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Research with Impact

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Research with Impact Research with Impact A selection of recent projects that illustrate the combination of clinical insight and scientific rigour that drives ICES research. Helping to inform Supporting Patients First Contributing to policy Driving the development Advancing Ontario’s Canada’s opioid response by mapping access to changes for the prevention of new cardiovascular mental health strategy primary care of concussions risk prediction models with system-wide with big data benchmarking and analysis Institute for Clinical Evaluative Sciences 9 Tara Gomes David Juurlink Helping to inform Canada’s opioid response The inappropriate use of prescription opioids has ICES research also helped to inform the Canadian The work of ICES and ODPRN emerged as a significant public health and safety issue Medical Association’s 2015 policy statement on harms has helped to drive rapid, in Ontario and across Canada. Work conducted at associated with opioids and other psychoactive targeted regional responses ICES contributed to the speed with which Ontario has prescription drugs, which recommended the launch to the opioid crisis. modelled for other provinces the collection of timely of a comprehensive national strategy. ICES senior and robust data and analysis for an evidence-informed scientist David Juurlink presented at the House of response to the opioid crisis. Commons Standing Committee on Health during the strategy formulation in October 2016, and delivered ICES scientist Tara Gomes is principal investigator of a keynote address at Canada’s national Opioid ICES research helped to the Ontario Drug Policy Research Network (ODPRN), Conference the following month. inform Ontario’s Strategy to in which ICES is a partner. A 2016 CMAJ paper co- Prevent Opioid Addiction authored by Gomes demonstrated that national vital Also informed by ICES/ODPRN research, Ontario’s statistics can be used to analyze prescription opioid- Strategy to Prevent Opioid Addiction and Overdose and Overdose, now being related mortality with considerable accuracy in the is now being implemented. In January 2017, based on implemented, including the absence of more sophisticated surveillance systems, an ODPRN analysis, Ontario delisted high-strength delisting of high-strength to accelerate national surveillance and monitoring formulations of long-acting opioids from the Ontario formulations of long-acting strategies. Gomes’s methodology used ICES linked Drug Benefit Formulary to help prevent addiction and opioids from the Ontario Drug data for validation and is now being replicated in other support appropriate prescribing. ICES and ODPRN Benefit Formulary. provinces. The paper was awarded the 2017 Article of have been conducting ongoing rapid analysis of opioid the Year by the CIHR’s Institute of Health Services and utilization patterns, including an analysis of palliative Policy Research. care patients to determine the policy’s potential ICES research helped to impact on this patient population. inform the CMA’s 2015 policy At the local level, ongoing data collection and analysis statement on harms contributed by ICES and ODPRN about patterns of associated with opioids and opioid use for each of the province’s public health other psychoactive units and Local Health Integration Networks has been helping to inform rapid regional responses to the prescription drugs, which opioid crisis. recommended the launch of a comprehensive national strategy. 10 2016/17 ANNUAL REPORT Rick Glazier Supporting Patients First by mapping access to primary care With the passage of Ontario’s Patients First Act “Low attachment and low continuity mean disordered Working in partnership with in 2016, the province’s 14 Local Health Integration care,” explains Glazier. “Where people don’t have the Toronto Central LHIN, Networks assumed responsibility for planning and regular access to a family doctor, we see chaotic ICES researchers have used performance improvement for the primary health care patterns of health system use, with more use of administrative and other data system. The Act requires that this planning take place emergency services and less use of preventative held at ICES to create at smaller regional levels to better address the unique measures like cancer screening and diabetes care. neighbourhood-level maps health care needs of the province’s diverse urban, rural That’s where you’ll see higher health costs.” that pinpoint areas where and remote communities. The neighbourhood mapping process is gradually being patients have low access to Some of the groundwork for this more localized applied across Ontario, with planners at other LHINs primary care. planning has been undertaken by the Ontario Community requesting similar data. Health Profiles Partnership (OCHPP), using data held at ICES. Guiding the project is Rick Glazier, a senior To support local capacity building, the OCHPP The neighbourhood mapping scientist at ICES and lead of its primary care and maintains an open-access web data portal. The tool process is gradually being population health research program. Dr. Glazier is also enables health policy planners and local agencies applied across Ontario, with a scientist at the Centre for Urban Health Solutions at to interact with the data for planning purposes. For planners at other LHINs St. Michael’s Hospital. example, the Toronto Central LHIN, a partner in the requesting similar data. OCHPP, has been using the tool to plan local access to Glazier and his team were approached by the Toronto interprofessional care, including Family Health Teams Central LHIN to create neighbourhood-level maps for and Community Health Centres. prioritizing resource allocation. By linking primary care The Ontario Community “By bringing together the issues of primary care and records with geographic and demographic data, the Health Profiles Partnership population health, we can see how they overlap and team identified areas where residents were less likely uses linked data from ICES to to be attached to a primary care physician and where influence each other,” says Glazier. “Looking at these maintain a web portal that continuity of care was low. interactions in the context of equity and geography, we can map, neighbourhood by neighbourhood and allows health policy planners region by region, where health investment is most and local agencies such as needed in Ontario.” Community Health Centres to interact with the data for planning purposes. Institute for Clinical Evaluative Sciences 11 Donald Redelmeier Alison Macpherson Contributing to policy changes for the prevention of concussions Inspired by his work caring for patients diagnosed to address child and youth concussion. The Rowan’s International news coverage with acute concussion in the Sunnybrook emergency Law Advisory Committee, named in honour of a of Donald Redelmeier’s work department, ICES senior scientist Donald Redelmeier young woman who died following a rugby injury, was on concussion and suicide has set out to investigate media anecdotes on the link established by an act of the Ontario legislature in informed ongoing discussions between concussions and suicide. This curiosity- 2016 with a mandate to create new guidelines around of risk in professional driven investigation revealed that a patient’s history concussion in children and youth in sport. The Manitoba sports, including the NFL, CFL of concussion could triple the subsequent risk of government subsequently announced plans for similar and NHL. suicide. Redelmeier’s 2016 paper received coverage legislation. Former NHL player Eric Lindros cited ICES from major news outlets in Canada, the United States in his championing of Rowan’s Law, adding that the and Europe and contributed to evolving discussions Ontario legislation “should be the gold standard across about the prevention and treatment of head injuries in Canada that we all support.” Work by Macpherson and professional athletes, including those in the NFL, CFL Guttmann on child and youth and NHL. The work has also led to increased attention concussions has informed to preventing concussions among adults engaged in Rowan’s Law, proposed everyday activities. legislation that will lead to Also concerned about rising concussion rates in province-wide practice children and youth, ICES senior adjunct scientist guidelines for youth sport. Alison Macpherson, a professor at York University, and ICES chief science officer Astrid Guttmann, a physician at the Hospital for Sick Children, examined the treatment of pediatric concussion cases in emergency departments and primary care centres across Ontario. Their study determined that rates of pediatric concussion had risen sharply in 10 years, nearly doubling for boys and more than doubling for girls. Hockey and ice skating were the leading causes. These findings have informed Ontario legislation 12 2016/17 ANNUAL REPORT Jack Tu Driving the development of new cardiovascular risk prediction models with big data The Cardiovascular Health in Ambulatory Care for goal setting. For example, the Heart and Stroke Launched in 2012, the Research Team (CANHEART) big data project was Foundation used the index to inform its ambitious CANHEART big data initiative launched in 2012. Under the direction of Jack Tu, a 2020 Mission Impact Goals, with an aim of reducing the conducts multifactorial senior scientist at ICES and lead of its cardiovascular risk factors for heart disease and stroke by 10% and analyses of cardiovascular research program, the multi-year project uses encoded the death rate from heart disease and stroke
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