Variation in Availability of Continuous Ambulatory Electrocardiographic Monitors Across Canadian Provinces
Bibliographic record
Abstract
Background: Continuous ambulatory electrocardiographic (ECG) monitors are essential for diagnosing cardiac arrhythmias. In Canada, individual provinces dictate access to and reimbursement for these services. This study examines variations in access to continuous ambulatory ECG monitoring in Canada. Methods: We reviewed publicly available provincial schedules of benefits, to identify the durations of continuous ambulatory ECG monitoring reimbursed across Canadian provinces. We abstracted data on the duration, modality, and reimbursement criteria for monitoring services. Additionally, at least one specialist from each province provided information on the types of monitors available, their accessibility, and further information on local reimbursement processes. Results: We found significant variability in continuous ambulatory ECG monitoring coverage across provinces. Shorter monitoring durations (24 and 48 hours) are available in all provinces, but coverage for longer durations varies. Only patients in Ontario, Nova Scotia, and Saskatchewan can access publicly funded, 14-day, continuous, ambulatory ECG monitors. Ambulatory ECG monitoring is available from hospitals in all provinces. Direct-to-patient device delivery is available in all but 4 provinces (Alberta, Saskatchewan, Manitoba, and Nova Scotia). Testing by private entities is available in 5 provinces (British Columbia, Alberta, Saskatchewan, Ontario, and Quebec). Conclusions: The availability of continuous, ambulatory, ECG monitoring across Canadian provinces has considerable variability. Measures are needed to ensure equitable access to ambulatory ECG monitoring services nationwide. Creating national monitoring guidelines could set goals for provinces to work toward, enhancing access for all Canadians and reinforcing values of the Canada Health Act.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.022 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.008 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.000 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".