Charles de Mestral, MD, PhD, FRCSC
SPECIALTY AND TITLE
Unity Health Toronto – St. Michael’s Hospital
Associate Professor, Department of Surgery, University of Toronto
Associate Professor (status), Institute of Health Policy Management and Evaluation, University of Toronto
AREA OF RESEARCH
As a vascular surgeon, I regularly see people with diabetes and peripheral artery disease (PAD) at risk of limb loss. Too many have failed to received preventative care we know can help avoid foot wounds and amputation. As a scientist, I recognized that there were few Canadian studies on the disease burden and real-world effectiveness of preventative care related to leg amputation in people with diabetes or PAD. As a result, my primary research program goal has been to address these evidence gaps by (i) better defining the clinical and economic burden of leg amputation in Canada and (ii) characterizing the utilization, outcomes and access barriers for health services that contribute to amputation prevention among people living with diabetes and PAD in Canada.
MAJOR CONTRIBUTIONS TO SCIENCE AND/OR HEALTH CARE DELIVERY
My research team and collaborators have pursued various approaches to generate data to address the aforementioned evidence gaps around amputation prevention, specific to the Canadian context. These approaches have included “big data” analysis of administrative health data, survey of providers, scoping review of published and grey literature, evaluation of a local limb salvage program through a quality improvement framework, cost analyses from the perspective of the ministry of health, decision analytic modelling as well as patient engagement. These different approaches are providing a multifaceted understanding of the scope of the problem from a patient and health system perspective and are directly informing the design of coordinated amputation prevention strategies, specific to the Canadian context.