Research Priorities - Clinical Research

Allergy

Established ongoing research encompasses mechanisms and mediators of anaphylaxis, peanut allergy, latex allergy and causes and management of chronic sinusitis. Psychosocial causes of multiple chemical sensitivity, and new variants of familial angioedema are topics of ongoing investigation. Clinical trials of immunoglobulin replacement, new treatments for C1 esterase inhibitor deficiency and monoclonal anti-IgE therapy in peanut allergy are a few of the many areas of investigation by division members. Scientist Profiles.

Anesthesiology

Clinical areas of research and education address important issues in peri-operative and critical care medicine with the long term goal of reducing organ injury, morbidity and mortality in critically ill patients. Specific areas of clinical research include peri-operative transesophageal echocardiography to assess ventricular function, blood conservation, innovations in airway management, optimization of the management of patients with traumatic brain injury and novel methods of treating acute and chronic pain. Educational initiatives include strategies to maximize patient safety and the development of broad based strategies to optimize education including low and high fidelity simulation techniques. Scientist Profiles.

Cardiovascular

Clinical research spans human physiology studies in cardiac catheterization; novel applications of imaging (ultrasound and magnetic resonance) in cardiovascular physiology and disease; development of innovative coronary and large vessel minimally invasive interventions; clinical registries and clinical trials in coronary artery disease; congestive heart failure, cardiac arrhythmias and resuscitation. Scientist Profiles.

Critical Care and Emergency Medicine

Clinical research in Critical Care and Emergency Medicine addresses a number of clinically important topics in critical care from prevention, inhospital and out of hospital care and recovery. Topics of inquiry include resuscitation, injury prevention, early post arrest care, sepsis, acute lung injury, infectious diseases, and mechanical ventilation. The studies deal with questions across the gamut of translational research from 'Bench to Bedside to Curbside' including: trials addressing biomarkers, physiological studies, surveys, meta-analyses, clinical decision rules, knowledge translation, ethics of waiver of consent trials, and randomized clinical trials. There are two endowed research chairs affiliated with this research priority; the Cara Phelan Chair of Trauma Research currently held by Dr. Andrew Baker and the Robert and Dorothy Pitts Chair in Acute Care and Emergency Medicine currently held by Dr. Laurie Morrison, who is the Director of the Rescu research program. Scientist Profiles.

Endocrinology

Diabetes is a priority area with a number of areas of interest ranging from islet cell biology, translational research to develop novel therapies, health care delivery, and clinical trials to investigate new dietary and pharmacologic therapies to prevent and treat diabetes and its complications. Other areas of interest include the epidemiology and treatment of osteoporosis and other metabolic bone diseases as well as animal models of atherosclerosis and clinical trials to investigate new dietary and pharmacologic therapies to prevent and treat dyslipidemia and atherosclerosis. Scientist Profiles.

Gastroenterology

Foci are the development and evaluation of novel screening tests, diagnostic tests and imaging technologies, outcomes assessment tools, minimally invasive endoscopic and innovative medical therapies, and cost-effective health care delivery strategies for patients with functional gastrointestinal disorders, inflammatory bowel disease, gastrointestinal cancers and pancreaticobiliary disorders. Administrative databases, registries, surveys, randomized clinical trials and mixed methods are used. Scientist Profiles.

General Internal Medicine

Clinical areas of research include health issues among homeless people and other disadvantaged populations, the care of patients with complex medical conditions, continuity of care, diagnostic imaging, medical aspects of pregnancy, and drug prescribing. Methodological approaches include decision analyses, economic evaluations, randomized trials, analyses of large observational databases, and public engagement in health care decision making. Scientist Profiles.

General Surgery

General surgery has several areas of focus including robotics and high fidelity simulation as a means to develop surgical skills. There is a strong emphasis on the critically ill surgical patient including the inflammatory response in critical illness, severe sepsis and intra-abdominal infection. Health services research as it pertains to surgical oncology (breast, colorectal cancer). Scientist Profiles.

Hematology/Oncology

Our division carries out clinical research in malignant diseases, including the study of novel chemotherapeutic agents and molecular-targeted biologics for breast and gastrointestinal cancers, and trials in HIV-associated malignancy. We are also engaged in research into quality improvement (eg. identifying barriers to wait-times for delivery of systemic therapy), patient safety (eg. optimizing chemotherapy drug delivery), and healthcare outcomes research, which encompasses practice guideline development, systematic reviews and decision analysis. Our clinical research in benign hematology is concentrated in the area of management of hemophilia and other congenital bleeding disorders. Scientist Profiles.

Infectious diseases

Clinical areas of research focus on emerging infectious diseases affecting immigrant and refugee populations such as tuberculosis, viral hepatitis, and childhood vaccine preventable diseases, international travel and infectious diseases with pandemic potential, HIV-AIDS with an emphasis on treatment and its complications among women, neuropsychological features of HIV-AIDS, and hospital infection control. Methodologies to study these research areas are varied and often trans-disciplinary comprising clinical and population epidemiology, randomized clinical trials, mathematical modeling, economic evaluation, geographic methods, quality of life studies, and large dataset analysis. Scientist Profiles.

Injury Prevention and Trauma

Research spans several phases of injury control including cluster randomized controlled trials to evaluate injury prevention initiatives, neighbourhood risk factors for injury, health services research pertaining to organized systems of trauma care and trauma care delivery. Acute care research focuses on traumatic brain injury, resuscitation, teamwork and interprofessional collaboration and the post-injury inflammatory response. Scientist Profiles.

Lab Medicine & Pathology

Research is focused on clinical studies related to Infection Control, including strategies to deal with Pandemics. Scientist Profiles.

Mental Health

Clinical areas of research include self-harm and suicide studies, HIV and neurobehavioral research, studies of mental ilnnesss and homelessness, studies related to memory, cognition and perception in old age and mental health systems research. The Arthur Sommer Rotenberg endowed chair in suicide studies is located in the SMH mental health service. Scientist Profiles.

Musculoskeletal

Our work spans from testing of devices (plates, surgical techniques) or treatments in randomized controlled trials to developing and testing outcome measures and their statistical modeling. We have expertise in qualitative and quantitative methods to explore these areas, and place a strong emphasis on the application of the results in clinical practice and health policy. Areas of emphasis: fracture treatment, fracture prevention in osteoporotic patients, prognostic cohort studies, e-data collection and reporting, measurement and outcomes research, and knowledge translation (facilitative best practice). Scientist Profiles.

Neurosciences

Clinical areas of research in MS include clinical trials of new agents in MS, genetic epidemiology and genetic susceptibility to MS, health service research and neuropsychiatric complications from an imaging perspective (MRI). In stroke, new potential neuroprotective agents are being examined. Stroke outcome is a major research area including the influence of the type of hospitalization, sociodemographic and health service factors upon patient outcome. A third area of research is in education, with a particular interest in doctor-patient communication and error disclosure. Read more.

Nursing

Key priorities for Nursing Research are generating, managing and translating knowledge that is relevant to nursing practice and safer health care systems. Areas of funded research include both a clinical focus including fetal alcohol spectrum disorder, pain management, consent in critical care research and wound care management, and a health services research focus including patient safety (learning from near misses, team based disclosure of errors, culture and leadership in critical care) and evaluating research capacity strategies and other innovations in nursing care. Scientist Profiles

Nutrition

Research includes dietary studies to define preventative strategies and treatment options for the metabolic syndrome, type 2 diabetes, cardiovascular disease, hyperlipidemia and renal disease and the dietary factors determining cell growth, cancer promotion and inhibition, development of glycemic index and dietary portfolio concepts for effective blood glucose and lipid control and exploration of novel foods, herbs and botanicals including salba and gensenosides in the treatment of chronic disease. Scientist Profiles.

Occupational and Environmental Health

Occupational disease research through the Centre for Research Expertise in Occupational Disease, is focused on four programs: occupational contact dermatitis, occupational lung disease, hand arm vibration syndrome and biological hazards. Occupational research in these areas spans the spectrum from causative agents, exposure assessment, prevention, early recognition, diagnosis, return to work, outcomes and health services delivery. In the environmental area, our research focuses on the cardiorespiratory effects of inhaled contaminants. It includes basic work on mechanisms of disease and physiological and clinical responses. A new state of the art facility built in conjunction with Southern Ontario Centre for Atmospheric Aerosol Research enables controlled exposures to ambient particulate and gaseous materials, as well as characterization of the exposures. Scientist Profiles.

Obstetrics and Gynecology

Clinical areas of research include: perinatal care for the disadvantaged, risk factors for adverse maternal and neonatal outcomes, post-partum depression, pregnancy and birth outcomes related to maternal country of origin, sexually transmitted infections, minimally invasive gynecological interventions, surgical simulation in gynecologic surgery and the development of interprofessional educational programs for undergraduate trainees. Scientist Profiles.

Ophthalmology

Areas of clinical and translational research include glaucoma, diabetic retinopathy, retinal detachment and age-related macular degeneration. The retina unit and the internationally-recognized glaucoma and nerve protection unit are involved in early to late phase clinical trials of diagnostic tests and novel compounds to detect and prevent vision loss. The retina unit is focused on research in neurovascular protection, with the goal of stabilizing abnormal blood vessels and the nerves they serve. We have developed the National Ocular Trauma database, and have recently opened Toronto&s only adult visual electrophysiology unit, the latter providing an unprecedented opportunity to bring novel theories of disease, and new treatments, from bench to bedside. Scientist Profiles.

Pediatrics

Clinical pediatric research activities include studies focusing on physical and developmental outcomes of "at-risk" infants and children. Areas of clinical outcomes research include neonatal follow-up, neonatal hyperbilirubinemia, kernicterus, nutritional deficiencies (including iron deficiency) and drug and alcohol exposures. There is educational research addressing simulation as an educational tool in neonatal resuscitation. Scientist Profiles.

Primary Care

Clinical areas of research include medical issues of particular importance to the poor and homeless, the delivery of primary care in low and middle income countries, aboriginal health, alternative and complementary medicine, urban neighbourhoods and health, diabetes and designing the family practice of the future. Methodological approaches include analyses of administrative databases, geographic methods, pragmatic randomized trials, qualitative methods and mixed methods. Scientist Profiles. Scientist Profiles.

Renal Disease/Nephrology

Clinical research in the Division of Nephrology encompasses clinical disorders of fluid and electrolytes and acid-base balance; pathophysiology and prevention of nephrolithiasis; pathophysiology of acute renal failure in critical care; dialysis modalities for acute renal failure in critical care; hemodialysis; renal transplantation; health economics and choice of dialysis modality; and development of practice guidelines for diabetic nephropathy and hypertension. Scientist Profiles.

Respirology

Research interests include clinical research in Cystic Fibrosis and Hereditary Hemorrhagic Telangiectasia, addressing the natural history and complications, using clinical databases to assess outcomes and interactions between sleep disordered breathing and the cardiovascular system. Basic science foci include use of molecular biology to examine muscle and lung growth and repair. Scientist Profiles.