A5073231762- Health Systems, Economic Evaluations, Quality of Life
- Genomics and Rare Diseases
- BRCA gene mutations in cancer
- Cancer Genomics and Diagnostics
- Economic and Financial Impacts of Cancer
- Ethics in Clinical Research
- Patient-Provider Communication in Healthcare
- Biomedical Ethics and Regulation
- Privacy, Security, and Data Protection
- Blockchain Technology Applications and Security
- Genetic factors in colorectal cancer
- Health Literacy and Information Accessibility
- Cystic Fibrosis Research Advances
- Mobile Health and mHealth Applications
- CAR-T cell therapy research
- Nutrition, Genetics, and Disease
- Lymphoma Diagnosis and Treatment
- Health and Medical Research Impacts
- Privacy-Preserving Technologies in Data
- Pancreatic and Hepatic Oncology Research
- Chronic Lymphocytic Leukemia Research
- Medication Adherence and Compliance
- Bioinformatics and Genomic Networks
- Biosimilars and Bioanalytical Methods
- Neurogenetic and Muscular Disorders Research
Simon Fraser University
2024-2025
Fraser Health
2025
Cancer Research Institute
2024
University of British Columbia
2015-2024
Canadian Centre for Applied Research in Cancer Control
2019-2022
BC Cancer Agency
2022
Vancouver Coastal Health
2015-2016
Purpose: To determine real-world diagnostic rates, cost trajectories, and cost-effectiveness of exome sequencing (ES) genome (GS) for children with developmental and/or seizure disorders in British Columbia, Canada.Methods: Based on medical records review, we estimated costs outcomes 491 patients who underwent standard care (SOC) testing at BC Children's Hospital.Results informed a state-transition Markov model examining three competing strategies: (1) SOC last-tier access to ES; (2)...
Genomic testing is becoming routine for diagnosing rare childhood genetic disease. Evidence underlying sustainable implementation limited, focusing on short-term endpoints such as diagnostic yield, unable to fully characterize patient and family valued outcomes. Although genomic widely available, evidentiary outcomes uncertainty persist key challenges implementation. We examine whether the current evidence base reflects public tolerance genomics diagnose conducted focus groups with general...
PURPOSE Targeted therapy and immunotherapy promise improved survival in patients with advanced melanoma, yet the effectiveness cost-effectiveness of multigene panel sequencing compared single-gene BRAF testing to guide therapeutic decisions is unknown. METHODS Our population-based quasi-experimental retrospective target trial emulation used comprehensive patient-level data for 364 British Columbia, Canada, adults an melanoma diagnosis receiving or between September 1, 2016, December 31,...
Multi-gene panel testing is replacing single-gene for patients with suspected hereditary cancer syndromes. The detection of a syndrome allows tested individuals to initiate enhanced primary and secondary prevention efforts-where available-with view reduce disease burden. Current policy prevents programmes from communicating genetic test results potentially affected family members, yet it well documented that face multiple challenges in initiating such discussions relatives.In response this...
Importance Etiologic diagnoses for rare diseases can involve a diagnostic odyssey, with repeated health care interactions and inconclusive diagnostics. Prior studies reported cost savings associated genome-wide sequencing (GWS) compared cytogenetic or molecular testing through rapid genetic diagnosis, but there is limited evidence on whether diagnosis from GWS reduced costs. Objective To measure changes in costs after Canadian English children suspected diseases. Design, Setting,...
This paper reports on end users' perspectives the use of a blockchain solution for private and secure individual “omics” health data management sharing. is one output multidisciplinary project investigating social, data, technical issues surrounding application technology in context personalized healthcare research. The studies potential ethical, legal, cognitive constraints self-sovereign sharing, whether such can be addressed through careful design solution.
Single-arm trials are common in precision oncology. Owing to the lack of randomized counterfactual, resultant data not amenable comparative outcomes analyses. Difference-in-difference (DID) methods present an opportunity generate causal estimates time-varying treatment outcomes. Using DID, our study within-cohort effects genomics-informed versus standard care on clinical and cost outcomes.We focus adults with advanced cancers enrolled single-arm BC Cancer Personalized OncoGenomics program...
Abstract Introduction Genetic testing for hereditary cancer syndromes (HCSs) can improve health outcomes through risk mitigation strategies. Effective communication between tested individuals and their family members is key to reducing the burden. Our objective was develop a patient portal familial patients undergoing HCS genetic testing, followed by an early‐phase evaluation. Methods The developed following completion of 25 semistructured interviews with having undergone susceptibility at...
(1) Background: Precision oncology has the potential to improve patient health and wellbeing through targeted prevention treatment. Owing uncertain clinical economic outcomes, reimbursement been limited. The objective of this pan-Canadian qualitative study was investigate barriers precision implementation from perspectives system stakeholders. (2) Methods: We conducted 32 semi-structured interviews with technology decision makers (n = 14) clinicians 18) experienced oncology. Participants...
New clinical genomic assays for lymphoid cancers allow improved disease stratification and prognostication. At present, implementation has been appropriately limited, owing to a paucity of evidence support cost effectiveness. Understanding patients' values precision oncology under conditions uncertainty can be used inform priority-setting decisions. Our objective was ascertain qualitative preferences attitudes prognostic-based testing. Individuals who were diagnosed with cancer between 2000...
<sec> <title>BACKGROUND</title> Evaluating precision medicine outcomes requires access to real-world and clinical trial data that is often siloed. Access based on consent, consent patients’ informed preferences. Data sharing preferences have been studied through heuristic theory, using quantitative experiments. Although rarely employed, qualitative investigations allow for in-depth exploratory study by probing mechanisms behind disclosure behaviors. Exploring decision-making reveals not only...
e21508 Background: Compared to single-gene BRAF testing guide targeted treatment for advanced melanoma, multi-gene panels can identify additional gene mutations with known therapeutic or prognostic relevance. No randomized control trials of panel sequencing have been completed in melanoma. This study determined the population-level cost-effectiveness compared Methods: Our population-based retrospective emulated a hypothetical pragmatic trial using comprehensive patient-level clinical and...
Abstract Costly targeted cancer treatments challenge publicly-funded healthcare systems seeking to align expected benefit with value for money. In 2021, The Canadian Agency Drugs and Technologies in Health (CADTH) published a provisional funding algorithm risk-based treatment of chronic lymphocytic leukemia (CLL). We estimate the cost-effectiveness this against current standard care. constructed probabilistic Markov model comparing next generation sequencing (NGS) assay-guided front-line...