History of RHSCIR
RHSCIR is largely the vision of two people: Canada's Man In Motion, Rick Hansen, and Dr. Marcel Dvorak a spine surgeon and researcher at Vancouver General Hospital and the University of British Columbia.
Rick Hansen has been a tireless advocate for spinal cord injury research since his epic two year, 40,000 km Man In Motion World Tour. When the concept of and the need for a Canadian spinal cord injury registry was promoted to him by Dr. Dvorak, Rick began championing the idea and provided funding through the Rick Hansen Foundation.
In 2004, through Rick and Dr. Dvorak’s efforts, RHSCIR was established with a significant investment from Health Canada. In 2008, RHSCIR became a program of the Rick Hansen Institute.
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Randomized clinical trials are expensive and lengthy, and they often exclude a participating institution from exploring other promising avenues. Sometimes there are tremendous variations in the performance of the procedure or in the techniques that are applied at different sites in a multi-centre clinical trial — particularly in surgical interventions. These variations cannot be controlled in a randomized clinical trial. An observational study, on the other hand, will give better information on the real world effectiveness of a specific procedure or technique.
When it comes to SCI in particular, there is general agreement today that differences in acute care approaches—for example, time to surgery and stabilization of an injury—seem to make a difference in long term outcomes. We believe there is no better way of assessing the benefits or adverse effects of different acute strategies than by using a registry, such as the Rick Hansen SCI Registry.
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Many people take for granted that the best evidence of the effectiveness of a particular treatment can be provided by a clinical trial. In some cases, this is no doubt true. However, an increasing number of experts believe that positive or adverse effects of various treatments or interventions can in many cases be better assessed by comprehensive cohort studies with high quality follow-up; the type of scrutiny that is possible within an empowered registry. At the same time, a registry allows researchers and clinicians to gain important statistical knowledge and discover best practices for diagnosis and determining outcomes and supports the management and staffing of hospital spinal cord injury programs.
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