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Rising awareness about the potential link between vitamin D deficiency and adverse health outcomes has seen an increase in the rate of vitamin D testing in developed countries. The cost of a single vitamin D test is moderate (e.g., $61.32 in British Colombia) but the elevated testing rate contributes to substantial healthcare costs. Concern over rising costs led to reform in testing coverage in 2010 in Ontario, followed by other provinces. The changes in Ontario were based on a 2010 report by the Ontario Health Technology Advisory Committee (OHTAC) on the clinical utility of vitamin D testing (reviewed in this report). Despite a lack of direct evidence on testing, a recommendation was made against providing testing for the general population. Tests are now indicated only for individuals with specific conditions (i.e., osteoporosis, rickets, osteomalacia, malabsorption syndromes, renal disease, and individuals taking medications that may affect vitamin D status). The Endocrine Society and Osteoporosis Canada also recommend against screening for low risk individuals. There is a lack of evidence to suggest that the rise in test frequency has translated into improved healthcare practices. For example, the temporal increase in testing in Australia has not resulted in improved osteoporosis detection in women aged 45 to 74. There is also a lack of evidence on the cost-effectiveness of testing. In light of the rise in test frequency, assay and cut-off inconsistency, and the lack of evidence for the utility of testing, this report will investigate the clinical and cost-effectiveness of testing in the general population.

Vitamin D Deficiency --- Vitamin D Deficiency --- Vitamin D --- Diagnostic Techniques and Procedures --- Cost-Benefit Analysis --- diagnosis. --- economics. --- analysis. --- economics. --- Canada

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Debridement is the removal of necrotic tissue, foreign debris, bacterial growth, callus, wound edge, and wound bed tissue from chronic wounds in order to stimulate the wound healing process. Stimulation of wound healing mediated by debridement is thought to occur by the conversion of a chronic non-healing wound environment to an acute healing environment through the removal of cells that are not responsive to endogenous healing stimuli. Debridement is used commonly in standard wound treatment of diabetic foot ulcers (DFUs). Methods of debridement include surgery (sharp debridement), chemical debridement (antiseptics, polysaccharide beads, pastes), autolytic (hydrogels, hydrocolloids and transparent films), biosurgery (maggots), mechanical (hydrodebridement), and biochemical debridement (enzyme preparations). Callus is a buildup of keratinized skin formed under conditions of repeated pressure or friction and may contribute to ulcer formation by creating focal areas of high plantar pressure. The debridement of callus has been proposed to be relevant for both treatment and prevention of DFU. The purpose of this report is to retrieve and review existing evidence of comparative clinical effectiveness of different methods of debridement for the treatment of DFUs. Additionally examined in this report is the clinical effectiveness for treatment and prevention of DFU using callus debridement. Cost-effectiveness, and existing debridement guidelines for the treatment of DFUs will also be reviewed.

Diabetic Foot --- Debridement --- Treatment Outcome --- Cost-Benefit Analysis --- surgery. --- economics. --- methods. --- Canada --- Foot --- Debridement. --- Diabetes --- Wireless communication systems --- Patient monitoring --- Foot Ulcer --- Diabetes Complications --- Chronic wound --- Clinical medicine --- Clinical trial --- Cohort study --- Diabetic foot ulcer --- Health --- Health care --- Health sciences --- Medical guideline --- Ulcers --- Complications --- Safety measures. --- Equipment and supplies. --- therapy.

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The purpose of this report is to review the available evidence on the clinical efficacy and safety of vaginally administered micronized progesterone capsules for the prevention of miscarriage and preterm birth.

Progesterone --- Progesterone --- Capsules --- Abortion, Spontaneous --- Premature Birth --- Treatment Outcome --- administration & dosage. --- therapeutic use. --- prevention & control. --- prevention & control. --- Canada

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Rising awareness about the potential link between vitamin D deficiency and adverse health outcomes has seen an increase in the rate of vitamin D testing in developed countries. The cost of a single vitamin D test is moderate (e.g., $61.32 in British Colombia) but the elevated testing rate contributes to substantial healthcare costs. Concern over rising costs led to reform in testing coverage in 2010 in Ontario, followed by other provinces. The changes in Ontario were based on a 2010 report by the Ontario Health Technology Advisory Committee (OHTAC) on the clinical utility of vitamin D testing (reviewed in this report). Despite a lack of direct evidence on testing, a recommendation was made against providing testing for the general population. Tests are now indicated only for individuals with specific conditions (i.e., osteoporosis, rickets, osteomalacia, malabsorption syndromes, renal disease, and individuals taking medications that may affect vitamin D status). The Endocrine Society and Osteoporosis Canada also recommend against screening for low risk individuals. There is a lack of evidence to suggest that the rise in test frequency has translated into improved healthcare practices. For example, the temporal increase in testing in Australia has not resulted in improved osteoporosis detection in women aged 45 to 74. There is also a lack of evidence on the cost-effectiveness of testing. In light of the rise in test frequency, assay and cut-off inconsistency, and the lack of evidence for the utility of testing, this report will investigate the clinical and cost-effectiveness of testing in the general population.

Vitamin D Deficiency --- Vitamin D Deficiency --- Vitamin D --- Diagnostic Techniques and Procedures --- Cost-Benefit Analysis --- diagnosis. --- economics. --- analysis. --- economics. --- Canada

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Pharmaceutical technology --- Medical tehnology --- Technology Assessment, Biomedical. --- Medical Laboratory Science. --- Technology, Pharmaceutical. --- Pharmaceutical technology. --- Evaluation --- Assessment, Biomedical Technology --- Assessment, Technology --- Biomedical Technology Assessment --- Technology Assessment --- Technology Assessment, Health --- Assessment, Health Technology --- Assessments, Biomedical Technology --- Assessments, Health Technology --- Assessments, Technology --- Biomedical Technology Assessments --- Health Technology Assessment --- Health Technology Assessments --- Technology Assessments --- Technology Assessments, Biomedical --- Technology Assessments, Health --- Pharmaceutical laboratory techniques --- Pharmaceutical laboratory technology --- Technology, Pharmaceutical --- Technology --- Pharmaceutic Technology --- Pharmaceutical Technology --- Pharmacy Technology --- Technology, Pharmaceutic --- Technology, Pharmacy --- Chemistry, Pharmaceutical --- Drug Industry --- Clinical Laboratory Science --- Medical Laboratory Technology --- Technology, Medical Laboratory --- Clinical Laboratory Sciences --- Laboratory Science, Clinical --- Laboratory Science, Medical --- Laboratory Sciences, Clinical --- Laboratory Sciences, Medical --- Laboratory Technologies, Medical --- Laboratory Technology, Medical --- Medical Laboratory Sciences --- Medical Laboratory Technologies --- Science, Clinical Laboratory --- Science, Medical Laboratory --- Sciences, Clinical Laboratory --- Sciences, Medical Laboratory --- Technologies, Medical Laboratory --- Medical Laboratory Personnel --- Clinical Laboratory Techniques --- Medical technology --- Evaluation. --- Canada. --- Health care technology --- Health technology