Welcome to the fall issue of the CNODES Quarterly Newsletter, where we update on recent, past and upcoming CNODES events. We also provide team updates on projects and other CNODES-related activities.


CNODES Trainee Spotlight | Donica Janzen, University of Manitoba


Donica Janzen, BSP, is a PhD candidate at the College of Pharmacy at the University of Manitoba. She obtained her Bachelor of Science in Pharmacy from the University of Saskatchewan in 2011. After graduation, she worked as a pharmacist in northern Manitoba. Later, she decided to pursue graduate training in pharmacoepidemiology at the University of Manitoba in order to bridge the gaps in evidence that she encountered in her work. She started an MSc with Dr. Silvia Alessi-Severini in 2016 and transferred to the PhD program in 2018.


Read full trainee profile


Colin R. Dormuth is the Training Team lead.

Find his bio here.


The Methods Team would like to welcome two new additions. Michael Webster-Clark, PhD, is a postdoctoral fellow who will be working on methods for transportability and generalizability of results within and across networks, as well as other pharmacoepidemiologic methods. Qi Zhang, MSc, is joining us as a research assistant to work on methods research and visualizations of CNODES data. Michael and Qi will sit at the Coordinating Centre (when we get back to the office!). We look forward to a productive year and some potential collaborations!


Robert Platt is the Methods Team lead. Find his bio here.


Our team has been working on two projects: (a) continued development of the CNODES Variable Library, and (b) development of a data quality literature review and survey tool.


The CNODES Variable Library


The Variable Library is a resource to support investigators as they select variables to use for CNODES multi-database research projects. The Variable Library contains information about measures of drug exposures, health conditions, healthcare use, and determinants of health. All measures included in the CNODES Variable Library are identified and extracted from the Statistical Analysis Plans (SAPs) of completed CNODES projects. Site-specific adaptation forms are carefully reviewed to ensure that any deviations from the SAP in the specification of measures (e.g., differences in diagnosis codes across sites) are also captured. Wherever possible, the Variable Library contains documentation about decisions to select one measure over another, such as existing studies about the validity (i.e., accuracy) of a measure. This last element of the Variable Library has, to date, rarely been captured in existing SAPs, but will be an important addition to new SAPs. Carolina Moriello and Audray St-Jean did much of the preparatory work on the Variable Library (thank you!). Dr. Lix’s research assistant, Ko Long Choi, who is based at the University of Manitoba, is continuing this work. A process document to describe the contents of the library and who will extract and verify this information has also been developed, which is important for ensuring consistency in the Library contents.


Data Quality Literature Review and Survey Tool


The administrative data used by CNODES were never intended to be used for research about drug safety and effectiveness; data quality and variability in quality across sites is a potential threat to the validity of research findings. Distributed health data networks in other jurisdictions have developed tools and methods to conduct standardized data quality assessments and report the results of these assessments in a transparent way. Examples of toolkits that have been developed include (1) the Sentinel Data Quality Review and Characterization Programs, which are used for data quality review and characterization of the Sentinel Distributed Database, and (2) the OHDSI (Observational Health Data Sciences and Informatics) tool called ACHILLES (Automated Characterization of Health Information at Large-scale Longitudinal Evidence Systems), which provides characterizations and visualizations of databases and the OHDSI Data Quality Dashboard, which performs over 1500 data quality checks on the OHDSI common data model. The Database Development Team has conducted a literature review of these tools and methods and is currently compiling this information into a report. A next step is to conduct a survey about existing data quality assessment practices at each site, and then use this information to explore the development of a harmonized data quality reporting system for all CNODES sites.


Lisa Lix is the Database Development Team lead. Find her bio here.


Gender Parity in Pharmacoepidemiology Authorship


The Knowledge Translation Team has published a manuscript, Exploring female parity in pharmacoepidemiology authorship: A case study of the Canadian Network for Observational Drug Effect Studies and its citing articles, by Ingrid Sketris, Robyn Traynor, Melissa Helwig, Elaine Burland, and Samuel Stewart, in Pharmacoepidemiology and Drug Safety (PDS). The authors examined the relationship between gender and authorship in CNODES journal articles and the literature citing them. Women contributed to 36% of journal article authorships, including 14% of corresponding author positions for CNODES articles. CNODES articles had a slightly higher percentage of female authorships than the citing literature (36% vs 29%, difference of 7%, 95% CI: [1, 13%]). Bibliometric databases and a gender application programming interface (API; https://gender-api.com/en/) provide readily available data that with mindful use can benchmark female parity in academic authorship. The API provided gender classification for 94% of CNODES authors but had challenges with non-Latin and gender-neutral names. This analysis provides a benchmark and method to monitor progress in female parity in pharmacoepidemiology authorship. Further work is needed to determine and address barriers and facilitators to women’s recruitment and advancement in the field of pharmacoepidemiology.


Ingrid Sketris is the Knowledge Translation Team lead. Find her bio here.






Sketris IS, Traynor RL, Helwig M, Burland E, Stewart SA. Exploring female parity in pharmacoepidemiology authorship: A case study of the Canadian Network for Observational Drug Effect Studies and its citing articles. Pharmacoepidemiol Drug Saf. 2021 Sep 27. doi: 10.1002/pds.5364. Online ahead of print.


Dormuth CR, Fisher A, Hudson M, Austin PC, Ernst P, Bresee L, Chateau D, Tamim H, Paterson JM, Lafrance JP, Taylor-Gjevre RM, Platt RW, for the Canadian Network for Observational Drug Effect Studies (CNODES) Investigators. Impact of concomitant conventional DMARD on persistence of biologic DMARDS in rheumatoid arthritis: multi-centre, population-based cohort study. Semin Arthritis Rheum. 2021 Aug 19;S0049-0172(21)00156-6. doi: 10.1016/j.semarthrit.2021.08.002. Online ahead of print.


Van den Ham HA, Souverein PC, Klungel OH, Platt RW, Ernst P, Dell’Aniello S, Schmiedl S, Rottenkolber M, Huerta C, Martín Merino E, León-Muñoz LM, Montero D, Andersen M, Aakjær M, De Bruin M, Gardarsdottir H. Major bleeding in users of direct oral anticoagulants in atrial fibrillation: a pooled analysis of results from multiple population-based cohort studies. Pharmacoepidemiol Drug Saf. 2021 Oct;30(10):1339-1352. doi: 10.1002/pds.5317.


Sinyavskaya L, Schnitzer M, Renoux C, Guertin JR, Talbot D, Durand M. Evidence of the different associations of prognostic factors with censoring across treatment groups and impact on censoring weight model specification: the example of anticoagulation in atrial fibrillation. Am J Epi. 2021 Jun 24;kwab186. doi: 10.1093/aje/kwab186. Online ahead of print.


Ou LB; Moriello C; Douros A; Filion KB. Domperidone and the Risks of Sudden Cardiac Death and Ventricular Arrhythmia: A Systematic Review and Meta-Analysis of Observational Studies. Br J Clin Pharmacol. 2021 Oct;87(10):3649-3658. doi: 10.1111/bcp.14737.


Filion KB, Yu YH. Invited commentary: The prevalent new user design in pharmacoepidemiology: challenges and opportunities. Am J Epidemiol. 2021 Jul 1;190(7):1349-1352. doi: 10.1093/aje/kwaa284. (Invited Editorial)


Durand M, Schnitzer M, Pang M, Carney G, Eltonsy S, Filion KB, Fisher A, Jun M, Matteau A, Paterson JM, Quail J, Renoux C for the Canadian Network for Observational Drug Effect Studies (CNODES) Investigators. Effectiveness and safety among direct oral anticoagulants in nonvalvular atrial fibrillation: A multi-database cohort study with meta-analysis. Br J Clin Pharmacol. 2021 Jun;87(6):2589-2601. doi: 10.1111/bcp.14669.


Moriello C; Paterson JM; Reynier P, Dahl M; Aibibula W; Fisher A; Gamble JM; Kuo IF; Ronksley PE; Winquist B; Filion KB for the Canadian Network for Observational Drug Effect Studies (CNODES) Investigators. Off-label postpartum use of domperidone in Canada: a multidatabase cohort study. CMAJ Open. 2021 May 14; (9)2: E500-E509.


Mohammadhassanzadeh H, Sketris I, Traynor R, Alexander S, Winquist B, Stewart S. Using Natural Language Processing to examine the uptake, content and readability of media related to an observational research study on isotretinoin exposure and pregnancy. JMIR Form Res. 2020 Jan 14;4(1):e13296.


St-Jean A, Chateau D, Dahl M, Ernst P, Daneman N, Sketris IS, Zhang J, Marra F, Quail J, Bugden S, for the Canadian Network for Observational Drug Effect Studies (CNODES) Investigators. Regional Variation in the Potentially Inappropriate First Line Use of Fluoroquinolones in Canada as a Key to Antibiotic Stewardship? A Drug Utilization Review Study. BMC Infect Dis. 2021 Aug 3;21(1):733.


Lix LM, Sobhan S, St-Jean A, Daigle JM, Fisher A, Yu OHY, Dell’Aniello S, Hu N, Bugden SC, Shah BR, Ronksley PE, Alessi-Severini S, Douros A, Ernst P, Filion KB, for the Canadian Network for Observational Drug Effect Studies (CNODES) Investigators. Validity of an Algorithm to Identify Cardiovascular Deaths from Administrative Health Records: A Multi-Database Population-Based Cohort Study. BMC Health Serv Res. 2021 Jul 31;21(1):758.


Brunetti VC, Reynier P, Azoulay L, Yu OHY, Ernst P, Platt RW, Filion KB. SGLT-2 Inhibitors and the Risk of Hospitalization for Community-Acquired Pneumonia: A Population-based Cohort Study. Pharmacoepidemiol Drug Saf. 2021 Jun;30(6):740-748.


Masarwa R, Brunetti VC, Aloe S, Henderson M, Platt RW, Filion KB. Efficacy and Safety of Metformin for Obesity: A Systematic Review. Pediatrics. 2021;147:e20201610.


Coulombe J, Moodie EEM, Platt RW. Weighted regression analysis to correct for informative monitoring times and confounders in longitudinal studies. Biometrics. 2021 Mar;77(1):162-174.


Pang M, Platt RW, Schuster T, Abrahamowicz M. Spline-based accelerated failure time model. Stat Med. 2021 Jan 30;40(2):481-497.


Suissa S. Single-arm trials with historical controls: Study designs to avoid time-related biases. Epidemiology. 2021 Jan;32(1):94-100.




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