Lisa M Lix

The University of Winnipeg, Winnipeg, Manitoba, Canada

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Publications (200)829.62 Total impact

  • Lisa M Lix, William D Leslie
    Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 11/2014; 29(11):2323-2326. · 6.04 Impact Factor
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    ABSTRACT: Response shift (RS) is an important phenomenon that influences the assessment of longitudinal changes in health-related quality of life (HRQOL) studies. Given that RS effects are often small, missing data due to attrition or item non-response can contribute to failure to detect RS effects. Since missing data are often encountered in longitudinal HRQOL data, effective strategies to deal with missing data are important to consider. This study aims to compare different imputation methods on the detection of reprioritization RS in the HRQOL of caregivers of stroke survivors.
    Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. 10/2014;
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    ABSTRACT: We investigated sex- and age-specific associations between income and fractures at the hip, humerus, spine, and forearm in adults aged ≥50 years. Compared to men with the highest income, men with the lowest income had an increased fracture risk at all skeletal sites. These associations were attenuated in women.
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    ABSTRACT: Objective: Historically, meeting criteria for a mental disorder has been used as a proxy for the need for mental health services, yet research suggests that a significant proportion of disorders remit without treatment. In this study, risk factors for poor longitudinal outcomes of individuals with untreated common mental disorders were determined, with the goal of identifying individuals with unmet need and informing the development of targeted interventions. Methods: Data came from the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC), a longitudinal, nationally representative survey of the adult U.S. population (age ≥18; N=34,653). Respondents were assessed for past-year depressive, anxiety, and substance use disorders and mental health service use via face-to-face interviews conducted at two time points, three years apart. Among respondents without a history of mental health treatment, logistic regression analyses examined factors associated with persistence of the disorder, comorbidity, or suicide attempt (that is, presence of any axis I disorder in the past year at wave 2 or any suicide attempt during the follow-up) versus spontaneous recovery of baseline disorders. Results: Certain sociodemographic factors, comorbid mental disorders at baseline (such as three or more axis I disorders, adjusted odds ratio [AOR]=1.64, 95% confidence interval [CI]=1.27-2.12), and childhood maltreatment (AOR=1.47, CI=1.23-1.75) were predictors of disorder persistence, comorbidity, or suicide attempt in depressive, anxiety, and substance use disorders during the follow-up. Conclusions: In addition to considering the presence of a mental disorder, policy makers should consider other variables, such as childhood maltreatment and comorbidity, in estimating treatment need.
    Psychiatric Services 10/2014; · 2.01 Impact Factor
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    ABSTRACT: To estimate systemic autoimmune rheumatic disease (SARD) prevalence using administrative data for pediatric populations in four Canadian provinces. Physician billing claims and inpatient hospitalizations from Alberta, Manitoba, Quebec, and Saskatchewan were used to define cases aged ≤18 years with a SARD diagnosis code in: one or more hospitalization, two or more physician visits within 2 years and at least 2 months apart, or one or more physician visit to a rheumatologist. Estimates ranged from 15.9/100,000 in Quebec [95 % confidence interval (95 % CI) 14.1, 18.0] to 23.0/100,000 in Manitoba (95 % CI 17.9, 29.2). SARDs were more common in females than in males across all provinces. There was a slightly higher prevalence among those living in urban compared to rural areas of Alberta (rate difference 14.4, 95 % CI 8.6, 20.1) and Saskatchewan (rate difference 13.8, 95 % CI 1.0, 26.6). Our results provide population-based prevalence estimates of pediatric SARDs in four Canadian provinces.
    Rheumatology international. 09/2014;
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    ABSTRACT: We aimed to determine the predictors and risk for death among persons with either Crohn's disease (CD) or UC compared with the general population.
    Gut 09/2014; · 10.73 Impact Factor
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    ABSTRACT: Background: A comprehensive study of what individuals with inflammatory bowel disease (IBD) are eating that encompasses food avoidance, dietary sugar consumption, and a comparison with the non-IBD Canadian population has not been documented. The aim was to analyze these interrelated dietary components. Methods: Food avoidance and sugar intake data were collected from 319 patients with IBD enrolled in the University of Manitoba IBD Cohort Study. Diets of those with IBD (n = 256) were compared with a matched, non-IBD Canadian cohort using the nutrition questions obtained from the Canadian Health Measures Survey (CHMS). Results: Food avoidance among IBD is prevalent for alcohol, popcorn, legumes, nuts, seeds, deep-fried food, and processed deli meat, with a higher prevalence among those with active IBD. Patients with active IBD also consumed significantly more portions of sports drinks and sweetened beverages compared with those with inactive disease. Compared with the non-IBD Canadian population, patients with IBD consume significantly less iron-rich food but more milk. Conclusions: Food avoidance is common among those with IBD but may be due more to personal preferences, while sugar-laden beverages may be displacing other foods higher in nutrients. The overall diet of patients with IBD differed from that of the non-IBD Canadian population, but deficiencies were observed in both groups. Considering malnutrition among persons living with IBD, nutrition education by trained dietitians as part of the IBD team is imperative to address food avoidance and overall balance nutrition as part of treating and preventing nutrition deficiencies.
    JPEN. Journal of parenteral and enteral nutrition. 09/2014;
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    ABSTRACT: In an observational study population of 62,413 individuals (6,455 [10 %] with diabetes), diabetes was independently associated with major osteoporotic fractures (MOFs) but did not significantly modify the effect of FRAX(TM) risk factors or prior fracture site. However, the presence of diabetes exerted a much stronger effect on hip fracture risk in younger versus older individuals.
    Osteoporosis International 08/2014; 25(12). · 4.04 Impact Factor
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    ABSTRACT: CMAJ OPEN, 2(3) E139 Research CMAJ OPEN I n August 2012, the US Centers for Disease Control and Prevention released recommendations to expand screening for hepatitis C virus (HCV) infection to include a 1-time blood test for anyone born between 1945 and 1965 (i.e., the baby boomer generation). This recom-mendation was based in part on estimates that this cohort accounts for three-quarters of all hepatitis C cases in the United States. 1 Furthermore, of the estimated 4.3% of the population born in the 1950s who were infected, 50% were unaware of their status. 2,3 Currently in Canada, screening recommendations for HCV are based on an individual assessment of risk rather than the patient's age or year of birth. 4 The Canadian Health Measures Survey, a nationally representative household survey, estimated the seropreva-lence of HCV for 2007–2011 to be 0.5% (95% confidence interval [CI] 0.3%–0.9%), with only 30% of those people (95% CI 16%–51%) aware of their infection. Prevalence was elevated among those aged 50–79 years compared with those aged 14–49 years. 5 Similar to other household surveys, the Canadian Health Measures Survey does not include the homeless or prison populations, in which the prevalence of HCV infection is considerably higher. Hepatitis C has resulted in a considerable morbidity and mortality burden in Canada. 6–8 Based on health-adjusted life-years, a composite measure of premature mortality and reduced functioning because of disease, hepatitis C accounts for the largest proportion of disease burden among 51 infectious dis-eases in Ontario. 9 A study in British Columbia found signifi-cantly elevated standardized mortality ratios for liver-and drug-related causes of death as well as for all-cause mortality among Historical trends and projected hospital admissions for chronic hepatitis C infection in Canada: a birth cohort analysis
    CMAJ Open. 08/2014; 2(3).
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    ABSTRACT: There is a paucity of published population-based estimates of the prevalence of chronic inflammatory arthritis in the pediatric population. We used administrative health data to estimate the prevalence of chronic inflammatory arthritis in individuals ≤18 years in three Canadian provinces: Quebec, Manitoba, and Saskatchewan. Cases aged ≤18 years were identified by meeting any one of the following criteria: (a) ≥1 hospital discharge abstract with an ICD-9 code of 714 or ICD-10-CA codes of M05, M06 or M08, or (b) ≥2 ICD-9 714 billing codes ≥8 weeks apart, but within 2 years, or (c) ≥1 ICD-9 714 billing code by a rheumatologist. Crude prevalence estimates per 10,000 population were estimated with 95 % confidence intervals (CIs). Prevalence estimates were 11.7 per 10,000 individuals ≤18 years of age in Manitoba, 9.8 per 10,000 in Saskatchewan, and 8.0 per 10,000 in Quebec. In pairwise comparisons of rate differences, Manitoba and Saskatchewan had higher estimates than Quebec. Prevalence estimates were higher for females than males, with a difference of 5.9 cases per 10,000 residents (95 % CI 5.1, 6.7). Saskatchewan was the only province with a higher estimate in urban compared to rural residents (5.2, 95 % CI 2.5, 8.0). Variations in provincial estimates may be due to differences in underlying population characteristics. Although these estimates have face validity and are in keeping with the range of previously published pediatric prevalence estimates, studies to establish the empiric validity of case-finding algorithms are needed to advance research in pediatric chronic disease epidemiology.
    Rheumatology International 07/2014; · 2.21 Impact Factor
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    ABSTRACT: Missing data due to attrition or item non-response can result in biased estimates and loss of power in longitudinal quality-of-life (QOL) research. The impact of missing data on response shift (RS) detection is relatively unknown. This overview article synthesizes the findings of three methods tested in this special section regarding the impact of missing data patterns on RS detection in incomplete longitudinal data.
    Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation. 07/2014;
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    ABSTRACT: One quarter of osteoporotic fractures occur in men. TBS, a gray-level measurement derived from lumbar spine DXA image texture, is related to microarchitecture and fracture risk independently of BMD. Previous studies reported the ability of spine TBS to predict osteoporotic fractures in women. Our aim was to evaluate the ability of TBS to predict clinical osteoporotic fractures in men.
    Bone 07/2014; · 4.46 Impact Factor
  • Journal of Clinical Densitometry 07/2014; 17(3):398. · 1.71 Impact Factor
  • Journal of Clinical Densitometry 07/2014; 17(3):406–407. · 1.71 Impact Factor
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    ABSTRACT: The purpose of this research was to perform a scoping review of published literature on the validity of administrative health data for ascertaining health conditions in the pediatric population (<=20 years).
    BMC Health Services Research 05/2014; 14(1):236. · 1.77 Impact Factor
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    ABSTRACT: It is unknown how responsive the Fracture Risk Assessment (FRAX) tool is to osteoporosis treatment (OTX) or whether it can serve as a target for "goal‐directed" treatment. We studied 11,049 untreated women aged ≥50 years undergoing baseline and follow‐up DXA examinations in Manitoba, Canada. We identified clinical risk factors, intervening OTX based on medication possession ratios (MPR),and incident fractures. FRAX scores for major osteoporotic and hip fractures were computed for each scan using the most current(updated) FRAX inputs. Over 4 years, median FRAX scores showed an increase of 1.1% for major fractures and 0.3% for hip fractures,including women highly adherent to OTX (0.6% and 0.1% increases). Few (2.2%) highly adherent women had a decrease in major fracture probability exceeding 4%, whereas 9.0% had a decrease in hip fracture probability exceeding 1%. Compared with untreated women, OTX was associated with a higher dose‐dependent likelihood of attenuating the expected increase in major fracture risk:adjusted odds ratios (aOR) 2.3 (95% confidence interval [CI] 1.8–2.9) for MPR <0.50; 7.3 (95% CI 5.6–9.6) for MPR 0.50–0.79; and 12.0(95% CI 9.5–15.2) for MPR ≥0.80. In the 4 years after the second DXA scan, 620 (6%) women had major fractures (152 hip fractures). FRAX scores were strongly predictive of incident major fractures (adjusted hazard ratios [aHR] per SD increase in FRAX 1.8, 95%CI 1.7–1.9) and hip fractures (aHR per SD 4.5, 95% CI 3.7–5.7); however, change in FRAX score was not independently associated with major fracture (p=0.8) or hip fracture (p=0.3). In conclusion, FRAX scores slowly increased over time, and this increase was attenuated but not prevented by treatment. Few women had meaningful reductions in FRAX scores, and change in FRAX score did not independently predict incident fracture, suggesting that FRAX with BMD is not responsive enough to be used as a target for goal‐directed treatment.
    Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 05/2014; 29(5):1074-80. · 6.04 Impact Factor
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    ABSTRACT: Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) are used to treat hypertension, however in vivo and clinical studies suggests that ARBs and ACE inhibitors may exert different effects on bone. The association between long-term use of ARBs and ACE inhibitors, and fracture requiring medical attention is limited. We conducted a population-based, retrospective cohort study with propensity score-matching using administrative databases in Ontario, Canada to examine the risk of osteoporosis-related fractures in hypertensive elderly treated with ARBs versus ACE inhibitors. We identified a cohort of newly treated hypertensive patients aged 66 years and older who initiated an ACE inhibitor from May 1, 2004 to March 31, 2012 and matched them to ARB users on propensity score, sex and age at drug initiation. The primary outcome was hip fracture and secondary outcomes were non-hip major osteoporotic fractures (other femoral, clinical vertebral, forearm, wrist, humerus) and other osteoporotic fractures (pelvis, clavicle, patella, shoulder, upper arm, tibia, fibula, ankle, scapula, ribs, sternum, trunk). We calculated hazard ratios (HRs) using Cox proportional hazards model with robust standard errors. Of the 87,635 patients who initiated treatment, 28,819 (32.9%) started ARBs and 58,816 (67.1%) started ACE inhibitors. Among new ARB users, 27,815 (96.5%) were successfully matched to ACE inhibitor users. Without dose adjustment, no significant association was observed for ARBs relative to ACE inhibitor users for hip fractures (HR = 0.88; 95% confidence interval [CI] 0.70–1.11), with a decreased risk of other major osteoporotic fractures (HR = 0.81; CI 0.70–0.93) and no significant association for other osteoporotic fractures (HR = 0.88; CI 0.74–1.05). When adjusted for dosage, there was no significant difference between the effects of ARBs and ACE inhibitors on hip (HR = 0.99; CI 0.78–1.25), other major osteoporotic (HR = 0.87; CI 0.75–1.01) and other osteoporotic fractures (HR = 0.90; CI 0.74–1.08). © 2014 American Society for Bone and Mineral Research
    Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 05/2014; · 6.04 Impact Factor
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    ABSTRACT: Background Although conventional wisdom suggests that low socioeconomic status (SES) is a robust predictor of medication nonadherence, the strength of this association remains unclear. Objectives 1) To estimate the proportion of studies that identified SES as a potential risk indicator of nonadherence, 2) to describe the type of SES measurements, and 3) to quantify the association between SES and nonadherence to antihypertensive pharmacotherapy. Methods A systematic review and meta-analysis research design was used. We searched multiple electronic databases for studies in English or French examining nonadherence to antihypertensive medications measured by electronic prescription databases where explanatory factors were considered. Two authors independently assessed quality, described the SES measure(s), and recorded its association with nonadherence to antihypertensives. A random-effects model meta-analysis was performed, and heterogeneity was examined by using the I2 statistic. Results Fifty-six studies with 4,780,293 subjects met the inclusion criteria. Twenty-four of these studies (43%) did not report any SES measures. When it was reported (n = 32), only seven (13%) examined more than one component but none performed a multidimensional assessment. Most of the studies relied on income or income-related measures (such as prescription-drug benefits or co-payments) (27 of 32 [84%]). Meta-analysis could be quantified in 40 cohorts reported in 30 studies. Overall, the pooled adjusted risk estimate for nonadherence according to SES (high vs. low) was 0.89 (95% confidence interval 0.87–0.92; I2 = 95%; P < 0.001). Similar patterns were observed in all subgroups examined. Conclusions Published studies have not found a strong association between low SES and nonadherence to antihypertensive medications. However, important limitations in the assessment of SES can be identified in virtually all studies. Future studies are required to ascertain whether a stronger association is observed when SES is determined by comprehensive measures.
    Value in Health 03/2014; 17(2):288–296. · 2.19 Impact Factor
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    ABSTRACT: To estimate systemic autoimmune rheumatic disease (SARD) prevalence across 7 Canadian provinces using population-based administrative data evaluating both regional variations and the effects of age and sex. Using provincial physician billing and hospitalization data, cases of SARD (systemic lupus erythematosus, scleroderma, primary Sjögren syndrome, polymyositis/dermatomyositis) were ascertained. Three case definitions (rheumatology billing, 2-code physician billing, and hospital diagnosis) were combined to derive a SARD prevalence estimate for each province, categorized by age, sex, and rural/urban status. A hierarchical Bayesian latent class regression model was fit to account for the imperfect sensitivity and specificity of each case definition. The model also provided sensitivity estimates of different case definition approaches. Prevalence estimates for overall SARD ranged between 2 and 5 cases per 1000 residents across provinces. Similar demographic trends were evident across provinces, with greater prevalence in women and in persons over 45 years old. SARD prevalence in women over 45 was close to 1%. Overall sensitivity was poor, but estimates for each of the 3 case definitions improved within older populations and were slightly higher for men compared to women. Our results are consistent with previous estimates and other North American findings, and provide results from coast to coast, as well as useful information about the degree of regional and demographic variations that can be seen within a single country. Our work demonstrates the usefulness of using multiple data sources, adjusting for the error in each, and providing estimates of the sensitivity of different case definition approaches.
    The Journal of Rheumatology 03/2014; · 3.26 Impact Factor

Publication Stats

2k Citations
829.62 Total Impact Points


  • 2014
    • The University of Winnipeg
      Winnipeg, Manitoba, Canada
  • 2007–2014
    • Health Sciences Centre Winnipeg
      Winnipeg, Manitoba, Canada
  • 1996–2014
    • University of Manitoba
      • • Department of Internal Medicine
      • • Department of Community Health Sciences
      • • Department of Psychiatry
      • • Department of Psychology
      Winnipeg, Manitoba, Canada
  • 2013
    • Sunshine Hospital
      Bhaganagar, Andhra Pradesh, India
    • The University of Sheffield
      • Medical School
      Sheffield, England, United Kingdom
    • University of Melbourne
      • Northwest Academy Centre
      Melbourne, Victoria, Australia
    • McGill University Health Centre
      Montréal, Quebec, Canada
    • University of British Columbia - Vancouver
      • Department of Obstetrics and Gynaecology
      Vancouver, British Columbia, Canada
  • 2012–2013
    • University of Alberta
      • Department of Medicine
      Edmonton, Alberta, Canada
  • 2008–2013
    • University of Saskatchewan
      • School of Public Health
      Saskatoon, Saskatchewan, Canada
    • University of Regina
      • Department of Psychology
      Regina, Saskatchewan, Canada
  • 2011–2012
    • The University of Calgary
      • • Department of Community Health Sciences
      • • Department of Clinical Neurosciences
      Calgary, Alberta, Canada
    • CancerCare Manitoba
      Winnipeg, Manitoba, Canada
    • University of Waterloo
      Waterloo, Ontario, Canada
  • 2010–2011
    • McGill University
      • Division of General Internal Medicine
      Montréal, Quebec, Canada
  • 2000
    • Health Canada
      Ottawa, Ontario, Canada