Angie Hamson, Shannon Hill, Aneeka Hafeez, Michelle Clark, Robyn Butcher
What Is the Problem? How Might Early Intervention Help Fix the Problem? The number of adolescents and young adults living with eating disorders is on the rise. This increase was especially noticeable during the height of the COVID-19 pandemic, with more than a 50% increase in the number of young women being hospitalized with an eating disorder. Early intervention programs are those delivered by community or health care–based organizations that offer interventions to treat adolescents and young adults living with eating disorders within the first 3 years of diagnosable disorder, with the intention of providing earlier access and preventing disease progression. What Did We Do? Advisors with lived experience of eating disorders shared their perspectives and priorities to help reviewers contextualize the evidence and interpret the findings in the literature. Advisors highlighted their treatment experiences and priorities for early intervention, highlighting equity considerations and challenges. We conducted a literature search to identify, gather, synthesize, and summarize relevant evidence to inform our understanding of the clinical effectiveness and clinical harms of early intervention programs. A search of the economic literature was conducted to identify economic evaluations of early intervention programs to treat adolescents and young adults living with eating disorders. Based on an assessment of the clinical evidence, the uncertainty and heterogeneity of the information precluded a de novo cost-effectiveness analysis (CEA). As such, a narrative summary of the health care resources required to implement an early intervention program for adolescents and young adults living with eating disorders was conducted. What Did We Find? Advisors with lived experience of eating disorders described a need for greater access to specialized services focused on eating disorder treatment, equity, capacity building, and culture change. Specific treatment approaches mentioned included family-based treatment, cognitive behavioural therapy, peer support, and group therapy. We identified 14 studies related to the clinical effectiveness of early intervention programs. We did not identify any studies evaluating clinical harms. The findings from included studies suggest that earlier engagement and access to eating disorder support could have clinical benefits; however, interpretation of these findings are uncertain due to various factors. No evidence was identified in the search for information on the cost-effectiveness of early intervention programs for the treatment of adolescents and young adults living with an eating disorder. The resources needed to run early intervention programs (or other similar interventional programs) to treat eating disorders may include administration, staffing, training, IT support and infrastructure, and other overhead costs related to the location in which the service is provided. What Does This Mean? The clini
{"title":"Early Intervention Programs for Adolescents and Young Adults With Eating Disorders","authors":"Angie Hamson, Shannon Hill, Aneeka Hafeez, Michelle Clark, Robyn Butcher","doi":"10.51731/cjht.2023.801","DOIUrl":"https://doi.org/10.51731/cjht.2023.801","url":null,"abstract":"What Is the Problem? How Might Early Intervention Help Fix the Problem? \u0000 \u0000The number of adolescents and young adults living with eating disorders is on the rise. This increase was especially noticeable during the height of the COVID-19 pandemic, with more than a 50% increase in the number of young women being hospitalized with an eating disorder. \u0000Early intervention programs are those delivered by community or health care–based organizations that offer interventions to treat adolescents and young adults living with eating disorders within the first 3 years of diagnosable disorder, with the intention of providing earlier access and preventing disease progression. \u0000 \u0000What Did We Do? \u0000 \u0000Advisors with lived experience of eating disorders shared their perspectives and priorities to help reviewers contextualize the evidence and interpret the findings in the literature. Advisors highlighted their treatment experiences and priorities for early intervention, highlighting equity considerations and challenges. \u0000We conducted a literature search to identify, gather, synthesize, and summarize relevant evidence to inform our understanding of the clinical effectiveness and clinical harms of early intervention programs. \u0000A search of the economic literature was conducted to identify economic evaluations of early intervention programs to treat adolescents and young adults living with eating disorders. Based on an assessment of the clinical evidence, the uncertainty and heterogeneity of the information precluded a de novo cost-effectiveness analysis (CEA). As such, a narrative summary of the health care resources required to implement an early intervention program for adolescents and young adults living with eating disorders was conducted. \u0000 \u0000What Did We Find? \u0000 \u0000Advisors with lived experience of eating disorders described a need for greater access to specialized services focused on eating disorder treatment, equity, capacity building, and culture change. Specific treatment approaches mentioned included family-based treatment, cognitive behavioural therapy, peer support, and group therapy. \u0000We identified 14 studies related to the clinical effectiveness of early intervention programs. We did not identify any studies evaluating clinical harms. \u0000The findings from included studies suggest that earlier engagement and access to eating disorder support could have clinical benefits; however, interpretation of these findings are uncertain due to various factors. \u0000No evidence was identified in the search for information on the cost-effectiveness of early intervention programs for the treatment of adolescents and young adults living with an eating disorder. \u0000The resources needed to run early intervention programs (or other similar interventional programs) to treat eating disorders may include administration, staffing, training, IT support and infrastructure, and other overhead costs related to the location in which the service is provided. \u0000 \u0000What Does This Mean? \u0000 \u0000The clini","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":" 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138963439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
What Is the Issue? A nonconvulsive seizure is seizure activity defined by an altered mental status, subtle limb twitches, or changes in speech. They are more difficult to identify than convulsive seizures as they do not have the distinctive motor activity associated with convulsive seizures. Patients in emergency departments (EDs) and intensive care units (ICUs) with suspected nonconvulsive seizures must be monitored with an electroencephalogram (EEG) to confirm diagnosis. Rapid detection of nonconvulsive seizures is crucial — a delay in treatment risks brain injury. There can be significant delays in accessing conventional EEG monitors and treatment because of limited supply in critical care settings, such as EDs and ICUs. What Is the Technology? The Ceribell system is a rapid response point-of-care EEG designed for use in the ED and ICU to help identify patients who are having nonconvulsive seizures. The portable device has an artificial intelligence (AI) algorithm, Claritγ, that monitors seizure activity within a 5-minute interval to determine the seizure burden during that time frame. The device alerts a bedside care provider if seizure activity occurs. This information can guide physicians’ treatment plans. What Is the Potential Impact? Within the ED and ICU, Ceribell could be used to increase access to EEG, allowing for faster detection of nonconvulsive seizures. Conventional EEG monitors are expensive and usually require a trained specialist to use and interpret findings. Most hospitals have limited access to conventional EEGs, which can lead to delays in treating patients with nonconvulsive seizures. In critical care settings, Ceribell may improve efficiency and patient flow by shortening time to diagnosis, preventing unnecessary treatment escalation, decreasing transfers to tertiary care hospitals. What Else Do We Need to Know? The Ceribell system is not available in Canada as of this writing. The Ceribell system could improve time to treatment for patients with suspected nonconvulsive seizures due to the complexity and personnel needs of conventional EEG systems. Current research on the Ceribell system has mostly been retrospective with small sample sizes; therefore, the results may not be generalizable to a wider population. If the system is implemented in hospitals, training is required to ensure that all health care professionals in the ED or ICU know when to order the portable EEG so that the use of Ceribell is prioritized for patients with suspected nonconvulsive seizures. Datasets used to train AI algorithms tend to underrepresent equity-deserving groups, so implementing AI systems such as Ceribell with Clarity in health care settings could increase health care inequity for those not well represented in algorithm data.
{"title":"Artificial Intelligence–Enhanced Rapid Response Electroencephalography for the Identification of Nonconvulsive Seizure","authors":"Candice Madakadze, Sarah C. McGill","doi":"10.51731/cjht.2023.800","DOIUrl":"https://doi.org/10.51731/cjht.2023.800","url":null,"abstract":"What Is the Issue? \u0000 \u0000A nonconvulsive seizure is seizure activity defined by an altered mental status, subtle limb twitches, or changes in speech. They are more difficult to identify than convulsive seizures as they do not have the distinctive motor activity associated with convulsive seizures. \u0000Patients in emergency departments (EDs) and intensive care units (ICUs) with suspected nonconvulsive seizures must be monitored with an electroencephalogram (EEG) to confirm diagnosis. Rapid detection of nonconvulsive seizures is crucial — a delay in treatment risks brain injury. \u0000There can be significant delays in accessing conventional EEG monitors and treatment because of limited supply in critical care settings, such as EDs and ICUs. \u0000 \u0000What Is the Technology? \u0000 \u0000The Ceribell system is a rapid response point-of-care EEG designed for use in the ED and ICU to help identify patients who are having nonconvulsive seizures. \u0000The portable device has an artificial intelligence (AI) algorithm, Claritγ, that monitors seizure activity within a 5-minute interval to determine the seizure burden during that time frame. The device alerts a bedside care provider if seizure activity occurs. This information can guide physicians’ treatment plans. \u0000 \u0000What Is the Potential Impact? \u0000 \u0000Within the ED and ICU, Ceribell could be used to increase access to EEG, allowing for faster detection of nonconvulsive seizures. \u0000Conventional EEG monitors are expensive and usually require a trained specialist to use and interpret findings. Most hospitals have limited access to conventional EEGs, which can lead to delays in treating patients with nonconvulsive seizures. \u0000In critical care settings, Ceribell may improve efficiency and patient flow by shortening time to diagnosis, preventing unnecessary treatment escalation, decreasing transfers to tertiary care hospitals. \u0000 \u0000What Else Do We Need to Know? \u0000 \u0000The Ceribell system is not available in Canada as of this writing. \u0000The Ceribell system could improve time to treatment for patients with suspected nonconvulsive seizures due to the complexity and personnel needs of conventional EEG systems. \u0000Current research on the Ceribell system has mostly been retrospective with small sample sizes; therefore, the results may not be generalizable to a wider population. \u0000If the system is implemented in hospitals, training is required to ensure that all health care professionals in the ED or ICU know when to order the portable EEG so that the use of Ceribell is prioritized for patients with suspected nonconvulsive seizures. \u0000Datasets used to train AI algorithms tend to underrepresent equity-deserving groups, so implementing AI systems such as Ceribell with Clarity in health care settings could increase health care inequity for those not well represented in algorithm data. \u0000","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"32 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139007298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle Clark, M. Mierzwinski-Urban, Jeff Mason, Qiukui Hao
What Is the Issue? Dementia refers to symptoms affecting cognition (including memory), behaviour, and mood, which can significantly impact daily activities and independence. Conditions that may contribute to the development of dementia include Alzheimer disease (AD), Parkinson disease, and stroke. As the population ages, the number of people in Canada living with dementia will continue to increase. More than 60% of people with dementia live at home rather than in a long-term care facility. Approximately 40% of people aged 80 and older who have dementia reside in long-term care facilities, while others stay in their homes. When living at home in the community, support is needed to maintain safety, independence, and quality of life for both the person living with dementia and their caregiver(s). Most of the assistive technologies used to help support people with dementia to live in their homes are paid for by the user and not by provincial or territorial insurance programs, highlighting issues of equity of access related to income. What Is the Technology? A variety of technologies, including medical devices and consumer electronics, are available that can be used with the intention of helping people living with dementia stay in their homes. Technologies to support the care of people living with dementia can be broadly grouped into 2 categories: technologies related to diagnosis, assessment, and early risk identification and technologies related to management and rehabilitation. This report primarily focuses on technologies that aim to provide management and rehabilitation; these aim to support people with dementia (and their caregivers) – allowing people to live in their homes and communities for longer. These are often classified as assistive devices and include GPS trackers, fall monitoring systems, and connected technologies that can increase and simplify access to services such as food or grocery delivery, pharmacies, and telehealth. What Is the Potential Impact? User-friendly, connected, and effective technologies that allow freedom for people living with dementia may also reduce caregiving stress; however, most randomized trials of assistive technologies have not demonstrated the usefulness of these technologies in real-world settings in a way that support them being formally incorporated into dementia management. The use of supportive technologies may help people living with dementia stay safely in their homes for longer, thereby reducing the burden on long-term care facilities and providing potential savings to the health care system. What Else Do We Need to Know? There is a constant conflict between safety and privacy for people living with dementia who may not always be aware of their current state of cognition and may not be able to provide adequately informed consent for the continued use of monitoring technologies. The evidence suggests further research into the effectiveness of these technologies in real-wo
{"title":"Technologies to Increase Freedom for People Living With Dementia","authors":"Michelle Clark, M. Mierzwinski-Urban, Jeff Mason, Qiukui Hao","doi":"10.51731/cjht.2023.797","DOIUrl":"https://doi.org/10.51731/cjht.2023.797","url":null,"abstract":"What Is the Issue? \u0000 \u0000Dementia refers to symptoms affecting cognition (including memory), behaviour, and mood, which can significantly impact daily activities and independence. Conditions that may contribute to the development of dementia include Alzheimer disease (AD), Parkinson disease, and stroke. As the population ages, the number of people in Canada living with dementia will continue to increase. \u0000More than 60% of people with dementia live at home rather than in a long-term care facility. Approximately 40% of people aged 80 and older who have dementia reside in long-term care facilities, while others stay in their homes. When living at home in the community, support is needed to maintain safety, independence, and quality of life for both the person living with dementia and their caregiver(s). \u0000Most of the assistive technologies used to help support people with dementia to live in their homes are paid for by the user and not by provincial or territorial insurance programs, highlighting issues of equity of access related to income. \u0000 \u0000What Is the Technology? \u0000 \u0000A variety of technologies, including medical devices and consumer electronics, are available that can be used with the intention of helping people living with dementia stay in their homes. \u0000Technologies to support the care of people living with dementia can be broadly grouped into 2 categories: technologies related to diagnosis, assessment, and early risk identification and technologies related to management and rehabilitation. \u0000This report primarily focuses on technologies that aim to provide management and rehabilitation; these aim to support people with dementia (and their caregivers) – allowing people to live in their homes and communities for longer. \u0000These are often classified as assistive devices and include GPS trackers, fall monitoring systems, and connected technologies that can increase and simplify access to services such as food or grocery delivery, pharmacies, and telehealth. \u0000 \u0000What Is the Potential Impact? \u0000 \u0000User-friendly, connected, and effective technologies that allow freedom for people living with dementia may also reduce caregiving stress; however, most randomized trials of assistive technologies have not demonstrated the usefulness of these technologies in real-world settings in a way that support them being formally incorporated into dementia management. \u0000The use of supportive technologies may help people living with dementia stay safely in their homes for longer, thereby reducing the burden on long-term care facilities and providing potential savings to the health care system. \u0000 \u0000What Else Do We Need to Know? \u0000 \u0000There is a constant conflict between safety and privacy for people living with dementia who may not always be aware of their current state of cognition and may not be able to provide adequately informed consent for the continued use of monitoring technologies. \u0000The evidence suggests further research into the effectiveness of these technologies in real-wo","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"70 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138598367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CADTH recommends that Sogroya should be reimbursed by public drug plans for the long-term treatment of pediatric patients who have growth failure due to an inadequate secretion of endogenous growth hormone (growth hormone deficiency [GHD]) if certain conditions are met. Sogroya should only be covered to treat children who are at least 2.5 years of age, have not reached puberty yet, and are diagnosed with GHD. Sogroya should only be reimbursed for a patient who is under the care of a pediatric endocrinologist and whose growth plates have not closed if Sogroya does not cost more than somatropin and somatrogon.
{"title":"Somapacitan (Sogroya)","authors":"Cadth","doi":"10.51731/cjht.2023.796","DOIUrl":"https://doi.org/10.51731/cjht.2023.796","url":null,"abstract":"\u0000CADTH recommends that Sogroya should be reimbursed by public drug plans for the long-term treatment of pediatric patients who have growth failure due to an inadequate secretion of endogenous growth hormone (growth hormone deficiency [GHD]) if certain conditions are met. \u0000Sogroya should only be covered to treat children who are at least 2.5 years of age, have not reached puberty yet, and are diagnosed with GHD. \u0000Sogroya should only be reimbursed for a patient who is under the care of a pediatric endocrinologist and whose growth plates have not closed if Sogroya does not cost more than somatropin and somatrogon. \u0000","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"139 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138598626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CADTH recommends that Omvoh be reimbursed by public drug plans for the treatment of moderately to severely active ulcerative colitis (UC) if certain conditions are met. Omvoh should only be covered for patients who are eligible for the reimbursement of other advanced drugs for the treatment of moderately to severely active UC (i.e., biologics and Janus kinase [JAK] inhibitors) based on the criteria used by each public drug plan. Omvoh should only be reimbursed if prescribed by a physician experienced in the diagnosis and management of UC but should not be reimbursed if used in combination with biologic therapies or JAK inhibitors for UC. For ongoing treatment to keep UC under control, Omvoh should only be reimbursed if initial treatment reduces the severity of UC after 24 weeks. Patients should be reassessed every year for renewal. The cost of Omvoh should not exceed the drug program cost of treatment with the least costly biologic reimbursed for the treatment of UC.
{"title":"Mirikizumab (Omvoh)","authors":"Cadth","doi":"10.51731/cjht.2023.795","DOIUrl":"https://doi.org/10.51731/cjht.2023.795","url":null,"abstract":"\u0000CADTH recommends that Omvoh be reimbursed by public drug plans for the treatment of moderately to severely active ulcerative colitis (UC) if certain conditions are met. \u0000Omvoh should only be covered for patients who are eligible for the reimbursement of other advanced drugs for the treatment of moderately to severely active UC (i.e., biologics and Janus kinase [JAK] inhibitors) based on the criteria used by each public drug plan. \u0000Omvoh should only be reimbursed if prescribed by a physician experienced in the diagnosis and management of UC but should not be reimbursed if used in combination with biologic therapies or JAK inhibitors for UC. For ongoing treatment to keep UC under control, Omvoh should only be reimbursed if initial treatment reduces the severity of UC after 24 weeks. Patients should be reassessed every year for renewal. The cost of Omvoh should not exceed the drug program cost of treatment with the least costly biologic reimbursed for the treatment of UC. \u0000","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"46 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138602148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
What Is the Issue?
The monitoring of vital signs is a key component of patient care. Metrics such as heart rate, body temperature, respiratory rate, and oxygen saturation allow health care staff to monitor the well-being of their patients.
What Is the Technology?
Single-use, wearable devices for vital sign monitoring have a variety of designs that are embedded with sensors that allow for continuous monitoring. They transmit data wirelessly to a base unit within a health care setting or a home.
What Is the Potential Impact?
For patients in the hospital, single-use wearable monitors can allow for fewer interruptions to rest. For patients leaving the hospital, the wearable monitors can allow for peace of mind and earlier discharge because the individual continues to be monitored remotely. In out-of-hospital settings, vital sign monitoring can signal when a person should seek additional care. The potential impacts may extend to caring for older adults at home.
What Else Do We Need to Know?
This Horizon Scan summarizes information regarding the effectiveness, safety, cost, and other considerations should there be a broad implementation of emerging wearable devices for the remote measurement of vital signs.
{"title":"Single-Use Wearable Wireless Sensors for Vital Sign Monitoring","authors":"Michelle Clark, Sharon Bailey","doi":"10.51731/cjht.2023.780","DOIUrl":"https://doi.org/10.51731/cjht.2023.780","url":null,"abstract":"What Is the Issue?
 The monitoring of vital signs is a key component of patient care. Metrics such as heart rate, body temperature, respiratory rate, and oxygen saturation allow health care staff to monitor the well-being of their patients.
 What Is the Technology?
 Single-use, wearable devices for vital sign monitoring have a variety of designs that are embedded with sensors that allow for continuous monitoring. They transmit data wirelessly to a base unit within a health care setting or a home.
 What Is the Potential Impact?
 For patients in the hospital, single-use wearable monitors can allow for fewer interruptions to rest. For patients leaving the hospital, the wearable monitors can allow for peace of mind and earlier discharge because the individual continues to be monitored remotely. In out-of-hospital settings, vital sign monitoring can signal when a person should seek additional care. The potential impacts may extend to caring for older adults at home.
 What Else Do We Need to Know?
 This Horizon Scan summarizes information regarding the effectiveness, safety, cost, and other considerations should there be a broad implementation of emerging wearable devices for the remote measurement of vital signs.","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":" 24","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135292340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
What Was the Question?
How can health policy decision-makers prepare for the potential future use of new and emerging treatments for Alzheimer disease (AD) and other dementias?
What Did We Do?
We identified emerging technologies for early diagnosis.
We assessed the infrastructural capacity to deliver amyloid-targeted therapy in Canada, including the availability of PET-CT imaging equipment for confirming treatment eligibility, access to MRI units for monitoring treatment side effects, and IV infusion clinics for administering the treatment.
We engaged with clinicians who treat people with dementia, researchers involved with dementia-related health research, and people with dementia and their caregivers.
What Did We Find?
There are several emerging diagnostic technologies — including blood, imaging, saliva, and ocular tests, and artificial intelligence algorithms — that could diagnose AD in its early stages more easily and quickly.
The availability of PET-CT and MRI units, radiopharmaceuticals, and cyclotrons is currently not sufficient to accommodate the implementation of amyloid-targeted therapies in Canada.
People living with dementia described barriers to accessing adequate, appropriate, and equitable care. Clinicians and researchers said that access to timely and reliable diagnosis must be improved.
What Does This Mean?
Our work highlights recent advances in AD diagnosis and treatment, related health system gaps in terms of accessing diagnostic testing and treatment, and the unmet needs of people living with dementia and their caregivers.
It is important that health systems prepare for the potential surge in the number of people with dementia who might need additional diagnostic tests, treatments, monitoring, and models of care.
{"title":"Is Canada Prepared for the Surge of Dementia?","authors":"None CADTH","doi":"10.51731/cjht.2023.781","DOIUrl":"https://doi.org/10.51731/cjht.2023.781","url":null,"abstract":"What Was the Question?
 
 How can health policy decision-makers prepare for the potential future use of new and emerging treatments for Alzheimer disease (AD) and other dementias?
 
 What Did We Do?
 
 We identified emerging technologies for early diagnosis.
 We assessed the infrastructural capacity to deliver amyloid-targeted therapy in Canada, including the availability of PET-CT imaging equipment for confirming treatment eligibility, access to MRI units for monitoring treatment side effects, and IV infusion clinics for administering the treatment.
 We engaged with clinicians who treat people with dementia, researchers involved with dementia-related health research, and people with dementia and their caregivers.
 
 What Did We Find?
 
 There are several emerging diagnostic technologies — including blood, imaging, saliva, and ocular tests, and artificial intelligence algorithms — that could diagnose AD in its early stages more easily and quickly.
 The availability of PET-CT and MRI units, radiopharmaceuticals, and cyclotrons is currently not sufficient to accommodate the implementation of amyloid-targeted therapies in Canada.
 People living with dementia described barriers to accessing adequate, appropriate, and equitable care. Clinicians and researchers said that access to timely and reliable diagnosis must be improved.
 
 What Does This Mean?
 
 Our work highlights recent advances in AD diagnosis and treatment, related health system gaps in terms of accessing diagnostic testing and treatment, and the unmet needs of people living with dementia and their caregivers.
 It is important that health systems prepare for the potential surge in the number of people with dementia who might need additional diagnostic tests, treatments, monitoring, and models of care.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":" 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135291715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
What Is the Issue?
Professional dental care is important to help maintain oral health. Routine dental cleaning usually includes both scaling and polishing. Scaling is the removal of plaque and tartar from the crown and root surfaces of teeth. Polishing is the removal of residual plaque and external stains from the teeth.
To support decisions about the optimal components for professional dental cleaning, it is important to understand the potential benefits and harms of routine dental polishing when compared to no routine dental polishing.
What Did We Do?
We searched for clinical and cost-effectiveness literature comparing routine dental polishing with no routine dental polishing. We also looked for evidence-based guidelines that provide recommendations about the use of routine dental polishing for the maintenance of oral health in adults and children.
An information specialist conducted a search of peer-reviewed and grey literature sources published between January 1, 2018, and September 28, 2023.
Documents were excluded if we could not isolate the effects of dental polishing from other dental procedures or if polishing techniques were used for a purpose other than the routine polishing of teeth.
What Did We Find?
We did not find any studies directly evaluating the clinical or cost-effectiveness of routine dental polishing versus no routine dental polishing, or guidelines about the use of routine dental polishing, that met the inclusion criteria for this review.
We identified limited literature that examines the combined effects of routine scaling and polishing. Research is needed that distinguishes the effects of routine dental polishing from the effects of other dental procedures.
What Does This Mean?
Without comparative clinical or cost-effectiveness evidence about routine dental polishing versus no routine dental polishing, decision-makers may also wish to consider that patients value routine scaling and polishing, and that the cost of dental care may be a barrier to visiting the dentist for some people.
New polishing methods, such as air powder polishing, may also be useful to consider when making decisions about routine polishing to support dental health. These methods include some of the benefits of scaling and may present opportunities to reduce periodontal inflammation or the length of a dental appointment.
{"title":"Routine Dental Polishing for Oral Health","authors":"Kendra Brett, Jennifer Horton","doi":"10.51731/cjht.2023.779","DOIUrl":"https://doi.org/10.51731/cjht.2023.779","url":null,"abstract":"What Is the Issue?
 
 Professional dental care is important to help maintain oral health. Routine dental cleaning usually includes both scaling and polishing. Scaling is the removal of plaque and tartar from the crown and root surfaces of teeth. Polishing is the removal of residual plaque and external stains from the teeth.
 To support decisions about the optimal components for professional dental cleaning, it is important to understand the potential benefits and harms of routine dental polishing when compared to no routine dental polishing.
 
 What Did We Do?
 
 We searched for clinical and cost-effectiveness literature comparing routine dental polishing with no routine dental polishing. We also looked for evidence-based guidelines that provide recommendations about the use of routine dental polishing for the maintenance of oral health in adults and children.
 An information specialist conducted a search of peer-reviewed and grey literature sources published between January 1, 2018, and September 28, 2023.
 Documents were excluded if we could not isolate the effects of dental polishing from other dental procedures or if polishing techniques were used for a purpose other than the routine polishing of teeth.
 
 What Did We Find?
 
 We did not find any studies directly evaluating the clinical or cost-effectiveness of routine dental polishing versus no routine dental polishing, or guidelines about the use of routine dental polishing, that met the inclusion criteria for this review.
 We identified limited literature that examines the combined effects of routine scaling and polishing. Research is needed that distinguishes the effects of routine dental polishing from the effects of other dental procedures.
 
 What Does This Mean?
 
 Without comparative clinical or cost-effectiveness evidence about routine dental polishing versus no routine dental polishing, decision-makers may also wish to consider that patients value routine scaling and polishing, and that the cost of dental care may be a barrier to visiting the dentist for some people.
 New polishing methods, such as air powder polishing, may also be useful to consider when making decisions about routine polishing to support dental health. These methods include some of the benefits of scaling and may present opportunities to reduce periodontal inflammation or the length of a dental appointment.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"24 95","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135541211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
What Is the Issue?
Case carts are commonly used in perioperative practice to transport surgical instruments and supplies to and from surgical settings in a timely manner. Open case carts are easy to manoeuvre and clean, while closed case carts effectively contain both sterile and contaminated surgical supplies during transport. Appropriate selection of case carts for surgical settings may support effective workflow processes, infection prevention and control measures, and personnel safety.
What Did We Do?
To inform decisions about appropriate selection of case carts, CADTH sought to identify and summarize the literature comparing infection control and personnel safety between open and closed case carts. An information specialist conducted a search of peer-reviewed and grey literature sources. CADTH also attempted to identify guidelines about the appropriate use of case carts in surgical settings.
What Did We Find?
No studies directly evaluating the comparative clinical effectiveness of open versus closed case carts or guidelines concerning their use in surgical settings were identified that met the inclusion criteria for this review. Research focused on the management of infection control and prevention and personnel safety is needed to evaluate the clinical effectiveness of open and closed case carts and inform guidance concerning the selection of open versus closed case carts in surgical settings.
What Does It Mean?
Without any comparative effectiveness evidence, decision-makers may want to consider the organizational features (e.g., sterile processing workflow systems, transport distance to the operating room) to inform the choice of either open or closed case carts. Measures to promote personnel safety when using any case cart may include training for use as well as cart inspection and monitoring processes.
{"title":"Case Carts in Surgical Settings","authors":"Monica Emode, Melissa Severn","doi":"10.51731/cjht.2023.778","DOIUrl":"https://doi.org/10.51731/cjht.2023.778","url":null,"abstract":"What Is the Issue?
 Case carts are commonly used in perioperative practice to transport surgical instruments and supplies to and from surgical settings in a timely manner. Open case carts are easy to manoeuvre and clean, while closed case carts effectively contain both sterile and contaminated surgical supplies during transport. Appropriate selection of case carts for surgical settings may support effective workflow processes, infection prevention and control measures, and personnel safety.
 What Did We Do?
 To inform decisions about appropriate selection of case carts, CADTH sought to identify and summarize the literature comparing infection control and personnel safety between open and closed case carts. An information specialist conducted a search of peer-reviewed and grey literature sources. CADTH also attempted to identify guidelines about the appropriate use of case carts in surgical settings.
 What Did We Find?
 No studies directly evaluating the comparative clinical effectiveness of open versus closed case carts or guidelines concerning their use in surgical settings were identified that met the inclusion criteria for this review. Research focused on the management of infection control and prevention and personnel safety is needed to evaluate the clinical effectiveness of open and closed case carts and inform guidance concerning the selection of open versus closed case carts in surgical settings.
 What Does It Mean?
 Without any comparative effectiveness evidence, decision-makers may want to consider the organizational features (e.g., sterile processing workflow systems, transport distance to the operating room) to inform the choice of either open or closed case carts. Measures to promote personnel safety when using any case cart may include training for use as well as cart inspection and monitoring processes.","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"24 94","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135541212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
CADTH recommends that Imcivree be reimbursed by public drug plans for weight management in adult and pediatric patients 6 years of age and older with obesity due to Bardet-Biedl syndrome (BBS) if certain conditions are met.
Imcivree should only be covered for patients who are aged 6 years and older and have a clinically or genetically confirmed diagnosis of BBS and obesity.
Imcivree should only be reimbursed if prescribed by an endocrinologist, pediatric endocrinologist, and/or specialist in weight management or obesity and the cost of Imcivree is reduced. When first prescribed, Imcivree should only be reimbursed for 26 weeks. Reimbursement may be renewed on a yearly basis for patients who experience a clinically meaningful decrease in body weight or body mass index (BMI).
{"title":"Setmelanotide (Imcivree)","authors":"None CADTH","doi":"10.51731/cjht.2023.777","DOIUrl":"https://doi.org/10.51731/cjht.2023.777","url":null,"abstract":"
 CADTH recommends that Imcivree be reimbursed by public drug plans for weight management in adult and pediatric patients 6 years of age and older with obesity due to Bardet-Biedl syndrome (BBS) if certain conditions are met.
 Imcivree should only be covered for patients who are aged 6 years and older and have a clinically or genetically confirmed diagnosis of BBS and obesity.
 Imcivree should only be reimbursed if prescribed by an endocrinologist, pediatric endocrinologist, and/or specialist in weight management or obesity and the cost of Imcivree is reduced. When first prescribed, Imcivree should only be reimbursed for 26 weeks. Reimbursement may be renewed on a yearly basis for patients who experience a clinically meaningful decrease in body weight or body mass index (BMI).
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135873220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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