anesthesia research update - mcmaster faculty of health...
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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
Medicine!Simulation /
Education!
Cardiac / Thrombosis!
Other!
Current Projects: Topics���
Type!Chronic Pain! 12!Acute Pain / Regional Anesthesia ! 6!Perioperative Medicine! 7!Cardiac Anesthesia / Thrombosis! 6!Anesthesia Education / Simulation! 11!Obstetric Anesthesia! 1!Pediatric Anesthesia! 2!General Anesthesia! 11!Critical Care! 1!
Total! 57!
Current Projects: Study Type���
Type!Case Reports! 1!Retrospective Chart Reviews! 11!Prospective Cohort Studies! 7!Randomized Controlled Trials! 12!Qualitative / Interviews! 4!Laboratory Studies! 2!Systematic Reviews! 3!Narrative Reviews! 1!Simulation! 4!
Total! 45!
Current Projects: Funding���Funding Status! Number! Comment!
Unfunded! 26!11 Chart reviews!1 RCTs!4 Systematic Reviews!
Grants Submitted! 2!!CIHR X 2!!
Funded! 27!9 RCTs!4 Simulation Studies!5 Cohort Studies!
Total! 55!
Funding Source! Number! $! %! Comment!Anesthesia Department Investigator-Driven Studies!CARF! 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 Departments!Sick Kids Foundation! 1! 130000! 7.6! HIP study - Pediatrics!CIHR! 1! 400000! 23.6! VISION - Cardiology!
Subtotal! 530000! 31.4!
Industry Funded Studies!Pfizer! 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! MUMC!HGH!St. Joseph’s!Henderson!
642 completed patients!752 completed patients!1007 completed patients!1600 active patients!
4000!
POISE-II! MUMC!HGH!St. Joseph’s!Henderson!
!!Start Date – June 2010!
!!100!
ENIGMA-II! MUMC!HGH!Henderson!
!Start Date – June 2010!
!250!
Collaborations with Cleveland Clinics�Dr. 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 @ MUMC 70 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 Events���Event! Date!
Department Research Meetings! Monthly!MDCL 2249!
Spring Research Retreat! April 21: 18:00-21:00!Ancaster 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 17!University Club!
CANNeCTIN!April 26-29!
The David Braley, Cardiac, Vascular, and Stroke Research Institiute!
Publications 2010 In 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 anaesthesia journals. 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!