Showing papers by "Saskatchewan Health published in 2008"

Positive predictive value of ICD-9 codes 410 and 411 in the identification of cases of acute coronary syndromes in the Saskatchewan Hospital automated database

Abstract: Background Case definitions are essential to epidemiological research. Objectives To evaluate ICD-9 codes 410 and 411 to identify cases of acute coronary syndromes (ACS), and the clinical information availability in the administrative and hospital discharge records of Saskatchewan, Canada. Methods In the context of a safety cohort study, we identified hospitalisations with primary discharge codes 410 (2260) and 411 (799). We selected all records with code 411, and a random sample (200) with code 410. Based on information obtained by trained abstractors from hospital records, events were classified by two cardiologists as definite or possible according to adapted AHA/ESC criteria. The validity of 410 and 411 codes was assessed by calculating the positive predictive value (PPV). Completeness of the recorded information on risk factors and use of aspirin was explored. Results The PPVs of the codes 410 and 411 for ACS were 0.96 (95%CI: 0. 92–0.98) and 0.86 (95%CI: 0.83–0.88), respectively. The PPV of 410 for acute myocardial infarction (AMI) was 0.95 (95%CI: 0.91–0.98). The PPV of 411 was 0.73 (95%CI: 0.70–0.77) for primary unstable angina (UA) and 0.09 (95%CI: 0.07–0.11) for AMI. Hospital charts review revealed key information for clinical variables, smoking, obesity and use of aspirin at admission. Conclusions ICD-9 410 code has high PPV for AMI cases, likewise 411 for UA cases. Case validation remains important in epidemiological studies with administrative health databases. Given the pathophysiology of ACS, both AMI and UA might be used as study end points. In addition to code 410, we recommend the use of 411 plus validation. Copyright © 2008 John Wiley & Sons, Ltd.

The safety of rosuvastatin in comparison with other statins in over 25 000 statin users in the Saskatchewan Health Databases

Abstract: Purpose To compare mortality and the incidence of hospitalization for myopathy, rhabdomyolysis, acute renal failure and acute liver injury in patients receiving rosuvastatin and those taking other statins. Methods Patients prescribed a statin that they had not used before were selected from the Saskatchewan Health Databases (SHD) and followed up from 1 July 2003 until 31 March 2005. Results We studied 10 384 patients on rosuvastatin and 14 854 taking other statins. Two cases of myopathy were identified (one on rosuvastatin, one on another statin). The relative risk (RR) of myopathy in patients currently taking rosuvastatin compared with other statins was 1.31 (95% confidence interval [CI]: 0.13–13.41). Two cases of rhabdomyolysis were detected among current rosuvastatin users (incidence: 2.9 [95% CI: 0.8–10.7] per 10 000 person-years). No cases of acute liver injury occurred among rosuvastatin patients. Seventeen cases of acute renal failure were identified (five among rosuvastatin users, 12 taking other statins). The RR of acute renal failure in current rosuvastatin users compared with other statins was 0.49 (95% CI: 0.16–1.50). We identified 285 deaths during the study period (87 among rosuvastatin users, 198 taking other statins). The RR of death in current rosuvastatin users compared with other statins was 0.42 (95% CI: 0.32–0.57). Conclusions We found no evidence that patients prescribed rosuvastatin were at greater risk of the study outcomes than patients prescribed other statins. There was no evidence of increased mortality among patients taking rosuvastatin, even after allowing for age, sex and prior statin use. Copyright © 2008 John Wiley & Sons, Ltd.

Antidepressants and risk of prostate cancer: a nested case-control study.

Abstract: Although the association between antidepressant drug use and risk of cancer has received considerable attention in the past years, no work has been done specifically on prostate cancer. We carried out a population-based case-control study to assess the risk of prostate cancer in association with exposure to tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). 7767 prostate cancer cases diagnosed between 1981 and 2000 were accrued through the Saskatchewan Cancer Agency. Saskatchewan Health identified a total of 31,068 male controls who were matched on age and calendar time. Data on exposure to TCAs and SSRIs were compiled from the Saskatchewan outpatient prescription drug database, and covered a period upto 24 years. A positive significant association was found between TCA use and risk of prostate cancer, when exposure took place 2-5 years before diagnosis, with rate ratios of 1.31, 1.58, and 2.42 at the low, medium and high average daily dose levels, respectively. Exposure to SSRIs was not found to be significantly associated with the risk of prostate cancer. TCA use 2-5 years in the past was associated with a small dose-dependent increase in the risk of prostate cancer. Nevertheless, detection bias could have contributed to the observed association.

Best practice: E-Model--prescribing physical activity and exercise for individuals with fibromyalgia.

Abstract: Fibromyalgia (FM) is a serious and debilitating condition, encompassing a wide range of symptoms. Physical therapists often advocate the incorporation of leisure time physical activity (exercise training or recreational physical activity) as an important management strategy for individuals with FM. Decisions about physical activity prescription in clinical practice are informed by a variety of sources. This topical review considers physical activity prescription using the E-Model as a framework for best practice decision making. We examine findings from randomized trials, published experts, and qualitative studies through the lens of the model's five Es: 1) evidence, 2) expectations, 3) environment, 4) ethics, and 5) experience. This approach provides a robust foundation from which to make best practice decisions. Application of this model also facilitates the identification of gaps and discrepancies in the literature, future opportunities for knowledge exchange and translation, and future research.

Judgement of confidence in childhood memories

Abstract: Memory judgement processes, based on the characteristics and associations of retrieved memories such as sensory details and supporting memories, are considered as important as retrieval in several autobiographical memory models. Judgement processes have received less research attention than memory characteristics themselves. The present studies examined memory judgement using qualitative analysis of the reasons participants gave for confidence in retrieved childhood memories. For memories they were confident of, participants cited memory phenomenology, especially sensory and affective details, much more frequently than consistency with other autobiographical knowledge. For memories they were not confident of, participants reported lack of consistency with autobiographical knowledge or with others' memories more often than memory phenomenology as reasons for their uncertainty. Participants' comments also revealed several metacognitive beliefs about the relationship between memory characteristics and accuracy. These data are consistent with two-process models of memory judgement associated with true versus false memories. Copyright © 2007 John Wiley & Sons, Ltd.

Public Health Use of Surveillance for West Nile Virus in Horses: Saskatchewan, 2003–2005

Abstract: Summary West Nile virus (WNV) infection in horses was first reported in Canada in 2001 and in the province of Saskatchewan in 2002. This paper outlines the surveillance results of WNV in Saskatchewan horses from 2003 to 2005 and describes the usefulness of its inclusion in an integrated surveillance program in Saskatchewan. The number of human and horse cases was highest in 2003, the epidemic year and then substaintially lower in 2004 and 2005. Horses provided additive information about WNV activity in rural areas with low human population, however, this required willingness and active participation by veterinarians and horse owners. Vaccination impedes the future use of horses in WNV surveillance for public health or veterinary purposes; however, for zoonoses where no vaccination is available, domestic animals would be useful components for surveillance. Integration of surveillance data from human and animal health provide the benefit of a more complex epidemiological picture that can be used to improve public health.