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Anesthesia Research Update
June 2010
Overview
Research Infrastructure
Current Projects
Current Funding
Research Events
Resident Research
Research Infrastructure
Research Coordinators
Lynda Rickards Email: [email protected] Part-time Research Coordinator Supervisor: Dr. Buckley Chronic Pain Research: PREGA,
Small vs Large dose epidural steroid/LA
Toni Tidy Email: [email protected] Ext: 21737 Office: MDCL 2109 Full-time Research
Coordinator Supervisor: Dr. Paul Department Research Coordination
Assists with REB submissions Grant proposals Organization of study documents Monthly department research meetings Research dinner meeting organization Research retreat organization Patient recruitment, data collection
Summer Student Research Coordinators Adam Jokhio Email: [email protected] Summer Research Coordinator Supervisors: Dr. Buckley/Dr. Paul MDCL 2109
Usawa Email: Chronic Pain Research Coordinator Supervisors: Dr. Buckley/Dr. Paul HGH
Prathiba Shanthanna Email: HGH Research Coordinator Supervisors: Dr. Syed/Dr. Paul MDCL 2109 Enigma II, Thrombosis trials
Methodology and Statistical Support
Emmy Cheng, MSc Email: [email protected] Ext: 905-522-1155 x35329 Statistician 50% FTE Meetings by appointment
Lehana Thebane, PhDEmail: [email protected]
Ext: 905-522-1155 x33720 Biostatistician & Methodologist 20% FTE In department (MDCL 2111) on
Wednesday mornings
Assists withStudy Question Formulation
Research design Data analysis plan Research Methodology Seminars Monthly Research Meetings Sample size calculation
Assists withData analysis Descriptive and inferential statistics
“The sponsor shall maintain all records referred to in this Division for a period of 25 years.”
Research Organization
Study Details REB Forms and Updates
Grant Details Case Report Forms
Getting Started: Suggested Project Workflow
Step Assistance
•Identify a research problem
•Formulate a research question Meet with Lehana or Colleagues
•Design the study Meet with Lehana or Colleagues
•Look for student volunteers Medical students or Residents
•Write up introduction and methods
•Consider presenting at research interest group
•Submit REB form Toni Tidy can assist
•Look for funding (if necessary) Toni Tidy can assist
•Mail all documents to Toni REB approval and updates, study details, grant details
•Register all clinical trials on “clinicaltrials.gov” Toni Tidy can assist
Active Projects
Acute Pain Chronic Pain
Perioperative
MedicineSimulation / Education
Cardiac / Thrombosis
Other
Current Projects: Topics
TypeChronic Pain 12Acute Pain / Regional Anesthesia 6Perioperative Medicine 7Cardiac Anesthesia / Thrombosis 6Anesthesia Education / Simulation 11Obstetric Anesthesia 1Pediatric Anesthesia 2General Anesthesia 11Critical Care 1
Total 57
Current Projects: Study Type
TypeCase Reports 1Retrospective Chart Reviews 11Prospective Cohort Studies 7Randomized Controlled Trials 12Qualitative / Interviews 4Laboratory Studies 2Systematic Reviews 3Narrative Reviews 1Simulation 4
Total 45
Current Projects: FundingFunding Status Number Comment
Unfunded 2611 Chart reviews1 RCTs4 Systematic Reviews
Grants Submitted 2 CIHR X 2
Funded 279 RCTs4 Simulation Studies5 Cohort Studies
Total 55
Funding Source Number $ % CommentAnesthesia Department Investigator-Driven StudiesCARF 1 40000 2.4 CAS research funding - RCA
Canadian Space Agency 1 30000 1.8 Simulation
CPSI 1 217000 12.8 RCA Study
HHS Anesthesia Academic Fund 4 37000 2.2 Up to $15, 000/yr available to HHS staff
HHS Foundation NIF 1 25000 1.5 Available to new staff (≤ 5 yrs)
HSFO/HSFQ 1 179500 10.6 ENIGMA-II
RMA 1 1278 0.07 Available to residents
RCPSC 1 25000 1.5 Simulation
MOHLTC 1 450000 26.6 Simulation
Subtotal 1004778 59.5
Collaborative Studies with Other DepartmentsSick Kids Foundation 1 130000 7.6 HIP study - Pediatrics
CIHR 1 400000 23.6 VISION - Cardiology
Subtotal 530000 31.4
Industry Funded StudiesPfizer 1 88400 5.2 Chronic Pain - Pregabalin
NovoNordisk 1 ? Cardiac/Thrombosis
Purdue Pharma 1 66600 3.9 Chronic Pain
Subtotal 155000 9.2
Total 17 1689778
Current Projects: Funding Sources
Multi-Centre Trials@ HHS and St. Joseph’s
Project Title Sites Recruitment(Completed or Active)
Local Sample Size
VISION MUMCHGHSt. Joseph’sHenderson
642 completed patients752 completed patients1007 completed patients1600 active patients
4000
POISE-II MUMCHGHSt. Joseph’sHenderson
Start Date – June 2010 100
ENIGMA-II MUMCHGHHenderson
Start Date – June 2010 250
Collaborations with Cleveland ClinicsDr. Daniel Sessler
LMA PerfecTemp Warming System
Arizant Healthcare Disposable Zero-Heat-Flux Thermometer
(DTT)
Study Question? Is the LMA PefecTemp system and the Bair Hugger warming systems equally good?
Is there an agreement between temperatures measured with the DTT system and the Swan-Ganz PA catheter?
Population Patients with elective abdominal surgery under general anesthetic to last >2hrs in the supine position
Patients to undergo elective cardiac surgery
Sample Size 45 patients @ MUMC70 patients total
80 patients total
Intervention Non-disposable warming bed Disposable zero-heat-flux thermometer probe
Outcome Intraoperative distal esophageal (core) temperature with PerfecTemp is non-inferior to upper body forced air warming
Zero-heat-flux thermometry is a reliable and accurate estimator of core temperature
Research EventsEvent Date
Department Research Meetings MonthlyMDCL 2249
Spring Research Retreat April 21: 18:00-21:00Ancaster Old Mill
Resident Exchange Day June 4: 09:00-17:00@ UWO
Research Interest Group Dinner Meetings Ad Hoc: 3-4/yr
Research Dinner Meetings with Dr. Dan Sessler/Outcomes Research
March 24 and June 17University Club
CANNeCTINApril 26-29
The David Braley, Cardiac, Vascular, and Stroke Research Institiute
Publications 2010In preparation/To be submitted:
Paul et al. Risk Factors for Respiratory Depression on Acute Pain Service
Paul et al. Using root cause analysis to reduce adverse events on an APS
Wong, A. Anesthesiologists' work: From the front lines. CJA 2010
Wong, A. Teaching and Learning in Anesthesiology: A Cross-cultural Comparison of a Thai and Canadian residency program
Submitted 2010:
Paul, J. et al. The Impact of a Comprehensive Initiative on PCA Errors. Anesthesiology 2010
Published 2010:
Blew, P. The Royal College Examination in Anesthesiology. CJA September 2010
Bruppacher, H. et al. National representation in the anesthesia literature: A bibliometric analysis of highly cited anaesthesiajournals. In Press. Anaesthesia 2010
Paul, J. et al. Femoral nerve block improves analgesia following TKA: A Meta-Analysis of RCTs. Accepted. Anesthesiology 2010
Syed et al. The Influence of Perioperative Coagulation Status on Postoperative Blood Loss in Complex Cardiac Surgery: A Prospective Observational Study. Anesthesia and Analgesia. April 30 2010
Resident Research All residents must have one of the following:
published an article (letters to the editor acceptable) in a peer-review journal, or
written up a research proposal; or
completed a quality assurance project (retrospective review focussed on a specific quality of care issue); or
completed a comprehensive review paper
before completion of residency training. The expectation is that all residents will present at least once during their residency training at Resident Exchange Day, which is held in June of each year in conjunction with the University of Western Ontario. This presentation can be either the methods of a planned project or the results of a completed study.
Although not mandatory, all residents are strongly encouraged to participate in either basic or clinical research that involves the design of a study, data collection, analysis and manuscript preparation.
Conclusions:
Research infrastructure is quite good: statistical, methodology and coordination support
Large number of active projects: 45projects amongst 21 staff
We have received significant funding with a number of pending grants: $1.7 million
Resident research needs to be encouraged more
The goal to improve the department research culture in the long-term