Using a Common Form for Consistent Collection and Reporting of FASD Data from Across Canada: A Feasibility Study.

Background: This study was undertaken to determine the feasibility of collecting information on individuals newly diagnosed with Fetal Alcohol Spectrum Disorder (FASD) in multi-disciplinary diagnostic programs across Canada.

Objective: To determine the frequencies of specific diagnoses within the spectrum, the frequencies and patterns of specific functional deficits, and the range of recommendations made for intervention and management for children and adults.

Methods: All qualifying clinics in Canada were invited to join this project and complete questionnaires on the patients that were seen during the research period.

The Relationship Between Dermatologist- and Patient-Reported Acne Severity Measures and Treatment Recommendations.

Background: Acne treatment recommendations for individual patients may be derived from multiple factors including dermatologist- and patient-reported constructs.

Objectives: To evaluate the effects of dermatologist- and patient-reported measures on acne treatment recommendations by dermatologists.

Methods: An observational cross-sectional survey of acne patients was conducted with patient-reported quality of life and dermatologist-reported measures of primary and secondary (scar) acne severity using 3 assessment approaches: maximal regional grade, total grade, and facial grade.

Evaluation of a chronic disease management system for the treatment and management of diabetes in primary health care practices in Ontario: an observational study.

Background: Computerized chronic disease management systems (CDMSs), when aligned with clinical practice guidelines, have the potential to effectively impact diabetes care.

Objective: The objective was to measure the difference between optimal diabetes care and actual diabetes care before and after the introduction of a computerized CDMS.

Methods: This 1-year, prospective, observational, pre/post study evaluated the use of a CDMS with a diabetes patient registry and tracker in family practices using patient enrolment models.

Effect of provider and patient reminders, deployment of nurse practitioners, and financial incentives on cervical and breast cancer screening rates.

Objective: To evaluate the effect of the Provider and Patient Reminders in Ontario: Multi-Strategy Prevention Tools (P-PROMPT) reminder and recall system and pay-for-performance incentives on the delivery rates of cervical and breast cancer screening in primary care practices in Ontario, with or without deployment of nurse practitioners (NPs).

Design: Before-and-after comparisons of the time-appropriate delivery rates of cervical and breast cancer screening using the automated and NP-augmented strategies of the P-PROMPT reminder and recall system.

Setting: Southwestern Ontario.

Community mobilization, participation, and blood pressure status in a Cardiovascular Health Awareness Program in Ontario.

Purpose: To determine the feasibility of a community-wide approach integrated with primary care (Cardiovascular Health Awareness Program [CHAP]) to promote monitoring of blood pressure (BP) and awareness of cardiovascular disease risk.

Design: Demonstration project.

Setting: Two midsized Ontario communities.

Impact of a computerized system for evidence-based diabetes care on completeness of records: a before-after study.

Background: Physicians practicing in ambulatory care are adopting electronic health record (EHR) systems. Governments promote this adoption with financial incentives, some hinged on improvements in care. These systems can improve care but most demonstrations of successful systems come from a few highly computerized academic environments.

Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review.

Background: The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations).

Methods: We conducted a decision-maker-researcher partnership systematic review.

Computerized clinical decision support systems for primary preventive care: a decision-maker-researcher partnership systematic review of effects on process of care and patient outcomes.

Background: Computerized clinical decision support systems (CCDSSs) are claimed to improve processes and outcomes of primary preventive care (PPC), but their effects, safety, and acceptance must be confirmed. We updated our previous systematic reviews of CCDSSs and integrated a knowledge translation approach in the process. The objective was to review randomized controlled trials (RCTs) assessing the effects of CCDSSs for PPC on process of care, patient outcomes, harms, and costs.

Development and validation of a Scale for Acne Scar Severity (SCAR-S) of the face and trunk.

Background: scarring is an important component of overall acne severity, but there are no global scales for its evaluation inclusive of the face and trunk.

Objective: our objective was to develop a global scale for acne scar severity inclusive of the trunk and the face.

Methods: a six-category global severity scale (SCAR-S) was developed for assessment of acne scarring at each of the face, chest, and back.

Detection of cognitive impairment and dementia using the animal fluency test: the DECIDE study.

Objectives: To evaluate the performance of a one-minute screening test measured against a validated 10-minute screening test for mild cognitive impairment (MCI) in detecting CI in patients aged > or = 65 years with two or more vascular risk factors (VRF).

Methods: Patients (n=1523) aged 65 years or older without documented CI symptoms or dementia with two or more VRF participated in this study set in Canadian primary care practice. Baseline data was collected, followed by the 1-minute animal fluency (AF) test and the 10-minute Montreal Cognitive Assessment (MoCA).

Effect of quality of life impact and clinical severity on adherence to topical acne treatment.

Background: Topical medications are the most commonly prescribed treatments for acne patients. However, adherence to these treatments and possible associations with clinical severity and quality of life (QoL) impact are unclear.

Purpose: We evaluated the association between sociodemographic factors, clinical severity, and QoL impact and adherence to topical acne treatments.

Women's views on reminder letters for screening mammography: Mixed methods study of women from 23 family health networks.

Objective: To explore women's perspectives on the acceptability and content of reminder letters for screening mammography from their family physicians, as well as such letters' effect on screening intentions.

Design: Cross-sectional mailed survey followed by focus groups with a subgroup of respondents.

Setting: Ontario.

Limitations of statin monotherapy for the treatment of dyslipidemia: a projection based on the Canadian lipid study--observational.

Objective: Several randomized controlled trials indicate that a low density lipoprotein cholesterol (LDL-C) target <2.0 mmol/L is appropriate for individuals at high risk of coronary artery disease (CAD). Recently released Canadian lipid management guidelines (2006) have incorporated this evidence into their recommendations.

Heart and Stroke Foundation of Ontario (HSFO) high blood pressure strategy's hypertension management initiative study protocol.

Background: Achieving control of hypertension prevents target organ damage at both the micro and macrovascular level and is a highly cost effective means of lowering the risk for heart attack and stroke particularly in people with diabetes. Clinical trials demonstrate that blood pressure control can be achieved in a large proportion of people. Translating this knowledge into widespread practice is the focus of the Hypertension Management Initiative, which began in 2004 with the goal of improving the management of this chronic health condition by primary care providers and patients in the community.

Divergence of demographic factors associated with clinical severity compared with quality of life impact in acne.

Background: Previous smaller studies suggest that age, gender, and duration of acne may individually be associated with clinical acne severity and quality of life (QoL) impact.

Objective: Our purpose was to concurrently evaluate the association of demographic factors with clinical acne severity and with QoL impact.

Methods: Clinical acne severity was assessed using the Investigators Global Assessment, whereas QoL impact was evaluated by the patient-completed Acne-QoL.

Enhancing hypertension awareness and management in the elderly: lessons learned from the Airdrie Community Hypertension Awareness and Management Program (A-CHAMP).

Background: High blood pressure (BP) is an established and modifiable cardiovascular risk factor; however, awareness and management of this primarily asymptomatic disease remains suboptimal.

Objectives: The Airdrie Community Hypertension Awareness and Management Program (A-CHAMP) was a community-based BP program for seniors designed to improve public and health care provider awareness and management of hypertension.

Methods: Volunteer peer health educators (VPHEs) were recruited from the community and trained to manage BP screening sessions in local pharmacies.

Prevalence and severity of facial and truncal acne in a referral cohort.

Background: There is a paucity of information on the prevalence and severity of acne of the face, chest, and back.

Purpose: This study was designed to examine the prevalence and severity of acne on the face, chest, and back in a referral cohort of patients with acne using a validated global acne severity scale.

Methods: Acne patients referred to dermatologists were evaluated at the face, chest, and back.

Patient views on reminder letters for influenza vaccinations in an older primary care patient population: a mixed methods study.

Objectives: To explore the perspectives of older adults on the acceptability of reminder letters for influenza vaccinations.

Methods: We randomly selected 23 family physicians from each Family Health and Primary Care network participating in a demonstration project designed to increase the delivery of preventive services in Ontario. From the roster of each physician, we surveyed 35 randomly selected patients over 65 years of age who recently received a reminder letter regarding influenza vaccinations from their physician.

Cardiovascular Health Awareness Program (CHAP): a community cluster-randomised trial among elderly Canadians.

Objective: High blood pressure is an important and modifiable cardiovascular disease risk factor that remains under-detected and under-treated. Community-level interventions that address high blood pressure and other modifiable risk factors are a promising strategy to improve cardiovascular health in populations. The present study is a community cluster-randomised trial testing the effectiveness of CHAP (Cardiovascular Health Awareness Program) on the cardiovascular health of older adults.

Practice patterns in the management of chronic obstructive pulmonary disease in primary practice: the CAGE study.

Background: The information on usual care for patients with chronic obstructive pulmonary disease (COPD) in primary care is limited in Canada.

Objective: To evaluate primary care practice in patients with COPD in Quebec and Ontario compared with recommended care.

Methods: The COPD Care Gap Evaluation (CAGE) was a prospective, cross-sectional study.

Practice and physician characteristics associated with influenza vaccination delivery rates following a patient reminder letter intervention.

As part of the "Provider and Patient Reminders in Ontario: Multi-strategy Prevention Tools" demonstration project, the purpose of this study was to explore the practice and physician characteristics associated with influenza vaccination rates following a reminder letter intervention for patients 65 years of age and older. Using a sample of 179 physicians, we estimated a multiple linear regression model to examine variables predictive of vaccination delivery rates. Several provider characteristics, including certification with the College of Family Physicians of Canada and practicing in an urban area, were predictive of the success of the reminder letter campaign.

Development and validation of a comprehensive acne severity scale.

Background: Although more than 25 acne grading systems exist, only 2 are inclusive of truncal acne. There is neither a gold standard nor a consistently used standardized system.

Purpose: Our purpose was to develop and validate an acne grading system incorporating severity at the face, chest, and back.

Is There a Tension between Clinical Practice and Reimbursement Policy? The Case of Osteoarthritis Prescribing Practices in Ontario.

Background: Reimbursement policies, such as those used to manage the public drug program for senior citizens in Ontario, focus on providing access to cost-effective drug therapies. These policies may create a dilemma for physicians who want to prescribe a particular drug to a patient, but must factor reimbursement restrictions affecting patient-level access into the prescribing decision.

Methods: Information was collected from 102 physicians about prescriptions given to osteoarthritis patients (n=2,147) aged 65 years or older.

Acceptability of reminder letters for Papanicolaou tests: a survey of women from 23 Family Health Networks in Ontario.

Objective: To explore women's perspectives on the acceptability and content of reminder letters from the family physician for Papanicolaou (Pap) test screening and the effect of reminder letters on compliance with screening recommendations.

Methods: A population-based survey was conducted in 23 Family Health Networks and Primary Care Networks participating in a demonstration project to increase the delivery of preventive services in Ontario. Questionnaires were mailed to randomly selected women aged 35 to 69 years who had received a reminder letter for a Pap test from their family physician within the previous six months.

Influence of decision aids on patient preferences for anticoagulant therapy: a randomized trial.

Background: Decision aids have been shown to be useful in selected situations to assist patients in making treatment decisions. Important features such as the format of decision aids and their graphic presentation of data on benefits and harms of treatment options have not been well studied.

Methods: In a randomized trial with a 3 x 2 factorial design, we investigated the effects of decision aid format (decision board, decision booklet with audiotape, or interactive computer program) and graphic presentation of data (pie graph or pictogram) on patients' comprehension and choices of 3 treatments for anticoagulation, identified initially as "treatment A" (warfarin), "treatment B" (acetylsalicylic acid) and "treatment C" (no treatment).