Jason Robert Guertin

Jason Robert Guertin
Laval University | ULAVAL · Department of Social and Preventive Medicine

PhD

About

81
Publications
5,747
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
432
Citations
Introduction
Jason Robert Guertin currently works at the Department of Social and Preventive Medicine, Laval University. Jason does research in Epidemiology and Health Economics.
Additional affiliations
January 2017 - present
Laval University
Position
  • Professor (Assistant)
January 2015 - December 2016
McMaster University
Position
  • PostDoc Position
January 2011 - present
L'Institut national d'excellence en santé et en services sociaux
Position
  • Research consultant

Publications

Publications (81)
Article
Full-text available
Background: Propensity score (PS) methods are frequently used within economic evaluations based on nonrandomized data to adjust for measured confounders, but many researchers omit the fact that they cannot adjust for unmeasured confounders. Objective: To illustrate how confounding due to unmeasured confounders can bias an economic evaluation despit...
Article
Background: Although many Canadian studies have provided disease-specific or patient group-specific utility scores, the utility score norms currently available for the general Canadian population are outdated. Canadian guideline recommendations for the economic evaluation of health technologies advocate for utilities reflecting those of the genera...
Article
Full-text available
Background: Comparative performance of the traditional propensity score (PS) and high-dimensional propensity score (hdPS) methods in the adjustment for confounding by indication remains unclear. We aimed to identify which method provided the best adjustment for confounding by indication within the context of the risk of diabetes among patients exp...
Article
Full-text available
PurposeHigh-dimensional propensity scores (hdPS) can adjust for measured confounders, but it remains unclear how well it can adjust for unmeasured confounders. Our goal was to identify if the hdPS method could adjust for confounders which were hidden to the hdPS algorithm. Method The hdPS algorithm was used to estimate two hdPS; the first version (...
Article
Full-text available
Background In 2019, more than $34.5 billion was spent on prescription drugs in Canada. However, little is known about the distribution of this spending across medications and settings (outpatient and inpatient) over time. The objective of this paper is to describe the largest expenditures by medication class over time in inpatient and outpatient se...
Article
Full-text available
Objectives: The aim of this study was: (1) to adapt the time-driven activity-based costing (TDABC) method to emergency department (ED) ambulatory care; (2) to estimate the cost of care associated with frequently encountered ambulatory conditions; and (3) to compare costs calculated using estimated time and objectively measured time. Methods: TDA...
Article
Background The effectiveness of audit and feedback (A&F) interventions to improve compliance to healthcare guidelines is supported by randomised controlled trials (RCTs) and meta-analyses of RCTs. However, there is currently a knowledge gap on their cost-effectiveness. Objective We aimed to assess whether A&F interventions targeting improvements i...
Article
Full-text available
Background: Health economic evaluations are needed to assess the impact on the healthcare system of emerging treatment patterns for advanced prostate cancer. The objective of this study is to review the scientific literature identifying cost-effectiveness and cost analyses that are assessing treatments for metastatic hormone-sensitive prostate canc...
Article
Full-text available
Background: Musculoskeletal disorders (MSKDs) are among the most disabling and costly non-fatal health conditions. They may lead to long-term consequences such as chronic pain, physical limitations, and poorer quality of life. They also account for a significant proportion of emergency department visits, representing between 18% and 25% of all visi...
Article
Full-text available
Background: Cost studies appear sporadically in the scientific literature and are rarely revised unless drastic technological advancements occur. However, health technologies and medical guidelines evolve over time. It is unclear if these changes render obsolete prior estimates. We examined this issue in a cost study in the context of patients' fi...
Article
Full-text available
Purpose: Confounding adjustment is required to estimate the effect of an exposure on an outcome in observational studies. However, variable selection and unmeasured confounding are particularly challenging when analyzing large healthcare data. Machine learning methods may help address these challenges. The objective was to evaluate the capacity of...
Article
Objectives Underuse of high-value clinical practices and overuse of low-value practices are major sources of inefficiencies in modern healthcare systems. To achieve value-based care, guidelines and recommendations should target both underuse and overuse and be supported by evidence from economic evaluations. We aimed to conduct a systematic review...
Article
Full-text available
Limited data are available to understand costs and trends over time in the Canadian pharmaceutical market across all sectors. To fill this gap, a retrospective time series analysis of annual prescription drug purchases in Canada between 2001 and 2020 was conducted using data from the IQVIA Canadian Drugstore and Hospital Purchases Audit. Spending h...
Preprint
Full-text available
Background In an accountable world, being able to take into account the value given by relevant stakeholders to an intervention that could be offered to the population is considered as desirable. DCE is an approach particularly suited for the measurement of such values in the field of prenatal care. Yet, DCE studies in the field of prenatal screeni...
Article
Background There are an estimated 11 million burn injuries requiring medical attention every year worldwide. Although potentially deadly, burn injuries are now considered a chronic disease with multiple lifetime physical and psychological sequelae. However, it remains unclear how these events affect patients’ utility scores. We aimed to conduct a s...
Article
Full-text available
Objective The growth of healthcare spending is a major concern for insurers and governments but also for patients whose health problems may result in costs going beyond direct medical costs. To develop a comprehensive tool to measure direct and indirect costs of a health condition for patients and their families to various outpatient contexts. Met...
Article
Inverse probability of censoring weights (IPCWs) may reduce selection bias due to informative censoring in longitudinal studies. However, in studies with an active comparator, the associations between predictors and censoring may differ across treatment groups. We used the clinical example of anticoagulation treatment with warfarin or a direct oral...
Article
Full-text available
Medical genetic services are facing an unprecedented demand for counseling and testing for hereditary breast and ovarian cancer (HBOC) in a context of limited resources. To help resolve this issue, a collaborative oncogenetic model was recently developed and implemented at the CHU de Québec-Université Laval; Quebec; Canada. Here, we present the pro...
Preprint
Full-text available
In a real-life setting, little is known regarding the effectiveness of statins for primary prevention among older adults, and analysis of observational data can add crucial information on the benefits of actual patterns of use. Latent class growth models (LCGM) are increasingly proposed as a solution to summarize the observed longitudinal treatment...
Article
Background There is a need to perform a Canadian French translation and linguistic validation of the health-related quality of life utility measure for pre-school children (HuPS) conceptually equivalent to the original Canadian English version. Research design and methods The translation process consisted of forward and back translations. The ling...
Preprint
BACKGROUND In Canada, 30 to 60% of patients presenting to emergency departments (ED) are ambulatory. This category has been labeled as a source of ED overuse. Acting on the presumption that primary care practices (PCP) and walk-in clinics (WIC) offer equivalent care at a lower cost, governments have invested massively in improving access to these a...
Article
Background In Canada, 30%-60% of patients presenting to emergency departments are ambulatory. This category has been labeled as a source of emergency department overuse. Acting on the presumption that primary care practices and walk-in clinics offer equivalent care at a lower cost, governments have invested massively in improving access to these al...
Preprint
Objectives The purpose of this study was to assess utility scores of patients presenting to the emergency department (ED) with a musculoskeletal disorder and to explore the influence of diverse factors on health-related quality of life. Design Secondary analysis of data obtained before randomization during a pragmatic randomized controlled trial...
Article
Background. Observational economic evaluations (i.e., economic evaluations in which treatment allocation is not randomized) are prone to confounding bias. Prior reviews published in 2013 have shown that adjusting for confounding is poorly done, if done at all. Although these reviews raised awareness on the issues, it is unclear if their results imp...
Article
Full-text available
Introduction Underuse of high-value clinical practices and overuse of low-value practices are major sources of inefficiencies in modern healthcare systems. Injuries are second only to cardiovascular disease in terms of acute care costs but data on the economic impact of clinical practices for injury admissions are lacking. This study aims to summar...
Article
Background: The debate over acetylsalicylic acid (ASA) therapy for primary prevention of cardiovascular disease (CVD) has recently resurfaced, but scarce data are available on prophylactic ASA use in Canada for this purpose. This study aimed to evaluate the prevalence and factors associated with ASA use, and the potential impact of implementing th...
Article
Full-text available
Objectives To describe healthcare use and spending before and on becoming a new (incident) senior high-cost user (HCU) compared with senior non-HCUs; to estimate the incremental costs, overall and by service category, attributable to HCU status; and to quantify its monetary impact on the provincial healthcare budget in Ontario, Canada. Design We c...
Article
Background: Most health care spending is concentrated within a small group of high-cost health care users. To inform health policies, we examined the characteristics of index hospital admissions and their predictors among incident older high-cost users compared to older non-high-cost users in Ontario. Methods: Using Ontario administrative data,...
Article
Full-text available
Introduction : Low acuity patients have been controversially tagged as a source of emergency department (ED) misuse. Authorities for many Canadian health regions have set up policies so these patients preferably present to walk-in clinics (WIC). We compared the cost and quality of the care given to low acuity patients in an academic ED and a WIC of...
Article
Full-text available
Background The number of frail elderly will increase as the world population ageing accelerates. Since frail elders are at risk of falls, hospitalizations and disabilities, they will require more health care and services. To assess frailty prevalence using health administrative databases, to examine the association between frailty and the use of me...
Article
Background: Utility scores are frequently used as preference weights when estimating quality-adjusted life years within cost-utility analyses or health- adjusted life expectancies. Though previous Canadian estimates for specific chronic conditions have been produced, these may no longer reflect current patient populations. Data and methods: Data fr...
Article
Full-text available
Background Senior high cost health care users (HCU) are a priority for many governments. Little research has addressed regional variation of HCU incidence and outcomes, especially among incident HCU. This study describes the regional variation in healthcare costs and mortality across Ontario’s health planning districts [Local Health Integration Net...
Article
Full-text available
Objective: The study objective was to determine use of pain-related health care resources and associated direct and indirect costs over a two-year period in cardiac surgery patients who developed chronic post-surgical pain (CPSP). Methods: This multicentric observational prospective study recruited patients prior to cardiac surgery; these patients...
Article
Full-text available
We recently conducted two economic evaluations of a hypothetical pharmacogenomic test for statin-induced myopathy (SIM) in patients at high cardiovascular risk. Although the models differed in modeling technique and data inputs, both yielded similar results. We believe our approach to assessing the economic value of a diagnostic test was highly adv...
Article
Background: Statin (HMG-CoA reductase inhibitor) therapy is the mainstay dyslipidemia treatment and reduces the risk of a cardiovascular (CV) event (CVE) by up to 35%. However, adherence to statin therapy is poor. One reason patients discontinue statin therapy is musculoskeletal pain and the associated risk of rhabdomyolysis. Research is ongoing t...
Article
Full-text available
Background Idiopathic pulmonary fibrosis (IPF), although rare, is a severe and costly disease. Objective To estimate the clinical and economic burden of IPF over multiple years before and after diagnosis using comprehensive administrative databases for the province of Quebec, Canada. Methods Several administrative databases from Quebec, providing...
Article
Full-text available
Background/Objective There is a lack of Canadian data on the effectiveness of diabetes interventions in the workplace. To better inform workplace stakeholders, the objective of this study was to evaluate the effectiveness of Motivaction™, a diabetes screening and education pilot program in the workplace. Methods The Motivaction™ program involves a...
Article
Full-text available
Introduction Senior high-cost users (HCUs) are estimated to represent 60% of all HCUs in Ontario, Canada’s most populous province. To improve our understanding of individual and health system characteristics related to senior HCUs, we will examine incident senior HCUs to determine their incremental healthcare utilisation and costs, characteristics...
Article
Objectives There is a lack of Canadian data concerning the effectiveness of diabetes interventions in the workplace. The objective of this study was to evaluate the effectiveness of Motivaction, a diabetes screening and education pilot program, in the workplace. Methods The Motivaction program involves a voluntary web-based diabetes health-risk as...
Article
Background: Screening for undiagnosed atrial fibrillation may lead to treatment with oral anticoagulation therapy, which can decrease the risk of ischemic stroke. The objective of this study was to conduct an economic evaluation of the Program for the Identification of 'Actionable' Atrial Fibrillation in the Pharmacy Setting (PIAAF-Pharmacy), whic...
Article
Full-text available
Background St. Joseph's Health System has implemented an integrated comprehensive care bundle care (ICC) program with the hopes that it would improve patients' care while reducing overall costs. The aim of this analysis was to evaluate the performance of the ICC program within patients admitted with chronic pulmonary obstructive disease (COPD). Me...
Article
Full-text available
Background A sub-study of the Ontario Bariatric Registry was conducted to evaluate the impact of bariatric surgery on mobility, health-related quality of life (HRQoL), healthcare resource utilization (HRU), and employment status. Methods The 1-year change in mobility following bariatric surgery was evaluated using the mobility domain of the EuroQOL...
Article
Background Many observational studies have found an association between the exposure to statins and the increased risk of diabetes, mostly through the use of intent-to-treat (ITT) like exposure measure (EM). ITT like EM may not adequately reflect the mechanism of action by which statins could cause diabetes. Objective To determine if continuous...
Article
Full-text available
Background: Statins are the mainstay hypercholesterolemia treatment and reduce the risk of cardiovascular events in patients. However, statin therapy is often interrupted in patients experiencing musculoskeletal pain or myopathy, which are common in this patient group. Currently, the standard tests for diagnosing statin myopathies are difficult to...
Article
Pharmacogenomics (PGx) tests have the potential of improving the effectiveness of expensive new drugs by predicting the likelihood, for a particular patient, to respond to a treatment. The objective of this study was to develop a pharmacoeconomic model to determine the characteristics and the cost-effectiveness of a hypothetical PGx test, which wou...
Article
Aims: The objective of this study was to estimate the maximal clinical benefit that could be reasonably expected from a cholesterol-lowering intervention. Materials and methods: We used a hypothetical population at high risk of cardiovascular disease events from three risk assessment models including the Framingham risk function, the Score Canad...
Article
Background Statins are the mainstay hypercholesterolemia treatment and reduce the risk of cardiovascular events in patients. However, statin therapy is often interrupted in patients experiencing musculoskeletal pain or myopathy, which are common in this patient group. Currently, the standard tests for diagnosing statin myopathies are difficult to i...
Article
Full-text available
Background: Most economic evaluation models compare a new patented drug (NPRx) to a generic comparator. Drug costs within these models are usually limited to the retail cost of both drugs at the time of model conception. However, the retail cost of the NPRx is expected to drop once generic versions of this molecule are introduced following the exp...
Article
Full-text available
Recent trials report the efficacy of continuous tenofovir-based pre-exposure prophylaxis (PrEP) for prevention of HIV infection. The cost effectiveness of 'on demand' PrEP for non-injection drug-using men who have sex with men at high risk of HIV acquisition has not been evaluated. To conduct an economic evaluation of the societal costs of HIV in C...
Technical Report
Full-text available
L’insuffisance cardiaque est une maladie grave et invalidante qui pèse lourdement sur le pronostic vital. L’implantation d’un dispositif d’assistance ventriculaire (DAV) peut assurer la survie du patient à court terme jusqu’à la transplantation ou, à long terme, en cas d’impossibilité (temporaire ou permanente) d’une transplantation. Le présent do...
Article
Background: ADHD medications increase clinical encounters for cardiovascular symptoms. Uncertain are the roles of differences in ADHD medications and restrictive practices by drug programs. Methods: We conducted two nested case-control studies. The first was nested within a cohort of children de novo users of methylphenidate, amphetamines or ato...
Article
In the management of advanced heart failure, the option of long-term mechanical circulatory support (MCS) as destination therapy (DT), rather than as a temporary bridge to cardiac transplantation, is increasingly being offered to highly selected patients. Recent technological advancements in implantable devices, such as continuous flow systems and...