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HALL, STEPHEN F.
 Stephen Hall, MSc., MD, FRCSC
Email: sfh@post.queensu.ca
Office Phone: 613-533-6000, ext. 78535
· Member, Division of Cancer Care and
Epidemiology, Cancer Research Institute at
Queen's University
· Otolaryngology/ Head and Neck Surgery
· CIHR New Investigator Program
· Professor, Department of Oncology, Division of
Surgical Oncology, Queen's University
Please click here to view Publications
Please click here to view Team Members
Dr. Hall is an an Otolarygologist/Head and Neck Surgeon with an MSc in Clinical Epidemiology. His research interests include treatment variation/treatment outcome and the use of high quality databases to describe the relationship between treatment and outcomes in head and neck cancer. Dr. Hall is currently supported by the New Investigator program of CIHR.
Research as Principal or Co-Investigator
Controversy in Differentiated Thyroid Cancer: “Can 75% of Surgeons be Wrong?” PI: Hall, SF.
In the absence of randomized clinical trials, population-based research can be used to answer fundamental questions on treatments and effectiveness. In this study we will review the pathology reports of over 3500 patients with differentiated thyroid cancers from 1990 to 2002 across Ontario. This clinical information will be augmented with electronic data (demography, other treatments and outcomes) and clinical data (select operative records) to create a complete dataset of variables that can be used to approach questions with an unbiased methodology. A survey of thyroid surgeons will also be also performed in an attempt to understand what influences clinical decisions in the absence of evidence.
This project will assess the variation in overall management and the effectiveness of treatment policies for all patients but will focus on the management of small tumors where the controversy is greatest and the evidence is most lacking. When asked for evidence supporting aggressive surgical management for patients with known low risk disease, a prominent thyroid expert quoted the results of a national survey that showed 75% of patients with early stage disease had total thyroidectomy and simply replied, “Can 75% of surgeons be wrong?” As small tumors make up almost all of the cases responsible for the seeming increasing incidence of thyroid cancer and as the natural history of small tumors is unknown, the need for evidence for surgeons, patients and providers is becoming more urgent.
Tough choices: the treatment of cancer of the hypopharynx. PI: Hall, SF; Co-PI: Groome PA. Canadian Institutes of Health Research, $373,944, 2003-2006.
Head and neck cancer represents approximately 5% of all cancers with the hypopharynx site being the least common of the major head and neck sites. Cancer of the hypopharynx is unique in oncology because there has not been, and it is unlikely that there will be, randomized trials on the established treatments utilized in cancer treatment centers in Ontario. Cancer of the hypopharynx has the worst prognosis of all the head and neck sites. When treating a disease with such a poor prognosis, patients and oncologists rely on evidence to make difficult decisions about complex treatments. Due to the current lack of evidence, we do not know the relative effectiveness of traditional treatments of radiotherapy, surgery or combined surgery with postoperative radiotherapy for this patient group.
Furthermore, when the true effectiveness of treatment is not known, practice varies. When we do not know our baseline outcomes, it makes it difficult to extrapolate the results of emerging treatments to specific patients. Additionally, when we do not know if equipoise exists, it is impossible to justify randomized clinical trials.
The objective of this project wat to provide evidence, in the absence of randomized trials, to enable physicians to make appropriate treatment recommendations, for treatment centers to develop guidelines and to provide information to patients making tough choices, across Ontario.
Early Detection, Treatment Variation and Treatment Delay in cancers of the oral cavity. PI: Groome PA. Co-I: Browman G, Hall SF, Irish J, Mackillop WJ, O'Sullivan B. Canadian Institutes of Health Research, $520,000, 2004-2007.
Translating the results of clinical trials of radiochemotherapy. PI: Mackillop WJ. Co-I: Brundage MD, Groome PA, Hall SF, Madarnas Y, Pater J, Browman G, et al. Ontario Cancer Research Network, $700,000, 2002-2005.
Can we use CIHI discharge separation data to assess comorbidity in head and neck cancer patients. PI: Hall SF. Queen's Clinical Teachers Grant 2004.
Are functional status and comorbidity independent predictors of survival? PI: Hall SF. Deering Fund, Kingston General Hospital 2002.
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Reviewed/Updated March 2009
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