News

Candidates sought for new research chair in health equity

sjohnston — Fri, 12 Feb 2010 07:38:00 GMT

McMaster University is seeking an outstanding researcher to assume the newly established Centre for Health Economics and Policy Analysis/Ontario Ministry of Health and Long-Term Care Chair in Health Equity.

Candidates should be mid-career scholars leading successful research programs around the theme of equity in health services, systems and/or health, with relevant training in any of several fields such as health policy, health economics, geography, ethics or public health.

For full details, click here.

Role of ethics in hospital policy development subject of seminar

sjohnston — Thu, 11 Feb 2010 09:22:07 GMT

A project that aims to develop best practices for the ethical analysis of policies within health care institutions will be the focus of the CHEPA monthly seminar on Feb. 24.

Andrea Frolic, clinical and organizational ethicist with Hamilton Health Sciences, will lead the discussion entitled What is “ethical” health policy analysis? The roles of ethics committees in hospital policy development, from 12:30 p.m. to 1:30 p.m. in HSC-1J8.

While hospitals invest significant resources to develop institutional policies governing diverse issues such as consent procedures, the hiring/firing process and disposal of human remains, this type of micro-level health policy garners little theoretical attention in the literature on hospital governance. Many of these policies have significant ethical dimensions.

The presentation will describe a project initiated by the Hamilton Health Sciences Clinical Ethics Committee (CEC), and include specific information on the typical roles of ethics committees within hospitals and the literature on the functions of ethical frameworks in health policies. Katherine Drolet, a master’s candidate in the Anthropology of Health program at McMaster, will report on the literature review and methodology of the research project. The CEC’s recent attempts to describe, analyze and refine its policy review process using a Quality Improvement framework will also be explained.

Discussion will focus on the intersection of ethics, policy and practice within hospitals.

Frolic’s research interests focus on moral distress, narrative ethics and ethics consultation. Since joining Hamilton Health Sciences in 2004, she has worked on various projects including recruiting and training a nationally-recognized Ethics Consultation Service Team, developing an integrated approach to ethics from bedside to boardroom, and creating an ethical decision-making framework.

Frolic earned her PhD in medical anthropology from Rice University in Houston, and completed a clinical ethics fellowship at University of Texas MD Anderson Cancer Center, as well as an MA in religion and culture at Wilfrid Laurier University.

All are welcome to attend the seminar.

10-01

Sjohnston — Fri, 22 Jan 2010 10:18:18 GMT

Mentzakis E, Stefanowska P, Hurley J. A Discrete Choice Experiment Investigating Preferences for Funding Drugs Used to Treat Orphan Diseases Available in PDF

Seminar to examine methods to improve health care program evaluation

sjohnston — Wed, 06 Jan 2010 12:04:51 GMT

A research scientist with expertise in studying evaluation methods for health care related programs will be the speaker for the CHEPA monthly seminar on Jan. 20.

Sanjeev Sridharan, director of the evaluation program at the Centre for Research on Inner City Health at St. Michael’s Hospital in Toronto, and an associate professor of health policy, management and evaluation at the University of Toronto, will deliver a presentation entitled Ten Steps to Making Evaluations Matter.

The presentation will focus on the need to go beyond the “cookie-cutter” type of thinking that often characterizes evaluations of programs. The 10 steps Sridharan will propose build on the belief that any system of performance measurement and evaluation needs to first confront the complexity of the program.

The 10 steps are based on a “realist” approach to evaluation, which attempts to understand why programs work. The proposed steps are informed by program theory, learning frameworks and pathways of influence, evaluation design, and learning, spread and sustainability.

Sridharan will describe how this system could lead to comprehensive evaluation plans and designs for evaluations that would have greater potential to influence programs and policies. The application of the 10 steps to knowledge translation, health inequities and international development will also be discussed.

The seminar will be held in HSC-1J8 from 12:30 to 1:30 p.m. All are welcome to attend.

Sridharan earned his PhD in social ecology from the University of California at Irvine, and a master’s degree in public policy from Purdue University in Indiana. He is a scientist with the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital.

His research interests and activities include health inequalities, community interventions for public health, evaluation design and methodologies and primary prevention.

New research chair to focus on equity in access to health services

sjohnston — Wed, 02 Dec 2009 06:44:00 GMT

A new endowed research chair focused on health equity has been established at McMaster University.

The Centre for Health Economics and Policy Analysis/Ontario Ministry of Health and Long-Term Care Chair in Health Equity will lead an innovative research program focused on the production and communication of timely, relevant research that addresses the challenge of ensuring equity of access to health services.

Policymakers and health care providers struggle with many crucial questions as they seek to provide quality health services to Canadians in the face of limited resources. The new chairholder will take the lead in directing research that would help answer questions of particular relevance to the long-standing goals of Canada’s and Ontario’s health systems to provide equity in the financing, funding and provision of health services, to achieve equitable health outcomes.

The chair is funded by $2 million provided by CHEPA, the ministry and McMaster’s Faculty of Health Sciences.

A search committee has been formed to find a suitable candidate with relevant disciplinary or interdisciplinary training in any of several fields, including health policy, health economics, geography, ethics or public health.

The Chair in Health Equity, who will also be a member of CHEPA, will allow the centre to increase its status as a world leader in the production and dissemination of knowledge related to equity in the financing, funding and delivery of health services and health systems. Several CHEPA faculty members include equity in health services and systems as a major focus of their research programs.

For full details, click here.

Workshop on equity in health care attracts international economists

sjohnston — Tue, 01 Dec 2009 17:22:00 GMT

Canadian and international health economists will gather at McMaster University this week to discuss the challenges of inequalities in health and health care use.

A one-and-a-half-day workshop entitled Equity in Health and Health Care Utilization, organized under the direction of CHEPA Associate Director Michel Grignon, will take place on Dec. 3 and 4.

A series of papers will be presented and discussed with the goal of building bridges between health economists involved in the measurement of equity and its causes and health policy experts and policymakers.

Keynote addresses will be given by economist and political scientist John Roemer of Yale University, and Pedro Rosa Dias from The University of York in the United Kingdom.

Roemer is the Elizabeth S. and A. Varick Professor of Political Science and Economics at Yale, and a fellow of the Econometric Society, an international society for the advancement of economic theory in its relation to statistics and mathematics. Roemer’s research focuses on political economy and distributive justice. He has a degree in mathematics from Harvard University, and a PhD from the University of California, Berkeley.

Rosa Dias is a research fellow with the University of York’s Centre of Health Economics, one of the largest health economics research centres in the world, which is known particularly for its work in health technology assessment, health status measurement, performance measurement and productivity, health care financing, and econometric methodology.

Roemer and Adalsteinn Brown, assistant deputy minister for the Health System Strategy Division of the Ontario Ministry of Health and Long-Term Care, will provide closing remarks at the end of the workshop, on pending issues and next steps related to the inequalities in health care use and social inequalities in health.

About 30 people are expected to take part in the workshop.

Knowledge exchange in the organization of health care systems focus of seminar

sjohnston — Fri, 06 Nov 2009 09:24:29 GMT

A study of the link between knowledge and action as it applies at the policy and organizational level in health care systems will be discussed at the CHEPA monthly seminar on Nov. 18.

Damien Contandriopoulos, a researcher with the School of Public Health Research Institute at the University of Montreal, will present the preliminary findings from a systematic review funded by the Canadian Institutes of Health Research.

The review examined the broad field of research on how knowledge translates into action, with the intention of integrating the findings into a general framework on organizational-level knowledge exchange processes in health care systems.

There is a robust integrated body of evidence that focuses on the relation between clinical knowledge and practice, and those frameworks are fundamental to the improvement of quality, effectiveness and efficiency in the delivery of health care. However, policy-making and organizational-level interventions also play a major role in improving health care delivery, and frameworks at this level are much less developed than those at the clinical level.

The model being developed through this systematic review focuses explicitly on organizational and policy level systems where the ultimate outcome of knowledge use will depend on the interaction of a variety of interdependent stakeholders.

Contandriopoulos will discuss some of the methodological challenges of the systematic review and present the main dimensions of the model being developed.

The seminar will be held in HSC-1J7 from 12:30 p.m. to 1:30 p.m. All are welcome to attend.

Contandriopoulos is an associate professor in the Faculty of Nursing at the University of Montreal. He has a PhD in public health administration and a master’s degree in anthropology, from the University of Montreal. His research focuses on developing public health policies, government structures and organizational forms, and decision-making, lobbying and public participation.

Citizens panel contributes to assessment process for Ontario's health technologies

sjohnston — Tue, 27 Oct 2009 10:34:57 GMT

A citizen’s reference panel that is providing input on Ontario’s evidence-based health technology assessment process will convene at McMaster University on Nov. 7 for its third meeting since being established early this year.

The panel, which has been assembled as part of a research project of CHEPA Director Julia Abelson, will be discussing the challenges of combining scientific evidence about existing and novel breast cancer screening modalities with social values judgments about the age at which screening should begin for average- and high-risk women.

The Ontario Ministry of Health and Long-Term Care is funding the two-year pilot project, which is gathering information on incorporating public values into decision-making for the province’s health system.

The panel consists of citizens selected from each of Ontario’s 14 Local Health Integration Network regions who meet to discuss various issues related to the province’s analysis and implementation of health technologies. The panel’s views contribute to the work of the Medical Advisory Secretariat (MAS), which oversees the province’s health technology assessment processes, and the arms-length Ontario Health Technology Advisory Committee (OHTAC).

The Citizens’ Reference Panel on Health Technologies (CRPHT) has already made an impact. At its inaugural meeting in February, the panel discussed patient information and choice in screening technologies for the early detection of colorectal cancer. Their views on how the public should be informed and choose whether to take part in colorectal cancer screening tests informed OHTAC’s final recommendations to the Ontario health care system regarding the use of these technologies.

At its second meeting held in May, panel members discussed two topics: how best to incorporate societal and ethical values into the health technology assessment process, decisions, and the use of a new technology known as percutaneous aortic valve replacement (PAVR).

The CRPHT is part of a two-year research project, and plans for 2010 call for another two or three meetings during the year.

Five new students join McMaster's Health Policy PhD program

sjohnston — Wed, 30 Sep 2009 07:07:00 GMT

Five new students have joined McMaster’s Health Policy PhD program, which provides interdisciplinary training to prepare intellectual leaders in the field of health policy.

The program launched in 2008 draws outstanding students from diverse graduate training backgrounds, including interdisciplinary health fields, social sciences disciplines and professional programs.

The four-year Health Policy PhD program, unique in Canada, enjoys a special relationship with CHEPA, which provides a dynamic and collegial environment for health policy education and scholarship.

Students accepted to the program for the 2009-10 academic year are:

• Leslie Malloy-Weir, who has an Honours B.Sc. in biology and an Honours BA in gerontology from McMaster, and a master’s degree in gerontology from Simon Fraser University in Vancouver, where she focused on health literacy and seniors. In her PhD studies she is pursuing research interests related to health literacy and shared decision-making, under the supervision of Cathy Charles.

• Kaelean Moat, who has recently completed his Master of Science degree in International Health Policy at the London School of Economics, and has an Honours B.H.Sc. degree from the University of Western Ontario. He plans to focus on the use of research to inform policy in low income countries, with a particular emphasis on the impact of decentralization reforms on health systems in Africa and South Asia. He is supervised by John Lavis. Moat has received a CHEPA Doctoral Fellowship.

• Yaw Owusu, a native of Ghana who has M.Sc. degrees in economics and finance, and in environmental sciences from the Southern Illinois University Edwardsville, and a B.Sc. in agricultural science from the Kwame Nkrumah University of Science and Technology. He plans to develop his research interests in the relationship between health insurance, environmental health policy, and health care accessibility and financing in developing nations, under the supervision of Michel Grignon. Owusu has been granted a CHEPA Doctoral Fellowship.

• Jennifer Reddock, who has a MA in Organizational Communication from Howard University in Washington. She is a former journalist who worked in the Eastern Caribbean and in television news production in Washington DC. She has also worked for the United Nations as a communications consultant on global development projects. Her studies at McMaster will focus on formulating responses to public health challenges in developing countries. She is supervised by Michel Grignon.

• Jessica Shearer, who has a M.H.Sc. degree from the Johns Hopkins School of Public Health and is a graduate of McMaster’s Arts & Science Program. She has worked in India and Senegal evaluating community-based public health projects, and with India's national immunization program. At McMaster she will pursue work in the evaluation of innovative approaches to facilitate the use of health research evidence in health policy decision-making in low- and middle-income countries, under the supervision of John Lavis. Shearer was awarded the Harry Lyman Hooker Senior Fellowship.

09-05

Sjohnston — Mon, 28 Sep 2009 08:43:56 GMT

Lessard C, Birch S. Complex Problems or Simple Solutions? Enhancing Evidence-based Economics to Reflect Reality. Available in PDF

Labelle lecture to focus on comparative effectiveness research in U.S. health reform

sjohnston — Fri, 25 Sep 2009 06:16:58 GMT

As the debate over health care reform in the United States rages on, comparative effectiveness research (CER) is emerging as a key method to inform discussions.

A renewed interest in CER methods and applications to determine which drugs, devices and procedures are most effective while carrying the lowest risk for adverse side effects, has the potential to deliver timely and crucial information to physicians and improve efficiency and quality of care.

However, controversies remain regarding the inclusion of costs in such research, and while many countries rely on CER for policymaking, the American health care system seeks to avoid any formal rationing mechanism, and wants to promote physician and patient autonomy in treatment choices, while containing costs.

This year’s Labelle Lecture on Oct. 7 will focus on how traditional CER would need to be modified in order to deliver the information required for the U.S. system to achieve its goals.

Anirban Basu, an assistant professor of medicine at the University of Chicago, will deliver this year’s lecture entitled Comparative Effectiveness Research: Another Emperor With No Clothes? He will discuss how novel designs and methods of CER will be required to reveal heterogeneity and comparative effectiveness at the smallest sub-group, or even at the individual level.

Using a case study on the use of antipsychotic drugs and diabetes in patients with schizophrenia, Basu will highlight the translation of traditional CER results to behaviour, and its implications for patient welfare. He will discuss the importance of individualized CER and methods to achieve necessary results.

The lecture will be held in HSC-1A1 from 3 p.m. to 4:30 p.m. All are welcome.

Baus has a master’s degree in biostatistics and a PhD in public policy. He is a faculty research fellow at the National Bureau of Economic Research, and received the 2009 Bernie O’Brien New Investigator Award from the International Society for Pharmacoeconomics and Outcomes Research. O’Brien, who died in 2004, was a professor in the Department of Clinical Epidemiology and Biostatistics at McMaster University.

Basu’s research interests lie in revealing heterogeneity in clinical and economic outcomes in order to establish the value of individualized care, and translating such information for public policy using innovative methods in comparative effectiveness and cost-effectiveness research.

Discussant for the lecture is Stirling Bryan, director of the Centre for Clinical Epidemiology and Evaluation, at the University of British Columbia.

The Labelle Lectureship is an annual event organized by CHEPA, the Department of Clinical Epidemiology and Biostatics and the Programs for Assessment of Technology in Health Research Institute. It was established in 1992 in memory of Roberta Labelle, a founding member of CHEPA who died in 1991. The annual lectureship features a health services researcher with emerging recognition and an interdisciplinary approach to research.

Fairness in allocating health system resources subject of CHEPA seminar

sjohnston — Thu, 10 Sep 2009 05:29:22 GMT

The views of decision makers on fairness in the allocation of resources in the health systems of Canada, Uganda and Norway will be explored at the first CHEPA monthly seminar of the 2009-10 academic year on Sept. 23.

Lydia Kapiriri, an assistant professor in the Department of Health, Aging and Society at McMaster University, will present a paper entitled Fairness and Accountability for Reasonableness: Do the views of priority setting decision makers differ across health systems and levels of decision-making?

The paper reports the elements of fairness described by 184 decision makers involved in priority setting at various levels of the health systems in the three countries. The results from Canada focus on Ontario. The paper compares the views on fairness against the four conditions of ‘accountability for reasonableness’ ¬– relevance, publicity, appeals and enforcement.

Accountability for reasonableness is an ethical framework for fairness in the priority setting process. The four conditions of the framework have been used to evaluate fairness in several contexts, but no studies have compared the acceptability of the conditions to decision makers across health systems and levels of priority setting.

Kapiriri will discuss how identified elements of fairness aligned with the four conditions of accountability for reasonableness, and the implications of these findings.

The seminar will be held in HSC-1J7 from 12:30 to 1:30 p.m. All are welcome to attend.

Kapiriri has a PhD in International Health from the University of Bergen in Norway, and a Master of Public Health and a Bachelor of Medicine degree from Makerere University in Kampala, Uganda. She also has a Master of Public Health degree in primary health care management from the Royal Tropical Institute, KIT, Amsterdam in the Netherlands.

Her research interests focus on health systems and global health research, including understanding the processes, the criteria and rationales for priority setting in health care at the different levels of decision-making. She is also interested in HIV/AIDS research among underprivileged populations.

Examining issues of consent on use of personal information for health research

sjohnston — Wed, 05 Aug 2009 10:06:55 GMT

A research project involving two CHEPA members has shown that regardless of their health conditions, people want control over how their personal information is used for health research.

Cathy Charles and Lisa Schwartz were co-investigators on the project that compared the attitudes and expectations regarding privacy and the use of personal information for health research among people with selected stigmatizing conditions and with the general public.

The results, published online in BMC Medical Ethics, found that the purpose of the research and the type of information to be collected were more important in determining consent than the health conditions of participants. In particular, participants were less likely to share personal health information when the research was for profit. People were also more willing to link their health information with biological samples than with information about their income, occupation or education.

The team of researchers led by former CHEPA associate member Don Willison surveyed 1,137 people in the Hamilton area and across Canada who either had potentially stigmatizing conditions (HIV, alcoholism, chronic depression or lung cancer) or lower-stigma conditions (hypertension, breast cancer or diabetes), as well as a reference group of healthy people. Subjects were presented with a series of research situations and asked to indicate how much control they would want over the use of their personal information in each case. The choices were regressed onto demographics, health condition, and attitude measures of privacy, disclosure concern, and the benefits of health research.

“We found that people are happy to let their information be used for research, but they still want to maintain control,” said Willison, a part-time associate professor of Clinical Epidemiology and Biostatistics. “So the challenge is finding a balance between the two.”

The researchers concluded that individuals should be offered some choice in use of their information for different types of health research, even if limited to selectively opting-out. However, many questions remain, including how best to capture the opinions of those who are more privacy sensitive.

The research was funded by the Canadian Institutes of Health Research.

To view the full report, click here.

CHEPA awards two doctoral fellowships for 2009/10

sjohnston — Sat, 13 Jun 2009 06:57:24 GMT

Two students with international educational and work experience have been awarded CHEPA Doctoral Fellowships for the 2009-10 academic year.

Kaelan Moat, who is currently working towards his Master of Science degree in International Health Policy at the London School of Economics and Political Science, and Yaw Owusu, who has a Master of Science degree in Environmental Sciences, Public Policy Administration from the Southern Illinois University Edwardsville, will both join McMaster’s Health Policy PhD program in September.

Moat, who also has a Bachelor of Health Sciences degree from the University of Western Ontario, has volunteered and worked in India, South Korea, Canada and the United Kingdom. From October 2005 to April 2006, he worked with underprivileged children in Maharashtra, India, through a placement with AIESEC International, following which he went to South Korea to teach English as a second language. He then worked as the International Fundraising Coordinator for Free the Children in Toronto, an international development NGO, before moving to London, England to pursue graduate studies in health policy.

His experience of the past few years increased his interest in health policy, evolving into a desire to understand and compare health systems, with a particular emphasis on barriers that have an impact on health reform and policy. Through the Health Policy PhD program, Moat plans to focus on the use of research to inform policy in low income countries, with a particular emphasis on the impact of decentralization reforms on health systems in Africa and South Asia.

Moat will be supervised by CHEPA member John Lavis.

Owusu grew up in the African nation of Ghana, and earned a Bachelor of Science degree in Agricultural Science at the Kwame Nkrumah University of Science and Technology. He then moved to Illinois to pursue graduate education, and has worked in research, economics and financial analysis positions while pursuing a Master of Science in Economics and Finance and later the master’s degree in environmental sciences. He relocated to Ontario after completing the latter degree in 2006.

In Ontario he has worked as a financial analyst, a research analyst and on an international development project involving research on bio-materials as a source of income and to provide improvement in the standard of living in developing countries.

Owusu plans to develop his research interests in the relationship between health insurance, environmental health policy, and health care accessibility and financing in developing nations. He intends to carry out comparative research on health policy issues in both developed and developing countries. His primary area of interest is in Africa, where recent government liberalization and privatization policies have begun to make an impact on health policies.

Owusu will be supervised by CHEPA member Michel Grignon.

09-04

Sjohnston — Thu, 04 Jun 2009 12:54:03 GMT

McDonald, H. Criteria for Evaluating the Quality of Decision Aids: A Critical Appraisal of the IPDAS Presentation of Probabilities Domain. Available in PDF