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4/4/2019

CHEO Research Institute 2018-19 CHAMO Innovation Fund competition

The CHEO Research Institute is happy to announce the results of the 2018-2019 CHAMO Innovation Fund competition. Funds from the competition photo of CHAMO winnersare to support the development of new and innovative approaches to health care delivery and to provide leadership in the dissemination of new knowledge across the healthcare system. These projects will no doubt impact healthcare delivery and offer opportunities to translate new knowledge into medical practice locally and nationally.

Congratulations go out to the following successful applicants and their teams:

• Dr. Sharon Whiting ($89,195.00) for the project entitled “A Framework to Evaluate and Measure Outcomes for an Epilepsy Transition Program.” Epilepsy can have a serious effect on adolescent development, with many patients experiencing significant neurological, developmental, psychological, social, and/or socio-economic difficulties well into adult life. As young adults with epilepsy struggle during adolescence, they also experience a dramatic disruption in their continuity of care as they change from their pediatric healthcare providers to adult ones. This disruption highlights a significant gap in health care delivery and a period of vulnerability as patients may be lost to follow-up or may even stop their medications. Furthermore, the prospect of leaving their pediatric neurologist often produces fear, anxiety, and apprehension of the unknown. Given this, we have initiated an innovative collaboration between the pediatric and adult neurology divisions for the establishment of an “Epilepsy Transition Program”. However, an evidence-based assessment of the outcomes of this program has not yet been incorporated into the standard care model. This proposal will establish a framework to assess and determine the strengths of the model, determine areas of future improvement, and provide a method for future study and implementation to other centers in Ontario.

• Dr. Hugh McMillan and Dr. Kristin Kernohan ($89,160.00) for the project entitled “Investigation of RNA Sequencing as a Diagnostic Tool for Inherited Metabolic Diseases.” Inherited metabolic diseases (IMDs) are genetic conditions caused by mutations in genes essential for one of the many complex reactions our cells use to convert food into usable energy. There are over 1000 IMDs which collectively affect ~1 in 800 individuals. Many of these individuals have been evaluated by multiple medical professionals but still lack an accurate diagnosis. IMDs are often caused by mutations in an individual's DNA which result in decreased activity of that gene - this type of mutation is difficult to identify with DNA sequencing. This project will use a new technology to evaluate gene activity directly in patient cells compared to healthy cells, to determine which genes are impacted. It is anticipated that this approach will provide a diagnosis for many IMD patients who have not been able to obtain a diagnosis from DNA-sequencing. For patients, an accurate genetic diagnosis informs care and counseling, and facilitates targeted effective treatments. Within the healthcare system, accurate diagnoses obviate further testing and unnecessary surveillance, thereby creating healthcare efficiencies. Establishing this new technology will contribute to CHEO, and ultimately Canada's, standing as a leader in IMDs.

• Dr. Kevin Cheung ($90,054.00) for the project entitled “Improving Patient Experience by Addressing Clinic Queue Times.” Waiting in a busy clinic for a scheduled doctor’s appointment is a frustrating experience, made worse only when waiting with a young, sick, or injured child. There are two ways to address this problem: (1) decrease the wait time, and (2) improve the experience while waiting. Using data from our electronic medical record, our research looks to address both of these issues. We will identify the predictors of the duration of a patient’s visit to the clinic. This will allow us to improve appointment schedules to decrease the wait time in the clinic. Second, we have developed the Queue Time Patient Interface (QTPI) to provide patients and their families with a real-time estimate of how long they will have to wait in the clinic to see their doctor. The goal of this
2018-2019 CHAMO Innovation Fund Recipients Page 2 of 2
project is to test our innovation: Does the presentation of these queue times improve the patient experience? These projects are not only important to improve patient and family experience but may also reduce stress on staff and clinic resources.

• Dr. Pranesh Chakraborty ($71,100.00) for the project entitled “Leveraging Metabolomics to Improve the Diagnosis of Inherited Metabolics Diseases (IMD).” Inherited Metabolic Diseases (IMD) are a large group of genetic diseases that are caused by problems in genes that govern the body's biochemical pathways. The application of broad gene panel and genome-wide sequencing tests for patients with suspected IMD has been very exciting and successful in providing diagnoses to patients. Still, we are not able to find a diagnosis for a majority of patients. This project represents one of the first attempts to use new "metabolomic" approaches which are ready for use in a clinical setting as an adjunct to genomic diagnostics. Metabolomics is an approach where hundreds to thousands of chemicals are measured in a patient's blood or urine. We will test samples from 50 healthy children, 50 children with known IMD, and 50 children who are strongly suspected to have an IMD but who remain undiagnosed. If this strategy is successful, it could be rapidly implemented in other hospitals and clinics rapidly by sharing the methodology and/or receiving samples for testing at CHEO.

• Dr. Sherri Katz ($90,060.00) for the project entitled “Screening for Obstructive Sleep Apnea in Children with Obesity Using Personal Mobile Technology (SCOUT).” Children with obesity have a 10-50% chance of developing obstructive sleep apnea (OSA) in their lifetime. OSA is a serious condition where a person stops breathing periodically during sleep; it is associated with high blood pressure, behavioural issues, and lower quality of life. Early diagnosis and treatment is critical, but the best way to diagnose OSA, a `sleep study', is in short supply. Given the limited resources, this study aims to see if mobile video clips (smartphone recordings) can be used to screen children with obesity to identify those at highest risk of OSA, so they can be prioritized for an earlier sleep study. Parents of children with obesity already scheduled for sleep studies will be recruited and asked to record short video clips of their child sleeping. During the night of the sleep study, parents will independently rate whether they think their child has OSA based on the videos, as will two clinicians. Children will then undergo a sleep study to compare to the ratings. This study will help determine whether videos can be used to accurately screen for OSA in this high risk population, prioritizing children for earlier diagnosis and treatment.
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