Our Research Themes

Genomics

Genomics and precision medicine are being increasingly integrated into clinical practice. These technologies may lead to better diagnostic accuracy, earlier referral to appropriate treatment interventions and a better treatment response based on targeted use of drugs and other interventions. However, new generations of sequencing technologies are costly and can produce additional findings that result in further downstream healthcare costs. It is not yet clear whether such technologies are cost-effective or where they should be positioned in a diagnostic pathway to maximize value for money. TASK force members are working to generate evidence regarding economic value, including social and ethical considerations to inform implementation.

Prospective study led by Drs. Wendy Ungar and Robin Hayeems on clinical utility and cost-effectiveness of whole genome sequencing for children with cardiomyopathy. In progress.

Prospective study led by Drs. Robin Hayeems and Wendy Ungar to develop and validate psychometric tools to quantify the clinical and personal utility of genetic tests. In Progress.

Neurodevelopmental Disorders

Children with neurodevelopment disorders (NDDs) and their families face life-long challenges and require extensive ongoing educational, health and social service support. The severity and high prevalence of NDDs place a high economic burden on parents and public service systems. It is crucial to understand which programs, treatments and services provide the best value for money. The TASK team is involved in a number of projects in the area of paediatric NDDs, collecting cost data and evaluating cost-effectiveness of existing and novel interventions.

Dr. Ungar is leading economic evaluations of interventions being studied by researchers within the CHILD-BRIGHT Network, a pan-Canadian research network examining interventions to optimize the health of Canadian children born with brain-based disorders. In progress.

As part of a collaborative multi-disciplinary PACE Coaching Project, TASK lead a cost-effectiveness analysis comparing parent coaching to services ordinarily available to toddlers at risk for autism spectrum disorder in British Columbia.

Using data collected by the Pathways in ASD cohort study, TASK is examining how child and youth health, education and community services are integrated to support optimal trajectories of developmental health.

Multi-disciplinary and multi-site prospective study, where TASK is leading a cost analysis of the New Brunswick and Nova Scotia early intensive behavioural programs for preschoolers with autism spectrum disorder.

Public Health and Pharmaceutical Policy

Health technology assessment (HTA) provides evidence for informed decision making in health policy. As part of it’s HTA activities, TASK informs policies in child health. TASK also conducts research specifically in the area of public health and pharmaceutical policy. For example, the TASK team has examined gaps in prescription drug coverage for paediatric drugs and is examining the value of pharmacogenomics testing.

Methods Research

TASK’s projects in health economic methods include patient preferences research; development and assessment of instruments to measure resource use, costs or quality of life; reviews of economic evaluation methods; and the use and applicability of the PEDE database and other economic evaluation databases for decision-making.

  • Xie X, Tiggelaar S, Wang M, Vandersluis S, Ungar WJ. Developing economic models for assessing the cost-effectiveness of multiple diagnostic tests: Methods and ApplicationsMedical Decision Making, 2022; 42(7): 861-871.
  • Ungar WJ. Assessing value in child healthChildren, 2021; 8(11): 972.
  • Bashir NS, Walters TD, Griffiths AM, Ito S, Ungar WJ. Imputing missing patient-level data and propensity score matching in cost-effectiveness analysis. Expert Review of Pharmacoeconomics & Outcomes Research. 2022; 22(3): 442-454.
  • Cernat A, Hayeems RZ, Prosser LA, Ungar WJ. Incorporating cascade effects of genetic testing in economic evaluation: A scoping review of methodological challengesChildren. 2021, 8(5): 346.
  • Ungar WJ, Zur RM. Costs and consequences: An introduction to economic evaluation in radiology. In Doria AS, Tomlinson G, Beyene J and Moineddin R (Eds) Research Methods in Radiology. New York: Theme Medical Publishers Inc., 2017.
  • Ungar WJ. Technology Assessment at Sick Kids (TASK): A Health Technology Assessment Research Unit devoted to Child Health. In Sampietro-Colom L, Martin J (Eds), Hospital-based Health Technology Assessment. New York: Springer Press, 2017.
  • Ungar WJ. A further examination of the problem of double-counting in incremental cost-utility analysesExpert Review of Pharmacoeconomics and Outcomes Research. 2016; 16(3): 333-335.
  • Zlotnik Shaul R, Ungar WJ. Maximizing the benefit and mitigating the risks of moral hazardAmerican Journal of Bioethics. 2016; 16(7):44-6.
  • Ungar WJ, Zur RM. Health economic evaluation for improving child health in low- and middle-income countries. In MacLeod S, Hill S, Rane A, Koren G (Eds), Challenges in Optimizing Drug Treatment for Children in the Developing World. New York: Springer Press, 2015.
  • Ungar WJ, Prosser LA, Burnett H. Values and evidence colliding: Health technology assessment in child healthExpert Review of Pharmacoeconomics and Outcomes Research. 2013; 13(4):417-419.
  • Ungar WJ (Editor). Economic Evaluation in Child Health. Oxford: Oxford University Press, 2010.
  • Ungar WJ. Preface, in Ungar WJ (ed) Economic Evaluation in Child Health. Oxford: Oxford University Press, 2010.
  • Ungar WJ, Gerber A. The uniqueness of child health and challenges to measuring costs and consequences, in Ungar WJ (ed) Economic Evaluation in Child Health. Oxford: Oxford University Press, 2010.
  • Costa V, Ungar WJ, Health technology assessment in child health, in Ungar WJ (ed) Economic Evaluation in Child Health. Oxford: Oxford University Press, 2010.
  • Ungar WJ. Paediatric health economic evaluations: A world viewHealthcare Quarterly -World Health & Population. 2006; 8(4): 89-101.
  • Ungar WJ. Gesundheitsökonomische Analysen in der Pädiatrie: Historischer Überblick und Untersuchung nach Art der Interventionen. In: Gerber A & Lauterbach KW (Eds). Gesundheitsökonomie und Pädiatrie. Stuttgart: Schattauer Publishers. September 2006.
  • Ungar WJ, Santos MT. Quality appraisal of pediatric health economic evaluations. International Journal of Technology Assessment and Health Care. 2005; 21(2):203-210.
  • Ungar W.  Bias – it’s everywhere! A commentary on the impact of bias and the assessment of agreement in the measurement of medication use in epidemiology research. Pharmacoepidemiology and Drug Safety. 1998; 7:425-427.
  • Ungar W. The choice of pharmacoeconomic study design during drug development, Part 1. Pharmacoepidemiology and Drug Safety. 1997; 6: 391-397.
  • Ungar W. The choice of pharmacoeconomic study design during drug development, Part 2. Pharmacoepidemiology and Drug Safety. 1997; 6(6): 399-407.
  • Ungar W. Good Clinical Practices: Principles and application of the European Community note for guidance. Drug Information Journal. 1994; 28:339-348.

Respiratory Conditions

TASK performs systematic reviews, cost-effectiveness analyses and methods research in the area of respiratory conditions, including asthma and bronchiolitis.

Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis research conducted at TASK includes assessing patient preferences for drug treatment and cost effectiveness of biologic response modifiers.

Specific Applications

TASK conducts cost-effectiveness analysis of paediatric health interventions and devices in the fields of infectious disease, appendicitis, fetal alcohol spectrum disorder, oncology and surgical interventions.

TASK conducts research on cost-effectiveness and quality of life in pediatric inflammatory bowel disease including Crohn’s disease, and gastroenterology.

Other Paediatric Conditions