Publications

Guidance on human health risk assessment for environmental impact assessment in Alberta. [Version 1]

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Environmental assessment is a key element of Alberta's process for the review and approval of new major industrial projects. The process requires the preparation of an environmental impact... More ≫

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Environmental assessment is a key element of Alberta's process for the review and approval of new major industrial projects. The process requires the preparation of an environmental impact assessment (EIA) report, which includes information on the potential human health impacts of the proposed project. The primary objective of this document is to provide general guidance for the completion of a Human Health Risk Assessment (HHRA) as part of an EIA, with the overall goal of ensuring quality, consistency and completeness of risk assessments conducted in Alberta.

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An assessment of sleep disordered breathing diagnosis using Level I versus Level III sleep studies : final report

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This assessment considers the evidence on using Level I (in-laboratory polysomnography) versus Level III (ambulatory, in-home) sleep studies for the diagnosis of sleep disordered breathing and... More ≫

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This assessment considers the evidence on using Level I (in-laboratory polysomnography) versus Level III (ambulatory, in-home) sleep studies for the diagnosis of sleep disordered breathing and specific conditions that fall within this disorder.

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STE report : transarterial radioembolization for the treatment of hepatic neoplasia : final STE report

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The report reviews the use of transarterial radioembolization (TARE) for the treatment of primary and secondary hepatic neoplasia for the purpose of considering its potential as a publically... More ≫

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The report reviews the use of transarterial radioembolization (TARE) for the treatment of primary and secondary hepatic neoplasia for the purpose of considering its potential as a publically funded health service in Alberta.

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Vitamin D testing : rapid literature review

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The clinical utility of testing individuals deemed at average risk for vitamin D deficiency has received the attention of the medical community in recent years. The objectives of this literature... More ≫

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The clinical utility of testing individuals deemed at average risk for vitamin D deficiency has received the attention of the medical community in recent years. The objectives of this literature review were: to outline the specific indications for vitamin D testing as reflected in the literature; to identify the number and type of studies for each indication; to review the abstracts of vitamin D randomized controlled trials, systematic reviews and meta-analyses; and to review the Health Technology Assessment reports available.

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Point-of-care testing for oral anticoagulant management with portable prothrombin time systems

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Atrial fibrillation, venous thrombosis and thromboembolism are common diseases which require oral anticoagulant therapy (OAT). The current gold-standard method for monitoring the international... More ≫

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Atrial fibrillation, venous thrombosis and thromboembolism are common diseases which require oral anticoagulant therapy (OAT). The current gold-standard method for monitoring the international normalized ratio (INR) is laboratory testing of blood obtained by venepuncture. However, patients may find testing to be time consuming and inconvenient. With the development of portable coagulometers it is now possible to measure INR outside the laboratory setting. This review looks at the effectiveness of patient self-management (PSM), patient self-testing (PST) and point-of-care testing (POCT) by health care practitioners using portable coagulometers, compared to conventional laboratory testing.

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Photodynamic therapy for the treatment of Barrett’s esophagus : a systematic review and economic evaluation

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Barrett's esophagus is a benign condition, usually caused by long-term gastroesophageal reflux disease. In some individuals the abnormal Barrett's tissue develops precancerous cells. Barrett's... More ≫

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Barrett's esophagus is a benign condition, usually caused by long-term gastroesophageal reflux disease. In some individuals the abnormal Barrett's tissue develops precancerous cells. Barrett's esophagus with high grade dysplasia is associated with a higher risk of developing one type of esophageal cancer. Interventions to remove the dysplastic tissue are intended to reduce this risk. Photodynamic therapy is one of several less invasive, endoscopic treatment options for Barrett’s esophagus that offer an alternative to surgical removal of the esophagus. This review assesses the evidence on the safety and effectiveness of photodynamic therapy for the treatment of Barrett's esophagus with high grade dysplasia in comparison to esophagectomy and other endoscopic treatments for this condition. It also examines the social and economic considerations for the provision of PDT in comparison to alternate treatments.

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Artificial disc arthroplasty (ACDA)

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Artificial cervical disc arthroplasty (ACDA) is a surgical procedure that may replace cervical fusion in selected patients suffering from cervical degenerative disc disease. The main outcome of... More ≫

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Artificial cervical disc arthroplasty (ACDA) is a surgical procedure that may replace cervical fusion in selected patients suffering from cervical degenerative disc disease. The main outcome of ACDA that sets it apart from fusion is the preservation of the spine mobility. The aim of this report is to review the literature for evidence of effectiveness and safety of the cervical artificial disks approved by Health Canada.

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Predictors of multiple births and infant deaths in Alberta

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Records of multiple births and infant deaths in the province of Alberta between 1997 and 2004 were analyzed. Multiple births are at increased risk of morbidity and mortality. Infant death is among... More ≫

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Records of multiple births and infant deaths in the province of Alberta between 1997 and 2004 were analyzed. Multiple births are at increased risk of morbidity and mortality. Infant death is among the most devastating possible events in the lifetime of a family. Close scrutiny of factors related to infant death may help discern strategies to prevent some deaths. Associations between a number of maternal and infant indicators and these two outcomes were considered. The goal was to understand the differing influences of the maternal and infant indicators, with a particular emphasis on potentially modifiable factors.

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Predictors of preterm and small-for-gestational-age births in Alberta

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The births of early or small babies are a major public health concern, because preterm birth and low birth weight are the primary causes of infant morbidity and mortality. Infants born too early... More ≫

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The births of early or small babies are a major public health concern, because preterm birth and low birth weight are the primary causes of infant morbidity and mortality. Infants born too early or too small potentially face huge emotional, social, health and financial burdens. This study analyzed records of live singleton births occurring in Alberta between 1997 and 2004 and associations between a number of maternal and infant indicators and preterm or low-birth-weight outcomes were considered. The goal was to understand the differing influences of the maternal and infant indicators on birth outcomes, with a particular emphasis on potentially modifiable factors. Reducing the rate of maternal prenatal smoking and delayed childrearing, in concert with promoting regular prenatal visits and prenatal education, are found to be the most likely routes to reducing adverse birth outcomes.

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Fetal fibronectin testing for the diagnosis of preterm labour : a review of the economics literature and cost analysis for Alberta

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Preterm birth (PTB) is one of the biggest problems in modern obstetrics, as it is responsible for the majority of perinatal mortality and adverse long-term neurological outcomes. For spontaneous... More ≫

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Preterm birth (PTB) is one of the biggest problems in modern obstetrics, as it is responsible for the majority of perinatal mortality and adverse long-term neurological outcomes. For spontaneous preterm labour (PTL) without rupture of membranes, the majority of women presenting with symptoms will go on to deliver at term. Thus, the challenge in practise is to correctly identify those women who are in true preterm labour and will deliver preterm. The fetal fibronectin (fFN) test is a diagnostic test that can be used to help diagnose PTL in women. The primary advantage of the test is its simplicity of use and the strong negative predictive value. This potentially gives the ability to more accurately identify those women who are in true preterm labour, and who therefore need to be transferred and treated. The objectives of this report was to review the published literature examining the economic impact of fFN test, and to examine the cost implications of fetal fibronectin testing in...

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