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Evaluative Clinical Sciences

SRI platforms

David Gladstone, B.Sc., MD, PhD, FRCPC

Scientist

Sunnybrook Health Sciences Centre
2075 Bayview Ave., Room A4 42
Toronto, ON
M4N 3M5

Phone: 416-480-4866
Fax: 416-480-5753

Education:

  • B.Sc., 1992, human biology, University of Toronto, Canada
  • MD, 1996, U of T, Canada
  • Certificate in medical education, Institute of Medical Sciences, U of T
  • FRCPC (neurology), 2003
  • PhD, 2006, U of T

Appointments and Affiliations:

  • Scientist, Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute
  • Associate professor, department of medicine, division of neurology, U of T
  • Director, Sunnybrook Regional Stroke Prevention Clinic and Rapid Transient Ischemic Attack Clinic
  • Adjunct scientist, Institute for Clinical Evaluative Sciences

Research Focus:

  • Stroke prevention
  • Atrial fibrillation
  • Anticoagulant therapy
  • Cryptogenic stroke
  • Transient ischemic attacks
  • Intracerebral hemorrhage
  • Emergency stroke treatment, tissue plasminogen activator, thrombolysis
  • Clinical trials and outcomes research
  • Quality of care and patient safety
  • Post-stroke recovery and neurorehabilitation

Research Summary:

Dr. Gladstone is a clinician-scientist, stroke neurologist and associate professor of medicine at the University of Toronto. He is interested in pragmatic, clinically relevant research that can be readily applied to practice to improve patient care and outcomes. He is principal investigator of national multicentre clinical trials aimed at optimizing outcomes for patients with stroke and transient ischemic attack (TIA). His research has been funded by peer-reviewed grants from the Canadian Stroke Network and the Canadian Institutes of Health Research, among others. He has authored or co-authored more than 100 scientific publications spanning the spectrum of stroke care including stroke prevention, prehospital care, emergency treatment of ischemic and hemorrhagic stroke, transient ischemic attacks, cryptogenic stroke, atrial fibrillation, anticoagulant therapies, outcome measures in stroke recovery and neurorehabilitation. He completed his PhD through the Royal College Clinician-Scientist Training Program and his thesis earned the McNaughton national research award from the Canadian Neurological Society. He has held a Clinician-Scientist Award from the Heart and Stroke Foundation, and is the recipient of the Sunnybrook Young Investigator Award and the Early Researcher Award from the Ontario Ministry of Research and Innovation.

His major focus is clinical trials research aimed at improving primary and secondary stroke prevention through better detection and treatment of atrial fibrillation. He is principal investigator of EMBRACE, the largest trial of prolonged noninvasive cardiac rhythm monitoring for patients with cryptogenic stroke or TIA. The results of this trial, published in the New England Journal of Medicine, demonstrated the effectiveness of a new strategy that significantly improves the detection and treatment of this common but often silent stroke risk factor. As part of the Canadian Stroke Prevention Intervention Network, he is leading SCREEN-AF, a primary prevention screening trial that aims to develop a practical and cost-effective strategy to improve early detection and treatment of atrial fibrillation in primary care patients aged 75 years or older.

Dr. Gladstone is principal investigator of SPOTLIGHT, a randomized trial testing an innovative image-guided emergency treatment protocol to reduce bleeding in the brain for patients with hemorrhagic stroke. He also directs projects within the Ontario Stroke Registry (formerly known as the Registry of the Canadian Stroke Network), one of the world’s largest stroke databases, evaluating quality of care and practice gaps in stroke management.

Dr. Gladstone has been working to develop Sunnybrook as a premier regional stroke centre and has been site principal investigator for several national and international clinical trials investigating new treatments for acute ischemic and hemorrhagic stroke. He is a top-rated teacher and has delivered more than 500 presentations to educate health care professionals about best practices in stroke care.

Selected Publications:

See current publications list at PubMed.

  1. Gladstone DJ, Geerts WH, Douketis J, Ivers N, Healey JS, Leblanc K. How to monitor patients receiving direct oral anticoagulants for stroke prevention in atrial fibrillation. Ann Intern Med. 2015 Sep 1;163(5):382–5.
  2. Gladstone DJ, Dorian P, Spring M, Panzov V, Mamdani M, Healey JS, Thorpe KE. Atrial premature beats predict atrial fibrillation in cryptogenic stroke: results from the EMBRACE trial. Stroke. 2015 Apr;46(4):936–41.
  3. Gladstone DJ, Spring M, Dorian P, Panzov V, Thorpe KE, Hall J, Vaid H, O'Donnell M, Laupacis A, Côté R, Sharma M, Blakely JA, Shuaib A, Hachinski V, Coutts SB, Sahlas DJ, Teal P, Yip S, Spence JD, Buck B, Verreault S, Casaubon LK, Penn A, Selchen D, Jin A, Howse D, Mehdiratta M, Boyle K, Aviv R, Kapral MK, Mamdani M, EMBRACE investigators and coordinators. Atrial fibrillation in patients with cryptogenic stroke. N Engl J Med. 2014 Jun 26;370(26): 2467–77.
  4. Gladstone DJ, Bui E, Fang J, Laupacis A, Lindsay MP, Tu JV et al. Potentially preventable strokes in high-risk patients with atrial fibrillation who are not adequately anticoagulated. Stroke. 2009 Jan;40(1):235–40.
  5. Gladstone DJ, Danells CJ, Armesto A, Staines WR, McIlroy WE, Graham SJ, Herrmann N, Szalai JP, Black SE, the Subacute Therapy with Amphetamine and Rehabilitation for Stroke (STARS) Gladstone DJ, Kapral MK, Fang J, et al. Management and outcomes of transient ischemic attacks in Ontario. CMAJ. 2004 Mar 30;170(7):1099–1104.

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