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.

Cost-effectiveness of whole genome sequencing in paediatric cardiomyopathy

• 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.

The clinical and personal utility of genomic testing

• 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.

The use of discrete event simulation to assess the cost-effectiveness of alternative genome-based diagnostic strategies in autism spectrum disorder

• Yuen T, Penner M, Carter MT, Szatmari P, Ungar WJ. Cost-effectiveness of genome and exome sequencing in children diagnosed with autism spectrum disorder. Applied Health Economics & Health Policy. 2018; 16(4): 481-493.
• Yuen T. Generating Evidence to Streamline the Clinical Pathway in Autism Spectrum Disorder Using Simulation Models: Cost-effectiveness Comparisons of Screening and Genetic Testing Strategies. Doctoral Dissertation. June 2017.

Cost item identification, measurement and valuation of whole genome sequencing compared to clinical microarray in a centralized paediatric Genome Clinic

• Jegathisawaran J, Tsiplova K, Ungar WJ. A microcosting and cost-consequence analysis of genomic testing strategies (including trios) in autism spectrum disorder. TASK Report No. 2018-01. 2018. Highlights, Executive Summary, Full Report, Appendices, Supplement, Fact Sheet.
• Tsiplova K, Zur RM, Marshall CR, Stavropoulos DJ, Pereira SL, Merico D, Young EJ, Sung WWL, Scherer SW, Ungar WJ. A microcosting and cost-consequence analysis of genomic testing strategies in autism spectrum disorder. Genetics in Medicine. 2017; 19(11): 1268-1275.
• Tsiplova K. Zur RM, Ungar WJ. A microcosting and cost-consequence analysis of genomic testing strategies in developmental delay and autism spectrum disorder. TASK Report No. 2016-02.2. 2016. Highlights, Executive Summary, Full Report, Appendices, Supplement
• Hayeems RZ, Bhawra J, Tsiplova K, Meyn MS, Monfared N, Bowdin S, Stavropoulos DJ, Marshall CR, Basran R, Shuman C, Ito S, Cohn I, Hum C, Girdea M, Brudno M, Cohn RD, Scherer SW, Ungar WJ. Care and cost consequences of pediatric whole genome sequencing compared to chromosome microarray. European Journal of Human Genetics. 2017.
• Bashir N, Ungar WJ. The 3-I Framework: A framework for developing public policies regarding pharmacogenomics (PGx) testing in Canada. Genome. 2015; 58(12): 527-540.
• Caulfield T, Evans J, McGuire A, McCabe C, Bubela T, Cook-Deegan R, Fishman J, Hogarth S, Miller FA, Raviskty V, Biesecker B, Borry P, Cho M, Carroll JC, Etchegary H, Joly Y, Kato K, Soo-Jin Lee S, Rothenberg K, Sankar P, Szego MJ, Ossorio P, Pullman D, Rousseau F, Ungar WJ, Wilson B. Reflections on the cost of “low-cost” whole genome sequencing: Framing the health policy debate. PLoS Biology. 2013; 11(11): e1001699.

A cost-effectiveness analysis of maternal genotyping to guide treatment for postpartum pain and avert infant adverse events

• Moretti ME, Lato DF, Berger H, Koren G, Ito S, Ungar WJ. A cost-effectiveness analysis of maternal genotyping to guide treatment for postpartum pain and avert infant adverse events. The Pharmacogenomics Journal. 2017.
• Moretti ME, Ungar WJ, Berger H, Koren G, Ito S. A cost-effectiveness analysis of maternal genotyping to guide treatment for postpartum pain and avert infant adverse events. TASK Report No. 2015-01. Highlights, Executive Summary, Full Report
• Moretti ME. A Cost-effectiveness Analysis of Maternal Genotyping to Guide Treatment for Postpartum Pain and Avert Infant Adverse Events. November 2014.

Cost-effectiveness analysis of thiopurine methyltransferase genotype testing

• Zur RM, Roy L, Ito S, Beyene J, Carew C, Ungar WJ. Thiopurine s-methyltransferase testing for averting drug toxicity: A meta-analysis of diagnostic test accuracy The Pharmacogenomics Journal. 2016; 16(4): 305-311.
• Zur RM, Roy LM, Ungar WJ. Thiopurine s-methyltransferase testing for averting drug toxicity in patients receiving thiopurines: A meta-analysis of diagnostic test accuracy. Toronto: The Hospital for Sick Children, October 2015. TASK Report No. 2015-03. Highlights, Executive Summary, Full Report, Appendices
• Roy L, Zur RM, Ungar WJ. Thiopurine s-methyltransferase testing for averting drug toxicity in patients receiving thiopurines: A systematic review and quality appraisal. TASK Report No. 2015-02. Highlights, Executive Summary, Full Report, Appendices
• Burnett HF, Tanoshima R, Chandranipapongse W, Madadi P, Ito S, Ungar WJ. Testing for thiopurine methyltransferase status for safe and effective administration of thiopurines: A systematic review of clinical guidance documents. The Pharmacogenomics Journal. 2014; 14(6):493-502.
• Burnett H, Chandranipapongse W, Tanoshima R, Ito S, Ungar WJ.  Thiopurine dosing using thiopurine methyltransferase status: A systematic review of clinical guidance. TASK Report No. 2013-02. Highlights, Executive Summary, Full Report, Appendices
• Donnan JR, Ungar WJ, Mathews M, Rahman P. Systematic review of thiopurine methyltransferase genotype and enzymatic testing strategies. Therapeutic Drug Monitoring. 2011; 33:192–199.
• Donnan JR, Ungar WJ, Mathews M, Hancock-Howard RL, Rahman P. A cost effectiveness analysis of thiopurine methyltransferase testing for guiding 6-mercaptopurine dosing in children with acute lymphoblastic leukemia. Pediatric Blood & Cancer. 2011; 57:231-239.
• Donnan J, Ungar WJ, Mathews M, Hancock Howard R. Health technology assessment of thiopurine methyltransferase genetic testing for guiding 6-mercaptopurine doses in pediatric patients with acute lymphoblastic leukemia, TASK Report No. 2010-02. 2010. Highlights, Executive Summary, Full Report, Appendices

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.

Cost-effectiveness and value of alternative clinical screening and assessment approaches in autism spectrum disorder   

• Yuen T, Carter MT, Szatmari P, Ungar WJ. Cost-effectiveness of universal or high-risk screening compared to surveillance monitoring in autism spectrum disorder. Journal of Autism and Developmental Disorders, 2018; 48(9): 2968-2979.
• Yuen T, Penner M, Carter MT, Szatmari P, Ungar WJ. Assessing the accuracy of the Modified Checklist for Autism in Toddlers: A systematic review and meta-analysis. Developmental Medicine and Child Neurology, 2018; 60(11): 1093-1100.
• Penner M, Anagnostou E, Ungar WJ. Practice patterns and determinants of wait time for autism spectrum disorder diagnosis in Canada. Molecular Autism, 2018; 9:16.
• Penner M, Anagnostou E, Ungar WJ. Systematic review of clinical guidance documents for autism spectrum disorder diagnostic assessment. Autism, 2018; 22(5): 517-527.
• Penner M, Anagnostou E, Ungar WJ. Environmental scan of Canadian and UK policies for autism spectrum disorder diagnostic assessment. Paediatrics & Child Health, 2018.
• Yuen T. Generating Evidence to Streamline the Clinical Pathway in Autism Spectrum Disorder Using Simulation Models: Cost-effectiveness Comparisons of Screening and Genetic Testing Strategies. Doctoral Dissertation, June 2017.
• Penner M. Policy Analysis and Evaluation of National Clinician-reported Practices for the Diagnosis of Autism Spectrum Disorder. Masters Dissertation, June 2016.
• Ungar WJ. Next generation sequencing and health technology assessment in autism spectrum disorder. Canadian Journal of Child and Adolescent Psychiatry. 2015; 24(2): 123-127.

The Pre-School Autism Treatment Impact (PATI) Study: A population-based comparative effectiveness and cost-effectiveness study of intervention models for preschoolers with autistic spectrum disorders

• A multi-disciplinary and multi-site prospective study, where TASK is leading a cost-effectiveness analysis of the New Brunswick and Nova Scotia early intensive behavioural programs for preschoolers with autism spectrum disorder. In progress.
• Smith IM, Flanagan HE, Ungar WJ, D’Entremont B, Garon N, den Otter J, Waddell C, Bryson SE, Tsiplova K, Léger, N, Vezina F, Murray P. Comparing the one-year impact of preschool autism intervention programs in two Canadian provinces. Autism Research, 2019
• Ungar WJ, Tsiplova K, Millar N, Smith IM. Development of the Resource Use Questionnaire (RUQ-P) for families with preschool children with neurodevelopmental disorders: Validation in children with autism spectrum disorder. Clinical Practice in Pediatric Psychology. 2018; 6(2): 164-178, 2018.

PACE (Parent And Child Early) Coaching Project

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

The Pathways in Autism Spectrum Disorder (ASD) cohort study

• 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. In progress.
• Dempsey EE, Smith IM, Flanagan HE, Duku E, Lawrence MA, Szatmari P, Zwaigenbaum L, Vaillancourt T, Volden J, Mirenda P, Waddell C, Georgiades S, Elsabbagh M, Ungar WJ, Bennett T. Psychometric properties of the Merrill-Palmer-Revised Scales of Development in preschool children with autism spectrum disorder. Assessment, 2019.
• Zaidman Zait A, Mirenda P, Szatmari P, Duku E, Smith IM, Vaillancourt T, Volden J, Waddell C, Bennett T, Zwaigenbaum L, Elsabaggh M, Georgiades S, Ungar WJ. Profiles of social and coping resources in families of children with autism spectrum disorder: Relations to parent and child outcomes. Journal of Autism and Developmental Disorders; 2018; 48(6): 2064-2076.

Health Economics Evaluation Platform within CHILD-BRIGHT

• 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.

Other projects

• Lin E, Durbin J, Guerriere D, Volpe T, Selick A, Kennedy J, Ungar WJ, Lero DS. Assessing care-giving demands, resources and costs of family/friend caregivers for persons with mental health disorders: A scoping review. Health & Social Care in the Community, 2018.
• Motiwala S, Gupta S, Lilly M, Ungar WJ, Coyte PC. The cost-effectiveness of expanding Intensive Behavioural Intervention (IBI) to all autistic children in Ontario. Healthcare Policy. 2006; 1(2):135-151.

Health technology assessment (HTA) provides evidence for informed decision making in health policy. As part of its 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.

• Ungar WJ, Denburg A. An international perspective on ethical considerations in health economic evaluation: A primer for pediatric psychologists. In press, Clinical Practice in Pediatric Psychology, 2018.
• Denburg AE, Ungar WJ, Greenberg M. Public drug policy for children in Canada, Canadian Medical Association Journal, 189(30): E990-E994, 2017.
• Bashir N, Ungar WJ. The 3-I Framework: A framework for developing public policies regarding pharmacogenomics (PGx) testing in Canada. Genome. 2015; 58(12): 527-540.
• Caulfield T, Evans J, McGuire A, McCabe C, Bubela T, Cook-Deegan R, Fishman J, Hogarth S, Miller FA, Raviskty V, Biesecker B, Borry P, Cho M, Carroll JC, Etchegary H, Joly Y, Kato K, Soo-Jin Lee S, Rothenberg K, Sankar P, Szego MJ, Ossorio P, Pullman D, Rousseau F, Ungar WJ, Wilson B. Reflections on the cost of “low-cost” whole genome sequencing: Framing the health policy debate. PLoS Biology. 2013; 11(11): e1001699.
• Ungar WJ, Paterson M, Cope S, Kozyrskyj A. Improving drug benefits for children with asthma: Building a research agenda. Healthcare Policy. 2008; 3(4):66-76.
• Sharieff W, Zlotkin S, Ungar WJ, Feldman BM, Krahn M, Tomlinson G. Economics of preventing premature mortality and impaired cognitive development in children through home-fortification: A health policy perspective. International Journal of Technology Assessment and Health Care. 2008; 24(3):303-311.
• Ungar WJ, Kozyrskyj A, Paterson M, Ahmad F. Effect of cost-sharing on asthma medication use in children. Archives of Pediatrics & Adolescent Medicine. 2008; 162(2):104-110.
• Han RK, Ungar WJ, Macarthur C. Cost effectiveness analysis of a proposed public health legislative/educational strategy to reduce tap water scald injuries in children. Injury Prevention. 2007; 13(4): 248-253.
• Piwko C, Ungar WJ, Einarson TR, Wolping J, Koren G. The weekly cost of nausea and vomiting of pregnancy for women calling the Toronto Motherisk program. Current Medical Research & Opinion. 2007; 23(4):833-840.
• Ungar WJ, Witkos M. Public drug plan coverage for children across Canada: A portrait of too many colours. Healthcare Policy. 2005; 1(1):100-122.
• Ungar WJ, Ariely R. Health insurance, access to prescription medicines and health outcomes in children. Expert Review of Pharmacoeconomics & Outcomes Research. 2005; 5(2):215-225.
• Kopach R, Sadat S, Galloway I, Coyte PC, Ungar WJ. A cost-effectiveness analysis of medical documentation alternatives. International Journal of Technology Assessment in Health Care. 2005; 21(1):126-131.
• Ungar WJ, Daniels C, McNeill T, Seyed M. Children in need of Pharmacare: Medication funding requests at the Toronto Hospital for Sick Children. Canadian Journal of Public Health. 2003; 94(2):121-126.

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.

Caregiver effects

• Lavelle TA, D’Cruz B, Mohit B, Ungar WJ, Prosser LA, Neumann PJ, Tsiplova K, Vera-Llonch M, Lin P-J. Family spillover effects in pediatric cost-utility analyses. Applied Health Economics and Health Policy, 2019.
• Lin E, Durbin J, Guerriere D, Volpe T, Selick A, Kennedy J, Ungar WJ, Lero DS. Assessing care-giving demands, resources and costs of family/friend caregivers for persons with mental health disorders: A scoping review. Health & Social Care in the Community, 2018.
• Tsimicalis A, Stevens B, Ungar WJ, Greenberg M, McKeever P, Agha M, Guerriere D, Barr R, Naqvi A, Moineddin R. Determining the costs of families’ support networks following a child’s cancer diagnosis. Cancer Nursing: An International Journal for Cancer Care. 2013; 36(2):E8-E19.
• Tsimicalis A, Stevens B, Ungar WJ, McKeever P, Greenberg M, Agha M, Guerriere D, Naqvi A, Barr R. A mixed method approach to describe the out-of-pocket expenses incurred by families of children with cancer. Pediatric Blood and Cancer. 2013; 60(3):438-445.
• Guerriere DN, Tranmer JE, Ungar WJ, Manoharan V, Coyte PC. Valuing care recipient and family caregiver time: A comparison of methods. International Journal of Technology Assessment in Health Care. 2008; 24(1):52-59.
• Tranmer J, Guerriere D, Ungar WJ, Coyte PC. Valuing patient and caregiver time: A review of the literature. Pharmacoeconomics. 2005; 23(5):449-459.

Health economic methods

• 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: Thieme Medical Publishers Inc., 2017.
• Zlotnik Shaul R, Ungar WJ. Maximizing the benefit and mitigating the risks of moral hazard. American Journal of Bioethics. 2016; 16(7):44-6.
• Ungar WJ, Prosser LA, Burnett H. Values and evidence colliding: Health technology assessment in child health. Expert 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. Paediatric health economic evaluations: A world view. Healthcare Quarterly -World Health & Population. 2006; 8(4): 89-101.
• Ungar WJ, Ariely R. Health insurance, access to prescription medicines and health outcomes in children. Expert Review of Pharmacoeconomics & Outcomes Research, 5(2):215-225, 2005.
• 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 WJ, Witkos M. Public drug plan coverage for children across Canada: A portrait of too many colours. Healthcare Policy. 2005; 1(1):100-122.
• 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.

Instrument and tool development

• Ungar WJ, Tsiplova K, Millar N, Smith IM. Development of the Resource Use Questionnaire (RUQ-P) for families with preschool children with neurodevelopmental disorders: Validation in children with autism spectrum disorder. Clinical Practice in Pediatric Psychology. 2018; 6(2): 164-178.
• Guerriere DN, Ungar WJ, Corey M, Croxford R, Tranmer JE, Tullis E, Coyte PC. Evaluation of the Ambulatory and Home Care Record: Agreement between self-reports and administrative data. International Journal of Technology Assessment in Health Care. 2006; 22(2):203-10.
• Davidson-Grimwood SR, Snelgrove D, Ungar WJ. The development of an interview guide for use in dyad child-parent health related quality of life assessment. PRO Newsletter (peer-reviewed section). 2006; 37:12-14.
• Ungar WJ, Santos MT. The Pediatric Economic Database Evaluation (PEDE) project: Establishing a database to study trends in pediatric economic evaluation. Medical Care. 2003; 41(10):1142-1152.
• Ungar W, Santos M. The Pediatric Economic Database Evaluation (PEDE) project. Ottawa: Canadian Coordinating Office for Health Technology Assessment (CCOHTA); 2002. Technology Report no 26.
• Ungar WJ, Santos MT. The Pediatric Quality Appraisal Questionnaire (PQAQ): An instrument for evaluation of the pediatric health economics literature. Value in Health. 2003; 6(5):584-593.
• Ungar WJ, Josse R, Lee S, Ryan N, Adachi J, Hanley D, Breton M-C, Brown J. The Canadian SCORE questionnaire – optimizing the use of technology for low bone density assessment. Journal of Clinical Densitometry. 2000; 3(3):269-280.

Quality of life and utility research

• Ungar WJ. A further examination of the problem of double-counting in incremental cost-utility analyses. Expert Review of Pharmacoeconomics and Outcomes Research. 2016; 16(3): 333-335.
• Kromm SK, Bethell J, Kraglund F, Edwards S, Laporte A, Coyte PC, Ungar WJ. Characteristics and quality of pediatric cost-utility analyses. Quality of Life Research. 2012; 21(8):1315-1325.
• Ungar WJ. Understanding the value of information from pediatric clinical research. Pediatric Drugs. 2012; 14(5):295-297.
• Ungar WJ, Boydell K, Dell S, Feldman BM, Marshall D, Willan A, Wright J. A parent-child dyad approach to the assessment of health status and health-related quality of life in children with asthma. PharmacoEconomics. 2012; 30(8):697-712.
• Ungar WJ, Mirabelli C, Cousins M, Boydell KM. A qualitative analysis of a dyad approach to quality of life measurement in children with asthma. Social Science & Medicine. 2006; 63(9):2354-66.
• Ungar WJ. Challenges in health state valuation in pediatric economic evaluation: Are QALYs contraindicated? PharmacoEconomics. 2011; 29(8):641-652.

Preferences and preference elicitation techniques

• Goh, E.S. Genetic Counsellors’ Preferences for Preimplantation Genetic Diagnosis: A Discrete Choice Experiment. Master of Science Dissertation. June 2017.
• Ungar WJ, Hadioonzadeh A, Najafzadeh M, Tsao NW, Dell S, Lynd LD. Preferences for asthma control in parents and adolescents using a best-worst scaling experiment. Respiratory Medicine. 2014; 108(6):842-851.
• Ungar WJ, Hadioonzadeh A, Najafzadeh M, Tsao NW, Dell S, Lynd LD. Parents and adolescents preferences for asthma control: A best-worst scaling choice experiment using an orthogonal main effects design. BMC Pulmonary Medicine. 2005; 15:146.
• Azarpazhooh A, Dao T, Ungar WJ, Da Costa J, Figueiredo R, Krahn M, Friedman S. Patients’ values related to treatment options for teeth with apical periodontitis. Journal of Endodontics. 2016; 42(3): 365-70.
• Azarpazhooh A, Dao T, Ungar WJ, Chaudry F, Figueiredo R, Krahn M, Friedman S. Clinical decision-making for a tooth with apical periodontitis: the patients’ preferred level of participation. Journal of Endodontics. 2014; 40(6):784-789.
• Regier DA, Watson V, Burnett H, Ungar WJ. Task complexity and response certainty in discrete choice experiments: An application to drug treatments for juvenile idiopathic arthritis. Journal of Behavioral and Experimental Economics. 2014; 50:40-49.
• Burnett HF, Regier DA, Feldman BM, Miller FA, Ungar WJ. Parents’ preferences for drug treatments in juvenile idiopathic arthritis: A discrete choice experiment. Arthritis Care & Research. 2012; 64(9):1382-1391.
• Hancock-Howard RL, Ungar WJ, Marshall D, Einarson A, Koren G. Public preferences for counseling regarding antidepressant use during pregnancy: A discrete choice experiment. Birth Defects Research Part A: Clinical and Molecular Teratology. 2012; 94(7):532-539.

Systematic reviews

• Kwon J, Kim SW, Ungar WJ, Tsiplova K, Madan J, Petrou S. A systematic review and meta-analysis of childhood health utilities. Medical Decision Making. 2018; 38(3): 277-305.
• Zur RM, Roy L, Ito S, Beyene J, Carew C, Ungar WJ. Thiopurine s-methyltransferase testing for averting drug toxicity: A meta-analysis of diagnostic test accuracy. The Pharmacogenomics Journal. 2016; 16(4): 305-311.
• Zur RM, Roy LM, Ungar WJ. Thiopurine s-methyltransferase testing for averting drug toxicity in patients receiving thiopurines: A meta-analysis of diagnostic test accuracy. Toronto: The Hospital for Sick Children, October 2015. TASK Report No. 2015-03. Highlights, Executive Summary Full Report, Appendices
• Hancock, RL. An Economic Evaluation of Teratology Information Services. Doctoral Dissertation, 2010.
• Hancock RL, Koren G, Einarson, A, Ungar WJ. The effectiveness of Teratology Information Services (TIS). Reproductive Toxicology. 2007; 23(2):125-32.
• Cooper M, Ungar W, Zlotkin S. An assessment of inter-rater agreement of the literature filtering process in the development of evidence-based dietary guidelines. Public Health Nutrition. 2006; 9(4):494-500.

Trends in evidence

• Kwon J, Kim SW, Ungar WJ, Tsiplova K, Madan J, Petrou S. Patterns, temporal trends and methodological associations in the measurement and valuation of childhood health utilities. Quality of Life Research, 2019
• Payakachat N, Tilford JM, Ungar WJ. National Database for Autism Research (NDAR): Big Data opportunities for health services research and health technology assessment. Pharmacoeconomics. 2016; 34(2): 127-38.
• Sullivan SM, Tsiplova K, Ungar WJ. A scoping review of pediatric economic evaluation 1980-2014: Do trends over time reflect changing priorities in evaluation methods and childhood disease? Expert Review of Pharmacoeconomics and Outcomes Research. 2016; 16(5): 599-607.
• Sullivan S, Ungar WJ. Will the growth spurt continue? Trends in child health economic evaluation: 1980 to 2013. TASK Report No. 2016-01. Highlights, Executive Summary, Full Report.
• Ungar WJ, Santos MT. Trends in paediatric health economic evaluation: 1980 to 1999. Archives of Disease in Childhood. 2004; 89:26-29.
• Lipstein EA, Brinkman WB, Fiks AG, Hendrix KS, Kryworuchko J, Miller VA, Prosser LA, Ungar WJ, Fox D. An emerging field of research:  Challenges in pediatric decision making. Medical Decision Making. 2015; 35:403-408.
• Hancock RL, Ungar WJ, Einarson A, Koren G. International practices in the provision of teratology information: A survey of international teratogen information programs and comparisons with the North American model. Journal of Evaluation in Clinical Practice. 2010; 16(5):957-963.
• Hancock RL, Ungar WJ, Einarson A, Goodstadt M, Koren G. Providing information regarding exposures in pregnancy: a survey of North American Teratology Information Services. Reproductive Toxicology. 2008; 25(3): 381-387.
• Ungar WJ, Coyte PC.  The Pharmacy Medication Monitoring Program Advisory Board. Health services utilization reporting in respiratory patients Health services utilization reporting in respiratory patients. Journal of Clinical Epidemiology. 1998; 51(12):1335-1342.

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

• Mendlowitz A, Widjaja E, Phan C, Sun Z, Moretti ME, Schuh S, Coyte PC, Hancock-Howard R, Freedman S, Ungar WJ. A cost analysis of pulse oximetry as a determinant in the decision to admit infants with mild to moderate bronchiolitis. Pediatric Emergency Care, 2018.
• Najafzadeh M, Ungar WJ, Hadioonzadeh A, Tsao N, Lynd LD. Comparing different experimental designs for best-worst scaling choice experiments: The case of asthma control. International Journal of Health Preference Research, 2018.
• Ungar WJ, Hadioonzadeh A, Najafzadeh M, Tsao NW, Dell S, Lynd LD. Parents and adolescents preferences for asthma control: A best-worst scaling choice experiment using an orthogonal main effects design. BMC Pulmonary Medicine. 2015; 15:146.
• Ungar WJ, Hadioonzadeh A, Najafzadeh M, Tsao NW, Dell S, Lynd LD. Quantifying preferences for asthma control in parents and adolescents using a best-worst scaling experiment. Respiratory Medicine. 2014; 108(6):842-851. 
• Schuh S, Freedman S, Coates A, Allen U, Parkin P, Stephens D, Ungar W, Da Silva Z, Willan A. Effect of oximetry on hospitalization in bronchiolitis – a randomized clinical trial. JAMA. 2014; 312(7):712-718.
•  Ungar WJ, Boydell K, Dell S, Feldman BM, Marshall D, Willan A, Wright J. A parent-child dyad approach to the assessment of health status and health-related quality of life in children with asthma. PharmacoEconomics. 2012; 30(8):697-712.
• Ungar WJ. Medication cost-sharing and health outcomes in children with asthma. JAMA. 2012; 307(12):1316-1318.
• Ungar WJ, Paterson JM, Gomes T, Bikangaga P, Gold M, To T, Kozyrskyj AL. Relationship of asthma management, socioeconomic status, and medication insurance characteristics to exacerbation frequency in children with asthma. Annals of Allergy, Asthma & Immunology. 2011; 106:17–23.
• To T, Wang C, Dell SD, Fleming-Carroll B, Parkin P, Scolnik D, Ungar WJ, the PAMG Team. Can an evidence-based guideline reminder card improve acute asthma management in emergency department? Respiratory Medicine. 2010; 104(9):1263-70.
• To T, Wang C, Dell S, Fleming-Carroll B, Parkin P, Scolnik D, Ungar W, the PAMG Team. Risk factors for repeat adverse asthma events in children after visiting an emergency department. Ambulatory Pediatrics. 2008; 8(5):281–287.
• Ungar WJ, Cope SF, Kozyrskyj A, Paterson JM. Socioeconomic factors and home allergen exposure in children with asthma. Journal of Pediatric Health Care. 2010; 24(2):108-115.
• Cope SF, Ungar WJ, Glazier RH. International differences in asthma guidelines for children. International Archives of Allergy and Immunology. 2009; 148(4):265-278.
• Cope SF, Ungar WJ, Glazier RH. Socioeconomic factors and asthma control in children. Pediatric Pulmonology. 2008; 43(8):745-752.
• Ungar WJ, Paterson M, Cope S, Kozyrskyj A. Improving drug benefits for children with asthma: Building a research agenda. Healthcare Policy. 2008; 3(4):66-76.
• Ungar WJ, Kozyrskyj A, Paterson M, Ahmad F. Effect of cost-sharing on asthma medication use in children. Archives of Pediatrics & Adolescent Medicine. 2008; 162(2):104-110.
• Yong JHE, Schuh S, Rashidi R, Vanderby S, Lau R, Laporte A, Nauenberg E, Ungar WJ. A cost-effectiveness analysis of omitting radiography in diagnosis of acute bronchiolitis. Pediatric Pulmonology. 2009; 44(2):122-127.
• Polisena J, Tam S, Lodha A, Laporte A, Coyte PC, Ungar WJ. An economic evaluation of asthma action plans for children with asthma. Journal of Asthma. 2007; 44 (7):501-508.
• Ungar WJ, Davidson-Grimwood SR, Cousins M. Parents were accurate proxy reporters of urgent pediatric asthma health services – a retrospective agreement analysis. Journal of Clinical Epidemiology. 2007; 60(11):1176-1183.
• Ungar WJ, Mirabelli C, Cousins M, Boydell KM. A qualitative analysis of a dyad approach to quality of life measurement in children with asthma. Social Science & Medicine. 2006; 63(9):2354-66.
• Kozyrskyj AL, Dahl ME, Ungar WJ, Becker AB, Law BJ. Antibiotic treatment of wheezing in children with asthma: What is the practice? Pediatrics. 2006; 117(6):e1104-10.
• Ungar WJ, Macdonald T, Cousins M. Better breathing or better living? A qualitative analysis of the impact of asthma medication acquisition on standard living and quality of life in low income families of children with asthma. Journal of Pediatric Health Care. 2005; 19(6):354-62.
• Ungar WJ, Chapman KR, Santos MT. Assessment of a medication-based asthma index for population research. American Journal of Respiratory and Critical Care Medicine. 2002; 165:190-194.
• Ungar WJ, Coyte PC. The Pharmacy Medication Monitoring Program Advisory Board. Prospective study of the patient-level cost of asthma care in children. Pediatric Pulmonology. 2001; 32:101-108.
• Ungar WJ, Coyte PC. The Pharmacy Medication Monitoring Program Advisory Board. Measuring productivity loss days in asthma patients. Health Economics. 2000; 9(1): 37-46.
• Ungar WJ, Coyte PC. The Pharmacy Medication Monitoring Program Advisory Board. Health services utilization reporting in respiratory patients. Journal of Clinical Epidemiology. 1998; 51(12):1335-1342.

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

• Luca NJ, Burnett HF, Ungar WJ, Moretti ME, Beukelman T, Feldman BM, Schwartz G, Bayoumi AM. Cost-effectiveness analysis of first line treatment with biologic agents in polyarticular juvenile idiopathic arthritis. Arthritis Care and Research. 2016; 68(12): 1803-1811.
• Burnett HF, Ungar WJ, Regier DA, Feldman BM, Miller FA. Parent willingness-to-pay for biologic treatments in juvenile idiopathic arthritis. Value in Health. 2014; 17(8):830-837.
• Regier DA, Watson V, Burnett H, Ungar WJ. Task complexity and response certainty in discrete choice experiments: An application to drug treatments for juvenile idiopathic arthritis. Journal of Behavioral and Experimental Economics. 2014; 50:40-49.
• Burnett HF, Regier DA, Feldman BM, Miller FA, Ungar WJ. Parents’ preferences for drug treatments in juvenile idiopathic arthritis: A discrete choice experiment. Arthritis Care & Research. 2012; 64(9):1382-1391.
• Ungar WJ, Costa V, Burnett H, Feldman BM, Laxer RM. The use of biologic response modifiers in polyarticular-course juvenile idiopathic arthritis: A systematic review. Seminars in Arthritis and Rheumatism. 2013; 42(6):597-618.
• Ungar WJ, Costa V, Hancock-Howard RL, Feldman B, Laxer RM. Cost-effectiveness of biologics in polyarticular-course juvenile idiopathic arthritis patients unresponsive to disease modifying anti-rheumatic drugs. Arthritis Care & Research. 2011; January; 63(1):111–119.
• Ungar WJ, Costa V, Burnett H. The use of biologic response modifiers in polyarticular course juvenile idiopathic arthritis – a systematic review update. TASK Report No. 2012-01. Report Update
• Costa V, Ungar WJ, Hancock Howard R, Feldman B, Laxer R. The use of biologic response modifiers in polyarticular-course juvenile idiopathic arthritis, TASK Report No. 2010-01, January 2010. Highlights, Executive Summary, Full Report, Appendices

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.

Infectious diseases

• Ting EEK, Sander B, Ungar WJ. Systematic review of the cost-effectiveness of influenza immunization programs. Vaccine. 2017. 35(15): 1828-1843.
• Ting EEK, Sander B, Ungar WJ. Systematic review of the cost-effectiveness of influenza immunization programs: A Canadian perspective. December 2015. TASK Report No. 2015-04. Highlights, Abstract, Full Report, Appendices
• Gauvreau C, Ungar WJ, Köhler JC, Zlotkin S. The use of cost-effectiveness analysis for pediatric immunization in developing countries. The Milbank Quarterly. 2012. 90(4):762-790.
• Costa V, Ungar WJ. Caspofungin in the empiric treatment of febrile neutropenia in pediatric patients: A comparison with conventional and liposomal amphotericin B, TASK Report No. 2008-01, 10 September 2008. Highlights, Abstract, Executive Summary, Full Report, Appendices
• Boutis K, Stephens D, Lam K, Ungar WJ, Schuh S. The impact of Severe Acute Respiratory Syndrome on a tertiary care pediatric emergency department. Canadian Medical Association Journal. 2004; 171(11): 1353-1358.

Appendicitis

• Hall NJ, Eaton S, Abbo O, Arnaud A, Beaudin M, Brindle M, Butter A, Davies D, Jancelewicz T, Johnson K, Keijzer R, Lapidus-Kroll E, Nasr A, Offringa M, Piche N, Rintala R, Skarsgard E, Svensson J, Ungar WJ, Wester T, Willan A, Zani A, St Peter SD, Pierro A. Appendectomy versus non-operative treatment for acute uncomplicated appendicitis in children: study protocol for a multicentre, open-label, non-inferiority, randomized controlled trial. BMJ Paediatrics Open. 2017; 1(1): e000028.
• Wan M, Doria A, Krahn M, Ungar WJ, Medina S, Sung L. Acute appendicitis in young children: cost-effectiveness of US versus CT in diagnosis–a Markov decision analytic model. Radiology. 2009; 250(2): 378-86.
• Doria AS, Amernic H, Dick P, Babyn P, Chait P, Langer J, Coyte PC, Ungar WJ. Cost-effectiveness analysis of weekday and weeknight or weekend shifts for assessment of appendicitis. Pediatric Radiology, 35(12):1186-95, 2005.

Fetal alcohol spectrum disorder

• Goh YI, Rovet J, Ungar W, Koren G. Mega-dose Vitamin C and E in Preventing FASD:  The Decision to Terminate the Study Prematurely. Journal of Fetal Alcohol Syndrome International. 2007; 5:e3.
• Goh YI, Rovet J, Ungar WJ, Koren G. The antioxidant effect: Can we mitigate fetal alcohol spectrum disorder with antioxidants? Journal of Fetal Alcohol Syndrome International. 2005; 3:e10.
• Stade B, Ungar WJ, Stevens B, Beyene J, Koren G. Cost of fetal alcohol spectrum disorder in Canada. Canadian Family Physician. 2007; 53(8):1303-04.
• Stade B, Stevens B, Ungar W, Beyene J, Koren G. Health-related quality of life of Canadian children prenatally exposed to alcohol. Health & Quality of Life Outcomes. 2006; 13(4):81.
• Stade B, Ungar WJ, Stevens B, Beyene J, Koren G. The burden of prenatal exposure to alcohol: Measurement of cost. Journal of Fetal Alcohol Syndrome International. 2006; 4: e5.
• Wu R, Laporte A, Ungar WJ. Cost effectiveness of an electronic medication ordering and administration system in reducing adverse drug events. Journal of Evaluation in Clinical Practice. 2007; 13(3):440-448.

Oncology

• Tsimicalis A, Genest L, Stevens B, Ungar WJ, Barr B, Greenberg M, Guerriere D, Naqvi A, Agha M. The impact of a childhood cancer diagnosis on the children and siblings’ school attendance, performance and activities: A qualitative descriptive study. Journal of Pediatric Oncology Nursing, 2018.
• Tsimicalis A, Stevens B, Ungar WJ, Greenberg M, McKeever P, Agha M, Guerriere D, Barr R, Naqvi A, Moineddin R. Determining the costs of families’ support networks following a child’s cancer diagnosis. Cancer Nursing: An International Journal for Cancer Care. 2013; 36(2):E8-E19.
• Tsimicalis A, Stevens B, Ungar WJ, McKeever P, Greenberg M, Agha M, Guerriere D, Naqvi A, Barr R. A mixed method approach to describe the out-of-pocket expenses incurred by families of children with cancer. Pediatric Blood and Cancer. 2013; 60(3):438-445.
• Hancock-Howard RL, McMahon M, Menon-Nair A, Woo G, Aziza A, Laporte A, Nauenberg E, Connolly BL, Wales PW, Ungar WJ. Cost-effectiveness analysis of implantable venous access device insertion using interventional radiologic versus conventional operating room methods in pediatric patients with cancer. Journal of Vascular and Interventional Radiology. 2010; 21(5):677-84.

Surgical interventions

• Dong Z, Connolly BK, Ungar WJ, Coyte P. A cost analysis of peripherally inserted central catheter in paediatric patients. International Journal of Technology Assessment in Health Care. 2018; 1-8.
• Burnett HF, Lambley R, West SK, Ungar WJ, Mireskandari, K. Cost-effectiveness analysis of clinic-based chloral hydrate sedation versus general anaesthesia for paediatric ophthalmological procedures. British Journal of Ophthalmology. 2015; 99:1565-1570.
• Burnett H, Lambley R, Ungar WJ, Mireskandari K. The cost-effectiveness of clinic-based chloral hydrate sedation versus general anaesthesia for paediatric ophthalmological procedures. TASK Report No. 2014-01, Highlights, Executive Summary, Full Report, Appendices
• Costa V, Ungar WJ. Systematic review on orchidopexy for the Canadian Paediatric Surgical Wait Times Project. TASK Report No. 2009-01. 2009. Full Report
• Piwko C, Lasry A, Alanezi K, Coyte PC, Ungar WJ. Economic evaluation of ondansetron versus dimenhydrinate for prevention of post-operative vomiting in children undergoing strabismus surgery. Pediatric Anesthesia. 2005; 15(9):755-761.
• Attard NJ, Wei X, Laporte A, Zarb GA, Ungar WJ. A cost minimization analysis of implant treatment in mandibular edentulous patients. International Journal of Prosthodontics. 2003; 16(3):271-276.

TASK conducts research on chronic paediatric conditions such as inflammatory bowel disease and Crohn’s disease, among others.

• Hughes A, Marshall J, Moretti ME, Ungar WJ. A cost-utility analysis of biosimilar infliximab compared to reference infliximab in adult switch patients with Crohn’s disease: a Canadian analysis. TASK Technical Report No. 2019-02. 2019. Highlights, Executive Summary, Full Report.
• Bashir NS, Walters TD, Griffiths AM,  Ito S, Ungar WJ.  The economic evaluation of early intervention with Anti-Tumor Necrosis Factor-α treatments in pediatric Crohn’s disease. TASK Technical Report No. 2019-01. 2019. Highlights, Executive Summary, Full Report.
• Woo G, Tomlinson G, Yim C, Lilly L, Therapondos G, Wong DKH, Ungar WJ, Einarson TR, Sherman M, Heathcote EJ, Krahn M. Health state utilities and quality of life in patients with hepatitis B. Canadian Journal of Gastroenterology. 2012; 26(7):445-451.
• Woo G, Tomlinson G, Nishikawa Y, Kowgier M, Sherman M, Wong DKH, Pham B, Ungar WJ, Einarson T, Heathcote EJ, Krahn M. Tenofovir and Entecavir are the most effective antiviral agents for chronic hepatitis B: A systematic review and Bayesian meta-analyses. Gastroenterology. 2010; 139(4):1218-29.
• Anvari M, Allen C, Marshall J, Armstrong D, Goeree R, Ungar W, Goldsmith C. A randomized controlled trial of laparoscopic Nissen fundoplication (LNF) versus proton pump inhibitors for treatment of patients with chronic gastro-esophageal reflux disease (GERD): three year outcomes. Surgical Endoscopy. 2011; 25(8):2547-2554.
• Anvari M, Allen C, Marshall J, Armstrong D, Goeree R, Ungar W, Goldsmith C. A randomized controlled trial of Laparoscopic Nissen Fundoplication (LNF) versus proton pump inhibitors for treatment of patients with chronic Gastro-Esophageal Reflux Disease (GERD): One-year Follow-up. Surgical Innovation. 2006; 13(4):238-49.
• Khan U, Bogue C, Ungar WJ, Hilliard P, Blanchette V, Carcao, M, Doria AS. Cost-effectiveness analysis of different imaging strategies for diagnosis of hemophilic arthropathy. Haemophilia. 2010; 16(2):322-32.
• Carcao M, Ungar WJ, Feldman B. Cost-utility analysis in evaluating prophylaxis in haemophilia. Haemophilia. 2004; 10(Suppl 1):50-57.
• Urbach DR, Ungar WJ, Rabeneck L. Whither surgery in the treatment of gastroesophageal reflux disease (GERD)? Canadian Medical Association Journal. 2004; 170(2):219-221.