Evidence map›Paper›PMID 30744703›Full record

ArticleSystematic reviews2019

Inappropriateness of health care in Canada: a systematic review protocol.

Janet E Squires, Ian D Graham, Doris Grinspun, John Lavis, France Légaré, Robert Bell, Stephen Bornstein, Susan E Brien, Mark Dobrow, Megan Greenough and 20 more

Abstract read
In one paragraph

Article in Systematic reviews, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Inappropriate use of clinical practices in Canada: a systematic review.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2022
    Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. The Frontline Nurse's Experience of Nursing Outlier Patients.International journal of environmental research and public health · 2020
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

30 authors.

Janet E SquiresClinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, P.O. Box 201-B, Ottawa, Ontario, K1H 8L6, Canada. janet.squires@uottawa.ca.ORCID 0000-0003-2208-7189
Ian D GrahamClinical Epidemiology Program, Ottawa Hospital Research Institute, 501 Smyth Road, P.O. Box 201-B, Ottawa, Ontario, K1H 8L6, Canada.
Doris GrinspunRegistered Nurses' Association of Ontario, Toronto, Canada.
John LavisDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
France LégaréPopulation Health and Practice Changing Research, Research Centre of the CHU de Québec, Québec City, Canada.
Robert BellDepartment of Surgery, University of Toronto, Toronto, Canada.
Stephen BornsteinNewfoundland & Labrador Centre for Applied Health Research, Memorial University, St. John's, Canada.
Susan E BrienPublic Reports, Health Quality Ontario, Toronto, Canada.
Mark DobrowInstitute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Megan GreenoughFaculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Canada.
Carole A EstabrooksFaculty of Nursing, University of Alberta, Edmonton, Canada.
Michael HillmerInformation Management, Data, and Analytics, Health System Information Management Division, Ontario Ministry of Health and Long-Term Care, Toronto, Canada.
Tanya HorsleyRoyal College of Physicians and Surgeons of Canada, Ottawa, Canada.
Alan KatzManitoba Centre for Health Policy, Department of Community Health Sciences and Family Medicine, University of Manitoba, Winnipeg, Canada.
Christina KrauseBritish Columbia Patient Safety & Quality Council, Vancouver, Canada.
Wendy LevinsonInstitute of Health Policy, Management, and Evaluation, Department of Medicine, University of Toronto, Toronto, Canada.
Adrian LevyDepartment of Community Health and Epidemiology, Dalhousie University, Halifax, Canada.
Michelina MancusoNew Brunswick Health Council, Moncton, Canada.
Alies MaybeePatients Advisors Network, Toronto, Canada.
Steve MorganFaculty of Medicine, School of Population and Public Health, University of British Columbia, Vancouver, Canada.
Letitia Nadalin PennoFaculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Canada.
Andrew NeunerHealth Quality Council of Alberta, Calgary, Canada.
Tamara RaderCanadian Agency for Drugs and Technologies in Health, Ottawa, Canada.
Janet RobertsPatient Collaborator, Toronto, Canada.
Gary TeareAlberta Health Services - Alberta Cancer Prevention Legacy Fund, Population, Public and Indigenous Health, Calgary, Canada.
Joshua TepperDepartment of Family and Community Medicine, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Amanda VandykFaculty of Health Sciences, School of Nursing, University of Ottawa, Ottawa, Canada.
Denise WidmeyerManitoba Institute for Patient Safety, Winnipeg, Canada.
Michael WilsonDepartment of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada.
Jeremy M GrimshawClinical Epidemiology Program, Ottawa Hospital Research Institute, Department of Medicine, University of Ottawa, Ottawa, Canada.

Funding

CIHR 201709PJT-156240
6 · The paper itself

Abstract

backgroundThere is increasing recognition in Canada and globally that a substantial proportion of health care delivered is inappropriate as evidenced by (1) harmful and/or ineffective practices being overused, (2) effective clinical practices being underused, and (3) other clinical practices being misused. Inappropriate health care leads to negative patient experiences, poor health outcomes, and inefficient use of scarce health care resources. The purpose of this study is to conduct a systematic review of inappropriate health care in Canada. Our specific objectives are to (1) systematically search and critically review published and grey literature for studies on inappropriate health care in Canada; (2) estimate the nature and magnitude of inappropriate health care in Canada and its provincial and territorial jurisdictions.

methodsWe will include all quantitative study designs reporting objective or subjective measurements of inappropriate health care in Canada over the last 10 years. We will search the following online databases: MEDLINE, Cochrane Central Register of Controlled Trials, EconLit, and ISI-Web of Knowledge, which contains Web of Science Core Collection-Citation Indexes, Science Citation Index Expanded, Conference Proceedings Citation Index-Science, and Conference Proceedings Citation Index-Social Science & Humanities. We will also search grey literature sources to identify provincial and national audits of inappropriate health care. Two authors will independently screen, assess data quality, and extract data for synthesis. Study findings will be synthesized narratively. We will organize our data into three care categorizations: preventive care, acute care, and chronic care. We will provide a compendium of inappropriate health care for each care category for Canada and each Canadian province and territory, where sufficient data exists, by calculating (1) overall medians of underuse, overuse, and misuse of clinical practices and (2) the range of medians of underuse, overuse, and misuse for each clinical practice investigated. DISCUSSION: This review will result in the first-ever evidence-based compendium of inappropriate health care in Canada. We will also develop detailed reports of inappropriate health care for each Canadian province and territory. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42018093495.

Indexed as

Delivery of Health CareMeta-Analysis as TopicSystematic Reviews as TopicUnnecessary ProceduresCanadaHumansQuality of Health CareResearch DesignDelivery of health careHealth services researchQuality of health care

Identifiers

PMID30744703
PMCPMC6371550

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.