Jason W Busse

McMaster University | McMaster · Departments of Anethesia and Clinical Epidemiology & Biostatistics

Background Creativity fuels societal progress and innovation, particularly in the field of medicine. The scientific study of creativity in medicine is critical to understanding how creativity contributes to medical practice, processes, and outcomes. An appraisal of the current scientific literature on the topic, and its gaps, will expand our unders...

Objective People living with chronic pain increasingly use medical cannabis for symptom relief. We conducted a retrospective cohort study examining cannabis for chronic pain relief using anonymous archival data obtained from the medicinal cannabis tracking app, Strainprint®. Method We acquired cannabis utilization data from 741 adults with chronic...

Introduction Clear definitions are essential in science, particularly in the study of abstract phenomena like creativity. Due to its inherent complexity and domain-specific nature, the study of creativity has been complicated, as evidenced by the various definitions used to describe it and the multitude of tools which claim to measure it. Surgery i...

Objective To compare the effectiveness of interventions for the management of long covid (post-covid condition). Design Living systematic review. Data sources Medline, Embase, CINAHL, PsycInfo, Allied and Complementary Medicine Database, and Cochrane Central Register of Controlled Trials from inception to December 2023. Eligibility criteria Tria...

Background Degenerative cervical myelopathy (DCM) occurs when spondylotic changes compress the spinal cord and cause neurologic dysfunction. Because of a lack of comparative data on nonoperative care versus surgery for DCM, it has been difficult to support patients through the shared decision-making process regarding treatment options. Our objectiv...

Background Degenerative Cervical Myelopathy is a debilitating condition and current recommendations encourage shared decision-making between surgeons and patients. However, there is limited data on patients’ values and preferences for surgical decision making. This study aimed to quantify and compare the relative importance of neurologic function,...

Background Increasing evidence has emerged for traditional, complementary and integrative medicine (TCIM) to treat COVID-19 which requires systematic summaries of the net benefits of interventions against standard care and one another. The study aims to conduct a systematic review and network meta-analysis (NMA) regarding TCIM therapies for treatin...

Introduction The properties of creative products–novelty and usefulness–are generally agreed upon by researchers. Yet, consensus is lacking on which personal and environmental factors contribute to an individual’s creative potential, or to what extent. substantial research work has been conducted in this area, leading to the publication of many sys...

Mobilizing pain care knowledge in Canada Norm Buckley and Jason Busse from the Michael G. DeGroote Institute for Pain Research & Care discuss the mobilization of knowledge about the pain environment in Canada, focusing on the role of an ad hoc community-based organization. Approximately every quarter, we bring together a wide variety of individuals...

Importance Cannabis use during adolescence and young adulthood may affect academic achievement; however, the magnitude of association remains unclear. Objective To conduct a systematic review evaluating the association between cannabis use and academic performance. Data Sources CINAHL, EMBASE, MEDLINE, PsycInfo, PubMed, Scopus, and Web of Science...

Background In recent studies, receipt of chiropractic care has been associated with lower odds of receiving prescription opioids and, among those already prescribed, reduced doses of opioids among patients with non-cancer spine pain. These findings suggest that access to chiropractic services may reduce reliance on opioids for musculoskeletal pain....

Simulation-based education in ultrasound-guided regional anesthesia (UGRA) improves knowledge, skills, and patient outcomes. Nevertheless, it is not known how simulation-based UGRA education is used across Canada. We aimed to characterize the current use of simulation-based UGRA education in Canadian anesthesiology residency training programs. We d...

BACKGROUND Myalgic encephalomyelitis (ME), also referred to as chronic fatigue syndrome (CFS), is a complex illness that typically presents with disabling fatigue, cognitive dysfunction, and functional impairment. The etiology and management of ME/CFS remain contentious and patients often describe their experiences through social media. OBJECTIVE...

Background The diagnosis, etiology, and optimal management of fibromyalgia remains contentious. This uncertainty may result in variability in clinical management. We conducted a systematic review and meta-analysis of cross-sectional studies examining physicians’ knowledge, attitudes, and practices regarding fibromyalgia. Methods We searched MEDLIN...

Safer and more effective use of opioids The Pain PLUS literature surveillance service demonstrates the importance of high-quality literature to support decision-making and practice for the use of opioids. McMaster University has had a significant leadership role in advancing the practice of evidence-based health care. Part of this leadership has be...

Background A composite endpoint (CEP) is a measure comprising 2 or more separate component outcomes. The use of these constructs is increasing. We sought to conduct a systematic review on the usage, quality of reporting, and appropriate use of CEPs in spine surgery research. Methods A systematic review was conducted following Preferred Reporting I...

Background Several studies have reported the overuse of spinal imaging, which, in Canada, led to several provincial pathways aimed at optimizing the use of imaging. We assessed temporal trends in spine imaging in two Canadian provinces. Methods We explored the use of X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) examinations...

Background An estimated 30% of veterans live with chronic pain, compared to 20% of Canadians in the general population. Veterans face health care challenges upon release from the military, increasing difficulties in obtaining chronic pain care. Aims We explored experiences of Canadian Armed Forces veterans living with chronic pain, their transitio...

This case series compares amounts of tetrahydrocannabinol and cannabidiol reported on product labels vs levels found in laboratory testing in legal oral cannabis oil products in Ontario, Canada.

Background: We performed a network meta-analysis of randomized controlled trials to assess the comparative effectiveness of available pharmacological prophylaxis for migraines. Methods: We searched MEDLINE, EMBASE, Web of Science, Scopus, PsycINFO and Cochrane CENTRAL up to October 2023 for trials that: (1) enrolled adults diagnosed with chronic mi...

Background: Several studies have reported overuse of spinal imaging, which, in Canada, led to several provincial pathways aimed at optimizing use of imaging. We assessed temporal trends in spine imaging in two Canadian provinces. Methods: We explored use of x-ray, computed tomography (CT), and magnetic resonance imaging (MRI) examinations of the ce...

Background Chronic postsurgical pain (CPSP) is common following musculoskeletal and orthopedic surgeries and is associated with impairment and reduced quality of life. Several interventions have been proposed to reduce CPSP; however, there remains uncertainty regarding which, if any, are most effective. We will perform a systematic review and netwo...

The opioid crisis in canada – Governmental responses and strategies Norm Buckley, Scientific Director at the Michael G. DeGroote Institute for Pain Research & Care, and Jason Busse, Director of the Michael G DeGroote National Pain Centre at McMaster University, discuss the complexities of chronic pain management and addressing the opioid crisis. Th...

Background Individuals receiving hemodialysis often experience concurrent symptoms during treatment and frequently report feeling unwell after dialysis. The degree to which intradialytic symptoms are related, and which specific symptoms may impair health-related quality of life (HRQoL) is uncertain. Objectives To explore intradialytic symptoms clu...

Objective To assess the creative potential of surgeons and surgeon trainees, as measured by divergent thinking. The secondary objectives were to identify factors associated with divergent thinking, assess confidence in creative problem-solving and the perceived effect of surgical training on creative potential, and explore the value of creativity i...

Background Cognitive behavioural therapy (CBT) has been shown to be effective for several psychiatric and somatic conditions; however, most randomized controlled trials (RCTs) have administered treatment in person and whether remote delivery is similarly effective remains uncertain. We sought to compare the effectiveness of therapist-guided remote...

Background Up to 15% of survivors of COVID-19 infection experience long-term health effects, including fatigue, myalgia, and impaired cognitive function, termed post COVID-19 condition or long COVID. Several trials that study the benefits and harms of various interventions to manage long COVID have been published and hundreds more are planned or ar...

Simulation-based medical education (SBME) is provided by all anesthesiology residency programs in Canada. The purpose of this study was to characterize SBME in Canadian anesthesiology residency training programs. We administered a 21-question survey to the simulation director/coordinator for all 17 Canadian academic departments of anesthesiology fr...

Objective Alteplase is the current standard of care for acute ischemic stroke. Tenecteplase is a newer fibrinolytic agent with preferable administration and lower costs; however, its comparative effectiveness to alteplase remains uncertain. We set out to perform a systematic review and meta-analysis to establish the benefits and harms of tenectepla...

Background Extremity fractures are common, and most are managed operatively; however, despite successful reduction, up to half of patients report persistent post-surgical pain. Furthermore, psychological factors such as stress, distress, anxiety, depression, catastrophizing, and fear-avoidance behaviors have been associated with the development of...

Objective The objective of this study is to evaluate the comparative benefits and harms of opioids and cannabis for medical use for chronic non-cancer pain. Design Systematic review and network meta-analysis. Data sources EMBASE, MEDLINE, CINAHL, AMED, PsycINFO, PubMed, Web of Science, Cannabis-Med, Epistemonikos and the Cochrane Library (CENTRAL...

Background Cannabis for medical purposes has been legal in Canada since 2001; however, physicians receive no formal training in this modality, and clinical use of cannabis remains controversial. This study aims to explore the values and preferences of people living with chronic pain (PLwCP) in using medical cannabis for chronic pain to inform guide...

Objective We explored the comparative effectiveness of available therapies for chronic pain associated with temporomandibular disorders (TMD). Design Systematic review and network meta-analysis of randomised clinical trials (RCTs). Data Sources MEDLINE, EMBASE, CINAHL, CENTRAL, and SCOPUS were searched to May 2021, and again in January 2023....

Objective We explored the comparative effectiveness of available therapies for chronic pain associated with temporomandibular disorders (TMD). Design Systematic review and network meta-analysis of randomised clinical trials (RCTs). Data sources MEDLINE, EMBASE, CINAHL, CENTRAL, and SCOPUS were searched to May 2021, and again in January 2023. Stu...

Clinical question What is the comparative effectiveness of available therapies for chronic pain associated with temporomandibular disorders (TMD)? Current practice TMD are the second most common musculoskeletal chronic pain disorder after low back pain, affecting 6-9% of adults globally. TMD are associated with pain affecting the jaw and associate...

Introduction Chronic non-cancer pain is common among military veterans; however, the prevalence is uncertain. This information gap complicates policy decisions and resource planning to ensure veterans have access to healthcare services that align with their needs. Methods Following Preferred Reporting Items for Systematic Review and Meta-Analysis...

Background Mental health problems, particularly anxiety and depression, are common in patients with chronic kidney disease (CKD), and negatively impact quality of life, treatment adherence, and mortality. However, the degree to which mental health and addictions services are utilized by those with CKD is unknown. We examined the history of mental h...

Aims and Objectives Myalgic encephalomyelitis (ME), also called chronic fatigue syndrome (CFS), is characterised by persistent fatigue, postexertional malaise, and cognitive dysfunction. It is a complex, long‐term, and debilitating illness without widely effective treatments. This study describes the treatment choices and experiences of ME/CFS pati...

The role of prescribing practices in managing chronic pain with opioids Norm Buckley and Jason Busse from the Michael G. DeGroote Institute for Pain Research and Care discuss prescribing practices, managing chronic pain with opioids, and the contribution of licit and illicit opioids towards the Canadian opioid crisis. Over the past 40 years, chroni...

Background: Higher doses of opioids, mental health comorbidities, co-prescription of sedatives, lower socioeconomic status and a history of opioid overdose have been reported as risk factors for opioid overdose; however, the magnitude of these associations and their credibility are unclear. We sought to identify predictors of fatal and nonfatal ov...

Importance Postoperative delirium (POD) is a common and serious complication after surgery. Various predisposing factors are associated with POD, but their magnitude and importance using an individual patient data (IPD) meta-analysis have not been assessed. Objective To identify perioperative factors associated with POD and assess their relative p...

Introduction A third of Canadian Armed Forces veterans report difficulty adjusting to post-military life. Moreover, an estimated 40% of Canadian veterans live with chronic pain, which is likely associated with greater needs during the transition from military to civilian life. This review explores challenges and transition needs among military pers...

Introduction Although interest in including non-randomised studies of interventions (NRSIs) in meta-analysis of randomised controlled trials (RCTs) is growing, estimates of effectiveness obtained from NRSIs are vulnerable to greater bias than RCTs. The objectives of this study are to: (1) explore how NRSIs can be integrated into a meta-analysis of...

Opioid use for chronic pain: Part 2 Norm Buckley and Jason Busse from the Michael G. DeGroote Institute for Pain Research & Care in Canada probe the effectiveness of opioid use in Canada as a treatment for chronic noncancer pain. Current best estimates suggest that 12% of individuals with chronic noncancer pain will achieve meaningful pain relief w...

Objective: Universally acknowledged standards for trustworthy guidelines include the necessity to ground recommendations in patient values and preferences. When information is limited - which is typically the case - guideline panels often find it difficult to explicitly integrate patient values and preferences into their recommendations. Our objec...

Objective: To explore guideline panelists' understanding of panel surveys for eliciting panels' inferences regarding patient values and preference, and the influence of the surveys on making recommendations. Study design and setting: We performed sampling and data collection from all four guideline panels that had conducted the surveys through O...

LAY SUMMARY Patients are more willing to accept treatments that match their preferences. The authors conducted a survey to find out what treatments military Veterans prefer for low back pain. The survey, which asked about experiences with low back pain and attitudes toward health care providers and treatments, reached 1,632 Canadian Armed Forces (C...

Study objective: The role of transversus thoracic muscle plane blocks (TTMPBs) during cardiac surgery is controversial. We conducted a systematic review to establish the effectiveness of this procedure. Design: Systematic review. We searched PubMed, Embase, Web of Science, CENTRAL, WanFang Data, and the China National Knowledge Infrastructure to...

Chronic post-surgical pain is reported by up to 40% of patients after lumbar microdiscectomy for sciatica, a complaint associated with disability and loss of productivity. We conducted a systematic review of observational studies to explore factors associated with persistent leg pain and impairments after microdiscectomy for sciatica. We searched e...

Background: Recent randomized trials have suggested that endovascular thrombectomy (EVT) alone may provide similar functional outcomes as the current standard of care, EVT combined with intravenous alteplase treatment, for acute ischemic stroke secondary to large vessel occlusion. We conducted an economic evaluation of these 2 therapeutic options....

Background: Excessive daytime sleepiness (EDS) is common among patients with obstructive sleep apnea (OSA). The comparative effectiveness of pharmacologic agents is unknown. Purpose: To compare the effectiveness of drugs for EDS in OSA using network meta-analysis. Data sources: MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov to 7 November 202...

Aims: Few multi-wave longitudinal studies have examined mental health changes across the coronavirus 2019 (COVID-19) pandemic. The current study examined: (a) overall changes in depression and anxiety over 10-waves of data collection; (b) subgroup moderators of changes; (c) clinical severity of the changes via minimally important differences (MIDs...

Using of opioids for chronic pain: Controversies, guidelines, research needs First in a series of five articles, Norm Buckley and Jason Busse explore the trials and tribulations associated with using opioids for chronic pain, particularly in Canada. The prescription of opioids for chronic pain is both clinically controversial and a highly politiciz...

Introduction A strong pipeline of creative ideas and individuals is critical if we are to tackle the complex healthcare challenges we will face in the 21st century. The field of creativity is severely underinvestigated in the context of surgery, and it is of interest to explore the level and nature of creativity in surgeons, across various specialt...

Background: Non-image guided injection treatments ("nerve blocks") are commonly provided in community pain clinics in Ontario for chronic non-cancer pain (CNCP) but remain controversial. Aim: We explored patients' perspectives of nerve blocks for CNCP. Methods: We administered a 33-item cross-sectional survey to patients living with CNCP pain...

Introduction Accurate measurement of health status is essential to assess veterans’ needs and the effects of interventions directed at improving veterans’ well-being. We conducted a systematic review to identify instruments that measure subjective health status, considering four components (ie, physical, mental, social or spiritual well-being). Me...

Introduction: Cannabis is used for medical and recreational purposes and may result in cannabis use disorder (CUD). This study explored the prevalence of cannabis use disorder and other psychiatric comorbidities among inpatients undergoing treatment for substance use disorder who reported medical cannabis use at admission. Methods: We assessed C...

Background Medical cannabis is commonly and increasingly used by Canadians to manage chronic pain. As of March 2021, Health Canada reported that approximately 300,000 Canadians who were authorized to access medical cannabis, which is more than a 1000% increase from the 24,000 registered in 2015. Physicians, however, receive limited information on t...

Background Emerging evidence suggests that access to chiropractic care may reduce the likelihood of initiating an opioid prescription for spinal pain; however, the impact of chiropractic care for patients already prescribed opioids is uncertain. We undertook a sequential explanatory mixed methods study to evaluate the association between initiating...

Importance Chronic, non-cancer pain affects approximately 20–30% of the population in North America, Europe, and Australia, with surgery and trauma frequently cited as inciting events. Prospective studies of fracture patients have demonstrated an association between somatic pre-occupation, poor coping, and low recovery expectations following surger...

Objective: Approximately one in four total knee replacement patients develop persistent pain. Identification of those at higher risk could help inform optimal management. Methods: We searched MEDLINE, EMBASE, CINAHL, AMED, SPORTDiscus and PsycINFO for observational studies that explored the association between risk factors and persistent pain (≥...

Introduction: Chronic pain is a debilitating problem that disproportionately affects military veterans. We completed a qualitative study that identified 20 research priorities of Canadian veterans living with chronic noncancer pain. The aim of this study was to establish the generalizability of these priorities. Materials and methods: From Janua...

Background and objectives: Functional outcomes are important for oncology patients undergoing lower extremity reconstruction. The objective of the current study was to describe patient reported function after surgery and identify predictors of postoperative function in musculoskeletal oncology patients undergoing lower extremity endoprosthetic rec...

Aim Whether or not use of intravenous alteplase in combination with endovascular thrombectomy (EVT) improves outcomes versus EVT alone, for acute stroke patients with large vessel occlusion presenting directly to a comprehensive stroke center, is uncertain. Methods Six randomized trials exploring this issue were published, and we synthesized this...

Background The Lancet Commission on Global Surgery established the Three Delays framework, categorising delays in accessing timely surgical care into delays in seeking care (First Delay), reaching care (Second Delay), and receiving care (Third Delay). Globally, knowledge gaps regarding delays for fracture care, and the lack of large prospective stu...

Importance: Chronic, non-cancer pain affects approximately 20-30% of the population in North America, Europe, and Australia, with surgery and trauma frequently cited as inciting events. Prospective studies of fracture patients have demonstrated an association between somatic pre-occupation, poor coping, and low recovery expectations following surge...