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Centre for Health Economics and Policy Analysis

Centre for Health Economics and Policy Analysis


CHEPA researchers have helped shape Canada’s health system for more than a quarter-century. They continue that tradition today, investigating pressing issues such as the relationship between doctors’ pay and health system costs; ethical concerns related to who gets what care and who has a say in it, and whether evidence supports the health decisions being made.

The centre was founded in 1988 by a group of health economics and health policy analysis pioneers -  Greg Stoddart, Jonathan Lomas, Roberta Labelle, David FeenyGeorge Torrance and Amiram Gafni - to be a multidisciplinary centre with research, teaching and service activities that provide timely and relevant evidence to inform policy-making at all levels of the health-care system.

It continues this tradition today, working at the intersection of the health and social sciences, evaluating how Ontario’s health system is performing and supporting the development of policies to enhance the system’s effectiveness and sustainability. Evidence about what works and what could be improved derives from the study of how well policies achieve their objectives and the consideration of values such as fairness and patient-centredness.

Using the tools of economics, sociology, political science and ethics, CHEPA researchers address issues such as:

  • Explaining and measuring the factors that cause social inequalities in health.
  • Finding the best ways to pay health-care providers and manage human resources to achieve higher quality and better outcomes for the money spent.
  • Researching the best methods for assessing new health technologies and treatments, as well as the social implications of these methods.
  • Assessing the roles of values and ethical considerations in health policy.
  • Using public and community engagement to learn about the health system.
  • Finding ways to support evidence-informed policymaking.

CHEPA’s knowledge exchange program, which uses multiple strategies for communicating and sharing information, ensures the knowledge generated through the work of its members is effectively communicated to health system decision-makers and other stakeholders. Collaboration with those who use the research ensures that CHEPA’s work meets the specific needs of these individuals and groups. Complementary initiatives, such as a rapid-response evidence service and training, enables health system leaders to identify and act on evidence and values in a timely way.

  • Personalizing Patient Care Under Uncertainty: Techniques to Inform Development of Clinical Guidelines and Treatment Choice

    A 2-Day Workshop by Professor Charles Manski

    April 11 (10am to 5pm, followed by an optional dinner) and April 12 (10am to 3pm), 2018 at McMaster Innovation Park, Hamilton, Ontario

    To register: Click here (workshop: $190 non-students; $50 for students. Optional dinner: $50 per person). This workshop is geared to PhDs, post-doctoral fellows, researchers, clinicians, health economists, statisticians, and others interested in statistical methods in healthcare.

    Course Objectives

    This is a 2-day course focussed on cutting edge statistical approaches that can be used to enhance the development of clinical guidelines and in informing treatment choice.

    Clinical research has favoured trial data because of the limited internal validity of observational studies.  Yet trials have methodological problems as well.  Small trial sizes limit subgroup specific conclusions for personalized care decisions of multimorbid patients. Extrapolation from trials to clinical practice may be difficult for multiple reasons. Partial identification analysis can address this challenge by providing reliable information on the range of treatment effect sets that are consistent with observational or trial data by considering all credible configurations of counterfactuals (i.e., the possible values of outcomes under alternative treatments).

    Dr. Charles ManskiProf. Charles Manski pioneered advances in partial identification across many policy applications. He is a superb speaker who can make technical information accessible to broad audiences. His recent work addresses opportunities to build further robustness and rigour into clinical decision-making in relation to patient care under uncertainty with applications to clinical guideline development, prognosis and treatment.

    Course topics to be covered include:

    - Review of psychological and economic research comparing evidence-based prediction with clinical judgment in personalized medicine

    - Critical appraisal of inappropriate extrapolation of results from trials and meta-analysis, and limitations of hypothesis testing for treatment decisions and power-based approaches to choosing trial sample size

    - Formal analysis of partial identification and extrapolation of treatment effects with experimental and observational data, including missing data problems

    - Formal analysis of decision under uncertainty with experimental and observational data, including discussion of optimal and reasonable decision criteria; rational expectations and subjective utility-based decisions; and decisions under ambiguity

    - Case study with course methods: nodal observation or dissection in treatment of melanoma

    - An adaptive diversification approach to public health policy which holds promise for reducing uncertainty over time, while fulfilling reasonable decision criteria in the present 

    Full story

  • CHEPA seminar to look at multimorbidity and polypharmacy implications

    Dr. Dee ManginThe context and implications of multimorbidity and polypharmacy for health care systems and patients will be addressed in a CHEPA seminar to be presented on February 21, 2018 by Dr. Dee Mangin, Professor and Associate Chair and Director of Research in McMaster University’s Faculty of Family Medicine.

    In her presentation, titled Policy, Performance and Polypharmacy, Dr. Mangin will also discuss the influences of policy and structures such as pay for performance, as well as potential policy issues, stakeholders and solutions.

    The seminar will take place on Wednesday, February 21, from 12:30 to 1:30 p.m. in CRL-B119. All are welcome to attend. If you are unable to attend in person you are welcome to participate remotely online, using WebEx. To join the seminar online, copy and paste the link below into your browser. The password is CHEPAseminar

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  • Professor Steve Birch to retire

    Stephen BirchSteve Birch, one of CHEPA’s long-time faculty members, “has left the building” and will officially retire on March 31, 2018.

    A professor in the Department of Health Research Methods, Evidence, and Impact (HEI) at McMaster University, Steve has won many awards and accolades and has hundreds of publications in peer-reviewed scientific journals. In the 2011 World Bank rankings of health economics researchers, he was ranked equal 1st in Canada and equal 35th in the world based on the volume and impact of his publications.  However, He says he is proudest of his collaborations with people, both colleagues and students.

    Full story


To read the Winter 2018 edition of the CHEPA newsletter, click here.

CHEPA Seminar Series

CHEPA sponsors a regular series of seminars during the academic year presented by invited speakers. For a schedule of future CHEPA seminars, click here.

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