Research

Overview

Our strategic goal is to provide scientific evidence that will inform best practice within three broad research themes: 

  1. Blood Utilization, the study of evidence-based blood product use, including alternatives, sustainability, and donor research.
  2. Health Outcomes Research, including large epidemiological studies to understand patterns of blood product utilization, and link donor characteristic, product processing methods and transfusion outcomes.
  3. Hemostasis and Bleeding Disorders, both inherited and acquired, including basic mechanistic studies in immune cytopenias and clinical studies on specialized blood product utilization.


This chart outlines the research themes listed above and below in a graphic format.


Research methodologies that are used to achieve our research goals include:

  • Experimental clinical trials (e.g. pragmatic randomized trials, and cluster designs)
  • Observational studies
  • Qualitative techniques
  • Quality improvement methods
  • Patient-reported outcomes
  • Large transfusion databases

Key Publications

Effect of Short-Term vs. Long-Term Blood Storage on Mortality after TransfusionHeddle NM, Cook RJ, Arnold DM, Liu Y, Barty R, Crowther MA, Devereaux PJ, Hirsh J, Warkentin TE, Webert KE, Roxby D, Sobieraj-Teague M, Kurz A, Sessler DI, Figueroa P, Ellis M, Eikelboom JW. N Engl J Med. 2016 Nov 17;375(20):1937-1945. This international clinical trial settled the long-standing debate over whether ‘fresh’ blood is better than ‘older’ blood.  Conducted across six centres in four countries, this pragmatic trial enrolled over 31,000 patients.  The trial did not show a difference in in-hospital mortality between patients who received fresh versus standard-issue red blood cells. This study has had major implications on inventory management and clinical practice.

Clinical practice guidelines from the AABB: Red blood cell transfusion thresholds and storage. Carson JL, Guyatt G, Heddle NM, Grossman BJ, Cohn CS, Fung MK, Gernsheimer T, Holcomb JB, Kaplan LJ, Katz LM, Peterson N, Ramsey G, Rao SV, Roback JD, Shander A, Tobian AA. JAMA 2016 Nov 15; 316(19):2025-35.  This international guideline has set the standard for RBC transfusion practices.

High-dose dexamethasone compared with prednisone for previously untreated primary immune thrombocytopenia: a systematic review and meta-analysis. Mithoowani S, Gregory-Miller K, Goy J, Miller MC, Wang G, Noroozi N, Kelton JG, Arnold DM. Lancet Haematology 2016 Oct;3(10):e489-e496. This meta-analysis showed that dexamethasone worked faster than prednisone for patients with immune thrombocytopenia (ITP) and appeared to be safer. These data will inform new international ITP treatment guidelines.

NHF-McMaster Guideline on Care Models for Haemophilia ManagementPai M, Key NS, Skinner M, Curtis R, Feinstein M, Kessler C, Lane SJ, Makris M, Riker E, Santesso N, Soucie JM, Yeung CHT, Iorio A and Schünemann HJ. Haemophilia. 2016 July; 22(S3):6-16. This clinical practice guideline was the first to be supported by a patient organization (the National Hemophilia Foundation), and featured innovative methods to establish treatment recommendations for hemophilia. It is being used as a model for other guidelines in rare diseases.

Red blood cell processing methods and in-hospital mortality: A transfusion registry cohort studyHeddle NM,Arnold DM, Acker JP, Liu Y, Barty RL, Eikelboom JW, Webert KE, Hsia CC, O’Brien SF, Cook RJ. Lancet Haematol 2016 May; 3(5):e246-54.

Knowledge Mobilization

Our knowledge mobilization strategy includes:

  • Publications and presentations 
  • Partnerships
  • Participation in governmental policies
  • Participation in international guideline initiatives
  • Mentorship
  • Social media (Twitter MCTransfusionRMCTR website)

Training

Education and training is a key mission of MCTR. Our group is committed to training highly qualified personnel in clinical research methodology, epidemiology, and policy relating to Transfusion Medicine in Canada.

Located within the Department of Medicine at McMaster University, MCTR has formal ties with the Departments of Clinical Epidemiology and Biostatistics and Pathology and Molecular Medicine. MCTR's inter-departmental collaborations with various Faculties in McMaster University (e.g., Faculties of Science, Health Sciences) and inter-institutional collaborations (e.g., University of Waterloo), provide a rich educational environment for trainees at all levels. McMaster University also provides opportunities for fellowship training in Transfusion Medicine through the Royal College Competency-based Training Program. Trainees will learn health research methodology, approaches to clinical and translational research, and evidence-based practices.