CENTRE FOR HEALTH EVALUATION & OUTCOME SCIENCES

Connecting the dots between research and the real world

Annual Report 2020–2021

2020:

The Year of Adaptation

This year was unlike any other. It demanded flexibility, humility and resilience from everyone around the world. As a group of research professionals, not only did we have to adapt to the daily changes necessitated by the realities of the pandemic, we also needed to quickly respond to the shifting research landscape as it was both constrained and accelerated by COVID-19. We are proud of our achievements this year, most notably how our researchers and staff met these monumental challenges with creativity and innovation.

About the Centre

WHAT WE DO

The Centre for Health Evaluation and Outcome Sciences (CHÉOS) conducts high-quality research to inform changes to the health care system. As a collaboration between cross-disciplinary scientists, clinicians, and expert research staff, we bridge the gap between data, research, and care to evaluate the effectiveness of health interventions at the population level to improve health outcomes for all.

Established in 1998, the Centre is jointly affiliated with the Providence Health Care Research Institute (PHCRI) and the University of British Columbia (UBC) Faculty of Medicine, and is housed in a teaching and research hospital in the heart of Vancouver, Canada.

WHO WE ARE

Our Vision

Bridging evidence and care to transform the health system and improve health outcomes for all.

Our Mission

Through interdisciplinary collaboration and mentorship of emerging health researchers, we produce and translate high-quality evidence that informs health care from the individual to the system level.

Our Values

COLLABORATION: We forge meaningful partnerships with researchers, health care professionals, people with lived experience, community-based organizations, and system-level decision-makers.

ORGANIZATIONAL INTEGRITY: We strive to uphold the highest principles for the conduct of research that is designed to improve the well-being of all people.

SCIENTIFIC RIGOR: We identify and address relevant and meaningful research questions from many perspectives through the rigorous application of appropriate and innovative scientific methods at all stages of research.

EQUITY, DIVERSITY, AND INCLUSION: We are dedicated to the promotion and practice of equity, diversity, and inclusion in our workplace and in the research that we conduct.

CHÉOS at a Glance

SERVICES SNAPSHOT

Our expert staff help researchers from around the world turn good ideas into great research.
Proportion of CHÉOS support by service type in 2020/2021

135+
staff members

221
new or existing projects supported in 2020/2021

RESEARCH SNAPSHOT

Our investigators are at the forefront of major areas of health research; many have clinical appointments and include Canada Research Chairs, MSFHR Scholars, and CIHR Investigators.

$21M+
in total funding held by CHÉOS Scientists in 2020/21*

*From UBC RISe, includes only CHÉOS Scientists at UBC and those appointed after March 31, 2021

$9M+
in new CIHR, SSHRC, MSFHR, PHAC and NIH grant funds awarded to CHÉOS Scientists as principal applicants in 2020/21

Our People

This year, we celebrated career appointments, new CHÉOS members, and a decades-long career in health research.
CHÉOS Director Dr. Aslam Anis announced as new Director of UBC SPPH

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Dr. Amy Salmon announced as new Associate Director of CHÉOS

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A Fond Farewell to Dr. Peter Dodek

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Dr. Nadia Khan appointed Division Head, General Internal Medicine

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New Scientist: Dr. Daniel Vigo

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New Scientist: Dr. Ricky Turgeon

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Responding to COVID-19

Our scientists rose to the challenge of COVID-19, adapting their existing programs and exploring new research questions to meet the most urgent needs of patients, decision-makers, and care providers.
Study examines COVID-19 impact on paramedics in B.C.

The CORSIP study is identifying workplace factors that increase or decrease the risk of COVID-19 infection to inform guidelines to protect paramedics’ health.

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What a scientist learned from getting COVID-19

As Dr. Amy Salmon continues to navigate the long-lasting effects of the virus, she is appreciative of the unique perspective it has brought to her work.

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This would be fascinating… if it wasn’t happening to me.

At-home resources to support mental wellness in times of isolation

Dr. Joseph Puyat leads a team investigating ways to improve and maintain mental wellness in times of mass quarantine and isolation.

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CHÉOS experts support BC study on new COVID-19 drug

A clinical trial for a new COVID-19 treatment developed by Vancouver biotech company AbCellera was launched in B.C., thanks to the expertise of CHÉOS staff.

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Maintaining health and well-being while we ‘flatten the curve’

Daily lives were turned upside down by COVID-19. Dr. Skye Barbic shares key lessons from occupational therapy to help deal with the disruptions caused by the pandemic.

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Pregnancy and labour in the time of COVID-19

A new CHÉOS-supported study looks to document people’s pregnancy experiences during the pandemic.

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There is a lot of uncertainty right now in the midst of the pandemic. This study will help to provide some guidance in this area, for patients, care providers, and decision-makers.
The race to find effective COVID-19 treatments is a team effort

As scientists around the world race to find an effective treatment for COVID-19, CHÉOS project managers are proud to be a small part of this global effort.

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CHÉOS researcher joins the fight against COVID-19

CHÉOS Program Head for Clinical Trials Dr. Joel Singer is part of an international team that received federal funding to help combat the COVID-19 pandemic.

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The impact of school disruptions: Lessons from the pandemic

New study led by CHÉOS Scientist Dr. Anne Gadermann explores the impact COVID-related school disruptions have had on student and teacher wellbeing.

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This study could help to identify ways, at the community and policy levels, for improving the wellbeing of students and teachers.

Staying the Course

Despite the pressures of the pandemic, our researchers continued to answer critical questions related to a wide range of health outcomes, populations, and people.
Taking ACTION to address cultural barriers to living donor kidney transplant

CHÉOS Scientist Dr. Jag Gill is working to reduce cultural inequities to living kidney donation and transplantation.

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I still can’t believe science makes it possible to take out my organ and have it continue to function and thrive in my sister. It’s remarkable.

– Garcha Johal, ACTION Study Advisory Committee

A new approach to an age-old barrier to care

CHÉOS Research Associate Dr. Beena Parappilly discusses how the unique Managed Alcohol Program at St. Paul’s improves patient care.

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PHC and VCH researchers collaborate on a novel toolkit for the antipsychotic drug clozapine

CHÉOS Scientist Dr. Joseph Puyat helped design the evaluation of the toolkit, in collaboration with colleagues at St. Paul’s and VCH.

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Obesity linked to social ties in older women, more so than in men

Research led by Drs. Annalijn Conklin and Nadia Khan indicates women who lack social ties have a greater likelihood of being obese.

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One quarter of prescription drugs in Canada may be in short supply

Research led by Dr. Wei Zhang finds that market factors and pricing policies may be to blame.

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How do Canadians living with chronic conditions use at-home care?

CHÉOS researchers address unanswered questions to guide policy and resource allocation for chronic disease management.

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Using health economics to find a better way to screen for prostate cancer

CHÉOS Scientists are examining the cost-effectiveness of a new blood test that aims to avoid the unnecessary health complications and costs of current methods.

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Nearly 20 per cent of Canadian men screened for prostate cancer may undergo unnecessary surgical biopsy.

IN THE NEWS
RESEARCH IN ACTION

Research Highlights

Each year, our Scientists publish over 300 peer-reviewed papers. Below is a small selection from The Evidence Speaks, a monthly series that summarizes some of the latest in CHÉOS research.

Hosseini Z, Veenstra G, Khan NA, Conklin AI. Social connections and hypertension in women and men: a population-based cross-sectional study of the Canadian Longitudinal Study on Aging. J Hypertens. 2020 Oct 22 epub ahead of print.

Watch an interview about this research with Dr. Conklin on Global News

Hypertension is a well-known risk factor for cardiovascular diseases (CVD) and is more common among women than men at older ages. The associations between social ties and hypertension are poorly understood, and studies from a sex and gender perspective are rare. To address this gap, CHÉOS Scientists Drs. Nadia Khan and Annalijn Conklin collaborated with colleagues from UBC and the University of Saskatchewan to investigate the types of social ties that affect hypertension most among older women and men in Canada, and whether different types interact to have a combined effect. Using Canadian Longitudinal Study on Aging cohort data, the team analyzed 28,238 people aged 45–85 years. They assessed four types of social ties—marital status, living arrangement, social network size, and social participation—alone and in combination to determine the effect on blood pressure and hypertension. They also examined gender differences. The study found that being non-partnered, participating in two or fewer social activities per month, or having a small network size was associated with a higher risk of hypertension in women. For men, living alone was associated with lower risk of hypertension. Increased social participation mitigated the adverse associations between non-partnership and blood pressure, especially among women. Overall, this study demonstrates that a number of types of social ties, plus specific combinations of them, are associated with hypertension; an effect appearing more pronounced in women. The results add to the literature on this topic and could be used to help inform clinical and public health strategies to reduce CVD burden.

CHÉOS Personnel: Nadia Khan, Annalijn Conklin

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Grunau B, Kime N, Leroux B, Rea T, Belle GV, Menegazzi JJ, Kudenchuk PJ, Vaillancourt C, Morrison LJ, Elmer J, Zive DM, Le NM, Austin M, Richmond NJ, Herren H, Christenson J. Association of Intra-arrest Transport vs Continued On-Scene Resuscitation With Survival to Hospital Discharge Among Patients With Out-of-Hospital Cardiac Arrest. JAMA. 2020 Sep;324(11):1058-67.

Read more on UBC News

There are established guidelines for the treatment of out-of-hospital cardiac arrest (OHCA) by emergency medical services (EMS); however, transport to hospital during OHCA resuscitative efforts varies by agency and region. In this cohort study, a team led by CHÉOS Scientist Dr. Brian Grunau and including CHÉOS Scientist Dr. Jim Christenson investigated whether transport to hospital during cardiac arrest (intra-arrest transport) is associated with survival to hospital discharge, compared with continued on-scene resuscitation. The researchers analyzed data from the Resuscitation Outcomes Consortium Cardiac Epidemiologic Registry of ten North American study sites. They included 27,705 consecutive EMS-treated patients with nontraumatic OHCA between April 2011 and June 2015. Using a methodology that accounts for initial resuscitative efforts and matches patients based on the time of their arrest, the researchers found that four per cent of patients who underwent intra-arrest transport survived to hospital discharge compared with 8.5 per cent of patients who received on-scene resuscitation. The results demonstrate that intra-arrest transport to the hospital was significantly associated with a lower probability of survival to hospital discharge, and lower probability of surviving with good neurological outcomes, compared with continued on-scene treatment. While there are some limitations to the study due to its observational design, it highlights the need for further investigation using randomized controlled trials.

CHÉOS Personnel: Brian Grunau, Jim Christenson

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Raymakers A, Sin D, Sadatsafavi M, FitzGerald J, Marra C, Lynd L. Statin use and lung cancer risk in chronic obstructive pulmonary disease patients: a population-based cohort study. Respir Res. 2020 May 19;21(118).

Chronic obstructive pulmonary disease (COPD) is often associated with comorbidities including cardiovascular disease (CVD), which is typically treated using statins. Data indicate that individuals living with COPD are also at an increased risk of developing lung cancer. In some cases, this risk is due to increased inflammation—an issue exacerbated by concomitant CVD and COPD. To further explore these interactions, CHÉOS Scientist Dr. Larry Lynd joined a team from UBC and University of Otago to evaluate the association between statin use and the risk of lung cancer among a cohort of COPD patients. Using information from several databases in B.C., the team identified 39,879 COPD patients. Of these, there were 994 cases of lung cancer and 12,469 patients who received statins during the study period. The analyses conducted suggest that statin use in COPD patients may reduce the risk of lung cancer. While the effect was not statistically significant across all exposure definitions, the results lend support to the hypothesis that COPD patients, likely characterized by elevated levels of inflammation, could significantly benefit from statin use.

CHÉOS Personnel: Larry Lynd

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Closson K, Karim ME, Sadarangani M, Naus M, Ogilvie GS, Donken R. Association between human papillomavirus vaccine status and sexually transmitted infection outcomes among females aged 18-35 with a history of sexual activity in the United States: A population survey-based cross-sectional analysisVaccine. 2020 Dec 14;38(52):8396–404.

CHÉOS Scientist Dr. Ehsan Karim worked with B.C. colleagues to investigate the association between HPV vaccination and sexually transmitted infection (STI) outcomes among females aged 18–35. Of the participants who have been sexually active and received the HPV vaccine, 6.1 per cent received it at the recommended age of 11–12 and 65.7 per cent received it after their first time having sex. The researchers noted that just 3.8 per cent of these females had an STI and 3.5 per cent had vaccine-type HPV (HPV 6/11/16/18). They concluded that there was no association between HPV vaccination and STI outcomes.

CHÉOS Personnel: Ehsan Karim

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Gadermann AC, Thomson KC, Richardson CG, Gagné M, McAuliffe C, Hirani S, Jenkins E. Examining the impacts of the COVID-19 pandemic on family mental health in Canada: findings from a national cross-sectional study. BMJ Open. 2021 Jan 12;11(1):e042871.

Read more on CBC News

CHÉOS Scientist Dr. Anne Gadermann and Program Head – Psychosocial Epidemiology Dr. Chris Richardson joined CHÉOS postdoctoral fellows Kimberly Thomson and Monique Gagné, plus a team from UBC School of Nursing, to investigate the impacts of COVID-19 on family mental health. Using survey data, the team discovered that almost half of parents with children aged under 18 reported worse mental health due to the pandemic. It was also reported that they drank more alcohol, felt more stressed about being safe from domestic violence, and experienced more thoughts about suicide and self-harm compared with the rest of the population. Furthermore, around one quarter of parents reported that their children’s mental health had worsened. These results could help inform policymakers and service providers about family needs during this trying time.

CHÉOS Personnel: Anne Gadermann, Kimberly Thompson, Chris Richardson

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Geoffrion R, Koenig NA, Zheng M, Sinclair N, Brotto LA, Lee T, Larouche M. Preoperative Depression and Anxiety Impact on Inpatient Surgery Outcomes. Ann Surg Open. 2021 Mar 16;2(1):e049.

A team led by CHÉOS Scientist Dr. Roxana Geoffrion and including CHÉOS Statistician Dr. Terry Lee recently analyzed the potential association between preoperative depression and anxiety and postoperative outcomes, and determined if these outcomes differed between sex. A total of 1,061 patients were recruited from surgical preadmission clinics at one hospital, among whom 455 males and 486 females had both preoperative and postoperative data available. The research indicated that females were more likely to be depressed or anxious before surgery than males. They determined that anxiety and depression, as measured via questionnaires, increased the chance of postoperative complications, extended length of stay, and/or hospital readmission in females but not males. As such, they concluded that preoperative depression and anxiety were associated with worse surgical outcomes in female patients.

CHÉOS Personnel: Roxana Geoffrion, Terry Lee

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Publications

CHÉOS research is found in some of the world’s top journals and covers a wide breadth of specialties, areas, and populations.

299
original research publications

37
reviews

50
editorials & commentaries

Top 10 areas of publication in 2020/2021