Development of a predictive model for loss of functional and cognitive abilities in long-term care home residents: a protocol.

Introduction: Long-term care (LTC) residents require extensive assistance with daily activities due to physical and cognitive impairments. Medical treatment for LTC residents, when not aligned with residents' wishes, can cause discomfort without providing substantial benefits. Predictive models can equip providers with tools to guide treatment recommendations that support person-centred medical decision-making.

Outcomes among patients with coronary artery bypass grafts presenting with acute coronary syndrome: impact of revascularization.

Background: Patients post-coronary artery bypass graft (CABG) can re-present with acute coronary syndrome (ACS); however, culprit lesion identification, as well as revascularization, is often challenging. Furthermore, the impact of revascularization in this patient group is relatively unknown.

Objectives: The purpose of our study was to evaluate the efficacy of percutaneous coronary intervention (PCI) in patients with previous CABG surgery presenting with ACS.

Association Between Serum Thyrotropin and Cancer Recurrence in Differentiated Thyroid Cancer: A Population-Based Retrospective Cohort Study.

Levothyroxine to suppress thyrotropin (TSH) to <0.5 mIU/L following thyroidectomy in differentiated thyroid cancer (DTC) may reduce recurrence in higher-risk DTC. However, there is limited evidence to support guideline recommendations to maintain TSH in the low-normal range of 0.

Association between maternal schizophrenia and risk of serious asthma exacerbations in childhood.

Background And Hypothesis: While maternal schizophrenia is linked to chronic childhood medical conditions, little is known about the risk of acute asthma exacerbations among children whose mothers have schizophrenia. This population-based study used health data for all of Ontario, Canada to evaluate whether having a mother with schizophrenia was associated with increased risk of asthma exacerbations.

Study Design: The study cohort included 385,989 children diagnosed with asthma from age 2 years onward, followed from the time of their asthma diagnosis up to a maximum of age 19 years.

Setting the balance of care for older adults at risk of hospitalization and delayed discharge: A mixed-methods research protocol.

Introduction: Delayed hospital discharge is a persistent care quality issue experienced across health systems worldwide and remains a priority area to be addressed in Canada. Often associated with a decrease in services while waiting to leave the hospital, delayed discharge from hospital can lead to increased frailty, physical and cognitive decline, and caregiver burnout. Optimizing availability of and timely access to community-based health and social care are avenues that could reduce initial admissions to the hospital and length of hospital stay, and facilitate hospital discharges.

The implementation of infant pain practice change resource to improve infant procedural pain practices: a hybrid type 1 effectiveness-implementation study.

Implementation of infant pain practice change (ImPaC) is a multifaceted web-based resource to support pain practice change in neonatal intensive care unit (NICU). We evaluated the (1) intervention effectiveness and (2) implementation effectiveness of ImPaC using a hybrid type 1 effectiveness-implementation study (ie, cluster randomized controlled trial and longitudinal descriptive study). Eligible level 2 and 3 Canadian NICUs were randomized to intervention (INT) or waitlisted to usual care (UC) for 6 months.

Higher Post-Acute Health Care Costs Following SARS-CoV-2 Infection Among Adults in Ontario, Canada.

Purpose And Introduction: Growing evidence suggests SARS-CoV-2 infection increases the risk of long term cardiovascular, neurological, and other effects. However, post-acute health care costs following SARS-CoV-2 infection are not known.

Patients And Statistical Methods: Beginning 56 days following SARS-CoV-2 polymerase chain reaction (PCR) testing, we compared person-specific total and component health care costs (2020 CAD$) for the first year of follow-up at the mean and 99 percentiles of health care costs for matched test-positive and test-negative adults in Ontario, Canada, between January 1, 2020, and March 31, 2021.

Prevalence and Impact of Fractures in Persons with Spinal Cord Injuries: A Population-Based Study Comparing Fracture Rates between Individuals with Traumatic and Nontraumatic Spinal Cord Injury.

Background: Musculoskeletal complications are one of the most common reasons for a patient with a spinal cord injury (SCI) to be rehospitalized. Bone loss due to immobilization and changes in metabolic processes because of the SCI lead to an increased risk of fractures.

Objective: To evaluate the prevalence and demographic characteristics of people living with an SCI who had a secondary fracture.

An equity indicator for assessing mental healthcare access: a national population case study.

Aims: Achieving equitable healthcare access is a global challenge. Improving whole-population mental health and reducing the global burden of mental disorders is a key recommendation of the 2018 Lancet Global Mental Health Commission, which proposed monitoring national indicators, including the proportion of people with severe mental disorders who are service-users. This study aims to derive an equity indicator from national datasets integrating need, service utilisation and socioeconomic status, and demonstrate its utility in identifying gaps in mental health service use amongst those with the greatest need, thereby guiding equitable healthcare delivery.

Implementation of the Comparison of Outcomes and Access to Care for Heart Failure (COACH) Trial.

Background: The Comparison of Outcomes and Access to Care for Heart Failure (COACH) trial demonstrated that use of a point-of-care risk assessment tool and a rapid ambulatory transitional heart failure clinic led to significant reductions in death and cardiovascular hospitalisation among patients with acute heart failure. We report a process evaluation of COACH intervention and strategy implementation.

Methods: We conducted longitudinal interviews with staff to assess barriers and facilitators to COACH implementation.

An International Factorial Vignette-Based Survey of Intubation Decisions in Acute Hypoxemic Respiratory Failure.

Objectives: Intubation is a common procedure in acute hypoxemic respiratory failure (AHRF), with minimal evidence to guide decision-making. We conducted a survey of when to intubate patients with AHRF to measure the influence of clinical variables on intubation decision-making and quantify variability.

Design: Factorial vignette-based survey asking "Would you recommend intubation?" Respondents selected an ordinal recommendation from a 5-point scale ranging from "Definite no" to "Definite yes" for up to ten randomly allocated vignettes.

Updated breast cancer costs for women by disease stage and phase of care using population-based databases.

Background: This study assessed health care system costs and resource utilization for adult women with breast cancer in Ontario, Canada. The goal was to update costs by stage, age, and phase of care from a health care system perspective.

Data And Methods: A retrospective analysis was conducted using linked population-based administrative data.

Morbidity among resettled refugees at arrival in Ontario, Canada (1994-2017): a controlled interrupted time series study examining the effect of the Immigration Refugee Protection Act, 2002.

Background: Immigration inadmissibility on medical grounds is common among high-income countries. In Canada, the Immigrant and Refugee Protection Act (IRPA) became law in 2002. With humanitarian protection as a priority, IRPA removed medical inadmissibility based on exceeding a cost threshold for the projected use of health and social services for resettled refugees.

Long-term clinical outcomes and healthcare resource utilization in male and female patients following hospitalization for heart failure.

Aims: Heart failure (HF) is a leading cause of hospitalization, and sex differences in care have been described. We assessed sex-specific clinical outcomes and healthcare resource utilization following hospitalization for HF.

Methods And Results: This was an exploratory analysis of patients hospitalized for HF across 10 Canadian hospitals in the Patient-Centered Care Transitions in HF (PACT-HF) cluster-randomized trial.

Am I attached? A patient-partnered approach to creating infographics about attachment to primary care in Ontario, Canada.

Background: Having a primary care provider is associated with better care experiences and lower care costs. In 2021, INSPIRE-PHC released Primary Care Data Reports - publicly available summaries of administrative billing data about how populations in each of Ontario's 60 health teams use primary care services. Given the characterization of Canadian primary care systems as 'in crisis', publicly available data about primary care at the regional level presented a significant opportunity for knowledge mobilization.

Postoperative outcomes among Northern versus Southern Ontario patients undergoing common intermediate- to high-risk elective surgeries: a population-based cohort study.

Purpose: Northern Ontario residents experience multiple health disparities compared with those in Southern Ontario. It is unknown whether this leads to differences in surgical outcomes. We sought to compare postoperative outcomes of patients from Northern and Southern Ontario.