David Henry

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Verified

David verified their affiliation via an institutional email.

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• MBChB, FRCP (Edin)
• Honorary Professor at Bond University

Introduction Recent evidence from the USA and Nordic countries suggests a possible association between psychostimulant use during gestation and adverse pregnancy and birth outcomes. Objectives and Approach We employed a distributed cohort analysis using linked administrative data for women who gave birth in New South Wales (NSW; Australia) and Ont...

Background Since COVID-19 was first recognised, there has been ever-changing evidence and misinformation around effective use of medicines. Understanding how pandemics impact on medicine use can help policymakers act quickly to prevent harm. We quantified changes in dispensing of common medicines proposed for “re-purposing” due to their perceived b...

Australia spends more than $20 billion annually on medicines, delivering significant health benefits for the population. However, inappropriate prescribing and medicine use also result in harm to individuals and populations, and waste of precious health resources. Medication data linked with other routine collections enable evidence generation in p...

Objective: To explore medical trainees experiences and views concerning college-mandated research projects. Setting: Online survey (Apr-Dec 2021) of current and recent past trainees of Australian and New Zealand colleges recruited through 11 principal colleges and snowballing. Participants: Current trainee or completed training in the past 5 years....

Background Early evidence on COVID-19 vaccine efficacy came from randomised trials. Many important questions subsequently about vaccine effectiveness (VE) have been addressed using real-world studies (RWS) and have informed most vaccination policies globally. As the questions about VE have evolved during the pandemic so have data, study design, and...

Background Sustained‐release (SR) tapentadol was listed on Australia's Pharmaceutical Benefits Scheme (PBS) in 2014 for chronic severe pain requiring long‐term opioid treatment. Dispensings have increased since listing despite declining trends in other PBS‐listed opioids. Preferential prescribing of SR opioids may increase the risk of dependence an...

Objective To identify healthcare professionals' knowledge, self‐reported use, and documentation of clinical decision aids (CDAs) in a large ED in Australia, to identify behavioural determinants influencing the use of CDAs, and healthcare professionals preferences for integrating CDAs into the electronic medical record (EMR) system. Methods Healthc...

Background Few studies have examined effectiveness of COVID-19 vaccines against COVID-19 and all-cause mortality across different pandemic periods in 2022. Methods We used linked whole-of-population data from the 2021 Australian Census, Australian Immunisation Register, death registrations and other national datasets including migration data. Amon...

Background: Conflicting evidence suggests a possible association between use of prescribed psychostimulants during pregnancy and adverse perinatal outcomes. Methods: We conducted population-based cohort studies including pregnancies conceived between April 2002 and March 2017 (Ontario, Canada; N = 554 272) and January 2003 to April 2011 [New Sou...

Objectives Tapentadol is a µ-opioid agonist, moderate noradrenaline reuptake inhibitor (NRI) and very weak serotonin reuptake inhibitor. The sustained release (SR) formulation is indicated for relief of chronic moderate to severe pain. We examined utilisation trends and concordance with prescribing guidelines of prescription SR tapentadol in Austra...

Purpose: We quantified changes in dispensing of common medicines proposed for 're-purposing' due to their perceived benefits as therapeutic or preventive treatments for COVID-19 in Australia, a country with relatively low COVID-19 incidence in 2020. Methods: We performed an interrupted time series analysis and cross-sectional study using nationwide...

Throughout the global coronavirus pandemic, we have seen an unprecedented volume of COVID-19 researchpublications. This vast body of evidence continues to grow, making it difficult for research users to keep up with the pace of evolving research findings. To enable the synthesis of this evidence for timely use by researchers, policymakers, and othe...

Background: This study aims to measure cancer incidence and mortality rates of Registered First Nations people in Ontario and compare them with those of other people in Ontario from 1991 to 2010. Data and methods: The federal Indian Register, the Ontario Cancer Registry and the Registered Persons Database were linked to develop a cohort of First...

Introduction Drug regulators require timely, relevant information to address questions about the safety of prescribed medicines. Some questions can be informed by initial rapid and simple analyses of linked exposure/outcome data. These analyses will establish how many individuals have received the drug, their characteristics, the availability of fo...

OBJECTIVE Queenslands Novel Coronavirus (SARS-CoV-2) suppression program has been relatively successful. Initially, it involved extensive community testing and repeat sampling of positive individuals for release from isolation. This enabled study of several characteristics, including persistence of detectable virus and how apparent viral clearance...

Background Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods We did an international, m...

Background Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods We did an international,...

Objectives Health region differences in immigration patterns and premature mortality rates exist in Ontario, Canada. This study used linked population-based databases to describe the regional proportion of immigrants in the context of provincial health region variation in premature mortality.Methods We analyzed all adult premature deaths in Ontario...

Objectives Patients do better in research-intense environments. The importance of research is reflected in the accreditation requirements of Australian clinical specialist colleges. The nature of college-mandated research training has not been systematically explored. We examined the intended research curricula of Australian trainee doctors describ...

Background Poor quality use of medicines (QUM) has adverse outcomes. Governments’ implementation of essential medicines (EM) policies is often suboptimal and there is limited information on which policies are most effective. Methods We analysed data on policy implementation from World Health Organisation (WHO) surveys in 2007 and 2011, and QUM dat...

Background: Smoking, unhealthy alcohol consumption, poor diet and physical inactivity are leading risk factors for morbidity and mortality, and contribute substantially to overall healthcare costs. The availability of health surveys linked to health care provides population-based estimates of direct healthcare costs. We estimated health behaviour a...

Objectives:Patients do better in research-intense environments. The importance of research is reflected in medical and surgical specialty accreditation requirements of Australian colleges. However, the nature of college-mandated research training, including scholarly projects, has not been systematically explored. We aimed to examine the research c...

Background: Premature mortality is a meaningful indicator of both population health and health system performance, which varies by geography in Ontario. We used the Local Health Integration Network (LHIN) sub-regions to conduct a spatial analysis of premature mortality, adjusting for key population-level demographic and behavioural characteristics...

Purpose: To examine the association of all-cause and premature mortality with four modifiable lifestyle behaviors and quantify the burden of behavioral-related premature death in Ontario, Canada. Methods: We analyzed a cohort of 149,262 adults in the 2000-2010 Canadian Community Health Surveys, linked to vital statistics data to ascertain deaths...

Background: Smoking, unhealthy alcohol consumption, poor diet and physical inactivity are leading risk factors for morbidity and mortality, and contribute substantially to overall healthcare costs. The availability of health surveys linked to health care provides population-based estimates of direct healthcare costs. We estimated health behaviour a...

Les données de santé collectées en routine et obtenues à des fins administratives et cliniques sans objectifs de recherche spécifiques a priori, sont de plus en plus utilisées pour la recherche. L'évolution rapide et la disponibilité de ces données ont révélé des problèmes qui ne sont pas abordés dans les outils d’évaluation existantes, tel que STR...

Importance Follow-up of participants in randomized trials may be limited by logistic and financial factors. Some important randomized trials have been extended well beyond their original follow-up period by linkage of individual participant information to routinely collected data held in administrative records and registries. Objective To perform...

Introduction Although RCTs remain the gold standard for generating clinical evidence, follow up of participants to study long-term effects is limited by cost and other logistical considerations. Linkage of participant information to routinely collected data potentially offers a cost-effective solution to achieving long-term follow-up of treatment e...

Background: Irrational use of medicines is widespread in the South-East Asia Region (SEAR), where policy implementation to encourage quality use of medicines (QUM) is often low. The aim was to determine whether public-sector QUM is better in SEAR countries implementing essential medicines (EM) policies than in those not implementing them. Methods...

Introduction The importance of Indigenous data sovereignty and Indigenous-led research processes is increasingly being recognized in Canada and internationally. For First Nations in Ontario, Canada, access to routinely-collected demographic and health systems data is critical to planning and measuring health status and outcomes in their population...

Appendix S1: Controlled Release Oxycodone Coverage Through Provincial Public Drug Programs

With falling mortality rates for several diseases, patients are living longer with complex multimorbidities. We explored the burden of multimorbidity at the time of death, how it varies by socioeconomic status, and trends over time in Ontario, Canada. We calculated the proportions of decedents with varying degrees of multimorbidity and types of con...

Although all-cause mortality rates have fallen in many countries in the last 40 years, the well-off and city dwellers have experienced the greatest gains. In this paper, we report on socio-economic and regional variations in premature mortality in Ontario. Premature mortality rates were highest in areas with the greatest degrees of social deprivati...

Purpose: This study investigated the impact of changing availability of tamper-deterrent and non-tamper-deterrent oxycodone on prescribing patterns of controlled-release oxycodone across Canada. Methods: We conducted a population-based, serial cross-sectional study of controlled-release oxycodone dispensing from community pharmacies across Canad...

Indigenous data governance principles assert that Indigenous communities have a right to data that identifies their people or communities, and a right to determine the use of that data in ways that support Indigenous health and self-determination. Indigenous-driven use of the databases held at the Institute for Clinical Evaluative Sciences (ICES) h...

AUTHORS This atlas was developed through the Ontario Population Trends in Improved Mortality: Informing Sustainability and Equity of the health care system (OPTIMISE) research program, an initiative of the Population Health Analytics Laboratory at the Dalla Lana School of Public Health (DLSPH), University of Toronto. OPTIMISE aims to develop measur...

Background: In February 2012, a reformulated tamper-deterrent form of long-acting oxycodone, OxyNeo, was introduced in Canada. We investigated the impact of the introduction of OxyNeo on patterns of opioid prescribing. Methods: We conducted population-based, cross-sectional analyses of opioid dispensing in Canada between 2008 and 2016. We estima...

Background: In 2012, the Ontario government withdrew public insurance coverage of imaging tests for uncomplicated low back pain. We studied the impact of this restriction on test ordering by physicians. Methods: We compared the numbers of lumbar spine radiography, computed tomography (CT) and single-segment magnetic resonance imaging (MRI) studi...

Objectives Violent deaths classified as undetermined intent (UD) are sometimes included in suicide counts. This study investigated age and sex differences, along with socioeconomic gradients in UD and suicide deaths in the province of Ontario between 1999 and 2012. Methods We used data from the Institute for Clinical Evaluative Sciences, which has...

The number of published systematic reviews of studies of healthcare interventions has increased rapidly and these are used extensively for clinical and policy decisions. Systematic reviews are subject to a range of biases and increasingly include non-randomised studies of interventions. It is important that users can distinguish high quality review...

Background Homicide – a lethal expression of violence – has garnered little attention from public health researchers and health policy makers, despite the fact that homicides are a cause of preventable and premature death. Identifying populations at risk and the upstream determinants of homicide are important for addressing inequalities that hinder...

We are at the dawn of a data deluge in health that carries extraordinary promise for improving the health of populations. However, current associated efforts, which generally center on the 'precision medicine' agenda, may well fall short in terms of its overall impact. The main challenges, it is argued, are less technical than the following: (1) id...

Introduction There is little argument that integrated data can provide a valuable resource for improved health system management, planning, and accountability as well as discovery and commercial use, but policies to enable and support integrated data fall short of the potential represented by integrated data. To understand the current level of prog...

Background Immigrants have been shown to possess a health advantage, yet are also more likely to reside in arduous economic conditions. Little is known about if and how the socioeconomic gradient for all-cause, premature and avoidable mortality differs according to immigration status. Methods Using several linked population-based vital and demogra...

Introduction Well-conducted randomised controlled trials (RCTs) provide the least biased estimates of intervention effects. However, RCTs are costly and time-consuming to perform and long-term follow-up of participants may be hampered by lost contacts and financial constraints. Advances in computing and population-based registries have created new...

Background Historically, women have lower all-cause mortality than men. It is less understood that sex differences have been converging, particularly among certain subgroups and causes. This has implications for public health and health system planning. Our objective was to analyse contemporary sex differences over a 20-year period. Methods We ana...

Non-randomised studies of the effects of interventions are critical to many areas of healthcare evaluation, but their results may be biased. It is therefore important to understand and appraise their strengths and weaknesses. We developed ROBINS-I ("Risk Of Bias In Non-randomised Studies-of Interventions"), a new tool for evaluating risk of bias in...

Importance: The association between incretin-based drugs, such as dipeptidyl peptidase 4 (DPP-4) inhibitors and glucagon-like peptide 1 (GLP-1) agonists, and acute pancreatitis is controversial. Objective: To determine whether the use of incretin-based drugs, compared with the use of 2 or more other oral antidiabetic drugs, is associated with an...

Background: Isotretinoin, a teratogen, is widely used to treat cystic acne. Although the risks of pregnancy during isotretinoin therapy are well recognized, there are doubts about the level of adherence with the pregnancy prevention program in Canada. Our objective was to evaluate the effectiveness of the Canadian pregnancy prevention program in 4...

Background: Skewed male:female ratios at birth have been observed among certain immigrant groups. Data on abortion practices that might help to explain these findings are lacking. Methods: We examined 1 220 933 births to women with up to 3 consecutive singleton live births between 1993 and 2012 in Ontario. Records of live births, and induced and...

Background: Systematic reviews of the effects of healthcare interventions frequently include non-randomized studies. These are subject to confounding and a range of other biases that are seldom considered in detail when synthesizing and interpreting the results. Our aims were to assess the reliability and usability of a new Cochrane risk of bias (...

The Cochrane risk of bias tool for non-randomized studies of interventions. (DOCX)

Consensus overall risk of bias ratings by study and corresponding reasons for ranking of Loke et al. [17] component studies. (DOCX)

Consensus overall risk of bias ratings by study and corresponding reasons for ranking of McGettigan and Henry [18] component studies. (DOCX)

Background: Inappropriate overuse of antibiotics contributes to antimicrobial resistance (AMR), yet policy implementation to reduce inappropriate antibiotic use is poor in low and middle-income countries. Aims: To determine whether public sector inappropriate antibiotic use is lower in countries reporting implementation of selected essential med...

Individual antibiotic use measures by country plus references. (XLS)

Reported antibiotic policy implementation by country. (XLSX)

Background: Characterizing high-cost users of health care resources is essential for the development of appropriate interventions to improve the management of these patients. We sought to determine the concentration of health care spending, characterize demographic characteristics and clinical diagnoses of high-cost users and examine the consisten...

Develop the science of data synthesis to join up the myriad varieties of health information, insist Julian H. Elliott, Jeremy Grimshaw and colleagues.

Clinical pharmacology is a medical specialty whose practitioners teach, undertake research, frame policy, give information and advice about the actions and proper uses of medicines in humans and implement that knowledge in clinical practice. It involves a combination of several activities: drug discovery and development; training safe prescribers;...

Liberated trial data have enduring potential to benefit patients, prevent harm, and correct misleading research Despite the importance of reproducibility in research, clinical trials are rarely subject to independent reanalysis. In a linked paper, Le Noury and colleagues (doi:10.1136/bmj.h4320) have restored and reanalysed the controversial “study...

Consumption of oral and transdermal prescription opioid analgesics in Canada is very high by international standards and has been driven to a significant degree by use of long-acting formulations, particularly in the most populous province, Ontario (ON). As part of the work of the Canadian Drug safety and Effectiveness Network (DSEN) CNODES was ask...

An analysis of recent trends in dispensing oral and trans-dermal opioid drugs in Canadian provinces

Consumption of oral and trans-dermal prescription opioid analgesics in Canada is very high by international standards and has been driven to a significant degree by use of long-acting formulations, particularly in the most populous province, Ontario (ON). This analysis revealed a number of important trends. Overall prescription numbers rose more fo...

Background: Since 2010, tamper-resistant long-acting oxycodone has been available in both the United States and Canada; however, generic non–tamper-resistant brands of the drug have only been introduced in Canada. We aimed to determine whether the introduction of generic non-tamper-resistant oxycodone in Canada led to increased sales from Canadian...

The Canadian Institutes of Health Research (CIHR) has asked the Council of Canadian Academies to assess timely access to health and social data for health research and health system innovation in Canada.

Background: Suboptimal medicine use is a global public health problem. For 35 years the World Health Organization (WHO) has promoted essential medicines policies to improve quality use of medicines (QUM), but evidence of their effectiveness is lacking, and uptake by countries remains low. Our objective was to determine whether WHO essential medici...

Ray Moynihan and colleagues outline suggestions for improving the way that medical evidence is produced, analysed, and interpreted to avoid problems of overdiagnosis and overtreatment. Please see later in the article for the Editors' Summary

Chronic respiratory diseases cause a significant health and economic burden around the world. In Canada, Aboriginal populations are at increased risk of asthma and chronic obstructive pulmonary disease (COPD). There is little known, however, about these diseases in the Canadian Métis population, who have mixed Aboriginal and European ancestry. A po...