31 results match your criteria: "Center for Practice-Changing Research[Affiliation]"

Preterm birth (PTB) is the leading cause of morbidity and mortality in children globally, yet its prevalence has been difficult to accurately estimate due to unreliable methods of gestational age dating, heterogeneity in counting, and insufficient data. The estimated global PTB rate in 2020 was 9.9% (95% confidence interval: 9.

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Dealing with predatory journal articles captured in systematic reviews.

Syst Rev

June 2021

Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, Ottawa, Ontario, Canada.

Background: Systematic reviews appraise and synthesize the results from a body of literature. In healthcare, systematic reviews are also used to develop clinical practice guidelines. An increasingly common concern among systematic reviews is that they may unknowingly capture studies published in "predatory" journals and that these studies will be included in summary estimates and impact results, guidelines, and ultimately, clinical care.

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Psychosocial and pharmacologic interventions for methamphetamine addiction: protocol for a scoping review of the literature.

Syst Rev

October 2020

Center for Practice Changing Research, Ottawa Hospital Research Institute, The Ottawa Hospital, General Campus, 501 Smyth Road, Box 201b, Ottawa, Ontario, K1H 8 L6, Canada.

Background: Methamphetamine use and harms are rising rapidly. Management of patients with methamphetamine use disorder (MUD) and problematic methamphetamine use (PMU) is challenging, with no clearly established best approach; both psychosocial and pharmacologic interventions have been described. Furthermore, given the diversity of individuals that use methamphetamines, there is a need to assess evidence for treatments for subgroups including youths; gay, bisexual, and other men who have sex with men; individuals with mental health comorbidities; and individuals in correction services.

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CARTR Plus: the creation of an ART registry in Canada.

Hum Reprod Open

June 2020

Better Outcomes Registry & Network (BORN) Ontario, CHEO Centre for Practice-Changing Research, Building 401 Smyth Road, Ottawa, Ontario Canada, K1H 8L1.

Study Question: What is the status of fertility treatment and birth outcomes documented over the first 6 years of the Canadian Assisted Reproductive Technologies Register (CARTR) Plus registry?

Summary Answer: The CARTR Plus registry is a robust database containing comprehensive Canadian fertility treatment data to assist with providing evidence-based rationale for clinical practice change.

What Is Known Already: The rate of infertility is increasing globally and having data on fertility treatment cycles and outcomes at a population level is important for accurately documenting and effecting changes in clinical practice.

Study Design Size Duration: This is a descriptive manuscript of 183 739 fertility treatment cycles from 36 Canadian clinics over 6 years from the CARTR Plus registry.

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Background: Given the complex nature of opioid addiction treatment and the rising number of available opioid substitution and antagonist therapies (OSAT), there is no 'gold standard' measure of treatment effectiveness, and each successive trial measures a different set of outcomes which reflect success in arbitrary or opportune terms. We sought to describe the variation in current outcomes employed across clinical trials for opioid addiction, as well as determine whether a discrepancy exists between the treatment targets that patients consider important and how treatment effectiveness is measured in the literature.

Methods: We searched nine commonly used databases (e.

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Background: Hearing loss is one of the leading causes of disability in Canada and worldwide, with more than one million Canadians enduring a hearing-related disability. Meniere's disease (MD) is a chronic condition of the inner ear, manifesting as a triad of disabling symptoms, including attacks of vertigo, fluctuating sensorineural hearing loss (SNHL), and tinnitus. Impacts on quality of life are severe, particularly with respect to restrictions in social participation and physical activity, fatigue, and reduced capacity to work.

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Economic Evaluation of Azacitidine in Elderly Patients with Acute Myeloid Leukemia with High Blast Counts.

Pharmacoecon Open

June 2020

Division of Hematology, Center for Practice-Changing Research, The Ottawa Hospital, University of Ottawa, 501 Smyth Rd., Box 704, Ottawa, ON, K1H 8L6, Canada.

Background: Azacitidine is an hypomethylating agent widely adopted for the treatment of acute myeloid leukaemia (AML) in patients who are ineligible for curative-intent chemotherapy. Patients with low bone marrow blast counts (< 30%) experience improved survival with azacitidine, but the benefits are significantly lower in patients with > 30% blasts in the bone marrow. As such, there is uncertainty around the economic benefit of azacitidine in patients with higher blast counts.

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Purpose: Epidemiologic and preclinical data suggest a potential role for vitamin D in breast cancer treatment and prevention. However, results of prospective randomized trials are inconsistent. The objective of this study was to assess the effects of high-dose cholecalciferol (vitamin D3) on breast tumour proliferation and apoptosis.

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Background: Nearly all newly infected children acquire Human Immunodeficiency virus (HIV) via mother-to-child transmission (MTCT) during pregnancy, labour or breastfeeding from untreated HIV-positive mothers. Antiretroviral therapy (ART) is the standard care for pregnant women with HIV. However, evidence of ART effectiveness and harms in infants and children of HIV-positive pregnant women exposed to ART has been largely inconclusive.

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Background: Hearing loss is one of the leading causes of disability worldwide, with greater than 20% of Canadian adults having measurable hearing loss in at least one ear. Patients with hearing loss experience impaired quality of life, and emotional and financial consequences that affect themselves and their families. Sudden sensorineural hearing loss (SSNHL) is a common but difficult to treat form of hearing loss that has a sudden onset of ≤ 72 h associated with various etiologies, with the majority of cases being idiopathic.

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The ethics of the Flexibility In duty hour Requirements for Surgical Trainees (FIRST) trial have been vehemently debated. Views on the ethics of the FIRST trial range from it being completely unethical to wholly unproblematic. The FIRST trial illustrates the complex ethical challenges posed by cluster randomised trials (CRTs) of policy interventions involving healthcare professionals.

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The antibiotic management of gonorrhoea in Ontario, Canada following multiple changes in guidelines: an interrupted time-series analysis.

Sex Transm Infect

December 2017

Department of Clinical Epidemiology Program, Ottawa Hospital Research Institute, Center for Practice Changing Research Building, The Ottawa Hospital, General Campus, Ottawa, Canada.

Objective: This study assessed adherence with first-line gonorrhoea treatment recommendations in Ontario, Canada, following recent guideline changes due to antibiotic resistance.

Methods: We used interrupted times-series analyses to analyse treatment data for cases of uncomplicated gonorrhoea reported in Ontario, Canada, between January 2006 and May 2014. We assessed adherence with first-line treatment according to the guidelines in place at the time and the use of specific antibiotics over time.

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Objectives: Compare the safety of antiepileptic drugs (AEDs) on neurodevelopment of infants/children exposed in utero or during breast feeding.

Design And Setting: Systematic review and Bayesian random-effects network meta-analysis (NMA). MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials were searched until 27 April 2017.

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Considerations and guidance in designing equity-relevant clinical trials.

Int J Equity Health

June 2017

School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Canada.

Health research has documented disparities in health and health outcomes within and between populations. When these disparities are unfair and avoidable they may be referred to as health inequities. Few trials attend to factors related to health inequities, and there is limited understanding about how to build consideration of health inequities into trials.

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Background: Pregnant women with epilepsy frequently experience seizures related to pregnancy complications and are often prescribed anti-epileptic drugs (AEDs) to manage their symptoms. However, less is known about the comparative safety of AED exposure in utero. We aimed to compare the risk of congenital malformations (CMs) and prenatal outcomes of AEDs in infants/children who were exposed to AEDs in utero through a systematic review and Bayesian random-effects network meta-analysis.

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Background/aims The use of the stepped wedge cluster randomized design is rapidly increasing. This design is commonly used to evaluate health policy and service delivery interventions. Stepped wedge cluster randomized trials have unique characteristics that complicate their ethical interpretation.

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Article Synopsis
  • Non-randomised studies are important for understanding healthcare, but they can sometimes be unfair or biased in their results.
  • ROBINS-I is a new tool created to help people evaluate these non-randomised studies better.
  • This tool is especially useful for researchers who want to compare the effects of different treatments or interventions.
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Maternal serum screening markers and nuchal translucency measurements in in vitro fertilization pregnancies: a systematic review.

Fertil Steril

November 2016

BORN Ontario, CHEO Research Institute, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Center for Practice-Changing Research, Ottawa, Ontario, Canada; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada; CHEO Research Institute, Centre for Practice-Changing Research, Ottawa, Ontario, Canada.

Objective: To study the current literature on the association between IVF treatment and maternal serum screening marker levels and nuchal translucency thickness.

Design: Systematic review.

Settings: Not applicable.

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Sustainability of knowledge translation interventions in healthcare decision-making: a scoping review.

Implement Sci

April 2016

Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, ON, M5B 1T8, Canada.

Article Synopsis
  • Knowledge translation (KT) is a process aimed at applying research to improve health outcomes, particularly for chronic diseases, and involves activities like synthesis and dissemination of information.
  • A scoping review was conducted, encompassing 62 studies involving 260,688 patients to assess the sustainability of KT interventions after 1 year or beyond initial funding, reviewing various types of studies from multiple databases.
  • The findings revealed that interventions ranged from 61 to 522 weeks, with patient education and self-management being common approaches, primarily focusing on patient-level outcomes across diverse chronic conditions.
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N-of-1 trials are a tapestry of heterogeneity.

J Clin Epidemiol

August 2016

Complementary and Alternative Research and Education Program (CARE), Department of Pediatrics, University of Alberta. Electronic address:

Objectives: To summarize the methods of design, analysis, and meta-analysis used in N-of-1 trials.

Study Design And Setting: Electronic search for English language articles published from 1950 to 2013. N-of-1 trials were selected if they followed an ABAB design and if they assessed a health intervention for a medical condition.

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Background: Liver resection is commonly performed for malignant and benign disease and is associated with frequent use of intraoperative and postoperative blood transfusions. Blood transfusions are potentially life-saving, but they have many adverse effects; some well understood, and others less so. Some of the poorly understood side effects include increased risk of postoperative complications and possibly worse oncologic outcomes.

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Effect of chronic hypertension on assisted pregnancy outcomes: a population-based study in Ontario, Canada.

Fertil Steril

April 2016

LifeQuest Centre for Reproductive Medicine, Toronto, Ontario, Canada; Department of Medicine and Department of Obstetrics and Gynecology, University of Toronto, Toronto, Ontario, Canada.

Objective: To evaluate maternal and neonatal outcomes in women with chronic hypertension who conceive using assisted reproductive technologies (ART).

Design: Population-based retrospective cohort study.

Setting: Obstetric hospitals.

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Anti-IgE monoclonal antibody therapy for the treatment of chronic rhinosinusitis: a systematic review.

Syst Rev

November 2015

Department of Otolaryngology-Head and Neck Surgery, University of Ottawa, The Ottawa Hospital, 737 Parkdale Ave., Room 459, Ottawa, Ontario, K1Y 1J8, Canada.

Background: Several options are available for the treatment of chronic rhinosinusitis (CRS), but disease control remains elusive for many patients. Recently, literature has emerged describing anti-IgE monoclonal antibody as a potential therapy for CRS. However, its effectiveness and safety are not well known.

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Network meta-analysis is increasingly used to allow comparison of multiple treatment alternatives simultaneously, some of which may not have been compared directly in primary research studies. The majority of network meta-analyses published to date have incorporated data from randomized controlled trials (RCTs) only; however, inclusion of non-randomized studies may sometimes be considered. Non-randomized studies can complement RCTs or address some of their limitations, such as short follow-up time, small sample size, highly selected population, high cost, and ethical restrictions.

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