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This health evidence review assesses the clinical effectiveness and economic impact of various vascular risk reduction (VRR) initiatives that have been implemented in Alberta, and promising new initiatives, to inform priority-setting decisions regarding risk-reduction initiatives. The assessment also examines the clinical benefit that future projects would need to achieve for them…

This health evidence review assesses strategies for the delivery of high-quality and cost-effective stroke rehabilitation care in Alberta to inform decisions about how the province might increase care capacity for stroke rehabilitation services and maximize the benefits of effective treatment interventions. The review assesses two novel approaches to the delivery of high-quality…

The clinical review and economic evaluation aimed to determine how Oncotype DX and Prosigna can be optimally used to determine which patients with early-stage breast cancer will benefit from adjuvant chemotherapy. This report addresses the following research question: For patients with early-stage (I–III), ER+, HER2?, node-negative or node-positive (one to three nodes) breast…

This evidence-based report examines expanding the role of paramedics in the community. It summarizes the various types of community paramedicine programs (characteristics, implementation, and funding sources in other jurisdictions) as well as the safety, effectiveness, and economic outcomes of these paramedic programs towards providing patients with alternate, non-emergency health…

Alberta STE Report written under contract with the Alberta Health Technologies Decision Process (AHTDP). This STE report examines the social and system demographics, technological safety and therapeutic efficacy/effectiveness, cost-effectiveness, and budget impact of endovascular therapy for acute ischemic stroke, contextualized to the Alberta setting. Section Authors: Section…

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…

Presenteeism, reduced productivity while working, has come into consideration as a major occupational health problem in many countries with serious consequences for both organizations and employees. Increasing evidence shows that presenteeism represents a significant source of productivity losses that can cost organizations much more than does absenteeism, and it can lead to an…

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,…

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 –…

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…

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…

  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 review considers the evidence of benefit from use of telerehabilitation (TRH) from studies that had clinical or administrative outcomes.

This health technology assessment report 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. Information Specialist: Liz Dennett

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…

The purpose of this report is to advance the area of workplace mental health through a comprehensive synthesis of published research evidence. More specifically, this report examines the evidence on the effectiveness of organizational-level interventions for the prevention of stress in the workplace for adult employees without diagnosed mental illness. The main effectiveness outcomes…

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…

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 report compares the use of telemental health services in Canada and Finland, focusing specifically on the use of videoconferencing. Information Specialist: Janice Varney

Evidence of benefit from telemental health applications: a systematic review. This review considers the evidence of benefit from use of telemental health (TMH) in studies that had clinical, economic, or administrative outcomes. The review also includes studies that provided information on the accuracy or feasibility of TMH. Information Specialist: Janice Varney

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 #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…

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) 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 #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 #34. This report reviews the literature on assessment of telecardiology, considering applications in pediatric care, hospital or clinic use for adults, emergency care, and home care. Information Specialist: Seana Collins NOTE: In 2006 the Alberta Heritage Foundation for Medical Research HTA unit moved to IHE. Documents…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report. In this systematic review, we have critically reviewed the literature addressing the social, legal and ethical issues related to genetic testing for cancer susceptibility, synthesized current information and identified existing gaps in knowledge. We believe the review will prove valuable to policy- and decision-makers…

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…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #32. The aim of this report was to critically appraise and synthesise the published evidence regarding the short- and long-term efficacy/effectiveness of surgical techniques for patients with deep venous incompetence, and attendant skin changes/ulceration, that is refractory to standard care. Information Specialist:…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #31. This report was prepared in response to a request from Alberta Health and Wellness (AHW) for information about the use of islet cell transplantation for patients with type 1 diabetes. AHW was specifically interested in the current status of islet cell transplantation using the Edmonton protocol for a sub-population…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #28. This report provides an overview of the evidence from systematic reviews on the effectiveness of suicide prevention strategies. 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…

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…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #27. This project is Part II of a request from several Regional Health Authorities and Alberta Health and Wellness, regarding two key objectives: to present information on the regulation of acupuncture in Alberta, including the scope of practice and coverage of services; and to conduct a systematic review of current…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #26. Given the very broad range of suicide prevention strategies, it is unrealistic to cover all of them in this report. Thus, the main focus of this review is to present the findings from primary research that assessed the efficacy/effectiveness of suicide prevention programs on school aged children and youth…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #25. This report is a systematic review of the literature on the use of computerized electrocardiogram (ECG) interpretation for detecting heart conditions as a part of routine medical examinations in healthy adults. The aim of this report is to inform practitioners and other interested parties on the available…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #24. This report has been produced in response to a request from Alberta Health and Wellness for an update on the use of vagus nerve stimulation (VNS) for refractory epilepsy. The intent was to inform health policy makers, medical practitioners, and the public on the current status of the use of VNS for refractory…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #23. This report is a systematic review and critical appraisal of the literature on the use of formal outpatient diabetes education as a therapeutic tool for self-management in adult patients with type 2 diatetes. It has been prepared to provide information to the Capital Health Authority in Alberta, Canada and…

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 #18. This report has been prepared following interest by the Alberta Cord Blood Bank in obtaining advice on the comparative effectiveness and costs of different types of stem cell transplantation. Earlier assessments by the Foundation have considered peripheral blood stem cell transplantation and cord blood transplantation.…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #17. The present report has been prepared as a follow up to the previous assessment because of continued interest in the technology by the health ministry and others. It considers studies that have been reported in the literature since completion of the earlier assessment (1997-1999) and focuses on the efficacy…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #20. This report presents data from the telepsychiatry program subsequent to the pilot project. The assessment of telepsychiatry beyond the pilot project stage had two primary focuses: a) to develop and document information collection systems initiated during the pilot project evaluation, and b) to assess the operation…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #19. A request for information about the use of low level laser therapy (LLLT) to assist wound healing was received from the Capital Health Authority (CHA). This technology has been increasingly used within the Edmonton area, with somewhat different approaches being taken by individual operators. The concern was…

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 #15. The present health technology assessment report has been prepared following a request by Alberta Health and Wellness for additional information on the use of stereotactic radiosurgery (SRS) in the treatment of acoustic neuroma, one of the applications considered in an earlier publication on SRS. Two main issues…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #14. This report has been prepared because of the interest by the Consumers' Association of Canada and the Health Ministry in the increasing use of newer types of intraocular lenses (IOLs) and in their comparative advantage. The focus of the report is on the safety, efficacy and effectiveness of the three types…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #13. This assessment has been prepared in view of the interest at the University of Alberta Hospital in developing a cord blood banking facility in the province and to provide information to decision makers on the current status of cord blood transplantation (CBT). The principal purpose of the assessment was to…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #12. This report has been prepared following a request from the provincial Clinical Practice Guidelines Program for information on the accuracy of diagnostic tests for the detection of bacterial vaginosis (BV), vulvovaginal candidiasis (VVC) and trichomoniasis in females of reproductive age. The intention of this…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #11. This report has been prepared in view of the increasing interest in ultrasound technology for diagnosis of osteoporosis. Until recently, quantitative ultrasound (QUS) was mainly being used in research settings. This procedure is still not covered by provincial fee schedules. The recent FDA pre-marketing approvals…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #10. This report has been prepared as part of a project to assess the role of high cost functional diagnostic imaging (FDI) and related methods in routine health care. In the present paper, the potential application of four FDI methods to the management of epilepsy is considered. The assessment considered the current…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #8. This report has been prepared to provide information to health authorities and others on the available evidence on effectiveness of HBOT and the possible economic impact on health care should a second HBO facility be established in the province. Issues addressed in the report include: Whether HBOT has been…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #9. The present report has been prepared following a request by Alberta Health in relation to referral of patients outside the province for treatment with stereotactic radiosurgery (SRS). There was interest by the department in the comparative effectiveness of the two main approaches to SRS (GK and LINAC) and in…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #7. This assessment was undertaken at the request of a Regional Health Authority to provide input into a funding decision on a computerized dynamic posturography (CDP) system for use by a rehabilitation department. The focus of this study was restricted to the clinical use of CDP by the rehabilitation community.…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #6. This report provides details of a telepsychiatry pilot project undertaken by the Provincial Mental Health Advisory Board-Central Alberta (PMHAB) in cooperation with four Regional Health Authorities. It supplements an earlier report issued by the Board describing the pilot project evaluation and has been prepared…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #5. This assessment of computerized gait analysis in the management of children with cerebral palsy (CP) or spina bifida (SB) has been prepared at the request of the Glenrose Hospital, Edmonton. The hospital has already undertaken developmental work towards establishing a gait analysis facility. Advice was sought…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #4. This outline of issues in the assessment of telehealth is intended as a resource document for health care funders, providers and administrators. Health authorities and others in Alberta face decisions on the procurement and use of this information and communication technology. Such decisions should be informed…

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…

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…

Alberta Heritage Foundation for Medical Research (AHFMR) HTA Report #1. This report has been prepared to provide information and assist discussion on the management of pressure sores, a significant source of morbidity in health care institutions. The focus of the report is on a specific technology, interface pressure measurement. It is expected that other issues in this are will…