Browsing by Author "Datta, Indraneel"
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Item Open Access A Cost-Utility Analysis of Robotic vs. Laparoscopic-assisted Rectal Cancer Resection(2022-06-17) Li, Mo Yu L.; Dixon, Elijah; Crump, Robert T.; Datta, Indraneel; Rennert-May, ElissaRobotic-assisted colorectal surgery is a novel minimally invasive approach to cancers of the rectum and rectosigmoid. Compared to the more established laparoscopic-assisted technique, the robotic platform offers three-dimensional visualization and greater degrees of instrument mobility. While the robotic technique has gained widespread use in the United States and Europe, implementation in Canada remains limited due to high costs. Although there is some evidence for improved robotic outcomes, there is minimal reporting of Canadian outcomes after robotic rectal and rectosigmoid cancer resection. Further, there is a paucity of economic evaluations informing the cost-effectiveness of robotic rectal cancer resection. We assessed clinicopathologic outcomes and surgeon learning curve associated with robotic-assisted rectal and rectosigmoid cancer resection in an Alberta setting. We then systematically reviewed existing economic evaluations on robotic-assisted colorectal surgery. Finally, we performed a cost-utility analysis to inform the robotic technology’s cost-effectiveness compared to the laparoscopic approach in rectal cancer care. Our Canadian outcomes study included 67 patients who underwent robotic-assisted rectal and rectosigmoid cancer resection in Alberta’s first robotic colorectal surgery program. We found that the Alberta clinicopathologic results are comparable to existing international studies despite surgeons in the Alberta program being robotic novices at the start of the series. Robotic operating time decreased significantly as surgeon experience increased. We found four economic evaluations in the literature reporting on cost-effectiveness of robotic-assisted colorectal surgery. Two studies found it to be cost-effective whereas the other two found the contrary. Due to significant inter-study heterogeneity and contradicting results, there is no definitive conclusion to robotic cost-effectiveness without further research. Our cost-utility analysis found that robotic-assisted rectal cancer surgeon is cost-effective compared to the laparoscopic approach at a Canadian cancer care-specific cost-effectiveness threshold of CAD $100,000, assuming high case volumes on the robot. The wider adoption of robotic technology in Canadian rectal cancer care should be considered at high volume centres.Item Open Access Complications related to deep venous thrombosis prophylaxis in trauma: a systematic review of the literature(BioMed Central, 2010-01-06) Datta, Indraneel; Ball, Chad G.; Rudmik, Lucas; Hameed, S Morad; Kortbeek, John BItem Open Access Development and initial implementation of electronic clinical decision supports for recognition and management of hospital-acquired acute kidney injury(2020-11-04) Howarth, Megan; Bhatt, Meha; Benterud, Eleanor; Wolska, Anna; Minty, Evan; Choi, Kyoo-Yoon; Devrome, Andrea; Harrison, Tyrone G; Baylis, Barry; Dixon, Elijah; Datta, Indraneel; Pannu, Neesh; James, Matthew TAbstract Background Acute kidney injury (AKI) is common in hospitalized patients and is associated with poor patient outcomes and high costs of care. The implementation of clinical decision support tools within electronic medical record (EMR) could improve AKI care and outcomes. While clinical decision support tools have the potential to enhance recognition and management of AKI, there is limited description in the literature of how these tools were developed and whether they meet end-user expectations. Methods We developed and evaluated the content, acceptability, and usability of electronic clinical decision support tools for AKI care. Multi-component tools were developed within a hospital EMR (Sunrise Clinical Manager™, Allscripts Healthcare Solutions Inc.) currently deployed in Calgary, Alberta, and included: AKI stage alerts, AKI adverse medication warnings, AKI clinical summary dashboard, and an AKI order set. The clinical decision support was developed for use by multiple healthcare providers at the time and point of care on general medical and surgical units. Functional and usability testing for the alerts and clinical summary dashboard was conducted via in-person evaluation sessions, interviews, and surveys of care providers. Formal user acceptance testing with clinical end-users, including physicians and nursing staff, was conducted to evaluate the AKI order set. Results Considerations for appropriate deployment of both non-disruptive and interruptive functions was important to gain acceptability by clinicians. Functional testing and usability surveys for the alerts and clinical summary dashboard indicated that the tools were operating as desired and 74% (17/23) of surveyed healthcare providers reported that these tools were easy to use and could be learned quickly. Over three-quarters of providers (18/23) reported that they would utilize the tools in their practice. Three-quarters of the participants (13/17) in user acceptance testing agreed that recommendations within the order set were useful. Overall, 88% (15/17) believed that the order set would improve the care and management of AKI patients. Conclusions Development and testing of EMR-based decision support tools for AKI with clinicians led to high acceptance by clinical end-users. Subsequent implementation within clinical environments will require end-user education and engagement in system-level initiatives to use the tools to improve care.Item Open Access A multicenter review of deep venous thrombosis prophylaxis practice patterns for blunt hepatic trauma(BioMed Central, 2009-06) Datta, Indraneel; Ball, Chad G; Rudmik, Lucas R.; Paton-Gay, Damian; Bhayana, Deepak; Salat, Peter; Schieman, Colin; Smith, Dean F.; vanWijngaarden-Stephens, Mary; Kortbeek, John B.Item Open Access Ten years of major equestrian injury: are we addressing functional outcomes?(BioMed Central, 2009) Ball, Jill E; Ball, Chad G; Mulloy, Robert H; Datta, Indraneel; Kirkpatrick, Andrew W.