Douglas G Manuel
Biographic Data
| ID | 5408219 |
|---|---|
| NAME | Douglas G Manuel |
| GIVEN NAMES | Douglas G |
| FAMILY NAME | Manuel |
| SIGNATURE | MANUEL D G |
| AFFILIATIONS | Institute for Clinical Evaluative Sciences |
| ORCID | 0000-0003-0912-0845 |
| VERIFIED | Yes |
| TOTAL WORKS | 43 |
| TOTAL CITATIONS | 79 |
| AUTHOR COUNT | 43 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1999 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 6 |
Empowering Older Patients in Advance Care Planning: Evaluating MyCareTM as a Decision Support Tool
BACKGROUND: Older adults with serious illness often face treatment decisions shaped by personal values, yet recognising and expressing those values in ways that guide decision-making can be challenging. This study evaluated the acceptability, usability and effectiveness of MyCare, a digital values clarification tool designed to help older adults identify and communicate their care preferences to substitute decision-makers, healthcare providers an…
City-wide built environment Sars-CoV-2 detection for Covid-19 surveillance
Built environment surveillance has shown promise for monitoring COVID-19 burden at granular geographic scales, but its utility for surveillance across larger areas and populations is unknown. Our study aims to evaluate the role of built environment detection of SARS-CoV-2 for the surveillance of COVID-19 across broad geographies and populations. We conducted a prospective city-wide sampling study to examine the relationship between SARS-CoV-2 on …
Key features of programs that integrate informal care: Considerations for a people-integrated care system
Background: Formal health care systems alone are insufficient to address patients needs for overall health and wellness over the life course. Over 90% of the care people receive is informal. Gaps of most concern include practical support, self-care, social relationships, and activities. Therefore, to scale solutions at a population level, there is a need to understand key features that support integrating informal and formal care across social, m…
Minimum Legal Age of Nonmedical Cannabis Purchase Laws and Cannabis-Related Hospitalizations in Canada, 2015 to 2022
Objectives. To determine whether the minimum legal age (MLA) for cannabis purchases is associated with reductions in cannabis-related hospitalizations in youths. Methods. We performed a population-based study examining all hospitalizations for cannabis use in Canada for individuals aged 15 to 44 years (n = 14.6 million in 2018) between January 1, 2015, and March 31, 2022. MLAs varied across Canada. We used a controlled interrupted time series des…
Potential value streams of an integrated Canadian serosurveillance network
The equitable impact of sugary drink taxation structures on sugary drink consumption among Canadians: A modelling study using the 2015 Canadian Community Health Survey-Nutrition
Objective: Estimate the impact of 20 % flat-rate and tiered sugary drink tax structures on the consumption of sugary drinks, sugar-sweetened beverages and 100 % juice by age, sex and socio-economic position. Design: We modelled the impact of price changes – for each tax structure – on the demand for sugary drinks by applying own- and cross-price elasticities to self-report sugary drink consumption measured using single-day 24-h dietary recalls fr…
Trends in outpatient and inpatient visits for separate ambulatory-care-sensitive conditions during the first year of the Covid-19 pandemic: A province-based study
Background: The COVID-19 pandemic led to global disruptions in non-urgent health services, affecting health outcomes of individuals with ambulatory-care-sensitive conditions (ACSCs). Methods: We conducted a province-based study using Ontario health administrative data (Canada) to determine trends in outpatient visits and hospitalization rates (per 100,000 people) in the general adult population for seven ACSCs during the first pandemic year (Marc…
Comparison of mortality hazard ratios associated with health behaviours in Canada and the United States: A population-based linked health survey study
Even when methodological and population differences are minimal, the association of health behaviours and mortality can vary across populations. It is therefore important to be cautious of between-study variation when aggregating relative effect estimates from differing populations, and when using external effect estimates for population health research and policy development
Socioeconomic position and consumption of sugary drinks, sugar-sweetened beverages and 100% juice among Canadians: A cross-sectional analysis of the 2015 Canadian Community Health Survey–Nutrition
Social inequities in sugary drink consumption exist in Canada. The associations differed by SEP indicator. Equitable interventions to reduce consumption are warranted
Development and validation of a predictive algorithm for risk of dementia in the community setting
BACKGROUND: Most dementia algorithms are unsuitable for population-level assessment and planning as they are designed for use in the clinical setting. A predictive risk algorithm to estimate 5-year dementia risk in the community setting was developed. METHODS: The Dementia Population Risk Tool (DemPoRT) was derived using Ontario respondents to the Canadian Community Health Survey (survey years 2001 to 2012). Five-year incidence of physician-diagn…
Places of death and places of care for Indigenous Peoples in Ontario: A retrospective cohort study
Cchsflow: An open science approach to transform and combine population health surveys
The cchsflow package has been added to the Comprehensive R Archive Network (CRAN) and contains support for over 160 CCHS variables, generating a combined data set of over 1 million respondents. By implementing open science practices, cchsflow aims to minimize the amount of time needed to clean and prepare data for the many CCHS users across Canada
The relationship between depression risk perception and self-help behaviours in high risk Canadians: A cross-sectional study
Prospectively registered at ClinicalTrials.gov (NCT02943876) as of 10/21/16
The Canadian Health Clock and health calculators
SETTING: This paper documents a participatory process of Health Portfolio staff in the design of a clock, and announces the 2020 Canadian Health Clock, with links to numerous online health calculators. The clock is part of the Health Portfolio's celebration activities in 2019 of "100 Years of Health", as the Department of Health was established in Canada in 1919. INTERVENTION: The intervention was the development of a clock on the Government of C…
A 15-Year Population-Based Investigation of Sexual Assault Cases Across the Province of Ontario, Canada, 2002–2016
Objectives. To estimate the population-level frequencies and standardized rates of sexual assault cases in the province of Ontario, Canada. Methods. We conducted a 15-year retrospective analysis (2002–2016) of sexual assault cases by linking 5 provincial administrative health databases. We defined sexual assault by an algorithm of 23 International Classification of Diseases, 10th Revision, and physician billing codes. We calculated age- and sex-s…
Municipal transportation policy as a population health intervention: Estimating the impact of the City of Ottawa Transportation Master Plan on diabetes incidence
Predicting High Health Care Resource Utilization in a Single-payer Public Health Care System: Development and Validation of the High Resource User Population Risk Tool
BACKGROUND: A large proportion of health care spending is incurred by a small proportion of the population. Population-based health planning tools that consider both the clinical and upstream determinants of high resource users (HRU) of the health system are lacking. OBJECTIVE: To develop and validate the High Resource User Population Risk Tool (HRUPoRT), a predictive model of adults that will become the top 5% of health care users over a 5-year …
Simulation modeling to enhance population health intervention research for chronic disease prevention
Association of Neighborhood Walkability With Change in Overweight, Obesity, and Diabetes
IMPORTANCE: Rates of obesity and diabetes have increased substantially in recent decades; however, the potential role of the built environment in mitigating these trends is unclear. OBJECTIVE: To examine whether walkable urban neighborhoods are associated with a slower increase in overweight, obesity, and diabetes than less walkable ones. DESIGN, SETTING, AND PARTICIPANTS: Time-series analysis (2001-2012) using annual provincial health care (N ≈ …
Do Rural Patients in Canada Underutilize Preventive Care for Myocardial Infarction
PURPOSE: The objective of this study was to explore Canadian rural-urban differences in the use of primary and secondary preventive diagnostic services for acute myocardial infarction (AMI)-a condition that is amenable to primary health care prevention efforts. METHODS: We examined primary and secondary preventive care services utilized 2 years prior to a patient's first AMI in a cohort of 30,491 patients in Ontario, Canada, from 2010 to 2012. Us…
Effectiveness of a hospital-initiated smoking cessation programme: 2-Year Health and Healthcare Outcomes
Considering the relatively low cost, greater adoption of hospital-initiated tobacco cessation interventions should be considered to improve patient outcomes and decrease subsequent healthcare usage
A cross-sectional, population-based study measuring comorbidity among people living with HIV in Ontario
People living with HIV in Ontario, especially women, had higher prevalence of comorbidity and multimorbidity than the general population. Quantifying this morbidity at the population level can help inform healthcare delivery requirements for this complex population
Economic evaluation of a hospital-initiated intervention for smokers with chronic disease, in Ontario, Canada
The OMSC appears to be cost-effective from the hospital payer perspective. Important consideration is the relatively low intervention cost compared to the reduction in costs related to readmissions for illnesses associated with continued smoking
Reducing social inequalities in health: The role of simulation modelling in chronic disease epidemiology to evaluate the impact of population health interventions
Reducing health inequalities has become a major public health priority internationally. However, how best to achieve this goal is not well understood. Population health intervention research has the potential to address some of this knowledge gap. This review argues that simulation studies can produce unique evidence to build the population health intervention research evidence base on reducing social inequalities in health. To this effect, the a…
Ascertainment of chronic diseases using population health data: A comparison of health administrative data and patient self-report
In the general population, discordance between self-report and administrative data was large for many chronic diseases, particularly disease with low prevalence, and differences were not easily explained by individual and disease characteristics
Avoidable mortality by neighbourhood income in Canada: 25 Years After the Establishment of Universal Health Insurance
Aim: To examine neighbourhood income differences in deaths amenable to medical care and public health over a 25-year period after the establishment of universal insurance for doctors and hospital services in Canada. Methods: Data for census metropolitan areas were obtained from the Canadian Mortality Database and population censuses for the years 1971, 1986, 1991 and 1996. Deaths amenable to medical care, amenable to public health, from ischaemic…
New Approaches to Immigrant Health Assessment
Avoidable Mortality in the United States and Canada, 1980–1996
A number of measures are currently used to evaluate health care performance for populations. Most measures focus on components of economic efficiency, medical efficacy, social acceptability, and organizational structure.1–4 Because of a lack of relevant data, health care outcomes are infrequently evaluated. Also, the relationship between health outcomes and health care is often obscured by various genetic, social, and environmental factors that, …
Predictive risk algorithms in a population setting: An overview
BACKGROUND: The widespread use of risk algorithms in clinical medicine is testimony to how they have helped transform clinical decision-making. Risk algorithms have a similar but underdeveloped potential to support decision-making for population health. OBJECTIVE: To describe the role of predictive risk algorithms in a population setting. METHODS: First, predictive risk algorithms and how clinicians use them are described. Second, the population …
A population-based risk algorithm for the development of diabetes: Development and validation of the Diabetes Population Risk Tool (DPoRT)
BACKGROUND: National estimates of the upcoming diabetes epidemic are needed to understand the distribution of diabetes risk in the population and to inform health policy. OBJECTIVE: To create and validate a population-based risk prediction tool for incident diabetes using commonly collected national survey data. METHODS: With the use of a cohort design that links baseline risk factors to a validated population-based diabetes registry, a model (Di…
Measuring the health burden of chronic disease and injury using health adjusted life expectancy and the Health Utilities Index
Objectives: To estimate the burden of illness from chronic disease and injury using a population based health survey, which contains both measures of chronic disease and a utility based health related quality of life (HRQOL) measure. Design: An adapted Sullivan method was used to calculate cause deleted health adjusted life expectancies for chronic conditions. Setting: Ontario, Canada, 1996/97. Subjects: The 1996/97 Ontario Health Survey (n=35 52…
Socioeconomic position and consumption of sugary drinks, sugar-sweetened beverages and 100% juice among Canadians: A cross-sectional analysis of the 2015 Canadian Community Health Survey–Nutrition
Social inequities in sugary drink consumption exist in Canada. The associations differed by SEP indicator. Equitable interventions to reduce consumption are warranted
Municipal transportation policy as a population health intervention: Estimating the impact of the City of Ottawa Transportation Master Plan on diabetes incidence
The role of ethnicity in predicting diabetes risk at the population level
Although from the individual risk perspective, incorporating information on ethnicity is important, when predicting new cases of diabetes at the population level and accounting for other risk factors, detailed ethnic information did not improve the discrimination and accuracy of the model or identify significantly more diabetes cases in the population
Recent Trends in Provincial Life Expectancy
The First Reported Cluster of Food-borne Cyclosporiasis in Canada
Life Expectancy at Birth at the Local Level in Ontario
Recent Trends in Provincial Life Expectancy
Measuring the health burden of chronic disease and injury using health adjusted life expectancy and the Health Utilities Index
Objectives: To estimate the burden of illness from chronic disease and injury using a population based health survey, which contains both measures of chronic disease and a utility based health related quality of life (HRQOL) measure. Design: An adapted Sullivan method was used to calculate cause deleted health adjusted life expectancies for chronic conditions. Setting: Ontario, Canada, 1996/97. Subjects: The 1996/97 Ontario Health Survey (n=35 52…
Avoidable Mortality in the United States and Canada, 1980–1996
A number of measures are currently used to evaluate health care performance for populations. Most measures focus on components of economic efficiency, medical efficacy, social acceptability, and organizational structure.1–4 Because of a lack of relevant data, health care outcomes are infrequently evaluated. Also, the relationship between health outcomes and health care is often obscured by various genetic, social, and environmental factors that, …
Manuel and Mao
We wholeheartedly agree with Clark and Shinoda-Tagawa that injuries are an important source of “avoidable mortality.” Injuries, along with tobacco-related causes of death, are arguably the most important source of deaths that could be avoided by the public health care system. Injury and lung cancer death rates, like death rates for most other avoidable causes, have been decreasing in both Canada and the United States, but the rates are lower in C…
New Approaches to Immigrant Health Assessment
Afterword
Socioeconomic status and non-fatal injuries among Canadian adolescents: Variations across SES and injury measures
The results suggest that differences related to the measures of SES chosen and the causes of injury under study may both contribute to discrepancies in past research on SES and non-fatal injuries among adolescents. To clarify the potential SES-injury relationship among youth, the findings emphasize a need for a greater understanding of the meaning and relevance of different SES measures for adolescents, and for an exploration of the pathways thro…
Avoidable mortality across Canada from 1975 to 1999
The regional differences in mortality for ages less than 65 years was attributable to causes of death amenable to medical care and public health, especially from causes responsive to public health
How many people have had a myocardial infarction? Prevalence estimated using historical hospital data
Estimating myocardial infarction prevalence using a limited number of years of hospital data is feasible, and validity increases when unobserved events are added to observed events. The "back tracing" method is simple, reliable, and produces a myocardial infarction registry with high estimated "completeness" for jurisdictions with linked hospital data
Avoidable mortality by neighbourhood income in Canada: 25 Years After the Establishment of Universal Health Insurance
Aim: To examine neighbourhood income differences in deaths amenable to medical care and public health over a 25-year period after the establishment of universal insurance for doctors and hospital services in Canada. Methods: Data for census metropolitan areas were obtained from the Canadian Mortality Database and population censuses for the years 1971, 1986, 1991 and 1996. Deaths amenable to medical care, amenable to public health, from ischaemic…
Health Impact of Hospital Restrictions on Seriously Ill Hospitalized Patients: Lessons From the Toronto Sars Outbreak
BACKGROUND: Restrictions on non-urgent hospital care imposed to control the 2003 Toronto severe acute respiratory syndrome outbreak led to substantial disruptions in hospital clinical practice, admission, and transfer patterns. OBJECTIVES: We assessed whether there were unintended health consequences to seriously ill hospitalized patients. STUDY DESIGN, SETTING, AND POPULATION: Population-based longitudinal cohort study of patients residing in To…
The effectiveness and efficiency of diabetes screening in Ontario, Canada: A population-based cohort study
Diabetes screening was high in this population-based cohort of Ontarians. Screening efficiency varied considerably in the population. Undiagnosed diabetes continues to be prevalent and remains concentrated in the highest risk groups for diabetes, especially among men
A population-based risk algorithm for the development of diabetes: Development and validation of the Diabetes Population Risk Tool (DPoRT)
BACKGROUND: National estimates of the upcoming diabetes epidemic are needed to understand the distribution of diabetes risk in the population and to inform health policy. OBJECTIVE: To create and validate a population-based risk prediction tool for incident diabetes using commonly collected national survey data. METHODS: With the use of a cohort design that links baseline risk factors to a validated population-based diabetes registry, a model (Di…
The role of ethnicity in predicting diabetes risk at the population level
Although from the individual risk perspective, incorporating information on ethnicity is important, when predicting new cases of diabetes at the population level and accounting for other risk factors, detailed ethnic information did not improve the discrimination and accuracy of the model or identify significantly more diabetes cases in the population
Predictive risk algorithms in a population setting: An overview
BACKGROUND: The widespread use of risk algorithms in clinical medicine is testimony to how they have helped transform clinical decision-making. Risk algorithms have a similar but underdeveloped potential to support decision-making for population health. OBJECTIVE: To describe the role of predictive risk algorithms in a population setting. METHODS: First, predictive risk algorithms and how clinicians use them are described. Second, the population …
On-time Vaccination Coverage in Premature Infants in Ontario, 2002–2009
Ascertainment of chronic diseases using population health data: A comparison of health administrative data and patient self-report
In the general population, discordance between self-report and administrative data was large for many chronic diseases, particularly disease with low prevalence, and differences were not easily explained by individual and disease characteristics
A cross-sectional, population-based study measuring comorbidity among people living with HIV in Ontario
People living with HIV in Ontario, especially women, had higher prevalence of comorbidity and multimorbidity than the general population. Quantifying this morbidity at the population level can help inform healthcare delivery requirements for this complex population
Economic evaluation of a hospital-initiated intervention for smokers with chronic disease, in Ontario, Canada
The OMSC appears to be cost-effective from the hospital payer perspective. Important consideration is the relatively low intervention cost compared to the reduction in costs related to readmissions for illnesses associated with continued smoking
Reducing social inequalities in health: The role of simulation modelling in chronic disease epidemiology to evaluate the impact of population health interventions
Reducing health inequalities has become a major public health priority internationally. However, how best to achieve this goal is not well understood. Population health intervention research has the potential to address some of this knowledge gap. This review argues that simulation studies can produce unique evidence to build the population health intervention research evidence base on reducing social inequalities in health. To this effect, the a…
Association of Neighborhood Walkability With Change in Overweight, Obesity, and Diabetes
IMPORTANCE: Rates of obesity and diabetes have increased substantially in recent decades; however, the potential role of the built environment in mitigating these trends is unclear. OBJECTIVE: To examine whether walkable urban neighborhoods are associated with a slower increase in overweight, obesity, and diabetes than less walkable ones. DESIGN, SETTING, AND PARTICIPANTS: Time-series analysis (2001-2012) using annual provincial health care (N ≈ …
Do Rural Patients in Canada Underutilize Preventive Care for Myocardial Infarction
PURPOSE: The objective of this study was to explore Canadian rural-urban differences in the use of primary and secondary preventive diagnostic services for acute myocardial infarction (AMI)-a condition that is amenable to primary health care prevention efforts. METHODS: We examined primary and secondary preventive care services utilized 2 years prior to a patient's first AMI in a cohort of 30,491 patients in Ontario, Canada, from 2010 to 2012. Us…
Effectiveness of a hospital-initiated smoking cessation programme: 2-Year Health and Healthcare Outcomes
Considering the relatively low cost, greater adoption of hospital-initiated tobacco cessation interventions should be considered to improve patient outcomes and decrease subsequent healthcare usage
Medicine (38 works) · Environmental health (29 works) · Population (26 works) · Demography (20 works) · Gerontology (20 works) · Public health (16 works) · Gerontology (15 works) · Health disparities and outcomes (11 works) · Demography (10 works) · Health care (10 works)