Project ID: P2020-078/2022 0970 259 000

Research Question/Objectives: The client is looking for Canadian specific costs of various resources associated with three types of cancers for a model that requires cost, outcomes, and patient inputs.

Cost, outcomes, and patient inputs and utilization rates of various resources will be identified for the following cohorts of cancers:

• Breast cancer
• Biliary tract cancer
• Hepatocellular carcinoma.

Availability of Results: study in progress

Project ID: P2020-090 / 2021 0970 285 000

Research Question/Objectives: The purpose of this study is to describe the patient pathways for obesity management at hospital and/or specialized obesity services in Canada. Treatment patterns defined by the initiation, discontinuation, sequence, timing and duration of specific obesity interventions, as well as the concurrent healthcare resource utilization (HCRU) will be described for patients with body mass index (BMI) ≥30 kg/m².

Research objectives:

• Describe the real-world obesity care pathway for patients BMI ≥30 kg/m², from their first obesity clinic visit to the end of follow up, by summarizing patients’ interactions with the healthcare system in Canada.
• Describe key patient characteristics (e.g., BMI, age, presence of comorbidities, Charlson Comorbidity Index) at specialist entry of the obesity care pathway.
• Describe what professionals (e.g., endocrinologists, surgeons, etc.) are involved in obesity management throughout the obesity care pathway.
• Describe the frequency, timing and duration of obesity treatment received along the obesity care pathway, including initiation, stopping and retreatment patterns, for the following types of obesity interventions: lifestyle modifications, pharmacological interventions, bariatric endoscopy, bariatric surgery.
• Describe HCRU throughout the obesity care pathway.
• Describe the incidence of key obesity-related comorbidities along the obesity care pathway (including, but not limited to, pre diabetes, type 2 diabetes [T2D], cardiovascular disease [CVD], others).
• If feasible, to evaluate the increase in HCRU and direct cost (assessed during follow-up) attributable to comorbidities, adjusting for relevant demographic and clinical characteristics (including BMI and changes in BMI over the follow-up period).
• Subject to adequate sample size, study objectives (when applicable) will be evaluated separately for patients in obesity class I (BMI 30-35), class II (BMI 35-40) and class III (BMI 40-45) at entry of the pathway, patients with and without comorbidities of interest (independently for each comorbidity) and patients who did or did not undergo bariatric surgery/endoscopy during follow-up.

Availability of Results: In progress

Project ID: P2021-104/ 2023 0970 322 000

Research Question/Objectives: Migraine is a common neurological disease caused due to activation of the trigeminovascular system (TGVS) in the brain. Migraine was identified as being the 2nd leading cause of disability globally after low back pain. The overall migraine prevalence in the Canadian population was reported as 8.3% (2.7 million), in 2010/2011. As per the International Classification of Headache Disorders (ICHD-3), migraine can be classified into various subtypes, including episodic and chronic migraines (CM). There are acute and preventive treatments available for migraines. While acute treatment reverses the attack, preventive treatments are used to reduce severity and frequency of attacks in patients with severe migraine. Preventive medication helps in decreasing the overall cost burden and healthcare utilization associated with the migraine attack.

Research objectives:

• Compare HCRU and cost of EM and CM patients using preventive medications with their respective matched non-migraine controls.
• Describe HCRU and cost of EM and CM patients based on number of preventive medication classes they cycle through.
• Describe HCRU and cost of EM and CM patients using preventive medications that are optimally managed vs. those that are sub-optimally managed.

Availability of Results: In progress

Project ID: P2022-114

Research Question/Objectives: The client is looking for Canadian-specific survival outcomes as well as treatment patterns, costs and health care resource utilization (HCRU) associated with three types of cancers (prostate cancer, mantle cell lymphoma (MCL) and bladder cancer)) using real-world, population-level data from Ontario databases.

The research objectives include: To determine survival outcomes as well as treatment patterns, costs and HCRU as outlined in the methods section for the following cancer cohorts:

1. Prostate cancer (follow up analysis)
2. Mantle cell lymphoma
3. Bladder cancer
4. Non-small cell lung cancer (follow up analysis)
5. Ovarian cancer

Availability of Results: study in progress

Project ID: P2022-112/ 2023 0970 332 000

Research Question/Objectives: The client has several objectives around the treatment of intraocular pressure (IOP).

To describe:

1. the proportion of patients in monotherapy, dual therapy or multiple agents at index, 12-, 24-, 36-, 60-, 84-, and 120-months post-index.
2. the average duration of IOP-lowering prescription eye drop use prior to the occurrence of a non-eye drop intervention for POAG, initiation of an oral IOP-lowering medication or treatment discontinuation for patient on IOP-lowering prescription eye drops for at least 5 years
3. the rate of switching and treatment escalation following the initiation of the index IOP-lowering prescription eye drop therapy.
4. the rate of discontinuation of IOP-lowering prescription eye drops by class and combination of classes of medication for patients on IOP-lowering prescription eye drops for at least 5 years
5. patient adherence to index treatment overall and for each class and combination of classes of IOP-lowering prescription eye drops medication at 3-, 6-, 12- and 24-months post-index for patients on IOP-lowering prescription eye drops for at least 5 years.
6. healthcare resource utilization (HCRU) including, but not limited to, physician and hospital visits for eye care of patients using IOP-lowering prescription eye drops overall, by class and combination of classes of medication.
7. time to and type of eye procedures for PAG diagnosis for patients on IOP-lowering prescription eye drops for at least 5 years

Availability of Results: study in progress

Project ID: P2022-120/2023 0970 324 000

Research Question/Objectives: The client seeks to summarize the number of hospitalizations with RSV-associated causes, and in-hospital all-cause mortality among hospitalizations with RSV in Ontario between January 1st, 2010 and December 31st, 2019, individually by week and segmented by demographic characteristics (e.g. age group) and risk status. Specific objectives include to summarize:

• the number of RSV-related hospitalizations, stratified by age and risk status.
• all-cause in-hospital mortality associated with RSV-related hospitalizations, stratified by age and risk status.
• the number of cardiorespiratory hospitalizations, stratified by age and risk status.
• the number of respiratory hospitalizations, stratified by age and risk status.
• the number of circulatory hospitalizations, stratified by age and risk status.
• the number of influenza-specific hospitalizations, stratified by age and risk status.

Availability of Results: study in progress

Project ID: P2022-121/2023 0970 330 000

Research Question/Objectives: The client seeks to investigate the true cost burden of sickle cell disease (SCD) to the Canadian health care system.

Primary objectives:

1. Describe the epidemiology of Ontarians with SCD, including incidence/prevalence, patient demographic & clinical characteristics, mortality.
2. Study patient journey in terms of clinical history, treatment patterns and outcomes, healthcare use and costs.
3. Assess the association between hemoglobin levels and other hemolytic biomarker on relevant clinical events (e.g., time to event analyses for endorgan damage, mortality, and other outcomes), costs and healthcare utilization.

Secondary objectives:

1. Stratify the primary objectives by:
   • Treatment received [such as hydroxyurea (HU) only, HU + transfusions, transfusions-only, transplants, opioids use, erythroid stimulating agents (ESAs), and iron chelation therapy (data availability and sample size permitting)]
   • Patient characteristics/outcomes (such as age)
2. Match the study cohort to general population controls to determine the difference in HCRU, costs, BOI and health outcomes.

Availability of Results: study in progress

Project ID: P2022-122/2023 0970 328 000

Research Question/Objectives: The client seeks to conduct a feasibility study.

Phase one

Identify sample sizes:

1. of SCD and B-thalassemia cohorts.
2. of SCD patients with recurrent VOCs sub-group, and B-thalassemia patients with transfusion-dependent thalassemia (TDT) subgroups.

Phase two

Describe:

1. baseline characteristics of cohorts and sub-groups
2. acute and chronic complications of cohorts and sub-groups.
3. treatment patterns of cohorts and sub-groups.

Availability of Results: study in progress

Project ID: P2021-097/2023 0970 331 000

Research Question/Objectives: The purpose of this study is to characterize regional variations in COPD burden and understand what factors are contributing to these regional differences. The existing evidence is limited and outdated, and this study will help to provide insight into recent trends and how health system changes have impacted COPD management overall.

Further, an examination of the impact of the COVID-19 pandemic on COPD burden will also be described. It is anticipated that findings from this study will be utilized to
inform initiatives aimed at improving care for patients with COPD.

Research objectives:

1. Describe regional variations in the care and burden of COPD across Canada.
2. Examine impact of within-province regional differences on hospitalizations and mortality for those with COPD.
3. Characterize regional variations in costs associated with healthcare resource.
4. Examine impact of COVID-19 on COPD burden.

Availability of Results: study in progress

Project ID: P2021-101/2024 0970 338 000

Research Question/Objectives:

The OBRI (Ontario Best Practices Research Initiative) Clinical Cohort (www.obri.ca) is a real-world observational dataset of RA patients in usual care in Ontario Canada designed to answer questions about real-world clinical practice for RA patients. Data linkage of the OBRI cohort with ICES administrative data adds the ability to accurately measure health care costs and assess comorbid conditions/medical events.

Prior research on the costs and burden of herpes zoster have relied on population administrative datasets that capture the costs of illness well but do not contain data on the clinical factors associated with costs or burden of disease. Clinical cohort studies of herpes zoster have the opposite limitation, they contain detailed clinical information but no accurate measurement of health care costs. An OBRI ICES linked cohort would be unique as it would contain both clinical covariates to account for different clinical characteristics and their effects on costs while also capturing health care costs in a standard way directly from the ministry of health databases. OBRI linked data would allow for comparisons between RA patients, the general population, and those with other inflammatory diseases.

Research objectives

What are:

1. the attributable health care costs and clinical conditions of herpes zoster among RA patients with herpes zoster compared to RA patients without herpes zoster over time?
2. the associations between RA disease activity, patient reported outcomes, RA medications, rate of hospitalizations, emergency department visits, and comorbities in RA patients with and without herpes zoster?
3. the attributable health care costs and clinical conditions of herpes zoster among RA patients with herpes zoster compared to the general population without herpes zoster over time?
4. the attributable health care costs and clinical conditions of herpes zoster among RA patients with herpes zoster compared to the general population with herpes zoster over time?

Availability of Results: study in progress