Scientists at WCRI are saving lives through prevention and treatment, breaking down barriers to diagnosis and treatment, and informing policy and practice.
This year, WCRI is celebrating what science can accomplish with important ideas, focus and support. The hereditary cancer team has made key discoveries in preventing and managing breast and ovarian cancer for 20 years at WCH. Their research has received more than 45,000 citations. They advocate for genetic testing for high-risk women who don’t have access to public programs and strive to develop new approaches to prevention and treatment with access to the world’s largest bio-bank of samples from BRCA mutation carriers.
WCRI is celebrating over twenty years of discovery in hereditary breast and ovarian cancer. View the research milestones since 1994.
Depression is one of the most common medical problems in pregnancy. One in 10 women are depressed while pregnant but as few as 20 per cent of those receive enough care to get better.
Dr. Simone Vigod is studying the effects of mental illness on mothers and babies and developing new approaches to help them recover.
Depression is much more common in women than men. For women who are depressed during pregnancy, proper treatment can prevent serious consequences for mothers and babies. “Untreated depression is associated with smaller babies, pre-term birth and more irritable infants,” says Dr. Vigod. Children may also face developmental delays.
Diagnosis is challenging because some symptoms, such as tiredness and difficulty concentrating, are also symptoms of pregnancy. Sometimes, women don’t seek help because they are ashamed of feeling unhappy with a baby on the way.
Once diagnosed, pregnant women face a tough choice. Those with milder symptoms can sometimes recover with non-pharmacologic treatment, such as counselling. But those with more severe symptoms may respond better to antidepressants. Research suggests antidepressants present a low risk of complications for the baby, but Dr. Vigod says the risk is never zero. “Women feel that they are caught between a rock and a hard place,” she says. To help them decide, she is piloting an online decision-aid. The tool helps them weigh the risks with evidence gathered from years of research.
She is also testing a new treatment option for pregnant women that does not affect the fetus. Transcranial direct current stimulation (tDCS) stimulates the area of the brain involved in depression. Evidence suggests it is effective for treating depression, but this is the first study testing it for pregnant women. The tDCS cap is small and portable, meaning that women could use it at home with help in the future, or maybe even on their own.
"This could change the future of how we treat pregnant women," Dr. Vigod says.
Women with psoriasis and related arthritis report more pain, fatigue and a lower quality of life than men with the same conditions.
Dr. Lihi Eder is working to improve the diagnosis and treatment of psoriasis and psoriatic arthritis. For that, she must study symptoms and responses to treatment in all kinds of patients – and sex and gender play a role.
While men tend to have more joint damage, women have worse function and are more likely to respond poorly to medications, with a higher chance of side-effects. “It creates a challenge in treating women,” Dr. Eder says.
Psoriasis affects about two per cent of the population, causing scaly, red patches of inflamed skin. Approximately one-third of psoriasis patients will develop inflammatory arthritis, termed psoriatic arthritis.
Dr. Eder’s research has found that psoriatic arthritis is badly underdiagnosed. Symptoms are complex and often mistaken for other conditions. She is part of a new collaboration between Women’s College Hospital’s Family Medicine, Dermatology and Rheumatology services to test better methods of screening. For example, she has identified genetic factors that could predispose people to psoriatic arthritis. Genetic testing may help identify those at risk sooner and personalize their treatment. Another important tool that could assist in early diagnosis of arthritis is musculoskeletal ultrasound of the joints. Dr. Eder’s research examines whether ultrasound could be used in the clinic as a point of care to increase the detection of psoriatic arthritis.
Improving diagnosis matters in part because psoriasis patients, particularly those with arthritis, are more likely to suffer from other chronic conditions such as depression, anxiety and heart disease. A focus of Dr. Eder’s research is reducing their risk of heart attack and stroke.
“Inflammation is not good for the arteries,” she says. New medications to reduce inflammation, tested on
both women and men, are one avenue she is exploring to reduce the risk of cardiovascular complications in patients with psoriatic disease.
Most of the women who die from breast and cervical cancer live in low- and middle-income countries. Many of these deaths are preventable with early detection.
As part of her appointment to the World Health Organization (WHO) in Geneva, Dr. Ophira Ginsburg joined the worldwide effort to reduce health disparities in women’s cancers. Her work developing policies and programming, such as recommendations for screening, prevention and treatment, supported the WHO’s mandate to reduce preventable deaths from noncommunicable diseases. Breast and cervical cancer are the most common cancers among women in most developing countries. Those facing extreme poverty, compounded by gender inequity, have the most difficulty accessing care. Dr. Ginsburg is also leading a commissioned series for The Lancet on health, equity and women’s cancers to launch in 2016. “The opportunity to work alongside the world’s foremost experts, making a difference in women’s lives, has been exceptionally rewarding,” she says.
During his year-long Harkness fellowship, Dr. Onil Bhattacharyya studied innovation centres that incorporate user-centred design and methods from the software industry to develop health services around patient needs – providing the right care in the right place. He also helped envision a digital health advisor that could store, share and analyze a patient’s health information to support care choices for the older adults and their caregivers. “I’ve spent a year studying how leading U.S. institutions develop new models of care, and will bring that expertise back to Women’s College Hospital,” says Dr. Bhattacharyya, the hospital’s Frigon Blau Chair in Family Medicine Research. He will continue to advise the Commonwealth Fund’s Breakthrough Opportunities Portfolio after his return.
Closing the data gap in research
Women and men face different health risks and sometimes respond differently to treatments, but studies rarely capture these distinctions. Women’s Xchange, the hospital’s women’s health research knowledge translation and exchange centre, is closing this data gap through a consultation service to help research groups integrate sex and gender into every phase of their studies, starting with the funding proposal. The team has provided consultation to large provincial and national projects and thereby helped them be successful in obtaining funding. Women’s Xchange also supports a growing community of women’s health researchers through semi-annual events, online resources, and the 15K Challenge funding opportunity for community-based research.
Many women do not know all of their emergency contraception options. That’s why a team led by Dr. Sheila Dunn, a scientist and primary care physician at Women’s College Hospital, launched the online guide whatsnextforme.ca. The website provides up-to-date evidence about emergency contraception and a clinic finder for sexual health clinics in Toronto.
A set of three free, online curricula designed by scientist Robin Mason, PhD, and her collaborators is training clinicians to provide victims of sexual abuse and violence with sensitive, informed care. More than 15,000 individuals have used DVeducation.ca since it launched. The latest, about addressing past sexual assault in clinical settings, was developed with scientist Janice Du Mont, EdD, and Sheila Macdonald, provincial coordinator of the Ontario Network of Sexual Assault/Domestic Violence Treatment Centres.
From research to access and treatment, many women are underserved because research has overlooked the differences between men and women. Women often have different risk factors for disease, symptoms and treatment responses. They are more likely than men to suffer from mental health issues and multiple chronic conditions. But many treatments in use today were disproportionately studied on men, and when women are included, the data are seldom reported separately. Women also face stressors and life circumstances that healthcare does not always accommodate. This is the Health Gap. And Women’s College Research Institute is uniquely positioned to close it. Most of our scientists are women and clinicians whose clinical work informs their research. All of them are transforming women’s health.
Science that recognizes the difference between men and women makes everyone healthier. Scientists at Women’s College Research Institute (WCRI) study how health conditions affect women in particular, often while treating them as patients at Women’s College Hospital (WCH). They also work to understand the context and circumstances that affect how women use the healthcare system.
This report highlights our scientists’ advances in research that help women access the care they need and prevent conditions before they start. Our scientists published more than 400 publications this year, a substantial increase of more than 80 per cent over the past five years. The institute had a 30 per cent increase in external research funding since 2012.
Scientists at WCH have undoubtedly saved many lives through 20 years of research in hereditary breast and ovarian cancer. Dr. Steven Narod, who directs the hereditary cancer team, was awarded the prestigious Killam Prize for Health Sciences this year for his groundbreaking contributions to this area. Recently, Dr. Mohammad Akbari identified a new breast cancer gene called RECQL.
We have also advanced research and care for pregnant women facing mental illness, and shed light on the risks of heart disease for patients with psoriatic arthritis. Our scientists have fostered international collaboration at the World Health Organization and the Commonwealth Fund.
As we pursue discoveries, we also work to improve how scientists, policy-makers and clinicians think about research. For example, Women’s Xchange is working to close the sex and gender data gap with a pioneering consultation service for scientists.
Findings continue to demonstrate that there are fundamental differences between the health of women and men. But there are many more questions to answer before we can deliver care that is truly tailored to women’s diverse needs. Researchers at Women’s College Hospital continue to investigate the most pressing issues in women’s health. We are proud of their progress this year and energized by the promise of advances to come.
Research is where change begins. It is the place where curiosity meets science, and where discovery has the power to transform.
Since the earliest days of this institution, Women’s College Hospital’s world-renowned scientists have strived, and succeeded, to ignite change by pushing the boundaries of research – by looking beyond the status quo through the lens of equity, diversity and access. The change they have created is closing crucial gaps in healthcare for women, for their families and for everyone – and building stronger communities for us all.
The opening of our new building has brought clinical care, research and education under the same roof, bringing extraordinary momentum to the innovative work of Women’s College Research Institute (WCRI). WCRI is now unparalleled on the world stage for its mission to advance health for women.
This elite institute is also the focus of dedicated and widespread support from Women’s College Hospital Foundation’s donor community – a family of over 33,000 individuals, corporations and foundations who believe fiercely in the power of this hospital and its research institute to close the gaps that are putting the lives and well-being of women at risk.
Among them are the extraordinary Gilgan family, who identified WCRI’s hereditary cancer team as their charity of choice for 2016. And Sharon Newman, who established The Sharon Newman Family Fund to give back to the research that saved her life – the very same research supported by the Gilgan family.
We extend our deepest respect and gratitude for the devotion, expertise and partnership of our WCRI colleagues, and for the donors who support and advance their pioneering research. Together, we are igniting change for women everywhere – and closing the health gap.
President & CEO
Women’s College Hospital Foundation
Endowed chairs established by our generous supporters:
Women’s College Research Institute’s highly sought-after summer student research program has mentored hundreds of participants since it launched in 2004. Through the program, students work closely with a scientist on a research project for 12 to 16 weeks. They also attend sessions provided by the scientists at Women’s College Hospital designed to build their skills in research.
In 2015-2016, Women’s College Hospital scientists advanced knowledge through a substantial increase in scientific publications and many national and international presentations.
Research shows that women’s needs, including physiological differences, cultural challenges and life circumstances, are often not taken into consideration. This is the Health Gap.
View other publications highlighting Women’s College Hospital’s impact in research and care.
Download the PDF version of the 2016 Research Report.
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Established in 2006, Women’s College Research Institute, based at Women’s College Hospital, is the leading research institute in Canada dedicated to the health of women. Our multidisciplinary scientists conduct research that prevents complex chronic conditions and develop innovative health system solutions to deliver better care. Women’s College Hospital is fully affiliated with the University of Toronto, where all of our scientists hold academic appointments.
Mohammad Akbari, MD, PhD
Sacha Bhatia, MD, MBA, FRCPC
Onil Bhattacharyya, MD, PhD, CCFP
Frigon-Blau Chair in Family Medicine Research
An-Wen Chan, MD, DPhil, FRCPC
Catherine Classen, PhD
Cindy-Lee Dennis, PhD
Shirley Brown Chair in Women’s Mental Health Research
Janice Du Mont, EdD
Sheila Dunn, MD, MSc, FCFP
Lihi Eder, MD, PhD
Ophira Ginsburg, MD, MSc, FRCPC
Paula Harvey, BMBS, PhD, FRACP
Gillian Hawker, MD, MSc, FRCPC
Sir John and Lady Eaton Professor and Chair of Medicine
Noah Ivers, MD, PhD, CCFP
Joanne Kotsopoulos, PhD
Iliana Lega, MD, MSc, FRCPC
Lorraine Lipscombe, MD, MSc, FRCPC
Mona Loutfy, MD, MPH, FRCPC
Robin Mason, PhD
Lisa McCarthy, PharmD, MSc
Advanced Practice Pharmacist/Clinician Scientist
Steven Narod, MD, PhD, FRCPC
Tier 1 Canada Research Chair in Breast Cancer
Paula Rochon, MD, MPH, FRCPC
VP, Research, Women’s College Hospital
RTO/ERO Chair in Geriatric Medicine, University of Toronto
John Semple, MD, MSc, FRCSC
Canadian Breast Cancer Foundation, Ontario Region, Chair in Surgical Breast Cancer Research
Valerie Taylor, MD, PhD, FRCPC
Jacob Udell, MD, MPH, FRCPC
Simone Vigod, MD, MSc, FRCPC
Shirley Brown Clinician-Scientist
Izzeldin Abuelaish, MD, MPH
Geoffrey Anderson, MD, PhD
Tony Antoniou, PhD
Anita Benoit, PhD
Cornelia Borkhoff, PhD
Shannon Dunn, PhD
Gillian Einstein, PhD
Eleanor Fish, PhD
Sophie Grigoriadis, MD, PhD, FRCPC
Andrea Gruneir, PhD
Eva Grunfeld, MSc, MD, DPhil, FCPC
Susan Jaglal, PhD
Ava John-Baptiste, PhD
Carmen Logie, MSW, PhD
Kelly Metcalfe, RN, PhD
Lori Ross, PhD
Leonardo Salmena, PhD
Lena Serghides, PhD
Mark Yudin, MD, MSc, FRCSC
WCRI scientists supervised more than 60 postdoctoral fellows, graduate students, practicum students and undergraduate students in 2015-2016. They also supervise many other students based at institutions across the country.
We thank the members of our Research Advisory Board for their contributions over the past year:
Linda Rabeneck (Chair), MD, MPH, FRCPC
Vice-President, Prevention and Cancer Control, Cancer Care Ontario
Professor of Medicine
Professor, Institute of Health Policy, Management and Evaluation; Dalla Lana School of Public Health
University of Toronto
Lori Ferris, PhD, CPsych, LLM
Associate Vice-President, Research (Oversight and Compliance)
Professor, Dalla Lana School of Public Health, University of Toronto
Alejandro Jadad, MD, DPhil, FRCPC, FCAHS, FRSA, LLD
Director, Institute for Global Health Equity & Innovation
Founder, Centre for Global eHealth Innovation
Professor, Dalla Lana School of Public Health
University of Toronto
Catharine Whiteside, MD, PhD, FRCPC
Executive Director, SPOR Network in Diabetes and its Related Complications
Emerita Professor and Former Dean of Medicine
University of Toronto
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Mohammad Akbari is identifying new genes involved with hereditary cancer, so that more women can assess their risk.
Sacha Bhatia is evaluating a national campaign to reduce inappropriate testing and treatments, ensuring patients everywhere will have access to the highest quality care.
Onil Bhattacharyya is adapting methods from user-centred design and technology startups to develop new models of care for patients with complex needs.
An-Wen Chan is studying inequities in access to skin cancer screening.
Catherine Classen is aiming to ensure that trauma survivors are not disadvantaged within the healthcare system so that they receive the care they need.
Cindy-Lee Dennis is advancing knowledge on perinatal depression and anxiety and developing interventions for prevention and treatment.
Janice Du Mont is informing policy and practice with her research on how sexual assault affects the health of women.
Sheila Dunn is uncovering ways to help newcomers and marginalized women learn about and access cancer screening.
Lihi Eder is studying psoriasis and psoriatic arthritis and their links to heart disease, including how women and men are affected differently.
Ophira Ginsburg is building policy and programming for women’s cancers globally, reducing gender inequality in prevention and screening.
Paula Harvey is revealing how cardiovascular regulation differs between women and men and applying that knowledge to new treatments.
Gillian Hawker and her team are working to reduce gender bias in doctors’ recommendations of patients for joint replacement surgery.
Noah Ivers is testing new ways to give doctors feedback on their clinical practice and strengthening links between patients and care providers to improve outcomes in primary care.
Joanne Kotsopoulos is identifying new methods to prevent and manage breast and ovarian cancer, so that all women have options that meet their needs.
Iliana Lega is untangling the relationship between diabetes and cancer, including breast cancer and childhood cancers.
Lorraine Lipscombe is helping women prevent and manage diabetes with care that fits their lives.
Mona Loutfy is reducing the stigma and health disparities that Canadian women with HIV experience.
Robin Mason is creating curricula to help health professionals provide more sensitive, compassionate care for survivors of domestic violence and sexual assault.
Lisa McCarthy is optimizing medications for older patients, who are often women, to help them stay healthier for longer.
Steven Narod is discovering the genetic risk factors for hereditary cancer and transforming approaches to prevention and treatment.
Paula Rochon is discovering better ways to promote health and wellness for understudied older adults, most of whom are women, by improving how drug therapy is prescribed.
John Semple is developing new techniques for breast reconstruction that hasten recovery and improve quality of life.
Valerie Taylor is pinpointing the overlaps between obesity, diabetes and mental illness, and how they are impacted by sex and gender.
Jacob Udell aims to narrow the gap between women and men, and the rich and the poor, in quality of care and prognosis after a heart attack.
Simone Vigod is breaking down barriers for pregnant and postpartum women to access mental health treatment.