Predicting 30-day risk from benzodiazepine/Z-drug dispensations in older adults using administrative data: A prognostic machine learning approach.

Objective: To develop a machine-learning (ML) model using administrative data to estimate risk of adverse outcomes within 30-days of a benzodiazepine (BZRA) dispensation in older adults for use by health departments/regulators.

Design, Setting And Participants: This study was conducted in Alberta, Canada during 2018-2019 in Albertans 65 years of age and older. Those with any history of malignancy or palliative care were excluded.

Predicting 30-Day Readmissions in Patients With Heart Failure Using Administrative Data: A Machine Learning Approach.

Background: We sought to develop machine learning (ML) models trained on administrative data which predict risk of readmission in patients with heart failure and to evaluate and compare the ML model with the currently used LaCE score using clinically informative metrics.

Methods And Results: This prognostic study was conducted in Alberta, Canada, on 9845 patients with confirmed heart failure admitted to hospital between 2012 and 2019. The outcome was unplanned all-cause hospital readmission within 30 days of discharge.

The use of patient-reported outcome measures in primary care: applications, benefits and challenges.

PROMs use in primary care has expanded from simply describing patient populations to contributing to decision-making, in response to the increasingly complex, ever-changing healthcare environment. In Alberta, primary care is organized into primary care networks (PCNs), where family physicians are grouped geographically and supported by allied health professionals. PCNs implement programs and services in response to local population health needs with frequent evaluation, often incorporating PROMs for this purpose.

The relationship between individual-level deprivation and health-related quality of life.

Objective: To examine the association between individual-level deprivation and health-related quality of life (HRQL) in the general population.

Methods: Data from a population-based survey in the Canadian province of Alberta were used. Individual-level deprivation was assessed using the Canadian Deprivation Index (CDI) and the Ontario Deprivation Index (ODI).

Discriminative validity of the EQ-5D-5 L and SF-12 in older adults with arthritis.

Background: The EQ-5D-5 L and the SF-12 are the most commonly used generic measures of health-related quality of life among people with arthritis. However, there is little evidence on the extent to which the individual dimensions and domains of these instruments perform among this population. The objective was to examine the discriminative validity of the EQ-5D-5 L and the SF-12 version 2 (and SF-6D) in capturing the burden of arthritis on health-related quality of life in older adults.

A modified Delphi process to identify, rank and prioritize quality indicators for continuous renal replacement therapy (CRRT) care in critically ill patients.

Background: Continuous renal replacement therapy (CRRT) is a complex and life-sustaining therapy, reserved for our most acutely ill patients, and should be delivered in a safe, consistent and high-quality manner. However valid evidence-based quality indicators (QIs) for CRRT care are lacking. The objective of this study was to develop a prioritized list of QIs for CRRT care that may be used in any CRRT program.

Rates of, and risk factors for, septic arthritis in patients with invasive pneumococcal disease: prospective cohort study.

Background: There are many case reports of septic arthritis complicating invasive pneumococcal disease (IPD); however, no study has compared patients with IPD with septic arthritis to those who didn't develop septic arthritis Thus, we aimed to determine the rates of, and risk factors for, septic arthritis in patients with invasive pneumococcal disease (IPD).

Methods: Socio-demographic, clinical, and serological data were captured on all patients with IPD in Northern Alberta, Canada from 2000 to 2014. Septic arthritis was identified by attending physicians.

Quality indicators of continuous renal replacement therapy (CRRT) care in critically ill patients: a systematic review.

Objectives: Renal replacement therapy is increasingly utilized in the intensive care unit (ICU), of which continuous renal replacement therapy (CRRT) is most common. Despite CRRT being a relatively invasive and resource intensive technology, there remains wide practice variation in its application. This systematic review appraised the evidence for quality indicators (QIs) of CRRT care in critically ill patients.

The Interplay Between Continuity of Care, Multimorbidity, and Adverse Events in Patients With Diabetes.

Objectives: To evaluate the impact of continuity of care and multimorbidity on health outcomes in patients with diabetes.

Research Design: Using a US claims database of insured patients, we identified those with incident diabetes between 2004 and 2008 and followed them until death, disenrollment, or December 31, 2010. Continuity of care was defined using Breslau's Usual Provider of Continuity (UPC; proportion of visits to the usual or predominant provider within 2 y of diabetes diagnosis).

Alternation as a form of allocation for quality improvement studies in primary healthcare settings: the on-off study design.

Background: Randomized controlled trials are considered the "gold standard" for scientific rigor in the assessment of benefits and harms of interventions in healthcare. They may not always be feasible, however, when evaluating quality improvement interventions in real-world healthcare settings. Non-randomized controlled trials (NCTs) are designed to answer questions of effectiveness of interventions in routine clinical practice to inform a decision or process.

Quality indicators in continuous renal replacement therapy (CRRT) care in critically ill patients: protocol for a systematic review.

Background: Renal replacement therapy is increasingly utilized in the intensive care unit (ICU), of which continuous renal replacement therapy (CRRT) is most common. Despite CRRT being a relatively resource-intensive and expensive technology, there remains wide practice variation in its application. This systematic review will appraise the evidence for quality indicators (QIs) of CRRT care in critically ill patients.

Cardiovascular medication utilization and adherence among adults living in rural and urban areas: a systematic review and meta-analysis.

Background: Rural residents face numerous barriers to healthcare access and studies suggest poorer health outcomes for rural patients. Therefore we undertook a systematic review to determine if cardiovascular medication utilization and adherence patterns differ for rural versus urban patients.

Methods: A comprehensive search of major electronic datasets was undertaken for controlled clinical trials and observational studies comparing utilization or adherence to cardiovascular medications in rural versus urban adults with cardiovascular disease or diabetes.