A5030837062- Respiratory viral infections research
- Pneumonia and Respiratory Infections
- Emergency and Acute Care Studies
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare Policy and Management
- COVID-19 epidemiological studies
- Primary Care and Health Outcomes
- Viral gastroenteritis research and epidemiology
- Influenza Virus Research Studies
- Food Security and Health in Diverse Populations
- Chronic Disease Management Strategies
- Vaccine Coverage and Hesitancy
- Public Health Policies and Education
- Child and Adolescent Health
- COVID-19 Impact on Reproduction
- Neonatal Respiratory Health Research
- Meta-analysis and systematic reviews
- Asthma and respiratory diseases
- Adolescent and Pediatric Healthcare
- Healthcare Systems and Technology
- Ethics and Legal Issues in Pediatric Healthcare
- COVID-19 and Mental Health
- Birth, Development, and Health
- Testicular diseases and treatments
- Viral Infections and Outbreaks Research
University of Toronto
2015-2024
Public Health Ontario
2014-2024
Institute for Clinical Evaluative Sciences
2020-2024
Dalhousie University
2023-2024
Yale University
2021-2022
3M (United States)
2018-2021
Hospital for Sick Children
2015-2021
SickKids Foundation
2015-2021
University College London
2020
Great Ormond Street Hospital
2020
Healthcare spending occurs disproportionately among a very small portion of the population. Research on these high-cost users (HCUs) health care has been overwhelmingly cross-sectional in nature and limited to few sociodemographic clinical characteristics available administrative databases. This study is first bridge this knowledge gap by applying population lens HCUs. We investigate associations between broad range SES future HCUs.A cohort adults from two cycles large, nationally...
Health care spending is overwhelmingly concentrated within a very small proportion of the population, referred to as high-cost users (HCU). To date, research on HCU has been limited in scope, focusing mostly those characteristics available through administrative databases, which have largely clinical nature, or relied ecological measures socio-demographics. This study links population health surveys data, allowing for investigation broad range individual-level and provides more thorough...
OBJECTIVE To provide the first population-based estimates of prediabetes and undiagnosed type 2 diabetes prevalence in Canada. RESEARCH DESIGN AND METHODS We combined two fasting subsamples Canadian Health Measures Survey, which were restricted to nonpregnant adults ≥20 years age (N = 3,494). Undiagnosed was defined as not having self-reported but blood glucose measures that met guidelines (i.e., plasma [FPG] level ≥7.0 mmol/L or hemoglobin A1c [HbA1c] ≥6.5% [≥48 mmol/mol]). Prediabetes an...
Importance Respiratory syncytial virus (RSV) transmission was disrupted worldwide following the COVID-19 pandemic, and further study is required to better understand these changes. Objective To compare observed expected RSV hospital intensive care unit (ICU) admission rates characteristics of admitted children during 2021-2022 2022-2023 seasons. Design, Setting, Participants A population-based cohort all aged younger than 5 years in Ontario, Canada, July 1, 2017, through March 31, 2023,...
Abstract Aims To estimate the healthcare costs attributable to diabetes in Ontario, Canada using a propensity‐matched control design and health administrative data from perspective of single‐payer system. Methods Incident cases among adults Ontario were identified Diabetes Database between 2004 2012 matched 1:3 subjects without databases on basis sociodemographics propensity score. Using comprehensive source databases, direct per‐person (Canadian dollars 2012) calculated. A cost analysis was...
Most quality appraisal tools were developed for clinical medicine and tend to be study-specific with a strong emphasis on risk of bias. In order more relevant public health, an appropriate tool needs less reliant the evidence hierarchy consider practice applicability. Given broad range study designs used in objective this was develop validate meta-tool that combines health-focused principles coupled set design-specific companion tools.Several design methods including literature review,...
Background Systematic reviews of the effects healthcare interventions frequently include non-randomized studies. These are subject to confounding and a range other biases that seldom considered in detail when synthesizing interpreting results. Our aims were assess reliability usability new Cochrane risk bias (RoB) tool for studies determine whether restricting analysis with low or moderate RoB made material difference results reviews. Methods Findings We selected two systematic...
Most infants hospitalized with respiratory syncytial virus (RSV) do not meet common "high-risk" criteria and are otherwise healthy. The objective of this study was to quantify the risks relative importance socioeconomic factors for severe, early-life RSV-related illness. We hypothesized several these factors, particularly those indicating severe social vulnerability, would have statistically significant associations increased RSV hospitalization rates may offer impactful targets...
COVID-19 vaccination has been associated with anaphylaxis and hypersensitivity reactions. Infectious disease physicians allergists in the Canadian Special Immunization Clinic (SIC) Network developed guidance for evaluating patients adverse events following immunization (AEFI) including suspected hypersensitivity. This study evaluated management event recurrence subsequent vaccinations.
Historically, women have lower all-cause mortality than men. It is less understood that sex differences been converging, particularly among certain subgroups and causes. This has implications for public health system planning. Our objective was to analyse contemporary over a 20-year period.We analysed data from population-based death registry, the Ontario Registrar's General Death file, which includes all deaths recorded in Canada's most populous province, 1992 2012 (N=1 710 080 deaths). We...
Abstract Background Vancomycin-resistant enterococci (VRE) are a serious antimicrobial resistant threat in the healthcare setting. We assessed cost-effectiveness of VRE screening and isolation for patients at high-risk colonisation on general medicine ward compared to no from payer perspective. Methods developed microsimulation model using local data literature, simulate 20-bed tertiary-care hospital with up 1000 admissions, approximating 1 year. Primary outcomes were accrued over patient’s...
Canada's experience with the coronavirus disease-2019 (COVID-19) pandemic has been characterized by considerable regional variation, as would be expected in a highly decentralized federation. Yet, country beset challenges, similar to many of those documented severe acute respiratory syndrome outbreak 2003. Despite high degree preparedness, relative success flattening curve during first wave was not matched much Canada second wave. This paper critically reviews response COVID-19 focus on role...
In December 2020, Ontario, Canada, entered a provincewide shutdown to mitigate COVID-19 transmission. A regionalized approach was taken reopen schools throughout early 2021 without any other opening of the economy, offering unique natural experiment estimate impact school reopening on community Estimated increases 0.07, 0.08, and 0.13 percentage points in case growth rates occurred 11–15, 16–20, 21–25, 26–30 days, respectively, after reopened. Although small, these changes were particularly...
Objectives Violent deaths classified as undetermined intent (UD) are sometimes included in suicide counts. This study investigated age and sex differences, along with socioeconomic gradients UD the province of Ontario between 1999 2012. Methods We used data from Institute for Clinical Evaluative Sciences, which has linked vital statistics Office Registrar General Deaths register Census Socioeconomic status was operationalised through four dimensions Marginalization Index. computed...
Gestational age is often incompletely recorded in administrative records, despite being critical to paediatric and maternal health research. Several algorithms exist estimate gestational using databases; however, many have not been validated or use complicated methods that are readily adaptable. We developed a simple algorithm common categories from routine data. leveraged population-based registry of all hospital births occurring Ontario, Canada over 2002–2016 including 1.8 million birth...
Inappropriate antibiotic prescribing, such as for viral illness, remains common in primary care. The objective of this study was to estimate the proportion community-prescribed antibiotics children aged less than 5 years attributable respiratory viruses.We fitted time-series negative binomial models predict weekly prescribing rates from positive pathogen tests period 1 April 2009 through 27 December 2017 using comprehensive, population-based administrative data all (<5 years) living...
Abstract Introduction Beyond clinical risk factors, little is known about the impact of social determinants on respiratory syncytial virus (RSV) burden. Our study aimed to estimate RSV-related hospitalization rates across sociodemographic and housing characteristics. Methods We conducted a population-based all hospitalizations in Ontario, Canada between September 1, 2016 August 31, 2019 using validated hospital discharge codes census data. Crude age-standardized annualized RSV incidence rate...