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This week at Open Medicine - new research

Posted Feb 02 2010 11:53am
  • Access to Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction in Canada: A Geographic Analysis. Alka Patel, Jack Tu, Nigel Waters, Dennis T. Ko, Mark Eisenberg, Thao Huynh, Stéphane Rinfret, Merril Knudtson and William Ghali

According to new research by Patel et al., published today in Open Medicine, approximately 64 percent of Canadian adults (age 40 and older) have access to primary percutaneous coronary intervention (PCI), a treatment for severe heart attacks, within 60 minutes. (In the U.S., 80 percent of adults have access to PCI within a similar time frame.) PCI, in which a balloon catheter is used to restore blood flow to the heart, is currently the recommended treatment for ST-segment elevated myocardial infarction (STEMI). The authors used geographic information systems and census data to estimate transit time to PCI facilities in Canada using ground transportation. They found that transit times vary greatly from province to province. In New Brunswick, for example, only 15 percent of adults age 40 and older have access to PCI in that time frame, while in Ontario that number is 73 percent. The study also evaluated how the addition of four hypothetical facilities would affect access. This research on geographic access to PCI has important mplications for policy makers creating regionalized care models for cardiac care.

This commentary discusses the policy implications of new research by Patel et al., using geographic information systems to estimate access to primary percutaneous coronary intervention (PCI), a technique used to manage severe heart attacks.

Late last year, the appointment of Bernard Prigent, vice-president of medical affairs at Pfizer Canada, to the governing council of the Canadian Institutes for Health Research (CIHR), generated much controversy and two hearings by a Standing Committee on Health of the House of Commons. In this editorial, the editors of Open Medicine present an official response from CIHR to a commentary and analysis piece by Steven Lewis, also published today in the journal.

  • Neoliberalism, conflict of interest, and the governance of health research in Canada. Steven Lewis, president, Access Consulting

Steven Lewis, a health policy consultant based in Saskatoon and a member of Open Medicine’s editorial board, criticizes the appoint of Bernard Prigent, vice-president of medical affairs at Pfizer Canada, to the governing council of the Canadian Institutes of Health Research. “More discouraging than the Prigent appointment in itself is the refusal of either government or the CIHR to acknowledge that the appointment raises even the possibility of conflict of interest,” he writes in a new commentary published today in Open Medicine. “It is one thing to make and defend a decision; it is quite another to refuse to recognize and substantively engage with the very real ethical issues at its core.”

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