Stirling Bryan

Key Research Areas
Associated Researchers
Associated Organizations

Recent Research Projects

Precision Medicine CanPREVENT AMR: Applying Precision Medicine Technologies in Canada to Prevent Antibody Mediated Rejection and Premature Kidney Transplant Loss

2017/18-2018/19 • $1,231,667 • PI,CO
Chronic kidney disease affects 1 in 10 Canadians with estimated costs of over $2 billion/year. Transplantation is the treatment of choice for those whose kidneys fail: it improves survival (>85% vs <50% at 5yr), optimizes quality of life (85% vs 70% of normal) and decreases health-care costs...

Integrating a quality of life assessment and practice support system in homecare services for older adults with life-limiting illness and their families

2015/16-2018/19 • $656,089 • PI,CO,Other
Older adults who have advancing life-limiting illnesses and who are receiving health care at home often have complex problems that affect both their ability to function and their overall quality of life (QOL). Progress has been made in the managing some aspects of chronic illness, including...

Implementation and Evaluation of an Enhanced PharmaNet-Based Adverse Drug Event Reporting Platform to Improve Patient Safety and Meet Adverse Drug Reaction Reporting Requirements

2015/16-2018/19 • $612,525 • PI,CO,Other
Adverse drug events (ADEs), unintended harmful events resulting from medication use, are a leading cause of emergency department (ED) visits and hospital admissions. Research enrolling over 3000 patients in three BC hospitals suggests that ADEs account for 12% of ED visits, causing over 200,000...

Understanding contextual factors to effectively and equitably scale up GetCheckedOnline to diverse populations and geographic settings

2017/18-2018/19 • $566,667 • PI,CO,Other
Digital health services are thought to be cost-effective and improve access particularly in rural areas, despite limited evidence and challenges to their implementation. We need to examine the "rhetoric and reality" of these services, and understand what external factors influence their success...

Mifepristone implementation in Canada (The CART-Mife Study)

2016/17-2018/19 • $400,000 • PI,CO
Mifepristone Implementation Research in Canada(The CART-Mife Study)Introduction: Although the gold standard for medical abortion care worldwide has been use of mifepristone since the late 1990’s, this medication was only recently approved in Canada (July 2015) with availability for use...

Statistical Methods for Patient-Reported Outcome Measures

2015/16-2018/19 • $309,764 • PI,CO,Other
Patient-reported outcome measures (PROMs) are used by patients to describe their health, including their quality of life, pain, fatigue, and depression. PROMs are used by physicians, nurses, and healthcare decision makers to describe the outcomes of care from the patient's point of view. In...

Interventions for undiagnosed and early-stage COPD: Informing policy, practice, and research through an Evaluation Platform in COPD (EPIC)

2015/16-2018/19 • $176,083 • PI,CO,Other
Chronic obstructive pulmonary disease (COPD) imposes a significant burden on Canadians. COPD is responsible for more hospitalizations than any other chronic disease in Canada. COPD is currently the fourth leading cause of death among Canadians but, due to slow progress in developing better...

Predictors of poor health and functional recovery following road trauma: An emergency department inception cohort study.

2018/19 • $175,185 • PI,CO
BACKGROUND: Each year in Canada, road trauma causes over 2,000 deaths and 10,000 serious injuries. Disability after an injury is a major public health concern, but the long term health outcome after road trauma is poorly investigated and based mostly on outdated research that does not reflect...

Optimizing the impact of internet-based testing for the control of HIV and sexually transmitted infections among gay, bisexual, and other men who have sex with men

2014/15-2017/18 • $372,583 • PI,CO,Other
The internet has changed the nature of gay communities and how knowledge is accessed. The majority of men who have sex with men (MSM) use the internet to meet sexual partners, and most also use it to look for health information. BCCDC has developed an internet-based service for testing for HIV...

Improving cardiovascular health for Canadians living with spinal cord injury: effects of exercise and targeted education

2011/12-2016/17 • $1,936,138 • PI,CO,Other
Annually, over 1000 Canadians sustain a traumatic spinal cord injury (SCI) and unwittingly join more than 41,000 Canadians living with this chronic and debilitating injury. The estimated annual costs of care in Canada exceed $1.5 billion. Recent data reveal that people with SCI are developing...

Walk the Talk: Transforming the Built Environment to Enhance Mobility in Seniors

2010/11-2016/17 • $1,500,000 • PI,CO
We aim to promote and enable mobility of older Canadians. We define mobility as the physical capacity of humans to walk or move themselves within their communities. Limited mobility predicts death in older adults and is a consistent risk factor for disability, social exclusion and poor quality...

Developing a Canadian framework for evaluation and decision-making for expensive drugs for rare diseases through innovation, value, and priority setting.

2011/12-2016/17 • $1,466,018 • PI,CO,Other
As our understanding of diseases and how to treat them evolves, so too must our decision making procedures for providing fair and cost effective treatments for those living with an illness. Today, one area of policy and decision making in particular lags behind, that for treating rare diseases....

Informing Future Orphan Drug Coverage Using Scenario Studies (iFOCUSS)

2014/15-2016/17 • $235,801 • PI,CO,Other
It has been estimated that approximately 1 in 12 Canadians suffer from 1 of over 7,000 different rare diseases. Orphan drugs used in the treatment of rare diseases routinely cost more than $500,000 per year. In Canada, many patients' medicines are covered by a private health insurance payer, or...

The economics of patient centred care: Evaluation of a patient decision aid for treatments in obstructive sleep apnea

2014/15-2016/17 • $105,000 • Scholarship/Fellowship,Other
For patients with obstructive sleep apnea (OSA) there are two front line treatments, continuous positive airway pressure (CPAP) and dental appliances. Currently, nearly everyone diagnosed with OSA is started on CPAP because it is highly effective. Despite this, adherence to CPAP is poor due to...

Exploring patient experience trajectories for knee arthroplasty: a mixed methods study

2015/16-2016/17 • $105,000 • Scholarship/Fellowship,Other
With a growing emphasis on patient-centred care, policymakers, doctors, and researchers need to better understand patient experience, and how that experience gives rise to patient satisfaction. Gaining a deeper understanding of how system-based and personal factors predict satisfaction, and how...

Listening to voices not often heard: An exploration of research needs of South Asian knee replacement patients

2016/17 • $25,000 • PI,CO,Other
Total knee arthroplasty (TKA) is a high volume surgery (approx. 56,000 per annum in Canada). Given that almost 20% of Canadians are from ethnic minorities, it is clear that a large number of TKA surgeries are being performed on ethnic minority patients. Understanding the experience of people...

Patient engagement with designing total knee arthroplasty intervention strategies: continuing a patient-oriented research agenda in total knee arthroplasty

2016/17 • $25,000 • PI,CO,Other
Total knee arthroplasty (TKA) is the most common joint replacement surgery in Canada, with the need expected to rise further in the future. However, up to 20% of patients report dissatisfaction post-surgery. Our research team investigated this issue through an earlier study and documented a...

Respiratory Sleep Disorders Research Team

2010/11-2015/16 • $1,433,129 • PI,CO
Team Mission: Our goal is to discover new knowledge about the causes, consequences, diagnosis, and treatment of obstructive sleep apnea (OSA) so that the well-being, health, and safety of patients with this disease can be improved. OSA is a major health problem affecting over 1,000,000...

Cannabis and Motor Vehicle Crashes: A Multicentre Culpability Study.

2010/11-2015/16 • $910,151 • PI,CO
Marijuana is the most commonly used illicit drug in Canada and many drivers, especially young adults, report driving after using marijuana. Although there is abundant experimental evidence that marijuana, either alone or in combination with alcohol, impairs the skills required for safe driving,...

Contraception Access Research Team - Contraception Cost-effectiveness Modeling (CART-CCM)

2013/14-2015/16 • $667,864 • PI,CO,Other
Family planning is acknowledged to be one of the top ten public health advances of the millennium. Health policy supporting accessible family planning has proven value leading to population-level gains in terms of health equity in developed countries around the world. Canadian health care...

Novel health economic methods to strengthen coverage decision-making of biologic response modifiers for the treatment of rheumatoid arthritis

2013/14-2015/16 • $105,000 • PI,Other
The current evidence used to inform drug regulatory approvals for biologic response modifiers for the treatment of rheumatoid arthritis (RA) has focused on efficiency, quantified as incremental cost-effectiveness. However, there are many discrepancies in this evidence base, and there has been...

A meta-narrative review of patient- and family-reported experience and outcome measures across transitions of care for frail seniors living at home.

2015/16 • $100,000 • PI,Other
As we confront the unprecedented aging of our Canadian population, there is pressing need for strategic, cross-sector care of the frail elderly whose healthcare costs are 4.5 times greater than adults 20-64 years old.1-2 While being in a state of increased vulnerability and risk, frail seniors...

Network meta-analysis: an important tool for drug safety and effectiveness

2011/12-2014/15 • $926,927 • PI,CO
Systematic reviews and meta-analyses typically aggregate knowledge about the effects and safety of interventions, such as drugs. They are now used by clinicians, policy analysts and others to help make practice decisions as well and policy/management decisions. A recent estimate suggests that 11...

Better Contraceptive Choices for Marginalized Women: Immediate vs. Interval Insertion of Intrauterine Contraception after Second Trimester Abortion

2010/11-2014/15 • $632,226 • PI,CO
Women seeking abortion beyond 12 weeks (2nd trimester) are at high risk of recurrent unwanted pregnancy. Often, women seeking a 2nd trimester abortion are disadvantaged by lower education and socio- economic status. The best reversible contraception to prevent repeat abortion is long acting,...

GetCheckedBC: Developing new knowledge to inform the province-wide implementation of an online STI/HIV testing service for youth

2012/13-2014/15 • $200,000 • PI,CO
The Internet is a medium that offers unprecedented reach to populations at risk for STIs and HIV. Youth (ages 15-24) bear a significant burden of STI/HIV infection in BC, particularly in some communities (e.g. rural, with large youth populations), and have been shown to be particularly receptive...

Physician- and region-level variations in health care services use

2010/11-2013/14 • $489,907 • PI,CO
Doctors make a majority of the decisions about how health care services are used, but we know very little about the demand each doctor makes on overall resources. This project is a first attempt to measure patterns of practice both for physicians and regions in BC. The four main research...

Why are so many patients dissatisfied with knee replacement surgery? Exploring variations of the patient experience.

2011/12-2013/14 • $439,600 • PI,CO,Other
Knee replacement surgery is the most requested joint replacement surgery in Canada. Knee replacements in Canada among those aged 55 to 64 tripled for men, and more than tripled for women, between 1995 and 2005, and will continue to increase in response to the needs of an aging population. As...

Evidence, values and priority setting methods in cancer control

2011/12-2013/14 • $365,630 • PI,CO,Other
The overarching aim of this study is to examine how we can combine evidence and public values to set priorities for cancer control programs (including prevention, screening, treatment and palliative/supportive care). Its objectives are to: (a) develop better methods for identifying, interpreting...

Novel Determinants of Change in Health Related Quality of Life Among Vulnerable Seniors

2010/11-2013/14 • $135,000 • Scholarship/Fellowship,Other
A relatively recent but significant shift in health research gives credence to outcomes as reported by patients themselves. The BMJ reported the need to complement 'clinical outcomes' with patient reported outcome measures (PROMs) to overcome the case characterized by the cliche that "the...

A Scoping Review on the Measurement of Community Integration of Homeless Persons

2013/14 • $50,000 • PI,CO,Other
Homelessness continues to present complex health, social and economic concerns for segments of Canadian society. Interventions to promote housing stability and health for homeless persons have shown promising results. However, the evidence of ‘next steps’ for the recently homeless, in terms of...

Contraception & Abortion in BC: Experience guiding Research guiding Care

2013/14 • $25,000 • PI,CO,Other
WHY: This meeting follows our CIHR funded research planning meeting of April 2011, convening again a broad range of provincial collaborators for dissemination of the findings from the BC Abortion Provider Survey (BCAPS) developed at that meeting. We seek to communicate and discuss effective...

Home-based newborn screening for biliary atresia using parent completed infant stool colour cards: a pilot feasibility study

2010/11-2012/13 • $452,764 • PI,CO
Biliary Atresia (BA) is the leading cause of death from liver disease in the pediatric population. Newborns with BA develop jaundice and pale stools in the first weeks of life. Delay in the diagnosis of BA is the single most important factor influencing its outcome. In Canada, 50% of infants who...

An integrated strategy for policy-relevant process-outcome evaluation in a regional trauma system

2010/11-2012/13 • $450,000 • PI,CO,Other
We propose to devise a comprehensive strategy for continuous improvement of trauma care system that addresses substantial gaps in the availability of information regarding processes and outcomes of trauma care in British Columbia. Specifically, we will determine the informational needs of...

Valuing health status of general population: Development of a Canadian preference-based scoring system for the new 5-level EQ-5D

2010/11-2012/13 • $443,766 • PI,CO
Quality of life (QoL) has become an important piece of information in addition to efficacy and safety when evaluating treatment effects. A common way of gathering QoL is to use a questionnaire to obtain the description of a person's health status and assign a value to it. The difference in...

Achieving High Performance in Health Care Priority Setting: developing and evaluating a framework for excellence

2010/11-2012/13 • $349,820 • PI,CO,Other
The intent of this project is to develop a framework that identifies how health care organizations can be transformed to achieve excellence in priority setting and resource management. There are five proposed phases: i. literature review on evaluating priority setting; ii. national survey of...

Mobilizing Evidence into Action to Improve Outcomes of Vulnerable Seniors

2010/11-2012/13 • $304,245 • PI,CO,Other
In Canada, there are over 25,000 fall-related fractures at the hip annually with significant personal and societal consequences. Approximately 20% of people die within 12 months of fracturing and half do not regain their previous level of mobility. The decreased mobility leads to muscle weakness...

Patient-Reported Outcome Measurement in the Context of Primary Health Care Reform: A Systematic Review and Expedited Knowledge Synthesis

2011/12-2012/13 • $100,000 • PI,CO
This proposal addresses the question: What are the most effective ways to measure the health outcome changes, as reported by patients themselves, resulting from primary health care reforms? Our emphasis on outcomes as reported by patients themselves is driven by a belief that individual patients...

CART Contraception Access Research Team/Groupe de recherché sur l'accessibilité à la contraception

2011/12 • $25,000 • PI,CO,Other
Contraception Access Research Team/ Groupe de recherche sur l'accessibilite a la contraception CART/GRAC Half of all pregnancies are unintended and half of these end in abortion. Marginalized and vulnerable populations are overrepresented among those with unintended pregnancies and particularly...

Community-Based Primary Healthcare for People with Chronic Life-Limiting Conditions

2011/12 • $25,000 • PI,CO,Other
We are proposing a 3 day face-to-face planning and development meeting in Victoria, British Columbia to develop a CIHR Team Grant proposal focusing on developing, testing and evaluating interventions and innovative and integrated models of community-based primary health care for people with...

Planning Meeting for Developing a Canadian framework for reimbursement decision-making for expensive drugs for rare diseases

2011/12 • $24,666 • PI,CO,Other
Approximately 1 in 12 Canadians suffers from 1 of more than 7,000 different rare diseases, and an estimated 250 new rare diseases are being discovered every year. Treatment of these disease can cost more than $500,00 per patient per year, every year. Thus, Canada needs a framework for priority...

Synthesizing knowledge on disinvestment processes in health care

2010/11 • $100,000 • PI,CO,Other
With the down turn in the world economy in 2008, public sectors across the globe have been forced to undertake unprecedented constraint. In health care, this comes on the heels of many years of growth, thus the change in direction has not only been in stark contrast to recent practice, but in...

Respiratory Sleep Disorders Research Team

2010/11 • $10,000 • PI,CO
The major goal of this team is to discover and disseminate new knowledge about the causes, health consequences, economic consequences, diagnosis and treatment of breathing disorders during sleep. Breathing disorders during sleep are a major health problem affecting over 1,000,000 Canadians and...

Patents