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Dive into the research topics where David R. Urbach is active.

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Featured researches published by David R. Urbach.


The Journal of Urology | 2010

Increasing Hospital Admission Rates for Urological Complications After Transrectal Ultrasound Guided Prostate Biopsy

Robert K. Nam; Refik Saskin; Yuna Lee; Ying Liu; Calvin Law; Laurence Klotz; D. Andrew Loblaw; John Trachtenberg; Aleksandra Stanimirovic; Andrew Simor; Arun Seth; David R. Urbach; Steven A. Narod

PURPOSE Transrectal ultrasound guided prostate biopsy is widely used to confirm the diagnosis of prostate cancer. The technique has been associated with significant morbidity in a small proportion of patients. MATERIALS AND METHODS We conducted a population based study of 75,190 men who underwent a transrectal ultrasound guided biopsy in Ontario, Canada, between 1996 and 2005. We used hospital and cancer registry administrative databases to estimate the rates of hospital admission and mortality due to urological complications associated with the procedure. RESULTS Of the 75,190 men who underwent transrectal ultrasound biopsy 33,508 (44.6%) were diagnosed with prostate cancer and 41,682 (55.4%) did not have prostate cancer. The hospital admission rate for urological complications within 30 days of the procedure for men without cancer was 1.9% (781/41,482). The 30-day hospital admission rate increased from 1.0% in 1996 to 4.1% in 2005 (p for trend <0.0001). The majority of hospital admissions (72%) were for infection related reasons. The probability of being admitted to hospital within 30 days of having the procedure increased 4-fold between 1996 and 2005 (OR 3.7, 95% CI 2.0-7.0, p <0.0001). The overall 30-day mortality rate was 0.09% but did not change during the study period. CONCLUSIONS The hospital admission rates for complications following transrectal ultrasound guided prostate biopsy have increased dramatically during the last 10 years primarily due to an increasing rate of infection related complications.


The New England Journal of Medicine | 2014

Introduction of surgical safety checklists in Ontario, Canada.

David R. Urbach; Anand Govindarajan; Refik Saskin; Andrew Wilton; Nancy N. Baxter; Abstr Act

BACKGROUND Evidence from observational studies that the use of surgical safety checklists results in striking improvements in surgical outcomes led to the rapid adoption of such checklists worldwide. However, the effect of mandatory adoption of surgical safety checklists is unclear. A policy encouraging the universal adoption of checklists by hospitals in Ontario, Canada, provided a natural experiment to assess the effectiveness of checklists in typical practice settings. METHODS We surveyed all acute care hospitals in Ontario to determine when surgical safety checklists were adopted. Using administrative health data, we compared operative mortality, rate of surgical complications, length of hospital stay, and rates of hospital readmission and emergency department visits within 30 days after discharge among patients undergoing a variety of surgical procedures before and after adoption of a checklist. RESULTS During 3-month periods before and after adoption of a surgical safety checklist, a total of 101 hospitals performed 109,341 and 106,370 procedures, respectively. The adjusted risk of death during a hospital stay or within 30 days after surgery was 0.71% (95% confidence interval [CI], 0.66 to 0.76) before implementation of a surgical checklist and 0.65% (95% CI, 0.60 to 0.70) afterward (odds ratio, 0.91; 95% CI, 0.80 to 1.03; P=0.13). The adjusted risk of surgical complications was 3.86% (95% CI, 3.76 to 3.96) before implementation and 3.82% (95% CI, 3.71 to 3.92) afterward (odds ratio, 0.97; 95% CI, 0.90 to 1.03; P=0.29). CONCLUSIONS Implementation of surgical safety checklists in Ontario, Canada, was not associated with significant reductions in operative mortality or complications. (Funded by the Canadian Institutes of Health Research.).


BMJ | 2006

Bias in published cost effectiveness studies: systematic review

Chaim M. Bell; David R. Urbach; Joel G. Ray; Ahmed Bayoumi; Allison B. Rosen; Dan Greenberg; Peter J. Neumann

Abstract Objective To investigate if published studies tend to report favourable cost effectiveness ratios (below


Journal of Clinical Oncology | 2013

Metformin Use and All-Cause and Prostate Cancer-Specific Mortality Among Men With Diabetes

David Margel; David R. Urbach; Lorraine L. Lipscombe; Chaim M. Bell; Girish Kulkarni; Peter C. Austin; Neil Fleshner

20 000,


JAMA | 2011

Association of ICU or Hospital Admission With Unintentional Discontinuation of Medications for Chronic Diseases

Chaim M. Bell; Stacey Brener; Nadia Gunraj; Cindy Huo; Arlene S. Bierman; Damon C. Scales; Jana Bajcar; Merrick Zwarenstein; David R. Urbach

50 000, and


BMJ | 2004

Does it matter what a hospital is “high volume” for? Specificity of hospital volume-outcome associations for surgical procedures: analysis of administrative data

David R. Urbach; Nancy N. Baxter

100 000 per quality adjusted life year (QALY) gained) and evaluate study characteristics associated with this phenomenon. Design Systematic review. Studies reviewed 494 English language studies measuring health effects in QALYs published up to December 2001 identified using Medline, HealthSTAR, CancerLit, Current Content, and EconLit databases. Main outcome measures Incremental cost effectiveness ratios measured in dollars set to the year of publication. Results Approximately half the reported incremental cost effectiveness ratios (712 of 1433) were below


Annals of Surgical Oncology | 2005

Extent of Thyroidectomy Is Not a Major Determinant of Survival in Low- or High-Risk Papillary Thyroid Cancer

Philip I. Haigh; David R. Urbach; Lorne Rotstein

20 000/QALY. Studies funded by industry were more likely to report cost effectiveness ratios below


Diseases of The Colon & Rectum | 1998

Bowel resection for Intestinal endometriosis

David R. Urbach; Carole S. Richard; Ki Lie; Theodore M. Ross

20 000/QALY (adjusted odds ratio 2.1, 95% confidence interval 1.3 to 3.3),


Journal of Neurosurgery | 2009

Shunt-dependent hydrocephalus after aneurysmal subarachnoid hemorrhage: incidence, predictors, and revision rates. Clinical article.

Cian J. O'Kelly; Abhaya V. Kulkarni; Peter C. Austin; David R. Urbach; M. Christopher Wallace

50 000/QALY (3.2, 1.8 to 5.7), and


Journal of The American College of Surgeons | 2003

A comparison of diet and exercise therapy versus laparoscopic Roux-en-Y gastric bypass surgery for morbid obesity: a decision analysis model

Emma Patterson; David R. Urbach; Lee L. Swanstrom

100 000/QALY (3.3, 1.6 to 6.8). Studies of higher methodological quality (adjusted odds ratio 0.58, 0.37 to 0.91) and those conducted in Europe (0.59, 0.33 to 1.1) and the United States (0.44, 0.26 to 0.76) rather than elsewhere were less likely to report ratios below

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Neil Fleshner

Princess Margaret Cancer Centre

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Pascale Lehoux

Université de Montréal

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Girish Kulkarni

Princess Margaret Cancer Centre

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