Anesthesia Research Update. June 2010

Transcription

1 Anesthesia Research Update June 2010

2 Overview Research Infrastructure Current Projects Current Funding Research Events Resident Research

3 Research Infrastructure

4 Research Coordinators Toni Tidy Ext: 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 Lynda Rickards Part-time Research Coordinator Supervisor: Dr. Buckley Chronic Pain Research: PREGA, Small vs Large dose epidural steroid/la

5 Summer Student Research Coordinators Adam Jokhio Summer Research Coordinator Supervisors: Dr. Buckley/Dr. Paul MDCL 2109 Prathiba Shanthanna HGH Research Coordinator Supervisors: Dr. Syed/Dr. Paul MDCL 2109 Enigma II, Thrombosis trials Usawa Chronic Pain Research Coordinator Supervisors: Dr. Buckley/Dr. Paul HGH

6 Methodology and Statistical Support Lehana Thebane, PhD Ext: 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 Emmy Cheng, MSc Ext: x35329 Statistician 50% FTE Meetings by appointment Assists withdata analysis Descriptive and inferential statistics

7 Research Organization The sponsor shall maintain all records referred to in this Division for a period of 25 years. Study Details Grant Details REB Forms and Updates Case Report Forms tonitidy@mcmaster.ca

8 Getting Started: Suggested Project Workflow Step Assistance Identify a research problem Formulate a research question Design the study Look for student volunteers Meet with Lehana or Colleagues Meet with Lehana or Colleagues Medical students or Residents Write up introduction and methods Consider presenting at research interest group Submit REB form Look for funding (if necessary) Mail all documents to Toni Register all clinical trials on clinicaltrials.gov Toni Tidy can assist Toni Tidy can assist REB approval and updates, study details, grant details Toni Tidy can assist

9 Active Projects Acute Pain Perioperati ve Medicine Chronic Pain Simulation / Education Other Cardiac / Thrombosis

10 Total 57 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

11 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

12 Current Projects: Funding Funding Status Number Comment Unfunded 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

13 Current Projects: Funding Sources Funding Source Number $ % Comment Anesthesia Department Investigator-Driven Studies CARF CAS research funding - RCA Canadian Space Agency Simulation CPSI RCA Study HHS Anesthesia Academic Fund Up to $15, 000/yr available to HHS staff HHS Foundation NIF Available to new staff ( 5 yrs) HSFO/HSFQ ENIGMA-II RMA Available to residents RCPSC Simulation MOHLTC Simulation Subtotal Collaborative Studies with Other Departments Sick Kids Foundation HIP study - Pediatrics CIHR VISION - Cardiology Subtotal Industry Funded Studies Pfizer Chronic Pain - Pregabalin NovoNordisk 1? Cardiac/Thrombosis Purdue Pharma Chronic Pain Subtotal Total

14 Multi-Centre HHS and St. Joseph s VISION POISE-II Project Title Sites Recruitment (Completed or Active) MUMC HGH St. Joseph s Henderson MUMC HGH St. Joseph s Henderson 642 completed patients 752 completed patients 1007 completed patients 1600 active patients Local Sample Size 4000 Start Date June ENIGMA-II MUMC HGH Henderson Start Date June

15 Collaborations with Cleveland Clinics Dr. Daniel Sessler Study Question? LMA PerfecTemp Warming System Is the LMA PefecTemp system and the Bair Hugger warming systems equally good? Arizant Healthcare Disposable Zero-Heat-Flux Thermometer (DTT) Is there an agreement between temperatures measured with the DTT system and the Swan-Ganz PA catheter? Population Sample Size Patients with elective abdominal surgery under general anesthetic to last >2hrs in the supine position 45 MUMC 70 patients total Patients to undergo elective cardiac surgery 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

16 Research Events Event Department Research Meetings Spring Research Retreat Resident Exchange Day Research Interest Group Dinner Meetings Research Dinner Meetings with Dr. Dan Sessler/Outcomes Research CANNeCTIN Date Monthly MDCL 2249 April 21: 18:00-21:00 Ancaster Old Mill June 4: UWO Ad Hoc: 3-4/yr March 24 and June 17 University Club April The David Braley, Cardiac, Vascular, and Stroke Research Institiute

17 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 inanesthesiology: 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

18 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.

19 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