Development of an online tool to determine appropriateness for an epilepsy surgery evaluation.

Objectives: Despite evidence that epilepsy surgery is more effective than medical therapy, significant delays between seizure intractability and surgery exist. We aimed to develop a new Web-based methodology to assist physicians in identifying patients who might benefit from an epilepsy surgery evaluation.

Methods: The RAND/UCLA appropriateness method was used.

Does concordance between survey responses and administrative records differ by ethnicity for prescription medication?

Background: Self-reported prescription medication use data is often used to measure differences across ethnic groups, but its accuracy may differ across ethnic groups.

Objective: We compared ethnic groups' self-reported medication use to their administrative records for respondents with diabetes, hypertension, and asthma.

Methods: We linked the Canadian Community Health Survey to administrative prescription drug records for 17,191 respondents in British Columbia, Canada.

Monitoring and evaluating efforts to control hypertension in Canada: why, how, and what it tells us needs to be done about current care gaps.

Blood pressure surveillance, monitoring, and evaluation of programs to prevent and control hypertension are critical because increased blood pressure is a leading risk for premature death and disability. Since 2003, the Hypertension Outcomes Research Task Force has existed in Canada, with members who assist in the development and revision of surveys and conduct analyses that help guide hypertension programs. Although the Task Force has tracked a 5-fold increase in the control of hypertension (from 13% in 1985-1992 to 65% in 2007-2009), surveillance data also indicate that many "care gaps" remain.

Case definitions for acute myocardial infarction in administrative databases and their impact on in-hospital mortality rates.

Objective: To identify validated ICD-9-CM/ICD-10 coded case definitions for acute myocardial infarction (AMI).

Data Sources: Ovid Medline (1950-2010) was searched to identify studies that validated acute myocardial infarction (AMI) case definitions. Hospital discharge abstract data and chart data were linked to validate identified AMI definitions.

Development and validation of a case definition for epilepsy for use with administrative health data.

The objective of this study was to develop and validate coding algorithms for epilepsy using ICD-coded inpatient claims, physician claims, and emergency room (ER) visits. 720/2049 charts from 2003 and 1533/3252 charts from 2006 were randomly selected for review from 13 neurologists' practices as the "gold standard" for diagnosis. Epilepsy status in each chart was determined by 2 trained physicians.

Implementation of ICD-10 in Canada: how has it impacted coded hospital discharge data?

Background: The purpose of this study was to assess whether or not the change in coding classification had an impact on diagnosis and comorbidity coding in hospital discharge data across Canadian provinces.

Methods: This study examined eight years (fiscal years 1998 to 2005) of hospital records from the Hospital Person-Oriented Information database (HPOI) derived from the Canadian national Discharge Abstract Database. The average number of coded diagnoses per hospital visit was examined from 1998 to 2005 for provinces that switched from International Classifications of Disease 9(th) version (ICD-9-CM) to ICD-10-CA during this period.

A systematic review of interventions to increase breast and cervical cancer screening uptake among Asian women.

Background: The Asian population is one of the fastest growing ethnic minority groups in western countries. However, cancer screening uptake is consistently lower in this group than in the native-born populations. As a first step towards developing an effective cancer screening intervention program targeting Asian women, we conducted a comprehensive systematic review, without geographic, language or date limitations, to update current knowledge on the effectiveness of existing intervention strategies to enhance breast and cervical screening uptake in Asian women.

Appropriateness of the use of intravenous immune globulin before and after the introduction of a utilization control program.

Background: Intravenous immune globulin (IVIG) is an expensive and sometimes scarce blood product that carries some risk. It may often be used inappropriately. We evaluated the appropriateness of IVIG use before and after the introduction of an utilization control program to reduce inappropriate use.

Symptomatic in-hospital deep vein thrombosis and pulmonary embolism following hip and knee arthroplasty among patients receiving recommended prophylaxis: a systematic review.

Context: Symptomatic venous thromboembolism (VTE) after total or partial knee arthroplasty (TPKA) and after total or partial hip arthroplasty (TPHA) are proposed patient safety indicators, but its incidence prior to discharge is not defined.

Objective: To establish a literature-based estimate of symptomatic VTE event rates prior to hospital discharge in patients undergoing TPHA or TPKA.

Data Sources: Search of MEDLINE, EMBASE, and the Cochrane Library (1996 to 2011), supplemented by relevant articles.

Outcomes in young South Asian Canadians after acute myocardial infarction.

Background: South Asians have a high prevalence of ischemic heart disease and experience high incident acute myocardial infarction (AMI) rates at younger ages than their white counterparts. The aim of this study was to compare outcomes after AMI in a Canadian population of South Asian and white patients, aged 20 to 55 years.

Methods: Using hospital discharge abstract administrative data, we included patients with incident AMI, residing in British Columbia and the Calgary Health Region, between April 1, 1995 and March 31, 2002.

Association between chronic conditions and perceived unmet health care needs.

Background: Although effective treatments exist, many Canadians with chronic medical conditions do not receive the full care they require, possibly as a consequence of limited accessibility or availability. A commonly used indicator of inadequate access to or availability of care is the perception of unmet health care needs. The objective of this study was therefore to determine the association between chronic conditions and perceived unmet health care needs.

Changes of adult population health status in China from 2003 to 2008.

Objectives: The purpose of this study was to examine the change in health status of China's adult population between the years of 2003 and 2008 due to rapid economic growth and medical system improvement.

Methods: Data from the third and fourth Chinese national health services surveys covering 141,927 residents in 2003 and 136,371 residents in 2008 who were aged >18 years were analyzed.

Results: Chinese respondents in 2008 were more likely to report disease than in 2003.

Association between GFR, proteinuria, and adverse outcomes among White, Chinese, and South Asian individuals in Canada.

Background: We investigated the association between proteinuria, estimated glomerular filtration rate (eGFR), and risk of mortality and kidney failure in white, Chinese, and South Asian populations.

Study Design: Population-based cohort study.

Setting & Participants: Participants from Alberta, Canada, with a serum creatinine and urine protein dipstick measurement from January 1, 2005, to December 31, 2005.

Diagnosed hypertension in Canada: incidence, prevalence and associated mortality.

Background: Hypertension is a leading risk factor for cardiovascular diseases. Our objectives were to examine the prevalence and incidence of diagnosed hypertension in Canada and compare mortality among people with and without diagnosed hypertension.

Methods: We obtained data from linked health administrative databases from each province and territory for adults aged 20 years and older.

Reduced health resource use after acupuncture for low-back pain.

Objectives: Acupuncture is commonly used to treat low-back pain (LBP) and clinical trials have demonstrated its efficacy. However, less is known about how the utilization of acupuncture impacts public health service utilization in the real world. This study investigates the association between acupuncture utilization for LBP and health care utilization by assessing whether patients who undergo acupuncture subsequently use fewer health care resources and whether those patients differ in their health care use from the general population with LBP.

Canadian pregnancy outcomes in rheumatoid arthritis and systemic lupus erythematosus.

Objective. To describe obstetrical and neonatal outcomes in Canadian women with rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE). Methods.

Validating a case definition for chronic kidney disease using administrative data.

Background: Administrative data are commonly used for surveillance of chronic medical conditions. The purpose of this study was to determine the validity of an algorithm derived from administrative data for identifying chronic kidney disease (CKD) compared to the reference standard of estimated glomerular filtration rate (eGFR).

Methods: We identified adults from the province of Alberta with at least two outpatient serum creatinine measurements within a 1-year time period.

Temporal associations of early patient transfers and mortality with the implementation of a regional myocardial infarction care model.

Background: In order to reduce the delays encountered through patient transfer, regional care models have been developed that directly transport subsets of acute myocardial infarction (AMI) patients to hospitals with percutaneous coronary intervention (PCI) facilities. Calgary is a Canadian city that implemented this type of model in 2004.

Methods: The study population included 9768 AMI patients admitted to Calgary hospitals between 1997 and 2007.

Development of an epilepsy-specific risk adjustment comorbidity index.

Purpose: To develop an epilepsy-specific comorbidity risk adjustment index for mortality outcomes research.

Methods: Data were extracted from five linked administrative databases in Calgary, Canada from April 1, 1996 to March 31, 2004. Epilepsy patients were defined using a validated ICD-9-CM- and ICD-10-CA-based case definition.

Building knowledge about health services utilization by refugees.

The objective of this study was to compare the utilization of outpatient physician, emergency department and hospital services between refugees and the general population in Calgary, Alberta. Data was collected on 2,280 refugees from a refugee clinic in Calgary and matched with 9,120 non-refugees. Both groups were linked to Alberta Health and Wellness administrative data to assess health services utilization over 2 years.

Cardiac medication prescribing and adherence after acute myocardial infarction in Chinese and South Asian Canadian patients.

Background: Failure to adhere to cardiac medications after acute myocardial infarction (AMI) is associated with increased mortality. Language barriers and preference for traditional medications may predispose certain ethnic groups at high risk for non-adherence. We compared prescribing and adherence to ACE-inhibitors (ACEI), beta-blockers (BB), and statins following AMI among elderly Chinese, South Asian, and Non-Asian patients.

Ethnic differences in the use of prescription drugs: a cross-sectional analysis of linked survey and administrative data.

Background: Evidence from the United States and Europe suggests that the use of prescription drugs may vary by ethnicity. In Canada, ethnic disparities in prescription drug use have not been as well documented as disparities in the use of medical and hospital care. We conducted a cross-sectional analysis of survey and administrative data to examine needs-adjusted rates of prescription drug use by people of different ethnic groups.

The Model for End-stage Liver Disease accurately predicts 90-day liver transplant wait-list mortality in Atlantic Canada.

Objective: To determine the generalizability of the predictions for 90-day mortality generated by Model for End-stage Liver Disease (MELD) and the serum sodium augmented MELD (MELDNa) to Atlantic Canadian adults with end-stage liver disease awaiting liver transplantation (LT).

Methods: The predictive accuracy of the MELD and the MELDNa was evaluated by measurement of the discrimination and calibration of the respective models' estimates for the occurrence of 90-day mortality in a consecutive cohort of LT candidates accrued over a five-year period. Accuracy of discrimination was measured by the area under the ROC curves.

Improved accuracy of co-morbidity coding over time after the introduction of ICD-10 administrative data.

Background: Co-morbidity information derived from administrative data needs to be validated to allow its regular use. We assessed evolution in the accuracy of coding for Charlson and Elixhauser co-morbidities at three time points over a 5-year period, following the introduction of the International Classification of Diseases, 10th Revision (ICD-10), coding of hospital discharges.

Methods: Cross-sectional time trend evaluation study of coding accuracy using hospital chart data of 3'499 randomly selected patients who were discharged in 1999, 2001 and 2003, from two teaching and one non-teaching hospital in Switzerland.