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193 results on '"Righolt, Christiaan H."'

9. Consistent Factors Influence Body Mass Index Thresholds for Total Joint Arthroplasty Across Health-Care Systems: A Qualitative Study.

Author

Godziuk, Kristine, Fast, Andrew, Righolt, Christiaan H., Giori, Nicholas J., Harris, Alex H.S., and Bohm, Eric R.

Subjects
ARTHROPLASTY, BODY mass index, HEALTH care industry, FAT, EVIDENCE gaps, WEIGHT loss
Abstract

Background: Body mass index (BMI) thresholds are used as eligibility criteria to reduce complication risk in total joint arthroplasty (TJA). This approach oversimplifies preoperative risk assessment and inadvertently restricts access to effective surgical treatment for osteoarthritis. A prior survey of orthopaedic surgeons in the United States identified complex underlying factors that influence BMI considerations. To understand whether similar factors exist and influence surgeons in a different health-care system setting, we investigated Canadian surgeons' views and use of BMI criterion thresholds for TJA access. Methods: A cross-sectional online qualitative survey was conducted with orthopaedic surgeons performing TJA in the Canadian health-care system. Responses were anonymous and questions were open-ended to allow for candid perspectives. Survey data were coded and a systematic process was followed to identify major themes. Findings were compared with U.S. surgeon perspectives. Results: Sixty-nine respondents had a mean age of 49.0 ± 11.4 years (range, 33 to 79 years), with a mean surgical experience duration of 15.7 ± 11.4 years (range, 2 to 50 years). Surgeons reported variable use of BMI thresholds in practice. Twelve interconnected factors that influence BMI considerations were identified: (1) variable evidence interpretation, (2) surgical challenge, (3) surgeon beliefs and biases, (4) hospital differences, (5) access to resources, (6) health system bias, (7) patient health status, (8) patient body fat distribution, (9) patient decisional burden (to lose weight or accept risk), (10) evidence gaps and uncertainties, (11) need for innovation, and (12) societal views. Nine themes matched with findings from U.S. surgeons. Conclusions: Parallel to the United States, complex, interconnected factors influence Canadian orthopaedic surgeons' variable use of BMI restrictions for TJA eligibility. Despite different health-care systems and reimbursement models, similar technical and personal factors were identified. With TJA practice guidelines advising against hard BMI criteria, attention regarding access to resources, surgical training, and innovations to address TJA complexity in patients with large bodies are critically needed. Future advancements in this sphere must balance barrier removal with risk reduction to ensure safe and equitable surgical care. Clinical Relevance: This study may influence surgeon behaviors with regard to hard BMI cutoffs for TJA and encourage critical thought about factors that influence decisions about surgical eligibility for patients with high BMI. [ABSTRACT FROM AUTHOR]

Published
2024
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19. Effectiveness of Coronavirus Disease 2019 Vaccines Against Hospitalization and Death in Canada: A Multiprovincial, Test-Negative Design Study

Author

Nasreen, Sharifa, primary, Febriani, Yossi, additional, Velásquez García, Héctor Alexander, additional, Zhang, Geng, additional, Tadrous, Mina, additional, Buchan, Sarah A, additional, Righolt, Christiaan H, additional, Mahmud, Salaheddin M, additional, Janjua, Naveed Zafar, additional, Krajden, Mel, additional, De Serres, Gaston, additional, and Kwong, Jeffrey C, additional

Published
2022
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21. Effectiveness of COVID-19 vaccines against hospitalization and death in Canada: A multiprovincial test-negative design study

Author

Nasreen, Sharifa, primary, Febriani, Yossi, additional, Velásquez García, Héctor Alexander, additional, Zhang, Geng, additional, Tadrous, Mina, additional, Buchan, Sarah A., additional, Righolt, Christiaan H., additional, Mahmud, Salaheddin M., additional, Janjua, Naveed Zafar, additional, Krajden, Mel, additional, De Serres, Gaston, additional, and Kwong, Jeffrey C., additional

Published
2022
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22. Corrigendum to “A nested case-control study measuring pertussis vaccine effectiveness and duration of protection in Manitoba, Canada, 1992–2015: A Canadian Immunization Research Network Study” [Vaccine 37(48) (2019) 7132–7137]

Author

Wilkinson, Krista, primary, Righolt, Christiaan H., additional, Kwong, Jeffrey C., additional, Schwartz, Kevin L., additional, Russell, Margaret L., additional, Crowcroft, Natasha S., additional, and Mahmud, Salaheddin M., additional

Published
2022
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24. Effectiveness of Coronavirus Disease 2019 Vaccines Against Hospitalization and Death in Canada: A Multiprovincial, Test-Negative Design Study.

Author

Nasreen, Sharifa, Febriani, Yossi, García, Héctor Alexander Velásquez, Zhang, Geng, Tadrous, Mina, Buchan, Sarah A, Righolt, Christiaan H, Mahmud, Salaheddin M, Janjua, Naveed Zafar, Krajden, Mel, Serres, Gaston De, and Kwong, Jeffrey C

Subjects
DRUG efficacy, RESEARCH, CONFIDENCE intervals, COVID-19 vaccines, MULTIPLE regression analysis, RETROSPECTIVE studies, TREATMENT effectiveness, CONGREGATE housing, HOSPITAL care, RESEARCH funding, DEATH, EVALUATION
Abstract

Background A major goal of coronavirus disease 2019 (COVID-19) vaccination is to prevent severe outcomes (hospitalizations and deaths). We estimated the effectiveness of messenger RNA (mRNA) and ChAdOx1 COVID-19 vaccines against severe outcomes in 4 Canadian provinces between December 2020 and September 2021. Methods We conducted this multiprovincial, retrospective, test-negative study among community-dwelling adults aged ≥18 years in Ontario, Quebec, British Columbia, and Manitoba using linked provincial databases and a common study protocol. Multivariable logistic regression was used to estimate province-specific vaccine effectiveness against COVID-19 hospitalization and/or death. Estimates were pooled using random-effects models. Results We included 2 508 296 tested participants, with 31 776 COVID-19 hospitalizations and 5842 deaths. Vaccine effectiveness was 83% after a first dose and 98% after a second dose against both hospitalization and death (separately). Against severe outcomes, effectiveness was 87% (95% confidence interval [CI], 71%–94%) ≥84 days after a first dose of mRNA vaccine, increasing to 98% (95% CI, 96%–99%) ≥112 days after a second dose. Vaccine effectiveness against severe outcomes for ChAdOx1 was 88% (95% CI, 75%–94%) ≥56 days after a first dose, increasing to 97% (95% CI, 91%–99%) ≥56 days after a second dose. Lower 1-dose effectiveness was observed for adults aged ≥80 years and those with comorbidities, but effectiveness became comparable after a second dose. Two doses of vaccines provided very high protection for both homologous and heterologous schedules and against Alpha, Gamma, and Delta variants. Conclusions Two doses of mRNA or ChAdOx1 vaccine provide excellent protection against severe outcomes. [ABSTRACT FROM AUTHOR]

Published
2023
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26. Background incidence rates of hospitalisations and emergency department visits for thromboembolic and coagulation disorders in Ontario, Canada for COVID-19 vaccine safety assessment: a population-based retrospective observational study

Author

Nasreen, Sharifa, primary, Calzavara, Andrew J, additional, Sundaram, Maria E, additional, MacDonald, Shannon E, additional, Righolt, Christiaan H, additional, Pai, Menaka, additional, Field, Thalia S, additional, Zhou, Lily W, additional, Wilson, Sarah E, additional, and Kwong, Jeffrey C, additional

Published
2021
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27. Effectiveness of BNT162b2 and mRNA-1273 covid-19 vaccines against symptomatic SARS-CoV-2 infection and severe covid-19 outcomes in Ontario, Canada: test negative design study

Author

Chung, Hannah, primary, He, Siyi, additional, Nasreen, Sharifa, additional, Sundaram, Maria E, additional, Buchan, Sarah A, additional, Wilson, Sarah E, additional, Chen, Branson, additional, Calzavara, Andrew, additional, Fell, Deshayne B, additional, Austin, Peter C, additional, Wilson, Kumanan, additional, Schwartz, Kevin L, additional, Brown, Kevin A, additional, Gubbay, Jonathan B, additional, Basta, Nicole E, additional, Mahmud, Salaheddin M, additional, Righolt, Christiaan H, additional, Svenson, Lawrence W, additional, MacDonald, Shannon E, additional, Janjua, Naveed Z, additional, Tadrous, Mina, additional, and Kwong, Jeffrey C, additional

Published
2021
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28. Effectiveness of BNT162b2 and mRNA-1273 COVID-19 vaccines against symptomatic SARS-CoV-2 infection and severe COVID-19 outcomes in Ontario, Canada: a test-negative design study

Author

Chung, Hannah, primary, He, Siyi, additional, Nasreen, Sharifa, additional, Sundaram, Maria E., additional, Buchan, Sarah A., additional, Wilson, Sarah E., additional, Chen, Branson, additional, Calzavara, Andrew, additional, Fell, Deshayne B., additional, Austin, Peter C., additional, Wilson, Kumanan, additional, Schwartz, Kevin L., additional, Brown, Kevin A., additional, Gubbay, Jonathan B., additional, Basta, Nicole E., additional, Mahmud, Salaheddin M., additional, Righolt, Christiaan H., additional, Svenson, Lawrence W., additional, MacDonald, Shannon E., additional, Janjua, Naveed Z., additional, Tadrous, Mina, additional, and Kwong, Jeffrey C., additional

Published
2021
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30. A multisite study of pertussis vaccine effectiveness by time since last vaccine dose from three Canadian provinces: A Canadian Immunization Research Network study

Author

Savage, Rachel D., primary, Bell, Christopher A., additional, Righolt, Christiaan H., additional, Wilkinson, Krista, additional, Schwartz, Kevin L., additional, Chen, Cynthia, additional, Bolotin, Shelly, additional, Deeks, Shelley L., additional, Drews, Steven J., additional, Jamieson, Frances B., additional, Johnson, Caitlin, additional, Kwong, Jeffrey C., additional, Mahmud, Salaheddin M., additional, Russell, Margaret L., additional, Simmonds, Kimberley A., additional, Svenson, Lawrence W., additional, and Crowcroft, Natasha S., additional

Published
2021
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35. A Call for Caution in Use of Pertussis Vaccine Effectiveness Studies to Estimate Waning Immunity: A Canadian Immunization Research Network Study

Author

Crowcroft, Natasha S, primary, Schwartz, Kevin L, additional, Savage, Rachel D, additional, Chen, Cynthia, additional, Johnson, Caitlin, additional, Li, Ye, additional, Marchand-Austin, Alex, additional, Bolotin, Shelly, additional, Deeks, Shelley L, additional, Jamieson, Frances B, additional, Drews, Steven J, additional, Russell, Margaret L, additional, Svenson, Lawrence W, additional, Simmonds, Kimberley, additional, Righolt, Christiaan H, additional, Bell, Christopher, additional, Mahmud, Salaheddin M, additional, and Kwong, Jeffrey C, additional

Published
2020
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44. A Call for Caution in Use of Pertussis Vaccine Effectiveness Studies to Estimate Waning Immunity: A Canadian Immunization Research Network Study.

Author

Crowcroft, Natasha S, Schwartz, Kevin L, Savage, Rachel D, Chen, Cynthia, Johnson, Caitlin, Li, Ye, Marchand-Austin, Alex, Bolotin, Shelly, Deeks, Shelley L, Jamieson, Frances B, Drews, Steven J, Russell, Margaret L, Svenson, Lawrence W, Simmonds, Kimberley, Righolt, Christiaan H, Bell, Christopher, Mahmud, Salaheddin M, and Kwong, Jeffrey C

Subjects
IMMUNIZATION, WHOOPING cough, IMMUNITY, WHOOPING cough vaccines
Abstract

Background Vaccine effectiveness (VE) studies provide essential evidence on waning vaccine-derived immunity, a major threat to pertussis control. We evaluated how study design affects estimates by comparing 2 case-control studies conducted in Ontario, Canada. Methods We compared results from a test-negative design (TND) with a frequency-matched design (FMD) case-control study using pertussis cases from 2005–2015. In the first study, we identified test-negative controls from the public health laboratory that diagnosed cases and, in the second, randomly selected controls from patients attending the same physicians that reported cases, frequency matched on age and year. We compared characteristics of cases and controls using standardized differences. Results In both designs, VE estimates for the early years postimmunization were consistent with clinical trials (TND, 84%; FMD, 89% at 1–3 years postvaccination) but diverged as time since last vaccination increased (TND, 41%; FMD, 74% by 8 years postvaccination). Overall, we observed lower VE and faster waning in the TND than the FMD. In the TND but not FMD, controls differed from cases in important confounders, being younger, having more comorbidities, and higher healthcare use. Differences between the controls of each design were greater than differences between cases. TND controls were more likely to be unvaccinated or incompletely vaccinated than FMD controls (P  < .001). Conclusions The FMD adjusted better for healthcare-seeking behavior than the TND. Duration of protection from pertussis vaccines is unclear because estimates vary by study design. Caution should be exercised by experts, researchers, and decision makers when evaluating evidence on optimal timing of boosters. [ABSTRACT FROM AUTHOR]

Published
2021
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