Poor agreement among asthma specialists on the choice and timing of initiation of a biologic treatment for severe asthma patients.

Background: As the number of monoclonal antibodies available for severe asthma is growing, specialists currently choose without clear guidelines. Despite increasing knowledge on treatment response to these monoclonal antibodies, making the optimal choice for each individual patient remains a challenge. However, evidence of this daily challenge is lacking.

Development and usability testing of a multifaceted intervention to reduce low-value injury care.

Background: Multifaceted interventions that address barriers and facilitators have been shown to be most effective for increasing the adoption of high-value care, but there is a knowledge gap on this type of intervention for the de-implementation of low-value care. Trauma is a high-risk setting for low-value care, such as unnecessary diagnostic imaging and the use of specialized resources. The aim of our study was to develop and assess the usability of a multifaceted intervention to reduce low-value injury care.

Direct medical costs of cardiovascular diseases: Do cost components vary according to sex and age?

Background: The aim was to estimate direct medical costs of men and women patients by age group related to cardiovascular diseases (coronary heart disease, strokes) in the province of Quebec, Canada from the economic perspective of the healthcare public system, encompassing five cost components: physician fees, hospitalization (hospital stay, intensive care stay), emergency visits and medication costs.

Methods: This matched case-control study involved secondary data from a longitudinal cohort study (1997-2018) of 4584 white-collar workers. Participants were followed for a four-year period.

Adaptation of a standardized self-reported cost questionnaire specific for the severe burn injury population (BI-CoPaQ).

Severe burn injuries (SBIs) are known to pose a significant burden on patients, caregivers, and the healthcare system. Yet, scarce data on the short and long-term clinical and economic impacts of these injuries limit the development of evidence-informed strategies and policies to better care for these patients. To fill in this gap, we adapted a previously validated self-reported out-of-pocket cost measurement questionnaire, the Cost for Patients Questionnaire (CoPaQ), to the severe burn injury survivor context.

Development of a Canadian Guidance for reporting real-world evidence for regulatory and health-technology assessment (HTA) decision-making.

Background And Objective: Real-world evidence (RWE) can complement and fill knowledge gaps from randomized controlled trials to assist in health-technology assessment (HTA) for regulatory decision-making. However, the generation of RWE is an intricate process with many sequential decision points, and different methods and approaches may impact the quality and reliability of evidence. Standardization and transparency in reporting these decisions is imperative to appraise RWE and incorporate it into HTA decision-making.

Evaluation and comparison of covariate balance metrics in studies with time-dependent confounding.

Marginal structural models have been increasingly used by analysts in recent years to account for confounding bias in studies with time-varying treatments. The parameters of these models are often estimated using inverse probability of treatment weighting. To ensure that the estimated weights adequately control confounding, it is possible to check for residual imbalance between treatment groups in the weighted data.

Costs of Presenteeism and Absenteeism Associated With Psychological Distress Among Male and Female Older Workers: A Cross-sectional Study.

Objective: We estimated, for women and men (1) the associations between psychological distress and the prevalences of presenteeism and absenteeism, (2) average hours lost annually per person, and (3) costs from the employers' economic perspective.

Methods: Participants were 1292 Canadian white-collar workers. Psychological distress, presenteeism, and absenteeism were assessed with validated questionnaires.

Strategies aiming to improve statin therapy adherence in older adults: a systematic review.

Background: Randomized clinical trials have shown that, under optimal conditions, statins reduce the risk of cardiovascular events in older adults. Given the prevalence and consequences of suboptimal adherence to statin among older adults, it is essential to document strategies designed to increase statin adherence in this population. The objective of this systematic review is to describe and summarize the effectiveness of interventions to improve statin adherence in older adults (≥ 65 years old).

Value-based comparison of ambulatory children with respiratory diseases in an emergency department and a walk-in clinic: a retrospective cohort study in Québec, Canada.

Objective: To compare health outcomes and costs given in the emergency department (ED) and walk-in clinics for ambulatory children presenting with acute respiratory diseases.

Design: A retrospective cohort study.

Setting: This study was conducted from April 2016 to March 2017 in one ED and one walk-in clinic.

Implementation of an audit and feedback module targeting low-value clinical practices in a provincial trauma quality assurance program: a cost-effectiveness study.

Background: Audit and Feedback (A&F) interventions based on quality indicators have been shown to lead to significant improvements in compliance with evidence-based care including de-adoption of low-value practices (LVPs). Our primary aim was to evaluate the cost-effectiveness of adding a hypothetical A&F module targeting LVPs for trauma admissions to an existing quality assurance intervention targeting high-value care and risk-adjusted outcomes. A secondary aim was to assess how certain A&F characteristics might influence its cost-effectiveness.

The economic burden of burned patients for hospitalization in Canada.

Background: Burn injuries pose a significant burden on both patients and healthcare systems. Yet, costs arising from the consumption of resources by these patients are rarely examined in Canada.

Objective: The objective of this study was to assess real-world costs resulting from the initial hospitalization of patients admitted to a major burn unit in Quebec, Canada.

Development of a Patient-Reported Experience Measure Tool for Ambulatory Patients With Acute Unexpected Needs: The APEX Questionnaire.

The aim of this study was to develop a patient-reported experience measure (PREM) for comparing the experience of care received by ambulatory patients with acute unexpected needs presenting in emergency departments (EDs), walk-in clinics, and primary care practices. The Ambulatory Patient EXperience (APEX) questionnaire was developed using a 5-phase mixed-methods approach. The questionnaire was pretested by asking potential users to rate its clarity, usefulness, redundancy, content and face validities, and discrimination on a 9-point scale (1 = strongly disagree to 9 = strongly agree).

Brown adipose tissue metabolism in women is dependent on ovarian status.

In rodents, loss of estradiol (E) reduces brown adipose tissue (BAT) metabolic activity. Whether E impacts BAT activity in women is not known. BAT oxidative metabolism was measured in premenopausal ( = 27; 35 ± 9 yr; body mass index = 26.

Exploring the Prevalence of Post-traumatic Stress Disorder and Post-traumatic Stress Symptoms in Parents Within 12 Months of Child Burn Injury: A Systematic Review.

Our systematic review aimed to investigate the prevalence of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) among parents within 12 months of their child's burn injury. A literature search was conducted in PubMed, Embase, Web of Science, Psychinfo, and CINAHL on January 6, 2023, for quantitative studies reporting the prevalence of PTSD and/or PTSS in parents within 12 months following their child's burn injury. The risk of bias was assessed using the Mixed Methods Appraisal Tool version 2018.

Effect of statin use for the primary prevention of cardiovascular disease among older adults: a cautionary tale concerning target trials emulation.

Objectives: Evidence concerning the effect of statins in primary prevention of cardiovascular disease (CVD) among older adults is lacking. Using Quebec population-wide administrative data, we emulated a hypothetical randomized trial including older adults >65 years on April 1, 2013, with no CVD history and no statin use in the previous year.

Study Design And Setting: We included individuals who initiated statins and classified them as exposed if they were using statin at least 3 months after initiation and nonexposed otherwise.

Methods used to account for caregivers' sex and gender within studies examining the financial burden of caregivers of children and adolescents : Results from a scoping review.

Background: Interest in the financial burden of informal caregivers has been growing. Unfortunately, it remains unclear which method(s) should be used when quantifying this burden.

Purpose: We conducted a scoping review aimed at identifying which methods have been used to conduct such work and quantified their performance.

Canadian trends in spending on liver hospitalizations and transplants: 2004-2020.

Background: The incidence and prevalence of liver disease are increasing and contribute to significant morbidity and mortality. In Canada, more than 3 million people live with liver diseases, accounting for approximately 2% of all hospitalizations. However, it remains unclear how much liver hospitalizations cost the Canadian health care system.

Postpandemic Evaluation of the Eco-Efficiency of Personal Protective Equipment Against COVID-19 in Emergency Departments: Proposal for a Mixed Methods Study.

Background: The COVID-19 pandemic has had a profound impact on emergency department (ED) care in Canada and around the world. To prevent transmission of COVID-19, personal protective equipment (PPE) was required for all ED care providers in contact with suspected cases. With mass vaccination and improvements in several infection prevention components, our hypothesis is that the risks of transmission of COVID-19 will be significantly reduced and that current PPE use will have economic and ecological consequences that exceed its anticipated benefits.

Marginal structural models with latent class growth analysis of treatment trajectories: Statins for primary prevention among older adults.

Latent class growth analysis is increasingly proposed as a solution to summarize the observed longitudinal treatment into a few distinct groups. When latent class growth analysis is combined with standard approaches like Cox proportional hazards models, confounding bias is not properly addressed because of time-varying covariates that have a double role of confounders and mediators. We propose to use latent class growth analysis to classify individuals into a few latent classes based on their medication adherence pattern, then choose a working marginal structural model that relates the outcome to these groups.

Integration of primary contact physiotherapists in the emergency department for individuals presenting with minor musculoskeletal disorders: Protocol for an economic evaluation.

Objectives: 1) To compare the average cost of an emergency department (ED) visit for various minor musculoskeletal disorders between two models of care (physiotherapist and ED physician or ED physician alone); 2) To evaluate the incremental cost-effectiveness ratio (ICER) of these two models of care over a 3-month period post-initial visit; and 3) To estimate the ICER of three ED models of care (physiotherapist and ED physician, ED physician alone, physiotherapist alone) over a two-year period.

Methods: Obj.1: The costs incurred by participants in the two groups during their ED visit will be calculated using the Time-Driven Activity-Based Costing (TDABC) method.