W A Ghali

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..However, such a strategy should only be undertaken if it is cost-effective...

..The three modes of transport considered in this study are ground ambulance, rotary wing air ambulance and fixed wing air ambulance...

..The resulting literature repository that our review has created can be of use to researchers and health system stakeholders interested in the topic of health system quality measurement and reporting...

..The purpose of this study was to compare HRQOL outcomes of men and women in Alberta, at one-year following initial catheterization, after adjustment for known demographic, co-morbid, and disease severity predictors of outcome...

..However, recent meta-analyses have prompted re-evaluation of this practice. The study objective was to evaluate the relative and absolute benefits and harms of aspirin for the prevention of incident MACE in patients with diabetes...

..Rosiglitazone remained available for use as more definitive safety trials were ongoing. This issue was reported in the lay media...

..The objective of this study is to determine if the clinical profiles and medication use of patients referred for diabetes care differ across income quintiles...

..We sought to determine the research priorities for perioperative medicine using a cross sectional survey of Canadian and American general internists...

..Consultation patterns to medical subspecialists and the patient factors that may influence consultation are reported for general medical services...

..Here, we describe the process of translating our data merging solution to ICD-10, and then validating its performance...

..Here, we present a methodological "case-report" of the yield of a multi-step survey study assessing views on health care among American emigres to Canada, a hard-to-reach population...

..The objective of this study was to compare six different imputation techniques for dealing with missing data in the Zung Self-reported Depression scale (SDS)...

..Contrast-induced nephropathy is an important cause of acute renal failure. We assess the efficacy of acetylcysteine for prevention of contrast-induced nephropathy among patients undergoing intravascular angiography...

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..Nutrition has been linked to cognition. We aimed to examine the effect of a nutrition based intervention, that of scheduled nutrition breaks during the work day, upon physician cognition, glucose, and hypoglycemic symptoms...

..The objective of the present study was to determine whether income is associated with referral to a diabetes centre within a universal health care system...

..Minkowski distance is a more promising method. Distances estimated with each metric are contrasted with road distance and travel time measurements, and an optimized Minkowski distance is implemented in spatial analytical modeling...

..To update appropriateness ratings for carotid endarterectomy using the best clinical evidence and to develop a tool to audit the procedure's use...

..However, the centralization of preoperative assessment clinics may introduce geographical barriers to utilization that are dependent on where a patient lives with respect to the location of the preoperative assessment clinic...

..This paper presents a list of high-priority methodological areas for researchers using health administrative data...

..In addition, the impact of this decision aid on patient knowledge, decisional conflict, well-being, and adherence will be assessed after 3 months, 6 months, and 12 months...

..We examined the association between risk-taking attitudes and cardiac patients' clinical and demographic characteristics, the likelihood of undergoing invasive cardiac procedures and survival...

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..The authors have previously reported on Canada-wide outcomes of coronary artery bypass graft (CABG) surgery for 1992/93 through 1995/96...

..We conducted a systematic review and meta-analysis of observational studies to assess the risk of thromboembolism associated with atrial flutter...

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..Our objectives were (1) to identify clinical variables associated with IABP use, and (2) to examine risk-adjusted rates of IABP use for 12 Massachusetts hospitals performing CABG operations...

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..Use of this method is widespread despite published concerns regarding the validity of resulting curves...

..However, the validity of these judgements is unknown. We therefore compared the importance of articles published on a "fast track" with those published in the usual way...

..Although some studies suggest that access to cardiac procedures may differ by sex, others have found no evidence of gender bias in cardiac care...

..Examples of applied research projects based on APPROACH data are also provided...

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..Alberta and British Columbia have comprehensive cardiac databases that provide detailed demographic, clinical and procedural data, including coronary anatomy, on all patients undergoing cardiac catheterization...

..The objectives of this study were to examine Canadian trends in rates of in-hospital death after CABG and to compare provincial risk-adjusted death rates...

..12), respectively. We conclude that renal insufficiency, both dialysis dependent and non-dialysis dependent, is an independent risk factor for increased mortality and poor long-term survival among patients undergoing coronary angiography...

..5%-33%) than does the Charlson/Deyo method (5%-25%). CONCLUSIONS: The Elixhauser comorbidity measurement method performs better than the widely used Charlson/Deyo method in the Canadian acute MI cases studied...

..2). The superior performance of the enhanced data model supports the use of this "enhancement" methodology and bears consideration when researchers are faced with nonrandom missing data...

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..Alternatively, some patients may have turned to chelation as a "last resort" after having been judged unsuitable for revascularization...

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..The ability to predict in-hospital mortality is less reliable for some of the individual comorbidities than it is for the summarized Charlson index scores in administrative data...

..Our findings indicate that controversial changes to the structure of the health care system can occur without loss of efficiency and reduction in quality of care...

..This nationwide study examined observed and risk-adjusted death rates for 23 Canadian hospitals performing CABG...

..3 mg/dl)...

..This study examines the use of an existing database to gain further insights into the relationship between geography and access to cardiac care, and the distance-access relationship for coronary revascularization in Alberta...

..The combination of these results with a recent randomized trial suggests that the benefits of aggressive revascularization therapies may extend to subsets of patients in older age groups...

..This study sought to determine the rate and the regional variation in the rate of CEA in Canada, its provinces, and census divisions for 1994-1997...

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..We sought to describe patient characteristics and outcomes according to hospital volume along with patterns of regionalization for hepatic resection in Canada from 1995 to 2004...

..Primary percutaneous coronary intervention (PCI) is a proven therapy for acute ST-segment elevation myocardial infarction. However, outcomes associated with primary PCI may differ depending on time of day...

..Programs caring for patients with chronic medical conditions such as ESRD should examine how computer databases could assist in clinical care and improve the efficiency with which that care is delivered to their patients...

..This was confirmed using computer simulations. SDT estimates should be abandoned in favor of more sophisticated estimates...

..Despite this, both income measures appear to be prognostically relevant, perhaps because individual and neighborhood income measure different constructs...

..The objective of this study was to determine whether income status was associated with burden of coronary atherosclerosis in patients with diabetes...

..Chronic kidney disease is common among the elderly, and these patients are at risk of progressive kidney dysfunction...

..We determined whether access to care differed between status Aboriginal people (Aboriginal people registered under the federal Indian Act) and non-Aboriginal people with chronic kidney disease...

..We were interested in evaluating how general internists assess, define, communicate, and attempt to modify perioperative cardiac risk...

..HRQOL data were collected at 1 year following catheterization using the Seattle Angina Questionnaire (SAQ), a disease-specific quality of life and symptom rating scale...

..Whether these factors have different effects on mortality post-acute myocardial infarction (AMI) in men and women is not clear...

..No sex differences were evident in the treatment of AMI among patients treated in an urban Canadian centre...

..These prediction rules can be useful for risk-adjustment analyses and for prognostication for individual patients...

..This study provides a valuable 'snapshot' of cardiac procedure use rates but indicates a clear need for more comprehensive collection of cardiac care data in Canada...

..928). An abnormal T axis was a significant predictor of overall mortality (p = 0.035) for death at any time in our unadjusted survival analysis, and a trend toward poorer survival persisted after adjustment for clinical covariates...

..In Canada, 0.51% of CABG procedures were combined CEA-CABG. The adjusted stroke and death rate was 2.67-fold greater in the combined CEA-CABG group compared to CABG alone. Randomized trials of the combined procedure are needed...

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..In addition, the need to adopt a longer-term view of risk in ACS patients is stressed, with particular regard to the important role of heart failure prediction and treatment...

..Acute kidney injury (AKI) is associated with early mortality after percutaneous coronary revascularization procedures, but its prognostic relevance to long-term clinical outcomes remains controversial...

..Findings indicated that enhancing the facilities of the patient care environment improved patients' overall perceptions of the quality of their hospital stay...

..001). CONCLUSION: To maximize the efficiency with which care is provided to patients with ESRD, dialysis programs should encourage the use of home/self-care hemodialysis and peritoneal dialysis...

..EA-derived measures should therefore be used when individual data are not available...

..However, little is known about the validity of administrative coding of procedure data. We conducted a detailed chart review to evaluate the accuracy and completeness of information on procedures in administrative data...

..We show that health systems should routinely measure physician wellness, and discuss the challenges associated with implementation...

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..Previous studies evaluated cardiac procedure use and outcome over the short term, with relatively few Asian patients included...

..Control of rheumatoid arthritis (RA) may reduce the risk of cardiovascular events. We sought to systematically assess the association between anti-tumor necrosis factor α (anti-TNFα) therapy in RA and cardiovascular event rates...

..These results provide evidence that administrative data can be used as a relatively valid source of data to define cases of hypertension for surveillance and research purposes...

..Significant improvements in left ventricular ejection fractions after ablation were observed in those with LVSD. Randomized trials are needed given the limitations of present data...

..The tradeoff between benefit and bleeding risk, however, has not been adequately characterized...

..Given that the validity of diagnosis-type indicators is unknown, we conducted a detailed chart review to evaluate the accuracy of diagnosis-type indicators for flagging complications...

..Studies comparing outcomes of cardiac care in women vs men yield various results, with some suggesting worse outcomes for women and others suggesting equivalent outcomes...

..In particular, a low rate of short-term adverse events is required for the long-term benefits of CE to accrue over time...

..Surnames have the potential to accurately identify ancestral origins as they are passed on from generation to generation. In this study, we developed and validated a Chinese surname list to define Chinese ethnicity...

..CONCLUSION: In situations with competing risks, and where an analysis focuses on first events, the CICR method is most appropriate, as K-M methods will tend to overestimate event rates...

..73 to 2.58]). CONCLUSIONS: These findings are suggestive of a protective effect of statin therapy in symptomatic patients pre-treated at the time of carotid endarterectomy, though this needs confirmation in a randomized controlled trial...

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..To describe health status outcomes at 4 years for a cohort of elderly patients with cardiac disease...

..We evaluated the prognosis associated with diabetes, in analyses stratified by sex, to determine whether similar differences are seen in a large unselected cohort of patients...

..Recognizing this, we conducted a multistep process to develop ICD-10 coding algorithms to define Charlson and Elixhauser comorbidities in administrative data and assess the performance of the resulting algorithms...

..Strategies aimed at slowing progression of kidney disease should consider underlying risk factors for progression and the negligible loss of kidney function that occurs in the majority of older adults...

..To determine the proportion of consultations requested by general internal medicine services that communicate key components of the consultation process to medical subspecialists...

..Among patients with a patent foramen ovale (PFO) and a prior cryptogenic ischemic stroke or TIA, the absolute and relative risk of recurrent events is unclear...

..A considerable number of patients receive chelation therapy to treat their coronary artery disease. However, there is no current empirical evidence to support its use...

..We performed a systematic review of the literature to assess the efficacy and safety of low-molecular-weight heparin administered at different times in relation to surgery vs oral anticoagulant prophylaxis...

..The prediction of patient complaints is not clearly understood. This is important in so far as patient complaints have been shown to correlate with other adverse outcomes of interest in acute care facilities...

..In part, this is due to the intrusiveness of the treatment (hemodialysis or peritoneal dialysis) that is required. It is unclear whether hemodialysis or peritoneal dialysis is associated with a higher HRQOL...