General Internal Medicine

KNOWLEDGE TRANSLATION PROGRAM

Director	Contact
Sharon E. Straus	University Health Network Toronto General Hospital EN  9-415 200 Elizabeth Street Toronto, ON M5G 2C4

Brief Description

The aims of this program are to establish a coordinated, rigorous and transformative program of research to explore methods of achieving knowledge translation in health care, using various educational and organizational interventions and developments in information technology, and targeting clinicians, patients and the public. The group combines clinicians with researchers from various disciplines including clinical epidemiology, human factors, computer science, and cognitive psychology.

Principal Investigators

Name	Department	Major Research Interest
Sharon Straus	Medicine	Evidence-based medicine
Mark Chignell	Mechanical Engineering	Human factors
John Mylopoulos	Computer Science	Knowledge management
Alberto Mendelsson	Computer Science	Information retrieval
Andre Kushniruk	Mathematics (York University)	Human factors
Graeme Hirst	Computer Science	Computational linguistics
Richard Owens	Faculty of Law	Health policy and data security

Recent Original Research Publications

Straus SE. Individualizing treatment decisions: the likelihood of being helped versus harmed. Evaluation and the Health Professions 25:210-24, 2002.

Straus SE, McAlister FA, Sackett DL, Deeks JJ on behalf of the COAD2 Investigators. A multicentre study on the accuracy of the clinical examination for chronic obstructive airways disease. J Gen Int Med 17:684-88, 2002.

Straus SE, Majumdar S, McAlister FA. New Science: Clinical evidence for stroke prevention. JAMA 288:1388-95, 2002.

Straus SE, Majumdar S, McAlister FA. New Practice: Clinical applications for stroke prevention. JAMA 288:1396-98, 2002.

Takeshita H, Davis D, Straus SE. Clinical evidence at the point of care in acute medicine: A handheld usability case study. Human Factors and Ergonomics (in press).

Future Directions

The literature suggests that systematic research is needed to reduce adverse events through the application of knowledge of safer care systems and enhanced support for evidence-based health care. Moreover, much of the research that has been done in this field to date addresses care in hospital settings (particularly at secondary and tertiary care sites) rather than in community outpatient settings where the bulk of health care delivery is provided. Rigorous methods are needed to analyze the cause of adverse events and to develop and evaluate methods of preventing such events, using important clinical outcomes. Finally, validated safety practices must be implemented using effective knowledge translational strategies. Innovative transdisciplinary partnerships between experts in safety and knowledge translation are needed to create safer clinical environments where knowledge about effective practice is available to clinicians at the point of care. We are currently such a team, with colleagues from cognitive psychology, engineering, computer science, and health care amongst others.

Funding has recently been received for the completion of a randomized trial of an Internet-based EBM educational intervention. Funding has also been received for the development and evaluation of the use of mobile computers packaged with high-quality evidence to bring evidence to the point of care. An online prescribing tool has been developed that links the evidence to the prescription, and we are attempting to integrate this tool with relevant clinical data from electronic health records. The impact of these tools on patient care will be evaluated through a randomized trial.