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Evidence to Improve Care

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The following evidence-based analyses and Ontario Health Technology Advisory Committee (OHTAC) recommendations are open for professional and public comment.

While feedback is welcome at any time, only those received within the 21 day consultation period will be considered for inclusion in final reports and recommendations.

Magnetic Resonance Imaging as an Adjunct to Mammography for Breast Cancer Screening in Women at Less Than High Risk for Breast Cancer


Health Quality Ontario Shares Recommendations From the Ontario Health Technology Advisory Committee


  • The Ontario Health Technology Advisory Committee recommends against publicly funding magnetic resonance imaging (MRI) as an adjunct to mammography for breast cancer screening in women who are at less than high risk for breast cancer and who have no personal history of breast cancer

Background

Breast cancer is the most common cancer among Canadian women.

The most common form of screening for breast cancer is mammography (an x-ray of the breast), which can detect breast cancer early, before clinical symptoms appear. However, mammography alone may miss breast cancer in some women. Magnetic resonance imaging (MRI), an imaging tool that uses magnetic fields and radio waves, may be able to detect breast cancers missed by mammography.

Screening with both mammography and MRI is currently recommended for women at high risk for breast cancer.


Health Quality Ontario Reviews Magnetic Resonance Imaging as an Adjunct to Mammography for Breast Cancer Screening in Women at Less Than High Risk for Breast Cancer

Although adding MRI screening to mammography may detect more cancers, it may also increase the frequency of false-positive test results (test results that show a woman has breast cancer when she does not). False-positive test results can lead to anxiety and unnecessary follow-up testing.

The Health Quality Ontario review looked at the impact of MRI as an adjunct test to mammography for breast cancer screening in women at less than high risk for breast cancer.



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Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) – a standing sub-committee of the Health Quality Ontario board of directors – reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.




Transcatheter Aortic Valve Implantation for Treatment of Aortic Valve Stenosis


Ontario Health Technology Advisory Committee Recommendation


  • The Ontario Health Technology Advisory Committee recommends that transcatheter aortic valve implantation be publicly funded in patients with severe symptomatic degenerative aortic valve stenosis:

    • Who are not candidates for surgical aortic valve replacement or

    • Who have an estimated risk of mortality of 8% or greater within 30 days of surgery, as determined by a multidisciplinary cardiac team after evaluating the patient’s Society of Thoracic Surgeons risk assessment score and other patient characteristics.

  • The Ontario Health Technology Advisory Committee recommends that transcatheter aortic valve implantation be offered only in selected hospitals, as determined by the Cardiac Care Network of Ontario.

Background

The aortic valve is one of four valves in the heart. Blood flows through the aortic valve when it is pumped from the left ventricle of the heart into the aorta (the main artery in the body). Aortic valve stenosis occurs if the valve narrows and cannot open all the way, partially blocking the flow of blood out of the heart. Severe aortic valve stenosis is a life-threatening condition that can lead to death, usually from heart failure.


Health Quality Ontario Reviews Transcatheter Aortic Valve Implantation

The diseased aortic valve can be removed and replaced with an artificial valve, but doing this involves open-heart surgery. Transcatheter aortic valve implantation, or TAVI, is a newer procedure. In most cases, cardiologists make a small opening in an artery near the groin to insert a catheter to deliver and implant the new valve. We reviewed the evidence that compared TAVI with surgical aortic valve replacement.


  Submit Feedback  


Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee (OHTAC) – a standing sub-committee of the Health Quality Ontario board of directors – reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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