Connecting the dots between research and the real world

Annual Report 2021–2022


Rising to the Challenge

As we marked a second year of global disruption due to the ongoing pandemic, the CHÉOS community worked tirelessly through change and uncertainty, contributing to worldwide efforts to combat COVID-19 while ensuring that all areas of our world-class research centre were supported and fostered.

Out of the most challenging times, a renewed sense of purpose arises. CHÉOS is growing with new minds, bold ideas, and expanding collaborations. We are dedicated to answering the big health questions of today, while anticipating the answers the world will need tomorrow. There are countless ways to improve the health of our system and our population that have yet to be discovered.

Thank you to all of our partners who are with us on this journey, as we continue to rise to the challenge, uncovering new ways of doing and knowing, and strive to advance health outcomes for all.

About the Centre


The Centre for Health Evaluation and Outcome Sciences (CHÉOS) conducts high-quality research to inform changes to the health care system. As a collaboration between cross-disciplinary scientists, clinicians, and expert research staff, we bridge the gap between data, research, and care to evaluate the effectiveness of health interventions at the population level to improve health outcomes for all.

Established in 1998, the Centre is jointly affiliated with Providence Research and the University of British Columbia (UBC) Faculty of Medicine, and is housed in a teaching and research hospital in the heart of Vancouver, Canada.


Our Vision

Bridging evidence and care to transform the health system and improve health outcomes for all.

Our Mission

Through interdisciplinary collaboration and mentorship of emerging health researchers, we produce and translate high-quality evidence that informs health care from the individual to the system level.

Our Values

COLLABORATION: We forge meaningful partnerships with researchers, health care professionals, people with lived experience, community-based organizations, and system-level decision-makers.

ORGANIZATIONAL INTEGRITY: We strive to uphold the highest principles for the conduct of research that is designed to improve the well-being of all people.

SCIENTIFIC RIGOR: We identify and address relevant and meaningful research questions from many perspectives through the rigorous application of appropriate and innovative scientific methods at all stages of research.

EQUITY, DIVERSITY, AND INCLUSION: We are dedicated to the promotion and practice of equity, diversity, and inclusion in our workplace and in the research that we conduct.

CHÉOS at a Glance


Our expert staff help researchers from around the world turn good ideas into great research.
Proportion of CHÉOS support by service type in 2021/2022

staff members

new or existing projects supported in 2021/2022


Our investigators are at the forefront of major areas of health research; many have clinical appointments and include Canada Research Chairs, MSFHR Scholars, and CIHR Investigators.

in total funding held by CHÉOS Scientists in 2021/2022*

*From UBC RiSE, includes only CHÉOS Scientists at UBC, as well as those appointed after March 31, 2022

in new CIHR, SSHRC, MSFHR, PHAC, Health Canada, and NIH grant funds awarded to CHÉOS Scientists as principal applicants in 2021/2022

Our People

This year, we welcomed several new CHÉOS Scientists and Research Associates to diversify our expertise into new areas of health research.
New Scientist: Dr. Amanda Slaunwhite

Read more >

New Scientist: Dr. Habib Chaudhury

Read more >

New Scientist: Dr. Mary De Vera

Read more >

New Scientist: Dr. Farinaz Havaei

Read more >

New Scientist: Dr. Alana Flexman

Read more >

New Scientist: Dr. Bohdan Nosyk

Read more >

New Scientist: Dr. Alastair Younger

Read more >

New Research Associate: Dr. Velma Mockett

Read more >

Understanding the impacts of COVID-19

Our scientists continue to innovate in an environment permanently altered by COVID-19 by addressing pandemic-related challenges affecting patients, decision-makers, and care providers.
Tracking & linking workplace hazards to prevent chronic disease

Dr. Mieke Koehoorn works to track and link workplace hazards to prevent chronic disease and shares why COVID-19 outbreaks happened in some unexpected areas.

Read more >

Tackling the global mental health crisis by scaling up accessibility

Dr. Daniel Vigo discusses the significance of combining the support provided by community peers with digital tools to help tackle the global mental health crisis.

Read more >

The resourcefulness of communities and the increasing availability of digital tools are helping to overcome barriers to accessing much-needed mental health resources.

How technology is improving long-term care

Keeping families connected with technology both during and after the pandemic.

Read more >

Learning from experience: COVID-19’s impact on people with opioid use disorder

Dr. Andrew Kestler is involved in a new study interviewing people with opioid use disorder to understand their perspectives of the pandemic.

Read more >

BC teachers report deteriorated mental health during pandemic

A new study examining the impact of COVID-19 on teachers in BC found four out of five reported worse mental health. Two-thirds reported a heavier workload than before the pandemic.

Read more >

Re-dawn of the digital age: Integrating technology & health care

The COVID-19 pandemic has catalyzed an increase in the use of digital technology and highlighted its importance in providing essential health care.

Read more >

Integrating technology as part of my health care has given me an opportunity to focus on me being me rather than being a patient.
Age, altruism, or a long-term view: Why do people living with HIV get the COVID-19 vaccine?

Understanding COVID-19 vaccine confidence in people living with HIV in Canada.

Read more >

Half of people with COVID-19 symptoms leaving emergency departments did not self-isolate as instructed

While people understood public health guidelines, they did not adhere to them, citing need for food, medication, and fresh air.

Read more >

Pandemic underlines need to address physician burnout

Two out of three Vancouver physicians surveyed in a new CHÉOS study faced burnout during the COVID-19 pandemic.

Read more >

We need to create a sustainable workforce because a more sustainable and thriving health care system means better quality of care for patients.

Big picture research with big impact

The researchers and staff at CHÉOS investigate a diverse range of health-related problems, spanning the health care, housing, and education systems, among others. Though each area and approach are unique, our work is united by a common thread: looking at the big picture from a population-level perspective that aims to provide evidence-based answers to questions with real-world impact.
Discover PHARM-HF, a clinic connecting pharmacists with patients with heart failure

Embedded within St. Paul’s Heart Function Clinic, PHARM-HF is a unique clinic where a pharmacist works directly with patients to start, change, and monitor their medications for heart failure.

Read more >

BePelvicHealthAware: Changing the conversation about the pelvic floor and women’s health

Dr. Roxana Geoffrion and her team have set out to change the way women’s health information is shared on the internet.

Read more >

These symptoms occur in about half of aging women, but women generally don’t talk about them because of embarrassment, and they end up seeking out answers in the wrong places, or finding no answers at all.

Decolonizing maternity care: The Ekw’í7tl Indigenous Doula Collective

How a group of Indigenous birthworkers are reclaiming the power of birth and empowering others to lead the way.

Read more >

The way that Indigenous birth looks and is defined is by each person; each birth looks different. We support birthers to choose what is meaningful for them.

Chest pain emergency? Using cardiac imaging to guarantee patient outcomes

Cardiac CT imaging provides a long-term warranty for emergency department patients with chest pain.

Read more >

Gaining PRECISION on chronic inflammatory diseases through patient voices

CHÉOS Scientists are collaborating with patients to prevent complications from chronic inflammatory conditions.

Read more >

Treatments like methadone help prevent fentanyl deaths, but engagement is declining

Study highlights the importance of opioid agonist therapy during the overdose crisis, including the need to support continued treatment.

Read more >

Validation is key: Taking steps to help individuals with eating disorders feel empowered

In recognition of Eating Disorders Awareness Week, CHÉOS’ Dr. Josie Geller shares her perspective on the importance of validation during the recovery journey.

Read more >

Chemotherapy combats early-stage colorectal cancer

Innovative use of chemotherapy prior to surgery to treat colorectal cancer has shown very promising results in a recent clinical study led by Dr. Carl Brown.

Read more >

It’s quite unusual to give chemo to a patient with an early rectal cancer, but so far the results have been quite impressive.

Transforming kidney care with remote Indigenous communities

A first-of-its kind kidney health assessment program addresses inequities in access to care for Indigenous people.

Read more >


Research Highlights

Each year, our Scientists publish over 300 peer-reviewed papers. Below is a small selection from The Evidence Speaks, a monthly series that summarizes some of the latest in CHÉOS research.

Besserer F, Kawano T, Dirk J, Meckler G, Tijssen JA, DeCaen A, Scheuermeyer F, Beno S, Christenson J, Grunau B, on behalf of the Canadian Resuscitation Outcomes Consortium. The association of intraosseous vascular access and survival among pediatric patients with out-of-hospital cardiac arrest. Resuscitation. 2021 Aug 10;167:49-57.

CHÉOS Scientists Drs. Brian Grunau and Jim Christenson, Emergency Medicine Program Head Dr. Frank Scheuermeyer, and investigators from the Canadian Resuscitation Outcomes Consortium studied the effect of intraosseous (IO) and intravenous (IV) access on outcomes in pediatric out-of-hospital cardiac arrest (OHCA). Reviewing data from 1,549 OHCAs in patients aged 17 and under, the team discovered that 895 patients had an IO line attempted with 822 being successful, while 488 had an IV line attempted with 345 being successful. The researchers then conducted a logistic regression analysis with 761 patients to determine the association between access method and survival. Of these patients, 601 received IO access and 160 received IV access. Only 5.2 per cent of patients who received IO access survived compared with 25 per cent of patients who received IV access. The research team concluded that IO access was associated with a lower chance of survival and more research is needed into the impact of IV access on pediatric OHCA outcomes.

View visual summary

Jarvis I, Davis Z, Sbihi H, Brauer M, Czekajlo A, Davies HW, Gergel SE, Guhn M, Jerrett M, Koehoorn M, Oberlander TF, Su J, van den Bosch M. Assessing the association between lifetime exposure to greenspace and early childhood development and the mediation effects of air pollution and noise in Canada: a population-based birth cohort study. Lancet Planet Health. 2021 Oct 1;5(10):e709-17.

CHÉOS Scientist Dr. Mieke Koehoorn was part of a team that analyzed data from 27,372 children born in Metro Vancouver to determine the association between lifetime exposure to greenspace and early childhood development, and whether this association is affected by traffic-related air and noise pollution. They estimated the amount of greenspace the children lived in and used data from the Early Development Instrument, a population-level tool that assesses children’s development in kindergarten, to assess early childhood development. The group noted that lifetime residential greenspace exposure may improve early childhood development by reducing exposure to traffic-related pollution, which can have adverse development effects. These results, combined with further research that replicates these findings, could help influence urban planning and green infrastructure interventions.

CHÉOS Scientist: Mieke Koehoorn  |  Read more on Science Daily

View visual summary

Yap J, Haines M, Nowroozpoor A, Armour R, Luongo A, Sidhu G, Scheuermeyer F, Hutton J, Helmer J, Bolster J, Puyat J, Christenson J, Grunau B. Rationale for Withholding Professional Resuscitation in Emergency Medical System-attended Out-of-Hospital Cardiac Arrest. Resuscitation. 2022 Jan;170:201-206.

CHÉOS’ Drs. Frank Scheuermeyer, Joseph Puyat, Jim Christenson, and Brian Grunau joined colleagues from the British Columbia Resuscitation Research Collaborative to investigate why treatment is withheld in some cases of out-of-hospital cardiac arrest (OHCA). Reviewing 5,959 OHCA cases that were not treated by emergency medical services (EMS), the team determined that in over 80 per cent of cases, withholding treatment was due to a prolonged interval between OHCA and EMS arrival. Other reasons included do not resuscitate orders (16 per cent), terminal disease (1.3 per cent), and family directive (0.7 per cent). It was concluded that finding a way to reduce the time between OHCA and EMS arrival and assessment could increase the proportion of OHCA treated and improve outcomes.

View visual summary

Gan WQ, Buxton JA, Scheuermeyer FX, Palis H, Zhao B, Desai R, Janjua NZ, Slaunwhite AK. Risk of cardiovascular diseases in relation to substance use disorders. Drug Alcohol Depend. 2021 Dec 1;229(Pt A):109132.

CHÉOS Program Head of Emergency Medicine Dr. Frank Scheuermeyer, Scientists Drs. Naveed Janjua and Amanda Slaunwhite (joined CHÉOS in February 2022), and team analyzed the associations between substance use disorders (SUD) and cardiovascular diseases (CVD). Analyzing data from 617,863 people over a four-year period, the researchers found that people with SUD were 1.7 times more likely to develop CVD than people without SUD. This association was more strongly pronounced among people who had opioid or stimulant use disorder. The study highlights that, while further research is required to understand precisely why this association exists, increased awareness around SUD and the risk of CVD is needed among both the community and health care providers.

View visual summary

Aguiar M, Laba T-L, Munro S, Burch T, Beckett J, Kaal KJ, Bansback N, Hudson M, Harrison M. Co-production of randomized clinical trials with patients: A case study in autologous hematopoietic stem cell transplant for patients with scleroderma. 2021 Sep 09;22(1):611.

Dr. Mark Harrison, CHÉOS Scientist, published a clinical trial case-study with CHÉOS Program Head of Decision Sciences Dr. Nick Bansback and Scientist Dr. Sarah Munro looking at the Scleroderma: Cyclophosphamide or Transplantation (SCOT) trial. The SCOT trial tested a stem cell transplantation treatment for severe scleroderma, an autoimmune disorder that causes healthy skin, and sometimes internal organs, to build up excess scar tissue which is often fatal. Although the treatment showed promise, the trial had challenges recruiting patients with only 33 per cent of the trial participant target recruited. Focus groups and an online discrete choice experiment (DCE) survey were used to gather patient perspectives about scleroderma treatment. Among the seven aspects of treatment found to be important to respondents — effectiveness, immediate and long-term risk, care team composition and experience, cost, and travel distance — deterrents of participation were largely due to concerns about transportation and insurance coverage. Dr. Harrison’s study then surveyed 278 people with scleroderma and found that treatment effectiveness and risk of late complications contributed the most to participants’ decisions about whether to participate in a clinical trial, but modifiable factors of distance to treatment center and cost also impacted their decision. To illustrate, offering a treatment closer to home at lower patient cost with holistic, multidisciplinary care could increase participation by up to 51 per cent. This research emphasizes the importance of a patient-engaged approach to understand the concerns and the trade-offs people are willing to inform clinical study design, improve recruitment rates, and potential uptake of the treatment being studied by considering patient preferences.

CHÉOS Scientists: Sarah Munro, Nick Bansback, Mark Harrison


View visual summary

Chew C, Aguiar M, Bansback N, Law MR, Harrison M. Patient perspectives on the British Columbia Biosimilars Initiative: a qualitative descriptive study. Rheumatol Int. 2021 May 7;1-12.

A group of researchers from UBC, including CHÉOS Program Head of Decision Sciences Dr. Nick Bansback and Scientist Dr. Mark Harrison, recently conducted several interviews to determine patients’ perspectives of switching from biologic (originator) drugs to biosimilar versions following B.C.’s launch of the Biosimilars Initiative in 2019. Before switching to a biosimilar, many patient participants experienced apprehension and anxiety, with common concerns being that the new biosimilar drug may be less efficacious or have more side effects than their current drug. However, following the switch, patients stated that communicating with their health care providers and social circles helped ease the transition. The results highlighted that considering patient perspectives and having good patient–provider communication are important when considering future switching policy changes.

CHÉOS Scientists: Nick Bansback, Mark Harrison

View visual summary

Tran K, Padwal R, Khan N, Wright M-D, Chan WS. Home blood pressure monitoring in the diagnosis and treatment of hypertension in pregnancy: a systematic review and meta-analysis. CMAJ Open. 2021 Jun 15;9(2):E642-E650.

Through a systematic review and meta-analysis, CHÉOS Scientists Drs. Karen Tran and Nadia Khan compared home and medical office blood pressure (BP) monitoring for pregnant people. The researchers analyzed data from 2,843 pregnant people across 19 studies and found that mean home-measured BP was slightly lower than mean office-measured BP in pregnant people, but this varied between the studies. In addition, they noted issues associated with home BP monitoring, such as incorrect technique, inconsistent monitoring schedule, and unknown target BP values. In order to develop evidence-based guidance for home BP monitoring, additional studies are needed to define diagnostic and treatment thresholds and generate information on when home monitoring results could indicate clinically important outcomes.

CHÉOS Scientists: Karen Tran, Nadia Khan

View visual summary

Coates MM, Ezzati M, Aguilar GR, Kwan GF, Vigo D, Mocumbi AO, Becker AE, Makani J, Hyder AA, Jain Y, Stefan DC, Gupta N, Marx A, Bukhman G. Burden of disease among the world’s poorest billion people: An expert-informed secondary analysis of Global Burden of Disease estimates. PLoS One. 2021 Aug 16;16(8):e0253073.

CHÉOS Scientist Dr. Daniel Vigo joined researchers from across the globe to determine disease burden among the world’s poorest billion people compared to high-income populations. Among the poorest billion, 65 per cent of diseases were communicable, maternal, neonatal, and nutritional (CMNN), 29 per cent were non-communicable (NC), and 6 per cent were injuries. The burden of all three categories was significantly higher among the poorest billion compared with high-income populations, as measured by age-standardized disability-adjusted life years: 2,147 per cent higher for CMNN diseases, 44 per cent higher for NC diseases, and 86 per cent higher for injuries. These results show that the largest disparities in disease burden are in CMNN conditions; however, injuries and NC diseases remain important factors to consider when thinking about preventing and treating diseases in low-income areas.

CHÉOS Scientist: Daniel Vigo

View visual summary

Umaefulam V, Fox T-L, Hazlewood G, Bansback N, Barber CEH, Barnabe C. Adaptation of a Shared Decision-Making Tool for Early Rheumatoid Arthritis Treatment Decisions with Indigenous Patients. Patient. 2022 Mar;15(2):233-243.

Patient decision aids promote meaningful conversations between patients and health care providers and support shared decision-making; however, they are not one-size-fits-all. CHÉOS Decision Sciences Program Head Dr. Nick Bansback and a team from the University of Calgary set out to take an early rheumatoid arthritis (RA) patient decision aid and adapt it for use with Indigenous patients. The investigators spoke with two cohorts of Indigenous patients with RA. Cohort one helped the team understand their needs and shared their feedback on the current early RA decision aid. Cohort two reviewed the subsequently amended decision aid to ensure the changes made were appropriate and provided additional feedback. The resulting tool could help improve shared decision-making between Indigenous people with RA and their health care providers, and support health equity-oriented health service interventions.

CHÉOS Scientists: Nick Bansback

View visual summary


CHÉOS research is found in some of the world’s top journals and covers a wide breadth of specialties, areas, and populations.

original research publications


editorials & commentaries

Top 10 areas of publication in 2021/2022