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5. “Bring the Hoses to Where the Fire Is!”: Differential Impacts of Marginalization and Socioeconomic Status on COVID-19 Case Counts and Healthcare Costs

Author

Cheung, Douglas C., Bremner, Karen E., Tsui, Teresa C.O., Croxford, Ruth, Lapointe-Shaw, Lauren, Giudice, Lisa Del, Mendlowitz, Andrew, Perlis, Nathan, Pataky, Reka E., Teckle, Paulos, Zeitouny, Seraphine, Wong, William W.L., Sander, Beate, Peacock, Stuart, Krahn, Murray D., Kulkarni, Girish S., and Mulder, Carol

Published
2022
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6. System-level performance measures of access to rheumatology care: a population-based retrospective study of trends over time and the impact of regional rheumatologist supply in Ontario, Canada, 2002–2019

Author

Barber, Claire E. H., Lacaille, Diane, Croxford, Ruth, Barnabe, Cheryl, Marshall, Deborah A., Abrahamowicz, Michal, Xie, Hui, Avina-Zubieta, J. Antonio, Esdaile, John M., Hazlewood, Glen, Faris, Peter, Katz, Steven, MacMullan, Paul, Mosher, Dianne, and Widdifield, Jessica

Published
2022
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13. Burden of opioid toxicity death in the fentanyl-dominant era for people who experience incarceration in Ontario, Canada, 2015–2020: a whole population retrospective cohort study

Author

Butler, Amanda, primary, Croxford, Ruth, additional, Bodkin, Claire, additional, Akbari, Hanaya, additional, Bayoumi, Ahmed M, additional, Bondy, Susan J, additional, Guenter, Dale, additional, McLeod, Katherine E, additional, Gomes, Tara, additional, Kanagalingam, Tharsan, additional, Kiefer, Lori A, additional, Orkin, Aaron Michael, additional, Owusu-Bempah, Akwasi, additional, Regenstreif, Leonora, additional, and Kouyoumdjian, Fiona, additional

Published
2023
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16. Cost‐effectiveness of second‐line ipilimumab for metastatic melanoma: A real‐world population‐based cohort study of resource utilization

Author

Lu, Brandon, primary, Dai, Wei Fang, additional, Croxford, Ruth, additional, Isaranuwatchai, Wanrudee, additional, Beca, Jaclyn, additional, Menjak, Ines B., additional, Petrella, Teresa M., additional, Mittmann, Nicole, additional, Earle, Craig C., additional, Gavura, Scott, additional, Mercer, Rebecca E., additional, Hanna, Timothy P., additional, and Chan, Kelvin K. W., additional

Published
2023
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19. Investigating Associations Between Access to Rheumatology Care, Treatment, Continuous Care, and Healthcare Utilization and Costs Among Older Individuals With Rheumatoid Arthritis

Author

Barber, Claire E.H., primary, Lacaille, Diane, additional, Croxford, Ruth, additional, Barnabe, Cheryl, additional, Marshall, Deborah A., additional, Abrahamowicz, Michal, additional, Xie, Hui, additional, Aviña-Zubieta, J. Antonio, additional, Esdaile, John M., additional, Hazlewood, Glen S., additional, Faris, Peter, additional, Katz, Steven, additional, MacMullan, Paul, additional, Mosher, Dianne, additional, and Widdifield, Jessica, additional

Published
2023
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20. Additional file 1 of System-level performance measures of access to rheumatology care: a population-based retrospective study of trends over time and the impact of regional rheumatologist supply in Ontario, Canada, 2002–2019

Author

Barber, Claire E. H., Lacaille, Diane, Croxford, Ruth, Barnabe, Cheryl, Marshall, Deborah A., Abrahamowicz, Michal, Xie, Hui, Avina-Zubieta, J. Antonio, Esdaile, John M., Hazlewood, Glen, Faris, Peter, Katz, Steven, MacMullan, Paul, Mosher, Dianne, and Widdifield, Jessica

Abstract

Additional file 1: Table S1. List of administrative databases used in this study. Fig. S1. Cohort Creation Flow-chart. Table S2. Complete list of disease modifying anti-rheumatic drugs (DMARDs) paid for by the Ontario Drug Benefit Plan

Published
2023
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23. Understanding COVID‐19 Risk in Patients With Immune‐Mediated Inflammatory Diseases: A Population‐Based Analysis of SARS–CoV‐2 Testing

Author

Eder, Lihi, primary, Croxford, Ruth, additional, Drucker, Aaron M., additional, Mendel, Arielle, additional, Kuriya, Bindee, additional, Touma, Zahi, additional, Johnson, Sindhu R., additional, Cook, Richard, additional, Bernatsky, Sasha, additional, Haroon, Nigil, additional, and Widdifield, Jessica, additional

Published
2022
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24. Initial health care costs for COVID-19 in British Columbia and Ontario, Canada: an interprovincial population-based cohort study

Author

Tsui, Teresa C.O., primary, Zeitouny, Seraphine, additional, Bremner, Karen E., additional, Cheung, Douglas C., additional, Mulder, Carol, additional, Croxford, Ruth, additional, Del Giudice, Lisa, additional, Lapointe-Shaw, Lauren, additional, Mendlowitz, Andrew, additional, Wong, William W.L., additional, Perlis, Nathan, additional, Sander, Beate, additional, Teckle, Paulos, additional, Tomlinson, George, additional, Walker, Jennifer D., additional, Malikov, Kamil, additional, McGrail, Kimberlyn M., additional, Peacock, Stuart, additional, Kulkarni, Girish S., additional, Pataky, Reka E., additional, and Krahn, Murray D., additional

Published
2022
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28. Cost-effectiveness of second-line ipilimumab for metastatic melanoma: A real-world population-based cohort study of resource utilization.

Author

Brandon Lu, Wei Fang Dai, Croxford, Ruth, Isaranuwatchai, Wanrudee, Beca, Jaclyn, Menjak, Ines B., Petrella, Teresa M., Mittmann, Nicole, Earle, Craig C., Gavura, Scott, Mercer, Rebecca E., Hanna, Timothy P., and Chan, Kelvin K. W.

Subjects
IPILIMUMAB, COST effectiveness, QUALITY-adjusted life years, COHORT analysis, CANADIAN dollar
Abstract

Background: The efficacy-effectiveness gap between randomized trial and real-world evidence regarding the clinical benefit of ipilimumab for metastatic melanoma (MM) has been well characterized by previous literature, consistent with initial concerns raised by health technology assessment agencies (HTAs). As these differences can significantly impact cost-effectiveness, it is critical to assess the real-world cost-effectiveness of second-line ipilimumab versus non-ipilimumab treatments for MM. Methods: This was a population-based retrospective cohort study of patients who received second-line non-ipilimumab therapies between 2008 and 2012 versus ipilimumab treatment between 2012 and 2015 (after public reimbursement) for MM in Ontario. Using a 5-year time horizon, censor-adjusted and discounted (1.5%) costs (from the public payer's perspective in Canadian dollars) and effectiveness were used to calculate incremental cost-effectiveness ratios (ICERs) in life-years gained (LYGs) and quality-adjusted life years (QALYs), with bootstrapping to capture uncertainty. Varying the discount rate and reducing the price of ipilimumab were done as sensitivity analyses. Results: In total, 329 MM were identified (Treated: 189; Controls: 140). Ipilimumab was associated with an incremental effectiveness of 0.59 LYG, incremental cost of $91,233, and ICER of $153,778/LYG. ICERs were not sensitive to discounting rate. Adjusting for quality of life using utility weights resulted in an ICER of $225,885/QALY, confirming the original HTA estimate prior to public reimbursement. Reducing the price of ipilimumab by 100% resulted in an ICER of $111,728/QALY. Conclusion: Despite its clinical benefit, ipilimumab as second-line monotherapy for MM patients is not cost-effective in the real world as projected by HTA under conventional willingness-to-pay thresholds. [ABSTRACT FROM AUTHOR]

Published
2023
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29. Outcomes of patients with chronic obstructive pulmonary disease diagnosed with or without pulmonary function testing

Author

Gershon, Andrea, Mecredy, Graham, Croxford, Ruth, To, Teresa, Stanbrook, Matthew B., and Aaron, Shawn D.

Subjects
Pulmonary function tests -- Analysis, Chronic obstructive lung disease -- Patient outcomes -- Analysis -- Diagnosis -- Care and treatment, Respiratory system agents -- Analysis -- Dosage and administration, Health
Abstract

BACKGROUND: A small number of people with chronic obstructive pulmonary disease (COPD) receive pulmonary function testing around the time of diagnosis. Because omitting testing increases misdiagnosis, we sought to determine whether health outcomes differed between patients whose COPD was diagnosed with or without pulmonary function testing. METHODS: We conducted a longitudinal population study of patients with physician-diagnosed COPD from 2005 to 2012 using health administrative data from Ontario, Canada. We assessed whether having pulmonary function testing around the time of diagnosis was associated with the composite outcome of admission to hospital for COPD or all-cause death, using adjusted survival analysis. RESULTS: Chronic obstructive pulmonary disease was diagnosed in 68 898 patients during the study period; 41.2% of patients received peridiagnostic pulmonary function testing. In adjusted analysis, patients who underwent testing were less likely to die or be admitted to hospital for COPD (adjusted hazard ratio [HR] 0.91, 95% confidence interval [CI] 0.89-0.94) and were more likely to be prescribed an inhaled long-acting bronchodilator than patients who did not undergo testing. Subgroup analysis suggested that the association of testing and outcomes was confined to patients with COPD diagnosed in the ambulatory care setting (adjusted HR 0.80, 95% CI 0.76-0.84). INTERPRETATION: Confirmation of a COPD diagnosis using pulmonary function testing is associated with a decreased risk of death and admission to hospital for COPD. In ambulatory patients, this effect may be from increased use of appropriate COPD medications. The findings of this study validate current guideline recommendations that encourage pulmonary function testing for diagnosis in all patients with suspected COPD., Chronic obstructive pulmonary disease (COPD) is the third leading cause of death, a leading cause of hospital admission and affects more than 10% of adults. (1-3) Pulmonary function testing plays [...]

Published
2017
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30. A Population‐Based Study Evaluating Retention in Rheumatology Care Among Patients With Rheumatoid Arthritis

Author

Barber, Claire E. H., primary, Lacaille, Diane, additional, Croxford, Ruth, additional, Barnabe, Cheryl, additional, Marshall, Deborah A., additional, Abrahamowicz, Michal, additional, Xie, Hui, additional, Avina‐Zubieta, J. Antonio, additional, Esdaile, John M., additional, Hazlewood, Glen, additional, Faris, Peter, additional, Katz, Steven, additional, MacMullan, Paul, additional, Mosher, Dianne, additional, and Widdifield, Jessica, additional

Published
2022
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31. Predictors of Place of Death for Seniors in Ontario: A Population-Based Cohort Analysis

Author

Motiwala, Sanober S., Croxford, Ruth, Guerriere, Denise N., and Coyte, Peter C.

Abstract

Place of death was determined for all 58,689 seniors (age greater than or equal to 66 years) in Ontario who died during fiscal year 2001/2002. The relationship of place of death to medical and socio-demographic characteristics was examined using a multinomial logit model. Half (49.2 %) of these individuals died in hospital, 30.5 per cent died in a long-term care facility, 9.6 per cent died at home while receiving home care, and 10.7 per cent died at home without home care. Co-morbidities were the strongest predictors of place of death (p less than 0.0001). A cancer diagnosis increased the chances of death at home while receiving home care; seniors with dementia were most likely to die in LTC facilities; and those with major acute conditions were most likely to die in hospitals. Higher socio-economic status was associated with greater probability of dying at home but contributed little to the model. Appropriate planning and resource allocation may help move place of death from hospitals to nursing homes or the community, in accordance with individual preferences. (Contains 1 note and 4 tables.)

Published
2006

32. Understanding COVID‐19 Risk in Patients With Immune‐Mediated Inflammatory Diseases: A Population‐Based Analysis of SARS–CoV‐2 Testing.

Author

Eder, Lihi, Croxford, Ruth, Drucker, Aaron M., Mendel, Arielle, Kuriya, Bindee, Touma, Zahi, Johnson, Sindhu R., Cook, Richard, Bernatsky, Sasha, Haroon, Nigil, and Widdifield, Jessica

Subjects
COVID-19 testing, INFLAMMATORY bowel diseases, POLYMYALGIA rheumatica, RHEUMATISM, PSORIATIC arthritis
Abstract

Objective: To investigate the incidence of and factors associated with SARS–CoV‐2 testing and infection in immune‐mediated inflammatory disease (IMID) patients versus matched non‐IMID comparators from the general population. Methods: We conducted a population‐based, matched cohort study among adult residents from Ontario, Canada, from January 2020 to December 2020. We created cohorts for the following IMIDs: rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, ankylosing spondylitis, systemic autoimmune rheumatic diseases, multiple sclerosis (MS), iritis, inflammatory bowel disease (IBD), polymyalgia rheumatica, and vasculitis. Each patient was matched with 5 patients without IMIDs based on sociodemographic factors. We estimated the incidence of SARS–CoV‐2 testing and infection in IMID patients and non‐IMID patients. Multivariable logistic regressions assessed odds of SARS–CoV‐2 infection. Results: We studied 493,499 patients with IMIDs and 2,466,946 patients without IMIDs. Patients with IMIDs were more likely to have at least 1 SARS–CoV‐2 test versus patients without IMIDs (27.4% versus 22.7%), but the proportion testing positive for SARS–CoV‐2 was identical (0.9% in both groups). Overall, IMID patients had 20% higher odds of being tested for SARS–CoV‐2 (odds ratio 1.20 [95% confidence interval 1.19–1.21]). The odds of SARS–CoV‐2 infection varied across IMID groups but was not significantly elevated for most IMID groups compared with non‐IMID comparators. The odds of SARS–CoV‐2 infection was lower in IBD and MS and marginally higher in RA and iritis. Conclusion: Patients across all IMIDs were more likely to be tested for SARS–CoV‐2 versus those without IMIDs. The risk of SARS–CoV‐2 infection varied across disease subgroups. [ABSTRACT FROM AUTHOR]

Published
2023
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33. COVID-19 Hospitalizations, Intensive Care Unit Stays, Ventilation, and Death Among Patients With Immune-mediated Inflammatory Diseases Compared to Controls

Author

Eder, Lihi, primary, Croxford, Ruth, additional, Drucker, Aaron M., additional, Mendel, Arielle, additional, Kuriya, Bindee, additional, Touma, Zahi, additional, Johnson, Sindhu R., additional, Cook, Richard, additional, Bernatsky, Sasha, additional, Haroon, Nigil, additional, and Widdifield, Jessica, additional

Published
2022
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36. Access and Analysis of Provincial Healthcare Administrative Data for Cohort Disclosure to Guide Community-Based Diabetic Retinopathy Screening

Author

Bowen, James, primary, Pow, Conrad, additional, Croxford, Ruth, additional, Rayner, Jennifer, additional, Sutakovic, Olivera, additional, Sissmore, Debbie, additional, Sissmore, Malcolm, additional, Stanimirovic, Aleksandra, additional, Bhatti, Sara, additional, Merritt, Rebecca, additional, Brent, Michael, additional, Shah, Baiju, additional, and Rac, Valeria, additional

Published
2021
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41. Understanding COVID‐19 Risk in Patients With Immune‐MediatedInflammatory Diseases: A Population‐BasedAnalysis of SARS–CoV‐2 Testing

Author

Eder, Lihi, Croxford, Ruth, Drucker, Aaron M., Mendel, Arielle, Kuriya, Bindee, Touma, Zahi, Johnson, Sindhu R., Cook, Richard, Bernatsky, Sasha, Haroon, Nigil, and Widdifield, Jessica

Abstract

To investigate the incidence of and factors associated with SARS–CoV‐2 testing and infection in immune‐mediated inflammatory disease (IMID) patients versus matched non‐IMID comparators from the general population. We conducted a population‐based, matched cohort study among adult residents from Ontario, Canada, from January 2020 to December 2020. We created cohorts for the following IMIDs: rheumatoid arthritis (RA), psoriasis, psoriatic arthritis, ankylosing spondylitis, systemic autoimmune rheumatic diseases, multiple sclerosis (MS), iritis, inflammatory bowel disease (IBD), polymyalgia rheumatica, and vasculitis. Each patient was matched with 5 patients without IMIDs based on sociodemographic factors. We estimated the incidence of SARS–CoV‐2 testing and infection in IMID patients and non‐IMID patients. Multivariable logistic regressions assessed odds of SARS–CoV‐2 infection. We studied 493,499 patients with IMIDs and 2,466,946 patients without IMIDs. Patients with IMIDs were more likely to have at least 1 SARS–CoV‐2 test versus patients without IMIDs (27.4% versus 22.7%), but the proportion testing positive for SARS–CoV‐2 was identical (0.9% in both groups). Overall, IMID patients had 20% higher odds of being tested for SARS–CoV‐2 (odds ratio 1.20 [95% confidence interval 1.19–1.21]). The odds of SARS–CoV‐2 infection varied across IMID groups but was not significantly elevated for most IMID groups compared with non‐IMID comparators. The odds of SARS–CoV‐2 infection was lower in IBD and MS and marginally higher in RA and iritis. Patients across all IMIDs were more likely to be tested for SARS–CoV‐2 versus those without IMIDs. The risk of SARS–CoV‐2 infection varied across disease subgroups.

Published
2023
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