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Systematic Reviews
Published in: Systematic Reviews 1/2019

Open Access 01-12-2019 | Care | Protocol

Inappropriateness of health care in Canada: a systematic review protocol

Authors: Janet E. Squires, Ian D. Graham, Doris Grinspun, John Lavis, France Légaré, Robert Bell, Stephen Bornstein, Susan E. Brien, Mark Dobrow, Megan Greenough, Carole A. Estabrooks, Michael Hillmer, Tanya Horsley, Alan Katz, Christina Krause, Wendy Levinson, Adrian Levy, Michelina Mancuso, Alies Maybee, Steve Morgan, Letitia Nadalin Penno, Andrew Neuner, Tamara Rader, Janet Roberts, Gary Teare, Joshua Tepper, Amanda Vandyk, Denise Widmeyer, Michael Wilson, Jeremy M. Grimshaw

Published in: Systematic Reviews | Issue 1/2019

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Abstract

Background

There is increasing recognition in Canada and globally that a substantial proportion of health care delivered is inappropriate as evidenced by (1) harmful and/or ineffective practices being overused, (2) effective clinical practices being underused, and (3) other clinical practices being misused. Inappropriate health care leads to negative patient experiences, poor health outcomes, and inefficient use of scarce health care resources. The purpose of this study is to conduct a systematic review of inappropriate health care in Canada. Our specific objectives are to (1) systematically search and critically review published and grey literature for studies on inappropriate health care in Canada; (2) estimate the nature and magnitude of inappropriate health care in Canada and its provincial and territorial jurisdictions.

Methods

We will include all quantitative study designs reporting objective or subjective measurements of inappropriate health care in Canada over the last 10 years. We will search the following online databases: MEDLINE, Cochrane Central Register of Controlled Trials, EconLit, and ISI-Web of Knowledge, which contains Web of Science Core Collection-Citation Indexes, Science Citation Index Expanded, Conference Proceedings Citation Index-Science, and Conference Proceedings Citation Index-Social Science & Humanities. We will also search grey literature sources to identify provincial and national audits of inappropriate health care. Two authors will independently screen, assess data quality, and extract data for synthesis. Study findings will be synthesized narratively. We will organize our data into three care categorizations: preventive care, acute care, and chronic care. We will provide a compendium of inappropriate health care for each care category for Canada and each Canadian province and territory, where sufficient data exists, by calculating (1) overall medians of underuse, overuse, and misuse of clinical practices and (2) the range of medians of underuse, overuse, and misuse for each clinical practice investigated.

Discussion

This review will result in the first-ever evidence-based compendium of inappropriate health care in Canada. We will also develop detailed reports of inappropriate health care for each Canadian province and territory.

Systematic review registration

Appendix
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Metadata
Title
Inappropriateness of health care in Canada: a systematic review protocol
Authors
Janet E. Squires
Ian D. Graham
Doris Grinspun
John Lavis
France Légaré
Robert Bell
Stephen Bornstein
Susan E. Brien
Mark Dobrow
Megan Greenough
Carole A. Estabrooks
Michael Hillmer
Tanya Horsley
Alan Katz
Christina Krause
Wendy Levinson
Adrian Levy
Michelina Mancuso
Alies Maybee
Steve Morgan
Letitia Nadalin Penno
Andrew Neuner
Tamara Rader
Janet Roberts
Gary Teare
Joshua Tepper
Amanda Vandyk
Denise Widmeyer
Michael Wilson
Jeremy M. Grimshaw
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
Systematic Reviews / Issue 1/2019
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-019-0948-1

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