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LONDON, ONTARIO - Living kidney donation rates have remained stagnant over the last decade, and many potential living donors find the evaluation process to be lengthy and difficult to navigate. Researchers from Lawson Health Research Institute and Western University have published results identifying indicators to monitor and improve the performance of transplant centres in how efficiently they evaluate individuals interested in becoming living kidney donors. The findings appear in the current issue of CJASN. 

In 2019, there were 219 living donor kidney transplants in Ontario. There are several advantages to kidney transplantation from a living donor compared to deceased. However, many living donor candidates drop out of the evaluation process for a variety of reasons. 

“From speaking with living donors, we know that some people find the evaluation process frustrating and cumbersome,” says Dr. Amit Garg, Professor at Western’s Schulich School of Medicine & Dentistry and Scientist at Lawson. “To ensure living donation is safe for both the donor and the recipient, a thorough evaluation is needed looking at medical, physical and psychosocial considerations.” Dr. Garg is also Director of the Living Kidney Donor Program at London Health Sciences Centre (LHSC). 

Marian Reich started the journey of living kidney donation 11 years ago, giving the gift of life to her sister-in-law, Susan. “The evaluation process took one full year to complete, and in that time Susan lost the option of a pre-emptive transplant and started dialysis. I wasn’t fully aware that I had to be the driver of the process, and how to do that.” 

Reich believes living donor evaluation should be consistent across the country, with a clearer process outlined for potential living donors and recipients. “Research studies like this one bring forth best practice and evidence-based information that includes the perspective of those with lived experiences.”

The research team, which included Patient Partners such as Reich who co-authored the paper, surveyed 77 participants who were kidney transplant recipients and recipient candidates, living kidney donors and donor candidates, or health care providers and administrators. 

Out-of-pocket cost incurred by donors is one of the most significant barriers to donation. Another challenge is the lack of reliable information about the expectations and requirements of the donation process. For example, the time commitment, nature of the testing and reasons for the tests performed. 

The evaluation process takes on average 10 months to complete, requiring multiple visits to the transplant centre. The intended recipient’s health may deteriorate during this wait to the point they may no longer receive a transplant. “By improving the efficiency of the process, more living donor candidates could complete the evaluation and more transplants performed,” adds Dr. Garg. 

The study found a diverse set of quality indicators to measure the evaluation process, focusing on efficiency and safety to improve patient outcomes. They also identified a single measure tracking the costs of living donor evaluation from a health system perspective to assist with planning and budgeting. 

“This is an important first step towards system monitoring, benchmarking and accountability in living kidney donor evaluation,” explains Dr. Steven Habbous, co-lead investigator and PhD graduate with Lawson and Western’s Schulich School of Medicine & Dentistry. “In other areas of the health care system, there are reported metrics that hospitals and funders use to compare performance between similar hospitals and track changes over time. We need to measure what we value, and value what we measure.”

The team will present the data to the Canadian National Living Kidney Donation Advisory Committee to help develop national guidelines. Potential improvement strategies are to evaluate multiple living donor candidates concurrently for the same recipient or offer some aspects of the evaluation virtually.

The study was funded by the Can-SOLVE CKD Network, a Canada-wide initiative to enhance kidney disease research and care in partnership with patients. The Ontario-based team led by Dr. Garg is one of 18 Can-SOLVE CKD research groups across the country investigating issues such as earlier diagnosis, better treatments, and innovative care – all based on priorities identified by patients.

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Dr. Amit Garg, study co-lead investigator, Professor at Western’s Schulich School of Medicine & Dentistry, and Scientist at Lawson. Dr. Garg is also Director of the Living Kidney Donor Program at LHSC.

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Dr. Steven Habbous, study co-lead investigator and PhD graduate with Lawson and Western’s Schulich School of Medicine & Dentistry

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Marian Reich, study co-author, Patient Partner and living kidney donor

LONDON, ON – A study led by researchers at Lawson Health Research Institute (Lawson) provides clinical validation of EpiSign, a molecular genomics test that diagnoses rare, heritable neurodevelopmental conditions.

Invented at Lawson by Dr. Bekim Sadikovic, the diagnostic test uses machine learning to analyze the EpiSign Knowledge Database. This database compiles information on rare genetic diseases using laboratory analyses of the epigenome from patients with suspected genetic abnormalities. The epigenome is a process that can change the expression of a gene without changing the gene sequence.

“Using 211 blood samples, we measured test performance and diagnostic yield in 207 subjects from two different cohorts,” explains Dr. Sadikovic, lead researcher at Lawson and Scientific and Clinical Director of the Verspeeten Clinical Genome Centre at London Health Sciences Centre (LHSC). The targeted cohort were subjects with previous genetic findings that were ambiguous or inconclusive. The screening cohort were those with clinical findings consistent with hereditary neurodevelopment syndromes but with no previous genetic findings.

“Of the 207 subjects tested, 57 were positive for a diagnostic episignature including 48 in the targeted cohort, and 8 in the screening cohort. Only four remained inconclusive after EpiSign analysis,” says Dr. Sadikovic. “This gives us strong evidence for the clinical use of EpiSign, as well as the ability to provide conclusive findings in the majority of subjects tested.”

While currently there are limited treatment options associated with many of these conditions,

providing a diagnosis can help physicians better predict the course of the disease, and allows for better planning and support for the patient. EpiSign is the only test in the world that has been clinically validated for testing these kinds of genetic disorders.

“Patients with rare diseases often wait years and undergo numerous exams and tests before receiving a correct diagnosis, if one is found at all,” says Matthew Tedder, PhD, staff scientist at the Greenwood Genetic Center, one of the EpiSign clinical testing laboratories. “EpiSign provides an additional high-yield diagnostic tool for clinicians to include in their evaluation of patients with undiagnosed diseases, providing better medical management for patients and hope for their families.”

The study, “Clinical epigenomics: genome-wide DNA methylation analysis for the diagnosis of Mendelian disorders", is published in February’s Genetics in Medicine and was completed in collaboration with the Greenwood Genetic Center and the University of Amsterdam.

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LONDON, ON - In a study involving 542 Crohn’s disease patients, researchers at Lawson Health Research Institute examined whether a patient’s DNA can be used to identify their risk of severe disease. They found that patients with a genetic variant in a gene called FXR (farnesoid X-receptor) are much more likely to need surgery and to need it earlier in their care journey. Surprisingly, they found that women with the genetic variant are at an even higher risk than men.

Crohn’s disease is an often debilitating condition that affects one in every 150 Canadians. The condition is characterized by intestinal inflammation caused by unnecessary attacks from the body’s immune system. It’s a disease that can behave and progress differently from one person to the next, with some requiring surgery to remove affected parts of the intestine.

“While medications are prescribed to manage Crohn’s disease, physicians have to balance the risk of side effects with the risk of undertreating severe cases of the disease,” explains Dr. Aze Wilson, Associate Scientist at Lawson Health Research Institute and Gastroenterologist at London Health Sciences Centre (LHSC). “In order to personalize treatment, it would be great to have a tool for identifying which patients will have the most severe cases of illness.”

Dr. Wilson and her colleagues became interested in the FXR gene because of its role in intestinal health. The FXR gene is a part of human DNA that controls how we process drugs and has also been linked to how well our intestines work. The research team suspected that variation in the gene could lead to poorer outcomes in Crohn’s disease patients. 

“Given the importance of FXR to intestinal health, we wanted to see whether it plays a role in disease severity and we discovered that it does,” says Dr. Wilson. “Our findings suggest that genetic testing could be used to identify patients at a high risk of poor outcomes. This would allow physicians to tailor treatments to give patients the best chance at success.”

The team also discovered that women who carried the genetic variant were at the highest risk of needing surgery and the highest risk of early surgery, even when compared to men with the genetic variant. Struck by this finding, they conducted further testing using laboratory-based cell models. They found that estrogen (a female sex hormone) in combination with the genetic variant reduced the function of FXR even further. 

“Differences between men and women with Crohn’s disease are not often considered in research or clinical practice. We apply treatments in the same way to both sexes, which may not be the best approach,” explains Dr. Wilson. “We identified a group of women who may benefit from a different approach to care. The study highlights the need for evaluating the effect of biological sex on disease and the interaction it may have with our DNA.”

Looking forward, the team hopes to further explore the effect of this genetic variant on intestinal health using laboratory-based cell models. They also hope to assess the value of genetic testing as a tool for informing treatment decisions made by patients and their physicians. 

“One of our larger goals as a research group is to develop a personalized care plan for patients with Crohn’s disease and ulcerative colitis – one that integrates genetic information and other biomarkers to improve how care is delivered to these patient populations,” notes Dr. Wilson. 

The study, “Genetic variation in the farnesoid X-receptor predicts Crohn’s disease severity in female patients,” is published in Nature’s Scientific Reports.  

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Dr. Aze Wilson, Associate Scientist at Lawson Health Research Institute and Gastroenterologist at London Health Sciences Centre (LHSC)

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LONDON, ONTARIO - A new study from Lawson Health Research Institute and Western University illustrates how the gut microbiome interacts with an oral medication in prostate cancer patients, suggesting bacteria in the gut play a role in treatment outcomes. The findings, published in Nature Communications, highlight how the drug abiraterone acetate is metabolized by bacteria in the gut to reduce harmful organisms while promoting those that fight cancer. The team suspects this is one of many examples of how the microbiome influences our response to medications. 

“Research is beginning to uncover the ways in which the human microbiome influences cancer development, progression and treatment,” explains Brendan Daisley, a PhD candidate at Western’s Schulich School of Medicine & Dentistry who is conducting research at Lawson. “Our study highlights a key interaction between a cancer drug and the gut microbiome that results in beneficial organisms with anti-cancer properties.”

Traditional prostate cancer therapies are designed to deprive the body of hormones called androgens, which are responsible for prostate cancer growth. 

“Unfortunately, traditional androgen deprivation therapies are not always effective,” explains Dr. Joseph Chin, Lawson Associate Scientist, Professor at Schulich Medicine & Dentistry and Urologist at London Health Sciences Centre (LHSC). "In those cases, alternative therapies are explored.”

Abiraterone acetate is a highly effective therapy used in the treatment of prostate cancer that has been resistant to other treatments. While abiraterone acetate also works to reduce androgens in the body, it does so through a different mechanism and, unlike traditional therapies, it is taken orally. 

“When drugs are taken orally, they make their way through the intestinal tract where they come into contact with billions of microorganisms,” says Dr. Jeremy Burton, Lawson Scientist, Associate Professor at Schulich Medicine & Dentistry and lead researcher on the study. “While it’s long been a mystery why abiraterone acetate is so effective, our team wondered if the gut microbiome plays a role.”

The team’s study included 68 prostate cancer patients from LHSC, including those being treated with abiraterone acetate and those being treated with traditional androgen deprivation therapies. The research team collected and analyzed patient stool samples, and conducted further experiments in their laboratory at St. Joseph’s Health Care London.

They discovered that patients’ gut microbiomes changed drastically after taking abiraterone acetate. Bacteria in the gut metabolized the drug leading to a significant increase in a bacterium called Akkermansia muciniphila. Referred to as a ‘next-generation probiotic,’ this bacterium’s relevance has recently been explored in several large cancer studies. It’s been shown to facilitate a better response to cancer immunotherapy drugs and it can elicit a wide range of other positive health benefits as well. The increase in Akkermansia muciniphila also led to an increased production of vitamin K2 which is known for anti-cancer properties that can inhibit tumour growth. 

The team also observed the impact of androgen depletion on the microbiome. Both abiraterone acetate and traditional androgen deprivation therapies led to a decrease in organisms that utilize androgen. 

“These findings clearly demonstrate that the gut microbiome is playing a role in treatment response,” notes Dr. Burton.

The team hopes to further explore drug-microbiome interactions with a goal of harnessing the microbiome to improve treatment outcomes for a variety of diseases. In another study, they are exploring whether fecal microbiota transplants from a healthy donor can change the microbiome of melanoma patients to increase organisms like Akkermansia muciniphila and improve response to immunotherapy. They also plan to study whether analysis of a patient’s microbiome can be used to predict their response to specific therapies.

“While more research is needed, we may one day be able to analyze a patient’s microbiome to determine the best course of treatment or even influence the microbiome to improve outcomes,” says Dr. Burton. “This could lead to a new frontier in personalized medicine.”

The study was made possible through the generous support of The W. Garfield Weston Foundation, St. Joseph’s Health Care Foundation and the Canadian Urologic Oncology Group. 

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Brendan Daisley, a PhD candidate at Western University’s Schulich School of Medicine & Dentistry who is conducting research at Lawson Health Research Institute

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Dr. Jeremy Burton (left) and Brendan Daisley (right) are conducting research on microbiome-drug interactions at Lawson Health Research Institute and Western University

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A recent study from London Health Sciences Centre and Lawson Health Research Institute suggests that using existing diagnostic CT scans in planning simple palliative radiation treatments can significantly cut down the waiting time for urgent treatment, resulting in a better experience for cancer patients.

“Reducing the time patients spend in a cancer centre has far-reaching benefits,” said lead study author Melissa O’Neil an Advanced Practice Radiation Therapist at London Health Sciences Centre’s (LHSC) London Regional Cancer Program (LRCP). “Faster treatment initiation means quicker relief from symptoms for patients. Utilizing existing scans is also cost-effective and frees up appointment slots or staff, allowing us to accommodate and assist more patients in need.”

Palliative radiation therapy is used to relieve symptoms in patients whose cancers cannot be cured. It’s often used when tumours cause pain, neurological issues or breathing problems such as blocked airways.

In the current standard practice, patients referred for palliative radiation typically require a CT simulation scan before starting their treatment. This scan creates 3D images that the patient's health care team uses to develop a customized radiation treatment plan. Unfortunately, this process often takes several hours, even with efforts to speed it up.

However, many of these patients have undergone previous diagnostic CT scans as part of their routine medical care. Previous research has shown that radiation oncology teams can create suitable palliative treatment plans for patients with bone and soft tissue metastases using these existing scans. This approach is less time-consuming than the more intensive simulation scans.

In the current study, O’Neil and her colleagues explored whether using existing CT scans to plan treatment before a patient arrives at the cancer centre could reduce their wait time while still ensuring appropriate care. They randomly assigned 33 patients who needed palliative radiation for tumours in their chest, abdomen or pelvis to either the standard treatment planning with on-site CT simulation scans or to treatment planning using diagnostic CT scans taken within the previous 28 days.

The study found that patients who didn't need the extra CT simulation scan spent much less time at the cancer centre on the day of their treatment – just under 30 minutes compared to nearly five hours for the others. Treatments were delivered successfully, and patient perception on time spent at the cancer centre was improved for those whose treatment planning used diagnostic CT scans taken without the previous 28 days. 

"For patients who need radiation to help treat symptoms of cancer, it's important for us to get them treated quickly and to minimize the time they spend waiting for medical appointments,” said Dr. David Palma, Radiation Oncologist at LHSC and Associate Scientist at Lawson. “This trial shows that this new approach not only saves resources by reducing the number of scans we do, but also substantially reduces the time patients spend waiting for urgent radiation.” 

"These findings are incredibly promising, especially in light of the nationwide shortage of radiation therapists," said Dr. Michael Ott, Physician Department Executive for Oncology at LHSC. “Work like this has benefits that can reach far beyond London, offering more relief for patients across the country."

The findings were presented at the American Society for Radiation Oncology’s Annual Meeting on Oct. 3, 2023. This meeting is recognized globally as the leading radiation oncology scientific event, drawing more than 8,500 attendees each year. 

While the study shows promise, the research team said it's important to note that using prior diagnostic scans may not be suitable for every type of cancer or patient. It depends on the specific area being treated and the technique used. 

For more information, please contact:    
Jessica Rabaey 
Communications Consultant 
London Health Sciences Centre 
T: 519-685-8500 ext. 77728
Jessica.rabaey@lhsc.on.ca 

London - A new study underway through Lawson Health Research Institute and Children’s Hospital at London Health Sciences Centre (LHSC), using virtual reality (VR) to help pediatric patients during painful and distressing procedures.

“Technology holds immense potential for improving the experience of our young patients and their families,” explains Dr. Naveen Poonai, Lawson Scientist, principal investigator and Emergency Department Physician at Children’s Hospital. “VR is becoming increasingly popular amongst young people and some early research shows VR has been helpful in painful procedures, even in adults.”

The study is focusing on pediatric patients who need port access. A port is a little reservoir that sits underneath the skin that allows access to blood or medication with the use of a needle. Ports are most commonly used in pediatric cancer patients.

“This can be very distressing for a patient and it can set the tone for their entire clinic day and course of treatment,” says Dr. Alexandra Zorzi, Lawson Associate Scientist and Pediatric Oncologist at Children’s Hospital. “Minimizing the stress, anxiety, and pain of the procedure is key to avoiding a negative experience.” 

The study team is recruiting 90 pediatric patients with existing medical ports.  Participants will be randomized into three groups.  One group will be using a VR headset that will allow them to play interactive games. The second group will have access to tablet technology, and the final group will be provided with non-technology distractions. Each procedure and the patient’s response will be recorded. Responses will then be compared using a tool called the ‘Observational Scale of Behavioral Distress’ to determine which intervention leads to the best outcomes.  

“My hopes are that we develop a variety of skills we can tailor to patients,” adds Dr. Zorzi. “There are patients who receive all kinds of support but still struggle, so having a variety of techniques available to see what works best is a positive step forward.”

The study is expected to be completed by the end of this year. The research team is already collaborating with Children’s Hospital staff and leadership to use VR as a clinical tool if the study proves the technology to be effective.

“We have plans in place to allow whatever we find as the best option to be part of routine care for kids needing port access,” notes Dr. Poonai. “We are also speaking with various medical teams to determine how we can incorporate this into practices across the hospital.”

The use of the VR devices has been made possible with generous support from the Children’s Health Foundation.

LONDON, ON - The COVID-19 pandemic has had a tangible impact on the mental health and wellbeing of Canadian health care workers, who have faced challenges that include increased workloads, resource constraints and fears of exposure to COVID-19.

Announced today, researchers out of Lawson Health Research Institute's MacDonald Franklin OSI Research Centre, have received $2.8 million in funding from the Public Health Agency of Canada (PHAC) to launch a project that will support the mental health and wellbeing of Canadian health care workers. The project is titled “Promoting Resilience and Mental Health: Adapting Canada’s Department of National Defence Road to Mental Readiness (R2MR) Program to Support Canadian Health Care Workers.”

The project will adapt the current Road to Mental Readiness Program, created for the Canadian Military. The aim is to identify mental health and wellness barriers in health care institutions, and create a streamlined framework that will build and promote supportive environments within institutions across the nation. 

“This program has been a personalized approach with the military, and we are now adapting it to focus on Canadian health care workers,” explains Dr. Anthony Nazarov, Associate Scientist at Lawson and the MacDonald Franklin OSI Research Centre at St. Joseph’s Health Care London. “We want to educate institutions to create an environment that supports wellness not just at the individual level, but at the institutional level as well.”

The project, which will span 14 months, will assist in the planning, adaptation and testing of the health care focused Road to Mental Readiness Program.

“One of the main reasons we felt this was necessary stems from a recent study our team conducted that focused on moral distress and the mental health of Canadian health care workers,” says Dr. Don Richardson, Lawson Scientist and Director of the MacDonald Franklin OSI Research Centre at St. Joseph’s. “Our preliminary study results found that many Canadian health care workers have been negatively impacted by the pandemic with conditions such as; posttraumatic stress disorder, stress and depression.” 

Once the research team has adapted the current Road to Mental Readiness Program, they will test it with health care workers to confirm its efficacy.

“We hope to have this type of resiliency program adopted by health care organizations across the country,” explains Dr. Richardson. “If proven effective, this would provide additional tools to health care workers to help them cope, improve their resiliency and hopefully mitigate future staff shortages.”

The funding is part of the federal 2021 budget which has committed an investment of $50 million over two years to support projects that address posttraumatic stress disorder and trauma in frontline and essential workers, and others affected by the pandemic. The nine projects announced, totaling an investment of $28.2 million, is the first round of projects being supported through this Budget 2021 commitment.

LONDON, ON – Led by Lawson Health Research Institute, London Health Sciences Centre (LHSC), University Health Network (UHN) and General Dynamics Land Systems-Canada (GDLS-Canada), researchers have designed a non-invasive ventilation mask that could significantly reduce aerosolization – the production of airborne respiratory droplets that may contain viruses or bacteria – when treating patients with COVID-19. The new device aims to reduce infection risks associated with non-invasive ventilation and lessen the demand for invasive ventilators. It is currently being tested through a clinical trial with patients at LHSC.

“Since the beginning of this pandemic, there have been global concerns about a shortage of ventilators,” says Dr. Tarek Loubani, Lawson Associate Scientist and Emergency Department Physician at LHSC. “Non-invasive ventilators like CPAP (continuous positive airway pressure) and BiPAP (bi-level positive airway pressure) machines are associated with an increased risk of COVID-19 transmission and so many hospitals have moved directly to invasive ventilation.”

COVID-19 is primarily spread through inhalation of respiratory droplets and the most severely ill patients require a ventilator to help them breathe. Unlike invasive ventilators, which require intubation, non-invasive ventilators help patients breathe through a mask that provides positive pressure to keep the lungs open and functioning. While non-invasive ventilators may be effective for some COVID-19 patients, their use comes with a much higher risk of spreading infection through aerosolization of respiratory droplets.

The team’s non-invasive ventilation mask aims to eliminate this risk. The novel device is customized from a standard firefighter’s mask using 3D printing and can be attached to any CPAP or BiPAP machine. Unlike traditional masks, it creates two tight seals – one around the patient’s nose and mouth and another around the face. Patients breathe in and out of a filter that captures any viral particles before they are released to the air.

“There are countless CPAP and BiPAP machines idling around the world while all resources go towards invasive ventilation,” explains Dr. Azad Mashari, Anesthesiologist at UHN’s Peter Munk Cardiac Centre. “Our mask aims to put these machines back into the clinician’s toolkit. By eliminating air leaks, we can improve patient safety and significantly reduce the risk of contracting COVID-19 for health-care workers and other patients.”

Drs. Loubani, Mashari and Benjamin Thomson, Nephrologist at Mackenzie Health, were part of a clinical research team that worked with engineers from GDLS-Canada to develop the device within six days.

“GDLS-Canada responded quickly to the urgent need to support those on the COVID-19 healthcare frontlines during this global health emergency,” says Doug Wilson-Hodge, GDLS-Canada’s Manager of Communications, Community and Government Relations. “The innovative design was very much a collaborative effort between all parties to contribute solutions to the COVID-19 pandemic.”

The initial clinical trial will test the device with up to 50 patients at LHSC’s Victoria Hospital and University Hospital with plans to expand to UHN. In addition to patients with COVID-19, participants will include those with asthma, chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF).

The research team anticipates other hospitals in Ontario and across Canada will join the study to create a multi-centre clinical trial. The device will be used in emergency departments and has potential to be used in intensive care units, remote nursing stations and during pre-hospital transport. It has also been designed for easy production in resource-strained locations. 

“This problem affects everyone and it’s critical that we all do what we can to help,” adds Dr. Loubani. “We hope it will help not only those in urban centres like Toronto and London, but people in remote communities around the world.”

The trial is being supported with funding from Glia, an organization internationally recognized for producing medical supplies that are easily accessible and can be manufactured in low-resource settings.

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Advanced imaging will help better guide radiation treatments

MEDIA RELEASE
For Immediate Release
January 12th, 2022

 

London, Ontario- Prostate cancer is the most common cancer among Canadian men, and it is estimated that one in eight men will be diagnosed with prostate cancer within their lifetime. Researchers at both Lawson Health Research Institute and Sunnybrook Research Institute, are teaming up on a study which is pairing advanced imaging technology with high precision short course radiotherapy, that could lead to better outcomes for patients.

“We have started to look at ways to integrate advanced imaging to help better understand the amount of cancer in the prostate and the location of cancer in the prostate to help guide radiation treatments,” says Lawson Scientist, and Radiation Oncologist at London Health Sciences Centre’s (LHSC) London Regional Cancer Program (LRCP), Dr. Glenn Bauman.

Currently when radiation is done, a computer tomography scan (CT)  gives radiologists the location and boundary of the prostate, but it doesn’t give details about the location of the cancer within the prostate.

“What we are doing in the study is integrating two other forms of imaging; magnetic resonance imaging (MRI) and prostate specific membrane antigen (PSMA) PET scans, both of which can give information on the exact location of the cancer,” explains Dr. Bauman. “This will allow us to refine the radiation treatment and to target the cancer with more intensified radiation.”

Scientist at Sunnybrook Research Institute, Dr. Andrew Loblaw says using advanced imaging will also pinpoint if the cancer has moved into other areas of the pelvic region, which helps target all possibilities and lessens the chance of the cancer coming back. The type of radiation being used for this study is called stereotactic body radiotherapy (SBRT) which is more accurate, and reduces both radiation side effects to adjacent organs, while also reducing treatment visits.

“The combination of PSMA and SBRT gives us the ability to save some normal tissue and dramatically reduce treatment times,” explains Dr. Loblaw. “If we know the cancer is in one place and not another, we can spare radiation from areas not needing it which spares side effects.”

The team plans to recruit 50 men for the study that have advanced prostate cancer and need more intense treatments.  Participants will undergo the advanced PSMA PET imaging at St. Joseph’s Health Care London.  The same imaging techniques will be used to determine and track if the cancer is responding well to treatments.

“This is a smarter tool that will help us more accurately know what patients have,” says Dr. Loblaw. “We will know if they have more of a metastatic disease and who has localized disease. Cure rates are better when you know exactly what you are trying to cure.”

Study participants will be closely monitored for five years, to determine the success of the more targeted and intense radiation treatments.  Dr. Bauman says this will also help quickly identify the potential need for more advanced therapies.

“Our treatments are good, but If there is a man we haven’t cured we want to know as soon as possible.”

The study has received funding by the Ontario Institute for Cancer Research (OICR) as part of the Institute’s new initiative that supports pre-clinical research and new clinical trials that focus on early stage, and recurrent cancers.
 

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About Lawson Health Research Institute: Lawson Health Research Institute is one of Canada’s top hospital-based research institutes, tackling the most pressing challenges in health care. As the research institute of London Health Sciences Centre and St. Joseph’s Health Care London, our innovation happens where care is delivered. Lawson research teams are at the leading-edge of science with the goal of improving health and the delivery of care for patients. Working in partnership with Western University, our researchers are encouraged to pursue their curiosity, collaborate often and share their discoveries widely. Research conducted through Lawson makes a difference in the lives of patients, families and communities around the world. To learn more, visit www.lawsonresearch.ca.

About Sunnybrook Research Institute: Sunnybrook Research Institute (SRI) is the research arm of Sunnybrook Health Sciences Centre, an internationally recognized academic health sciences centre fully affiliated with the University of Toronto. SRI is one of the fastest growing hospital-based research enterprises in Canada with well-established programs in basic and applied sciences which span across three scientific platforms and ten clinical programs, developing innovations in care for the more than 1.3 million patients the hospital cares for annually. Recognized as a Centre of Excellence in focused ultrasound, SRI has one of the most comprehensive and successful focused ultrasound research programs in the world, with technical, scientific and clinical experts accelerating progress in the field.

FOR MORE INFORMATION, PLEASE CONTACT:
Celine Zadorsky
Communications Consultant & External Relations
Lawson Health Research Institute
T: 519-685-8500 ext. 75664
C. 519-619-3872
@email
www.lawsonresearch.ca/news-events

LONDON, ON- A team at Lawson Health Research Institute and St. Joseph’s Health Care London, has created a new online tool called MyBrainPacer™ App to help assist people living with a mild traumatic brain injury (mTBI).

mTBI’s, including concussions, may come with lasting effects that can alter a person’s life.  Although a person with an mTBI may appear fine on the outside, many have to pace their day-to-day activities in order to allow the time needed for the brain to properly heal. That’s where the MyBrainPacer™ App can come into play as a helpful resource.

“By documenting activity levels over time, patients and their clinicians can better understand what activities are linked to worsening symptoms, which they can therefore avoid,” explains Dr. Dalton Wolfe, Lawson Scientist.

The online application is being used as a research tool, allowing Dr. Wolfe and his team to track its efficacy. Much like point tracking used by dieters to monitor food choices, through MyBrainPacer™ App, users can assign values to tasks like driving, grocery shopping, screen use and exercise so they can plan and pace their daily activity. Individual users are given a total number of points per day that will keep their persisting symptoms in the “safe range.” As users track their symptoms through the app, the app adjusts the daily point value to what is best for the user. The app is based on St. Joseph’s Pacing and Planning Program, which has helped hundreds of concussion patients achieve their recovery goals. 

“By putting the app in the hands of patients and the clinicians who treat them, the app has the potential to give us data that traces the recovery patterns of patients and how that relates to the activities that they participate in over time,” adds Dr. Wolfe. “This will enable us to document safe levels of activity for persons with specific characteristics or symptom profiles, which could be the key to unravelling better treatment strategies.” 

After a number of concussions, study participant Cindy Vanderveen, has been using the app to manage her brain injury and has noticed a positive change. 

“In the beginning I wasn’t able to drive farther than five minutes at a time,” remembers Cindy. “My care team at St. Joseph’s recommended MyBrainPacer™ App to help me plan and pace my day. Once I began to use the app to plan and track my activities, my symptoms dramatically decreased. I still have bad days and some tasks are harder than others, but through using MyBrainPacer™ App, I am able to do more activities independently and I am 90 per cent back to who I was.”

Currently anyone with an mTBI can enroll as a study participant on the MyBrainPacer™ App by visiting mybrainpacer.ca.  The research team is hoping to enroll approximately five-thousand users.

The creation of the app has been made possible by funding provided by the Cowan Foundation and other community supporters through St. Joseph’s Health Care Foundation.

LONDON, ON - A team from Lawson Health Research Institute are being funded by the Government of Ontario’s COVID-19 Rapid Research Fund to study whether inhaled sedatives can replace those that are delivered intravenously in COVID-19 patients requiring ventilation. The multi-centre clinical trial aims to address a global shortage of intravenous (IV) sedatives while improving patient outcomes. 

“When COVID-19 patients develop severe respiratory failure and need to be ventilated, they require sedation. While IV sedatives are currently used, there is concern about global drug shortages, particularly if there’s a second wave of COVID-19 in the fall,” explains Dr. Marat Slessarev, Scientist at Lawson and Critical Care Physician at London Health Sciences Centre (LHSC). “Even if we have enough ventilators, we won’t be able to ventilate patients without sedatives.”

The clinical trial, being co-led by Dr. Slessarev and Dr. Angela Jerath at Sunnybrook Health Sciences Centre, will study the replacement of IV sedatives with inhaled sedatives. Inhaled sedatives, also called volatiles, are widely available due to their use in operating rooms to sedate patients during surgery. While they have not been routinely used to sedate patients needing ventilation, early studies suggest they could be safe and even more effective than IV sedatives. 

“Preliminary studies in non-COVID patients with severe respiratory failure suggest that inhaled sedatives can reduce lung inflammation, shorten the duration of ventilation and potentially improve survival. Inhaled sedatives could therefore reduce the pandemic’s strain on ventilator capacity while improving patient outcomes,” says Dr. Slessarev. “Since these drugs are safe, cheap and readily available, they can easily be used to address IV sedative shortages if found effective.”

The researchers will recruit approximately 800 patients from across Canada and the United States including patients from LHSC. Each patient will be randomized to receive either IV sedatives or inhaled sedatives. Patient outcomes such as survival and length of ventilation will be compared between the two groups to determine which method of sedation is most effective. 

“This is the largest trial of its kind. If inhaled sedatives can shorten the length of ventilation or improve survival in patients with serve respiratory failure, this could cause a paradigm shift in the way we sedate patients in intensive care units (ICUs) around the world,” notes Dr. Slessarev. 

Given many survivors of critical illness experience cognitive impairment for months or even years after an intensive care unit (ICU) stay, the team is also planning a sub-study to assess whether one method of sedation results in better cognitive outcomes after treatment. 

In addition to funding from the Government of Ontario, the study is being supported with funding from the Canadian Institutes of Health Research (CIHR), London Health Sciences Foundation and Sunnybrook Health Sciences Centre.

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Dr. Marat Slessarev, Scientist at Lawson Health Research Institute and Critical Care Physician at London Health Sciences Centre (LHSC)

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LONDON, ON – A research team from Lawson Health Research Institute has announced promising results from a one-of-a-kind demonstration study that evaluated the use of smart technologies in the home for people with severe mental illness.   

“Our Smart Homes solution is for people who are having difficulty managing their everyday life and need a high level of care to maintain community living,” says Dr. Cheryl Forchuk, Assistant Scientific Director at Lawson and project lead for Smart Home Community Model Phase. “We have strong initial evidence showing that technology and applications embedded in the lived environment are safe, secure and appropriate for use in health care.” 

After prototyping this approach within a hospital setting through St. Joseph’s Health Care London, the research team outfitted affordable housing units at Canadian Mental Health Association (CMHA) Elgin-Middlesex and London and Middlesex Community Housing (LMCH) with smart home technology.  

There were 13 participants as part of this project phase who had different living situations such as individual apartments, group homes or family homes. Anxiety, mood and psychotic disorders were the most common mental health diagnoses, with many also suffering from chronic pain that make the activities of daily life difficult.  

“More and more, smart technologies like phone applications or virtual care are being used for mental health care. A smart home solution like the one we have tested could be considered a higher dose of technology, offered to clients with higher needs. The right dose for one may not work for another – the technological solutions used should vary depending on the individual,” explains Dr. Forchuk.  

Each study participant selected from a wide range of tools that would best meet their individual needs, with all but one participant selecting more than one tool. Devices such as smartphones and touch-screen monitors connect with applications to provide video-conferencing, questionnaires, and prompts and reminders based on the person’s care plan. They also had access to automated medication dispensers and smart health monitoring devices for tracking heart rate, activity and sleep. 

“All of the data is viewable by both the client and health care provider, allowing for more seamless care and identification of issues earlier on,” adds Dr. Forchuk.  

The study found that visits to a health or social service provider and the emergency department decreased, as did home visits from a provider. Telephone appointments increased and communication between the client and provider were enhanced. Almost 80 per cent of the participants felt that the technologies improved their health care overall.  

Higher levels of community integration and a greater sense of independence were also reported, including a better ability to remain connected with friends and family during the pandemic. When medication dispensers were used, no medication doses were missed. Participants felt they were better able to track their own health and more motivated to lead healthier lives. 

“The compliment of smart technology in our Supportive Independent Living Program has proven to improve the quality of life of participants by reducing use of emergency services and fostering learning opportunities for independent living skills to create a good quality of life,” says Nedrita Shemshedini, Manager of Supportive Independent Living at CMHA Elgin-Middlesex. “In a large-scale rollout, this model could improve wellbeing and empower persons to better manage their care.”  

The research team hopes this work will help inform the integration of smart technology more fully into mental health care delivery. Laura Pearson, Executive Director at Ontario Peer Development Initiative, urges that “there is a need for key policies to be addressed and changed in order to support funding and access for technology at a system level for the purpose of mental health care.”  

The community model phase of the Smart Homes project was generously funded by the Canada Mortgage and Housing Corporation (CMHC). 

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London, Ontario – In a Canadian first, St. Joseph’s Health Care London (St. Joseph’s) and Lawson Health Research Institute (Lawson), in partnership with GE HealthCare, will become a centre of excellence in personalized treatment of cancer and other diseases by advancing the powerful blend of precision diagnostic imaging and targeted therapy.

This rapidly emerging field of medicine is called molecular imaging and theranostics (MIT). Molecular imaging provides detailed imaging at the molecular level and theranostics is a term that combines the words therapeutics and diagnostics. Together, MIT is a two-pronged approach to diagnosing and treating cancers and other diseases that merges imaging with the use of radiotracers that can not only identify the location and extent of diseased tissues but also selectively destroy the abnormal cells while leaving surrounding healthy cells undamaged. 

“The centre will confirm St. Joseph’s and the wider London medical and scientific community as national and international leaders in advancing MIT in the diagnosis of disease, for instance in the identification of cancer and its sub-types, to allow more treatment options for patients,” says Dr. Narinder Paul, Lawson Scientist, Chief, Medical Imaging at St. Joseph’s and Physician Executive, Medical Imaging at London Health Sciences Centre (LHSC). “It will also allow for an expansion of scientific collaborations, increased numbers of scientific and medical learners, and access to the latest software to acquire and integrate imaging science with other patient information.”

The partnership with GE HealthCare will see St. Joseph’s become the first hospital in Canada to install the latest generation, state-of-the-art PET-CT from GE, which will be delivered to St. Joseph’s Hospital by September 2023. The new PET-CT will mean faster exams, better patient experience, more detailed images and increased accuracy in diagnosing disease at a lower dose of radiation for patients. It will also expand clinical care at St. Joseph’s by significantly enhancing research through the Imaging Research Group at Lawson, working together with researchers at LHSC, the London Regional Cancer Program, and Western University.

“We will leverage the combined scientific expertise and innovation of scientists from GE HealthCare and Lawson to maximize the future opportunities of molecular imaging theranostics made possible through PET- CT imaging and be leaders in Canada in this area of medical science,” says Dr. David Hill (D.Phil), Lawson’s Scientific Director. 

As a dedicated MIT centre of excellence, St. Joseph’s will…

•    Advance innovation and expand the science in precision imaging of disease through Lawson, and broaden the potential of PET-CT imaging
•    Develop new treatment options for patients with cancer and other diseases
•    Examine how to maximize the opportunities of digital health technologies to improve access for patients across Canada and optimize their treatment journeys 
•    Create a knowledge dissemination hub for Canada to educate and train others in the use of advanced imaging technologies, including how to organize hospital services to maximize access to patients and improve the health care system for all Canadians.

“St. Joseph’s is proud to be in partnership with GE HealthCare on this exciting opportunity to transform the care journey and outcomes for patients with cancer and other diseases, not only locally and regionally, but also nationally,” says Roy Butler (PhD), President and CEO of St. Joseph’s.  

For patients seen in London, the benefits will include expanded use of PET-CT, the ability to extract more information from their diagnostic images more rapidly and with less radiation exposure compared to current procedures, greater diagnostic and treatment accuracy, and new options for treatment, particularly for cancers that are more difficult to treat.  

“A personalized approach to medical care requires a very detailed understanding of the localization of disease and potential response to different treatment options,” says Dr. Paul who is also the Chair of Medical Imaging at Schulich School of Medicine & Dentistry at Western University. “We will be able to offer patients across our region access to the latest therapeutic options based on a deeper understanding of the nature of their individual disease conditions gained through next generation medical imaging.”

At its core, theranostics is about treating each patient as an individual, “recognizing that the same treatment plan doesn’t work for everyone – with the goal of providing more efficient and effective medical care,”  adds says Mike Hamilton, President, GE HealthCare Canada. “This collaboration aims to advance this practice for the benefit of clinicians and patients around the world.”

The new PET-CT at St. Joseph’s will replace an aging machine and has been made possible in part through the generosity of donors to St. Joseph’s Health Care Foundation, which is contributing $1 million to state-of-the-art machine. 

Additional details on this exciting partnership are available on St. Joseph’s website
 

LONDON, ON – St. Joseph’s Health Care London and Lawson Health Research Institute have announced plans to move forward with clinical trials testing a drug that could potentially be used to prevent and treat COVID-19. St. Joseph’s Health Care Foundation will accelerate the creation of the studies by providing seed funding to get the research started through donor support. Based on the immediate need, The St. Joseph’s Health Crisis Fund has been created by St. Joseph’s Health Care Foundation to enable these and other research studies currently in development through Lawson, the research arm of St. Joseph’s. 

While supporting urgent COVID-19 clinical trials will be an immediate focus, The St. Joseph’s Health Crisis Fund will also support critical patient care equipment and care and comfort items for healthcare staff and volunteers working on the frontlines of the pandemic across St. Joseph’s.

The initial clinical trials aim to study the use of hydroxychloroquine as a preventative medication and treatment for COVID-19. Led locally by Dr. Michael Silverman, Medical Director of St. Joseph’s Infectious Diseases Care Program, one trial will assess the safety and efficacy of using the drug to prevent COVID-19 in health care workers recently exposed to the virus. This trial will also assess the drug as a treatment for non-hospitalized patients with mild cases of the illness. St. Joseph’s will be one of many participating sites in the trial, which is being led by the Research Institute of the McGill University Health Centre.

“There is much debate surrounding the drug hydroxychloroquine. We do not yet know whether it’s safe or effective, and it should not be routinely recommended until we do,” says Dr. Silverman, also a Lawson Associate Scientist and city-wide Chair/Chief of Infectious Diseases. “We plan to carefully study the drug through a randomized controlled trial and assess whether it can help combat COVID-19.” 

Dr. Silverman is also partnering with Dr. Michael Borrie, Geriatrician at St. Joseph’s and Lawson Scientist, on a prevention trial to test the safety and efficacy of the drug for patients and residents at Parkwood Institute who have been exposed to COVID-19. They are at a higher risk of infection, as well as serious complications and potential admission to acute care. 

“Lawson researchers like Drs. Silverman and Borrie excel in rapid response research,” says Dr. David Hill, Lawson Scientific Director. “Hospital-based research is uniquely positioned to handle these types of studies, as close proximity to patients and sample collection is essential.”

St. Joseph’s Infectious Diseases Program is the only program of its kind in the region. Dr. Silverman, head of St. Joseph’s Infectious Disease program, has worked with communities in crisis in Zambia, Zimbabwe, Uganda and the rainforests of Guyana. He is working closely with other health care partners in the London and surrounding area to coordinate the region’s response to the COVID-19 pandemic. 

“The Sisters of St. Joseph, who founded our organization, faced contagious diseases and other pandemics at different times in our 150+ year history,” says Michelle Campbell. “Today, it’s a different time, and a new disease. Now, more than ever, we ask our community to help us address the crisis facing us all.” 

Those interested in donating to St. Joseph’s Health Crisis Fund are asked to visit St. Joseph’s Health Care Foundation’s website to learn more at sjhcfoundation.org. Donations can be made online, through direct mail submissions or by calling the Foundation directly at 519-646-6085.

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LONDON, ONTARIO - Since the start of the COVID-19 pandemic, researchers have been working to better understand and characterize the varied symptoms of the disease. One of the most concerning symptoms is the development of large blood clots that can cause blockages in the arteries that lead to the brain causing stroke.

Researchers at Western University and Lawson Health Research Institute led by Dr. Luciano Sposato have been investigating the relationship between COVID-19 and stroke to better understand the risk in patients and aid in treatment planning. In a new study published in the September 15, 2020 online issue of Neurology, the medical journal of the American Academy of Neurology, the research team reports that approximately two in every 100 patients admitted to hospital with COVID-19 will suffer a stroke, and 35 per cent will die as a result of both conditions. 

The researchers reported that in patients under 50 years old, nearly 50 per cent had no other visible symptoms of the virus at the time of stroke onset. They also found that the interplay of older age, other chronic conditions and the severity of COVID-19 respiratory symptoms are associated with an extremely elevated risk of death.

“One of the most eye-opening findings of this study is that for patients under 50 years old, many were totally asymptomatic when they had a stroke related to COVID-19. This means that for these patients, the stroke was their first symptom of the disease,” said Dr. Sposato, Associate Professor and the Kathleen and Dr. Henry Barnett Chair in Stroke Research at Western’s Schulich School of Medicine & Dentistry, and Scientist at Lawson.
Sposato says understanding the interplay between COVID-19 and stroke is important for treatment planning, especially in areas where COVID-19 is actively circulating in the community. 

“The take-home message here for health care providers is that if you are seeing a patient with a stroke, particularly in those under 50 years old with large clots, you need to think of COVID-19 as a potential cause even in the absence of respiratory symptoms,” said Dr. Sposato. 

The research team completed a systemic review of published cases of COVID-19 and stroke and pooled that data with another 35 unpublished cases from Canada, the USA and Iran. In total, the team examined 160 cases, looking at both clinical characteristics and in-hospital mortality.

“COVID-19 has changed the stroke landscape worldwide. As stroke neurologists, we need a new mindset to be able to promptly diagnose and treat patients with COVID-19 related strokes,” said Dr. Sebastian Fridman, Assistant Professor, Clinical Neurological Sciences at Schulich Medicine & Dentistry, research fellow at Lawson and first author on the study.

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Acute kidney injury associated with severe COVID-19 leads to high mortality rates
For Immediate Release

Severe cases of a COVID-19 infection can cause a host of serious complications, one of them being acute kidney injury. In a recent published study, scientists at Lawson Health Research Institute (Lawson) have found that acute kidney injury in patients with a severe COVID-19 infection is leading to a high mortality rate.

“These are patients who did not have kidney disease, or kidney injury prior to contracting COVID-19,” explains Dr. Peter Blake, Lawson researcher and Provincial Medical Director at the Ontario Renal Network. “This is what we call acute kidney injury, and in the case of these severe COVID-19 patients the kidney injury led to the need for acute dialysis.”

By accessing data collected through the Ontario Renal Network (ORN), Dr. Blake and his colleagues were able to examine 271 people at 27 renal programs across the province, including patients at London Health Sciences Centre (LHSC), who received acute dialysis for acute kidney injury due to a COVID-19 infection. The data examined was from the duration of the first two waves of the pandemic, up to January 31st, 2021.

“This is a complication that is occurs in 10 per cent of ICU COVID-19 cases,” says Dr. Blake, who is also a nephrologist at LHSC. “Men accounted for more than 75 per cent of this condition, half of the patients were diabetic and the majority of these patients were not seniors in the later stages of life, but rather middle-aged people.”

The provincially-collected data through the ORN also showed that patient populations living in postal codes with high ethnocultural deprivation were more likely to get this condition, at a rate of more than 60 per cent, and survival rates were not promising.

“The mortality rate was shockingly high with 64 per cent of these patients dying within 90 days,” adds Dr. Blake. “Many of those who survived remained in hospital for a long period of time and the one in five that did survive have remained on long-term dialysis.”

This study has been published in the Clinical Kidney Journal.  Looking ahead, the research team plans to follow up with patients who have survived this severe complication to track what lasting health affects occur within a six-to twelve-month post-survival period.

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MEDIA RELEASE
FOR IMMEDIATE RELEASE
Sunnybrook Health Sciences Centre and Lawson Health Research Institute
April 14, 2022
 

LONDON,ON - Five high-dose radiation treatments targeting uterine cancer rather than the current standard 25 treatments are safe and well-tolerated by patients, a new study published in JAMA Oncology has found.

SPARTACUS (Stereotactic Pelvic Adjuvant Radiation Therapy in Cancers of the Uterus) — a multi-institutional non-randomized controlled trial — looked to assess the feasibility and safety of using a specialized technique called stereotactic body radiation therapy (SBRT) for women with uterine cancer where instead of 25 treatments over five weeks, five treatments can be delivered over 1.5 weeks.

SBRT uses many precise beams of radiation to target tumours or cancerous cells. It uses a higher dose of radiation in a smaller number of treatments. It can be done on a standard linear accelerator, the machine that delivers radiation treatments.

Sixty-one women were enrolled in SPARTACUS at two centres — Sunnybrook Health Sciences Centre and the London Regional Cancer Program (LRCP) at London Health Sciences Centre (LHSC).

“Uterine cancer is a common cancer in women, usually treated with surgical removal followed by radiation and/or chemotherapy to reduce the risk of recurrence,” said Dr. Eric Leung, radiation oncologist at Sunnybrook’s Odette Cancer Centre. “External beam radiation is usually given over five weeks, and that can place a heavy burden on women who have to travel to a radiation centre every day, spend time away from home and work, and incur the financial burden of these factors as well.”

With a median follow-up of nine months, the patients enrolled in SPARTACUS reported an acceptable level of side effects from the radiation that resolved, and also reported a reasonable quality of life during treatment, Dr. Leung said.

“We were interested in examining the toxicity of the higher dose – would it affect the nearby bowels or bladder and place a heavy symptom burden on patients? We were pleased to find that patients reported their symptoms as manageable.”

“This study represents a novel way of treating uterine cancer in a shorter time. It was conducted mainly through the COVID pandemic and gave women a chance to receive treatment in less time with fewer visits to our centres,” said Dr. David D’Souza, radiation oncologist at LHSC and the study co-lead through Lawson Health Research Institute.

Patients will continue to be followed on the study for late side effects and further research is planned to further compare this more convenient schedule to the standard five-week course of radiation. 

“This novel treatment could lead to a practice change that places less burden on patients and on the healthcare system,” Dr. Leung said. “Delivering radiation over the course of a week and half rather than over five weeks for patients facing uterine cancer would open up healthcare resources by reducing visits and usage of the linear accelerators.”

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ADDIONAL QUOTES – Dr. David D’Souza:

“Giving radiation in a shorter time can have several advantages for both the patient and the health care system."

“Our study assessed the safety of delivering a higher dose of radiation in fewer treatments for patients with uterine cancer by adapting what has successfully been done for other types of cancer in the pelvis like prostate and rectal cancer.”

“This study was made possible with advances in treatment planning, radiation machine capabilities, and an outstanding radiation therapy program at LRCP.”
                                                                                  
ABOUT LAWSON HEALTH RESEARCH INSTITUTE
Lawson Health Research Institute is one of Canada’s top hospital-based research institutes, tackling the most pressing challenges in health care. As the research institute of London Health Sciences Centre and St. Joseph’s Health Care London, our innovation happens where care is delivered. Lawson research teams are at the leading-edge of science with the goal of improving health and the delivery of care for patients. Working in partnership with Western University, our researchers are encouraged to pursue their curiosity, collaborate often and share their discoveries widely. Research conducted through Lawson makes a difference in the lives of patients, families and communities around the world. To learn more, visit www.lawsonresearch.ca.

ABOUT SUNNYBROOK HEALTH SCIENCES CENTRE
Sunnybrook Health Sciences Centre is inventing the future of health care for the 1.2 million patients the hospital cares for each year through the dedication of its more than 10,000 staff and volunteers. An internationally recognized leader in research and education and a full affiliation with the University of Toronto distinguishes Sunnybrook as one of Canada’s premier academic health sciences centres. Sunnybrook specializes in caring for high-risk pregnancies, critically-ill newborns and adults, offering specialized rehabilitation and treating and preventing cancer, cardiovascular disease, neurological and psychiatric disorders, orthopaedic and arthritic conditions and traumatic injuries. The Hospital also has a unique and national leading program for the care of Canada’s war veterans. 

Media Contacts:
Celine Zadorsky
Communications & External Relations
Lawson Health Research Institute
T: 519-685-8500 ext. 75664
C: 519-619-3872
@email

Sunnybrook Health Sciences Centre
Communications & Stakeholder Relations
416-480-4040

LONDON, ON – A new population-based retrospective validation study, using ICES data collected between 2007 and 2014 in Ontario, has found that health records can be used to track service use as well as the needs of individuals experiencing homelessness. Researchers found that the algorithms tested were able to accurately identify up to 35 per cent of individuals who experience homelessness in a given year.

The best performing algorithm estimated a large increase in homelessness prevalence between 2007 and 2016, with approximately one in 200 adults in Ontario experiencing homelessness in 2016.

“We do not know how many people experience homelessness yearly in Ontario, or in the country as a whole. Current methods rely on shelter data, or large point-in-time counts that require large investments, and are only done in specific communities,” explains Lucie Richard, Lawson researcher and lead author of the study. “Also, not all people who are homeless use shelters. This approach gives us an alternative that can include a wide range of communities and different types of homelessness over time.”

While numerous computer algorithms are already used to analyze administrative databases and identify disease populations to measure the burden of chronic diseases in Canada, this study, conducted by researchers at Lawson Health Research Institute and Western University, is one of the first to validate and track a social determinant of health with good accuracy.

People who experience homelessness often face mental and physical health challenges, have an increased risk of illness and death, and are among the highest users of emergency and other health care services. Homelessness is an important health issue for Canadians.

This ability to track individuals experiencing homelessness over time using administrative databases provides inexpensive, long-term monitoring, which will inform efforts to improve housing and health status in the community and across the country. Researchers and health care providers can now track health status and health care usage of individuals experiencing homelessness.

Understanding how many people experience homelessness and what demographics correlate with homelessness will allow for better service planning, and providers will have the information needed to more appropriately meet the needs of this vulnerable population.

The study, “Validation study of health administrative data algorithms to identify individuals experiencing homelessness and estimate population prevalence of homelessness in Ontario, Canada” is published in BMJ Open.

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