Gustavo Saposnik

MD, MSc, FRCPC, PhD Candidate in Neuroeconomics

Scientist, Li Ka Shing Knowledge Institute

Biography

Research Interests

Stroke outcome, health services research, pharmacoeconomic and stroke therapy, quality of care, translating new emerging therapies into clinical practice, epidemiology of cerebrovascular disease

Research Activities

My current research focuses are Stroke Outcomes and Health Services Research. Specifically, I have looked at the domains of stroke care delivery, prevention, and improved stroke recovery. Both my research training and publications reflect my longstanding interests in these 3 areas. Ultimately, my personal goal is to identify innovative strategies which aim to improve access of care, stroke prevention, and reduce disability in stroke survivors.

Specifically, our team have looked at the domains of stroke care delivery, prevention, and improved stroke recovery. Both my research training and publications reflect my longstanding interests in these 3 areas. The first includes the assessment of how organized inpatient care affects stroke outcomes. We have developed and validated a risk score (called iScore) and a web tool to assist clinicians estimate clinical outcomes after a stroke. The iScore also showed to predict clinical response to thrombolysis (clot-buster medication) after an acute ischemic stroke. The second includes adherence to the guidelines and risk of stroke in selected populations. The last relates to a novel area: the use of virtual reality of stroke rehabilitation. More recently, we have taken it a step further by exploring the use of virtual reality with Nintendo Wii gaming technology in patients with recent strokes. We are also in the process of comparing different virtual reality systems.

To accomplish these tasks, I formed and led a working group on stroke outcome research involving many leading stroke researchers in Canada, and other specialists interested in stroke, called SORCan (Stroke Outcomes Research Canada). This has led to a series of publications, and others being submitted or in press. Our work has been highlighted in two summary reviews on ‘Advances in Health Policy and Outcomes’ published in STROKE Journal (Rudd et al. Stroke 2009;40;e301-e304 and Williams et al. Stroke 2010;41: e77-e80) and LANCET (Lancet 2011; 377: May 14). SORCan has the potential to be expanded and make worldwide contributions. Some of my success in these areas resulted from this productive network of colleagues and researchers in the field.

Our research program includes four main areas: stroke outcome research, stroke epidemiology, stroke & health policy, and new emerging therapies in cerebrovascular disease.

Accomplishments: Since my academic appointment at St. Michael’s Hospital (and creation of the Stroke Outcomes Research Program) in July 2006, I have obtained 3 personnel award (the 2008-2011 HSFO Clinician-Scientist Award, the 2012-2017 HSFC Distinguished Clinician Scientist Award and the HSFO MacDonald Research Award), 13 peer-reviewed operating grants (8 as PI). I have over 90 peer-reviewed papers published/in-press, 9 editorials, 4 book chapters, and more than 100 abstracts.

I have now established a successful research program involving a network of researchers studying Stroke Outcomes and Health Services Research that is unique within Canada, and perhaps globally.

Recent Publications

  1. Edwards, JD, Kapral, MK, Fang, J, Saposnik, G, Gladstone, DJ. Underutilization of Ambulatory ECG Monitoring After Stroke and Transient Ischemic Attack: Missed Opportunities for Atrial Fibrillation Detection. Stroke. 2016; :. doi: 10.1161/STROKEAHA.115.012195. PubMed PMID:27406109 .
  2. Xie, X, Lambrinos, A, Chan, B, Dhalla, IA, Krings, T, Casaubon, LK et al.. Mechanical thrombectomy in patients with acute ischemic stroke: a cost-utility analysis. CMAJ Open. ;4 (2):E316-25. Epub 2016/6/16. doi: 10.9778/cmajo.20150088. PubMed PMID:27398380 PubMed Central PMC4933608.
  3. Saposnik, G, Cohen, LG, Mamdani, M, Pooyania, S, Ploughman, M, Cheung, D et al.. Efficacy and safety of non-immersive virtual reality exercising in stroke rehabilitation (EVREST): a randomised, multicentre, single-blind, controlled trial. Lancet Neurol. 2016; :. doi: 10.1016/S1474-4422(16)30121-1. PubMed PMID:27365261 .
  4. Saposnik, G, Joundi, RA. Visual Aid Tool to Improve Decision Making in Anticoagulation for Stroke Prevention. J Stroke Cerebrovasc Dis. 2016; :. doi: 10.1016/j.jstrokecerebrovasdis.2016.05.037. PubMed PMID:27318647 .
  5. Joundi, RA, Cipriano, LE, Sposato, LA, Saposnik, G. Response to Letter Regarding Article, "Ischemic Stroke Risk in Patients With Atrial Fibrillation and CHA2DS2-VASc Score of 1: Systematic Review and Meta-Analysis". Stroke. 2016;47 (7):e194. doi: 10.1161/STROKEAHA.116.013721. PubMed PMID:27283197 .
  6. Bahit, MC, Coppola, ML, Riccio, PM, Cipriano, LE, Roth, GA, Lopes, RD et al.. First-Ever Stroke and Transient Ischemic Attack Incidence and 30-Day Case-Fatality Rates in a Population-Based Study in Argentina. Stroke. 2016;47 (6):1640-2. doi: 10.1161/STROKEAHA.116.013637. PubMed PMID:27217510 .
  7. Saposnik, G, Sempere, AP, Raptis, R, Prefasi, D, Selchen, D, Maurino, J et al.. Decision making under uncertainty, therapeutic inertia, and physicians' risk preferences in the management of multiple sclerosis (DIScUTIR MS). BMC Neurol. 2016;16 (1):58. doi: 10.1186/s12883-016-0577-4. PubMed PMID:27146451 PubMed Central PMC4855476.
  8. Swartz, RH, Bayley, M, Lanctôt, KL, Murray, BJ, Cayley, ML, Lien, K et al.. Post-stroke depression, obstructive sleep apnea, and cognitive impairment: Rationale for, and barriers to, routine screening. Int J Stroke. 2016;11 (5):509-18. doi: 10.1177/1747493016641968. PubMed PMID:27073189 .
  9. Bernhardt, J, Borschmann, K, Boyd, L, Thomas Carmichael, S, Corbett, D, Cramer, SC et al.. Moving rehabilitation research forward: Developing consensus statements for rehabilitation and recovery research. Int J Stroke. 2016;11 (4):454-8. doi: 10.1177/1747493016643851. PubMed PMID:27073187 .
  10. Lambrinos, A, Schaink, AK, Dhalla, I, Krings, T, Casaubon, LK, Sikich, N et al.. Mechanical Thrombectomy in Acute Ischemic Stroke: A Systematic Review. Can J Neurol Sci. 2016;43 (4):455-60. doi: 10.1017/cjn.2016.30. PubMed PMID:27071728 PubMed Central PMC4926268.
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Affiliations & Other Activities

  • Director, Stroke Research Unit, Mobility Program
  • Associate Professor, Medicine, St. Michael’s Hospital, University of Toronto
  • Cross-appointment, Health Policy, Management and Education (HPME), University of Toronto
  • Adjunct Scientist, Institute of Clinical Evaluative Sciences (ICES)