Lawrence Richer, MD, MSc

Professor and Vice Dean Research (clinical), Faculty of Medicine & Dentistry - Office of Research Admin

Contact

Professor and Vice Dean Research (clinical), Faculty of Medicine & Dentistry - Office of Research Admin
Email
lricher@ualberta.ca
Phone
(780) 492-0051
Address
2J2.04 University of Alberta Hospital
8440 112 Street
Edmonton AB
T6G 2B7

Overview

Area of Study / Keywords

Pediatric Neurology Autonomic Disorders Clinical Trials Real-World Evidence


About

My clinical and research interests are focussed on three interrelated areas: (1) evaluation of functional changes in the autonomic nervous system (ANS) in children with autonomic disorders; (2) development or evaluation of treatment strategies for children with autonomic disorders or headache including digital health interventions; and (3) the application real-world evidence and data-enabled algorithms in child health.

I also serve as the Vice-Dean Research (clinical) for the Faculty of Medicine and Dentistry, Center Director of the Northern Alberta Clinical Trials and Research Center (NACTRC; nactrc.ca), and Interim Division Director for Pediatric Neurology at the University of Alberta.


Research

Postural Orthostatic Tachycardia Syndrome in Children

The autonomic nervous system dynamically responds to changes around and within us. From temperature changes to changes in position, it is constantly adjusting blood pressure, heart rate, the size of our pupils, and whether we sweat or not - to name just a few. The autonomic nervous system touches all aspects of our body and so can be very difficult to understand when things go wrong.

Sometimes the system becomes dysregulated and this is one way to understand Postural Orthostatic Tachycardia Syndrome or POTS. In this condition, a person's heart rate increases dramatically when they are standing and they often feel lightheaded or unsteady. When this happens for weeks and months, they often begin to feel fatigued and develop other symptoms like headaches. It can be a very difficult disorder to live with and is often misunderstood by others. How could so many things go wrong all at the same time? That is what happens when the autonomic nervous system becomes dysregulated in POTS.

My research interests focus on better understanding POTS using traditional measures of autonomic reflexes like heart rate and blood pressure response to changes in position. I also use advanced MRI techniques to study brain blood flow in POTS. My overall aim is to better understand the underlying mechanisms in POTS. I am also very interested in developing better treatment strategies for POTS - including digital health interventions.

Real-World Evidence and Digital Health

The digitizing of our world and health systems have opened opportunities to use data and digital devices in ways that were not previously possible. For example, can routinely collected health data also be used to understand how treatments are working in real life - not just under the ideal conditions of a clinical trial. I work with a team of data analysts to make sense of the data we have available today and the data we will have available tomorrow - also known as Real-World Evidence (RWE).

Digital health is a broad new area that includes data-enabled innovation as well as digital devices that help patients with their health conditions. Digital health is expected to be an increasingly important area in health innovation, but evidence will need to be provided to support the use of these technologies. My interests are in working with innovators and applying what I know about RWE or clinical trials to help bring these innovations to patients.

Publications

Health resource utilization and cost before versus after initiation of second-generation long-acting injectable antipsychotics among adults with schizophrenia in Alberta, Canada: a retrospective, observational single-arm study

Author(s): Wong KO, Klarenbach SW, Martins KJB, Chue P, Dursun SM, Snaterse M, Guigue A, So H, Luu H, Vu K, Richer L
Publication Date: 7/2/2022
Volume: 22
Issue: 1
Page Numbers: 444
DOI: 10.1186/s12888-022-04075-y

A randomized trial of ketorolac and metoclopramide for migraine in the emergency department

Author(s): Richer LP, Ali S, Johnson DW, Rosychuk RJ, Newton AS, Rowe BH
Publication Date: 6/7/2022
Volume: 62
Issue: 6
Page Numbers: 681-9
DOI: 10.1111/head.14307

A novel preference-informed complementary trial (PICT) design for clinical trial research influenced by strong patient preferences

Author(s): Ali S, Hopkin , Poonai N, Richer L, Yaskina M, Heath A, Klassen TP, McCabe C on behalf of the KidsCAN PERC Innovative Pediatric Clinical Trials No OUCH Study Group & the KidsCAN PERC Innovative Pediatric Clinical Trials Methods Core
Publication Date: 3/12/2021
Volume: 22
Issue: 206
DOI: 10.1186/s13063-021-05164-1