Lawrence P Richer
Medicine & Dentistry-Pediatrics
University of Alberta
MD, MSc (Clinical Epidemiology)
Summary of research:
My research focusses on three interrelated areas: (1) evaluation of functional changes in the autonomic nervous system (ANS) in children with migraine, brain injury, and pediatric autonomic disorders in relation to clinical outcomes and novel therapeutic targets; (2) development or evaluation of therapeutic strategies for children in the above disorders; and (3) the integration of clinical and research informatics to support translational science, clinical trials, and health outcomes research. The ANS is a dynamic system responsible for the maintenance of a stable internal environment and to respond rapidly to external challenges or threats. Functional changes in the ANS are observed in disorders like migraine, brain injury, and other pediatric autonomic disorders. While initially adaptive, these changes over time may become maladaptive - often as the disorder becomes more chronic or with severe injury. Changes in the ANS may be predictive of undesirable clinical outcomes providing an early warning sign. A better understanding of these changes may also provide insight on the pathophysiologic mechanisms of the disorder and present novel therapeutic targets. However many of the medications frequently used in children to treat migraine or autonomic disorders for example, have not been tested in children - a problem that can no longer be tolerated. Children may metabolize medication differently or they may have side effects that are not observed in adults. In my research, I also aim to study therapeutic strategies commonly used in children or novel ones for their safety and efficacy in treating migraine, brain injury, and pediatric autonomic disorders. Assessing the safety and effectiveness of medications in the real world, however, can be challenging and sometimes cost prohibitive. The use of innovative clinical trial designs, pragmatic clinical trials, and informatics can overcome some of these challenges forming a third focus of my research and research administration interests. The integration of clinical and research informatics promises to bring efficiencies to the research enterprise and lead to improvements in patient care. Many obstacles in technology, policy, and process need to be addressed to realize this promise.