Aysegul Erman

University Health Network | UHN · Toronto General Hospital

Background Patients with chronic hepatitis C (CHC) can be cured with the new highly effective interferon‐free combination treatments (DAA) that were approved in 2014. However, CHC is a largely silent disease, and many individuals are unaware of their infections until the late stages of the disease. The impact of wider access to effective treatments...

Background Data on the economic burden of chronic hepatitis C (CHC) among immigrants are limited. Our objective was to estimate the CHC-attributable mortality and healthcare costs among immigrants in Ontario, Canada. Methods We conducted a population-based matched cohort study among immigrants diagnosed with CHC between May 31, 2003, and December...

Background: HCV elimination requires a thorough understanding of the care cascade. A direct-acting antiviral (DAA)-era description of the care cascade has not been undertaken in Ontario, Canada's most populous jurisdiction. Our primary objective was to describe the current population-level care cascade in the general Ontario population and among k...

Introduction: Recently, minimally invasive surgical therapies (MISTs) have become an alternative to surgery or pharmacotherapy to manage benign prostatic hyperplasia (BPH). This study evaluated the cost-utility of water vapor thermal therapy (WVTT) and prostatic urethral lift (PUL) compared to pharmacotherapy as initial treatment for patients with...

Background Chronic infection with hepatitis C virus (HCV) is a leading cause of liver-related mortality. Direct-acting antivirals (DAAs) have revolutionised treatment by offering profound improvements in sustained viral clearance (SVR) and tolerability resulting in rapid expansion of treatment for individuals for whom HCV treatment had previously b...

Background Hepatitis C virus (HCV) elimination requires a thorough understanding of the care cascade. A direct-acting-antiviral (DAA)-era description of the care cascade has not been undertaken in Ontario, Canada. Our primary objective was to describe the current population-level care cascade in the general Ontario population and among key risk-gro...

The current study assesses the extent to which government leaders’ personality traits are related to divergent policy responses during the pandemic. To do so, we use data from the Oxford COVID-19 Government Response Tracker initiative (OxCGRT) to measure the speed and magnitude of policy responses across countries and NEGex, a dataset that maps the...

Objective The objective of this paper is to conduct a systematic review that summarizes the cost-effectiveness of cleft lip and/or palate (CL/P) care in low- and middle-income countries (LMICs) based on existing literature. Design We searched eleven electronic databases for articles from January 1, 2000 to December 29, 2020. This study is register...

Background Recently, minimally invasive therapies (MITs), such as water vapor thermal therapy (WVTT) and prostatic urethral lift (PUL) have become an alternative to surgery or pharmacotherapy to manage benign prostatic hyperplasia (BPH), offering symptom relief with a favorable safety profile. The objective of this study was to evaluate the cost-ut...

Structured Summary Background Clostridioides difficile infection (CDI) is the leading cause of health care-associated infectious diarrhoea. Several preventative and treatment interventions exist, however, decisions for their use are typically made independent of other interventions along the care pathway. Aim To assess how the scope of the decisi...

Background: As the transmission of SARS-CoV-2 variants intensifies globally, the burden of COVID-19 on the already strained health systems is becoming increasingly concerning. While there is growing literature on the effects of various variants-of-concern (VOC) on increased transmission, the extent to which VOCs may lead to more severe disease rema...

Infections and deaths associated with COVID-19 show a high degree of heterogeneity across different populations. A thorough understanding of population-level predictors of such outcomes is crucial for devising better-targeted and more appropriate public health preparedness measures. While demographic, economic, and health-system capacity have featu...

The rapidly growing scholarship on the COVID-19 crisis has focused on a variety of macro-level factors to understand government policy responses. The current study addresses an important gap in this line of research by evaluating the extent to which government leaders’ personality traits have led to divergent policy responses during the pandemic. T...

The rapidly growing scholarship on the COVID-19 crisis has focused on a variety of macro-level factors to understand government policy responses. The current study addresses an important gap in this line of research by evaluating the extent to which government leaders’ personality traits have led to divergent policy responses during the pandemic. T...

Deaths associated with COVID-19 shows a high degree of heterogeneity across different populations. An assessment of the global variability in COVID-19-attributable deaths is essential for predicting the health and economic impact of future outbreaks in different settings. Moreover, a comprehensive understanding of population-level predictors is als...

Hepatitis C virus (HCV) affects approximately 250,000 Canadians. Although safe and effective (>95% cure rates) antiviral therapies have become available within the past 5 years, chronic HCV infection still remains a major driver of end-stage liver disease and liver transplantation. Both the Canadian Institute for Health Research and the Public Heal...

Objectives Mathematical models are increasingly important in planning for the upcoming chronic hepatitis C (CHC) elimination efforts. Such models require reliable natural history inputs to make accurate predictions on health and economic outcomes. Yet, hepatitis C virus disease progression is known to vary widely in the literature and published inp...

Background & aim: Direct-acting antivirals (DAAs) are highly effective, but expensive treatments for chronic hepatitis C (CHC). To manage costs, drug plans worldwide have rationed access to DAAs in a variety of ways. This study quantifies the health impact of formulary restrictions and presents a clinical decision tool for informing treatment timi...

Background: Chronic hepatitis B (CHB) infection poses a significant burden to public health worldwide. Most cases are clinically silent until late in the disease course. The main goal of current therapy is to improve survival and quality of life by preventing disease progression to cirrhosis and liver failure, and consequently hepatocellular carci...

Introduction: Benign prostatic hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland, which results in the development of lower urinary tract symptoms that can interfere with a patient's daily activities and negatively impact their quality of life. The gold standard treatment for moderate to severe BPH has been transurethral resec...

Objective To evaluate the cost‐effectiveness of using a surgery such as transurethral resection of the prostate (TURP) or photoselective vaporization of the prostate using greenlight laser (GL‐PVP) as initial treatment for men with moderate‐to‐severe benign prostate hyperplasia (BPH) compared to the standard practice of using pharmacotherapy as ini...

Chronic hepatitis C (CHC) is a leading cause of hepatic fibrosis and cirrhosis. The level of fibrosis is traditionally established by histology and prognosis is estimated using fibrosis progression rates (FPRs; annual probability of progressing across histological stages). However, newer non-invasive alternatives are quickly replacing biopsy. One a...

Background Chronic Hepatitis C viral infection (HCV) is a leading cause of cirrhosis, liver failure, and transplantation. The accurate estimation of HCV-disease progression is essential for evaluating the cost effectiveness of treatment and determining treatment prioritization. Aims The purpose of this study was to obtain updated progression rate...

Background: Because most hepatitis C virus (HCV) infections are asymptomatic and often unrecognized, screening for hepatitis C has been proposed as a plausible public health strategy. We examined the health and economic consequences of a selective one-time hepatitis C screening program for specific populations in the context of current treatment p...

Five years of Tamoxifen (Standard TAM) is a common treatment option for early-stage, hormone receptor positive (HR+) breast cancer (BC). Extending Standard TAM by 5 additional years (Extended TAM) can improve survival and BC recurrences. In postmenopausal women, the use of extended aromatase inhibitors (Extended AI) after Standard TAM is an alterna...

In our previous analyses, we found significantly lower levels of growth hormone receptor (GHR) mRNA in adipose tissues of obese than in those of lean individuals, suggesting that idiopathic obesity involves GH resistance due to decreased GHR availability. To understand the mechanism(s) behind this downregulation, we performed an in silico analysis...

Growth hormone (GH)-deficient individuals display increased adiposity that can be effectively reduced by GH therapy because of GH's lipolytic effects. However, similar GH treatments of individuals with idiopathic obesity (not associated with an endocrinopathy/syndrome) have had little success. We hypothesized that this form of obesity may be associ...

Rabs and Arfs/Arls are Ras-related small GTPases of particular relevance to membrane trafficking. It is thought that these proteins regulate specific pathways through interactions with coat, motor, tether and SNARE proteins. We screened a comprehensive list of Arf/Arl/Rab proteins, previously identified on purified Golgi membranes by a proteomics a...