Every year, close to 45,000 Canadians suffer sudden cardiac arrests and less than 10 per cent survive. Prompt cardiopulmonary resuscitation (CPR) and defibrillation are key to getting the heart started again; however, there is still controversy about how best to perform these procedures. This year, Dr. Ian Stiell and his colleagues resolved a major debate by showing that one minute of CPR from paramedics and firefighters before defibrillation is just as good as three minutes, and may even be better in some cases. The study, which is the largest cardiac arrest clinical trial in the world, was published in the prestigious New England Journal of Medicine and the results have influenced CPR practices globally.
Breast cancer treatment has become highly personalized, with women routinely receiving treatments tailored to the molecular profile of their tumour. But what if the cancer changes over time as it spreads to other organs? Dr. Mark Clemons designed a clinical trial to answer this question in 121 women with metastatic breast cancer. He found that in nearly 40 per cent of cases, the cancer had changed, making it more or less susceptible to certain treatments. Doing a second biopsy to check the molecular profile of the secondary tumours resulted in better treatment for one in seven women in the study. The results, published in the Journal of Clinical Oncology, have changed medical practice around the world.
New research led by Dr. Jeff Perry could save thousands of severe headache patients each year from having to undergo painful invasive testing for subarachnoid hemorrhage - a rare type of bleeding stroke. Traditionally this type of stroke could be ruled out only with a CT scan and a spinal tap, but Dr. Perry’s new study shows that a CT scan is enough, if done with a modern machine within six hours. The findings, published in the British Medical Journal, could help increase hospital efficiency, in addition to the direct benefits to patients.
People with HIV are increasingly able to avoid taking unnecessary antibiotics associated with major side effects, thanks to research led by Dr. Jonathan Angel. It was previously assumed that HIV patients with a low CD4 immune cell count always had to take these antibiotics to avoid getting pneumonia and other infections, however a systematic review led by Dr. Angel revealed that if the amount of virus in the blood is very low, it is safe to stop taking these medications even if there hasn’t been what has generally been accepted as an adequate improvement in immune function. This research, published in PLoS One, has already improved health and quality of life for many people with HIV in Ottawa, and it is beginning to have an impact around the world.
Health care administrators may try their best to incorporate research evidence into the development of new policies and procedures, but with more than 500,000 medical research papers published each year, it can be difficult to keep up. The establishment of “The Ottawa Hospital Evidence Secretariat” is now making it easier for decision-makers to quickly access research evidence, with benefits for both patients and the hospital budget. Under the leadership of Dr. David Moher, the group has already conducted 16 rapid evidence reviews which have contributed to the development of innovative new approaches to improve care for pregnant women, newborns, people with chronic diseases and patients in the emergency department. They have summarized their experience in a recent Systematic Reviews paper.