ambassador Program.
Link to Alberta Ambassador Guideline Adaptation Program
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…
The objective of this report is to assess research evidence on the safety and prognostic value of exercise testing (including electrocardiogram exercise testing and cardiopulmonary exercise testing) for the prediction of cardiac events in patients with chronic diseases including diabetes, chronic obstructive pulmonary disease (COPD), and arthritis. Information Specialist: Trish…
Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This report is about testing for Human Papillomavirus (HPV). HPV is one of the most common sexually transmitted infections and can also cause cervical cancer. Cervical screening aims to reduce cervical cancer incidence and mortality by detecting precancerous lesions early. Until…
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 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 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…
Alberta Heritage Foundation for Medical Research (AHFMR) Information Paper #26. The aim of this study was to determine whether laparoscopic adjustable gastric banding (LAGB) is a safe and effective procedure compared with open and/or laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic vertical banded gastroplasty (LVBG), especially in the longer term (> or = five…
Alberta Heritage Foundation for Medical Research (AHFMR) Information Paper #24. The objective of this paper is to present the current evidence on the efficacy/effectiveness and safety of celeoxib (Celebrex®) for the treatment of pain in patients with osteoarthritis (OA) and rheumatoid arthritis (RA). Information Specialist: Seana Collins NOTE: In 2006 the Alberta Heritage Foundation…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #35. The objective of this report is to assess the efficacy and safety of using trigger point injection (TPI) to treat patients with chronic non-malignant musculoskeletal pain, based on a systematic review of the current published evidence, and to determine the current state of the procedure, the feasibility of…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #30. Using the 1996 National Population Health survey data, this report provides an estimate of the prevalence of chronic pain (CP) among Albertans. It was estimated that 11.2% of Albertans suffer some level of CP and about 2.3% suffer from severe CP. As the proportion of individuals suffering from CP increases…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #29. The aim of this report was to present and critically appraise the published evidence on the prevalence of chronic non-malignant pain in the general population and the primary care setting. A secondary objective was to summarize all the available information in the primary studies about characteristics of pain…
| 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 #21. The three objectives of this assessment are to determine the available scientific evidence on: the effective time interval for mammography screening in asymptomatic women aged 50 to 69 years; the effective screening interval in asymptomatic women between the ages of 40 and 49 years; and the mortality rate…
Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #2. This paper is intended as a short overview of the effectiveness and status of a neurosurgical procedure, posteroventral pallidotomy (PVP), which is used in the treatment of some people with Parkinson's Disease. NOTE: In 2006 the Alberta Heritage Foundation for Medical Research HTA unit moved to IHE. Documents…