Browsing by Author "McDonald, Sarah D."

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    A population-based cohort study of breastfeeding according to gestational age at term delivery
    (2013) Lutsiv, Olha; Giglia, Lucia; Pullenayegum, Eleanor; Foster, Gary; Vera Pérez-Gacitúa, Claudio Mauricio; Chapman, Barbara; Fusch, Christoph; McDonald, Sarah D.
  • Thumbnail Image
    Item
    Evaluating patient values and preferences for thromboprophylaxis decision making during pregnancy: a study protocol
    (2012) Alonso Coello, Pablo.; Neumann Burotto, Gonzalo Ignacio; Ebrahim, Shanil; Guyatt, Gordon H.; Tikkinen, Kari A.; Eckman, Mark H.; McDonald, Sarah D.; Akl, Elie A.; Bates, Shannon M.
    Abstract Background Pregnant women with prior venous thromboembolism (VTE) are at risk of recurrence. Low molecular weight heparin (LWMH) reduces the risk of pregnancy-related VTE. LMWH prophylaxis is, however, inconvenient, uncomfortable, costly, medicalizes pregnancy, and may be associated with increased risks of obstetrical bleeding. Further, there is uncertainty in the estimates of both the baseline risk of pregnancy-related recurrent VTE and the effects of antepartum LMWH prophylaxis. The values and treatment preferences of pregnant women, crucial when making recommendations for prophylaxis, are currently unknown. The objective of this study is to address this gap in knowledge. Methods We will perform a multi-center cross-sectional interview study in Canada, USA, Norway and Finland. The study population will consist of 100 women with a history of lower extremity deep vein thrombosis (DVT) or pulmonary embolism (PE), and who are either pregnant, planning pregnancy, or may in the future consider pregnancy (women between 18 and 45 years). We will exclude individuals who are on full dose anticoagulation or thromboprophylaxis, who have undergone surgical sterilization, or whose partners have undergone vasectomy. We will determine each participant's willingness to receive LMWH prophylaxis during pregnancy through direct choice exercises based on real life and hypothetical scenarios, preference-elicitation using a visual analog scale (“feeling thermometer”), and a probability trade-off exercise. The primary outcome will be the minimum reduction (threshold) in VTE risk at which women change from declining to accepting LMWH prophylaxis. We will explore possible determinants of this choice, including educational attainment, the characteristics of the women’s prior VTE, and prior experience with LMWH. We will determine the utilities that women place on the burden of LMWH prophylaxis, pregnancy-related DVT, pregnancy-related PE and pregnancy-related hemorrhage. We will generate a “personalized decision analysis” using participants’ utilities and their personalized risk of recurrent VTE as inputs to a decision analytic model. We will compare the personalized decision analysis to the participant’s stated choice. Discussion The preferences of pregnant women at risk of VTE with respect to the use of antithrombotic therapy remain unexplored. This research will provide explicit, quantitative expressions of women's valuations of health states related to recurrent VTE and its prevention with LMWH. This information will be crucial for both guideline developers and for clinicians.
  • Thumbnail Image
    Item
    Prevalence and Predictors of Exclusive Breastfeeding at Hospital Discharge
    (LIPPINCOTT WILLIAMS & WILKINS, 2012) McDonald, Sarah D.; Pullenayegum, Eleanor; Chapman, Barbara; Vera, Claudio; Giglia, Lucia; Fusch, Christoph; Foster, Gary
    OBJECTIVE: To estimate the population-based prevalence and predictors of exclusive breastfeeding at hospital discharge in singleton and twin term newborns.
  • Thumbnail Image
    Item
    Women's values and preferences and health state valuations for thromboprophylaxis during pregnancy : A cross-sectional interview study
    (2016) Bates, Shannon M.; Alonso Coello, Pablo; Tikkinen, Kari A. O.; Ebrahim, Shanil; Cruz Lopes, Luciane; McDonald, Sarah D.; Qi Zhou; Akl, Elie A.; Neumann Burotto, Gonzalo Ignacio; Jacobsen, Anne Flem; Yuqing Zhang; Santamaría, Amparo; Annichino Bizzacchi, Joyce Maria; Morten Sandset, Per; Bitar, Wael; Eckman, Mark H.; Guyatt, Gordon H.