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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)
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 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 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 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)
INTRODUCTION Variation across research ethics boards (REBs) in conditions placed on access to medical records for research purposes raises concerns around negative impacts on research quality and on human subject protection, including privacy. AIM To study variation in REB consent requirements for retrospective chart review and who may have access to the(More)
OBJECTIVE Growing evidence indicates that life-sustaining therapies for the treatment of acute myocardial infarction (AMI) are underused among patients eligible for therapy, including the elderly and women. We examined the effect of a patient's comorbidity burden on use of these highly effective therapies in eligible populations of individuals with AMI. (More)
A b s t r a c t 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(More)
Canada's public-private mix in coverage for pharmaceuticals has long created variation across provinces in access to needed treatments and has contributed to persistent cost growth in both the private and public sectors. Among the recommendations of the 2002 Romanow Commission was a proposed national standard for "last-dollar" pharmacare that would cover(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)