Received: 7 January 2022
Accepted: 7 July 2022
First Online: 5 September 2022
: The study was carried out in accordance with relevant guidelines and regulations in the Declaration of Helsinki. We obtained ethics approval from the University of Manitoba’s Health Research Ethics Board (protocol number HS22485), and the study protocol underwent a privacy impact assessment at ICES, where the data are held. ICES is an independent, non-profit research institute whose legal status under Ontario’s health information privacy law allows it to collect and analyze health care and demographic data, without consent, for health system evaluation and improvement. Informed consent was not obtained from study participants, as Sect. 45 of the Personal Health Information Protection Act permits prescribed entities such as ICES to collect data and conduct analyses to improve health and healthcare without individual consent.
: Not applicable.
: The authors declare they have no competing interests.