Science Platforms

Quality of Care and Effectiveness Research

The Quality of Care and Effectiveness Research platform uses large-scale Canadian healthcare administrative databases to conduct population-based studies on quality of care and effectiveness related to the management of venous thromboembolism (VTE). The primary aim is to identify and characterize gaps in VTE care that will lead to interventions to reduce the clinical and economic burden of VTE in Canada and better inform knowledge translation strategies.

The Team

Platform Co-Leads

Vicky Tagalakis (Montreal, QC)
Alejandro Lazo-Langner (London, ON)

Working Group

Joel Ray (Toronto, ON)
Emmanuel Guindon (Hamilton, ON)
Eddy Lang (Calgary, AB)
Cynthia Wu (Edmonton, AB)
Sarah Takach Lapner (Edmonton, AB)
Deborah Siegal (Hamilton, ON)
Deepa Suryanarayan (Calgary, AB)
Jacob Easaw (Calgary, AB)
Jean-Philippe Galanaud (Toronto, ON)

The Projects

1. Validation of 3 provincial administrative healthcare databases in 3 provinces

Our shared databases from Ontario, Quebec, and Alberta comprise over 26 million people (73% of the Canadian population). Completing the validation of these 3 provincial databases is fundamental to our research. The Québec and Alberta Health Care databases have been validated for the diagnosis of VTE, including DVT and PE. The Ontario databases have been previously partially validated and additional studies are currently ongoing.

2. Management of acute pulmonary embolism in Canada

The aims of the project are to describe the patterns of care in PE patients, describe predictors of hospital admission and healthcare costs, and compare clinical outcomes between ambulatory and hospitalized patients with PE.

 We plan to conduct 3 parallel retrospective population-based cohort studies in patients diagnosed with a first PE event. Baseline population characteristics will be determined according to hospitalization status following the PE. Clinical outcomes will be major bleeding, death and VTE recurrence within 91 days of diagnosis.

 We believe that this study will provide information on determinants of hospital admission for PE and impact of hospitalization on clinical and economic outcomes. This information will help design knowledge translation interventions aimed at reducing hospital PE admissions, resulting in substantial cost savings.

3. Use of novel oral anticoagulants in vulnerable patient populations with venous thromboembolism

The aims of the project are  to describe new oral anticoagulant (NOAC) use patterns in vulnerable VTE patients; to describe rates and predictors of VTE related outcomes; and to compare effectiveness, safety and healthcare resource utilization of NOAC vs. vitamin K antagonists (VKA).

We plan to perform 3 parallel population-based retrospective cohort studies in patients with incident VTE from 2010 to 2014 meeting the aforementioned criteria. We will determine all outpatient prescription information for NOAC and VKA. Outcomes will include major bleeding, death, and recurrent VTE.

We believe this study will provide real world data on the use and safety of NOAC in vulnerable VTE patients. This information will help to design educational and knowledge translation strategies aimed at optimizing the prescription of NOAC in vulnerable populations in order to minimize treatment complications and associated costs, and informing the design of future studies in these patient groups.