Gustavo Saposnik


Scientist, Li Ka Shing Knowledge Institute


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 has 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 Heart and Stroke Foundation Ontario Clinician-Scientist Award, the 2012-2017 Heart and Stroke Foundation of Canada 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. Ospel, JM, Kashani, N, Wilson, AT, Fischer, U, Campbell, BCV, Sylaja, PN et al.. Endovascular treatment decision in acute stroke: does physician gender matter? Insights from UNMASK EVT, an international, multidisciplinary survey. J Neurointerv Surg. 2019; :. doi: 10.1136/neurintsurg-2019-015003. PubMed PMID:31363043 .
  2. Saposnik, G, Menon, BK, Kashani, N, Wilson, AT, Yoshimura, S, Campbell, BCV et al.. Factors Associated With the Decision-Making on Endovascular Thrombectomy for the Management of Acute Ischemic Stroke. Stroke. 2019; :STROKEAHA119025631. doi: 10.1161/STROKEAHA.119.025631. PubMed PMID:31327314 .
  3. Almusalam, N, Oh, J, Terzaghi, M, Maurino, J, Bakdache, F, Montoya, A et al.. Comparison of Physician Therapeutic Inertia for Management of Patients With Multiple Sclerosis in Canada, Argentina, Chile, and Spain. JAMA Netw Open. 2019;2 (7):e197093. doi: 10.1001/jamanetworkopen.2019.7093. PubMed PMID:31314113 PubMed Central PMC6647550.
  4. Burneo, JG, Antaya, TC, Allen, BN, Belisle, A, Shariff, SZ, Saposnik, G et al.. The risk of new-onset epilepsy and refractory epilepsy in older adult stroke survivors. Neurology. 2019;93 (6):e568-e577. doi: 10.1212/WNL.0000000000007895. PubMed PMID:31292225 .
  5. Ospel, JM, Kashani, N, Goyal, M, Menon, BK, Campbell, BCV, Fischer, U et al.. Time of day and endovascular treatment decision in acute stroke with relative endovascular treatment indication: insights from UNMASK EVT international survey. J Neurointerv Surg. 2019; :. doi: 10.1136/neurintsurg-2019-014976. PubMed PMID:31285376 .
  6. Saposnik, G, Mamdani, M, Montalban, X, Terzaghi, M, Silva, B, Saladino, ML et al.. Traffic Lights Intervention Reduces Therapeutic Inertia: A Randomized Controlled Trial in Multiple Sclerosis Care. MDM Policy Pract. ;4 (1):2381468319855642. doi: 10.1177/2381468319855642. PubMed PMID:31259250 PubMed Central PMC6589979.
  7. Saposnik, G, Oh, J, Terzaghi, MA, Kostyrko, P, Bakdache, F, Montoya, A et al.. Emotional expressions associated with therapeutic inertia in multiple sclerosis care. Mult Scler Relat Disord. 2019;34 :17-28. doi: 10.1016/j.msard.2019.05.029. PubMed PMID:31226545 .
  8. Saposnik, G, Hachinski, V. The pathway towards an effective reduction of stroke burden worldwide: teamwork. Lancet Neurol. 2019;18 (7):622-623. doi: 10.1016/S1474-4422(19)30198-X. PubMed PMID:31202465 .
  9. Levin, MF, Hiengkaew, V, Nilanont, Y, Cheung, D, Dai, D, Shaw, J et al.. Relationship Between Clinical Measures of Upper Limb Movement Quality and Activity Poststroke. Neurorehabil Neural Repair. 2019;33 (6):432-441. doi: 10.1177/1545968319847969. PubMed PMID:31072222 .
  10. Saposnik, G, Maurino, J, Sempere, AP, Terzaghi, MA, Amato, MP, Montalban, X et al.. Does attendance at the ECTRIMS congress impact on therapeutic decisions in multiple sclerosis care?. Mult Scler J Exp Transl Clin. ;5 (1):2055217319835226. doi: 10.1177/2055217319835226. PubMed PMID:30911401 PubMed Central PMC6423673.
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Affiliations & Other Activities

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