What Is the Issue?
Medication for opioid use disorder is essential for reducing cravings, withdrawal symptoms, and facilitating recovery, with buprenorphine being preferred over methadone by health care providers and people with opioid use disorder due to its lower overdose risk and perceived lower side effect profile.
In Canada, buprenorphine is available in various formulations, including buprenorphine-naloxone (BUP-NAL), commonly chosen for its safety benefits and convenience.
Sublingual buprenorphine-naloxone films offer faster dissolution and potentially other benefits compared to sublingual tablets, evaluating their comparative clinical and cost-effectiveness is important as they become more widely available.
What Did We Do?
To inform decisions about the appropriate selection of BUP-NAL formulations for treating individuals with opioid use disorder, CADTH sought to identify and summarize literature comparing the clinical effectiveness and cost-effectiveness of sublingual BUP-NAL films versus tablets. We also attempted to identify evidence-based recommendations for the use of BUP-NAL film.
A research information specialist conducted a literature search of the peer-reviewed and grey literature with a search strategy focused on sublingual BUP-NAL. The search was limited to English-language documents published since January 1, 2018. One reviewer screened articles for inclusion based on predefined criteria, critically appraised the included study, and narratively summarized the findings.
What Did We Find?
Sublingual BUP-NAL films may have lower abuse rates compared to sublingual BUP-NAL tablets among people who seek treatment at substance abuse treatment centres or who present needing medical advice or treatment for intentional misuse or abuse of potentially toxic substances, including opioids (1 study).
We did not find any clinical effectiveness studies that assessed aspects related to drug ingestion, drug abuse cessation, treatment programs, health-related quality of life, mental health or safety of BUP-NAL films or tablets that met our criteria for this review.
We did not find any studies on cost-effectiveness or evidence-based guidelines of sublingual BUP-NAL films or tablets that met our criteria for this review.
What Does It Mean?
Limited evidence from this review suggests that sublingual BUP-NAL films may lead to lower substance abuse rates compared to sublingual BUP-NAL tablets among people with OUD; however, we require more comprehensive research with rigorous methodological approaches to understand this topic better.
Considering the low abuse potential for BUP-NAL film, decision-makers may wish to use this formulation in settings where the potential for substance abuse is high.
{"title":"Buprenorphine-Naloxone Film Versus Tablets for Opioid Use Disorder","authors":"Kylie Tingley, Monika Mierzwinski-Urban","doi":"10.51731/cjht.2023.776","DOIUrl":"https://doi.org/10.51731/cjht.2023.776","url":null,"abstract":"What Is the Issue?
 
 Medication for opioid use disorder is essential for reducing cravings, withdrawal symptoms, and facilitating recovery, with buprenorphine being preferred over methadone by health care providers and people with opioid use disorder due to its lower overdose risk and perceived lower side effect profile.
 In Canada, buprenorphine is available in various formulations, including buprenorphine-naloxone (BUP-NAL), commonly chosen for its safety benefits and convenience.
 Sublingual buprenorphine-naloxone films offer faster dissolution and potentially other benefits compared to sublingual tablets, evaluating their comparative clinical and cost-effectiveness is important as they become more widely available.
 
 What Did We Do?
 
 To inform decisions about the appropriate selection of BUP-NAL formulations for treating individuals with opioid use disorder, CADTH sought to identify and summarize literature comparing the clinical effectiveness and cost-effectiveness of sublingual BUP-NAL films versus tablets. We also attempted to identify evidence-based recommendations for the use of BUP-NAL film.
 A research information specialist conducted a literature search of the peer-reviewed and grey literature with a search strategy focused on sublingual BUP-NAL. The search was limited to English-language documents published since January 1, 2018. One reviewer screened articles for inclusion based on predefined criteria, critically appraised the included study, and narratively summarized the findings.
 
 What Did We Find?
 
 Sublingual BUP-NAL films may have lower abuse rates compared to sublingual BUP-NAL tablets among people who seek treatment at substance abuse treatment centres or who present needing medical advice or treatment for intentional misuse or abuse of potentially toxic substances, including opioids (1 study).
 We did not find any clinical effectiveness studies that assessed aspects related to drug ingestion, drug abuse cessation, treatment programs, health-related quality of life, mental health or safety of BUP-NAL films or tablets that met our criteria for this review.
 We did not find any studies on cost-effectiveness or evidence-based guidelines of sublingual BUP-NAL films or tablets that met our criteria for this review.
 
 What Does It Mean?
 
 Limited evidence from this review suggests that sublingual BUP-NAL films may lead to lower substance abuse rates compared to sublingual BUP-NAL tablets among people with OUD; however, we require more comprehensive research with rigorous methodological approaches to understand this topic better.
 Considering the low abuse potential for BUP-NAL film, decision-makers may wish to use this formulation in settings where the potential for substance abuse is high.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"6 7","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135974491","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 cataract is an opacity of the lens and is the leading cause of reversible visual impairment worldwide. There are no medical treatments for cataracts but surgical procedures that replace the lens with a synthetic lens (called an intraocular lens [IOL]) have shown to be effective for restoring vision.
Premium lenses, including lenses to correct astigmatism (called toric lenses), are available but may not be covered by public or private health plans.
Given that there is an increased cost associated with toric lenses, there is a need to evaluate their effectiveness compared to other available corrective options, including glasses.
What Did We Do?
To inform decisions about the appropriate use of astigmatism-correcting IOLs, CADTH sought to identify and summarize literature that evaluates the clinical effectiveness of toric lenses against other corrective options.
An information specialist conducted a search of peer-reviewed and grey literature sources. One reviewer screened citations, and selected and critically appraised the included studies.
What Did We Find?
One systematic review (SR), 3 randomized controlled trials (RCTs), 1 prospective nonrandomized study, and 6 retrospective nonrandomized studies were identified that evaluated the clinical effectiveness of toric versus nontoric IOLs implanted during cataract surgery, including 1 with a pediatric focus.
Toric IOLs may be better than nontoric IOLs for postoperative astigmatism, but this may be dependent on the measurement of astigmatism evaluated (e.g., corneal astigmatism, residual refractive astigmatism, subjective refraction astigmatism, autorefraction astigmatism, spherical equivalent astigmatism, cylinder astigmatism, surgically induced astigmatism).
Toric IOLs may be better than nontoric IOLs for postoperative uncorrected visual acuity (VA), but it is unclear if this results in a clinically meaningful difference to the patient. None of the studies reported on spectacle independence.
Patient-centred outcomes were seldomly reported across the studies, and rarely used validated tools, making it difficult to conclude if there were patient-centred outcome differences between toric and nontoric IOLs.
Harms were reported across the studies through intraoperative complications, postoperative complications, and adverse events. Postoperative complications were statistically higher in the toric group in the SR, but there were not statistically significant differences in harms reported in the primary studies.
What Does it Mean?
It is difficult to draw conclusions across the studies and outcomes due to the variation in how outcomes were reported or because few studies report on these outcomes.
A proposed minimum set of core outcomes for cataract surgery was published in 2015. The studies included in this report did not align with this minimum set
{"title":"Intraocular Lenses for Cataract Surgery","authors":"Candyce Hamel, Sharon Bailey","doi":"10.51731/cjht.2023.775","DOIUrl":"https://doi.org/10.51731/cjht.2023.775","url":null,"abstract":"What Is the Issue?
 
 A cataract is an opacity of the lens and is the leading cause of reversible visual impairment worldwide. There are no medical treatments for cataracts but surgical procedures that replace the lens with a synthetic lens (called an intraocular lens [IOL]) have shown to be effective for restoring vision.
 Premium lenses, including lenses to correct astigmatism (called toric lenses), are available but may not be covered by public or private health plans.
 Given that there is an increased cost associated with toric lenses, there is a need to evaluate their effectiveness compared to other available corrective options, including glasses.
 
 What Did We Do?
 
 To inform decisions about the appropriate use of astigmatism-correcting IOLs, CADTH sought to identify and summarize literature that evaluates the clinical effectiveness of toric lenses against other corrective options.
 An information specialist conducted a search of peer-reviewed and grey literature sources. One reviewer screened citations, and selected and critically appraised the included studies.
 
 What Did We Find?
 
 One systematic review (SR), 3 randomized controlled trials (RCTs), 1 prospective nonrandomized study, and 6 retrospective nonrandomized studies were identified that evaluated the clinical effectiveness of toric versus nontoric IOLs implanted during cataract surgery, including 1 with a pediatric focus.
 Toric IOLs may be better than nontoric IOLs for postoperative astigmatism, but this may be dependent on the measurement of astigmatism evaluated (e.g., corneal astigmatism, residual refractive astigmatism, subjective refraction astigmatism, autorefraction astigmatism, spherical equivalent astigmatism, cylinder astigmatism, surgically induced astigmatism).
 Toric IOLs may be better than nontoric IOLs for postoperative uncorrected visual acuity (VA), but it is unclear if this results in a clinically meaningful difference to the patient. None of the studies reported on spectacle independence.
 Patient-centred outcomes were seldomly reported across the studies, and rarely used validated tools, making it difficult to conclude if there were patient-centred outcome differences between toric and nontoric IOLs.
 Harms were reported across the studies through intraoperative complications, postoperative complications, and adverse events. Postoperative complications were statistically higher in the toric group in the SR, but there were not statistically significant differences in harms reported in the primary studies.
 
 What Does it Mean?
 
 It is difficult to draw conclusions across the studies and outcomes due to the variation in how outcomes were reported or because few studies report on these outcomes.
 A proposed minimum set of core outcomes for cataract surgery was published in 2015. The studies included in this report did not align with this minimum set ","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135371514","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 reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class.
The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec.
This review assesses roflumilast cream 0.3% w/w (Zoryve) for topical use.
Indication: For topical treatment of plaque psoriasis, including treatment of psoriasis in the intertriginous areas, in patients 12 years of age and older.
{"title":"Roflumilast (Zoryve)","authors":"None CADTH","doi":"10.51731/cjht.2023.773","DOIUrl":"https://doi.org/10.51731/cjht.2023.773","url":null,"abstract":"
 CADTH reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class.
 The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec.
 This review assesses roflumilast cream 0.3% w/w (Zoryve) for topical use.
 Indication: For topical treatment of plaque psoriasis, including treatment of psoriasis in the intertriginous areas, in patients 12 years of age and older.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"14 8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135371495","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 reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class.
The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec.
This review assesses tisagenlecleucel (Kymriah) 1.2 × 106 to 6.0 × 108 CAR-positive viable T cells suspended in 1 or more patient-specific infusion bags for single-dose, one-time, IV administration.
Indication: For the treatment of adults with relapsed or refractory grade 1, 2, or 3a follicular lymphoma after 2 or more lines of systemic therapy.
{"title":"Tisagenlecleucel (Kymriah)","authors":"None CADTH","doi":"10.51731/cjht.2023.774","DOIUrl":"https://doi.org/10.51731/cjht.2023.774","url":null,"abstract":"
 CADTH reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class.
 The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec.
 This review assesses tisagenlecleucel (Kymriah) 1.2 × 106 to 6.0 × 108 CAR-positive viable T cells suspended in 1 or more patient-specific infusion bags for single-dose, one-time, IV administration.
 Indication: For the treatment of adults with relapsed or refractory grade 1, 2, or 3a follicular lymphoma after 2 or more lines of systemic therapy.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"69 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135372907","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?
Wet age-related macular degeneration (AMD) is a serious health concern that causes reduced vision-related function, poor overall quality of life, and increased health care resource usage.
Anti-vascular endothelial growth factor (VEGF) drugs are the first-line treatment for wet AMD, and they are injected into the eye. These drugs can slow disease progression but are expensive and require trained medical professionals to administer and monitor treatment response.
The criteria for initial injection, maintenance, and discontinuation of anti-VEGF drugs in patients with wet AMD remain unclear.
What Did We Do?
To inform decisions about the appropriate use of anti-VEGF drugs to treat adults with wet AMD, CADTH sought to identify and summarize recommendations about criteria for the diagnosis of wet AMD and best practices for subsequent treatment with anti-VEGF drugs.
An information specialist searched the peer-reviewed and grey literature for clinical practice guidelines published since 2018.
What Did We Find?
Three evidence-based guidelines recommend optical coherence tomography (OCT) to assess patients with suspected wet AMD. The National Institute for Health and Care Excellence (NICE) guidelines then strongly recommend fundus fluorescein angiography only when OCT does not exclude neovascular disease.
The evidence-based guidelines recommend anti-VEGF drugs for wet or neovascular AMD in adults, particularly for patients with recent disease progression. One guideline suggests starting anti-VEGF treatment as soon as possible once the diagnosis of wet AMD is made.
The NICE guideline suggests that there may not be any clinically significant distinctions in the effectiveness and safety of various anti-VEGF treatments, including aflibercept, bevacizumab, and ranibizumab, indicating a need for an individualized approach when selecting specific anti-VEGF drugs. However, 1 guideline is inconsistent with NICE, as it suggests choosing bevacizumab first.
During the maintenance phase of using anti-VEGF drugs, it is important to closely monitor the patient's response and the disease activity and adjust the injection intervals accordingly.
Guidelines recommend taking an individualized approach and emphasizing active patient involvement in switching and discontinuing anti-VEGF drugs for adults with wet AMD.
Guidelines or guidance documents without a literature search or unclear methods provided generally consistent recommendations with the included evidence-based guidelines.
We did not identify any evidence-based guidelines regarding the use of faricimab or brolucizumab. However, NICE published technology appraisals supporting the use of recently approved anti-VEGF drugs (faricimab and brolucizumab) as alternative options for patients who meet similar criteria for treatment with bevacizumab or aflibercept, and under agreed pricing con
{"title":"Anti-Vascular Endothelial Growth Factor Drugs for Age-Related Macular Degeneration","authors":"Qiukui Hao, Sharon Bailey","doi":"10.51731/cjht.2023.771","DOIUrl":"https://doi.org/10.51731/cjht.2023.771","url":null,"abstract":"What Is the Issue?
 
 Wet age-related macular degeneration (AMD) is a serious health concern that causes reduced vision-related function, poor overall quality of life, and increased health care resource usage.
 Anti-vascular endothelial growth factor (VEGF) drugs are the first-line treatment for wet AMD, and they are injected into the eye. These drugs can slow disease progression but are expensive and require trained medical professionals to administer and monitor treatment response.
 The criteria for initial injection, maintenance, and discontinuation of anti-VEGF drugs in patients with wet AMD remain unclear.
 
 What Did We Do?
 
 To inform decisions about the appropriate use of anti-VEGF drugs to treat adults with wet AMD, CADTH sought to identify and summarize recommendations about criteria for the diagnosis of wet AMD and best practices for subsequent treatment with anti-VEGF drugs.
 An information specialist searched the peer-reviewed and grey literature for clinical practice guidelines published since 2018.
 
 What Did We Find?
 
 Three evidence-based guidelines recommend optical coherence tomography (OCT) to assess patients with suspected wet AMD. The National Institute for Health and Care Excellence (NICE) guidelines then strongly recommend fundus fluorescein angiography only when OCT does not exclude neovascular disease.
 The evidence-based guidelines recommend anti-VEGF drugs for wet or neovascular AMD in adults, particularly for patients with recent disease progression. One guideline suggests starting anti-VEGF treatment as soon as possible once the diagnosis of wet AMD is made.
 The NICE guideline suggests that there may not be any clinically significant distinctions in the effectiveness and safety of various anti-VEGF treatments, including aflibercept, bevacizumab, and ranibizumab, indicating a need for an individualized approach when selecting specific anti-VEGF drugs. However, 1 guideline is inconsistent with NICE, as it suggests choosing bevacizumab first.
 During the maintenance phase of using anti-VEGF drugs, it is important to closely monitor the patient's response and the disease activity and adjust the injection intervals accordingly.
 Guidelines recommend taking an individualized approach and emphasizing active patient involvement in switching and discontinuing anti-VEGF drugs for adults with wet AMD.
 Guidelines or guidance documents without a literature search or unclear methods provided generally consistent recommendations with the included evidence-based guidelines.
 We did not identify any evidence-based guidelines regarding the use of faricimab or brolucizumab. However, NICE published technology appraisals supporting the use of recently approved anti-VEGF drugs (faricimab and brolucizumab) as alternative options for patients who meet similar criteria for treatment with bevacizumab or aflibercept, and under agreed pricing con","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135928228","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 Dupixent be reimbursed by public drug plans for the treatment of patients aged 6 months to younger than 12 years with moderate to severe atopic dermatitis (AD) whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable, if certain conditions are met.
The CADTH Canadian Drug Expert Committee (CDEC) recommendation for Dupixent for the treatment of patients aged 12 years and older with moderate to severe AD dated February 2023 continues to apply to patients who are not included in the population evaluated in this recommendation.
Dupixent should only be covered to treat patients aged 6 months to younger than 12 years with moderate to severe AD who previously tried and did not experience improvement with, or are unable to use, topically applied drugs.
Dupixent should only be reimbursed if the patient is under the care of a dermatologist, allergist, clinical immunologist, or pediatrician who has expertise in the management of moderate to severe AD, and if the cost of Dupixent is reduced. When first prescribed, Dupixent should only be reimbursed for 6 months. Dupixent should not be used in combination with phototherapy, any immunomodulatory drugs (including biologics), or a Janus kinase (JAK) inhibitor treatment for moderate to severe AD.
{"title":"Dupilumab (Dupixent)","authors":"None CADTH","doi":"10.51731/cjht.2023.772","DOIUrl":"https://doi.org/10.51731/cjht.2023.772","url":null,"abstract":"
 CADTH recommends that Dupixent be reimbursed by public drug plans for the treatment of patients aged 6 months to younger than 12 years with moderate to severe atopic dermatitis (AD) whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable, if certain conditions are met.
 The CADTH Canadian Drug Expert Committee (CDEC) recommendation for Dupixent for the treatment of patients aged 12 years and older with moderate to severe AD dated February 2023 continues to apply to patients who are not included in the population evaluated in this recommendation.
 Dupixent should only be covered to treat patients aged 6 months to younger than 12 years with moderate to severe AD who previously tried and did not experience improvement with, or are unable to use, topically applied drugs.
 Dupixent should only be reimbursed if the patient is under the care of a dermatologist, allergist, clinical immunologist, or pediatrician who has expertise in the management of moderate to severe AD, and if the cost of Dupixent is reduced. When first prescribed, Dupixent should only be reimbursed for 6 months. Dupixent should not be used in combination with phototherapy, any immunomodulatory drugs (including biologics), or a Janus kinase (JAK) inhibitor treatment for moderate to severe AD.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"100 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135928405","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 reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class.
The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec.
This review assesses ravulizumab (Ultomiris) for injection, 10 mg/mL and 100 mg/mL concentrate for solution for IV infusion.
Indication: For the treatment of adult patients with anti-acetylcholine receptor antibody–positive generalized myasthenia gravis.
{"title":"Ravulizumab (Ultomiris)","authors":"None CADTH","doi":"10.51731/cjht.2023.770","DOIUrl":"https://doi.org/10.51731/cjht.2023.770","url":null,"abstract":"
 CADTH reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class.
 The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec.
 This review assesses ravulizumab (Ultomiris) for injection, 10 mg/mL and 100 mg/mL concentrate for solution for IV infusion.
 Indication: For the treatment of adult patients with anti-acetylcholine receptor antibody–positive generalized myasthenia gravis.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"5 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135013494","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}
None of the identified studies were of sufficient quality to formulate conclusions on the clinical effectiveness of refractive laser surgeries compared to conventional vision correction for people with vision conditions.
The identified evidence for the clinical effectiveness of photorefractive keratotomy (PRK) was limited to 1 low-quality study that did not detect a visual acuity difference between participants who had PRK and participants who wore contact lenses.
Low-quality evidence from 1 study found participants who had undergone PRK had greater vision-related quality of life (QoL) than participants who had not had PRK. Another low-quality study found that participants who wore contact lenses had greater vision-related QoL than participants who had undergone a laser-assisted in situ keratomileusis (LASIK) procedure.
Low-quality evidence suggested that contact lenses resulted in fewer incidences of vision loss events than LASIK.
No evidence-based guidelines on best practices for refractive laser surgeries met the criteria for this review.
{"title":"Refractive Laser Surgery for Vision Conditions","authors":"Rob Edge, Jennifer Horton","doi":"10.51731/cjht.2023.766","DOIUrl":"https://doi.org/10.51731/cjht.2023.766","url":null,"abstract":"
 None of the identified studies were of sufficient quality to formulate conclusions on the clinical effectiveness of refractive laser surgeries compared to conventional vision correction for people with vision conditions.
 
 The identified evidence for the clinical effectiveness of photorefractive keratotomy (PRK) was limited to 1 low-quality study that did not detect a visual acuity difference between participants who had PRK and participants who wore contact lenses.
 Low-quality evidence from 1 study found participants who had undergone PRK had greater vision-related quality of life (QoL) than participants who had not had PRK. Another low-quality study found that participants who wore contact lenses had greater vision-related QoL than participants who had undergone a laser-assisted in situ keratomileusis (LASIK) procedure.
 Low-quality evidence suggested that contact lenses resulted in fewer incidences of vision loss events than LASIK.
 
 
 No evidence-based guidelines on best practices for refractive laser surgeries met the criteria for this review.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"20 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135166716","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}
Why Is This an Issue?
Emergency department (ED) overcrowding is a known issue in Canada that puts patients’ lives and health at risk when treatment needs within the ED exceed the resources required to address them.
The causes and consequences of ED overcrowding are complex, varied, and extend beyond the ED. Left unchecked, ED overcrowding contributes to a deteriorating standard of care as staff become overworked and burned out.
What Are the Potential Interventions to Address ED Overcrowding?
This roundup of 87 new and emerging interventions intended to alleviated ED overcrowding complements CADTH’s Emergency Department Overcrowding: An Environmental Scan of Contributing Factors and a Summary of Systematic Review Evidence on Interventions.
Interventions were included in this report if they are not captured in CADTH’s complimentary report Emergency Department Overcrowding: An Environmental Scan of Contributing Factors and a Summary of Systematic Review Evidence on Interventions because they are either new or are not yet in wide use in EDs and health systems across Canada and could be reasonably be expected to affect ED overcrowding (e.g., by improving patient flow through the ED or reducing the number of people seeking care in the ED). Interventions that could address multiple causal factors (e.g., e-consult services) were also included.
What Is the Potential Impact?
Decreasing ED overcrowding has the potential to improve the standard of care delivered to those accessing EDs and contribute to decreasing the burden on ED staff, regardless of the intervention or which contributing factor it aims to act upon.
Some interventions that can alleviate ED overcrowding also have an impact on primary and community care; bolstering preventive care, increasing access to diagnostic testing for those who need it, and improving access to health care supports can improve health outcomes.
What Else Do We Need to Know?
The pan-Canadian issue of ED overcrowding calls for real solutions. CADTH is examining the evidence and expert-informed considerations and producing a series of publications about the causes and consequences of, and solutions to, ED overcrowding in health care systems across the country.
The interventions identified in this report may be of interest to senior health care decision-makers who are anticipating health system innovation and transformation.
{"title":"Interventions Intended to Alleviate Emergency Department Overcrowding","authors":"Jeff Mason, Sean Secord, Danielle MacDougall","doi":"10.51731/cjht.2023.768","DOIUrl":"https://doi.org/10.51731/cjht.2023.768","url":null,"abstract":"Why Is This an Issue?
 
 Emergency department (ED) overcrowding is a known issue in Canada that puts patients’ lives and health at risk when treatment needs within the ED exceed the resources required to address them.
 The causes and consequences of ED overcrowding are complex, varied, and extend beyond the ED. Left unchecked, ED overcrowding contributes to a deteriorating standard of care as staff become overworked and burned out.
 
 What Are the Potential Interventions to Address ED Overcrowding?
 
 This roundup of 87 new and emerging interventions intended to alleviated ED overcrowding complements CADTH’s Emergency Department Overcrowding: An Environmental Scan of Contributing Factors and a Summary of Systematic Review Evidence on Interventions.
 Interventions were included in this report if they are not captured in CADTH’s complimentary report Emergency Department Overcrowding: An Environmental Scan of Contributing Factors and a Summary of Systematic Review Evidence on Interventions because they are either new or are not yet in wide use in EDs and health systems across Canada and could be reasonably be expected to affect ED overcrowding (e.g., by improving patient flow through the ED or reducing the number of people seeking care in the ED). Interventions that could address multiple causal factors (e.g., e-consult services) were also included.
 
 What Is the Potential Impact?
 
 Decreasing ED overcrowding has the potential to improve the standard of care delivered to those accessing EDs and contribute to decreasing the burden on ED staff, regardless of the intervention or which contributing factor it aims to act upon.
 Some interventions that can alleviate ED overcrowding also have an impact on primary and community care; bolstering preventive care, increasing access to diagnostic testing for those who need it, and improving access to health care supports can improve health outcomes.
 
 What Else Do We Need to Know?
 
 The pan-Canadian issue of ED overcrowding calls for real solutions. CADTH is examining the evidence and expert-informed considerations and producing a series of publications about the causes and consequences of, and solutions to, ED overcrowding in health care systems across the country.
 
 The interventions identified in this report may be of interest to senior health care decision-makers who are anticipating health system innovation and transformation.","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"136 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135168426","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 reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class.
The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec.
This review assesses Deucravacitinib (Sotyktu), 6 mg tablet, oral.
Indication: For the treatment of adult patients with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.
{"title":"Deucravacitinib (Sotyktu)","authors":"None CADTH","doi":"10.51731/cjht.2023.765","DOIUrl":"https://doi.org/10.51731/cjht.2023.765","url":null,"abstract":"
 CADTH reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class.
 The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada's federal, provincial, and territorial governments, with the exception of Quebec.
 This review assesses Deucravacitinib (Sotyktu), 6 mg tablet, oral.
 Indication: For the treatment of adult patients with moderate to severe plaque psoriasis who are candidates for systemic therapy or phototherapy.
","PeriodicalId":9437,"journal":{"name":"Canadian Journal of Health Technologies","volume":"101 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135169259","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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