Evaluative Clinical Sciences

Administrative Manager: Meredith Malloy
Phone: 416-480-6100 ext. 62895
Email: meredith.malloy@sunnybrook.ca

Education:

• MD, 1997, University of Toronto, Canada
• Royal College of Physicians and Surgeons of Canada, 2001, internal medicine, U of T
• Royal College of Physicians and Surgeons of Canada, 2003, critical care medicine, U of T
• PhD, 2007, clinical epidemiology, U of T

Appointments and Affiliations:

• Scientist, Evaluative Clinical Sciences, Tory Trauma Research Program, Sunnybrook Research Institute
• Chief, department of critical care medicine, Sunnybrook Health Sciences Centre
• Professor, department of medicine, interdepartmental division of critical care, U of T
• Adjunct scientist, Institute for Clinical Evaluative Sciences
• Associate faculty, Institute for Health Policy, Management and Evaluation, U of T
• Executive and organizing committee, Critical Care Canada Forum

Research Foci:

• System-level interventions to improve intensive care unit quality, safety and patient outcomes
• Health services research to improve outcomes for critically ill patients
• Improving post-resuscitation care for survivors of cardiac arrest
• Improving outcomes for critically ill patients with traumatic brain injury

Research Summary:

Dr. Scales conducts health services and translational health research that seeks to improve the outcomes of critically ill patients. He has conducted many large, pragmatic and cluster randomized controlled trials (RCTs).

He is conducting the Paramedic Initiated Treatment of Sepsis Targeting Out-of-hospital Patients (PITSTOP) trial, funded by the Canadian Institutes of Health Research (CIHR) (NCT03068741). This large, 2x2 factorial RCT is evaluating whether prompt recognition of sepsis followed by early antibiotics and/or intravenous fluids delivered by paramedics upon first response leads to improved survival compared with transportation of patients to the hospital for treatment with usual care.

He is also conducting the NEUROlogically-Impaired Extubation Timing Trial (NEURO-ETT). This CIHR-funded RCT (NCT02920580) seeks to determine the optimal airway management strategy for patients who are weaned to minimal ventilator settings but who are not yet extubated due to an underlying acute brain injury.

With Sunnybrook Research Institute scientist Dr. Farhad Pirouzmand, he is leading the PROphylaxis for venous ThromboEmbolism in Severe Traumatic brain injury (PROTEST) study. This CIHR-funded RCT (NCT03559114) will compare the efficacy and safety of early versus delayed thromboprophylaxis in patients with severe traumatic brain injury.

Selected Publications:

See current publications list at PubMed:

1. Scales DC, Cheskes S, Verbeek PR, Pinto R, Austin D, Brooks SC, Dainty KN, Goncharenko K, Mamdani M, Thorpe KE, Morrison LJ, Strategies for Post-Arrest Care (SPARC) Network. Prehospital cooling to improve successful targeted temperature management after cardiac arrest: a randomized controlled trial. Resuscitation. 2017 Dec;121:187–94.
2. Scales DC, Golan E, Pinto R, Brooks SC, Chapman M, Dale CM, Jichici D, Rubenfeld GD, Morrison LJ, Strategies for Post-Arrest Resuscitation Care Network. Improving appropriate neurologic prognostication after cardiac arrest. A stepped wedge cluster randomized controlled trial. Am J Respir Crit Care Med. 2016 Nov 1;194(9):1083–91.
3. Karkouti K, Callum J, Wijeysundera DN, Rao V, Crowther M, Grocott HP, Pinto R, Scales DC, TACS Investigators. Point-of-care hemostatic testing in cardiac surgery: a stepped-wedge clustered randomized controlled trial. Circulation. 2016 Oct 18;134(16):1152–62.
4. Hill AD, Fowler RA, Pinto R, Herridge MS, Cuthbertson BH, Scales DC. Long-term outcomes and health care utilization following critical illness—a population-based study. Crit Care. 2016 Mar 31;20(1):76.
5. Scales DC, Dainty K, Hales B, Pinto R, Fowler RA, Adhikari NK, Zwarenstein M. A multifaceted intervention for quality improvement in a network of intensive care units: a cluster randomized trial. JAMA. 2011 Jan 26;305(4):363–72.

Related News and Stories:

• Granted the means to advance novel health research ventures: Sunnybrook Research Institute scientists receive almost $9 million via Canadian Institutes of Health Research grant competitions (July 24, 2018)
• CIHR responds to revolt while releasing results: Peer rebellion brings promise of change to granting agency (July 18, 2016)
• National agency recognizes scientific excellence at Sunnybrook Research Institute: Scientists score high with multimillion-dollar funding investment (Oct. 13, 2015)
• 'Inadequate patient assessment': Canadian doctors missing glaring signs of sepsis, National Post (July 6, 2015)
• Heaven can wait, Toronto Star (Jan. 23, 2015)
• Scientists capture tri-council funding: Operating grants support work in brain sciences and cancer research (July 15, 2014)
• Organ donation: the heart of the matter, White Coat, Black Art (Dec. 13, 2013)
• Toronto researchers taking part in two of world’s largest cardiac arrest clinical trials, Globe and Mail (March 4, 2013)
• Quicker cooling after cardiac arrest studied in new trial, Globe and Mail (July 23, 2012)
• Quicker cooling after cardiac arrest (July 16, 2012)