Two in five Canadians will be diagnosed with cancer in Canada. Patients with cancer are known to use the ED frequently throughout their cancer journey, from diagnosis to treatment and survivorship. However, to date, very little is known about how these ED visits impact outcomes for patients with cancer. SREMI Clinician Scientist, Dr. Keerat Grewal, is studying this relationship between ED visits and patient outcomes throughout the cancer continuum. Her research aims to improve the care of patients with cancer in the ED.
This year, Dr. Grewal was awarded a three-year Canadian Institutes of Health Research (CIHR) project grant to lead a multidisciplinary, mixed-methods study examining the care of patients in Ontario who are diagnosed with cancer through the ED. As a part of this study, Dr. Grewal and her team surveyed emergency physicians across Ontario regarding follow-up practices for patients with suspected cancer in the ED and found that follow-up for patients varies substantially for different types of cancer. The team is now working on an IC/ES project using administrative data from across Ontario to quantify the number of patients with cancer in Ontario who use the ED prior to their diagnosis. Locally, at Mount Sinai Hospital, Dr. Grewal is collaborating with a team of physicians from the hospital to identify innovative ways to improve outpatient access to cancer diagnostics in order to avoid admission to hospital. The results Dr. Grewal’s research program is laying the foundation to improve access to cancer care from the ED and will help improve patient care for the many Canadians who will use the ED during their cancer diagnosis.
Dr. Grewal continues to study venous thromboembolism and anticoagulation in the ED. Keerat has partnered with investigators and clinicians from Thrombosis Canada, CanVECTOR, and IC/ES on a recent grant submission to examine real-world data on anticoagulation for cancer-associated thrombosis by comparing newer anticoagulants to older anticoagulants. Dr. Grewal is also a co-investigator on a Canada-wide grant studying testing for pulmonary embolism in the ED.
Dr. Grewal is active with various local and national emergency medicine initiatives. For instance, she is a member of the University of Toronto Emergency Medicine Resident Academic Project committee. She also sits on the CAEP Scientific Planning Committee for continuing medical education webinars. This year, she was invited to review Thrombosis Canada’s clinical guidelines on pulmonary embolism treatment. Dr. Grewal continues to mentor medical students and residents, supervising multiple residents and medical students who have gone on to present their research locally and nationally, and receive research awards. Dr. Grewal received her graduate school appointment this year with the Institute for Health Policy Management and Evaluation at the University of Toronto and will contribute to graduate school teaching and supervision.