Karim M Khan

• MD, PhD
• Professor (Full) at University of British Columbia

Background and objectives Peer review is ubiquitous in evaluating scientific research. While peer review of manuscripts submitted to journals has been widely studied, there has been relatively less attention paid to peer review of grant applications (despite how crucial peer review is to researchers having the means and capacity to conduct research...

Background. The specific roles and responsibilities expected of leaders of consensus-based decision committees, such as grant peer review panels and guideline development panels, are not well-defined, which makes it difficult to train people to lead well. We aimed to explore, describe and define the roles, responsibilities, and leadership character...

Objective: Exercise is an evidence-based strategy for preventing falls. However, its efficacy may vary based on individual characteristics, like gait speed. The study examined whether baseline gait speed modified the effects of home-based exercise on subsequent falls among older adults. Methods: This is a secondary analysis of a 12-month, random...

Exercise is an evidence-based strategy for preventing falls. However, its efficacy may vary based on individual characteristics, like gait speed. We performed a secondary analysis of a randomized controlled trial, to assess if baseline gait speed moderated the effects of an exercise program on subsequent falls among older adults. Community-dwelling...

Objectives Most first-time biomedical research grant applications are not funded. In the challenging research funding climate, resubmitting a grant application is a necessary task for scientists. Identifying which factors influence their decision to resubmit and the success of resubmissions will inform funders and applicants. However, data on resub...

Research projects, initiatives and conferences that include patients as partners rather than as participants are becoming more common. Including patients as partners (what we will call ‘patient partners’) is an approach called patient engagement or involvement in research, and we will call it patient engagement throughout this paper. Patient engage...

Objective Clinicians treating patients with patellofemoral pain (PFP) rely on consensus statements to make the best practice recommendations in the absence of definitive evidence on how to manage PFP. However, the methods used to generate and assess agreement for these recommendations have not been examined. Our objective was to map the methods use...

BACKGROUND: The Lancet Series of Low Back Pain (LBP) highlighted the lack of LBP data from low- and middle-income countries (LMICs). The study aimed to describe (1) what LBP care is currently delivered in LMICs and (2) how that care is delivered. METHODS: An online mixed-methods study. A Consortium for LBP in LMICs (n = 65) was developed with an ex...

Research projects, initiatives and conferences that include patients as partners rather than as participants are becoming more common. Including patients as research partners is an approach called patient engagement or involvement in research, and we will call it patient engagement throughout this paper. Patient engagement moves traditional health...

Cognitive frailty is characterized by concurrent physical frailty and mild cognitive impairment. and increases the risk for falls. Whether exercise can reduce falls in older adults with cognitive frailty is unknown. We examined the effects of a home-based exercise intervention on subsequent falls among community-dwelling older adults with cognitive...

Background: Adherence to established reporting guidelines can improve clinical trial reporting standards, but attempts to improve adherence have produced mixed results. This exploratory study aimed to determine how accurately a Large Language Model generative AI system (AI-LLM) could measure reporting guideline compliance in a sample of sports medi...

Background Eating frequency may affect body weight and cardiometabolic health. Intervention trials and observational studies have both indicated that high- and low-frequency eating can be associated with better health outcomes. There are currently no guidelines to inform how to advise healthy adults about how frequently to consume food or beverages...

Background Several open science-promoting initiatives have been proposed to improve the quality of biomedical research, including initiatives for assessing researchers’ open science behaviour as criteria for promotion or tenure. Yet there is limited evidence to judge whether the interventions are effective. This review aimed to summarise the litera...

The allocation of public funds for research has been predominantly based on peer review where reviewers are asked to rate an application on some form of ordinal scale from poor to excellent. Poor reliability and bias of peer review rating has led funding agencies to experiment with different approaches to assess applications. In this study, we comp...

The Canadian Institutes of Health Research (CIHR) commenced a Quality Assurance Program in 2019 to monitor the quality of peer review in its Project Grant Competition Peer Review Committees. Our primary aim was to describe the performance of CIHR grant peer reviewers, based on the assessments made by CIHR peer review leaders during the first 3 year...

Background Choose to Move (CTM), an effective health-promoting intervention for older adults, was scaled-up across British Columbia, Canada. Adaptations that enable implementation at scale may lead to ‘voltage drop’—diminished positive effects of the intervention. For CTM Phase 3 we assessed: i. implementation; ii. impact on physical activity, mobi...

Introduction Primary cam morphology is highly prevalent in many athlete populations, causing debilitating hip osteoarthritis in some. Existing research is mired in confusion partly because stakeholders have not agreed on key primary cam morphology elements or a prioritised research agenda. We aimed to inform a more rigorous, inclusive and evidence-...

Objectives To: (1) describe hamstring injury incidence and burden in male professional football players over 21 seasons (2001/02 to 2021/22); (2) analyse the time-trends of hamstring muscle injuries over the most recent eight seasons (2014/15 to 2021/22); and (3) describe hamstring injury location, mechanism and recurrence rate. Methods 3909 playe...

Introduction Primary cam morphology is a mostly benign bony prominence that develops at the femoral head-neck junction of the hip, but it is highly prevalent in many athlete populations. In the small proportion of athletes for whom it is not benign, the resulting hip osteoarthritis can be debilitating. Clinicians, athletes, patients and researchers...

The goal of the OPTIKNEE consensus is to improve knee and overall health, to prevent osteoarthritis (OA) after a traumatic knee injury. The consensus followed a seven-step hybrid process. Expert groups conducted 7 systematic reviews to synthesise the current evidence and inform recommendations on the burden of knee injuries; risk factors for post-t...

Background: Adherence to study registration and reporting best practices are vital to foster evidence-based medicine. Poor adherence to these standards in clinical trials conducted in Canada would be detrimental to patients, researchers, and the public alike. Methods: All registered clinical trials on ClinicalTrials.gov conducted in Canada as of 20...

Objective We synthesised and assessed credibility (ie, trustworthiness) of thresholds that define meaningful scores for patient-reported outcome measures (PROMs) following interventions for anterior cruciate ligament (ACL) tear or traumatic meniscus injury. Design Systematic review, narrative synthesis. Data sources We searched five databases, ha...

Consensus is an often neglected but important part of the scientific process. Consensus agreement allows researchers to agree on fundamentals such as terminology and taxonomy, to establish core outcome sets for reporting on medical conditions, and to set research priorities. Consensus methods are invoked by the scientific community to provide answe...

It is unclear whether cardiometabolic risk shares an interactive relationship with age-associated differences in cognition, and whether this relationship varies by biological sex. We conducted a cross-sectional analysis using baseline data from the Canadian Longitudinal Study on Aging (CLSA; 2010–2015) to examine whether 1) cardiometabolic risk has...

Poor reporting of medical and healthcare systematic reviews is a problem from which the sports and exercise medicine, musculoskeletal rehabilitation, and sports science fields are not immune. Transparent, accurate and comprehensive systematic review reporting helps researchers replicate methods, readers understand what was done and why, and clinici...

Background: Choose to Move is one of few scaled-up health-promoting interventions for older adults. The authors evaluated whether Choose to Move participants maintained their intervention-related gains in physical activity (PA), mobility, and social connectedness 12 months after the intervention ended. Methods: The authors assessed PA, mobility,...

One new case of dementia is detected every 4 seconds and no effective drug therapy exists. Effective behavioural strategies to promote healthy cognitive ageing are thus essential. Three behaviours related to cognitive health which we all engage in daily are physical activity, sedentary behaviour and sleep. These time-use activity behaviours are lin...

Background Cam morphology, a distinct bony morphology of the hip, is prevalent in many athletes, and a risk factor for hip-related pain and osteoarthritis. Secondary cam morphology, due to existing or previous hip disease (eg, Legg-Calve-Perthes disease), is well-described. Cam morphology not clearly associated with a disease is a challenging conce...

Introduction: Strength and balance exercises prevent falls. Yet, exercise adherence is often low. To maximize the benefit of exercise on falls prevention, we aimed to identify baseline cognitive and mobility factors that predict adherence to the Otago Exercise Program (OEP) - a home-based exercise program proven to prevent falls. Methods: We con...

Objective We identified adherence-based case-mixes from participants’ longitudinal adherence to falls prevention exercise interventions over 12 months. Second, we identified modifiable baseline predictors (cognition, mobility and functional status) based on case-mix adherence trajectories. Study design and outcome measures This study was a 12-mont...

Background Poor sleep is common among older adults at risk for dementia and may be due to circadian dysregulation. Light is the most important external stimulus to the circadian clock and bright light therapy (BLT) has been used for >20 years to help realign circadian rhythms. However, the ability of field methods (e.g., actigraphy) to accurately d...

A 12-month trial demonstrated the Otago Exercise Program (OEP), a home-based exercise program of strength and balance retraining exercises, significantly reduced the rate of subsequent falls among 344 older adults receiving care after a fall (JAMA, 2019). A significant improvement in processing speed, as measured by the Digit Symbol Substitute Test...

Objective To explore clinical characteristics in individuals with patellofemoral osteoarthritis (PFOA) compared to individually-matched asymptomatic controls. We also explored associations between functional performance and patient-reported symptoms with patellofemoral alignment. Methods We assessed 15 individuals with PFOA and 15 individually-mat...

Background: Comprehensive geriatric care (CGC) for older adults during hospitalization for hip fracture can improve mobility, but it is unclear whether CGC delivered after a return to community living improves mobility compared with usual post-discharge care. Objective: To determine if an outpatient clinic-based CGC regime in the first year afte...

Background Strength and balance retraining exercises reduce the rate of subsequent falls in community-dwelling older adults who have previously fallen. Exercise can also improve cognitive function, including processing speed. Given processing speed predicts subsequent falls, we aimed to determine whether improved processing speed mediated the effec...

An extensive body of literature supports the mental health benefits of exercise. Some clinicians are starting to embrace the concept “exercise is medicine.” In our study, we evaluated longitudinal qualitative data from participants with a mood disorder who participated in an exercise program. Recommendations from participants include providing a pr...

Muscle cramps are common and can occur in a wide range of settings. Older adults and pregnant women commonly complain of leg cramps while they are resting, athletes can cramp when they are pushing the limits of their endurance, and some people develop muscle cramps as a symptom of other medical conditions. One potential treatment that is already be...

High quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best practice methods—methods matter (greatly!). The 1st METHODS MATTER Meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise in research me...

Synopsis: High-quality sports injury research can facilitate sports injury prevention and treatment. There is scope to improve how our field applies best-practice methods-methods matter (greatly!). The first METHODS MATTER meeting, held in January 2019 in Copenhagen, Denmark, was the forum for an international group of researchers with expertise i...

Background: The Otago Exercise Program (OEP) has demonstrated cost-effectiveness for the primary prevention of falls in a general community setting. The cost-effectiveness of exercise as a secondary falls prevention (ie, preventing falls among those who have already fallen) strategy remains unknown. The primary objective was to estimate the cost-e...

Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport-specific or setting-specific consensus statement...

In 2013, the Oslo Sports Trauma Research Center Overuse Injury Questionnaire (OSTRC-O) was developed to record the magnitude, symptoms and consequences of overuse injuries in sport. Shortly afterwards, a modified version of the OSTRC-O was developed to capture all types of injuries and illnesses—The Oslo Sports Trauma Research Center Questionnaire...

Background Injury and illness surveillance, and epidemiological studies, are fundamental elements of concerted efforts to protect the health of the athlete. To encourage consistency in the definitions and methodology used, and to enable data across studies to be compared, research groups have published 11 sport- or setting-specific consensus statem...

Background Preseason training develops players’ physical capacities and prepares them for the demands of the competitive season. In rugby, Australian football, and American football, preseason training may protect elite players against in-season injury. However, no study has evaluated this relationship at the team level in elite soccer. Purpose/Hy...

There is no agreement on how to classify, define or diagnose hip-related pain—a common cause of hip and groin pain in young and middle-aged active adults. This complicates the work of clinicians and researchers. The International Hip-related Pain Research Network consensus group met in November 2018 in Zurich aiming to make recommendations on how t...

Using the Downs and Black checklist, the majority of included RCTs (8/11) were judged to be high-quality trials. Kosik et al interpreted study quality assessment findings to provide moderate-quality to high-quality evidence for therapeutic interventions improving patient-reported function in individuals with CAI. Using ROB2 on the same sample of RC...

In this editorial, we introduced risk of bias as the perceived risk that the results of a research study may underestimate or overestimate the truth. Systematic review authors should perform a domain-based risk of bias assessment that reflects risk of bias instead of assessing study quality. If a research study reports multiple outcome measures, se...

Hip-related pain can significantly impact quality of life, function, work capacity, physical activity and family life. Standardised measurement methods of physical capacity of relevance to young and middle-aged active adults with hip-related pain are currently not established. The aim of this consensus paper was to provide recommendations for clini...

The 1st International Hip-related Pain Research Network meeting discussed four prioritised themes concerning hip-related pain in young to middle-aged adults: (1) diagnosis and classification of hip-related pain; (2) patient-reported outcome measures for hip-related pain; (3) measurement of physical capacity for hip-related pain; (4) physiotherapist...

We assessed the efficacy of the home-based Otago Exercise Program (OEP) as a secondary falls prevention strategy in seniors referred to a falls prevention clinic after an index fall. We conducted a 12-month randomized controlled trial of 344 adults, aged 70 years and older, with = or > 1 fall resulting in medical attention in the prior 12 months. P...

In Reply Dr Cummings suggests that exercise has little benefit in preventing falls because “the risk ratio for any fall in the current study was 1.01”.¹ However, the primary objective of our trial was to examine whether exercise reduced the rate of falls, not the number of people who experienced a fall. All participants had experienced at least 1 f...

Importance Whether exercise reduces subsequent falls in high-risk older adults who have already experienced a fall is unknown. Objective To assess the effect of a home-based exercise program as a fall prevention strategy in older adults who were referred to a fall prevention clinic after an index fall. Design, Setting, and Participants A 12-month...

Purpose: We described patellofemoral alignment and trochlear morphology at one and five years after anterior cruciate ligament reconstruction (ACLR), and evaluated the associations between alignment and trochlear morphology (at one year) and worsening patellofemoral osteoarthritis (OA) features by five years. We also evaluated the associations bet...

Objective The aim of this systematic review was to investigate the methods used for estimating the population attributable fraction (PAF) to leisure-time physical inactivity (PI) of coronary artery diseases, hypertension and stroke in order to provide the best available estimate for PAF. Design Systematic review. Data sources Four electronic data...

Patellofemoral (PF) osteoarthritis (OA) is a prevalent and clinically important knee OA subgroup. Malalignment may be an important risk factor for PF OA. However, little is known about alignment in PF OA, particularly in an upright, weightbearing environment. Using a vertically‐oriented open‐bore MR scanner, we evaluated 3D knee alignment in 15 PF...

Objective We assessed the feasibility and acceptability of delivering a geriatrician-led evidence-based Falls Prevention Clinic to older adults with a history of falls. Design 12-month prospective cohort study. Setting Vancouver Falls Prevention Clinic, Vancouver, British Columbia, Canada ( www.fallsclinic.ca ). Participants 188 community-dwelli...

Objectives To systematically identify and qualitatively review the statistical approaches used in prospective cohort studies of team sports that reported intensive longitudinal data (ILD) (>20 observations per athlete) and examined the relationship between athletic workloads and injuries. Since longitudinal research can be improved by aligning the...

Background and purpose: Prolonged sedentary time and limited physical activity can result in deleterious effects on health and mobility, especially for older adults with fall-related hip fracture. Therefore, the purpose of this study was to examine the effect of a multidisciplinary clinic on sedentary behavior and physical activity (prespecified s...

Introduction Statins are widely used to inhibit cholesterol production in the liver among people with hypercholesterolemia. A recent epidemiological study in the UK has shown that statin use (unlike elevated BMI) is not associated with an increased risk of Achilles tendon rupture. However, because of laboratory reports suggesting a negative influen...

Primary data used to test the hypotheses in the current study. (XLSX)

Background: Lower extremity muscle strength tests are commonly used to screen for injury risk in professional soccer. However, there is limited evidence on the ability of such tests in predicting future injuries. Purpose: To examine the association between hip and thigh muscle strength and the risk of lower extremity injuries in professional mal...

Objective: Testing clinical interventions integrated within health care delivery systems provides advantages, but it is important to make the distinction between the design of the intervention and the operational elements required for effective implementation. Thus, the objective of this study was to describe contextual factors for an outpatient fo...

Background There is a physical inactivity pandemic around the world despite the known benefits of engaging in physical activity. This is true for individuals who would receive notable benefits from physical activity, in particular those with mood disorders. In this study, we explored the factors that facilitate and impede engagement in physical act...

Purpose: To develop methods for evaluating 3D patellofemoral and tibiofemoral alignment in vertical open-bore magnetic resonance (MR) scanners, with participants upright and fully weight-bearing; and to evaluate the repeatability of these methods in individuals with patellofemoral osteoarthritis (OA) and in asymptomatic knees. Materials and metho...

Objectives: Player unavailability negatively affects team performance in elite football. However, whether player unavailability and its concomitant performance decrement is mediated by any changes in teams' match physical outputs is unknown. We examined whether the number of players injured (i.e. unavailable for match selection) was associated wit...

Background/Objective: Recent epidemiologic data suggest that deficits in processing speed predict future injurious falls. Our primary objective was to determine a parsimonious predictive model of future falls among older adults who experienced ≥ 1 fall in the past 12 months based on the following categories: counts of 1) total, 2) indoor, 3) outdoo...

Objective We aimed to (i) determine reference values for trochlear morphology and patellofemoral (PF) alignment in adults without MRI-defined PF full thickness cartilage damage or knee pain; and (ii) evaluate dose-response patterns for these measures with prevalent MRI-defined PF structural damage and/or knee pain. Design The Framingham Community...

Background: The 9+ screening battery test consists of 11 tests to assess limitations in functional movement. Aim: To examine the association of the 9+ with lower extremity injuries and to identify a cut-off point to predict injury risk. Methods: Professional male football players in Qatar from 14 teams completed the 9+ at the beginning of the...

PurposePatellofemoral osteoarthritis (PFOA) occurs in approximately half of anterior cruciate ligament (ACL)-injured knees within 10–15 years of trauma. Risk factors for post-traumatic PFOA are poorly understood. Patellofemoral alignment and trochlear morphology may be associated with PFOA following ACL reconstruction (ACLR), and understanding thes...

This chapter discusses two particularly troublesome lower limb conditions that cause volleyball athletes, in general, a great deal of inconvenience and discomfort and which, on occasion, can truncate a player's career. The first of these is jumper's knee, a condition also known as patellar tendinopathy, patellar tendinosis, and, in the past, patell...

Background/objectives: A previous fall is a strong predictor of future falls. Recent epidemiologic data suggest that deficits in processing speed predict future injurious falls. Our primary objective was to determine a parsimonious predictive model of future falls among older adults who experienced ≥1 fall in the past 12 months based on the follow...

Purpose: Preference-based generic measures are gaining increased use in mobility research to assess health-related quality of life and wellbeing. Hence, we examined the responsiveness of these two measures among individuals at risk of mobility impairment among adults aged ≥70 years. Methods: We conducted a 12-month prospective cohort study of co...

I love Google images. Have you tried it? Put in ‘Helsinki’ and you see a wonderful mix of old and new; historical grandeur and contemporary elegance. I have to confess to having a soft spot for Finland and the Finns. My love affair began in 1995 with Professor Pekka Kannus, Sports physician, PhD, with prolific research publications including the cl...

A decade ago, Blair1 pondered the future of physical activity research, much of which has since come to pass. More recently, a BJSM Blog2 invited readers to consider how their future research would look. Given the increased international focus on reducing injury/illness in athletes, it is timely to consider what research needs to be undertaken and...

Background Patellofemoral pain (PFP) occurs frequently, and may be related to patellofemoral osteoarthritis (PFOA). Obesity is associated with increased risk of knee OA. This systematic review involves a meta-regression and analysis to determine the relationship between body mass index (BMI) and PFP and PFOA, and to determine the link between BMI a...