Projects 1996

1. Applying Total Quality Improvement(TQI) to the Blood Programme. A Donor Perspective. Bourque R, Goldsmith CH, Schatz M, Ali A, Blajchman M. Ontario Zone, Red Cross, Blood Services Research Fund. August 1996
2. Can We Make the Blood Programme Better? Goldsmith CH, Ali A, Schatz M, Willms DG, Blajchman M. The Canadian Red Cross Society, Ontario Division Blood Services Research Fund. January 1996
3. Economic Evaluation of Low Molecular Weight Heparin and Other Modalities for the Prevention of Deep Vein Thrombosis and Pulmonary Embolism following Total Hip or Knee Arthroplasty. Investigators: Anderson D. (PI), O'Brien B, Wells P, et al. Sponsor: CCOHTA. 1996
4. Effect of Therapeutic Exercise and Sleeping Neck Support on Patients with Chronic Neck Pain. Helewa A, Goldsmith CH, Smythe HA, Lee P, Aker PD, Obright K. The NHRDP January 1996
5. Productivity Costs of Schizophrenia in Canada Investigators: Goeree R, O'Brien B, Goering P, Blackhouse G. Sponsor: Health Canada 1996
6. Retrospective Study of Methotrexate-Hydrochloroquine Combination Therapy in Patients with Rheumatoid Arthritis. Bensen WG, Holbrook AM, Goldsmith CH. Sanofi-Winthrope. November 1996
7. Stroke Strengthening Study II. A Randomized Controlled Trial. Moreland JD, Cook DJ, Goldsmith CH. Heart and Stroke Foundation of Ontario. July 1996
8. Term Breech Trial. Medical Research Council of Canada Hannah M, Milne K, Saigal S, Willan A. Oct. 1996
9. The Development and Evaluation of Different Methods of Information Presentation to Allow Patients to Declare their Preferences Regarding Treatment for Atrial Fibrillation. Father Sean O'Sullivan Centre. Holbrook A. (PI), Labiris R, Sebaldt R.

Patients are increasingly involved in decisions regarding their health care. Many questions remain unanswered in this area of patient decision making. For example: it is unclear which patients wish to participate, to what extent they wish to make decisions and how they will acquire and use the information necessary to make informed decisions. We are completing a study to address the latter question. In this study, we wish to investigate different means of delivering information (interactive computer, decision board, tape-booklet each with pie chart or pictogram graphics) to elderly subjects about a specific health condition called atrial fibrillation. The elders (who do not have atrial fibrillation) complete tests of knowledge before and after, make their decision and complete scales of decisional conflict and explanation of choices. This is repeated without then with the actual names for the treatment choices.This study has made it obvious that many decisions by patients are not made based on benefit:risk evidence alone.

Atrial fibrillation is a chronic heart condition that increases the risk of stroke. Three forms of treatment are presently commonplace. In most individuals, the choice of treatment is not black and white but influenced by the individual patient's values regarding the balance of risks and benefits to them of each treatment. It is essential that their decision is based on accurate information. This study will allow us to determine which method is best for transmitting information to patients. The best method will be used in subsequent research to evaluate the actual treatment preferences of patients with various conditions. This example of patient-orientated research is instrumental to develop efficient ways of incorporating the patient's perspective into health care, particularly for therapies where there are significant risks as well as benefits.

1. The Diagnostic Validity of Clinical Tests in Temporomandibular Disorders. A Meta-Analysis. Gross AR, Haines AT, Goldsmith CH, McIntosh JM, Thomson MA. Chedoke-McMaster Hospital Fund. June 1996
2. To Determine the Effectiveness and Safety of Topiramate in the Treatment of Refractory Epilepsy under Real Life Conditions. Goldsmith CH, Levine MAH, Willison D, Poston J, Borden EK, Hu X. Janssen-Ortho Inc Canada. December 1996