Merrick F. Zwarenstein


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Projets de recherche récents

An Integrated Platform for Innovative Pragmatic Cluster-Randomized Registry Trials in Hemodialysis

2016/17-2020/21 • $3,048,135 • PI,CO,Other
. Dialysis is a life-saving treatment for people whose kidneys have stopped working. However, this treatment is difficult. Patients must be connected to a dialysis machine three times a week and the chances of dying are extremely high. One in three patients will die within a year of starting...

Promoting implementation of evidence-based care

2015/16-2020/21 • $1,912,865 • PI,Other
Evidence-practice gaps resulting from knowledge translation (KT) failures result in patients failing to benefit optimally from advances in healthcare and inefficient use of scarce healthcare resources. KT is about ensuring that decision-makers at all levels of the health system (including...

Ontario Healthcare Implementation Laboratory: A Learning Health System Approach that Leverages Data to Improve Quality in Primary Care

2018/19-2020/21 • $875,219 • PI,CO,Other
When clinicians do not have the supports in place to help them follow best practices, patients may not reliably receive the ideal tests and treatments. As a result, they are less likely to achieve the best possible health outcomes. Providing clinicians with data on how often they follow best...

Developing a framework for the ethical design and conduct of pragmatic trials to improve the quality and value of health care systems and practices

2017/18-2020/21 • $800,646 • PI,CO
The randomized controlled trial is the gold standard method for evaluating medical interventions. However, the majority of trials are conducted under laboratory-like conditions, which limits their applicability to the real-world clinical setting. There is therefore an urgent need for so-called...

Innovative Pragmatic Cluster-Randomized Registry Trials to Improve Hemodialysis Care

2020/21 • $777,767 • PI,CO,Other
We are planning to conduct a trial that will compare different concentrations of magnesium in dialysis solutions that are currently used in Canadian hemodialysis centres. There is some early evidence to suggest that a higher concentration of magnesium in the dialysis solution may help patients...

Hockey Fans in Training (Hockey FIT): A pragmatic cluster randomized controlled trial of a gender-sensitized weight loss and healthy lifestyle program for men who are overweight or obese

2018/19-2020/21 • $588,948 • PI,CO
About 40% of Canadian men are overweight and another 20% are obese. Approximately 70% of men's staggering health care costs (estimated at $36.9 billion annually) could be prevented if men improved their lifestyles (i.e., got active, ate better, and lost weight); however, few men engage in...

Developing and testing strategies to identify and support patients with chronic kidney disease in a disadvantaged Ontario primary care population

2018/19-2020/21 • $98,333 • Scholarship/Fellowship,Other
Chronic kidney disease is a medical condition where people have reduced function of their kidneys. In some case this can lead to kidney failure, which requires costly treatments to survive, such as dialysis or a kidney transplant. Many patients may never reach kidney failure, especially if their...

Caring near and far: a multi-province investigation of remote monitoring technologies connecting community-based older adults and their care team

2015/16-2019/20 • $731,343 • PI,CO,Other
There is a growing demand among older adults for home care services to manage the complexity of their chronic diseases and increasingly to support their wish to remain in their home as long as possible. In-home remote monitoring (RM) technologies can link clients, family caregivers, and health...

Transformation of Indigenous Primary Healthcare Delivery (FORGE AHEAD): Enhancement and Adaptation of Community-driven Innovations and Scale-up Toolkits

2016/17-2019/20 • $652,110 • PI,CO,Other
In Canada, there are significant disparities between the health status of Indigenous peoples and the general population with respect to diabetes. Community-driven innovations, activated by quality improvement processes, have the potential to reform local healthcare. The goal of the proposed...

CONSORT Extension for Trials Conducted in Existing Data Structures, Including Researcher-generated Cohorts, Registries, Electronic Health Records, and Administrative Databases

2018/19-2019/20 • $133,876 • PI,CO
Large-scale randomized trials (RCTs) are complex and expensive to perform. Less than one-third of RCTs achieve their planned recruitment target, follow-up of participants is labor intensive, and results from trials often cannot be generalized to real-world settings. To overcome these challenges,...

Dissemination of the CONsolidated Standards of Reporting Trials (CONSORT) statement for randomized controlled trails (RCTs) using cohorts and routinely collected health data

2018/19 • $10,000 • PI,CO
Randomized controlled trials (RCTs) conducted using cohorts and routinely collected health data, including registries, electronic health records, and administrative databases, are increasingly used in health care intervention research. However, relatively little guidance has been published on...

TITLE: Artificial Intelligence for Screening and Secondary Prevention of Chronic Kidney Disease in a Learning Health System in Ontario (LeHSOn -AI)

2017/18 • $19,933 • PI,CO,Other
Long lasting kidney disease (Chronic Kidney Disease, or CKD) is common (about 1 in 8 Canadian adults). Because it does not have any signs obvious to the person who has the condition, or to their clinician (doctor or nurse practitioner), it is often not recognized until very late in its course....

Patient-Centred Innovations for Persons with Multimorbidity

2013/14-2016/17 • $2,500,000 • PI,CO,Other
People with chronic conditions are likely to have more than one condition. But the healthcare system is mostly designed for one condition at a time. This 5-year proposal is for a Team whose goal will be to change primary health care and community-based chronic disease prevention and management...

Transformation of Indigenous Primary Healthcare Delivery (FORGE AHEAD): Community-driven Innovations and Strategic Scale-up Toolkits

2013/14-2016/17 • $2,500,000 • PI,CO,Other
In Canada, significant disparities between the health status of Indigenous peoples and the general population exist, particularly for chronic diseases such as diabetes. There is a pressing need to shift the present episodic care focus common to most First Nations communities, to one that...

Knowledge Translation Canada: A CIHR Strategic Training Initiative in Health Research

2010/11-2014/15 • $1,623,626 • PI,CO
Much of the $100B/year worldwide investment in biomedical and health research is wasted because of challenges to knowledge translation (KT) that remain understudied. KT is the science and practice of putting knowledge into action. Health systems fail to optimally use evidence with resulting...

Optimizing Audit and Feedback for Chronic Disease in Primary Care: A Mixed Methods Approach

2010/11-2014/15 • $196,250 • Scholarship/Fellowship,Other
There remains a large gap between ideal and actual care provided to patients with chronic diseases. Performance feedback reports describing the percentage of patients receiving evidence-based treatments and up-to-date investigations are often used when trying to influence the way that care is...

Managing the Dysexecutive Syndrome following traumatic brain injury: An ecologically valid rehabilitation approach.

2011/12-2013/14 • $433,527 • PI,CO
Successful community participation following acquired brain injury (ABI)continues to be an elusive goal for patients, clinicians and researchers. Our pilot work on a strategy training approach (Cognitive Orientation to Occupational Performance) shows that community dwelling survivors of ABI can...

Pilot KT intervention to address gender differences in access to post arrest care

2012/13-2013/14 • $218,994 • PI,CO
Heart disease is the most common cause of death in Canada. Forty thousand Canadians experience cardiac arrest each year. Thirty-three per cent of these are women. Women have a greater chance of surviving cardiac arrest long enough to reach the hospital. However, they have less chance than men do...

Strategic Planning to Support First Nations Communities Participating in the FORGE AHEAD Program

2013/14 • $24,997 • PI,CO,Other
The proposed planning activities, including a face-to-face meeting, will enhance existing partnerships as well as foster the development of new partnerships by bringing together members of a national steering committee that includes First Nations (FN) community representatives, academic...

Knowledge Translation Canada: A National Research Network

2010/11-2012/13 • $5,808,667 • PI,CO
The Ottawa Health Research Institute (OHRI) is the research arm of The Ottawa Hospital (TOH) and an Affiliate Institute of the University of Ottawa (uOttawa). Incorporated as a not-for-profit corporation, its Board of Directors includes representatives from the Hospital, University and...

Examining the impact of primary care reform in Ontario on access to and quality of care

2010/11-2011/12 • $422,696 • PI,CO
Ontario faces a serious shortage of health personnel of almost all kinds including family doctors and general practitioners (FP/GPs). A key strategy to overcome shortfalls in primary medical care is primary care reform. New models of care all involve rostering of patients so that most people in...

Canada Prime Plus: Selecting individual and organizational theories for interventions to change clinical practice

2010/11-2011/12 • $328,954 • PI,CO
The aim of this research is to find out if psychological concepts of behaviour can help us to understand whether we can predict, how the interaction between a team of specialised health care professionals will influence decisions regarding patient care (i.e., prescribing drugs, ordering tests)....

Feedback GAP: a trial of Goal-setting and Action-Plans to increase the effectiveness of audit and feedback interventions in primary care.

2011/12 • $151,954 • PI,CO
There remains a large gap between ideal and actual care provided to patients who are at high risk of cardiovascular disease in primary care, such as those with diabetes or with known heart disease. Performance feedback reports are often used when trying to influence the way that care is...

Ethical and policy issues in cluster randomized trials

2010/11-2011/12 • $138,925 • PI,CO
In traditional randomized trials, individual patients are enrolled after providing informed consent, randomized to receive a particular medical intervention, and followed to ascertain outcomes over time. Cluster randomized trials (CRTs), in contrast, randomly allocate intact groups of...

Evaluation of a strategy to improve cardiovascular disease screening and treatment for people with diabetes

2010/11-2011/12 • $82,339 • PI,CO,Other
Diabetes is a common and serious chronic disease. However, there is a large gap between the level of care that people should receive (based on research and guidelines) and the level of care they actually receive. With the release of their 2008 Clinical Practice Guidelines, the Canadian Diabetes...

Improving the Effectiveness of Audit and Feedback Interventions in Health Care

2011/12 • $25,000 • PI,CO
There is a persistent and well-recognized gap between ideal and actual care provided to patients by health providers across the entire range of clinical contexts. This quality-care-gap leads to increased costs for payers and sub-optimal outcomes for patients. A common method of closing the...

First Nations Community-Based Chronic Disease System Improvment Strategy - Planning Grant

2011/12 • $24,999 • PI,CO
The purpose of this application is to request funding for a series of planning meetings that will be used to form a national, interdisciplinary research team with expertise in First Nations health and to develop a submission for the Team Grant in Community-Based Primary Healthcare. The...

Patterns of Health Care Utilization Before and After Participation in a Chronic Disease Self-Management Program

2010/11 • $154,040 • PI,CO
In Canada, the majority of individuals over age 55 living in the community have at least one chronic condition. For many of these individuals, optimum self-management is difficult to achieve. Hence, self-management courses have been developed to empower participants, increase their confidence,...

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