St. Michael's Hospital

Extracorporeal CO2 elimination for acute exacerbation of severe COPD requiring invasive mechanical ventilation: a randomized controlled trial (the X-COPD trial)

Abstract Rationale Acute exacerbations of chronic obstructive pulmonary disease (AE-COPD) requiring invasive mechanical ventilation (IMV) are associated with high mortality and long-term disability. Extracorporeal CO₂ removal (ECCO₂R) using modern high-capacity devices may facili...

Effects of Evolocumab on Mortality Outcomes in Patients Without Previous Myocardial Infarction or Stroke: A Prespecified Analysis of the VESALIUS-CV Randomized Clinical Trial

BACKGROUND: Evolocumab, a PCSK9 (proprotein convertase subtilisin–kexin type 9) inhibitor, significantly reduced the risk of cardiovascular events in patients without previous myocardial infarction or stroke in the VESALIUS-CV trial (Effect of Evolocumab in Patients at High Cardi...

Use of Oxygen in the Emergency Department

ABSTRACT Oxygen is one of the most frequently used treatments in the emergency department (ED), but it should be prescribed and reassessed as an active therapy rather than left as a harmless default. Acute hypoxemia may reflect ventilation-perfusion mismatch, shunt, hypoventilati...

Prophylactic clip closure after right-colon endoscopic mucosal resection in a matched cohort of 470 patients exhibits sub-site heterogeneity

Background and study aims Clinically significant post-EMR bleeding (CSPEB) is the most common adverse event after endoscopic mucosal resection (EMR) of large non-pedunculated colorectal polyps (LNPCPs). Randomised trials of prophylactic through-the-scope clip (TTSC) closure have...

Cardiac imaging biomarkers of heart failure in diabetes for phenotyping, risk stratification, and evaluating therapeutic response

Type 2 diabetes mellitus (T2DM) is a well-established risk factor for the development of heart failure (HF), yet HF risk within this population is highly heterogeneous. Appropriate biomarker selection and a limited mechanistic understanding of the phenotypic subtypes of HF in T2D...

Identification, validation, and prediction of longitudinal recovery phenotypes in degenerative cervical myelopathy: analysis of prospective cohorts and a randomised controlled trial

Background Symptom evolution in degenerative cervical myelopathy (DCM) is traditionally characterized by severity of neurological deficit. A recent expert consensus challenged this view, proposing that DCM fluctuates across neurological, functional and health-related quality of l...

Considerations for optimal team-based rheumatology care: a qualitative study exploring the experiences of rheumatology health professionals

Interdisciplinary team-based rheumatology care models are a promising solution for improving access to high quality, equitable care for people with rheumatic and musculoskeletal disorders. There is limited understanding on health professionals’ perspectives on their needs to deli...

The symbolic power of decriminalization and recriminalization in shaping stigma toward people who use drugs in British Columbia

In January 2023, British Columbia (BC) implemented a three-year decriminalization pilot to reduce harms of drug criminalization and address stigma toward people who use drugs. In May 2024, the policy was amended to “recriminalize” drug possession, a reform that excluded most publ...

Unpacking the Comparator: Mapping “Usual Care” in Non-Surgical Knee OA Trials

Objectives “Usual care” is a common comparator in randomized trials (RCTs) evaluating interventions for knee osteoarthritis (OA), but it lacks a standardized definition. This scoping review aimed to systematically map how usual care has been defined and reported in knee OA RCTs,...

Sex Disparities in Clinical Need, Willingness, and Surgeon Recommendations for Total Knee Arthroplasty

Objectives Sex disparities exist in the receipt of total knee arthroplasty (TKA) for osteoarthritis (OA), with females disproportionately less likely to undergo surgery. Understanding the reasons for this gap is critical for equitable health care delivery. Lower willingness to un...

Team-Based Outpatient Rheumatology Care: A Scoping Review of Terminology, Team Composition, and Impact on Advancing the Quintuple Aim

Objectives Team-based models of rheumatology care, in which rheumatologists and interdisciplinary healthcare professionals (IHPs) collaborate in care delivery, are increasingly recognized to improve outcomes across all domains of the Quintuple Aim (population health, patient expe...