Département de médecine, division d’épidémiologie clinique
Département de physiothérapie et ergothérapie
Université McGill

My research program relates to Function, Disability and Quality of Life in Canada’s Vulnerable Populations. There are more similarities with respect to outcomes across different health conditions than there are differences. My outcomes research program uses the World Health Organization’s International Classification of Function, Disability and Health (ICF) as a framework. In the area of quality of life, I conduct research in measurement and in response shift. I have had research programs in the area of stroke where I monitored changes in rates of ischemic and hemorrhagic strokes over time and examined patterns of stroke care including continuity of care, access to rehabilitation, costs and outcomes. I also have developed a program of clinical trials in the area of rehabilitation and have written two chapters on design and analysis of randomized trials for the 3rd Edition of Medical Uses of Statistics and NEJM sponsored publication. I am also involved in the area of knowledge translation, taking the results of these and other trials to develop, implement, and evaluate community-based program that meet the needs of persons with disability for the duration of their life in the community. Other areas of stroke research involve quality of life of patients and caregivers and examining the establishment and evolution of depression post-stroke, and developing a harmonized measurement method for quantifying post-stroke recovery using both behavioral and imaging tests. Outcomes research has also led me to examine outcomes in areas of high volume and high impact. An example is surgery, cancer, and the elderly. This led to research on recovery post-surgery and to develop interventions to improve outcomes through pre-operative conditioning (prehabilitation). This work in outcomes has also indicated that functional status indicators are of tremendous importance in explaining outcomes and health services utilization. This has led me to examine the feasibility of using an electronic health record to capture health and functional status and use ICF coding system to create coded functional status indicators suitable for inclusion on administrative databases. Lately, I have applied research approaches from stroke into Multiple Sclerosis (MS) looking at outcomes, exercise interventions, and self-management. This work uncovered the need to address, not only physical disabilities, but also key outcomes of apathy and cognitive impairment. I co-lead a team looking at cognitive outcomes for people HIV. Throughout, I apply modern methodological and statistical approaches and develop material to make this, sometimes rather opaque, content accessible to clinical researchers.