Jemila Hamid

• PhD
• Professor at University of Ottawa

Introduction Haemoglobin is a commonly ordered laboratory test, used to assess both individual and population‐level health. To interpret test results, laboratories provide reference intervals (RIs) with lower (2.5th%) and upper (97.5th%) limits according to age and sex. Reference curves (RCs) treat age as a continuous variable. The objectives were...

Introduction Reference intervals and reference curves provide clinicians with a point of reference when evaluating patients’ laboratory test results. In practical applications, the 2.5th and 97.5th percentiles of healthy reference population are typically used as lower and upper reference limits. Guidelines outlining analytical and methodological s...

Background: In November 2011, the Canadian Task Force on Preventive Health Care released guidelines for screening women at average breast cancer risk. Weak recommendations (framed using GRADE methodology) were made for screening women aged 50 to 74 years every two to three years, and for not screening women aged 40 to 49 years. Methods: We conduct...

Context: There is no French-language training to educate nurses on the use of the Face, Legs, Activity, Cry, Consolability (FLACC) pain scale, whose scores guide the treatment of pediatric pain. Aims: The aim of this study was to evaluate a French online training program for the FLACC scale offered to Francophone undergraduate nursing students....

Background Childhood Hodgkin lymphoma survivors suffer from long‐term effects decades after treatment completion with a prevalence of pulmonary dysfunction of up to 65.2%. Aims This study explored the early trajectory of pulmonary function in pediatric cancer patients with Hodgkin lymphoma who received pulmonary toxic therapy. Methods and Results...

Objective To establish reference intervals (RIs) for fetal and neonatal small and large intestinal lengths. Methods Linear measurements on small and large intestines were made upon postmortem examination of 131 preterm and term infants with gestational ages between 13 and 41 weeks. All cases were referred from the Eastern Ontario and Western Québe...

Introduction The need to better prepare youth with type 1 diabetes for the transition from paediatric to adult care is evident. As part of a regional quality improvement initiative, a novel Pre-Transition (Pre-T) Visit was developed and piloted at a paediatric tertiary care centre in January 2018 for patients aged 15–18 years to capture the status...

Background The comparative safety and efficacy between anti-vascular endothelial growth factor agents (anti-VEGFs) and between combined therapies for patients with neovascular age-related macular degeneration (nAMD) is unclear. We conducted a systematic review to examine the comparative safety and efficacy anti-VEGFs for adults with nAMD. Methods...

Background: In November 2011, the Canadian Task Force on Preventive Health Care released guidelines for screening women at average breast cancer risk. Weak recommendations (framed using GRADE methodology) were made for screening women aged 50 to 74 years every two to three years, and for not screening women aged 40 to 49 years. Methods: We conduct...

Interrupted time series (ITS) design is commonly used to evaluate the impact of interventions in healthcare settings. Segmented regression (SR) is the most commonly used statistical method and has been shown to be useful in practical applications involving ITS designs. Nevertheless, SR is prone to aggregation bias, which leads to imprecision and lo...

Objective To assess implementation and to identify barriers and facilitators to implementation, sustainability and scalability of an implementation strategy to provide lay health workers (LHWs) with the knowledge, skills and tools needed to implement an intervention to support patient tuberculosis (TB) treatment adherence. Design Mixed-methods des...

Objective To establish reference intervals for hemoglobin and mean corpuscular volume (MCV) in an ethnically diverse community sample of Canadian children 36 months and younger. Methods We collected blood samples from young children at scheduled primary care health supervision visits at 2 weeks, 2, 4, 6, 9, 12, 15, 18, 24, and 36 months of age. Sa...

Introduction In response to the burden of chronic disease among older adults, different chronic disease self-management tools have been created to optimise disease management. However, these seldom consider all aspects of disease management are not usually developed specifically for seniors or created for sustained use and are primarily focused on...

Background With the global shortage of skilled health workers estimated at 7.2 million, outpatient tuberculosis (TB) care is commonly task-shifted to lay health workers (LHWs) in many low- and middle-income countries where the shortages are greatest. While shown to improve access to care and some health outcomes including TB treatment outcomes, lac...

Study objectives: To determine if polysomnographic (PSG) cardiorespiratory outcomes are associated with and could have the potential to predict the presence of postoperative adverse respiratory events in children with neuromuscular disease undergoing any surgical procedure. Methods: A retrospective cohort study was conducted at a tertiary pediat...

Background: Systematic reviews have established that exercise reduces falls in older adults, however the most effective types of exercise are not known. This secondary analysis determined the comparative effectiveness of fall prevention exercise approaches. Method: All fall prevention exercise interventions for older adults were identified from an...

Background Network meta-analysis (NMA) simultaneously synthesises direct and indirect evidence on the relative efficacy and safety of at least three treatments. A decision maker may use the coherent results of an NMA to determine which treatment is best for a given outcome. However, this evidence must be balanced across multiple outcomes. This stud...

Objective We aimed to examine the risk of concussion in children with a previous history of concussion. Design Systematic review and meta-analysis. The primary outcome was number of children with and without a previous lifetime history of concussion who sustained a diagnosed concussion within each study period. Risk of bias was assessed using the...

The Growth Curve Model (GCM) is a Generalized Multivariate Analysis of Variance (GMANOVA) model especially useful in the analysis of longitudinal data, growth curves as well as other response curves. The model is a natural extension of the classical Multivariate Analysis of Variance (MANOVA) model and among other assumptions, relies on the assumpti...

Statistical models often rely on several assumptions including distributional assumptions on outcome variables as well as relational assumptions representing the relationship between outcomes and independent variables. Model diagnostics is, therefore, a crucial component of any model fitting problem. Residuals play important roles in model diagnost...

Introduction African, Caribbean and Black (ACB) communities are disproportionately infected by HIV in Ontario, Canada. They constitute only 5% of the population of Ontario yet account for 25% of new diagnoses of HIV. The aim of this study is to understand underlying factors that augment the HIV risk in ACB communities and to inform policy and pract...

Background The FLACC (Face, Legs, Activity, Cry, Consolability) pain scale is commonly used for pediatric pain assessment; however, no online educational tool exists to facilitate the use of the scale. Aims This study aimed to develop an online educational tool and evaluate its effect on nurse knowledge, user confidence, and scoring accuracy. Des...

Background Segmented regression (SR) is the most common statistical method used in the analysis of interrupted time series (ITS) data. However, this modeling strategy is indicated to produce spurious results when applied to aggregated data. For multicenter ITS studies, data at a given time point are often aggregated across different participants an...

Background Network meta-analysis (NMA) simultaneously synthesises direct and indirect evidence on the relative efficacy and safety of at least three treatments. A decision maker may use the coherent results of an NMA to determine which treatment is best for a given outcome. However, this evidence must be balanced across multiple outcomes. This stud...

Background: Network meta-analysis (NMA) simultaneously synthesises direct and indirect evidence on the relative efficacy and safety of at least three treatments. A decision maker may use the coherent results of an NMA to determine which treatment is best for a given outcome. However, this evidence must be balanced across multiple outcomes. This stu...

Objectives: Sepsis is responsible for a substantial proportion of global childhood morbidity and mortality. However, evidence demonstrates major inaccuracies in the use of the term "sepsis" in clinical practice, coding, and research. Current and previous definitions of sepsis have been developed using expert consensus but the specific criteria use...

Objective Interrupted time series (ITS) designs are robust quasi-experimental designs commonly used to evaluate the impact of interventions and programs implemented in healthcare settings. This scoping review aims to 1) identify and summarize existing methods used in the analysis of ITS studies conducted in health research, 2) elucidate their stren...

Adolescents (≤19 years of age) have lower rates of breastfeeding (BF) compared to older mothers. BF self-efficacy (SE), defined as a mother′s confidence in her ability to breastfeed her infant, has been identified as an important factor influencing BF outcomes. An innovative youth-informed BF program for young women was designed and implemented, wh...

Classification of a disease often depends on more than one test, and the tests can be interrelated. Under the incorrect assumption of independence, the test result using dependent biomarkers can lead to a conflicting disease classification. We develop a copula-based method for this purpose that takes dependency into account and leads to a unique de...

Background: As the population ages, older hospitalized patients are at increased risk for hospital-acquired morbidity. The Mobilization of Vulnerable Elders (MOVE) program is an evidence-informed early mobilization intervention that was previously evaluated in Ontario, Canada. The program was effective at improving mobilization rates and decreasin...

Objective To provide a framework for quantifying the robustness of treatment ranks based on Surface Under the Cumulative RAnking curve (SUCRA) in network meta-analysis (NMA) and investigating potential factors associated with lack of robustness. Methods We propose the use of Cohen’s kappa to quantify the agreement between SUCRA-based treatment ran...

Objectives: The implementation of competency-based evaluations increases the emphasis on in-training assessment. The Consultation Letter Rating Scale (CLRS), published by the Royal College of Physicians and Surgeons of Canada, is a tool that assesses written-communication competencies. This multisite project evaluated the tool's validity, reliabil...

Background: Isotonic crystalloid fluid bolus therapy is used in critically ill children to restore or maintain hemodynamic stability. However, the ideal choice of crystalloid remains to be determined. The most easily available and most frequently used crystalloid is 0.9% saline, an unbalanced crystalloid, that has been associated with hyperchlorem...

Introduction Clinical trials and systematic reviews of trials involving vitamin D supplementation have mainly focused on defining the optimal amount of vitamin D dosage. However, the comparative effectiveness of different dosing schedules (ie, daily vs bolus dosing schedule) has been largely unexplored; and currently, there is no consensus regardin...

Background: This study aimed to improve our understanding of the natural history of cystic fibrosis (CF) by comparing lung function and body mass index z-score (zBMI) between patients with different genotypes and identify a genotype with outcomes most comparable to homozygous ΔF508 patients. Methods: Data was obtained from the Canadian CF Regist...

Background: A systematic review (SR) was conducted to evaluate the comparative effectiveness of geriatrician-led models of care, and an integrated knowledge translation (iKT) approach facilitated SR relevance. Activities to engage knowledge users (KUs) in the SR were evaluated for perceived level of engagement. Study design and setting: KUs incl...

Objectives To evaluate the comparative effectiveness and safety of intravitreal bevacizumab, ranibizumab and aflibercept for patients with choroidal neovascular age-related macular degeneration (cn-AMD), diabetic macular oedema (DMO), macular oedema due to retinal vein occlusion (RVO-MO) and myopic choroidal neovascularisation (m-CNV). Design Syst...

Background Bed rest for older hospitalized patients places them at risk for hospital-acquired morbidity. We previously evaluated an early mobilization intervention and found it to be effective at improving mobilization rates and decreasing length of stay on internal medicine units. The aim of this study was to conduct a replication study evaluating...

Background: Falls are a common occurrence and the most effective quality improvement (QI) strategies remain unclear. Methods: We conducted a systematic review and network meta-analysis (NMA) to elucidate effective quality improvement (QI) strategies for falls prevention. Multiple databases were searched (inception−April 2017). We included randomise...

Objective The objective of this study was to identify relevant outcomes and measures to inform a systematic review (SR) on the comparative effectiveness of geriatrician-led care models. Study Design and Setting In the modified Delphi to select outcomes for inclusion in the SR, knowledge users (KUs) from Ontario, Alberta, and Saskatchewan rated out...

As the population ages, older hospitalized patients are at increased risk for hospital-acquired morbidity. The Mobilization of Vulnerable Elders (MOVE) program is an evidence-informed early mobilization intervention that was previously evaluated in Ontario, Canada. The program was effective at improving mobilization rates and decreasing length of s...

Aim To describe the process of obtaining consensus of outcome priorities between families of children with medical complexity (CMC) and their healthcare providers (HCPs) for the purpose of evaluating changes to service delivery. Method The consensus of outcomes involved surveying families of CMC and HCPs and an in‐person consensus meeting. Priorit...

Existing methods for estimating the parameters of the Growth Curve Model (GCM) rely on the assumption that the underlying distribution for the error terms is multivariate normal. However, we often come across skewed data in practical applications; and estimators developed under the normality assumption may not be valid in such situations. Simulatio...

Traditional inference on the growth curve model (GCM) requires ‘small p large n’ ( n≫p) and cannot be applied in high-dimensional scenarios, where we often encounter singularity. Several methods are proposed to tackle the singularity problem, however there are still limitations and gaps. We consider a Bayesian framework to derive a statistic for te...

Introduction: More than half of older adults (age ≥ 65 yr) have 2 or more high-burden multimorbidity conditions (i.e., highly prevalent chronic diseases, which are associated with increased health care utilization; these include diabetes [DM], dementia, depression, chronic obstructive pulmonary disease [COPD], cardiovascular disease [CVD], arthrit...

Background: Systematic reviews are infrequently used by health care managers (HCMs) and policy-makers (PMs) in decision-making. HCMs and PMs co-developed and tested novel systematic review of effects formats to increase their use. Methods: A three-phased approach was used to evaluate the determinants to uptake of systematic reviews of effects an...

The Growth Curve Model (GCM) assumes the same shape of profiles for each group, where group means are assumed to be represented by polynomials of the same degree. The model, therefore, is inappropriate when analyzing data from studies involving groups with mean growth curves represented by different shapes. We consider the Extended Growth Curve Mod...

Importance Falls result in substantial burden for patients and health care systems, and given the aging of the population worldwide, the incidence of falls continues to rise. Objective To assess the potential effectiveness of interventions for preventing falls. Data Sources MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Agel...

Background and objectives: Guideline recommendations for the same clinical condition may vary. The purpose of this study was to determine the degree of agreement among comparable asthma and bronchiolitis treatment recommendations from guidelines. Methods: National and international guidelines were searched by using guideline databases (eg, Natio...

Osteoporosis is affecting over 200 million people worldwide. Despite available guidelines, care for these patients remains sub-optimal. We developed an osteoporosis tool to address the multiple dimensions of chronic disease management. Findings from its evaluation showed a significant increase from baseline in osteoporosis investigations and treatm...

Background/objectives: To examine the comparative effectiveness and safety of cognitive enhancers for Alzheimer's disease (AD). Design: Systematic review and Bayesian network metaanalysis (NMA). Setting: MEDLINE, EMBASE, Cochrane Library, CINAHL, Ageline (inception-March 2016). Participants: Individuals with AD in randomized controlled trial...

Objectives The primary objective was to establish reference intervals for laboratory tests used to assess iron status in young children using the Clinical and Laboratory Standards Institute guidelines. A secondary objective was to compare the lower limit of the reference interval with the currently recommended cut-off value for haemoglobin and seru...

Background: older patients admitted to hospitals are at risk for hospital-acquired morbidity related to immobility. The aim of this study was to implement and evaluate an evidence-based intervention targeting staff to promote early mobilisation in older patients admitted to general medical inpatient units. Methods: the early mobilisation impleme...

Objective: To statistically compare and evaluate commonly used methods of estimating reference intervals and to determine which method is best based on characteristics of the distribution of various datasets. Design and methods: Three approaches for estimating reference intervals, i.e. parametric, non-parametric, and robust, were compared with s...

Objectives Interrupted time series (ITS) design involves collecting data across multiple time points before and after the implementation of an intervention to assess the effect of the intervention on an outcome. ITS designs have become increasingly common in recent times with frequent use in assessing impact of evidence implementation interventions...

Introduction: Peroral endoscopic myotomy (POEM) is a novel intervention for the treatment of achalasia, which combines the advantages of endoscopic access and myotomy. The purpose of this study was to perform a systematic review of the literature to evaluate the efficacy and safety of POEM. Methods: The systematic review was conducted following...

Objective Malnutrition in children pervades all aspects of their health, growth, cognitive and social development and can lead to irreversible and lifelong effects. We examine the prevalence and determinants of malnutrition in children under 5 in the Ghanaian population. Methods Using data from the latest available Ghana Demographic and Health Surv...

Background Comprehensive geriatric assessment (CGA) is an integrated model of care involving a geriatrician and an interdisciplinary team and can prioritize and manage complex health needs of older adults with multimorbidity. CGAs differ across healthcare settings, ranging from shared care conducted in primary care settings to specialized inpatient...

Background: The gender gap in academia is long-standing. Failure to ensure that our academic faculty reflect our student pool and national population deprives Canada of talent. We explored the gender distribution and perceptions of the gender gap at a Canadian university-affiliated, hospital-based research institute. Methods: We completed a sequen...

566Background: Consensus is lacking regarding an effective surveillance strategy for the detection of colorectal cancer (CRC) recurrence at a curative stage. This study aims to evaluate the effect of carcinoembryonic antigen (CEA) measurement alone vs. CEA as part of an intensive surveillance strategy for the detection of curative CRC recurrence. M...

Linear principal component analysis (PCA) is a widely used approach to reduce the dimension of gene or miRNA expression data sets. This method relies on the linearity assumption, which often fails to capture the patterns and relationships inherent in the data. Thus, a nonlinear approach such as kernel PCA might be optimal. We develop a copula-based...

We have developed a new approach to determine the threshold of a biomarker that maximizes the classification accuracy of a disease. We consider a Bayesian estimation procedure for this purpose and illustrate the method using a real data set. In particular, we determine the threshold for Apolipoprotein B (ApoB), Apolipoprotein A1 (ApoA1) and the rat...

Background The Team Standardized Assessment of a Clinical Encounter Report (StACER) was designed for use in Geriatric Medicine residency programs to evaluate Communicator and Collaborator competencies. Methods The Team StACER was completed by two geriatricians and interdisciplinary team members based on observations during a geriatric medicine tea...

Background: Improving care is a key strategy for reducing the burden of injuries, but it is unknown whether the use of quality indicators (QI) is associated with patient outcomes. We sought to evaluate the association between the use of QIs by trauma centers and outcomes in adult injury patients. Methods: We identified consecutive adult patients...

Background: Despite availability of effective treatment, tuberculosis (TB) remains an important cause of morbidity and mortality globally, with low- and middle-income countries most affected. In many such settings, including Malawi, the high burden of disease and severe shortage of skilled healthcare workers has led to task-shifting of outpatient...

Recent advances in technology have allowed researchers to collect large scale complex biological data, simultaneously, often in matrix format. In genomic studies, for instance, measurements from tens to hundreds of thousands of genes are taken from individuals across several experimental groups. In time course microarray experiments, gene expressio...

Introduction Alzheimer's dementia (AD) is the most common cause of dementia, and several organisations, such as the National Institute for Health and Care Excellence, suggest that management of patients with AD should be tailored to their needs. To date, little research has been conducted on the treatment effect in different subgroups of patients w...

Room transfers are suspected to promote the development of delirium in hospitalized elderly patients, but no studies have systematically examined the relationship between room transfers and delirium incidence. We used a case-control study to determine if the number of room transfers per patient days is associated with an increased incidence of deli...

Background Printed educational materials (PEMs) are commonly used simple interventions that can be used alone or with other interventions to disseminate clinical evidence. They have been shown to have a small effect on health professional behaviour. However, we do not know whether they are effective in primary care. We investigated whether PEMs imp...

Introduction The choice of a basal insulin regimen to manage type 1 diabetes mellitus (T1DM) may have different risks of adverse events and effectiveness, due to the difference in the effectiveness of these agents across patient characteristics (eg, baseline glycosylated haemoglobin; A1C). Currently, there is a lack of high quality evidence to supp...