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Background

Who we are

SORCan is a group of investigators with a shared research interest in stroke outcomes, stroke epidemiology and stroke health services research.

Mission and Objectives

SORCan focuses on research and discovering new understanding about stroke and stroke care delivery.

SORCan will partner with existing groups (eg. Canadian Stroke Consortium, Canadian Stroke Strategy, Canadian Stroke Network, ICES etc.) to achieve its goals.

SORCan will function, initially, via the projects and funding of individual members.

SORCan seeks to garner team grant research funding for future initiatives.

Terms of Reference (TOR)

The SORCan will meet by teleconference or directly a minimum of three times per year. Additional meetings (teleconference or other) may be called at the discretion of the Chair. SORCan meetings can also take place during National or International Stroke Conferences. Meetings will follow “Robert’s Rules of Order” and minutes and an action tracker will be kept of all meetings. A quorum for meetings is 50% of members plus one. The committee will predominantly operate by consensus but where consensus cannot be reached majority for decision making will be fifty percent of a quorum committee plus one.

Any funding received by SORCan will be managed in a research trust account at the chair’s home institution. However all expenditures will need to be approved in principal by the SORCan membership in one of two ways. Firstly, expenditures may be approved by a consensus (or vote) of the participants of a SORCan meeting that has quorum with funding approvals tracked in meeting minutes. Secondly, the Chair may obtain approval for expenditures by letter or email assuming 2/3rds of total membership approve the expense. Multiple expenses may be approved by the SORCan membership in the form of a budget attached to a specific time frame.

The Founding Chair of SORCan is Gustavo Saposnik and SORCan will be chaired by the Founding Chair for a four-year term. Election of a new chair will be by vote at a SORCAN meeting where there is quorum. To be elected as Chair, any candidate will need to receive more votes than any other candidate in the running. Should there be only one candidate considered for chair then the chair can be appointed by acclamation based on a greater than 50% vote of members present at a meeting where there is quorum.

Membership in the SORCan Group will be by invitation or application and new memberships will require approval in one of two ways. Firstly, a new membership can be approved by consensus (or vote) of a SORCan meeting where there is quorum. Secondly, a new member may be approved assuming 2/3rds of total membership can provide a letter or email supportive of the new member.

Publications financially supported by funds or resources contributed by SORCan will need to acknowledge SORCan in the acknowledgements section of the manuscript, poster, presentation or other publication. Where SORCan does not contribute funds or resources, SORCan members can exercise individual discretion in determining whether the SORCan will be acknowledged in the authorship or acknowledgements sections of a manuscript, poster, presentation or other publication. Where SORCan members work in collaboration a principal investigator/author needs to be identified for each project. The principal investigator/author will then designate the authorship order of other investigators/authors based on contribution. Alternatively where two or more authors plan to make clearly equal contributions to a particular project authorship order can be decided by negotiation at the initiation of the project. Changes in initial order of authorship can occur after the start of a project only by unanimous consensus of the authors affected by any such change. The ICMJE criteria for authorship of publications will be adhered to.

What is outcomes research?

According to the Agency for Healthcare Research and Quality (AHRQ), outcomes research seeks to understand the end results of particular health care practices and interventions. This includes outcomes that people experience and care about, such as change in the motor or cognitive function. For individuals with chronic conditions such as cerebrovascular disease, ‘end results’ include quality of life as well as mortality. By linking the care people get to the outcomes they experience, outcomes research can become the key to developing better ways to monitor and improve the quality of care.  SORCan supports research aimed at improving health outcomes as part of its strategic plan.

Measuring Outcomes

Historically, clinicians have relied primarily on traditional biomedical measures, such as the results of laboratory tests, to determine whether a health intervention is necessary and whether it is successful. Researchers have discovered, however, that when they use only these measures, they miss many of the clinically meaningful outcomes. Hence, outcomes research also measures how people function and their experiences with care.
In patients with cerebrovascular disease there are several outcome measures that can be considered. Moreover, SORCan has the specific mandate of evaluating outcomes under different perspectives: the payer/government, the clinician, and patients/families.

Table 1. Examples of Outcomes in Stroke Research

Measure
Example
Mortality
30-day stroke fatality
Physiologic measures
Blood pressure
Clinical events
Myocardial infarction or recurrent stroke
Symptoms that may limit rehabilitation
Neglect
Functional measures
SF-36, scale of fatigue
Rehospitalization
Hospital readmission, ED visit
Disability
mRS at 90 days, at discharge
Medical complications
Pneumonia, urinary tract infeccion, pulmonary embolism
Discharge disposition
Discharge home, rehabilitation institurion, home care
Length of hospital stay (LOS)
Mean / median LOS
Patients' experiences with care
Quality of Stroke Care
Indicators of quality of stroke care