Dr. Amy Yu is thinking big — really big. As a leader of an ambitious new research project aimed at improving women’s outcomes after stroke, she’s heading up a network of more than 50 experts from across Canada, including clinicians, researchers, people with lived experience, engineers, computer scientists, statisticians, educators, decision-makers and more.
The project, called StrokeGoRed, has been awarded $5 million over five years through the research networks of excellence in women’s heart and/or brain health, a new initiative funded by Heart & Stroke, along with partners Brain Canada and the Canadian Institutes of Health Research – Institute of Gender and Health.
The team is big because the target is big. According to Dr. Yu, an assistant professor of medicine at the University of Toronto and a stroke neurologist at Toronto’s Sunnybrook Health Sciences Centre, they are looking at the entire continuum of stroke care. That covers everything from understanding risk factors and preventing stroke, through acute care, to recovery and rehabilitation after a stroke.
Heart & Stroke asked Dr. Yu to explain what makes StrokeGoRed unique, how it will tackle some of the most pressing questions around women and stroke, and what the team could achieve.
What problem is this research aiming to solve?
Dr. Yu: We know that women and men experience stroke differently in terms of risk factors, how they're being investigated for stroke, and sometimes how they're treated. And women have been shown — in research in Canada and elsewhere — to have worse outcomes in the current way we measure stroke outcomes, such as needing to go into long-term care, or having more disability.
StrokeGoRed is short for Stroke in Women: Growing Opportunities to Realize optimal Evaluation, Diagnosis, and outcomes. So, we really wanted to come together and look at how women and men experience stroke throughout the entire continuum of care. We want to better understand what the differences are, how big they are, and how we can better individualize care.
What are some aspects of stroke care the network will look at?
Dr. Yu: There are several components. One is a discovery phase on understanding sex-specific risk factors. What should we be screening women for? What should women be aware of when they speak to their doctors, or when they think about their health?
There's also a descriptive phase where we're looking at outcomes reported by patients, and drilling down on certain symptoms including sleep, cognition, mental health and return to work. In this phase, we’ll be asking, how can we better support our patients? Or, where do we need more research to find better treatments or management strategies for these symptoms?
What are the advantages of this network approach to research?
Dr. Yu: Members of the network have so much expertise to advance knowledge on sex and gender differences and stroke. The funding allows us to ask questions in all the different areas.
It’s super exciting to be able to bring together the experts on minor stroke, acute stroke, imaging, rehab, patient reported outcomes, along with an Indigenous scholar, patient partners, and many more.
With all these people at the table, we have a really broad perspective and a lot of diverse views on the questions, within a very collaborative group.
How will the network tackle specific topics?
Dr. Yu: To give an example, the stroke rehab expert will be asking novel rehab questions, and within the network, they can seek input from the prevention side. They can say, “Let's develop our questionnaire and analyses together and look at how hospital-based care can influence rehab later.”
Why is it important for the network to include people with lived experience of stroke?
Dr. Yu: They have intimately experienced the continuum of care – which we, as clinicians and researchers within our own specific areas, have not.
They bring a lot of insight in helping us shape our questions, because we want to make sure that our questions matter to patients. They also bring insight as to how we go about the research. So, if we are developing a questionnaire, we want to make sure our questions are acceptable to patients.
What changes do you hope to see in the next five years as a result of this research?
Dr. Yu: We will have several scientific publications and presentations. We expect to be presenting new knowledge about sex and gender differences in stroke, whether it's about risk factors, how to better treat patients, how to reduce inequities in care, or imaging markers of subsequent brain health.
Taken together, I hope this will answer some questions about how to better individualize care for women with stroke in Canada, in our clinics, in our hospitals and in our rehab centres.
I hope we’ll be able to provide advice for clinicians to inform their practice, and for the public, to improve their perception and knowledge of stroke risk and risk factors.
What are you personally most excited about?
Dr. Yu: This work is going to positively shape clinical care and future questions and research in this field. I really think we will grow as clinicians and researchers.
I’m also really excited about our ability to build capacity and support future researchers in the area. We will be announcing an award competition for post-doctoral fellows who are working in the areas of sex and gender in stroke and stroke rehabilitation.
Plus, we're building collaborations and understanding and relationships with Indigenous communities, particularly those in Northern Manitoba. By developing understanding and trust, we're going to be able to support these communities to answer questions that they have about their health.
- Find out more about women’s research network of excellence
- Learn more about women’s unique risk factors for heart disease and stroke
