Jump in with SKIP Impact: Dr. Mohamed Eltorki
Dr. Mohamed Eltorki’s latest research has the potential to change the way children with acute abdominal pain are treated in emergency rooms.
“For children who come into the ER with acute abdominal pain and are suspected of having appendicitis, what is the best analgesic to give?” he asks. “I find the literature lacking on this and opioids were not necessarily effective.”
Dr. Eltorki is an Assistant Professor of Pediatric Emergency Medicine at McMaster University Children’s Hospital. His new grant is for a feasibility trial that will compare ketorolac, a nonsteroidal anti-inflammatory drug used for short-term pain management, to morphine (opioid) pain relief.
“We want to know: Is ketorolac just as good as morphine but with fewer side effects? So, we can either avoid or reduce the use of opioids in kids, in light of the current opioid crisis.”
Dr. Samina Ali, SKIP’s Stollery Hub Lead, is one of Dr. Eltorki’s co-investigators, and recommended he take advantage of Jump in with SKIP, a program that helps researchers develop knowledge mobilization plans for their grant proposals. SKIP also provides a letter of support, as well as practical help building patient inclusion and engagement.
“I was in the process of developing a knowledge mobilization plan, but my understanding of knowledge mobilization was superficial,” Dr. Eltorki explains.
According to him, SKIP’s involvement was pivotal to the development of his grant proposal, not only making the language accessible to patients and families but influencing the design of the study itself.
“Having SKIP as a partner on the grant goes a long way, and we’ll also have them as a partner in knowledge mobilization once the project is completed.”
One of the most valuable pieces of advice from SKIP? To involve a patient or parent partner in a significant role. This led Dr. Eltorki to invite Karen Beattie, a parent partner and member of the Family Hospital Advisory Council, to join the team as a co-investigator. Beattie reviewed the proposal and helped rewrite the summary.
“It was very different from the original,” says Dr. Eltorki. “Even though we don’t think we are talking in medical terminology and jargon, we do. Some of the things we say in the lay summary — like ‘moderate or severe pain’ or ‘multicentre study vs. single centre’— sound pretty straightforward to me but are not accessible enough for many children and families.
“They were changed by Karen to ‘big pain’ or ‘large amount of pain’ and ‘large study vs. small study’. She highlighted what parents need to know, which is the impact of the study on their child and their community and how this relates to the opioid crisis — instead of the type of outcome measures we are using.”
Dr. Eltorki also rethought his research design as a result of his consultation with SKIP. He started out planning to try ketorolac vs. placebo, then morphine as rescue therapy. “But my partners advised me that this might not be acceptable for study participants who are in pain. I changed the trial design and adapted it to be family- and child-friendly while not giving away too much from the scientific rigour of the study.”
“Research is not a one-person show anymore,” he adds. “Knowledge mobilization is no longer just about publishing the results and presenting them at niche conferences — it’s much more."
“Successful researchers are the ones who design methodologically-sound studies that answer their research questions, take the new knowledge generated, and translate it to implement change that is measurable and impactful to patients at the bedside.
“This requires a large degree of coordination, networking with national and international collaborators, and partnerships with non-traditional partners who bring lived experiences to the research program, like caregivers, parents, and children.”
