Sharon E. Straus's research while affiliated with Toronto Grace Health Centre and other places
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Publications (983)
Background
The global spread of COVID-19 created an explosion in rapid tests with results in < 1 hour, but their relative performance characteristics are not fully understood yet. Our aim was to determine the most sensitive and specific rapid test for the diagnosis of SARS-CoV-2.
Methods
Design: Rapid review and diagnostic test accuracy network me...
Background:
Stigmatisation, misinformation and discrimination have been magnified globally due to the COVID-19 pandemic. The healthcare sector was not spared from this. We conducted a transnational study, using the Health Stigma and Discrimination framework (HSDF) to explore public perception and reactions to the COVID-19 pandemic in a multicultur...
Background:
There is growing evidence of harm associated with trazodone and nonbenzodiazepine sedative hypnotics (e.g., zopiclone); however, their comparative risk of harm is unknown.
Methods:
We conducted a retrospective cohort study with linked health administrative data, which enrolled older (≥66 years old) nursing home residents living in Al...
Background
The COVID-19 pandemic has led to stigmatization of individuals based on race/ethnicity, age, gender, and occupation, among other factors. We canvassed Canadian residents to explore perceptions of and experiences with stigma during the COVID-19 pandemic.Methods
We conducted an online survey between June 10 and December 31 2020. The survey...
Background
In Canada, the Canadian Institutes of Health Research launched the Strategy for Patient-Oriented Research (SPOR) in 2011. The strategy defines ‘patient-oriented research’ as a continuum of research that engages patients as partners, focuses on patient priorities, and leads to improved patient outcomes. The overarching term ‘patient’ is i...
Objectives
To chart the global literature on gender equity in academic health research.
Design
Scoping review.
Participants
Quantitative studies were eligible if they examined gender equity within academic institutions including health researchers.
Primary and secondary outcome measures
Outcomes related to equity across gender and other social i...
Objectives
To identify ML tools in hospital settings and how they were implemented to inform decision-making for patient care through a scoping review. We investigated the following research questions: What ML interventions have been used to inform decision-making for patient care in hospital settings? What strategies have been used to implement th...
Purpose
Model-based economic evaluations require conceptualization of the model structure. Our objectives were to identify important health states, events, and patient attributes to be included in a model-based cost-effectiveness analysis of fall prevention interventions, to develop a model structure to examine cost-effectiveness of fall prevention...
Background
The prevalence of overweight (15%) and obesity (6%) in children under 5 years of age in Canada are high, and young children with overweight and obesity are at increased risk of the development of chronic disease(s) in adulthood. Prior research has demonstrated very few published trials on effective obesity prevention interventions in you...
Knowledge translation (KT) is the science and practice of dissemination and implementation of evidence. We describe how research funders operationalize and evaluate KT initiatives, identify challenges and opportunities, and suggest strategic considerations for KT support. We conducted an environmental scan, which included a systematic search of pub...
Person-level surveillance (n = 14 million) and neighbourhood-level income data were used to explore magnitude of inequalities in COVID-19 hospitalizations and deaths over five waves in Ontario, Canada. Despite attempts at equity-informed policies alongside fluctuating levels of public health measures, the magnitude of inequalities in hospitalizatio...
Objectives
Individual participant data (IPD) from randomised controlled trials (RCTs) can be used in network meta-analysis (NMA) to underpin patient care and are the best analyses to support the development of guidelines about the use of healthcare interventions for a specific condition. However, barriers to IPD retrieval pose a major threat. The a...
Background
Due to the explosion in rapid reviews in the literature during COVID-19, their utility in universal health coverage and in other routine situations, there is now a need to document and further advance the application of rapid review methods, particularly in low-resource settings where a scarcity of resources may preclude the production o...
Background
Connections between individuals and organizations can impact knowledge translation (KT). This finding has led to growing interest in the study of social networks as drivers of KT. Social networks are formed by the patterns of relationships or connections generated through interactions. These connections can be studied using social networ...
During the past few years, several innovative treatments for noncommunicable chronic disease have become available, including SGLT2i (sodium-glucose cotransporter-2 inhibitors), GLP-1a (glucagon-like-peptide 1 agonists), ARNI (angiotensin receptor-neprilysin inhibitors), and finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist...
BACKGROUND
Clear, accurate and transparent risk communication is critical to providing policy makers and the public with direction to reduce transmission and implement effective preparedness strategies during a health emergency.
OBJECTIVE
For those living in Canada, we aimed to explore preferred sources of obtaining COVID-19 information, perceptio...
Background: In November 2011, the Canadian Task Force on Preventive Health Care released guidelines for screening women at average breast cancer risk. Weak recommendations (framed using GRADE methodology) were made for screening women aged 50 to 74 years every two to three years, and for not screening women aged 40 to 49 years.
Methods: We conduct...
Background:
Patients with acute heart failure are frequently or systematically hospitalized, often because the risk of adverse events is uncertain and the options for rapid follow-up are inadequate. Whether the use of a strategy to support clinicians in making decisions about discharging or admitting patients, coupled with rapid follow-up in an ou...
Objective
To examine the comparative efficacy and complications of long-acting and intermediate-acting insulin for different patient characteristics for type 1 diabetes mellitus (T1DM).
Design
Systematic review and individual patient data (IPD) network meta-analysis (NMA).
Data sources
MEDLINE, EMBASE and the Cochrane Central Register of Controll...
Economically marginalized communities have faced disproportionately higher risks for infection and death from COVID-19 across Canada. It was anticipated that health disparities would dissipate over time and during subsequent waves. We used person-level surveillance and neighbourhood-level income data to explore, using Lorenz curves and Gini coeffic...
Background
Falls are a leading cause of injury-related hospitalizations among adults aged 65 years and older and may result in social isolation.
Objective
To summarise evidence on falls and subsequent social isolation and/or loneliness in older adults through a scoping review.
Eligibility criteria
Studies were eligible for inclusion if the popula...
The Senior Friendly Hospital Accelerating Change Together in Ontario program linked the Collaborative Network Model and the Senior Friendly Hospital Framework in a unique multi-hospital knowledge-to-practice initiative to improve care for hospitalized older adults. The design enabled teams from 78 Ontario hospitals to close a shared skills and know...
Objective:
The objective of this scoping review is to identify and characterize relevant knowledge translation methods tools (those that provide guidance for optimized knowledge translation practice) to uncover candidate quality indicators to inform a future quality assessment tool for knowledge translation strategies.
Introduction:
Knowledge tr...
Exercise and nutrition interventions are often recommended for frailty; however, effective strategies are required for real-world implementation. Our primary aim was to assess the feasibility and acceptability of telephone and virtual delivery of MoveStrong, an 8-week exercise and nutrition program with a 4-week follow-up for older pre-frail and fr...
Objectives
The synthesis of individual patient data (IPD) from randomised clinical trials (RCTs) can strengthen evidence used for decision-making. Network meta-analyses (NMA) modelling IPD usually include non-sponsored or publicly sponsored RCTs. Evidence suggests that IPD sharing may depend on study characteristics, such as funding type, RCT size,...
During the SARS-CoV-2 pandemic, astonishingly rapid research averted millions of deaths worldwide through new vaccines and repurposed and new drugs. Evidence use informed life-saving national policies including non-pharmaceutical interventions. Simultaneously, there was unprecedented waste, with many underpowered trials on the same drugs. We identi...
Objectives
Alzheimer’s dementia (AD) is the most common type of dementia. However, it is unclear which cognitive enhancer is optimal for severe AD. Patient-level data from people with AD can be helpful to explore patient-level variation per treatment response. Pooling individual patient data (IPD) from multiple randomised clinical trials (RCTs) of...
Governments can use social media platforms such as Twitter to disseminate health information to the public, as evidenced during the COVID-19 pandemic [Pershad (2018)]. The purpose of this study is to gain a better understanding of Canadian government and public health officials’ use of Twitter as a dissemination platform during the pandemic and to...
Atypical disease presentations are common in older adults with COVID-19. The objective of this study was to determine the prevalence of atypical and typical symptoms in older adults with COVID-19 through progressive pandemic waves and the association of these symptoms with in-hospital mortality. This retrospective cohort study included consecutive...
Background
Network meta-analysis (NMA) is increasingly used in guideline development and other aspects of evidence-based decision-making. We aimed to develop a risk of bias (RoB) tool to assess NMAs (RoB NMA tool). An international steering committee recommended that the RoB NMA tool to be used in combination with the Risk of Bias in Systematic rev...
![Knowledge-to-Action Framework [18]](publication/362488476/figure/fig2/AS:1185538220523523@1659665746557/Knowledge-to-Action-Framework-18_Q320.jpg)
Background
Models, theories, and frameworks (MTFs) provide the foundation for a cumulative science of implementation, reflecting a shared, evolving understanding of various facets of implementation. One under-represented aspect in implementation MTFs is how intersecting social factors and systems of power and oppression can shape implementation. Th...
Background
Transparent reporting of rapid reviews enables appropriate use of research findings and dissemination strategies can strengthen uptake and impact for the targeted knowledge users, including policy-makers and health system managers. The aim of this literature review was to understand reporting and dissemination approaches for rapid review...
Background
Despite improvement, sepsis mortality rates remain high, with an estimated 11 million sepsis-related deaths globally in 2017 (Rudd et. al, Lancet 395:200-211, 2020). Low- and middle-income countries (LMICs) are estimated to account for 85% of global sepsis mortality; however, evidence for improved sepsis mortality in LMICs is lacking. We...
Atypical disease presentations are common in older adults with COVID-19. The objective of this study was to determine the prevalence of atypical and typical symptoms in older adults with COVID-19 through progressive pandemic waves and the association of these symptoms with in-hospital mortality. This retrospective cohort study included consecutive...
Objective:
We provide guidance for considering equity in rapid reviews through examples of published COVID-19 rapid reviews.
Study design and setting:
This guidance was developed based on a series of methodological meetings, review of internationally renowned guidance such as the Cochrane Handbook and the Preferred Reporting Items for Systematic...
Background:
The COVID-19 pandemic has affected older adults disproportionately, and delirium is a concerning consequence; however, the relationship between delirium and corticosteroid use is uncertain. The objective of the present study was to describe patient characteristics, treatments and outcomes among older adults hospitalized with COVID-19,...
Objectives
Alzheimer’s dementia (AD) is the most common type of dementia. However, it is unclear which cognitive enhancer is optimal for severe AD. Patient-level data from people with AD can be helpful to explore patient-level variation per treatment response. Pooling individual patient data (IPD) from multiple randomised clinical trials (RCTs) of...
Background:
The growing burden associated with population aging, dementia and multimorbidity poses potential challenges for the sustainability of health systems worldwide. We sought to examine how the intersection among age, dementia and greater multimorbidity is associated with health care costs.
Methods:
We did a retrospective population-based...
Background:
There is limited research of electronic tools for self-management for patients with chronic kidney disease (CKD). We sought to evaluate participant engagement, perceived self-efficacy and website usage in a preliminary evaluation of My Kidneys My Health, a patient-facing eHealth tool in Canada.
Methods:
We conducted an explanatory se...
Objectives
The synthesis of individual patient data (IPD) from randomised clinical trials (RCTs) can strengthen evidence used for decision-making. Network meta-analyses (NMA) modelling IPD usually include non-sponsored or publicly sponsored RCTs. Evidence suggests that IPD sharing may depend on study characteristics, such as funding type, RCT size,...
Background
Diabetes often places a large burden on people with diabetes (hereafter ‘patients’) and the society, that is, in part attributable to its complications. However, evidence from models predicting diabetes complications in patients remains unclear. With the collaboration of patient partners, we aimed to describe existing prediction models o...
Background
The field of knowledge translation (KT) has been criticized for neglecting contextual and social considerations that influence health equity. Intersectionality, a concept introduced by Black feminist scholars, emphasizes how human experience is shaped by combinations of social factors (e.g., ethnicity, gender) embedded in systemic power...
Objectives
Older adults are at high risk of influenza-related complications or hospitalization. The purpose of this systematic review is to assess the relative cost-effectiveness of all influenza vaccine options for older adults.
Methods
This systematic review identified economic evaluation studies assessing the cost-effectiveness of influenza vac...
Objectives
The COVID-19 pandemic has stimulated growing research on treatment options. We aim to provide an overview of the characteristics of studies evaluating COVID-19 treatment.
Design
Rapid scoping review
Data sources
Medline, Embase and biorxiv/medrxiv from inception to 15 May 2021.
Setting
Hospital and community care.
Participants
COVID-...
Introduction
Cet essai pilote randomisé par étapes de huit semaines a permis d’évaluer le programme MoveStrong, qui vise à enseigner aux adultes présentant une fragilité ou une préfragilité un entraînement à l’équilibre et à la force musculaire ainsi qu’un apport suffisant en protéines pour prévenir les chutes et améliorer la mobilité.
Méthodologi...
Background
This 8-week pilot stepped-wedge randomized controlled trial evaluated the MoveStrong program for teaching adults who have frailty/pre-frailty about balance and functional strength training and sufficient protein intake to prevent falls and improve mobility.
Methods
We recruited individuals aged 60 years and over, with a FRAIL scale scor...
Background
Older adults experience symptoms of depression, leading to suffering and increased morbidity and mortality. Although we have effective depression therapies, physical distancing and other public health measures have severely limited access to in-person interventions.
Objective
To describe the efficacy of virtual interventions for reducin...
Background: Summaries of systematic reviews are a reference method for the dissemination of research evidence on the effectiveness of public health interventions beyond the scientific com-munity. Motivated reasoning and cognitive dissonance may interfere with readers’ ability to process the information included in such summaries. Methods: We conduc...
Background:
The waves of COVID-19 infections in Ontario, Canada, were marked by differences in patient characteristics and treatment. Our objectives were to (i) describe patient characteristics, treatment, and outcomes of hospitalized older adults with COVID-19 between waves 1, 2, and 3, (ii) determine if there was an improvement in in-hospital mo...
SARS-CoV-2 is a novel respiratory virus that has quickly spread across the globe. The virus uses a protein called Spike and its associated receptor binding domain (RBD) to interact with angiotensin converting enzyme-2 (ACE-2) on the surface of epithelial cells in the respiratory tract. Although a definite correlate of protection against COVID-19 ha...
In 2009, the Canadian Institutes of Health Research, Health Canada, and other stakeholders established the Drug Safety and Effectiveness Network (DSEN) to address the paucity of information on drug safety and effectiveness in real-world settings. This unique network invited knowledge users (e.g., policy makers) to submit queries to be answered by r...
Objective:
To examine the comparative efficacy and safety of cognitive enhancers by patient characteristics for managing Alzheimer's dementia (AD).
Design:
Systematic review and individual patient data (IPD) network meta-analysis (NMA) based on our previously published systematic review and aggregate data NMA.
Data sources:
MEDLINE, Embase, Co...
Although SARS-CoV-2 infects the upper respiratory tract, we know little about the amount, type, and kinetics of antibodies (Ab) generated in the oral cavity in response to COVID-19 vaccination. We collected serum and saliva samples from participants receiving two doses of mRNA COVID-19 vaccines and measured the level of anti-SARS-CoV-2 Ab. We detec...
Background
There is an urgent need to understand the determinants (i.e., barriers and facilitators) of de-implementation. The purpose of this study was to develop a comprehensive list of determinants of the de-implementation of low-value care from the published literature and to compare this list to determinants identified by a group of stakeholder...
Background
SARS-CoV-2 omicron variant of concern (VOC) has evolved multiple mutations within the spike protein, raising concerns of increased antibody evasion. In this study, we assessed the neutralization potential of COVID-19 convalescent sera and sera from vaccinated individuals against ancestral SARS-CoV-2 and VOCs.
Methods
The neutralizing ac...
Context: The objective of CHOICES (Community Heart Outcomes Improvement and Cholesterol Education Study) is to understand how evidence-informed cholesterol management can prevent cardiovascular disease (CVD) in 14 health regions at higher risk in Ontario, Canada using a suite of educational interventions. An integrated knowledge translation (IKT) a...
Objectives
The incidence of type 1 diabetes mellitus is increasing every year requiring substantial expenditure on treatment and complications. A systematic review was conducted on the cost-effectiveness of insulin formulations, including ultralong-, long-, or intermediate-acting insulin, and their biosimilar insulin equivalents.
Methods
MEDLINE,...
Self-management in chronic kidney disease (CKD) can slow disease progression; however, there are few tools available to support patients with early CKD. My Kidneys My Health is a patient-focused electronic health (eHealth) self-management tool developed by patients and caregivers. This study will investigate the implementation of My Kidneys My Heal...
Objectives
The objective of our systematic review was to identify the effective interventions to prevent or mitigate social isolation and/or loneliness in older adults who experienced a fall.
Design
Systematic review.
Data sources
MEDLINE, Embase, the Cochrane Central Register of Controlled Trials and Ageline were searched (from inception to Febr...
Canada has made great progress in synthesizing, disseminating, and integrating research findings into health systems and clinical decision-making; yet gaps exist in the research-to-practice continuum. The Strategy for Patient-Oriented Research (SPOR) Evidence Alliance aims to help close gaps by providing decision-makers with evidence that is timely...
Objective
To develop a web-based decision support tool that guides users through a series of simple questions for recommending knowledge synthesis methods suitable for their research question.
Study design and setting
We used findings from previous work to structure a set of questions along key dimensions of different knowledge synthesis methods....
Background
To meet the needs of older adults with frailty better, it is essential to understand which aspects of care are important from their perspective. We therefore sought to assess the importance of a set of quality indicators (QI) for monitoring outcomes in this population.
Methods
In this mixed-method study, key stakeholders completed a sur...
Objective:
To estimate the incidence of SARS-CoV-2 in education workers and the factors associated with infection between March 2020 and July 2021.
Methods:
A prospective cohort study of education workers working ≥8 h per week in Ontario, Canada. Participants self-reported results of tests for SARS-CoV-2 and completed online surveys about demogr...
Objective: We provide guidance for considering equity in rapid reviews through examples of published COVID-19 rapid reviews.
Study design and setting: This guidance was developed based on a series of methodological meetings, review of internationally renowned guidance such as the Cochrane Handbook and the Preferred Reporting Items for Systematic Re...
Background: Network meta-analysis (NMA) is increasingly used in guideline development and other aspects of evidence-based decision-making. We aimed to develop a risk of bias (RoB) tool to assess NMAs (RoB NMA tool). An international steering committee intended the RoB NMA tool to be used in combination with ROBIS (recommend as it was designed to as...
Introduction: Network meta-analysis (NMA) is increasingly used in guideline development and other aspects of evidence-based decision-making. We engaged with stakeholders in early phases of the development of a new tool to assess risk of bias (RoB) in NMA to facilitate its later use and potentially widen its impact.
Methods: We surveyed stakeholders...
Background
Thiamine supplementation may improve cardiac function in older adults with heart failure (HF). Our objectives were to determine (i) the feasibility of conducting a large trial of thiamine supplementation in HF and (ii) the effects of thiamine on clinical outcomes.
Methods
We conducted a double-blinded randomized placebo-controlled two-p...
Purpose:
Ensuring a representative workforce is a matter of equity and social justice and has implications for patient care and population health. We examined the relationship of the binary gender identity and race of physicians who felt comfortable to self-identify, with workplace experiences and career satisfaction in academic medicine.
Methods...
Systematic reviews with network meta-analysis that ignore potential dose effects could limit the applicability and validity of review findings. This article aims to help content experts (eg, clinicians), methodologists, and statisticians better understand how to incorporate dose effects in network meta-analysis. Three models are described that make...
The omicron variant of concern (VOC) of SARS-CoV-2 was first reported in November 2021 in Botswana and South Africa. Omicron variant has evolved multiple mutations within the spike protein and the receptor binding domain (RBD), raising concerns of increased antibody evasion. Here, we isolated infectious omicron from a clinical specimen obtained in...
Background
Intensive care unit (ICU) patients undergoing transitions in care are at increased risk of adverse events and gaps in medical care. We evaluated existing patient- and family-centered transitions in care tools and identified facilitators, barriers, and implementation considerations for the application of a transitions in care bundle in cr...
The following chapter highlights the methodological similarities/differences and strengths/weaknesses between systematic reviews and two common alternative approaches for knowledge synthesis: rapid reviews and scoping reviews. In doing so, the intention is to provide readers with guidance in determining whether a rapid or scoping review may be more...
This is the introductory paper in a collection of four papers on the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance, a pan-Canadian research initiative that was funded by the Canadian Institutes of Health Research in September of 2017. Here, we introduce the SPOR enterprise in Canada, provide a rationale for the creation of the SPO...
The Strategy for Patient Oriented Research (SPOR) Evidence Alliance is a research initiative in Canada whose mission is to promote the synthesis, dissemination, and integration of research results into health care and public health decision-making and clinical practice. The aim of this paper is to ( i) outline the governance and committee structure...