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CONTEXT The effectiveness of recruiting local medical opinion leaders to improve quality of care is poorly understood. OBJECTIVE To evaluate a guideline-implementation intervention of clinician education by local opinion leaders and performance feedback to (1) increase use of lifesaving drugs (aspirin and thrombolytics in eligible elderly patients,(More)
OBJECTIVES To determine whether informed consent introduces selection bias in prospective observational studies using data from medical records, and consent rates for such studies. DESIGN Systematic review. DATA SOURCES Embase, Medline, and the Cochrane Library up to March 2008, reference lists from pertinent articles, and searches of electronic(More)
BACKGROUND Government legislators and research ethics boards in some jurisdictions require all patients to give written informed consent before enrollment in clinical registries. However, the effect of such a requirement on the use of clinical registries and the extent to which registry data can be generalized remain uncertain. METHODS We examined the(More)
BACKGROUND Evidence-based guidelines for the treatment of patients with acute myocardial infarction (AMI) have been published and disseminated by the American College of Cardiology and the American Heart Association. Few studies have examined the rates of adherence to these guidelines in eligible populations and the influence of age and gender on highly(More)
BACKGROUND In patients who have had acute myocardial infarction, the delay between the onset of symptoms and hospital presentation is a critical factor in determining the initial management strategy and outcomes of treatment. OBJECTIVE To examine the determinants of delayed hospital presentation in patients who have had acute myocardial infarction. (More)
OBJECTIVES This study sought to determine public opinion on alternatives to project-specific consent for use of their personal information for health research. DESIGN The authors conducted a fixed-response random-digit dialed telephone survey of 1,230 adults across Canada. MEASUREMENTS We measured attitudes toward privacy and health research; trust in(More)
BACKGROUND Every year in Ontario, the records of over 42 million prescriptions dispensed to persons eligible for Ontario Drug Benefit (ODB) benefits are transmitted to a central database. The ODB database is the second largest database of medications in Canada, containing records on almost half of all medications dispensed in Ontario. There is no(More)
OBJECTIVE To determine how patients and physicians balance the perceived benefits and harms of sharing electronic health data for patient care and for secondary purposes. DESIGN Before-after survey of patients and providers in practices using electronic medical records (EMRs) enrolled in a clinical trial in Ontario, Canada. MEASUREMENTS Outcomes were(More)
OBJECTIVES To assess patients' preferred method of consent for the use of information from electronic medical records for research. DESIGN Interviews and a structured survey of patients in practices with electronic medical records. SETTING Family practices in southern Ontario, Canada. PARTICIPANTS 123 patients: 17 were interviewed and 106 completed a(More)
BACKGROUND The association between volume of patients treated and quality of care has important implications for patient referral policies and approaches to quality improvement. Most studies have focused on hospital volume alone and health outcomes. OBJECTIVES The objective of this work was to examine the association of hospital and physician volume with(More)