January 26, 2023
"My name is Dr. Grant Pagdin. I live in Kelowna British Columbia and my practice focuses on anti-aging and regenerative medicine. I have a specific interest in using PRP and stem cells for regenerative procedures. Principally the focus is on orthopedic issues, so tendons, ligaments, and joints. But also we address areas of cosmetic concern, like facial rejuvenation and scalp treatments for the stimulation of hair growth. I also do regenerative injections for sexual enhancement for both men and women. I started doing regenerative procedures back in 2013. Initially we were interested in getting some feedback from our patients as to how they were doing. And typically we would just ask them questions, what do you estimate has been your improvement? And they would give us sort of a percentage, oh, I feel 60% better.
More recently, we've taken an interest in tracking outcomes a bit more specifically than just asking patients subjectively how much better they feel.
How do you capture patient outcomes?
One of the issues that we faced initially when we made a decision to engage in some formal follow-up with symptom scores was actually get the patients to kind of buy in and participate. So the platform that we're using for gathering this data is very user friendly. We encourage the patients at the time that they enroll for a treatment of PRP to download an app that they can interact with. And the great thing is that my staff doesn't have to constantly be sending out reminders for our patients to complete these sorts of questions. The system is completely automated so that the reminders come to the patient automatically they fill in the data for us and the data comes to us directly for our analysis. So that we have been able to establish a really good percentage of participation amongst our PRP clients.
How will you use these data in your practice?
In terms of the reasons behind why we would be collecting this data and what we might be using it for? There's really three main areas that are important to me. Number one is I want to be able to have some actual objective numbers that I can share with prospective clients. And that way they can have a little bit better handle on exactly what I'm doing and what what kinds of outcomes I'm experiencing. The second area that I think is important for me is to be able to share some of my outcomes with my colleagues. Now we want to make sure that we're comparing apples with apples. So I make sure that my PRP for instance is concentrated at five times baseline. And so we're able to indicate the sorts of parameters around the intervention that we're doing and also share some of our outcomes data with like-minded colleagues. So in this way we could actually pull together some data that is much more powerful than just the data I'm collecting my own clinic. If there were other providers doing similar procedures, then we could say, well you know over the 200 or 300 cases that we have done together, these are the sorts of outcomes we're getting. Then the numbers start to become really very significant. And then the third important reason why I want to try to collect this data is that we are in a field that is increasingly facing regulatory oversight. And we know that you know Health Canada is particularly interested in regulating cells and biologic materials. So any use of stem cells, whether fat or bone marrow or any other sources are being classified as drugs. And the individual colleges of physicians and surgeons in each province are keeping a close eye on this field as well. So that I think that it behooves us to be acknowledging that these types of interventions are experimental in nature. We tell our patients that there's no guarantee as to the outcome, but we want to make sure that we are tracking outcomes to ensure that these procedures are being done safely and effectively.
How can interested colleagues learn more?
At this point in my practice, I have collected data on over 60 subjects for a variety of different indications and I am willing to share that data with my regenerative medicine colleagues. I would also encourage my colleagues to be collecting data of their own and sharing that as well because I think that's a very important way that we can really move this field forward. I think if we pool our efforts and and work together cooperatively then I think this field of regenerative medicine in Canada can really advance that by leaps and bounds. So I'd invite my colleagues to reach out and I'd be happy to give you some more information on just exactly what we're doing and share with you some of the data that I've accumulated to date."
March 28, 2023
Statistical Significance and Clinical Relevance are two important concepts in the field of medicine, and particularly in clinical research. Being a bit more specific, statistical significance refers to the likelihood that a result is not due to chance.
March 17, 2023
Real-world evidence (RWE) is valuable not only for regulatory compliance, clinical decision-making and tracking adverse events. It can also drive patient engagement, profitability and professional advancement.
January 27, 2023
In this newsletter, we summarize the work of leading physicians as they develop clinical decision support for common musculoskeletal pathologies. Through the quality improvement and pragmatic studies embedded in their Circles, those clinicians are generating sustained financial and professional value for themselves, and improving patient care, with minimum burden. Moreover, their Circles are often supported by industry.