Merrick Zwarenstein, MBBCh, MSc, PhD
Professor, Department of Family Medicine, Epidemiology & Biostatistics
Office: PHFM 2141
Merrick Zwarenstein is a health services researcher, focussed on research methodology, specifically randomized trials of complex interventions in primary care. He has trained at the Karolinska Institute in Sweden (PhD), the London School of Hygiene in the UK (MSc in Community Health) and Witwatersrand University Medical School in South Africa (Medical degree and MSc in Microbiology). He worked briefly as a family doctor in Cape Town, South Africa but has not been clinically active for a long time.
He has helped to bring together partners from over a dozen countries to promote the conduct and use of health systems research, especially pragmatic randomised trials in healthcare decision-making. As well as supporting the development of many research projects, he also led the production of a number of tools for health services researchers, including web based training tools for randomized trials and two new and widely used guidelines for the design and the reporting of pragmatic randomized trials. These have been cited over 1000 times and are widely regarded as the standard descriptions of the pragmatic approach to randomized trial design.
He developed new uses for routine administrative databases in Ontario for large-scale implementation and cluster randomized trial evaluation of quality of care interventions, resulting in some of the world’s largest randomized trials, in primary care and community care. For example, four of these randomized trials evaluate amongst all Ontario primary care physicians the effects of a knowledge translation intervention, showing that printed educational materials do not improve adherence to evidence based care guidelines.
He has studied nurse-physician collaboration and routinised patient care, in South Africa and in Canada, as a threat to safety and quality of hospital care, and efficiency of resource use. He has helped to quantify this problem and led systematic reviews of effects of interventions for collaboration. He has co-authored a book on Teamwork in the Health professions. He has also worked in the development of new approaches to primary care provider support and education for HIV/AIDS and ART care, which in expanded form, are now being implemented as South African national policy.
He is currently supervising one Epidemiology and Biostatistics MSc student, who is analysing a randomized trial; one PhD Epidemiology/Computer Science student who is developing and testing artificial intelligence tools in primary care, and one post-doctoral student who is evaluating the development and implementation of a Learning Health System (a strategy for outcome improvement and engagement) in a publicly funded primary care system focussing on marginalized communities.