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Ongoing Private
Sector Projects

The following projects are currently being completed by DAS.

Client: imshealth | brogan

Research Question/Objectives: Hypoparathyroidism is a rare disease as noted by NORD and typically is caused by damage to the parathyroid during head and neck surgery. Treatment is chronic and consists of vitamin D and calcium supplements. In contrast to hyperparathyroidism, hypoparathyroidism is not well studied, and only five prevalence studies have been published outside of Canada. This study aims to understand the epidemiology and burden of hypoparathyroidism in Ontario. Specifically, the research questions of interest are:

  • What is the prevalence, incidence, and burden of illness of hypoparathyroidism in Ontario?
  • What treatments are received by hypoparathyroidism patients in Ontario?
  • What are the costs and resource utilization of Ontarians with hypoparathyroidism?

Availability of Results: study in progress


Client: Amgen Canada Inc.

Research Question/Objectives: There are minimal data available in Canada describing the prevalence of Atherosclerotic Cardiovascular Disease (ASCVD) as defined in the Canadian Cardiovascular Society dyslipidemia guidelines, nor are there data on the progression of the disease over time and the association with healthcare utilization. With the recent availability of new non-statin medications to lower low density lipoprotein – Cholesterol (LDL-C levels) and demonstrated improvement in morbidity and mortality outcomes in patients treated with these drugs, there is a need to understand the real-world burden of illness and cost of ASCVD to the Canadian healthcare system. Specifically, the research objectives of interest are:

  • To describe the incidence, prevalence, patient characteristics (including comorbidities), and health resource utilization of patients with ASCVD in Ontario, Canada.
  • To describe the time from first ASCVD event to second event, and subsequent event(s), and/or mortality, if applicable.
  • To describe the type of second and/or subsequent event(s) relative to the type of primary event.

Availability of Results: study in progress


Client: imshealth | brogan

Research Question/Objectives: Ulcerative colitis and Crohn’s disease are the most prevalent types of inflammatory bowel diseases (IBD), with etiologies rooted in a complex interplay of genetic, microbial, and environmental factors. The overall objective of this retrospective study is to estimate the health care resource utilization and direct medical costs associated with Crohn’s disease and ulcerative colitis patients, when treated with biologic therapies, and compare the difference by type of index biologic used. Specifically, the research objectives of interest are:

  • Determine the health care resource utilization and direct medical cost of IBD study patient cohort treated with a biologic and retained on it for at least 24 months, compared to a non-IBD cohort.
  • Determine the occurrence of disease specific health outcomes for an IBD study patient cohort treated with a biologic and retained on it for at least 24 months, compared to a non-IBD cohort.
  • Estimate and describe the proportion of patients that are primary non-responders and primary responders.

Availability of Results: study in progress


Client: Hoffmann-La Roche Limited

Research Question/Objectives: Breast cancer is responsible for over one quarter of all new cancer cases among Canadian women. Second to lung cancer, it is the most common cause of cancer death in females and is responsible for almost 137,000 potential life years lost. In the first year after diagnosis average direct health care costs in Ontario are estimated at almost $21,000 (2009 CAD) per patient and lifetime total direct health care costs in Canada are over $300M. Despite the significant clinical and economic burden, recent research studies of the epidemiology, treatment patterns and health care utilization of women with breast cancer in Ontario are limited and do not provide information specific to patient characteristics such as biomarker status (HER2+/-, HR+/-) and TNM staging at diagnosis. The purpose of this study will be to investigate the incidence of breast cancer among women in Ontario and the impact of patient baseline characteristics on patterns of care, clinical outcomes and health care utilization. Specifically, the research objectives of interest are:

  • To determine the epidemiology, treatment patterns and health care resource utilization for women diagnosed with breast cancer.
  • To identify a cohort of incident breast cancer patients and understand their characteristics at diagnosis (e.g. age, disease stage, nodal status, HER2 status, hormone receptor status).
  • To describe patterns of care and clinical outcomes in the cohort.
  • To determine health care resource utilization by disease subtype.

Availability of Results: study in progress


Client: Amgen Canada Inc.

Research Question/Objectives: Osteoporosis and the clinical fractures associated with the disease have significant consequences on human health and quality of life and represent a major burden to society. As with many other chronic and asymptomatic diseases, osteoporosis is under diagnosed and undertreated. The rates of treatment for osteoporosis are also sub-optimal, even among patients who have suffered hip or other fragility fractures. Studies conducted in a variety of different populations indicate that the rates of BMD testing and treatment following fragility fractures are generally <50%, and often <10%. The purpose of this study will be to describe the real-world management (including screening and treatment) and Health Resource Utilization (HRU) of patients subsequent to a primary fragility fracture in Ontario, Canada.

Research Objectives

Primary Objectives:

  • To describe the incidence of primary fragility fractures in patients over (65+).
  • To describe the real-world management, including screening and treatment, and resource utilization following a primary fragility fracture.

Secondary Objectives:

  • To characterize the publicly-insured Ontario fragility fracture patient.
  • To describe patient management, including screening and treatment, prior to a fragility fracture in patients (65+).
  • To describe the rate of subsequent fractures, related procedures, complications, hospitalizations and mortality subsequent to a primary fragility fracture.

Exploratory Objectives:

  • To describe the persistence to osteoporosis treatments in patients (65+) who have had a fragility fracture.
  • To describe comorbidities of interest and steroid-use in patients over (65+) who have had a fragility fracture.
  • To describe opioid pain medications in patients (65+) prior to, and following a fragility fracture.
  • To describe the HRU costs for matched patients who have not had a fragility fracture.
  • To describe mortality for matched patients who have not had a fragility fracture.

Availability of Results: study in progress


Client: Sunnybrook Research Institute

Research Question/Objectives: Cancer costs in Canada are high and steadily increasing. In order to determine updated costs specific to certain cancer types, Ontario administrative data that will include utilization of publicly available health resources (e.g., hospitalizations, physician services, same day surgeries, medications, etc.) as well as outcomes (e.g., survival) will be used.

This study will investigate the outcomes and public health care costs of resources associated with:

  • ovarian cancer with a BRCA mutation
  • locally advanced non-small cell stage III lung cancer
  • locally advanced or metastatic urothelial cancer
  • recurrent or metastatic squamous cell carcinoma of the head and neck.

Availability of Results: study in progress


Client: imshealth | brogan

Research Question/Objectives: Refractory depression, also called treatment-resistant depression (TRD), is commonly encountered by mental health professionals, even in the context of treatment with appropriate anti-depressants. Up to two thirds of patients with major unipolar depression will not respond to the first medication prescribed and 10 - 33% will not respond to multiple interventions. General consensus is emerging that unipolar major depression is considered resistant or refractory when at least two trials with anti-depressants fail to produce a significant clinical improvement.

Primary objective:

  • To measure the economic burden (direct costs) of TRD to the Ontario health care system compared to major depressive disorder (non-TRD) patient population and the general population. 

Secondary objectives:

  • To describe the Ontario TRD patient population in terms of clinical and demographic characteristics
  • To quantify the depression-related health care resource utilization (HCRU) of TRD patients in Ontario compared to the non-TRD patient population and to the general population
  • To measure incremental HCRU and incremental costs of TRD patients by the number of anti-depressant failures
  • To determine the average number of failed anti-depressant lines before MDD patients progress to an electroconvulsive therapy (ETC).

Availability of Results: study in progress


Client: Pfizer Canada Inc.

Research Question/Objectives: All Canadian provinces have funded pneumococcal conjugate vaccine (PCV) universal immunization programs since 2006. Surveillance data from Ontario has shown corresponding declines in invasive pneumococcal disease. Pneumococcus is one of the most common causes of otitis media, but little information is available on incidence rates and impact of the PCV program.

Myringotomy is a surgical procedure in which a tiny slit is made in the tympanic membrane to release the buildup of fluid associated with otitis media with effusion (OME). Indications for this procedure have remained consistent since the 1990’s, and this study aims to investigate the rates in Ontario from 1991 to 2016.

The hypothesis is that the conjugated pneumococcal vaccine (both PCV7 and PCV13) have decreased the rates of complicated or recurrent acute otitis media (AOM), leading to less chronic otitis media and hospitalized mastoiditis and therefore the rates of subsequent myringotomy on a population wide basis will have declined since 1996.

Research objectives:

  • To demonstrate using retrospective analyses of administrative databases that the incidence rates of otitis media with effusion, antibiotic use, mastoiditis and myringotomy declined in Ontario from 1991 to 2016 coinciding temporally with the introduction of pneumococcal conjugate vaccines (PCVs).
  • To demonstrate that total billing costs associated with otitis media with effusion (OME), antibiotics use, mastoiditis and myringotomy declined during the same time period.

Availability of Results: study in progress



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