DEPARTMENT OF MEDICINE E-Mail Newsletter
October 2008 Volume 1 Issue 3
Message from the Physician-in-Chief
Dear Colleagues,
This issue of the newsletter highlights the winners of the 2007-08 Department awards for teaching, research, mentoring and leadership. It is inspiring to see the talent of our faculty members—we are all proud of their accomplishments. This year we are starting a new celebration which we will hold each fall. On November 12, the Department will host a special event at the Vaughan Estate. The event will include brief presentations by 3 faculty members—Ayelet Kuper (a junior educator), Kaveh Shojania (a mid career scientist) and Sandra Black (a senior scientist). The goal of this is to share with the entire faculty what 3 of our excellent members are doing.. Afterwards we will hold a dinner and present the awards.
We plan to hold this type of event each October or November and then in the winter we will have our dinner and dance (last years was GREAT). So let’s CELEBRATE!!!
Yours, Wendy
Research Spotlight: Cardiology/General Internal Medicine
Measuring and improving cardiovascular care through cardiovascular outcomes research
By: Dr. Jack Tu
There have been many advances in the treatment of patients with cardiovascular disease over the past few decades (e.g. thrombolytics, percutaneous coronary interventions (PCIS), statins, etc.) and yet there remains a large gap between optimal care and actual care for many cardiac patients in hospitals throughout the world. My research is focused on measuring and improving cardiovascular care through the collection, linkage, and analysis of large population-based databases of patients with cardiovascular disease and stroke in Ontario and across Canada. I have the privilege of collaborating with a number of colleagues at Sunnybrook on these projects including Drs Dennis Ko, Eric Cohen, Dr. Eugene Crystal, and Dr. David Gladstone.
As the Team Leader of the Canadian Cardiovascular Outcomes Research Team (www.ccort.ca), funded by a Canadian Institutes of Health Research (CIHR) Team Grant, I work with over 30 colleagues across Canada who are interested in the field of cardiovascular outcomes research, which focuses on determining what works and doesn’t work in the ‘real- Department of Medicine E-mail Newsletter Pg. 2 world’ treatment of cardiac patients. Our group is busy studying a number of important research questions including 1) Determining the optimal reperfusion policy for treating STEMI patients across Canada, 2) Determining the effects of variations in cardiac drug policy on drug utilization and patient outcomes, 3) Determining the optimal rate of cardiovascular procedure utilization, 4) Studying how Electronic Medical Records can be used to evaluate the quality of cardiac care in a primary care setting, and 5) Examining trends over time in the risk factors, treatment, and outcomes of cardiac patients across Canada. In addition to these projects, I am also a Co-Principal Investigator of the Ontario Implantable Cardioverter Defibrillator (ICD) project with Dr. Douglas Lee of UHN/ICES, and Co-Lead on the “Variations in Revascularization Practices in Ontario” project with Dr. Eric Cohen of Sunnybrook/CCN. Through these projects, we strive to make not only an academic contribution but also to improve the actual care of patients with cardiovascular disease in Canada.
Dr Jack Tu is a Clinician Scientist who holds a Doctor of Medicine degree (awarded in 1988) from the University of Western Ontario, a Master of Science degree in Clinical Epidemiology (awarded in 1993) from the University of Toronto and a PhD in Health Policy (awarded in 1996) from Harvard University. He began his academic career in 1996. He is currently a Senior Scientist at the Institute for Clinical Evaluative Sciences (ICES) in Toronto and is the head of the Cardiovascular and Diagnostic Imaging research program at ICES. In addition, he holds a Canada Research Chair in Health Services Research Tier I and was promoted in 2004 to Professor of Medicine, Public Health Sciences, and Health Policy, Management & Evaluation at the University of Toronto. He is also an attending physician in the Divisions of Cardiology (Schulich Heart Program) and General Internal Medicine at Sunnybrook Health Sciences Centre. Dr. Tu is an internationally-recognized health services researcher, who has published over 195 peer-reviewed journal articles, including articles in the New England Journal of Medicine, Journal of American Medical Association, Annals of Internal Medicine, Lancet, and other leading general internal medicine and subspecialty journals. He has held several million dollars in peer-reviewed grants as a principal investigator from the Canadian Institutes of Health Research, Heart and Stroke Foundation, and other funding agencies. His key areas of interests are • Quality of acute myocardial infarction/congestive heart failure care• Rates, waits, and outcomes of patients undergoing cardiac procedures• Quality of care in stroke/carotid surgery• Effectiveness of health care report cards for improving care• International comparisons of health care systems.
Resource: Research and Evaluation – Centre for Health Services Sciences
Launched in July 2007, the Centre for Health Services Sciences (CHSS) is uniquely designed to maximize scientific, clinical and managerial expertise at Sunnybrook Health Sciences Centre. An integrated platform of both the hospital and its research institute, the goal of CHSS is to help achieve the academic mission of Sunnybrook to discover, apply, evaluate and translate knowledge, thereby ensuring that the findings generated will benefit patients and staff now and in the future.
Through CHSS, researchers, clinicians and managers work together within a coordinated framework to understand barriers to providing evidence-based care, and to develop and test new methods to help translate evidence into practice more effectively. Everyone within CHSS works closely with frontline health care providers to overcome these barriers, identify and leverage catalysts for change, and support the diffusion of best practices throughout Sunnybrook. The goal of CHSS is to support the spread of innovation and best practices for safety and quality throughout the hospital.
The Centre for Health Services Sciences has four research platforms, each led by renowned clinicians and experts in their discipline: ♦ Patient safety and improvement research, Dr. Edward Etchells ♦ Clinical studies resource centre, Keitha McMurray ♦ Hospital epidemiology, Dr. Donald Redelmeier ♦ Knowledge translation, Dr. Andrew Smith Department of Medicine E-mail Newsletter Pg. 3
Uniting these efforts and leading CHSS as its inaugural chair is Dr. Merrick Zwarenstein, a highly regarded international health services researcher and program manager Katie Dainty.
Work now underway includes the following: ♦ a campaign championed by CHSS to intensify the hospital’s efforts to reduce surgical site infections and to tackle patient flow ♦ financial, logistic, and technical coordination for clinicians from all professions who wish to do health services, quality & patient safety research at Sunnybrook ♦ collaboration with stakeholders to streamline and support research processes, including partnership with the REB office ♦ assistance with clinical trial support needs of investigators ♦ partnerships with the Clinical Epidemiology unit for statistical and methodological support ♦ evaluation of knowledge translation strategies ongoing in the hospital ♦ alignment of health services research efforts with hospital priorities ♦ providing consultation and networking resources to all researchers & management at Sunnybrook
The centre aims to support and encourage all staff across the hospital, including Department of Medicine members, in their efforts to embed evidence-driven improvement into the care they deliver to patients. The continuing development of CHSS will ensure that innovation occurring at the interface between care and research is captured and translated readily into those areas where it will have the most impact.
In a nutshell, if you have a research question, need to find someone at Sunnybrook who does the same kind of research you do or are just curious about health services science – call CHSS. For help or more information, contact Katie Dainty, program manager for CHSS: 416-480-6100, ext. 88128, or [email protected].
2008 Sunnybrook Department of Medicine Award winners
Teaching
In-Patient Teaching Award Part-Time Teaching Award Ambulatory Teaching Award
Rob Fowler Brian Wong Liesly Lee
Young Teacher Award Pre-Clerkship Award
Khalil Sivjee Eugenia Piliotis
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Research
Junior Investigator Award Senior Investigator Award
Matthew Cheung Linda Rabeneck
Mentorship Leadership
William J. Sibbald Mentoring Award Department of Medicine Leadership
Jan Hux Maureen Trudeau
Honours and Awards received September 2008
Infectious Diseases Dr. Nick Daneman: - Was awarded the Mark Bisby Fellowship from Canadian Institute Health Research for being one of the top ranking candidates in the Health Research Training Competition
Nephrology Dr. Sheldon Tobe: - Chaired the Recommendations Task Force of the Canadian Hypertension Education Program (CHEP) at its annual consensus conference on Friday October 24th at the Canadian Cardiovascular Conference in Toronto.
Team - The Thromboembolism Team received one of 5 Team Awards from the hospital in September (there were 40 applicants). Members of the team are: Dr. Bill Bartle, Dr. Richard Jay, Dr. Rita Selby, Patti Cornish, Guna Budrevics, Lynne Riley, Artemis Diamanturos, Barbara Huth, and Dr. Bill Geerts
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Selected Publications September 2008
Cardiology Jack Tu: Published (Sept 2008): - Austin PC, Donovan LR, Yun L, TU JV. Comparing clinical and administrative data for profiling hospitals on post-discharge medication use by AMI patients. Am Heart J; 156:595-605, 2008. (Senior Responsible Author) - Lee DS, Birnie D, Cameron D, Crystal E, Dorian P, Gula LJ, Healey JS, Janmohammed A, Khaykin Y, Krahn AD, LeFeuvre C, Simpson CS, Yee R, Hardy J, Slaughter PM, Chen Z, Alter DA, Laupacis A, TU JV. Design and implementation of a population-based registry of implantable cardioverter defibrillators (ICDs) in Ontario. Heart Rhythm; 5:1250-1256, 2008. (Senior Responsible Author)
In Press: - Rinfret S, Behlouli H, Eisenberg MJ, Humphries K, TU JV, Pilote L. Class effects of statins in elderly patients with congestive heart failure: a population-based analysis. (In Press ~ Am Heart J) (Senior Responsible Author) - Jackevicius C, TU JV, Ross J, Ko D, Krumholz H. Use of Exetimibe in the United States and Canada. (In Press ~ N Engl J Med) (Senior Responsible Author) - Jackevicius C, TU JV, Demers V, Melo M, Cox J, Rinfret S, Kalavrouziotis D, Johansen H, Behlouli H, Newman A, Pilote L. Cardiovascular Outcomes with Removal of Clopidogrel Prior Authorization in Patients Receiving Coronary Stents. (In Press ~ N Engl J Med) (Senior Responsible Author) - TU JV, Khalid L, Donovan LR, Ko DT, and the CCORT/CCS Canadian AMI Quality Indicator Panel. Indicators of quality of care for patients with acute myocardial infarction. (In Press ~ Can Med Assoc J) (Senior Responsible Author)
Endocrinology Baiju Shah: - Shah BR. Utilisation of physician services for diabetic patients from ethnic minorities. Journal of Public Health (Oxford), 30:327-31, 2008. - Shah BR, Booth GL. Predictors and effectiveness of self-management education in clinical practice. Patient Education and Counseling, 2008 Sep 19; [Epub ahead of print]. - Bhattacharyya OK, Shah BR, Booth GL. Management of cardiovascular disease in patients with diabetes: the 2008 Canadian Diabetes Association guidelines. Canadian Medical Association Journal, 2008 Sep 18; [Epub ahead of print].
Gastroenterology Fred Saibil: - Levine AJ, Wallace K, Tsang S, Haile RW, Saibil F, Ahnen D, Cole BF, Barry EL, Munroe DJ, Ali IU, Ueland P, Baron JA. MTHFR genotype and colorectal adenoma recurrence: data from a double-blind placebo-controlled clinical trial. Cancer Epidemiol Biomarkers Prev 17(9):2409–2415, 2008. (collaborator)
Infectious Diseases Andy Simor - Golding GR, Campbell JL, Spreitzer DJ, Simor AE, Mulvey MR. A preliminary guideline for the assignment of methicillin-resistant Staphylococcus aureus to a Canadian pulsed-field gel electrophoresis epidemic type using spa typing. Can J Med Microbiol Infect Dis 2008; 19:273-8.
Infectious Diseases and Geriatric Medicine Andy Simor and Barbara Liu - Nicolle LE, Mubareka S, Simor A, Liu B, McNeil S, Loeb M. Variation in mortality rates among long-term care facilities for residents with lower respiratory tract infection. Infect Control Hosp Epidemiol 2008; 29:754-9.
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Medical Oncology/Haematology Kevin Imrie Peer Reviewed - Shehata, N., Walker, I., Meyer, R., Haynes, A.E., and Imrie, K., The use of erythropoiesis-stimulating agents in patients with non-myeloid hematological malignancies: a systematic review. Ann Hematol, 2008 [Epub ahead of print]. (Senior author, 40% effort)
- Marcus, R., Imrie, K., Solal-Celigny, P., Catalano, J.V., Dmoszynska, A., Raposo, J.C., Offner, F.C., Gomez-Codina, J., Belch, A., Cunningham, D., Wassner-Fritsch, E., and Stein, G., Phase III Study of R- CVP Compared With Cyclophosphamide, Vincristine, and Prednisone Alone in Patients With Previously Untreated Advanced Follicular Lymphoma. J Clin Oncol, 2008. 26(28): p. 4579-86. (Collaborator, 30% effort).
Maureen Trudeau Invited Publication - Robson D, Trudeau M. Molecular aberrations in breast cancer and their implications for future therapy. Biological Therapy of Breast Cancer. August 2008, Vol. 9, No. 1, pages 13-16. (Senior author, 10% effort).
Respirology & Clinical Immunology William Geerts
- Geerts WH, Bergqvist D, Pineo GF, Heit JA, Samama CM, Lassen MR, Colwell CW. Prevention of venous thromboembolism. American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008;133:381S-453S - Douketis J, Cook D, Meade M, Guyatt G, Geerts W, Skrobik Y, Albert M, Granton J, Hebert PC, Pagliarello G, Marshall JC, Fowler R, Freitag A, Rabbat C, Anderson D, Zytaruk N, Heels-Ansdell D, Crowther M, for the Canadian Critical Care Trials Group. Prophylaxis against deep vein thrombosis in critically ill patients with severe renal insufficiency with the low-molecular-weight heparin dalteparin: An assessment of safety and pharmacodynamics: The DIRECT Study. Arch Intern Med 2008;168:1805-1812
Rheumatology Dr. Mary Bell - Lineker, Sydney C., Bell, Mary J., Boyle, Jennifer, Badley, Elizabeth M., Flakstad, Lois, Fleming, John, Lyddiatt, Anne, MacDonald, Jane, McCarthy, Jack and Zummer, Michel. Coauthor. ”Implementing Arthritis Clinical Practice Guidelines in Primary Care”. Medical Teacher, published online 29 Sep 2008 at http://dx.doi.org/10.1080/01421590802158377. Impact Factor 1.229. - Oswald AE, Bell MJ, Snell L, Wiseman J. Coauthor. The Current State of Musculoskeletal Clinical Skills Teaching for Pre-clerkship Medical Students. Journal of Rheumatology (Manuscript ID 2008-0308.R1) In Press. Impact Factor 3.151.
Grants Received September 2008
Medical Oncology Matthew Cheung: Along with Drs. Nicole Mittmann, Nancy Risebrough, Kevin Imrie, Anita Rachlis, and Linda Taggart (PGY-2), received a grant ($21,963) from the Canadian Foundation for AIDS Research (CANFAR) for a project titled “Changes in Incidence and Outcomes of HIV-related Hematologic Malignancies in the Era of Combination Antiretroviral Therapy”.
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Our Chief Medical Resident
Dr. Paul Bunce
Dr. Paul Bunce, a 4th year resident, is the Chief Medical Resident in the Department of Medicine at Sunnybrook.
Paul has a BSc in Psychology from the University of Waterloo and a Masters of Arts degree in Clinical Psychology from Simon Fraser University. Paul subsequently completed his MD at the University of Toronto.
Paul is the recipient of many honours and awards, including the 2004 U of T medical school MVP in intramural ice hockey. Most recently, he received the 2008 Sopman Humanitarian Award while at the University Health Network for the characteristics of humanity, compassion and understanding along with the ability to communicate with patients and families.
Since arriving at Sunnybrook, Paul has been very busy in ensuring that the needs of the residents are met and although he has only been her 3 months, he has been quite instrumental in getting a face lift for the John Edmeads resident room. In addition, he recently purchased a bicycle, and can often be seen struggling along Mount Pleasant Ave in the early morning.
Paul’s role model is Dave Maslove, and his favourite Blue Jay is John McDonald. When he’s not hovering around the medical wards or sneaking into Eva’s office to steal candy, he is known to enjoy eating good food, drinking moderately- priced wine, and writing songs dedicated to his former senior resident.
Paul can be reached at 416-480-4594 but feel free to visit him in his office at Room D416b.
Notices
Economics Committee membership: - Congratulations to Dr. Steve Shadowitz who has been re-elected to the Economics Committee. Other members of the Committee are: Drs. Mary Anne Cooper, Wendy Levinson, Chris Morgan (Chair), Matt Oliver and Lorne Zinman.
Fall Social Event: - The Department’s Annual Awards Dinner will be held on Wednesday November 12 in the Courtyard Ballroom at the Vaughn Estates from 5pm – 8pm. The program will start with Research presentations from 3 of the department’s researchers, Drs. Sandra Black, Ayelet Kuper and Kaveh Shojania, followed by dinner and the presentation of awards.
WebCV: - The WebCV project spearheaded by Dr. Dante Morra is scheduled to be rolled out at Sunnybrook in January 2009. The WebCV is designed to make life a little easier for staff as it will facilitate the preparation of several reports including, Curriculum Vitae, Bio Sketch, Annual Activity Report, Teaching Dossier and Creative Professional Activity Dossier . Faculty will be asked to submit their Curriculum Vitae to the WebCV team for inputting into the database. Once this is done, one on one training will commence for all faculty members and their assistants. The details are being worked out and as soon as the planning is finalized staff will be updated. Department of Medicine E-mail Newsletter Pg. 8
Department of Medicine Sunnybrook Health Sciences Centre 2075 Bayview Ave Suite D4-74 Toronto Ontario M4N 3M5 Phone: 416-480-4592 Fax: 416-480-6191 Email: [email protected] Fully affiliated with the University of Toronto
For questions, comments and submissions, please contact Denise Campbell [email protected] or 416-480-6100 x2007