Boris Sobolev
Relevant Thesis-Based Degree Programs
Affiliations to Research Centres, Institutes & Clusters
Great Supervisor Week Mentions
PhD studies are made easier with the mentorship and guidance of a great supervisor. I am fortunate to work with Boris Sobolev @sobbor who never ceases to challenge and expand my thinking about our field of health services research. #greatsupervisor @UBCGradSchool @ubcspph
@ubc A PhD student can have no better supervisor than @sobbor. A brilliant academic, excellent teacher, and wise mentor. #greatsupervisor
Graduate Student Supervision
Doctoral Student Supervision
Dissertations completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest dissertations.
Background: In Canada, clinical need, resource allocation, and variation in demand determine how soon diagnosed ischemic heart disease are treated. Therefore, patients who require non-emergency revascularization by coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI) may find their procedures are delayed during periods of higher demand for cardiac care or reduced supply of hospital services. Research has shown that some patients who undergo CABG have health outcome benefits compared to those who have PCI and that some delays increase mortality. However, these studies did not account for PCI as an alternative treatment in the event of delay, nor did they consider disease progression or repeat revascularization as outcomes. Using health services research methods, I sought to establish if patients who had delayed CABG would have been better off instead undergoing timely PCI.Methods: I constructed a retrospective cohort consisting of 25,520 BC residents 60 years or older who underwent first-time non-emergency revascularization for angiographically-proven, stable left main or multi-vessel ischemic heart disease in British Columbia between January 1, 2001, and December 31, 2016. In three separate analyses, I compared patients who had delayed CABG with those who had timely PCI on the outcomes of 1) mortality, 2) cardiovascular disease progression, and 3) repeat revascularization. To adjust for between-group differences, I used inverse probability of treatment weights calculated from a propensity score model containing information on patient, structure, and process factors.Results: At three years follow-up, I found that patients who underwent delayed CABG had statistically better outcomes than timely PCI patients: lower mortality, slower cardiovascular disease progression, and fewer repeat revascularizations. Differences favouring delayed CABG were established early across all analyses and maintained throughout the study period.Conclusion: This work suggests that non-emergency patients who wish to receive CABG as their revascularization treatment will not see its benefits attenuated by delay and that PCI may not be suitable as an alternative treatment strategy. This dissertation adds to the knowledge of patients who receive revascularization care, physicians who deliver that care, and policymakers who plan for that care.
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Master's Student Supervision
Theses completed in 2010 or later are listed below. Please note that there is a 6-12 month delay to add the latest theses.
BACKGROUND. Across Canada there are substantial differences in the organization and evaluation of regional trauma systems. The design, evaluation and improvement of trauma care is frustrated by variable definitions of trauma systems, their primary objectives, and preferred performance measures. Tools that support decision makers in design and policy development are needed 2, 3. OBJECTIVE. This research aimed to 1) describe decision makers’ perceptions of the scope and objectives of ideally organized regional systems of trauma care and injury control in Canada, and 2) identify decision makers’ informational needs, specifically with regard to performance measures meaningful as actionable guidance for the design and policy development of regional systems of trauma care and injury control. METHODS. Based on a literature review of commonly used trauma system performance measures, a 35-question structured electronic survey was constructed, vetted by a reference group of experts, tested, and circulated over a 3-week period. The framing sample was 342 health administrators and trauma directors self-reported to be involved in decision making for organized injury management and control from all health regions of Canada. Survey responses were collated and descriptive statistics generated. RESULTS. There were 82 complete responses for a response rate of 24.0%. There was strong support for a broadly inclusive definition of a trauma system and for government oversight using standard performance indicators. Among responders there was near equal support, 41.2% and 31.7% respectively, for ensuring delivery of rapid and appropriate care (processes of care) and minimizing individual and societal burden of injury (outcomes of care) as the overarching drivers of system design. Of 24 listed performance indicators, measures of timeliness of care, preventable deaths, severity-adjusted hospital mortality, safety, satisfaction and access to care were preferred. CONCLUSION. This study showed that decision makers responsible for regional trauma systems in Canada believe that the ideal trauma system should coordinate multiple agencies influential in injury management around clear system objectives that address both major and minor trauma, and that government endorsed national standards are needed to ensure efficient and effective processes that reduce the individual and societal burden of injury.
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