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McSween-Cadieux E, Lane J, Hong QN, Houle AA, Lauzier-Jobin F, Saint-Pierre Mousset E, Prigent O, Ziam S, Poder T, Lesage A, Dagenais P. Production and use of rapid responses during the COVID-19 pandemic in Quebec (Canada): perspectives from evidence synthesis producers and decision makers. Health Res Policy Syst 2024; 22:22. [PMID: 38351054 PMCID: PMC10863098 DOI: 10.1186/s12961-024-01105-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has required evidence to be made available more rapidly than usual, in order to meet the needs of decision makers in a timely manner. These exceptional circumstances have caused significant challenges for organizations and teams responsible for evidence synthesis. They had to adapt to provide rapid responses to support decision-making. This study aimed to document (1) the challenges and adaptations made to produce rapid responses during the pandemic, (2) their perceived usefulness, reported use and factors influencing their use and (3) the methodological adaptations made to produce rapid responses. METHODS A qualitative study was conducted in 2021 with eight organizations in the health and social services system in Quebec (Canada), including three institutes with a provincial mandate. Data collection included focus groups (n = 9 groups in 8 organizations with 64 participants), interviews with decision makers (n = 12), and a document analysis of COVID-19 rapid responses (n = 128). A thematic analysis of qualitative data (objectives 1 and 2) and a descriptive analysis of documents (objective 3) were conducted. RESULTS The results highlight the teams and organizations' agility to deal with the many challenges encountered during the pandemic (e.g., increased their workloads, adoption of new technological tools or work processes, improved collaboration, development of scientific monitoring, adaptation of evidence synthesis methodologies and products). The challenge of balancing rigor and speed was reported by teams and organizations. When available at the right time, rapid responses have been reported as a useful tool for informing or justifying decisions in a context of uncertainty. Several factors that may influence their use were identified (e.g., clearly identify needs, interactions with producers, perceived rigor and credibility, precise and feasible recommendations). Certain trends in the methodological approaches used to speed up the evidence synthesis process were identified. CONCLUSIONS This study documented rapid responses producers' experiences during the COVID-19 pandemic in Quebec, and decision makers who requested, consulted, or used these products. Potential areas of improvements are identified such as reinforce coordination, improve communication loops, clarify guidelines or methodological benchmarks, and enhance utility of rapid response products for decision makers.
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Affiliation(s)
- Esther McSween-Cadieux
- Department of School and Social Adaptation Studies, Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada.
- Centre RBC d'expertise Universitaire en Santé Mentale, Université de Sherbrooke, Sherbrooke, Canada.
| | - Julie Lane
- Department of School and Social Adaptation Studies, Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada
- Centre RBC d'expertise Universitaire en Santé Mentale, Université de Sherbrooke, Sherbrooke, Canada
| | - Quan Nha Hong
- School of Rehabilitation, Université de Montréal, Montreal, Canada
| | - Andrée-Anne Houle
- Centre RBC d'expertise Universitaire en Santé Mentale, Université de Sherbrooke, Sherbrooke, Canada
- Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, Canada
| | - François Lauzier-Jobin
- Centre RBC d'expertise Universitaire en Santé Mentale, Université de Sherbrooke, Sherbrooke, Canada
| | - Eliane Saint-Pierre Mousset
- Department of School and Social Adaptation Studies, Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada
- Centre RBC d'expertise Universitaire en Santé Mentale, Université de Sherbrooke, Sherbrooke, Canada
| | - Ollivier Prigent
- Department of School and Social Adaptation Studies, Faculty of Education, Université de Sherbrooke, Sherbrooke, Canada
| | - Saliha Ziam
- School of Business Administration, Université TÉLUQ, Montreal, Canada
| | - Thomas Poder
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), CIUSSS-de-l'Est-de-l'île-de-Montréal, Montreal, Canada
- Department of Management, Evaluation and Health Policy, School of Public Health, University of Montreal, Montreal, Canada
| | - Alain Lesage
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal (CR-IUSMM), CIUSSS-de-l'Est-de-l'île-de-Montréal, Montreal, Canada
| | - Pierre Dagenais
- Department of Medicine, Faculty of Medicine and Health Science, University of Sherbrooke, Sherbrooke, Canada
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Bilodeau J, Quesnel-Vallée A, Poder T. Work stressors, work-family conflict, parents' depressive symptoms and perceived parental concern for their children's mental health during COVID-19 in Canada: a cross-sectional analysis. BMC Public Health 2023; 23:2181. [PMID: 37936129 PMCID: PMC10629015 DOI: 10.1186/s12889-023-17037-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 10/20/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND Work-related stressors and work-family conflict are important social determinants of mental health. While the impact of these stressors on parents' mental health is well documented, we know comparatively less about their impact on children's mental health. Furthermore, though the COVID-19 pandemic has significantly altered these stressors, particularly with the increase in teleworking, major knowledge gaps persist regarding the association between parents' stressors and perceived parental concern for their children's mental health during the COVID-19 pandemic. Based on the stress contagion perspective, this study tests (1) the mediating role of parents' depressive symptoms with parental concern for their children's mental health, and (2) whether these associations vary depending on whether parents had the opportunity to engage in telework. METHODS A path analysis was performed from a cross-sectional analytic sample of 780 employed parents in the province of Quebec (Canada). The same model was then stratified by teleworking opportunity. The model's indirect associations were obtained by the bootstrap bias-corrected method with 1,000 replications. RESULTS The results show that the stressors of work-to-family conflict, increased difficulties in work-family balance since the COVID-19 pandemic, irregular schedules, low esteem derived from work, and job insecurity were all indirectly associated with an increase in parental concern for their children's mental health through increased parents' depressive symptoms. However, some associations differ depending on teleworking status. The indirect associations involving increased difficulties in work-family balance since the COVID-19 pandemic as well as irregular work schedules were observed only in the teleworking group. CONCLUSIONS This study fills a gap in research on the association between the work-family interface and parental concern for their children's mental health during the COVID-19 pandemic. It highlights the importance of concerted and cohesive action between child health policies and those regarding work and work-family balance to prevent work-related psychosocial risks, particularly considering the post pandemic expanded and persistent reliance on teleworking.
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Affiliation(s)
- Jaunathan Bilodeau
- Department of Sociology, McGill University, 3460 McTavish Street, Montreal, QC, H3A 0E6, Canada.
| | - Amélie Quesnel-Vallée
- Department of Sociology, McGill University, 3460 McTavish Street, Montreal, QC, H3A 0E6, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | - Thomas Poder
- École de Santé Publique, Université de Montréal, Montreal, Canada
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Hudon C, Chouinard MC, Dumont-Samson O, Gobeil-Lavoie AP, Morneau J, Paradis M, Couturier Y, Poitras ME, Poder T, Sabourin V, Lambert M. Integrated case management between primary care clinics and hospitals for people with complex needs who frequently use healthcare services: A multiple-case embedded study. Health Policy 2023; 132:104804. [PMID: 37028261 DOI: 10.1016/j.healthpol.2023.104804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/29/2023] [Accepted: 04/02/2023] [Indexed: 04/05/2023]
Abstract
INTRODUCTION Case management (CM) is recognized to improve care integration and outcomes of people with complex needs who frequently use healthcare services, but challenges remain regarding interaction between primary care clinics and hospitals. This study aimed to implement and evaluate an integrated CM program for this population where nurses in primary care clinics worked with a hospital case manager. METHODS A multiple embedded case study was conducted in the Saguenay-Lac-Saint-Jean region (Québec, Canada), in four dyads including a clinic and a hospital. Mixed data collection included, at baseline and 6 months, interviews and focus groups with stakeholders, patient questionnaires (patient experience of integrated care and self-management), and emergency department (ED) visits in the previous 6 months. RESULTS Integrated CM implementation was optimal when all stakeholders provided collective leadership, and were supportive of the program, particularly the physicians. The 6-month program enabled the observation of positive qualitative outcomes in most clinic-hospital dyads where implementation occurred. Full implementation was associated with improved care integration. DISCUSSION AND CONCLUSION Integrated CM between primary care clinics and hospitals is a promising innovation to improve care integration for people with complex needs who frequently use healthcare services. Collective leadership and physicians' buy-in to integrated CM are important to foster the implementation.
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Hurtubise K, Gaboury I, Berbari J, Battista MC, Schuster T, Phoenix M, Rosenbaum P, Kraus De Camargo O, Lovo S, Pritchard-Wiart L, Zwicker JG, Beaudoin AJ, Morin M, Poder T, Gagnon MP, Roch G, Levac D, Tousignant M, Colquhoun H, Miller K, Churchill J, Robeson P, Ruegg A, Nault M, Camden C. Training Intervention and Program of Support (TIPS) for fostering adoption of family-centred telehealth in pediatric rehabilitation: Protocol for a multi-method, prospective hybrid type 3 implementation-effectiveness study (Preprint). JMIR Res Protoc 2022; 11:e40218. [PMID: 36306158 PMCID: PMC9652740 DOI: 10.2196/40218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 07/28/2022] [Accepted: 08/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background Children with disability face long wait times for rehabilitation services. Before the COVID-19 pandemic, telehealth adoption was low across pediatric rehabilitation. Owing to the COVID-19 pandemic restrictions, pediatric therapists were asked to rapidly shift to telehealth, often with minimal training. To facilitate the behavior changes necessary for telehealth adoption, provision of appropriate evidence-based training and support is required. However, evidence to support the effective implementation of such training is lacking. The successful real-world implementation of a training intervention and program of support (TIPS) targeting pediatric therapists to enhance the adoption of family-centered telerehabilitation (FCT) requires the evaluation of both implementation and effectiveness. Objective This study aimed to evaluate TIPS implementation in different pediatric rehabilitation settings and assess TIPS effectiveness, as it relates to therapists’ adoption, service wait times, families’ perception of service quality, and costs. Methods This 4-year, pan-Canadian study involves managers, pediatric occupational therapists, physiotherapists, speech-language pathologists, and families from 20 sites in 8 provincial jurisdictions. It will use a multimethod, prospective, hybrid type 3 implementation-effectiveness design. An interrupted time series will assess TIPS implementation. TIPS will comprise a 1-month training intervention with self-paced learning modules and a webinar, followed by an 11-month support program, including monthly site meetings and access to a virtual community of practice. Longitudinal mixed modeling will be used to analyze indicators of therapists’ adoption of and fidelity to FCT collected at 10 time points. To identify barriers and facilitators to adoption and fidelity, qualitative data will be collected during implementation and analyzed using a deductive-inductive thematic approach. To evaluate effectiveness, a quasi-experimental pretest-posttest design will use questionnaires to evaluate TIPS effectiveness at service, therapist, and family levels. Generalized linear mixed effects models will be used in data analysis. Manager, therapist, and family interviews will be conducted after implementation and analyzed using reflective thematic analysis. Finally, cost data will be gathered to calculate public system and societal costs. Results Ethics approval has been obtained from 2 jurisdictions (February 2022 and July 2022); approval is pending in the others. In total, 20 sites have been recruited, and data collection is anticipated to start in September 2022 and is projected to be completed by September 2024. Data analysis will occur concurrently with data collection, with results disseminated throughout the study period. Conclusions This study will generate knowledge about the effectiveness of TIPS targeting pediatric therapists to enhance FCT adoption in pediatric rehabilitation settings, identify facilitators for and barriers to adoption, and document the impact of telehealth adoption on therapists, services, and families. The study knowledge gained will refine the training intervention, enhance intervention uptake, and support the integration of telehealth as a consistent pediatric rehabilitation service option for families of children with disabilities. Trial Registration ClinicalTrials.gov NCT05312827; https://clinicaltrials.gov/ct2/show/NCT05312827 International Registered Report Identifier (IRRID) PRR1-10.2196/40218
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Affiliation(s)
- Karen Hurtubise
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster Univeristy, Hamilton, ON, Canada
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Longueuil, QC, Canada
| | - Jade Berbari
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Marie-Claude Battista
- Department of Medicine, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Tibor Schuster
- Department of Family Medicine, McGill Univeristy, Montreal, QC, Canada
| | - Michelle Phoenix
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster Univeristy, Hamilton, ON, Canada
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Olaf Kraus De Camargo
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Stacey Lovo
- School of Rehabilitation Sciences, University of Saskatchewan, Saskatoon, SK, Canada
| | | | - Jill G Zwicker
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Department of Occupational Sciences and Occupational Therapy, University of British Columbia, Vancouver, BC, Canada
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Audrée Jeanne Beaudoin
- Institut Universitaire de Première Ligne en Santé et Services Sociaux, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- École de Réadaptation, Faculté de Médecine et Sciences de la Santé, Univeristé de Sherbrooke, Sherbrooke, QC, Canada
| | - Mélanie Morin
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- École de Réadaptation, Faculté de Médecine et Sciences de la Santé, Univeristé de Sherbrooke, Sherbrooke, QC, Canada
| | - Thomas Poder
- School of Public Health, Université de Montréal, Montréal, QC, Canada
- Centre de Recherche de l'Institut Universitaire en Santé Mentale de Montréal, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Est de l'Île de Montréal, Montréal, QC, Canada
| | - Marie-Pierre Gagnon
- Population Health and Optimal Health Practices Research Unit, Centre Hospitalier de Québec-Univeristé Laval Research Centre, Québec, QC, Canada
- Faculty of Nursing, Univeristé Laval, Québec, QC, Canada
| | - Geneviève Roch
- Population Health and Optimal Health Practices Research Unit, Centre Hospitalier de Québec-Univeristé Laval Research Centre, Québec, QC, Canada
- Faculty of Nursing, Univeristé Laval, Québec, QC, Canada
| | - Danielle Levac
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Faculty of Medicine, Univeristé de Montréal, Montréal, QC, Canada
| | - Michel Tousignant
- École de Réadaptation, Faculté de Médecine et Sciences de la Santé, Univeristé de Sherbrooke, Sherbrooke, QC, Canada
| | - Heather Colquhoun
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, ON, Canada
| | - Kimberly Miller
- BC Children's Hospital Research Institute, Vancouver, BC, Canada
- Department of Physical Therapy, Univeristy of British Columbia, Vancouver, BC, Canada
| | | | | | - Andréa Ruegg
- Training Intervention and Program of Support Study Team, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martine Nault
- Training Intervention and Program of Support Study Team, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Chantal Camden
- CanChild Centre for Childhood Disability Research, School of Rehabilitation Sciences, McMaster University, Hamilton, ON, Canada
- Centre de Recherche du Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
- École de Réadaptation, Faculté de Médecine et Sciences de la Santé, Univeristé de Sherbrooke, Sherbrooke, QC, Canada
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Belan M, Gélinas M, Carranza-Mamane B, Langlois MF, Morisset AS, Ruchat SM, Lavoie K, Adamo K, Poder T, Gallagher F, Pesant MH, Jean-Denis F, Baillargeon JP. Protocol of the Fit-For-Fertility study: a multicentre randomised controlled trial assessing a lifestyle programme targeting women with obesity and infertility. BMJ Open 2022; 12:e061554. [PMID: 35440463 PMCID: PMC9020282 DOI: 10.1136/bmjopen-2022-061554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Women with obesity are at a higher risk of infertility as well as gestational and neonatal complications. Lifestyle changes are universally recommended for women with obesity seeking fertility treatments, but such intervention has only been assessed in very few robust studies. This study's objectives are therefore to assess the clinical outcomes and cost-effectiveness of an interdisciplinary lifestyle intervention (the Fit-For-Fertility Programme; FFFP) targeting women with obesity and subfertility in a diverse population. METHODS AND ANALYSIS This pragmatic multicentre randomised controlled trial (RCT) will include 616 women with obesity (body mass index ≥30 kg/m2 or ≥27 kg/m2 with polycystic ovary syndrome or at-risk ethnicities) who are evaluated at a Canadian fertility clinic for subfertility. Women will be randomised either to (1) the FFFP (experimental arm) alone for 6 months, and then in combination with usual care for infertility if not pregnant; or (2) directly to usual fertility care (control arm). Women in the intervention group benefit from the programme up to 18 months or, if pregnant, up to 24 months or the end of the pregnancy (whichever comes first). Women from both groups are evaluated every 6 months for a maximum of 18 months. The primary outcome is live birth rate at 24 months. Secondary outcomes include fertility, pregnancy and neonatal outcomes; lifestyle and anthropometric measures; and cost-effectiveness. Qualitative data collected from focus groups of participants and professionals will also be analysed. ETHICS AND DISSEMINATION This research study has been approved by the Research Ethics Board (REB) of Centre intégré universtaire de santé et des services sociaux de l'Estrie-CHUS (research coordinating centre) on 10 December 2018 and has been or will be approved successively by each participating centres' REB. This pragmatic RCT will inform decision-makers on improving care trajectories and policies regarding fertility treatments for women with obesity and subfertility. TRIAL REGISTRATION NUMBER NCT03908099. PROTOCOL VERSION 1.1, 13 April 2019.
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Affiliation(s)
- Matea Belan
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Myriam Gélinas
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Belina Carranza-Mamane
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Obstetrics and Gynecology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie-France Langlois
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Anne-Sophie Morisset
- School of Nutrition, Faculty of Agricultural and Food Science, Laval University, Quebec city, Quebec, Canada
| | - Stephanie-May Ruchat
- Department of Human Kinetics, Université du Quebec à Trois-Rivières, Trois-Rivières, Quebec, Canada
| | - Kim Lavoie
- Research Center CIUSSS-NIM, Montreal Behavioural Medicine Centre, Montreal, Quebec, Canada
- Department of Psychology, Université du Québec a Montréal, Montréal, Quebec, Canada
| | - Kristi Adamo
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Thomas Poder
- School of Public Health, University of Montreal, Montreal, Quebec, Canada
- CIUSSS de l'Est de l'Île de Montréal, Centre de recherche de l'Institut universitaire en santé mentale de Montréal, Montreal, Quebec, Canada
| | - Frances Gallagher
- School of Nursing, Université de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Marie-Hélène Pesant
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Farrah Jean-Denis
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Jean-Patrice Baillargeon
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, Sherbrooke, Quebec, Canada
- Research Center of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
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Azzano P, Dufresne É, Poder T, Bégin P. Economic considerations on the usage of biologics in the allergy clinic. Allergy 2021; 76:191-209. [PMID: 32656802 DOI: 10.1111/all.14494] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 07/04/2020] [Accepted: 07/08/2020] [Indexed: 12/27/2022]
Abstract
The advent of biologic therapies has transformed care for severe atopic disorders but their high cost poses new challenges with regard to long-term sustainability and fair allocation of resources. This article covers the basic concepts of cost-utility analyses and reviews the available literature on cost utility of biologic drugs in atopic disorders. When used within their limits as part of a multi-dimensional assessment, economic analyses can be extremely useful to guide decision-making and prioritization of care. Despite the good quality of most cost-utility analyses conducted for the use of biologics in asthma and other atopic diseases, their conclusions regarding cost-effectiveness are extremely variable. This is mainly due to the use of inconsistent estimates of health utility benefit with therapy. Development of reliable and validated instruments to measure disutility in atopic disorders and measure of indirect costs in atopic disease are identified as a priority for future research.
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Affiliation(s)
- Pauline Azzano
- Department of Pediatrics CHU Sainte‐Justine Montreal QC Canada
| | - Élise Dufresne
- Department of Pediatrics CHU Sainte‐Justine Montreal QC Canada
| | - Thomas Poder
- Department of Management, Evaluation and Health Policy School of Public Health University of Montreal Montreal QC Canada
- Research Center of the Institut Universitaire en Santé Mentale de Montréal Montreal QC Canada
| | - Philippe Bégin
- Department of Pediatrics CHU Sainte‐Justine Montreal QC Canada
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Abstract
Background: Short-Form Six-Dimension version 2 (SF-6Dv2) is a multi-attribute utility instrument that can be used in combination with the SF-36v2 (SF-6Dv2SF-36) or as an independent instrument in two forms: six questions (SF-6Dv2ind-6) and 10 questions (SF-6Dv2ind-10). The purpose of this research was to assess the consistency between the results of the SF-6Dv2ind-6 and the SF-6Dv2SF-36 in patients with breast cancer.Research design and methods: This cross-sectional study was carried out on 418 patients with breast cancer. The degree of agreement between the descriptive systems of instruments was calculated using Spearman's correlation coefficient, global consistency index (GCI), and identically classified index (ICI).Results: The average size of the Spearman's correlation coefficients between the descriptive systems of instruments was higher than 0.5. The results of the GCI revealed that the level of agreement between dimensions of the two instruments had a mean of 64.9 (range 32.45-86.8). The SF-6Dv2SF-36 generates statistically higher values than does the SF-6Dv2ind-6, and mean difference between the two instruments was 0.087 for model 3 and 0.027 for model 10.Conclusions: This study provided evidence that the SF-6Dv2SF-36 and the SF-6Dv2ind-6 may produce different answers from patients with breast cancer and lead to a small difference in utility values.
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Affiliation(s)
- Hosein Ameri
- Health Policy and Management Research Center, Department of Health Services Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Safari
- Health Promotion Research Centre, Iran University of Medical Sciences, Tehran, Iran
| | - Thomas Poder
- Department of Management, Evaluation and Health Policy, School of Public Health, University of Montreal, Montreal, QC, Canada
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Marsh K, van Til JA, Molsen-David E, Juhnke C, Hawken N, Oehrlein EM, Choi YC, Duenas A, Greiner W, Haas K, Hiligsmann M, Hockley KS, Ivlev I, Liu F, Ostermann J, Poder T, Poon JL, Muehlbacher A. Health Preference Research in Europe: A Review of Its Use in Marketing Authorization, Reimbursement, and Pricing Decisions-Report of the ISPOR Stated Preference Research Special Interest Group. Value Health 2020; 23:831-841. [PMID: 32762984 DOI: 10.1016/j.jval.2019.11.009] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 11/07/2019] [Accepted: 11/27/2019] [Indexed: 06/11/2023]
Abstract
OBJECTIVE This study examines European decision makers' consideration and use of quantitative preference data. METHODS The study reviewed quantitative preference data usage in 31 European countries to support marketing authorization, reimbursement, or pricing decisions. Use was defined as: agency guidance on preference data use, sponsor submission of preference data, or decision-maker collection of preference data. The data could be collected from any stakeholder using any method that generated quantitative estimates of preferences. Data were collected through: (1) documentary evidence identified through a literature and regulatory websites review, and via key opinion leader outreach; and (2) a survey of staff working for agencies that support or make healthcare technology decisions. RESULTS Preference data utilization was identified in 22 countries and at a European level. The most prevalent use (19 countries) was citizen preferences, collected using time-trade off or standard gamble methods to inform health state utility estimation. Preference data was also used to: (1) value other impact on patients, (2) incorporate non-health factors into reimbursement decisions, and (3) estimate opportunity cost. Pilot projects were identified (6 countries and at a European level), with a focus on multi-criteria decision analysis methods and choice-based methods to elicit patient preferences. CONCLUSION While quantitative preference data support reimbursement and pricing decisions in most European countries, there was no utilization evidence in European-level marketing authorization decisions. While there are commonalities, a diversity of usage was identified between jurisdictions. Pilots suggest the potential for greater use of preference data, and for alignment between decision makers.
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Affiliation(s)
| | - Janine A van Til
- Health Technology and Services Research, University of Twente, Enschede, The Netherlands
| | | | | | | | | | - Y Christy Choi
- University of Minnesota College of Pharmacy, Minneapolis, Minnesota
| | | | - Wolfgang Greiner
- Department of Health Economics, Bielefeld University, Bielefeld, Germany
| | | | - Mickael Hiligsmann
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
| | | | - Ilya Ivlev
- Center for Health Research, Kaiser Permanente, Portland, OR, USA
| | | | - Jan Ostermann
- Department of Health Services Policy and Management, University of South Carolina, Columbia, SC, USA
| | | | - Jiat L Poon
- Eli Lilly and Company, Indianapolis, IN, USA
| | - Axel Muehlbacher
- Hochschule Neubrandenburg, Neubrandenburg, Germany; Department of Population Health Sciences, Duke University, Durham, NC, USA
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Langlois A, Lavergne MH, Leroux H, Killer K, Azzano P, Paradis L, Samaan K, Lacombe-Barrios J, Eiwegger T, Upton J, Sussman G, Poder T, Mâsse B, Roches AD, Bégin P. Correction to: Protocol for a double-blind, randomized controlled trial on the dose-related efficacy of omalizumab in multi-food oral immunotherapy. Allergy Asthma Clin Immunol 2020; 16:38. [PMID: 32477416 PMCID: PMC7240927 DOI: 10.1186/s13223-020-00435-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Alexandra Langlois
- 1Department of Allergy and Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC Canada
| | | | - Hélène Leroux
- Centre Hospitalier Sainte-Justine Research Center, Montreal, QC Canada
| | - Kerstin Killer
- Centre Hospitalier Sainte-Justine Research Center, Montreal, QC Canada
| | - Pauline Azzano
- 1Department of Allergy and Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC Canada
| | - Louis Paradis
- 1Department of Allergy and Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC Canada.,3Department of Allergy and Immunology, Centre Hospitalier de l'Université de Montréal, 3175 Chemin de la Côte Sainte-Catherine, Montreal, QC H3T1C5 Canada
| | - Kathryn Samaan
- 1Department of Allergy and Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC Canada
| | - Jonathan Lacombe-Barrios
- 1Department of Allergy and Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC Canada
| | - Thomas Eiwegger
- 4Division of Immunology and Allergy, Department of Paediatrics, The Hospital for Sick Children, The University of Toronto, Toronto, ON Canada
| | - Julia Upton
- 4Division of Immunology and Allergy, Department of Paediatrics, The Hospital for Sick Children, The University of Toronto, Toronto, ON Canada
| | | | - Thomas Poder
- 6Department of Management, Evaluation and Health Policy, School of Public Health, Université de Montréal, Montreal, QC Canada.,7Research Center of the Institut Universitaire de Santé Mentale de Montréal, Montreal, QC Canada
| | - Benoît Mâsse
- Centre Hospitalier Sainte-Justine Research Center, Montreal, QC Canada.,8School of Public Health, Université de Montréal, Montreal, QC Canada
| | - Anne Des Roches
- 1Department of Allergy and Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC Canada.,Centre Hospitalier Sainte-Justine Research Center, Montreal, QC Canada
| | - Philippe Bégin
- 1Department of Allergy and Immunology, Centre Hospitalier Universitaire Sainte-Justine, Montreal, QC Canada.,Centre Hospitalier Sainte-Justine Research Center, Montreal, QC Canada.,3Department of Allergy and Immunology, Centre Hospitalier de l'Université de Montréal, 3175 Chemin de la Côte Sainte-Catherine, Montreal, QC H3T1C5 Canada
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He J, Enomana H, Dupras J, Kermagoret C, Poder T. Measuring Recreation Benefit Loss under Climate Change with Revealed and Stated Behavior Data: The Case of Lac Saint-Pierre World Biosphere Reserve (Québec, Canada). Environ Manage 2019; 64:10.1007/s00267-019-01219-x. [PMID: 31707431 DOI: 10.1007/s00267-019-01219-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 10/10/2019] [Indexed: 06/10/2023]
Abstract
Based on a case study carried out on the Lac Saint-Pierre (LSP) World Biosphere Reserve (Québec, Canada), this paper estimates ecosystem service loss, more precisely the loss related to cultural and recreational activities of the LSP due to the fall of its water level under the pressure of climate change. We measure two dimensions of this loss. As a first step, the extrapolation of our representative survey reports $100 million annual loss in terms of recreation revenue due to the trip reduction to LSP, which is about 60% of current level. Subsequently, the travel-cost data and the contingent behavior data are combined in a revealed and stated behavior panel random-effect estimation, which reports an additional loss measured by consumer surplus that visitors can obtain from their trips up to $232 million, signifying 42% of reduction in their current value.
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Affiliation(s)
- Jie He
- Département d'Économique, Université de Sherbrooke, 2500 boulevard de l'Université, Sherbrooke, QC, J1K2R1, Canada.
| | - Hermann Enomana
- Département d'Économique, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jérôme Dupras
- Département des Sciences Naturelles, Université du Québec en Outaouais, Sherbrooke, QC, Canada
| | - Charlène Kermagoret
- Département des Sciences Naturelles, Université du Québec en Outaouais, Sherbrooke, QC, Canada
| | - Thomas Poder
- École de santé publique-Département de gestion, d'évaluation et de politique de santé, Université de Montréal, Montréal, QC, Canada
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11
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Tremblay D, Touati N, Poder T, Vasiliadis HM, Bilodeau K, Berbiche D, Denis JL, Pomey MP, Hébert J, Roch G, Prady C, Lévesque L. Collaborative governance in the Quebec Cancer Network: a realist evaluation of emerging mechanisms of institutionalization, multi-level governance, and value creation using a longitudinal multiple case study design. BMC Health Serv Res 2019; 19:752. [PMID: 31653231 PMCID: PMC6814997 DOI: 10.1186/s12913-019-4586-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 10/09/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND People living with and beyond cancer (PLC) receive various forms of specialty care at different locations and many interventions concurrently or over time. They are affected by the operation of professional and organizational silos. This results in undue delays in access, unmet needs, sub-optimal care experiences and clinical outcomes, and human and financial costs for PLCs and healthcare systems. National cancer control programs advocate organizing in a network to coordinate actions, solve fragmentation problems, and thus improve clinical outcomes and care experiences for every dollar invested. The variable outcomes of such networks and factors explaining them have been documented. Governance is the "missing link" for understanding outcomes. Governance refers to the coordination of collective action by a body in a position of authority in pursuit of a common goal. The Quebec Cancer Network (QCN) offers the opportunity to study in a natural environment how, why, by whom, for whom, and under what conditions collaborative governance contributes to practices that produce value-added outcomes for PLCs, healthcare providers, and the healthcare system. METHODS/DESIGN The study design consists of a longitudinal case study, with multiple nested cases (4 local networks nested in the QCN), mobilizing qualitative and quantitative data and mixed data from various sources and collected using different methods, using the realist evaluation approach. Qualitative data will be used for a thematic analysis of collaborative governance. Quantitative data from validated questionnaires will be analyzed to measure relational coordination and teamwork, care experience, clinical outcomes, and health-related health-related quality of life, as well as a cost analysis of service utilization. Associations between context, governance mechanisms, and outcomes will be sought. Robust data will be produced to support decision-makers to guide network governance towards optimized clinical outcomes and the reduction of the economic toxicity of cancer for PLCs and health systems.
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Affiliation(s)
- Dominique Tremblay
- Faculté de médecine et des sciences de la santé, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
- Centre de recherche Charles-Le Moyne - Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre intégré de santé et de services sociaux de la Montérégie-Centre, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
| | - Nassera Touati
- Centre de recherche Charles-Le Moyne - Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre intégré de santé et de services sociaux de la Montérégie-Centre, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
- École Nationale d’Administration Publique, 4750 Henri-Julien Avenue, Montréal, Québec, H2T 3E5 Canada
| | - Thomas Poder
- Département de gestion, d’évaluation et de politique de santé, École de santé publique, Université de Montréal, 7101, avenue du Parc, 3e étage, Montréal, Québec, H3N 1X9 Canada
- Centre de recherche de l’Institut Universitaire en Santé Mentale de Montréal, 7331, rue Hochelaga, Montréal, Québec, H1N 3V2 Canada
- École de gestion, Université de Sherbrooke, 2500, boulevard de l’Université, Sherbrooke, Québec, J1K 2R1 Canada
- Centre de recherche du Centre Hospitalier de l’Université de Sherbrooke (CR-CHUS), 3001, 12e Avenue Nord, Sherbrooke, Québec, J1H 5N4 Canada
| | - Helen-Maria Vasiliadis
- Faculté de médecine et des sciences de la santé, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
- Centre de recherche Charles-Le Moyne - Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre intégré de santé et de services sociaux de la Montérégie-Centre, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
| | - Karine Bilodeau
- Faculté des sciences infirmières, Université de Montréal, 2375 chemin Côte-Ste-Catherine, Montréal, Québec, H3T 1A8 Canada
| | - Djamal Berbiche
- Centre de recherche Charles-Le Moyne - Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre intégré de santé et de services sociaux de la Montérégie-Centre, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
| | - Jean-Louis Denis
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9 Canada
- École de santé publique, Université de Montréal, 7101, avenue du Parc, Montréal, Québec, H3N 1X9 Canada
- Centre de recherche en droit public, Université de Montréal, 3101, chemin de la Tour, Montréal, Québec, H3T 1J7 Canada
- Institut de recherche en santé publique de l’Université de Montréal (IRSPUM), Université de Montréal, 7101, avenue du Parc, Montréal, Montréal, Québec, H3N 1X9 Canada
| | - Marie-Pascale Pomey
- Centre de recherche du Centre hospitalier de l’Université de Montréal (CR-CHUM), 850, rue Saint-Denis, Montréal, Québec, H2X 0A9 Canada
- École de santé publique, Université de Montréal, 7101, avenue du Parc, Montréal, Québec, H3N 1X9 Canada
- Institut de recherche en santé publique de l’Université de Montréal (IRSPUM), Université de Montréal, 7101, avenue du Parc, Montréal, Montréal, Québec, H3N 1X9 Canada
| | - Johanne Hébert
- Département des sciences infirmières, Campus de Lévis - Université du Québec à Rimouski (UQAR, 1595, boulevard Alphonse-Desjardins, Lévis, Québec, G6V 0A6 Canada
- Hôtel-Dieu de Lévis, Centre de recherche du CISSS de Chaudière-Appalaches, 143, rue Wolfe, Lévis, Québec, G6V 3Z1 Canada
- Centre de recherche du Centre hospitalier universitaire de Québec (CRCHUQ), 11 Côte du Palais, Québec, Québec, G1R 2J6 Canada
- Équipe de recherche Michel-Sarrazin en oncologie psychosociale et soins palliatifs (ERMOS), Maison Michel-Sarrazin, 9, rue McMahon, Québec, Québec, G1R 3S3 Canada
| | - Geneviève Roch
- Hôtel-Dieu de Lévis, Centre de recherche du CISSS de Chaudière-Appalaches, 143, rue Wolfe, Lévis, Québec, G6V 3Z1 Canada
- Centre de recherche du Centre hospitalier universitaire de Québec (CRCHUQ), 11 Côte du Palais, Québec, Québec, G1R 2J6 Canada
- Faculté des sciences infirmières, Université Laval, 1050, avenue de la Médecine, Pavillon Ferdinand-Vandry, Québec, Québec, G1V 0A6 Canada
- Axe Santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, 10, rue de l’Espinay, Québec, Québec, G1L 3L5 Canada
- Centre de recherche sur les soins et les services de première ligne de l’Université Laval (CERSSPL‐UL), 2525, chemin de la Canardière, Québec, Québec G1J 0A4 Canada
| | - Catherine Prady
- Faculté de médecine et des sciences de la santé, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
- Centre de recherche Charles-Le Moyne - Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre intégré de santé et de services sociaux de la Montérégie-Centre, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
- Centre intégré de santé et de services sociaux de la Montérégie-Centre, 3120 boulevard Taschereau, Greenfield Park, Québec, J4V 2H1 Canada
- Centre intégré de cancérologie de la Montérégie, 3120 Boulevard Taschereau, Greenfield Park, Québec, J4V 2G9 Canada
| | - Lise Lévesque
- Faculté de médecine et des sciences de la santé, Campus de Longueuil - Université de Sherbrooke, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
- Centre de recherche Charles-Le Moyne - Saguenay–Lac-Saint-Jean sur les innovations en santé (CR-CSIS), Centre intégré de santé et de services sociaux de la Montérégie-Centre, 150 Place Charles-Le Moyne, Longueuil, Québec, J4K 0A8 Canada
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Camden C, Couture M, Pratte G, Morin M, Roberge P, Poder T, Maltais DB, Jasmin E, Hurtubise K, Ducreux E, Léger F, Zwicker J, Berbari J, Fallon F, Tousignant M. Recruitment, use, and satisfaction with a web platform supporting families of children with suspected or diagnosed developmental coordination disorder: a randomized feasibility trial. Dev Neurorehabil 2019; 22:470-478. [PMID: 30273508 DOI: 10.1080/17518423.2018.1523243] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objectives. To determine the feasibility of recruiting families of children with suspected or diagnosed developmental coordination disorder (sdDCD) and explore their satisfaction with a web-based intervention Design. A feasibility randomized trial was conducted. Participants were the parents of 5-12-year-old children with sdDCD. The intervention group had access to online resources, group and private forums, and videoconferencing with a therapist. Main outcomes were recruitement and retention rates. Satisfaction was documented through a post-intervention survey and interview. Results. The recruitment rate was seven participants per month (n = 28 participants) and retention rate was 68%. Satisfaction was moderate. No differences in use and satisfaction were observed between groups. Participants formulated recommendations for improving the intervention, including targeting families earlier in the diagnosis process, and pre-scheduling meetings with therapists. Conclusions. This study demonstrated the feasibility of future trials, and highlighted avenues for improvement. Parent involvement during the development of the intervention is discussed at length. Abbreviations: DCD: Developmental Coordination Disorder; sdDCD: suspected or diagnosed Developmental Coordination Disorder; RCT: randomized-controled trial.
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Affiliation(s)
- Chantal Camden
- School of rehabilitation, University of Sherbrooke , Canada
| | | | | | - Mélanie Morin
- School of rehabilitation, University of Sherbrooke , Canada
| | | | - Thomas Poder
- School of rehabilitation, University of Sherbrooke , Canada.,UETMIS and CRCHUS, CIUSSS de l'Estrie - CHUS , Canada
| | | | | | | | | | - France Léger
- Rehabilitation center of the CIUSSS de l'Estrie-CHUS , Canada
| | - Jill Zwicker
- School of rehabilitation, University of British Columbia , Canada
| | - Jade Berbari
- School of rehabilitation, University of Sherbrooke , Canada
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Gagnon M, Noel C, Cardinal M, Tetu C, Cavallé-Garrido T, Vaujois L, Bigras J, Roy-Lacroix M, Poder T, Vanasse A, Marelli A, Dallaire F. LOW YIELD OF FETAL ECHOCARDIOGRAPHY WHEN NO SUSPICION OF HEART DISEASE BY REFERRING OBSTETRICIAN. Can J Cardiol 2017. [DOI: 10.1016/j.cjca.2017.07.195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Abstract
OBJECTIVE To conduct a systematic review of the literature describing the impact of speech recognition systems on report error rates and productivity in radiology departments. METHODS The search was conducted for relevant papers published from January 1992 to October 2013. Comparative studies reporting any of the following outcomes were selected: error rates, departmental productivity, and radiologist productivity. The retrieved studies were assessed for quality and risk of bias. RESULTS The literature search identified 85 potentially relevant publications, but, based on the inclusion and exclusion criteria, only 20 were included. Most studies were before and after assessments with no control group. There was a large amount of heterogeneity due to differences in the imaging modalities assessed and the outcomes measured. The percentage of reports containing at least one error varied from 4.8% to 89% for speech recognition, and from 2.1% to 22% for transcription. Departmental productivity was improved with decreases in report turnaround times varying from 35% to 99%. Most studies found a lengthening of radiologist dictation time. CONCLUSION Overall gains in departmental productivity were high, but radiologist productivity, as measured by the time to produce a report, was diminished.
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Affiliation(s)
- Imane Hammana
- Centre hospitalier de l'Universitè de Montrèal Montrèal, Quèbec CANADA
| | - Luigi Lepanto
- Centre hospitalier de l'Universitè de Montrèal Tour Saint-Antoine, Montrèal, Quèbec, H2X 0A9 CANADA
| | - Thomas Poder
- Centre hospitalier de l'Universitè de Sherbrooke Sherbrooke, Quèbec CANADA
| | | | - My-Sandra Ly
- Universitè de Montrèal, Ècole Polytechnique Montrèal, Quèbec CANADA
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Baillot A, Baillargeon JP, Brown C, Poder T, Langlois MF. The 6-min Walk Test Reflects Functional Capacity in Primary Care and Obese Patients. Int J Sports Med 2015; 36:e1. [DOI: 10.1055/s-0035-1569351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- A. Baillot
- Medicine/Endocrinology, Université de Sherbrooke, Sherbrooke, Canada
| | - J.-P. Baillargeon
- Medicine/Endocrinology, Université de Sherbrooke, Sherbrooke, Canada
| | - C. Brown
- Centre de recherche du CHUS, Medecine, Sherbrooke, Canada
| | - T. Poder
- Centre de recherche du CHUS, Medecine, Sherbrooke, Canada
| | - M.-F. Langlois
- Medicine/Endocrinology, Université de Sherbrooke, Sherbrooke, Canada
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Gagnon MP, Desmartis M, Poder T, Witteman W. Effects and repercussions of local/hospital-based health technology assessment (HTA): a systematic review. Syst Rev 2014; 3:129. [PMID: 25352182 PMCID: PMC4218945 DOI: 10.1186/2046-4053-3-129] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 10/13/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health technology assessment (HTA) is increasingly performed at the local or hospital level where the costs, impacts, and benefits of health technologies can be directly assessed. Although local/hospital-based HTA has been implemented for more than two decades in some jurisdictions, little is known about its effects and impact on hospital budget, clinical practices, and patient outcomes. We conducted a mixed-methods systematic review that aimed to synthesize current evidence regarding the effects and impact of local/hospital-based HTA. METHODS We identified articles through PubMed and Embase and by citation tracking of included studies. We selected qualitative, quantitative, or mixed-methods studies with empirical data about the effects or impact of local/hospital-based HTA on decision-making, budget, or perceptions of stakeholders. We extracted the following information from included studies: country, methodological approach, and use of conceptual framework; local/hospital HTA approach and activities described; reported effects and impacts of local/hospital-based HTA; factors facilitating/hampering the use of hospital-based HTA recommendations; and perceptions of stakeholders concerning local/hospital HTA. Due to the great heterogeneity among studies, we conducted a narrative synthesis of their results. RESULTS A total of 18 studies met the inclusion criteria. We reported the results according to the four approaches for performing HTA proposed by the Hospital Based HTA Interest Sub-Group: ambassador model, mini-HTA, internal committee, and HTA unit. Results showed that each of these approaches for performing HTA corresponds to specific needs and structures and has its strengths and limitations. Overall, studies showed positive impacts related to local/hospital-based HTA on hospital decisions and budgets, as well as positive perceptions from managers and clinicians. CONCLUSIONS Local/hospital-based HTA could influence decision-making on several aspects. It is difficult to evaluate the real impacts of local HTA at the different levels of health care given the relatively small number of evaluations with quantitative data and the lack of clear comparators. Further research is necessary to explore the conditions under which local/hospital-based HTA results and recommendations can impact hospital policies, clinical decisions, and quality of care and optimize the use of scarce resources.
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Affiliation(s)
- Marie-Pierre Gagnon
- Centre de recherche du CHU de Québec, 10 rue de l'Espinay, D6-726 Quebec City, QC G1L 3L5, Canada.
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Rampe D, Poder T, Zhao ZY, Schilling WP. Calcium channel agonist and antagonist binding in a highly enriched sarcolemma preparation obtained from canine ventricle. J Cardiovasc Pharmacol 1989; 13:547-56. [PMID: 2470991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The purpose of the present study was to characterize the binding of the Ca2+ channel agonist (+/-)[3H]Bay K 8644 in a highly enriched cardiac membrane preparation and to examine its interactions with other Ca2+ channel ligands. Scatchard analysis showed that (+/-)[3H]Bay K 8644 displayed some 265-fold less affinity for its receptor than did the Ca2+ channel antagonist (+)[3H]PN200-110. Furthermore, (+/-)[3H]Bay K 8644 binding site density was significantly less than that seen for (+)[3H]PN200-110. Kinetic analysis of (+/-)[3H]Bay K 8644 binding revealed biphasic association and dissociation rates. The Ca2+ channel antagonist MDL 12,330A stimulated both (+)[3H]PN200-110 and (+/-)[3H]Bay K 8644 binding by effects on Kd. In contrast, diltiazem inhibited (+)[3H]PN200-110 binding but had no effect on (+/-)[3H]Bay K 8644 binding. Both MDL 12,330A and diltiazem inhibited Ca2+-dependent contraction in rat aortic rings but the combination of these two drugs was less than additive in this regard. We conclude that the binding profile of (+/-)[3H]Bay K 8644 results from the racemic nature of this ligand and that MDL 12,330A and diltiazem interact at sites distinct from one another on or around the slow voltage-dependent Ca2+ channel.
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Affiliation(s)
- D Rampe
- Department of Physiology, Baylor College of Medicine, Houston, Texas
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