The CanSAGE research grant is a catalyst grant for gynecologic research.
In 2021, CanSAGE established an annual grant opportunity for gynecologic research, targeted to early-career clinicians. Each year brings a new competition for CanSAGE members to be awarded one or two prizes of $2,500 or $5,000 for pilot work that will produce data for a potentially larger grant application.
For 2024-25, CanSAGE Research Grants were awarded to Dr. Monique Marguerie, MIGS Academic Fellow, University of Calgary, and Dr. Jennifer McCall, Fellow in Minimally Invasive Gynecologic Surgery, University of Ottawa.
Drs. Marguerie and McCall recently updated us on the progress of their research projects:
Monique Marguerie, MD, MSc
MIGS Academic Fellow, University of Calgary, Calgary, Alberta
Mentor: Ari Sanders MD, MSc, FRCSC
Project: Baclofen for Post-Operative Pain Control in Patients with Chronic Pelvic Pain
The research project I am working on is looking at the use of baclofen postoperatively following total laparoscopic hysterectomy in patients with chronic pelvic pain. We are working to establish a pilot clinical trial to look at whether the use of baclofen post-operatively improves pain control or reduces narcotic use post operatively in these patients.
Right now we are still working on getting the project approved through regulating authorities, including Health Canada and Ethics, but I’m hopeful that we will be able to start recruiting patients in the fall! We have not yet used the research money but will use it as the study gets off the ground.
Jennifer McCall, MD, FRCSC, MHM
Fellow in Minimally Invasive Gynecologic Surgery, University of Ottawa, Ottawa, Ontario
Mentor: Sukhbir Sony Singh, MD, FRCSC, FACOG
Project: Patient Decision Aids for Endometriosis and Uterine Fibroids – A Systematic Review
As the fortunate recipient of the CanSAGE Research Grant, I have been working with my team on a systematic review of Patient Decision Aids (PDAs) for endometriosis and fibroids. As surely the readers of this newsletter know, endometriosis and fibroids are conditions that require individuality when selecting treatment due to variability in disease presentation, mixed evidence of superiority of one intervention over another, and numerous psychosocial factors including access to treatments, desire to maintain fertility, and personal preferences. PDAs aim to enhance decision making by providing patients with accurate information about their condition, potential treatment options, and relative risks and benefits of each treatment.
Our objective is to summarize the evidence on PDAs for endometriosis and fibroids and to discover whether PDAs, compared to standard care, improve patient outcomes in people with endometriosis and fibroids, including satisfaction with decision-making. Our team is also completing an environmental scan (a rigorous search of publicly available information for patients, rather than of research literature) for PDAs to complement this search of the medical literature. This project is laying the groundwork for the development of PDAs for these conditions.
Electronic databases of MEDLINE(R) ALL via Ovid, Embase Classic+Embase via Ovid, Cochrane Central Register of Control Trials via Ovid, CINAHL via EBSCOhost, and Scopus were searched in December 2024. Studies were included if they were 1) published in English and, 2) of randomized control trial (RCT), pre-post intervention, observational, or qualitative in study design. The main search concepts included terms related to endometriosis or fibroids, and patient decision aids (PROSPERO# CRD42025618767).
The final search resulted in 3,957 records for title and abstract screening after de-duplication. 6 full-text articles were eligible for full-text extraction. Among the six studies were 2 randomized controlled trials; a before-and-after study; a multi-phase user-centred participatory design study with qualitative focus groups, user-testing interviews, and continuous adaptation tracking; a hybrid effectiveness-implementation stepped-wedge design and RE-AIM planning and evaluation framework; and a descriptive case series. All six studies pertained to uterine fibroids. No studies on patient decision aids for endometriosis met inclusion criteria. Three studies were from the same research group studying the Option Grid patient decision aid for symptomatic uterine fibroids +/- for heavy menstrual bleeding in the absence of uterine fibroids. One research group studied a combination of a DVD, booklet, decision worksheet, and nurse coach access. Another group studied the use of the drawMD OB/GYN iPadTM. The final study examined the effect of an in-consultation discussion of a set of pictures, diagrams, radiologic images, and textual lists displayed on a laptop. All of the studies were conducted in the USA. Studies ranged from 9 to 781 participants, with a total of 1178 patients across the 6 studies. The majority of participants were between age 30 and 50 and were Black or white.
Key insights varied by PDA. The Option Grid PDA increased likelihood of high-quality shared-decision-making experiences, was easy to use and trustworthy, and was valued as a tool for shared-decision-making. In-consultation image review prompted patients’ questions, comments and gestures, led to patients expressing information about their medical history and concerns, and helped patients understand and remember specific medical information, while clinicians consistently presented all significant information and adapted explanations to each patient’s particular concerns. The use of an iPad didn’t impact the outcome compared to standard counselling. The DVD PDA increased awareness of treatment options, knowledge, and satisfaction with their decision and its relation to their preference.
Few studies have been published related to PDAs for fibroids and none for endometriosis, demonstrating the need for creation of evidence-based PDAs for these conditions.
Thanks to my wonderful co-authors on this project!
- Helena Kim, BHSc, Department of Obstetrics and Gynecology, University of Ottawa
- Nigèle Langlois, MLIS, Health Sciences Library, University of Ottawa
- Ryan Pecore, BSc, School of Psychology, University of Ottawa
- Teresa Flaxman, PhD, Ottawa Hospital Research Institute
- Serena Corsini-Munt, PhD, CPsych, School of Psychology, University of Ottawa
- Sukhbir Sony Singh, MD, FRCSC, FACOG, Department of Obstetrics and Gynecology, University of Ottawa
