Research on diagnosis and outcomes of stroke in children

Akshat Pai, a fourth year PhD student in the Institute of Medical Science at the University of Toronto, and former Leong Scholar provides an update on his project, which investigates the role of clinical and non-clinical factors on outcomes of stroke in children.

The “Using the Ontario Marginalization Index to Explore the Impact of Health Inequities on Time to Diagnosis and Outcomes of Stroke in Childhood: A Province-wide Study” is a multi-center project, that has been introduced to more than ten children’s hospitals across Canada (from British Columbia to Newfoundland and Labrador). I am currently recruiting families and patients that are generally under-represented in health research to participate in this important work.

I have gathered essential information about baseline sociodemographic, clinical, and radiological characteristics in this study, with the support of the Leong Centre. These findings will provide an understanding about how important individual- and neighborhood-level data can be to elucidate the complex relationship between clinical and non-clinical factors in pediatric stroke research. One manuscript related to these findings is currently under peer-review in an international journal. A second manuscript focused on the role of ethnocultural backgrounds related to my previous work as a MSc student in the Dlamini Lab is underway. The next steps are to present key findings from this study at academic conferences. Most recently, I have submitted an abstract to the International Stroke Conference 2024. If accepted, I will present on the association between infarct volume, neighborhood-level deprivation, and outcomes in pediatric stroke in Phoenix, Arizona for an audience of trainees, clinicians, and scientists at the forefront of stroke-related research.

This fall, I will continue to complete my course requirements for the PhD in Medical Science program and Health Services and Policy Research collaborative specialization program at the Institute of Health Policy, Management and Evaluation. As part of my research practicum, I have also been onboarded as an ICES student and will leverage population-based data to investigate the role of air pollution on incidence and outcomes of pediatric stroke in Ontario.

Being a Leong Scholar has provided me with a tremendous amount of support to pursue novel and timely research that will impact thousands of families. I am excited to continue working under the supervision of Dr. Nomazulu Dlamini at The Hospital of Sick Children.

Question: What impact do you hope your research findings will have on patients?

Answer: My project is unique due to being intentionally rooted in social determinants of health with an overarching goal to address the more upstream “causes of the causes”. By leveraging not only individual-level health information but complementing it with census-based neighborhood-level social determinants of health data, the research findings are expected to holistically address the complex interplay of factors impacting post-stroke outcomes in children.