First-Year Medical Student (MS1)
Walter C MacKenzie Health Sciences Centre, University of Alberta
Edmonton, AB T6G 2R7
Master's Thesis
Cascade Health Service Use in the Families of Children with Cardiomyopathy: Implications for Health Technology Assessment
I earned an MSc in Health Services Research with a specialization in Health Technology Assessment (HTA) from the University of Toronto Institute of Health Policy, Management, and Evaluation (IHPME) in June 2020. While completing my MSc, I was also a research trainee at the Hospital for Sick Children (SickKids) in the department of Child Health Evaluative Sciences, and a member of the Technology Assessment at SickKids (TASK) Force.
My MSc research focused on health services and economic implications of genetic and genomic technologies in child health. My thesis explored the care and cost consequences of cascade genetic testing and clinical screening in the families of children with cardiomyopathy, and the implications of cascade effects for HTA methodology. You can read my thesis in full here.
Abstract
Background
Cardiomyopathy (CMP) is a genetically heterogeneous disease of the myocardium. Clinical practice guidelines recommend cascade genetic testing and clinical screening to relatives of affected individuals, however health technology assessment (HTA) does not account for these cascade effects.
Purpose
To report the pattern and costs of cascade health service use in relatives of children with CMP.
Methods
A retrospective cohort study was conducted among children with CMP who underwent genetic testing. A cost analysis of services offered to probands’ relatives was undertaken from the health care payer perspective.
Results
Data were available for relatives of 53 probands. The mean cost of offered cascade health services was $1,173 per family. Multiple one-way sensitivity and scenario analyses were undertaken to address uncertainty.
Conclusions
Quantifying cascade health services is essential to economic evaluation of emerging genetic technologies. Optimizing HTA methods for incorporating cascade effects will enhance economic evaluation of genomics for funding decisions.
Funding
My MSc studies were generally supported by:
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the Canadian Institutes of Health Research (CIHR) through a Canada Graduate Scholarships Master's Award (CGS-M);
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the Hospital for Sick Children (SickKids) through a Restracomp Master's Scholarship; and
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the Institute of Health Management, Policy, and Evaluation (IHPME) and the University of Toronto.
Meet My Committee
I am profoundly grateful for the mentorship, guidance, encouragement, kindness, and endless patience of my supervisor, Dr Wendy Ungar, and my committee member, Dr Robin Hayeems.
Wendy Ungar, PhD, MSc
Dr Ungar was primary supervisor. She holds the Canada Research Chair in Economic Evaluation and Technology Assessment in Child Health. Dr Ungar is a Professor in the Institute of Health Policy, Management, and Evaluation (IHPME) at the University of Toronto, and a Senior Scientist in Child Health Evaluative Sciences (CHES) at the SickKids Research Institute. She is an expert in the application of health technology assessment and health economics methods to paediatric populations.
Robin Hayeems, PhD, ScM
Dr Hayeems was my committee member. She holds the Canada Research Chair in Genomics and Health Policy. Dr Hayeems is an Associate Professor in the Institute of Health Policy, Management, and Evaluation (IHPME) at the University of Toronto, and a Scientist in Child Health Evaluative Sciences (CHES) at the SickKids Research Institute. She is trained in genetic counselling, and has expertise in public health, bioethics, health policy research, and health services research.