The relation between promotional spending on drugs and their therapeutic gain: a cohort analysis.
This study examines the most heavily promoted drugs and the therapeutic value of those drugs to help determine whether doctors should be using promotional material to inform themselves about drugs. METHODS: Lists were constructed of the 50 most heavily promoted drugs (amount of money spent on journal advertisements and visits by sales representatives) and the 50 top-selling drugs (by dollar value) for 2013, 2014 and 2015. Therapeutic gain was determined by examining ratings from the Patented Medicine Prices Review Board and the French drug bulletin Prescrire International and was categorized as major, moderate or litt...
Source: cmaj - September 13, 2017 Category: General Medicine Authors: Lexchin J Tags: CMAJ Open Source Type: research

Working hard but working differently: a qualitative study of the impact of generational change on rural health care.
Abstract BACKGROUND: There is limited literature evaluating generational change in the physician workforce and the adjustments required of practices, practitioners and the health care system as a whole. The purpose of this study was to explore rural practitioners' experiences of their current contexts relevant to recruitment and retention and to determine how practices are responding to changing aspirations of new practitioners. METHODS: We used qualitative methods. Participants were selected to ensure diversity of career stage. Semistructured interviews conducted with 39 physicians, 2 nurses and 1 practice a...
Source: cmaj - September 12, 2017 Category: General Medicine Authors: Snadden D, Kunzli MA Tags: CMAJ Open Source Type: research

Secondary prevention treatment after acute stroke in older South Asian, Chinese and other Canadians: a retrospective data analysis.
Abstract BACKGROUND: Little is known about whether there are differences in medication use between older patients of Chinese descent, those of South Asian descent and other Canadian patients after acute ischemic or primary intracerebral hemorrhagic stroke. The aim of this population-based study was to evaluate potential ethnic differences in secondary prevention pharmacotherapy after acute stroke. METHODS: Using health administrative data, we conducted a retrospective analysis of all patients aged 66 years or more admitted to hospital with acute stroke in Ontario (1997-2011) and British Columbia (1997-2009). ...
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Khan NA, McAlister FA, Pilote L, Palepu A, Quan H, Hill MD, Fang J, Kapral MK Tags: CMAJ Open Source Type: research

Accuracy and predictive value of incarcerated adults' accounts of their self-harm histories: findings froman Australian prospective data linkage study.
Abstract BACKGROUND: Self-harm is prevalent in prison populations and is a well-established risk factor for suicide. Researchers typically rely on self-report to measure self-harm, yet the accuracy and predictive value of self-report in prison populations is unclear. Using a large, representative sample of incarcerated men and women, we aimed to examine the level of agreement between self-reported self-harm history and historical medical records, and investigate the association between self-harm history and medically verified self-harm after release from prison. METHODS: During confidential interviews with 13...
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Borschmann R, Young JT, Moran P, Spittal MJ, Snow K, Mok K, Kinner SA Tags: CMAJ Open Source Type: research

Sepsis, one of CMAJ's four new areas of focus.
PMID: 28893873 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Kelsall D, Kissoon N Tags: CMAJ Source Type: research

The quadruple burden of sepsis.
PMID: 28893874 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Dugani S, Laxminarayan R, Kissoon N Tags: CMAJ Source Type: research

Duration of antiresorptive activity of zoledronate in postmenopausal women with osteopenia: a randomized, controlled multidose trial.
Abstract BACKGROUND: Intravenous zoledronate 5 mg annually reduces fracture risk, and 5 mg every 2 years prevents bone loss, but the optimal dosing regimens for these indications are uncertain. METHODS: We conducted a 3-year open-label extension of a 2-year randomized, placebo-controlled, double-blind study. Late postmenopausal women with osteopenia were assigned to receive a single baseline dose of 1 mg, 2.5 mg or 5 mg of zoledronate or placebo. The primary outcome was change in spine bone mineral density (BMD). Secondary outcomes were changes in hip BMD and serum markers of bone turnover. RESULTS: The ...
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Grey A, Bolland MJ, Horne A, Mihov B, Gamble G, Reid IR Tags: CMAJ Source Type: research

Recommendations on screening for abdominal aortic aneurysm in primary care.
PMID: 28893876 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Canadian Task Force on Preventive Health Care Tags: CMAJ Source Type: research

Superimposed lateralized exanthem in a 30-year-old woman.
ejo R PMID: 28893877 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Alcántara-Reifs CM, Salido-Vallejo R Tags: CMAJ Source Type: research

Canadian hepatitis C virus screening guideline: a disconnect between evidence and recommendations.
PMID: 28893878 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Haines A, Wong WWL, Krahn M Tags: CMAJ Source Type: research

Extrapolation warning.
PMID: 28893879 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Quinlan C Tags: CMAJ Source Type: research

How physicians can "flex their advocacy muscles".
How physicians can "flex their advocacy muscles". CMAJ. 2017 Sep 11;189(36):E1152 Authors: Collier R PMID: 28893880 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

CMA votes for review of medical liability system.
PMID: 28893881 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

Harm reduction is about providing safety for patients.
PMID: 28893882 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

CMA's new mission and vision statements rankle some members.
PMID: 28893883 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

Doctors and health funding must focus on most vulnerable: Philpott.
PMID: 28893884 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

Physicians debate tax reforms at CMA annual meeting.
PMID: 28893885 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

Doctors dissect medicine's bullying problem.
PMID: 28893886 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

Doctors should buckle up for health reforms: Barrette.
PMID: 28893887 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

Focus on patients, the rest will follow, says new CMA pres.
PMID: 28893888 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

Lively debate on disability insurance for medical students at CMA meeting.
PMID: 28893889 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

Healthier doctors means healthier patients: CMA president-elect.
PMID: 28893890 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

Health leaders must share the reins of reform: outgoing CMA pres.
PMID: 28893891 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

CMA must address physician burnout, pharmacare, say doctors.
PMID: 28893892 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

Physicians support assisted death for mature minors, but not mental illness.
PMID: 28893893 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

Fees for medical liability protection decrease in populous regions.
PMID: 28893894 [PubMed - in process] (Source: cmaj)
Source: cmaj - September 11, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

Temporal trends in the association between socioeconomic status and cancer survival in Ontario: a population-based retrospective study.
Abstract BACKGROUND: Cancer survival is known to be associated with socioeconomic status. The income gap between the richer and poorer segments of the population has widened over the last 20 years in Canada. The purpose of this study was to investigate temporal trends in disparities in cancer-specific survival related to socioeconomic status in Ontario. METHODS: There were 920 334 cancer cases between 1993 and 2009 in the Ontario Cancer Registry. We linked median household income from the Canadian census to the registry. We calculated 5-year cancer-specific survival rates for all cancers combined and for spec...
Source: cmaj - September 6, 2017 Category: General Medicine Authors: Dabbikeh A, Peng Y, Mackillop WJ, Booth CM, Zhang-Salomons J Tags: CMAJ Open Source Type: research

Human seroprevalence of Borrelia miyamotoi in Manitoba, Canada, in 2011-2014: a cross-sectional study.
Abstract BACKGROUND: Hard tick-borne relapsing fever caused by Borrelia miyamotoi has been reported in Russia, the Netherlands, Germany, Japan and the northeastern and upper midwestern United States. We sought to investigate the presence of B. miyamotoi infection in humans in Manitoba, Canada. METHODS: Two hundred fifty sera collected from residents of Manitoba with suspected Lyme disease between 2011 and 2014 were tested for Borrelia burgdorferi antibody using a C6 peptide enzyme-linked immunosorbent assay (ELISA) followed by Western blot. Residual sera were then anonymized, stored at -80°C and subsequen...
Source: cmaj - September 6, 2017 Category: General Medicine Authors: Kadkhoda K, Dumouchel C, Brancato J, Gretchen A, Krause PJ Tags: CMAJ Open Source Type: research

A cross-sectional population-based study of breast cancer screening among women with HIV in Ontario, Canada.
Abstract BACKGROUND: As women with HIV live longer, the need for age-appropriate breast cancer screening will increase. We compared rates of screening mammography among women with and without HIV. METHODS: We used administrative health databases to identify all women in Ontario, Canada, who were eligible for screening mammography (aged 50 to 74 yr and no history of breast cancer) as of Apr. 1, 2011. We used multivariable log-binomial regression to compare the 2-year period prevalence of screening mammography in 2011 to 2013 among women with and without HIV and to examine the correlates of screening among wome...
Source: cmaj - August 30, 2017 Category: General Medicine Authors: Kendall CE, Walmsley S, Lau C, Jembere N, Burchell AN, Loutfy M, Raboud J, Rosenes R, Rourke SB, Antoniou T Tags: CMAJ Open Source Type: research

New CMAJ policy on sharing study data.
PMID: 28847778 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 28, 2017 Category: General Medicine Authors: Kelsall D Tags: CMAJ Source Type: research

It's time to allow assisted injection in supervised injection sites.
PMID: 28847779 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 28, 2017 Category: General Medicine Authors: Gagnon M Tags: CMAJ Source Type: research

Perinatal suicide in Ontario, Canada: a 15-year population-based study.
We examined the epidemiology of and health service use related to suicides during pregnancy and the first postpartum year. METHODS: In this retrospective, population-based cohort study, we linked health administrative databases with coroner death records (1994-2008) for Ontario, Canada. We compared sociodemographic characteristics, clinical features and health service use in the 30 days and 1 year before death between women who died by suicide perinatally, women who died by suicide outside of the perinatal period and living perinatal women. RESULTS: The perinatal suicide rate was 2.58 per 100 000 live births, wit...
Source: cmaj - August 28, 2017 Category: General Medicine Authors: Grigoriadis S, Wilton AS, Kurdyak PA, Rhodes AE, VonderPorten EH, Levitt A, Cheung A, Vigod SN Tags: CMAJ Source Type: research

Pediatric longitudinal melanonychia.
PMID: 28847781 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 28, 2017 Category: General Medicine Authors: Burleigh A, Lam JM Tags: CMAJ Source Type: research

Beware selection bias.
PMID: 28847782 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 28, 2017 Category: General Medicine Authors: Barrett JFR, Zaltz A, Geary M, Sermer M, Kingdom J Tags: CMAJ Source Type: research

The end of forceps deliveries?
PMID: 28847783 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 28, 2017 Category: General Medicine Authors: Pairaudeau N Tags: CMAJ Source Type: research

The authors reply to "The end of forceps deliveries?" and "Beware selection bias".
The authors reply to "The end of forceps deliveries?" and "Beware selection bias". CMAJ. 2017 Aug 28;189(34):E1098 Authors: Muraca GM, Lisonkova S, Joseph KS, Skoll A, Cundiff GW, Brant R, Sabr Y PMID: 28847784 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 28, 2017 Category: General Medicine Authors: Muraca GM, Lisonkova S, Joseph KS, Skoll A, Cundiff GW, Brant R, Sabr Y Tags: CMAJ Source Type: research

Medical cannabinoids.
Authors: PMID: 28847785 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 28, 2017 Category: General Medicine Tags: CMAJ Source Type: research

Research Canada calls for public investment in health research.
PMID: 28847786 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 28, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

Tackling Pharma corruption in Ukraine.
PMID: 28847787 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 28, 2017 Category: General Medicine Authors: Colborne M Tags: CMAJ Source Type: research

Minors buy e-cigs online with ease. What about pot?
PMID: 28847788 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 28, 2017 Category: General Medicine Authors: Collier R Tags: CMAJ Source Type: research

Screening for atrial fibrillation in Canadian pharmacies: an economic evaluation.
The objective of this study was to conduct an economic evaluation of the Program for the Identification of 'Actionable' Atrial Fibrillation in the Pharmacy Setting (PIAAF-Pharmacy), which screened 1145 participants aged 65 years or more at 30 community pharmacies in Ontario and Alberta between October 2014 and April 2015. METHODS: We used a 2-part decision model to evaluate the short- and long-term costs and quality-adjusted life-years (QALYs) of a pharmacy screening program for atrial fibrillation compared to no screening. Data from the PIAAF-Pharmacy study were used for the short-term model, and the relevant literat...
Source: cmaj - August 22, 2017 Category: General Medicine Authors: Tarride JE, Dolovich L, Blackhouse G, Guertin JR, Burke N, Manja V, Grinvalds A, Lim T, Healey JS, Sandhu RK Tags: CMAJ Open Source Type: research

Routinely collected data: the importance of high-quality diagnostic coding to research.
PMID: 28827435 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 21, 2017 Category: General Medicine Authors: Nicholls SG, Langan SM, Benchimol EI Tags: CMAJ Source Type: research

Association between sedentary time and mortality across levels of frailty.
We examined whether the degree of frailty affects the association between sedentary behaviours and higher risk of mortality. METHODS: In this prospective cohort study, we used data from 3141 community-dwelling adults 50 years of age or older from the 2003/04 and 2005/06 cohorts of the US National Health and Nutrition Examination Survey. Time engaged in sedentary behaviours was measured using uniaxial accelerometers, and frailty was based on a 46-item frailty index. Mortality data were linked up to 2011. We used Cox proportional hazard models to estimate the hazard ratio (HR) of sedentary behaviour. RESULTS: We fo...
Source: cmaj - August 21, 2017 Category: General Medicine Authors: Theou O, Blodgett JM, Godin J, Rockwood K Tags: CMAJ Source Type: research

Finding the right balance between precision medicine and personalized care.
PMID: 28827437 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 21, 2017 Category: General Medicine Authors: McAlister FA, Laupacis A, Armstrong PW Tags: CMAJ Source Type: research

Iatrogenic pulmonary air embolism.
PMID: 28827438 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 21, 2017 Category: General Medicine Authors: Fernando SM, Munene PM, Pena E Tags: CMAJ Source Type: research

The utility and value of the "surprise question" for patients with serious illness.
The utility and value of the "surprise question" for patients with serious illness. CMAJ. 2017 Aug 21;189(33):E1072-E1073 Authors: Romo RD, Lynn J PMID: 28827439 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 21, 2017 Category: General Medicine Authors: Romo RD, Lynn J Tags: CMAJ Source Type: research

The authors respond to "The utility and value of the 'surprise question' for patients with serious illness".
The authors respond to "The utility and value of the 'surprise question' for patients with serious illness". CMAJ. 2017 Aug 21;189(33):E1074 Authors: Downar J, Goldman R, Pinto R, Englesakis M, Adhikari N PMID: 28827440 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 21, 2017 Category: General Medicine Authors: Downar J, Goldman R, Pinto R, Englesakis M, Adhikari N Tags: CMAJ Source Type: research

Growing use of integrated e-health systems.
PMID: 28827441 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 21, 2017 Category: General Medicine Authors: Webster P Tags: CMAJ Source Type: research

Resignations raise questions about OMA finances.
PMID: 28827442 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 21, 2017 Category: General Medicine Authors: Vogel L Tags: CMAJ Source Type: research

CMA adopts patient focus.
PMID: 28827443 [PubMed - in process] (Source: cmaj)
Source: cmaj - August 21, 2017 Category: General Medicine Authors: Owens B Tags: CMAJ Source Type: research