What We Do

Team members: Dr. Mathew Grandy (PI), Beverley Lawson, Sarah Sabri, Ingrid Sketris, Heather Neville, Virginia McIntyre, Isaac Bai

This is a local project led by Dr. Mathew Grandy to validate a case definition for chronic opioid use within primary care EMR data. Following this we will do descriptive work, applying the definition to the provincial MaRNet-FP data set with the hope that we can eventually aid in informing practitioners about high-risk patients in their practices and long-term risk reduction for these patients.

Team members: Dr. Fred Burge (PI), Dr. Anders Lenskjold (Co-PI), Dr. Emily Marshall, Sarah Sabri, Dr. Mathew Grandy, Dr. Joanna Zed, Erin Christian, Matt Holland, Juanna Ricketts

We are analyzing EMR data collected before and during the pandemic from MaRNet-FP participants to understand patient visit patterns and how they’ve changed over the last year. Not only will we use standard statistical descriptions, but we are excited, that for the first time, we will be using machine learning to identify characteristics of patients at risk who were not previously meeting this categorization. The results will shed light on the type of patients seen in-person or virtually and those who were not seen by their primary care provider. The overarching goal of this study is to deliver the best possible care to at-risk patients in Nova Scotia. The results of the study are expected to be published in the spring of 2021.

Team members: Dr. Fred Burge, Dr. Anders Lenskjold, Dr. Samina Abidi, Dr. Raza Abidi, Dr. Mathew Grandy.

Diagnostic overtesting is not always beneficial for patients or providers. For patients, there is the potential to do more harm by labelling and overtreating them with further unnecessary health services. For the provider, possible overuse of health services may reduce availability for other patients. Thyroid Stimulating Hormone (TSH) testing is among “Choosing Wisely Canada’s” list of “Thirteen Things Physicians and Patients Should Question”. For his master’s thesis study, Dr. Anders Lenskjold will use MaRNet-FP data to explore the extent of TSH testing, its possible overuse, and the consequences in Nova Scotia for patients and primary care providers.

Team members: Dr. Helena Piccinini-Vallis (PI), Dr. Pantelis Andreou (Co-I), Dr. Lynn Bussey (Co-I), Dr. Jillian Coolen (Co-I), Dr. Matt Grandy (Co-I), Leanne MacKeen (Co-I)

This study, led by Dr. Helena Piccinini-Vallis, is novel in Nova Scotia and Canada. It will pioneer the systematic extraction of prenatal data from primary care EMRs containing prenatal and postpartum data that represent the continuity of care during women’s reproductive years as is typical in primary care. Such a platform could contribute to a robust knowledge base in the area of maternity care, with the potential for regional (Maritime provinces) and national expansion and collaborations leading to improvements in the delivery of primary maternity health care. As a secondary objective, this study also expands the relatively unchartered territory of linking the Nova Scotia Atlee Perinatal Database with the primary care platform developed through this study. The study aligns with the chronic disease priority of Nova Scotia Health on many levels, as it pertains to the diagnosis and management of a precursor of chronic disease (GDM), the diagnosis of a chronic disease (type 2 diabetes), and the prevention of another chronic disease (downstream childhood obesity). Further, the results of this study are potentially of particular relevance to African Nova Scotians and Indigenous Peoples of Nova Scotia, who experience very disproportionate rates of GDM, type 2 diabetes, and obesity (including childhood obesity). 

Team members: Dr. Olga Theou (Co-PI), Dr. Barry Clarke (Co-PI), Susan Savage (Co-I), Dr. Melissa Andrew (Co-I), Dr. Fred Burge (Co-I), Melissa Buckler (Co-I), Dr. Valerie Lewis (Co-I), Dr. Emily Marshall (Co-I), Dr. Kenneth Rockwood (Co-I), Dr. Grace Warner (Co-I), Dr. Mary Gorman (Co-I), Dr. Elaine Moody (Co-I), Dr. Grace Park (Co-I), Dr. Xiaowei Song (Co-I), Dr. Jaymi Cormier, Beverley Lawson, Lynn Edwards, Lisa Bedford, Ron Swan, Dr. Olive Bryanton

Dr. Sabrina Wong from the University of British Columbia led this project. The aim of this research was to create and validate a case definition of frailty using primary care EMR data. Locally we recruited practices to help validate this case definition by applying the Rockwood clinical frailty scale to a number of their patients. Once the initial validation work was completed, we utilized machine learning to help hone the definition in the hopes that we would be able to translate this finding into a tool that allows for better identification of frail patients for early intervention and health service planning. The project has been submitted for publication and should be published later this year.