Presenters from CADTH Ann Vosilla, BC Liaison Officer, KMLO Sheila Tucker, NL Liaison Officer, KMLO Kathleen Kulyk, SK Liaison Officer, KMLO Stephanie Smith, NB Liaison Officer, KMLO Dawn Priestley, Yukon & NWT Liaison Officer, KMLO Jeannette Smith, Federal Programs & Nunavut Liaison Officer, KMLO

…about clothing for hospitalized psychiatric patients? (BC)

…about lab tests in Newfoundland and Labrador? …about lab tests in Newfoundland and Labrador?

Background CADTH Rapid Response Service in Newfoundland and Labrador Customers are Department of Health and Community Services and regional health authorities. Service model is highly valued. Customers report that Rapid Response fills a unique need, especially in areas with limited access to evidence providers. “We truly appreciate the level of expertise and professionalism evident at CADTH.” Kelli O’Brien, Vice-President – Long Term Care and Rural Health Western Health, Newfoundland

Delivering the Evidence on Lab Tests in Newfoundland and Labrador Stool Antigen Tests for Helicobacter pylori Infection: A Review of Clinical and Cost-Effectiveness and Guidelines (January 2015) Summary with critical appraisal RESEARCH QUESTIONS 1.What is the diagnostic accuracy and clinical effectiveness of stool antigen tests in patients with suspected H. pylori infections? 2.What is the cost-effectiveness of stool antigen tests in patients with suspected H. pylori infections? 3.What are the evidence-based guidelines associated with stool antigen tests in patients with suspected H. pylori infections?

What the Evidence Says Key Findings Diagnostic Accuracy Certain commercially available stool antigen tests with high test performance provide reliable results in diagnosing H. Pylori. Cost-Effectiveness A stool antigen test-and-treat strategy was cost-effective. Evidence-Based Guidelines Guidelines recommend a laboratory-based validated monoclonal stool test for test-and-treat strategies and for follow-up testing after eradication therapy.

Observations on the Report Relevance Provided evidence to help address a local issue where uncertainty existed. Timeliness Negotiated with the customer and delivered to fit with their decision horizon. Significance Implications for clinical practice, patient access, and cost.

Going Forward Increasing awareness and use. Transferability / leveraging of existing reports. CADTH ‘Lab Test’ event webinars have garnered local interest. Potential for implementation support: Knowledge exchange sessions Clinical practice tools Other interventions developed in partnership with laboratory medicine professionals

…about surgical masks in operating rooms? (SK)

Interior Slide 12

Research Questions 1.What is the clinical evidence regarding the effectiveness of wearing surgical masks in the operating room to reduce bacterial transmission from staff to patients? 2.What are the clinical practice guidelines for the wearing of surgical masks in the operating room? 13

Results Key Messages: No evidence was found to support the use of surgical face masks to reduce the frequency of surgical site infections No evidence was found on the effectiveness of wearing surgical face masks to protect staff from infectious material in the operating room Guidelines recommend the use of surgical face masks by staff in the operating room to protect both operating room staff and patients (despite lack of evidence 14

Conclusion The rapid response report “What is the clinical evidence regarding the effectiveness of wearing surgical masks in the operating room?” is my favorite to date because it helped me to examine my nursing practice, understand the evidence available and guided me towards best practice 15

…about islet cell transplantation for patients with unstable diabetes? (NB)

Meet the Customer Dr. Zeljko Bolesnikov Medical Consultant Medicare Eligibility and Claims NB Department of Health 17

Requests for Out of Province Coverage 18

The Issue: Evidence Needed Islet Cell Transplantation in Patients with Unstable Diabetes… ?? 19

The Rapid Response 20 …In conclusion, limited evidence suggests that islet transplantation is effective in maintaining insulin independence and is associated with improved clinical outcomes for unstable type 1 diabetes. There is a trend of increasing insulin independence and decreasing risks of adverse events related to this evolving technology. The cost-effectiveness of islet transplantation relative to the current treatment standards is undetermined based on the limited evidence.

The Outcome / Decision 21

…about Tranexamic Acid in Pre- hospital (ambulance) settings? (Yukon)

Meet Gerard… 23

When bad things happen to good tourists 24 Photos: and

Control excessive bleeding in trauma patients? 25 Photo source: elements.de/sandoz_ca/2/index-fr.php?cat=p

Getting to work… 26 Photo credit: Yukon EMS

27 Photo credit:

…about therapy dogs and horses for mental health? (Federal)

Puppies and Ponies

Seriously? 30

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33 news.nationalpost.com/2014/11/25/michael-den-tandt-canadian-veterans-deserve-better-than-the-conservative-party/ THE CANADIAN PRESS/Adrian Wyld

34 Photo credit, Bruno Schlumberger

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