Accessing Health and Health-Related Data in Canada
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Programs Synopses
Employment and Social Development Canada Overview of Programs and Emerging Best Practices Related to Preventing Violence and Increasing Safety for Indigenous Women and Girls For the National Inquiry into the Missing and Murdered Indigenous Women and Girls Indigenous Coordination and Engagement Division, Indigenous Affairs Directorate, Skills and Employment Branch, ESDC 10/12/2018 Contents Employment and Social Development Canada’s Mandate .............................................. 2 Systemic Barriers and Challenges .................................................................................. 4 Emerging Best Practices ................................................................................................. 5 1. Co-Development and Engagement .......................................................................... 5 2. Supporting Innovation and Increasing Flexibility ...................................................... 8 3. Improving Access and Building Trust ....................................................................... 9 4. Culturally Appropriate Indicators for Success ........................................................ 11 Providing Support to Affected Families ......................................................................... 12 The Federal Income Support for Parents of Murdered or Missing Children Grant (2013 – Present) .................................................................................................................. 12 ANNEX A ..................................................................................................................... -
2019 Abstract Book
2019 NATIONAL MEETING / ÉDITION 2019 DU CONGRÈS ANNUEL: TAKING ACTION LE SURDIAGNOSTIC : PASSEZ À L’ACTION ABSTRACT BOOK CAHIER DES RÉSUMÉS Dear National Meeting Attendees, We are excited to be hosting the National Meeting in Montreal, Quebec and for the first time featuring both English and French sessions. I would like to thank our co-host, the Quebec Medical Association and our partner, the Canadian Medical Association for their contributions to this year’s event. The 2019 National Meeting includes a special celebration marking the fifth anniversary of the Choosing Wisely Canada campaign. I am thrilled to celebrate this important milestone with the Choosing Wisely Canada community and recognize our collective efforts in reducing unnecessary tests and treatments. In the past five years, Choosing Wisely Canada has evolved from a conversation between clinicians and patients to the national voice for reducing unnecessary tests and treatments in health care. There has been unparalleled engagement and dedication from clinicians, administrators, researchers and systems leaders. There are close to 350 quality improvement projects related to the campaign taking root across the country and 12 active provincial and territorial campaigns to help accelerate the pace of change locally. As Chair of Choosing Wisely Canada, I am proud of the sizable impact our community has had in Canada and the momentum the campaign has gained. This year’s theme Taking Action is reflective of our next chapter of the campaign. The abstracts featured in this book are a testament to the breadth of projects taking place from coast-to-coast and showcase the energy of our community in putting campaign recommendations into practice. -
From Explanatory to Pragmatic Clinical Trials: a New Era for Effectiveness Research
From Explanatory to Pragmatic Clinical Trials: A New Era for Effectiveness Research Jerry Jarvik, M.D., M.P.H. Professor of Radiology, Neurological Surgery and Health Services Adjunct Professor Orthopedic Surgery & Sports Medicine and Pharmacy Director, Comparative Effectiveness, Cost and Outcomes Research Center (CECORC) UTSW April 2018 Acknowledgements •NIH: UH2 AT007766; UH3 AT007766 •NIH P30AR072572 •PCORI: CE-12-11-4469 Disclosures Physiosonix (ultrasound company): Founder/stockholder UpToDate: Section Editor Evidence-Based Neuroimaging Diagnosis and Treatment (Springer): Co-Editor The Big Picture Comparative Effectiveness Evidence Based Practice Health Policy Learning Healthcare System So we need to generate evidence Challenge #1: Clinical research is slow • Tradi>onal RCTs are slow and expensive— and rarely produce findings that are easily put into prac>ce. • In fact, it takes an average of 17 ye ars before research findings Howlead pragmaticto widespread clinical trials canchanges improve in care. practice & policy Challenge #1: Clinical research is slow “…rarely produce findings that are easily put into prac>ce.” Efficacy vs. Effectiveness Efficacy vs. Effectiveness • Efficacy: can it work under ideal conditions • Effectiveness: does it work under real-world conditions Challenge #2: Clinical research is not relevant to practice • Tradi>onal RCTs study efficacy “If we want of txs for carefully selected more evidence- popula>ons under ideal based pr actice, condi>ons. we need more • Difficult to translate to real practice-based evidence.” world. Green, LW. American Journal • When implemented into of Public Health, 2006. How pragmatic clinical trials everyday clinical prac>ce, oZen seecan a “ voltage improve drop practice”— drama>c & decreasepolicy from efficacy to effec>veness. -
Payments to Ontario Physicians from Ministry of Health and Long-Term Care Sources: Update 2005/06 to 2017/18
Response to an Ontario Ministry of Health and Long-Term Care Applied Health Research Question Payments to Ontario Physicians from Ministry of Health and Long-Term Care Sources: Update 2005/06 to 2017/18 Prepared By Sue Schultz, Rick Glazier, Erin Graves, Michael Schull and Rinku Sutradhar Submission Date May 3, 2019 Submitted To Negotiations Branch Negotiations and Accountability Management Division Ontario Ministry of Health and Long-Term Care ICES Project No. 2018 0866 010 004 Corresponding Authors Dr. Michael Schull ICES 2075 Bayview Avenue, G-Wing Toronto, ON M4N 3M5 Tel: 416-480-4055, ext. 4297 [email protected] Sue Schultz, Senior Epidemiologist [email protected] Note: This file replaces the 2017 update which contained results to 2015/16. Acknowledgement This study was supported by ICES (formerly the Institute for Clinical Evaluative Sciences), which is funded by the Ontario Ministry of Health and Long-Term Care (MOHLTC). The opinions, results and conclusions are those of the authors and are independent from the funding source. No endorsement by ICES or the Ontario MOHLTC is intended or should be inferred. © ICES. All rights reserved. Payments to Ontario Physicians from Ministry of Health and Long-Term Care Sources: Update 2005/06 to 2017/18 Study Population All active Ontario physicians. Time Frame The study reports physician payments for Ontario and by specialty for the years 2005/06 to 2017/18. Although previous reports have included payment estimates for 2000/01 to 2004/05 as well, the data for these years are known to be incomplete. The decision was made to exclude these early years to ensure comparable data across all years with respect to trends over time. -
Information Sheet for the Canada Pension Plan Retirement Pension
Information Sheet for the Canada Pension Plan Retirement Pension This information sheet provides step-by-step information on how to complete the application for a Canada Pension Plan (CPP) retirement pension. You can receive your pension anytime after the month of your th 60 birthday. For information on Canada's public pensions and for help estimating how much income you may need for your retirement, according to your personal financial situation, you can use the Canadian Retirement Income Calculator. This online tool is available at www.servicecanada.gc.ca. For More Information To learn more about Canada Pension Plan, Old Age Security Program and Service Canada online services, please visit our Web site at: www.servicecanada.gc.ca. In Canada and the United States, call English: 1-800-277-9914 French: 1-800-277-9915 TTY: 1-800-255-4786 From all other countries: 613-957-1954 (we accept collect calls) (Please have your Social Insurance Number ready when you call.) This information sheet contains general information concerning the Canada Pension Plan (CPP) retirement pension. If there are any differences between what is in the information sheet and the CPP legislation, the legislation is always right. Service Canada delivers Employment and Social Development Canada programs and services for the Government of Canada SC ISP-1000A (2020-07-16) E 1 / 8 Disponible en français Information Sheet for the Canada Pension Plan Retirement Pension Question 4: Proof of Birth You do not need to provide proof of birth with your application. However, the Canada Pension Plan has the right to request proof of birth at any time, when considered necessary. -
Using Randomized Evaluations to Improve the Efficiency of US Healthcare Delivery
Using Randomized Evaluations to Improve the Efficiency of US Healthcare Delivery Amy Finkelstein Sarah Taubman MIT, J-PAL North America, and NBER MIT, J-PAL North America February 2015 Abstract: Randomized evaluations of interventions that may improve the efficiency of US healthcare delivery are unfortunately rare. Across top journals in medicine, health services research, and economics, less than 20 percent of studies of interventions in US healthcare delivery are randomized. By contrast, about 80 percent of studies of medical interventions are randomized. The tide may be turning toward making randomized evaluations closer to the norm in healthcare delivery, as the relevant actors have an increasing need for rigorous evidence of what interventions work and why. At the same time, the increasing availability of administrative data that enables high-quality, low-cost RCTs and of new sources of funding that support RCTs in healthcare delivery make them easier to conduct. We suggest a number of design choices that can enhance the feasibility and impact of RCTs on US healthcare delivery including: greater reliance on existing administrative data; measuring a wide range of outcomes on healthcare costs, health, and broader economic measures; and designing experiments in a way that sheds light on underlying mechanisms. Finally, we discuss some of the more common concerns raised about the feasibility and desirability of healthcare RCTs and when and how these can be overcome. _____________________________ We are grateful to Innessa Colaiacovo, Lizi Chen, and Belinda Tang for outstanding research assistance, to Katherine Baicker, Mary Ann Bates, Kelly Bidwell, Joe Doyle, Mireille Jacobson, Larry Katz, Adam Sacarny, Jesse Shapiro, and Annetta Zhou for helpful comments, and to the Laura and John Arnold Foundation for financial support. -
Interpreting Indirect Treatment Comparisons and Network Meta
VALUE IN HEALTH 14 (2011) 417–428 available at www.sciencedirect.com journal homepage: www.elsevier.com/locate/jval SCIENTIFIC REPORT Interpreting Indirect Treatment Comparisons and Network Meta-Analysis for Health-Care Decision Making: Report of the ISPOR Task Force on Indirect Treatment Comparisons Good Research Practices: Part 1 Jeroen P. Jansen, PhD1,*, Rachael Fleurence, PhD2, Beth Devine, PharmD, MBA, PhD3, Robbin Itzler, PhD4, Annabel Barrett, BSc5, Neil Hawkins, PhD6, Karen Lee, MA7, Cornelis Boersma, PhD, MSc8, Lieven Annemans, PhD9, Joseph C. Cappelleri, PhD, MPH10 1Mapi Values, Boston, MA, USA; 2Oxford Outcomes, Bethesda, MD, USA; 3Pharmaceutical Outcomes Research and Policy Program, School of Pharmacy, School of Medicine, University of Washington, Seattle, WA, USA; 4Merck Research Laboratories, North Wales, PA, USA; 5Eli Lilly and Company Ltd., Windlesham, Surrey, UK; 6Oxford Outcomes Ltd., Oxford, UK; 7Canadian Agency for Drugs and Technologies in Health (CADTH), Ottawa, ON, Canada; 8University of Groningen / HECTA, Groningen, The Netherlands; 9University of Ghent, Ghent, Belgium; 10Pfizer Inc., New London, CT, USA ABSTRACT Evidence-based health-care decision making requires comparisons of all of randomized, controlled trials allow multiple treatment comparisons of relevant competing interventions. In the absence of randomized, con- competing interventions. Next, an introduction to the synthesis of the avail- trolled trials involving a direct comparison of all treatments of interest, able evidence with a focus on terminology, assumptions, validity, and statis- indirect treatment comparisons and network meta-analysis provide use- tical methods is provided, followed by advice on critically reviewing and in- ful evidence for judiciously selecting the best choice(s) of treatment. terpreting an indirect treatment comparison or network meta-analysis to Mixed treatment comparisons, a special case of network meta-analysis, inform decision making. -
Health System Use by Frail Ontario Seniors an In-Depth Examination of Four Vulnerable Cohorts
Health System Use by Frail Ontario Seniors An in-depth examination of four vulnerable cohorts November 2011 Health System Use by Frail Ontario Seniors An in-depth examination of four vulnerable cohorts Editors Susan E. Bronskill, PhD Ximena Camacho, MMath Andrea Gruneir, PhD Minnie M. Ho, MHSc November 2011 Health System Use by Frail Ontario Seniors ICES II PUBLICATION INFORMATION Canadian Cataloguing in Publication Data How to Cite This Publication Published by the Institute for Clinical Evaluative Health System Use by Frail Ontario Seniors: An The production of Health System Use by Frail Ontario Sciences (ICES) In-Depth Examination of Four Vulnerable Cohorts. Seniors was a collaborative venture. Accordingly, to give credit to individual authors, please cite individual © 2011 Institute for Clinical Evaluative Sciences ISBN: 978-1-926850-21-4 (Online) chapters and title, in addition to editors and book title. All rights reserved. No part of this publication may be Institute for Clinical Evaluative Sciences (ICES) Bronskill SE, Corbett L, Gruneir A, Stevenson, reproduced, stored in a retrieval system or transmitted G1 06, 2075 Bayview Avenue JE. Introduction. In: Bronskill SE, Camacho X, Gruneir A, in any format or by any means, electronic, mechanical, Toronto, ON M4N 3M5 Ho MM, editors. Health System Use by Frail Ontario photocopying, recording or otherwise, without the Telephone: 416-480-4055 Seniors: An In-Depth Examination of Four Vulnerable proper written permission of the publisher. www.ices.on.ca Cohorts. Toronto, ON: Institute for Clinical Evaluative The opinions, results and conclusions included in this Sciences; 2011. report are those of the authors and are independent from the funding sources. -
Patient Reported Outcomes (PROS) in Performance Measurement
Patient-Reported Outcomes Table of Contents Introduction ............................................................................................................................................ 2 Defining Patient-Reported Outcomes ............................................................................................ 2 How Are PROs Used? ............................................................................................................................ 3 Measuring research study endpoints ........................................................................................................ 3 Monitoring adverse events in clinical research ..................................................................................... 3 Monitoring symptoms, patient satisfaction, and health care performance ................................ 3 Example from the NIH Collaboratory ................................................................................................................... 4 Measuring PROs: Instruments, Item Banks, and Devices ....................................................... 5 PRO Instruments ............................................................................................................................................... 5 Item Banks........................................................................................................................................................... 8 Devices ................................................................................................................................................................. -
A National Strategy to Develop Pragmatic Clinical Trials Infrastructure
A National Strategy to Develop Pragmatic Clinical Trials Infrastructure Thomas W. Concannon, Ph.D.1,2, Jeanne-Marie Guise, M.D., M.P.H.3, Rowena J. Dolor, M.D., M.H.S.4, Paul Meissner, M.S.P.H.5, Sean Tunis, M.D., M.P.H.6, Jerry A. Krishnan, M.D., Ph.D.7,8, Wilson D. Pace, M.D.9, Joel Saltz, M.D., Ph.D.10, William R. Hersh, M.D.3, Lloyd Michener, M.D.4, and Timothy S. Carey, M.D., M.P.H.11 Abstract An important challenge in comparative effectiveness research is the lack of infrastructure to support pragmatic clinical trials, which com- pare interventions in usual practice settings and subjects. These trials present challenges that differ from those of classical efficacy trials, which are conducted under ideal circumstances, in patients selected for their suitability, and with highly controlled protocols. In 2012, we launched a 1-year learning network to identify high-priority pragmatic clinical trials and to deploy research infrastructure through the NIH Clinical and Translational Science Awards Consortium that could be used to launch and sustain them. The network and infrastructure were initiated as a learning ground and shared resource for investigators and communities interested in developing pragmatic clinical trials. We followed a three-stage process of developing the network, prioritizing proposed trials, and implementing learning exercises that culminated in a 1-day network meeting at the end of the year. The year-long project resulted in five recommendations related to developing the network, enhancing community engagement, addressing regulatory challenges, advancing information technology, and developing research methods. -
Long-Term MI Outcomes at Hospitals with Or Without On-Site Revascularization
ORIGINAL CONTRIBUTION Long-term MI Outcomes at Hospitals With or Without On-site Revascularization David A. Alter, MD, PhD Context Many studies have found that patients with acute myocardial infarction (AMI) C. David Naylor, MD, DPhil who are admitted to hospitals with on-site revascularization facilities have higher rates Peter C. Austin, PhD of invasive cardiac procedures and better outcomes than patients in hospitals without such facilities. Whether such differences are due to invasive procedure rates alone or Jack V. Tu, MD, PhD to other patient, physician, and hospital characteristics is unknown. Objective To determine whether invasive procedural rate variations alone account ARK TWAIN REPUTEDLY for outcome differences in patients with AMI admitted to hospitals with or without said: “To a man with a on-site revascularization facilities. hammer, every nail looks Design Retrospective, observational cohort study using linked population-based ad- like it needs driving.” ministrative data from a universal health insurance system. MThis aphorism is reflected in the oft- Setting One hundred ninety acute care hospitals in Ontario, 9 of which offered in- replicated finding that, when patients vasive procedures. with acute myocardial infarction (AMI) Patients A total of 25697 patients hospitalized with AMI between April 1, 1992, are admitted to hospitals with on-site re- and December 31, 1993, of whom 2832 (11%) were in invasive hospitals. vascularization facilities, they undergo Main Outcome Measures Mortality, recurrent cardiac hospitalizations, -
Should the Canada Revenue Agency Also Be a Social Benefits Agency?
canadian tax journal / revue fiscale canadienne (2021) 69:1, 8 7 - 9 8 https://doi.org/10.32721/ctj.2021.69.1.pf.robson Policy Forum: Should the Canada Revenue Agency Also Be a Social Benefits Agency? Jennifer Robson and Saul Schwartz* PRÉCIS L’Agence du revenu du Canada (ARC) joue un rôle important dans le versement de prestations aux Canadiens, mais devrait-on élargir ce rôle? La rapidité et la facilité avec lesquelles l’ARC a lancé plusieurs nouvelles prestations de revenu pendant la pandémie de COVID-19 ont suscité la question de savoir si l’Agence devrait assumer un rôle beaucoup plus important en tant qu’organisme de prestations sociales, en plus de celui de percepteur d’impôts. Nous passons en revue les arguments pour et contre cette question, en notant les faiblesses importantes qui entravent déjà le rôle actuel de l’ARC dans le versement des prestations et qui seraient exacerbées si on élargissait ce rôle. Tout compte fait, nous concluons qu’un rôle élargi n’est pas le meilleur choix. Nous suggérons que l’ARC pourrait plutôt consolider l’une de ses forces — la collecte et le partage de renseignements — afin que d’autres organismes puissent administrer plus efficacement les prestations qui ne sont pas directement liées au régime fiscal. ABSTRACT The Canada Revenue Agency (CRA) plays an important role in the delivery of benefits to Canadians, but should that role be expanded? The speed and ease with which several new income benefits were launched by theCRA during the COVID-19 pandemic have prompted the question of whether the agency should take on a much larger role as a social benefits agency, in addition to tax collector.