Health Technology Assessment Unit



Esmail R, Clement FM, Holroyd-Leduc J, Niven DJ, Hanson HM. Characteristics of knowledge translation theories, models and frameworks for health technology reassessment: expert perspectives through a qualitative exploration. BMC Health Serv Res. 2021 Apr 29;21(1):401. doi: 10.1186/s12913-021-06382-8.

McCarron TL, Clement F, Rasiah J, Moffat K, Wasylak T, Santana MJ. Co-designing strategies to support patient partners during a scoping review and reflections on the process: a commentary. Res Involv Engagem. 2021 May 10;7(1):25. doi: 10.1186/s40900-021-00272-3. 

Sypes, E.E., de Grood, C., Whalen-Browne, L., Clement, F.M., Parsons Leigh, J., Niven, D.J., Stelfox, H.T. Engaging patients in de-implementation interventions to reduce low-value clinical care: a systematic review and meta-analysis. BMC Med 18, 116 (2020).

Sypes, E.E., de Grood, C., Clement, F.M., Parsons Leigh, J., Whalen-Browne, L., Stelfox, H.T., Niven, D.J. Understanding the public’s role in reducing low-value care: a scoping review. Implementation Sci 15, 20 (2020).

Soril LJJ, Noseworthy TW, Stelfox HT, Zygun DA, Clement FM. Facilitators of and barriers to adopting a restrictive red blood cell transfusion practice: A population-based cross sectional survey. CMAJ Open. 2019 E252-E257.

Soril LJJ, Noseworthy TW, Stelfox HT, Zygun DA, Clement FM., A retrospective observational analysis of red blood cell transfusion practices in stable, non-bleeding adult patients admitted to nine medical-surgical intensive care units. J Intensive Care. 2019 Apr 4;7:19. doi: 10.1186/s40560-019-0375-3. eCollection 2019.

Soril LJJ, Noseworthy TW, Stelfox HT, Zygun DA, Clement FM. A retrospective observational analysis of red blood cell transfusion practices in stable, non-bleeding adult patients admitted to nine medical-surgical intensive care units. J Intensive Care. 2019 Apr 4;7:19. doi: 10.1186/s40560-019-0375-3. 

Soril LJJ, Noseworthy TW, Stelfox HT, Zygun DA, Clement FM. Facilitators of and barriers to adopting a restrictive red blood cell transfusion practice: a population-based cross-sectional survey. CMAJ Open. 2019 Apr 23;7(2):E252-E257. doi: 10.9778/cmajo.20180209. 

Soril LJJ, Niven DJ, Esmail R, Noseworthy TW, Clement FM. Untangling, Unbundling, and Moving Forwards: Framing Health Technology Reassessment in the Changing Conceptual Landscape. Int J Technol Assess Health Care. 2018 Jan;34(2):212-217. doi: 10.1017/S0266462318000120. 

Soril LJJ, Seixas BV, Mitton C, Bryan S, Clement FM. Moving low value care lists into action: prioritizing candidate health technologies for reassessment using administrative data. BMC Health Serv Res. 2018 Aug 15;18(1):640. doi: 10.1186/s12913-018-3459-1.

Brown DL, Clement F. Calculating Health Care Waste in Washington State: First, Do No Harm.  JAMA Internal Medicine. 2018 Sept 1, 178(9): 1262-1263

Soril LJJ, Noseworthy TW, Dowsett LE, Memedovich K, Holitzki HM, Lorenzetti DL, Stelfox HT, Zygun DA, Clement FM. Behaviour modification interventions to optimise red blood cell transfusion practices: a systematic review and meta-analysis. BMJ Open. 2018 May 18;8(5):e019912. doi: 10.1136/bmjopen-2017-019912.

Soril LJJ, MacKean G, Noseworthy TW, Leggett LE, Clement F. Achieving Optimal Technology Use: A Proposed Model for Health Technology Reassessment. SAGE Open Medicine. April 2017; 5.

Sevick K, Soril L, MacKean G, Noseworthy T, Clement FM.  Unpacking Early Experiences with Health Technology Reassessment in a Complex Healthcare System.  International Journal of Healthcare Management. 10:3. June 10 2017

Soril LJ, Clement F, Noseworthy TW. Bioethics, Health Technology Reassessment, and Management. Healthcare Management Forum. Nov 2016; 29(6).

MacKean, G., Noseworthy, T., Elshaug, A. G., Leggett, L., Littlejohns, P., Berezanski, J., & Clement, F. Health Technology Reassessment: The Art of the PossibleInternational journal of technology assessment in health care, 2013 29(04), 418-423.

Leggett, L.E., MacKean, G., Noseworthy, T.W., Sutherland, L.R., Clement, F.M. Health Technology Reassessment of Non-Drug Technologies: A Survey and Key Informant Interviews. Health Policy. 2013, 10:38.

Leggett, L.E., Noseworthy, T.W., Zarrabi, M., Lorenzetti, D., Sutherland, L.R., Clement, F.M. Health Technology Reassessment of Non-Drug Technologies: Current Practices. Int J Technol Assess Health Care; 2012; 28(3). 

Noseworthy, T.W., Clement, F.M. Health Technology Reassessment: Scope, Methodology and Language. Int J Technol Assess Health Care; 2012; 28(3). 

Prescription Drug Policy

Beall R, Hardcastle L, Clement F, Hollis A. How will recent trade agreements that extend market protections for brand-name prescription pharmaceuticals impact expenditures and generic access in Canada?  Health Policy. 2019

Memedovich, KA, Manns BM, Beall R, Hollis A, Clement FM.  The impact of pharmaceutical rebates on patients’ drug expenditures. CMAJ March 18, 2019 191 (11) E308-E312

Spackman E, Clement F, Allan GM, Bell CM, Bjerre LM, Blackburn DF, Blais R, Hazlewood G, Klarenbach S, Nicolle LE, Persaud N, Alessi-Severini S, Tierney M, Wijeysundera HC, Manns B. Developing key performance indicators for prescription medication systems. PLoS One. 2019 Jan 15;14(1):e0210794

Clement F, Memedovich KA. Drug coverage in Canada: gaps and opportunities. J Psychiatry Neurosci. 2018 May;43(3):148-150.

Campbell DJT, Manns BJ, Soril LJJ, Clement F. Comparison of Canadian public medication insurance plans and the impact on out-of-pocket costs. CMAJ Open. 2017 Nov 22;5(4):E808-E813. doi: 10.9778/cmajo.20170065.

Campbell DJ, Soril LJ, Clement F. Impact of Cost-Sharing Mechanisms on Patient-Borne Medication Costs. JAMA Internal Medicine. November 2016;176(11).

Parkinson B, Sermet C, Clement FM, Crausaz S, Godman B, Garner S, Choudhury M, Pearson S, Viney R, Lopert R, Elshaug A.  Disinvestment and Value-Based Purchasing Strategies for Pharmaceuticals: An International Review.  Pharmacoeconomics. 2015 Jun 6. 

Other Publications

Milaney, K., Haines-Saah, R., Farkas, B., Egunsola, O., Mastikhina, L., Brown, S., Lorenzetti, D., Hansen, B., McBrien, K., Rittenbach, K., Hill, L., O'Gorman, C., Doig, C., Cabaj, J., Stokvis, C., Clement, F. A scoping review of opioid harm reduction interventions for equity-deserving populations. The Lancet Regional Health - Americas 2022; 12: 100271.

Hofmeister M, Clement F, Patten S, Li J, Dowsett LE, Farkas B, Mastikhina L, Egunsola O, Diaz R, Cooke NCA, Taylor VH. The effect of interventions targeting gut microbiota on depressive symptoms: a systematic review and meta-analysis. CMAJ Open. 2021 Dec 21;9(4):E1195-E1204. doi: 10.9778/cmajo.20200283.

Minion J, Egunsola O, Mastikhina L, Farkas B, Hofmeister M, Flanagan J, Salmon C, Clement F. PICO Portal (product review). J Can Health Libr Assoc [Internet]. 2021 Dec. 1;42(3). 

Egunsola O, Li JW, Mastikhina L, Akeju O, Dowsett LE, Clement F. A Qualitative Systematic Review of Facilitators of and Barriers to Community Pharmacists–Led Anticoagulation Management Service. Annals of Pharmacotherapy. September 2021. doi:10.1177/10600280211045075

Egunsola O, Clement F, Taplin J, Mastikhina L, Li JW, Lorenzetti DL, Dowsett LE, Noseworthy T. Immunogenicity and Safety of Reduced-Dose Intradermal vs Intramuscular Influenza Vaccines: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021 Feb 1;4(2):e2035693. doi: 10.1001/jamanetworkopen.2020.35693.

McCarron TL, MacKean G, Dowsett LE, Saini M, Clement F. Patients' experience with and perspectives on neuromodulation for pain: a systematic review of the qualitative research literature. Pain. 161(8):1708-1715 2020.

Hofmeister M, Khadaroo R, Holroyd-Leduc J, Padwal R, Wagg A, Warkentin L, Clement F.  Cost-effectiveness Analysis of the Elder-Friendly Approaches to the Surgical Environment (EASE) Intervention for Emergency Abdominal Surgical Care of Adults Aged 65 Years and Older. JAMA Netw Open. 2020;3(4):e202034.

Hofmeister M, Klarenbach S, Soril LJJ, Scott-Douglas N, Clement FM. A Systematic Review and Jurisdictional Scan of the Evidence Characterizing and Evaluating Assisted Peritoneal Dialysis Models. Clinical Journal of the American Society of Nephrology. 2020 Apr 7;15(4):511-520

Esmail R, Hanson H, Holroyd-Leduc J, Brown S, Strifler L, Straus S, Niven D, Clement F. A scoping review of full-spectrum knowledge translation theories, models and frameworks. Implementation Science. 15:11 2020

Hofmeister M, Memedovich A, Brown S, Saini M, Dowsett LE, Lorenzetti D, McCarron T, MacKean G, Clement F. Effectiveness of Neurostimulation Technologies for the Management of Chronic Pain: A Systematic Review. Neuromodulation. 2020, 23(2) 150-157. doi: 10.1111/ner.13020. 

Coward S, Clement F, Benchimol EI, Bernstein CN, Avina-Zubieta JA, Bitton A, Carroll MW, Hazlewood G, Jacobson K, Jelinski S, Deardon R, Jones JL, Kuenzig ME, Leddin D, McBrien KA, Murthy SK, Nguyen GC, Otley AR, Panaccione R, Rezaie A, Rosenfeld G, Peña-Sánchez JN, Singh H, Targownik LE, Kaplan GG. Past and Future Burden of Inflammatory Bowel Diseases Based on Modeling of Population-based Data. Gastroenterology. 2019 Jan 10. pii: S0016-5085(19)30021-6

Brown S, Rittenbach K, Cheung S, McMaster F, McKean G, Clement F.  Current and Common Definitions of Treatment-Resistant Depression: Findings from a Systematic Review and Qualitative Interviews.  The Canadian Journal of Psychiatry. 2019 Feb 14:706743719828965.

Hofmeister M, Dowsett LE, Lorenzetti DL, Clement F. Ultrasound- versus fluoroscopy-guided injections in the lower back for the management of pain: a systematic review. Eur Radiol. 2019. Epub ahead of print. doi: 10.1007/s00330-019-06065-3

Hofmeister M, Memedovich A, Dowsett LE, et al. Palliative care in the home: a scoping review of study quality, primary outcomes, and thematic component analysis. BMC Palliat Care. 2018;17(1):41. Published 2018 Mar 7. doi:10.1186/s12904-018-0299-z

Han D, Danthurebandara V, Iragorri N, Clement F, Spackman E. Cost-effectiveness of Treatments for Chronic Constipation: A Systematic Review. Pharmacoeconomics. Jan 2018 Apr;36(4):435-449.

Memedovich KA, Dowsett LE, Spackman E, Noseworthy T, Clement FM.  The adverse health effects and harms related to marijuana use: An overview review.  CMAJ Open. 2018 Aug 16;6(3):E339-E346

Soril LJJ, Adams T, Phipps-Taylor M, Winblad U, Clement F. Is Canadian Healthcare Affordable? A Comparative Analysis of the Canadian Healthcare System from 2004 to 2014. Healthcare Policy. 2017 Aug;13(1):43-58.

Sevick L, Ghali S, Hill MD, Danthurebandara V, Lorenzetti DL, Noseworthy T, Spackman E, Clement FM.  A Systematic Review of the Cost and Cost-Effectiveness of Rapid Endovascular Therapy for Acute Ischemic Stroke.  Stroke 2017 Sept; 48(9):2519-2526. 

Holitzki, H., Dowsett, L.E., Spackmand, E., Noseworthy, T. & Clement, F. Health Effects of Exposure to Second-and Third-Hand Marjiuana Smoke: A Systematic Review. CMAJ Open, 5(4), E814. November 2017.

Sevick L, Santana, M, Ghali W, Clement FM.  Prospective Economic Evaluation of an Electronic Discharge Communication Tool: Analysis of a Randomized Controlled Trial.  BMJ OPEN 2017;7:e019139.

Dowsett LE, Clement F, Coward S, Lorenzetti D, Noseworthy T, Sevick L, Spackman E. Effectiveness of Surgical Treatment for Tarlov Cysts. Clin Spine Surg. 2017.

Dowsett LE, Coward S, Lorenzetti D, MacKean G, Clement F. Living with Hepatitis C Virus: A Systematic Review and Narrative Synthesis of Qualitative Literature. Canadian Journal of Gastroenterology and Hepatology. April 2017; 2017.

Spackman E, Haines-Saah R, Danthurebandara VM, Dowsett LE, Noseworthy T, Clement FM. Marijuana Use and Perceptions of Risk and Harm: A Survey among Canadians in 2016. Usage de la marijuana et perceptions des risques et dommages : sondage auprès des Canadiens en 2016. Healthcare Policy. 2017;13(1):17–27. doi:10.12927/hcpol.2017.25194

Clement F. Simple Measures to Reduce Chemical Exposure. JAMA Intern Med. 2016 Nov 1; 176(11):1707.

Coward S, Leggett L, Kaplan G, Clement F. Cost-effectiveness of Screening for Hepatitis C Virus: A Systematic Review of Economic Evaluations. BMJ Open. August 2016

Soril L JJ, Leggett LE, Lorenzetti DL, Noseworthy T, Clement FM. Characteristics of Frequent Users of the Emergency Department: A Systematic Review of International Healthcare Systems.  May 2016

Ho C, Cimon K, Weeks L, Mierzwinski-Urban M, Dunfield L, Soril L, Jabr M. Point-of-care Troponin Testing in Patients with Symptoms Suggestive of Acute Coronary Syndrome: A Health Technology Assessment. Canadian Agency for Drugs and Technologies in Health. March 2016.

Leggett LE, Khadaroo RG, Holroyd-Leduc J, Lorenzetti DL, Hanson H, Wagg A, Padwal R, Clement FM.  Measuring resource utilization: A systematic review of validated self-reported questionnaires.  Medicine.  2016 March 2016; 95(10).

Weaver C, Clement FM, Campbell N, James MT, Klarenbach S, Hemmelgarn BR, Tonelli M, McBrien KA for the Alberta Kidney Disease Network (AKDN) and the Interdisciplinary Chronic Disease Collaboration (ICDC).  Health care costs attributable to hypertension: a Canadian population-based cohort study.  Hypertension. 2015 Sep;66(3):502-8

Leggett LE, Hauer T, Martin BJ, Manns B, Aggarwal S, Arena R, Austford LD, Meldrum D, Ghali W, Knudtson ML, Norris CM, Stone JA, Clement F. Optimizing Value from Cardiac Rehabilitation: A Cost-Utility Analysis Comparing Age, Sex, and Clinical Subgroups. Mayo Clinical Proceedings. 2015, August; 90(8):1011-20.

Coward S, Heitman S, Clement FM, Hubbard J, Proulx M, Zimmer S, Panaccione R, Seow C, Leung Y, Datta N, Ghosh S, Kaplan G.  Ulcerative Colitis Associated Hospitalization Costs: A Population-Based Study. Canadian Journal of Gastroenterology and Hepatalogy. Can J Gastroenterol Hepatol. 2015 Jun 16. pii: 16814.

Leggett LE, Soril JJ, Coward S, Lorenzetti D, MacKean G, Clement FM. Repetitive Transcranial Magnetic Stimulation for Treatment-Resistant Depression in Adult and Youth Populations: A systematic literature review and meta-analysis. Primary care Companion for CNS Disorders. 2015, November.

Soril LL, Leggett LE, Lorenzetti DL, Noseworthy TW, Clement FM. Reducing Frequent Visits to the Emergency Department: A Systematic Review of Interventions. PLoS One. 2015 Apr 13;10(4)

Soril LJJ, Leggett, LE, Lorenzetti, DL, Silvius, J, Robertson, D, Mansell, L, Holroyd-Leduc, J, Noseworthy, TW, Clement, FM. Effective Use of the Built Environment to Manage Behavioural and Psychological Symptoms of Dementia: A Systematic Review. PLoS ONE. 2014, Dec: 9(12).

Leggett, LE, Soril LJJ, Lorenzetti DL, Noseworthy T, Steadman R, Tiwana S, Clement F. Radiofrequency Ablation for Chronic Low Back Pain: A Systematic Review of Randomized Controlled Trials. Pain Research and Management. 2014,Oct: 19(5):146-153.

Leggett LE, Lorenzetti D, Noseworthy T, Tiwana S, MacKean G, Clement FM.  Experiences and Attitudes towards Risk of Recurrence Testing in Women with Breast Cancer: A Systematic Review. Breast Cancer Res Treat. 2014 Apr;144(3):457-65.

Leggett, L. E., Lorenzetti, D. L., Noseworthy, T., Tiwana, S., MacKean, G., & Clement, F. (2014). Experiences and attitudes toward risk of recurrence testing in women with breast cancer: a systematic reviewBreast cancer research and treatment144(3), 457-465.

Steadman, R., Myers, R.P., Leggett, L.E., Lorenzetti, D., Noseworthy, T.W., Rose, S., Sutherland, L.R., Clement, F.M. 2013, 27:(3), A Health Technology Assessment of Transient Elastography in Adult Liver Disease. The Canadian Journal of Gastroenterology.