Ottawa Hospital Research Institute

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Clinical decision rules

If you’ve ever been treated in an emergency department anywhere in the world, chances are your health-care provider used a clinical decision rule developed at The Ottawa Hospital to help diagnose you. Researchers at The Ottawa Hospital and the University of Ottawa are world leaders in developing clinical decision rules that streamline diagnosis, reduce wait times and limit unnecessary diagnostic tests. In fact, three of the top five rules recommended for U.S. emergency departments were developed in Ottawa. Clinical decision rules developed in Ottawa are listed below.

Thrombosis (blood clot) rules

The Ottawa Score for the Risk of Recurrent Venous Thromboembolism in Cancer Patients

Wells’ Rule for Deep Vein Thrombosis

Wells’ Rule for Pulmonary Embolism

HERDOO2 Rule to guide duration of anticoagulation in women with unprovoked venous thromboembolism

Emergency Medicine Rules

Imaging decision rules

Canadian C-Spine Rule

Canadian CT Head Rule

The Ottawa Ankle Rules

The Ottawa Knee Rule

Risk scales

Canadian Syncope Risk Score

Canadian Transient Ischemic Attack (TIA) Score

Ottawa Chest Pain Cardiac Monitoring Rule

Ottawa COPD Risk Scale

Ottawa Heart Failure Risk Scale

Ottawa Subarachnoid Hemorrhage Rule

Research News

	Am I still a safe driver? This 5-min test could start the conversation August 18, 2023 - A five-minute questionnaire could help doctors start a conversation with older adults who have medical conditions that may affect their ability to drive.
	CT scan results help predict which mini-strokes lead to major strokes June 8, 2023 - This is the first study to confirm the additional risk of stroke related to these findings. It also suggests that adding these CT findings to TIA decision tools would further improve physicians’ ability to predict a patient’s future stroke risk and p
	How should patients with acute heart failure be monitored? This tool can help. March 7, 2023 - A clinical decision tool used in the emergency department can improve outcomes for patients with acute heart failure, according to trial involving more than 5,000 patients, published in the New England Journal of Medicine.
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	Tools can identify which patients should stop taking blood thinners for unexplained blood clots November 30, 2022 - Over 750,000 Canadians will have an unexplained vein blood clot in their lifetime, known as venous thrombosis.
	Questionnaire can find people with undiagnosed asthma, COPD June 2, 2022 - A team led by Dr. Shawn Aaron developed and validated a tool published in the European Respiratory Journal that can detect undiagnosed asthma and COPD in adults with symptoms.
	When is fainting a sign of a bigger problem? This tool can tell May 14, 2020 - Most of the time fainting is harmless, but for some people it can be caused by serious conditions like irregular heartbeat. A made-in-Ottawa tool can accurately tell emergency physicians which patients will have symptoms of these serious conditions
	Updated Ottawa Rules app could help doctors predict strokes, catch deadly brain bleeds May 14, 2020 - A free app for emergency department physicians based on Ottawa’s world-renowned clinical decision rules has added more rules to its roster.
	Ottawa doctor recognized as one of the top blood vessel researchers in Canada January 23, 2020 - Dr. Philip Wells has received a major honour recognizing his outstanding contributions to advancing care in blood and blood vessel sciences both in Canada and around the world.
	How long do people need to be monitored after fainting? January 21, 2019 - For the first time, physicians in the Emergency Department (ED) have evidence-based recommendations on how best to catch the life-threatening conditions that make some people faint. New research published in Circulation suggests that low-risk patient
	Decision tool identifies which patients with COPD are at risk of death, serious complications December 3, 2018 - A made-in-Ottawa decision tool can help emergency physicians identify which patients with chronic obstructive pulmonary disease are at high risk of serious complications including death. The Ottawa COPD Risk Scale is better than current practice at p
	Engaging patients in research every step of the way November 28, 2018 - CMAJ's new supplement on engaging patients in health research features commentaries led by Drs. Dean Fergusson, Simon Hatcher and Christian Vaillancourt, as well as 14 other teams affiliated with Ontario’s SPOR SUPPORT Unit (OSSU). As co-Scientific D
	Made-in-Ottawa rule helps patients with neck injuries in the emergency department October 17, 2018 - A study led by Dr. Ian Stiell found that triage nurses in the emergency department can safely use a made-in-Ottawa rule to make wait times shorter and more comfortable for patients who have neck pain after a fall or car collision. Due to a very small
	Tattoo artist grateful to be off blood thinners thanks to made-in-Ottawa rule April 26, 2017 - Ottawa resident Sarah Rogers would have been taking blood thinners for life, if not for a rule that showed she was at low risk of having a second blood clot.
	Does this ankle need an X-ray? There’s an app for that May 9, 2016 - An app based on internationally-known Ottawa Rules will save patients from unnecessary scans The Ottawa Rules, a set of rules used around the world to help health professionals decide when to order x-rays and CT scans, are now available as a

Researchers

Name	Scientific appointment	Diseases, conditions and populations of interest	Research and clinical approaches
Austin, Michael MD, FRCPC, DRCPSC (PTM)	Clinician Investigator (ACR)	Asthma, Cardiac arrest, Chronic obstructive pulmonary disease, Diabetes, Pain, Population health, Stroke	Clinical decision rules, Clinical trials, Cluster randomized trials, Cohort studies, Critical care, Emergency medicine, Palliative care, Risk assessment
Bose, Gauruv MD, FRCPC	Associate Scientist (NS)	Autoimmune diseases of the nervous system, Multiple sclerosis	Artificial intelligence and data science, Biomarkers, Clinical decision rules, Clinical trials, Cohort studies, Health economics
Breau, Rodney MD	Senior Scientist (ACR)	Cancer, Kidney disease, Prostate cancer	Clinical decision rules, Clinical research, Clinical trials, Cohort studies, Imaging, Patient decision aids, Patient engagement, Quality Improvement, Surgery, Systematic reviews, Transfusions
Fahed, Robert MD MSc	Associate Scientist (NS)	Stroke, Subarachnoid hemorrhage	Biostatistics, Clinical decision rules, Clinical research, Clinical trials, Cohort studies, Epidemiology, Imaging, Pragmatic trials, Quality Improvement, Shared decision making, Systematic reviews
Klein, Ran PhD	Clinician Investigator (MIR)	Cancer, Heart disease, Kidney disease, Lung disease, Vascular, heart and metabolic disease	Artificial intelligence and data science, Basic research, Bioinformatics, Biomarkers, Biostatistics, Clinical decision rules, Health technology, Imaging
Le Gal, Gregoire MD, PhD	Senior Scientist (ICD)	Thrombosis / thromboembolism	Clinical decision rules, Clinical research, Clinical trials, Epidemiology, Patient engagement, Peri-operative medicine
Murthy, Sanjay MD, FRCPC	Scientist (ICD)	Colorectal cancer, Crohn's, Gastrointestinal disease, Inflammatory bowel syndrome	Clinical decision rules, Clinical research, Cohort studies, Epidemiology, Health economics, Health services research
Perry, Jeffrey MD, MSc, CCFP-EM	Senior Scientist (ACR)	Stroke, Subarachnoid hemorrhage	Clinical decision rules, Emergency medicine
Ramsay, Timothy PhD	Senior Scientist (MIR)	Addiction, Alzheimer's, Amyotrophic lateral sclerosis, Anxiety, Ataxia, Attention deficit hyperactivity disorder (ADHD), Autism, Bipolar, Brain and neuromuscular disease, Chronic obstructive pulmonary disease, Colorectal cancer, Concussion, Cystic fibrosis, Dementia, Depression, First Nations, Inuit and Métis Health, HIV, Immigrant and refugee health, Influenza, Kidney disease, Lung cancer, Macular degeneration, Men's health, Multiple sclerosis, Muscular dystrophy, Myasthenia gravis, Obesity, Ovarian cancer, Parkinson's, Pulmonary hypertension, Septic shock, Spinal cord injury	Artificial intelligence and data science, Behaviour, Biomaterials, Biostatistics, Cell therapy, Clinical decision rules, Clinical research, Clinical trials, Cohort studies, Critical care, Drug development, Emergency medicine, Epidemiology, Health professional behaviour change, Health promotion, Health research methods, Health services research, Health technology, Immunization, Immunotherapy, Palliative care, Patient decision aids, Pharmacology, Pharmacy, Prevention, Psychology, Psychometrics, Public health, Qualitative methods, Quality Improvement, Regenerative medicine, Rehabilitation, Risk assessment, Shared decision making, Surgery, Surveys, Systematic reviews, Transfusions, Translational research, Transplantation, Viral therapy
Rodger, Marc MD	Senior Scientist Affiliate (ACR)	Pregnancy, Thrombosis / thromboembolism, Women's health	Clinical decision rules, Clinical research, Clinical trials, Cohort studies, Epidemiology, Systematic reviews
Santos, Marlise MD (FRCPC), MSc, MPH	Clinician Investigator (NS)	Alzheimer's, Anxiety, Ataxia, Autoimmune disease, Autoimmune diseases of the nervous system, Blood cancer, Brain and neuromuscular disease, Brain cancer, Cancer, Concussion, Dementia, Depression, Global health, Head and neck cancer, Health equity, Health in disadvantaged peoples, Infectious disease, Intellectual disabilities, Multiple sclerosis, Parkinson's, Population health, Sickle cell anemia, Spinal cord injury, Stroke, Subarachnoid hemorrhage, Thrombosis / thromboembolism, Traumatic brain injury, Traumatic injuries, Vascular cognitive impairment, Vascular, heart and metabolic disease	Artificial intelligence and data science, Basic research, Behaviour, Biostatistics, Cancer biotherapeutics, Clinical decision rules, Clinical research, Clinical trials, Cohort studies, Critical care, Epidemiology, Health economics, Health research methods, Health services research, Health technology, Imaging, Patient safety, Pragmatic trials, Prevention, Public health, Qualitative methods, Quality Improvement, Shared decision making, Surgery, Surveys, Systematic reviews
Stiell, Ian MD, MSc, FRCPC	Senior Scientist (ACR)	Chronic obstructive pulmonary disease, Heart disease	Clinical decision rules, Clinical trials, Emergency medicine
Taljaard, Monica PhD	Senior Scientist (MIR)		Biostatistics, Clinical decision rules, Clinical trials, Cluster randomized trials, Cohort studies, Epidemiology, Health professional behaviour change, Health research methods, Health services research, Knowledge translation and implementation research, Patient engagement, Quality Improvement
Thiruganasambandamoorthy, Venkatesh MBBS, CCFP-EM, MSc	Senior Scientist (ACR)	Cardiac arrest, COVID-19, Heart disease, Vascular, heart and metabolic disease	Artificial intelligence and data science, Clinical decision rules, Clinical research, Emergency medicine, Epidemiology, Health services research
Vaillancourt, Christian MD, MSc, FRCPC, CSPQ	Senior Scientist (ACR)	Cardiac arrest, Heart disease, Population health, Spinal cord injury, Traumatic brain injury, Traumatic injuries	Clinical decision rules, Clinical research, Clinical trials, Cluster randomized trials, Cohort studies, Critical care, Emergency medicine, Epidemiology, Health economics, Health professional behaviour change, Health services research, Knowledge translation and implementation research, Public health, Quality Improvement, Surveys, Systematic reviews