ICES Report: Increasing Access to Health Administrative Data with ICES Data &amp; Analytic Services

Ishiguro, Lisa; Saskin, Refik; Vermeulen, Marian J.; Yates, Erika; Gunraj, Nadia; Victor, J. Charles

doi:10.12927/hcq.2016.24617

Cited by 10 publications

(8 citation statements)

References 3 publications

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“…These studies used physician self-reported survey data subject to selection bias, as physicians willing to participate may be those who prescribe in accordance with guideline recommendations. A validation study is currently ongoing to compare our results with data from the Institute for Clinical and Evaluative Sciences (ICES), which encompasses publicly funded administrative health data for the Ontario population eligible for universal health coverage (31). Preliminary results from this study confirm no improvement in statin, ACEI, and ARB prescriptions at or after guideline intervention (P .…”

Section: Discussionmentioning

confidence: 75%

Impact of the Diabetes Canada Guideline Dissemination Strategy on the Prescription of Vascular Protective Medications: A Retrospective Cohort Study, 2010–2015

et al. 2018

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The 2013 Diabetes Canada guidelines launched targeted dissemination tools and a simple assessment for vascular protection. We aimed to 1) examine changes associated with the launch of the 2013 guidelines and additional dissemination efforts in the rates of vascular protective medications prescribed in primary care for older patients with diabetes and 2) examine differences in the rates of prescriptions of vascular protective medications by patient and provider characteristics. RESEARCH DESIGN AND METHODS The study population included patients (‡40 years of age) from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) with type 2 diabetes and at least one clinic visit from April 2010 to December 2015. An interrupted time series analysis was used to assess the proportion of eligible patients prescribed a statin, ACE inhibitor (ACEI)/angiotensin receptor blocker (ARB), or antiplatelet prescription in each quarter. Proton pump inhibitor (PPI) prescriptions were the reference control. RESULTS A dynamic cohort was used where participants were enrolled each quarter using a prespecified set of conditions (range 25,985-70,693 per quarter). There were no significant changes in statin (P = 0.43), ACEI/ARB (P = 0.42), antiplatelet (P = 0.39), or PPI (P = 0.16) prescriptions at baseline (guideline intervention). After guideline publication, there was a significant change in slope for statin (20.52% per quarter, SE 0.15, P < 0.05), ACEI/ARB (20.38% per quarter, SE 0.13, P < 0.05), and reference PPI (20.18% per quarter, SE 0.05, P < 0.05) prescriptions. CONCLUSIONS There was a decrease in prescribing trends over time that was not specific to vascular protective medications. More effective knowledge translation strategies are needed to improve vascular protection in diabetes in order for patients to receive the most effective interventions.

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Section: Discussionmentioning

confidence: 75%

Impact of the Diabetes Canada Guideline Dissemination Strategy on the Prescription of Vascular Protective Medications: A Retrospective Cohort Study, 2010–2015

et al. 2018

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“…We are now therefore validating our results using data from ICES (formerly the Institute for Clinical Evaluative Sciences), a prescribed entity under Ontario's privacy legislation authorized to collect and use health care data for the purposes of health system analysis, evaluation and decision support [17]. Our research questions were: did the 2013 Diabetes Canada guidelines influence the coverage of vascular protective medications in patients with diabetes?…”

Section: Introductionmentioning

confidence: 85%

Impact of the diabetes Canada guideline dissemination strategy on dispensed vascular protective medications for older patients in Ontario, Canada: a linked EMR and administrative data study

Greiver

Kalia

Moineddin

et al. 2020

BMC Health Serv Res

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Background: The 2013 Diabetes Canada guidelines recommended routinely using vascular protective medications for most patients with diabetes. These medications included statins and angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). Antiplatelet agents were only recommended for secondary prevention of cardiovascular disease. Using Electronic Medical Record (EMR) data, we previously found that guideline dissemination efforts were not associated with an increase in the rate of primary care prescriptions of these medications. However, this needs confirmation: patients can receive prescriptions from different sources including specialists and they may not always fill these prescriptions. Using both EMR and administrative health data, we examined whether guideline dissemination impacted the dispensing of vascular protective medications to patients. Methods: The study population included patients with diabetes aged 66 or over in Ontario, Canada. We created two cohorts using two different approaches: an Electronic Medical Record (EMR) algorithm for diabetes using linked EMRadministrative data and an administrative algorithm using population level administrative data. We examined data from January 2010 to December 2016. Patients with diabetes were deemed to be likely taking a medication (or covered) during a quarter if the daily amount for a dispensed medication would last for at least 75% of days in any given quarter. An interrupted time series analysis was used to assess the proportion of patients covered by each medication class. Proton pump inhibitors (PPIs) were used as a reference.

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“…The first limitation concerns the reliability of administrative healthcare data used, and the second concerns complexity of the clustering technique. Despite the population-wide universal health coverage in Ontario, which strives to provide equal access, and the reliability/validity of ICES data on ED and acute care visits [76][77][78], there may remain uncovered variation between the sexes due to differences in help-seeking behaviors. This may be especially true for certain external causes of TBI, for example, assault related TBI.…”

Section: External Cause and Tbi Severitymentioning

confidence: 99%

Sex-specific analysis of traumatic brain injury events: applying computational and data visualization techniques to inform prevention and management

Mollayeva

Tran

Chan

et al. 2022

BMC Med Res Methodol

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Background The interplay of host, agent, and environment implicated in traumatic brain injury (TBI) events is difficult to account for in hypothesis-driven research. Data-driven analysis of injury data can enable insight into injury events in novel ways. This research dissected complex and multidimensional data at the time of the TBI event by exploiting data mining and information visualization methods. Methods We drew upon population-based decade-long health administrative data collected through the routine operation of the publicly funded health system in Ontario, Canada. We applied a computational approach to categorize health records of 235,003 patients with TBI versus the same number of reference patients without TBI, individually matched based on sex, age, place of residence, and neighbourhood income quantile. We adopted the basic concepts of the Haddon Matrix (host, agent, environment) to organize emerging factors significantly related to TBI versus non-TBI events. To explore sex differences, the data of male and female patients with TBI were plotted on heatmaps and clustered using hierarchical clustering algorithms. Results Based on detected similarities, the computational technique yielded 34 factors on which individual TBI-event codes were loaded, allowing observation of a set of definable patterns within the host, the agent, and the environment. Differences in the patterns of host, agent and environment were found between male and female patients with TBI, which are currently not identified based on data from injury surveillance databases. The results were internally validated. Conclusions The study outlines novel areas for research relevant to TBI and offers insight into how computational and visual techniques can be applied to advance the understanding of TBI event. Results highlight unique aspects of sex differences of the host and agent at the injury event, as well as differences in exposure to adverse social and environmental circumstances, which can be a function of gender, aiding in future studies of injury prevention and gender-transformative care.

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ICES Report: Increasing Access to Health Administrative Data with ICES Data & Analytic Services

Cited by 10 publications

References 3 publications

Impact of the Diabetes Canada Guideline Dissemination Strategy on the Prescription of Vascular Protective Medications: A Retrospective Cohort Study, 2010–2015

Impact of the Diabetes Canada Guideline Dissemination Strategy on the Prescription of Vascular Protective Medications: A Retrospective Cohort Study, 2010–2015

Impact of the diabetes Canada guideline dissemination strategy on dispensed vascular protective medications for older patients in Ontario, Canada: a linked EMR and administrative data study

Sex-specific analysis of traumatic brain injury events: applying computational and data visualization techniques to inform prevention and management

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