
DR. STEVEN MARC FRIEDMAN
EMERGENCY MEDICINE BIOGRAPHY
Dr. Steven Marc Friedman is Attending Physician (Emergency Medicine) at University Health Network Emergency Medicine, Clinician Investigator at the Toronto General Hospital Research Institute, and Associate Professor, DFCM, Faculty of Medicine, University of Toronto. He completed his medical training at the University of Toronto and McMaster University, and an MPH at Harvard University, where he focused on health care management and research methods.
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Dr. Friedman is Director of STAR-EM, the Summer Teaching and Research in Emergency Medicine Program at University Health Network, Toronto. He was the founding Research Director of UHN Emergency Medicine. His scholarly work has been cited by Statistics Canada, The U.S. Centers for Disease Control and Prevention (CDC), and the World Health Organization (WHO).
Dr. Friedman's core research interests and scholarly publications relate to barriers to care in the emergency department (ED), cycling safety and injury prevention, and using the emergency department as a platform to improving public health. The overarching operational aim of his work has been to develop an emergency medicine program that mentors young physician researchers in emergency medicine.
Research Synopsis:
Projects relating to cycling safety and injury prevention have included a control-matched survey of Toronto bike-share users exploring cycling safety practices, barriers to helmet use, and impressions regarding proposed remedies to increase helmet use; a multi-centered collaboration exploration cycling injuries and the built environment; a quasi-experimental non-equivalent groups study designed to evaluate the health impacts of PBSPs (public bike share programs); a scoping review of non-legislative interventions to promote helmet use in adult cyclists; a trial to promote helmet use in injured cyclists using principles of behavioral economics; and an evidence-based review of Canadian cycling injuries and safety policy, leading to co-authorship of the Canadian Association of Emergency Physicians Position Paper on Cycling Safety.
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The COVID-19 pandemic inspired him to undertake SAVE-CoV - a pilot study of saliva assay for viral examination of SARS-CoV-2, and to publish a scoping review of interventions to overcome limited supply of masks during epidemics that was downloaded over 8000 times. Dr. Friedman is Co-I and UHN Emergency Medicine Lead on GENCOV, which aims to identify patient factors which affect COVID-19 severity and outcomes. Dr. Friedman is Co-I and UHN Emergency Medicine Lead on the VIRCAN evaluation of birth cohort hepatitis C screening in emergency departments and high risk community settings in Toronto. He was Co-I and Emergency Medicine Lead on Seamless Care Optimizing the Patient Experience (SCOPE) – a multidisciplinary, primary care practice-based Intervention to reduce ED visits and hospitalization for complex patients.
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Dr. Friedman’s research interests have also focused on quality and barriers to care in the emergency department (ED). Typical projects focusing on physician-related barriers to care have included a Canada-wide study of physician compliance with notifiable disease reporting requirements; a Canada-wide study of resident perceptions regarding personal on-call and procedural competence, adverse events and reporting these to supervisors; a study of interruptions and communication barriers in the emergency department; and clinical impact of discrepant diagnostic imaging reporting and reinterpretation. Patient-focused studies have explored patients who leave the ED without being seen; health-consumer perceptions regarding queue-jumping and preferential access; barriers to patient follow-up with specialty clinics after discharge from the ED; patient dignity and privacy in the ED; and patient comprehension and compliance with ED discharge instructions in a multicultural health setting.
RESEARCH INTERESTS
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Barriers to Care
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Health Services
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Cycling Safety
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Injury Prevention
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Quality Improvement & Patient Safety
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ED Administration
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Clinical Practice
TOP CITATIONS
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Gregory Morgan, Chun Yiu Jordan Fung, Anne-Claude Gingras, Karen Colwill, Laurent Briollais, Erika Frangione, Dawit Wolday, Freda Qi, Adrian Pasculescu, Melanie Delgado-Brand, Genevieve Mailhot, Tulunay Tursun, Saranya Arnoldo, Erin Bearrs, Alexandra Binnie, Bjug Borgundvaag, Selina Casalino, Sunakshi Chowdhary, Marc Dagher, Luke Devine, Lloyd T. Elliott, Steven M. Friedman, Zeeshan Khan, Elisa Lapadula, Georgia MacDonald, Tony Mazzulli, Shelley L McLeod, Chloe Mighton, Konika Nirmalanathan, David Richardson, Seth Stern, Ahmed Taher, Juliet Young, Jordan Lerner-Ellis, Jennifer Taher. Characterizing the SARS-CoV-2 antibody response and associations with patient factors: Serological profiling of participants enrolled in the GENCOV study. Clinical Biochemistry, Clinical Biochemistry, Volume 135, 2025, 110859, ISSN 0009-9120. Coauthor
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Peter Kavsak, Nicholas Mills, Lorna Clark, et al. Assay Precision and Risk of Misclassification at Rule-Out Cutoffs for High-Sensitivity Cardiac Troponin. Canadian Journal of Cardiology, Volume 40, Issue 11, 2102 – 2105. Nov 2024. Coauthor
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Selina Casalino, Chloe Mighton, Marc Clausen, Erika Frangione, Navneet Aujla, Georgia MacDonald, Juliet Young, Chun Yiu Jordan Fung, Gregory Morgan, Saranya Arnoldo, Erin Bearss, Alexandra Binnie, Bjug Borgundvaag, Sunakshi Chowdhary, Marc Dagher, Luke Devine, Steven Marc Friedman, Limin Hao, Zeeshan Khan, William Lane, Elisa Lapadula, Matthew Lebo, David Richardson, Seth Stern, Lisa Strug, Ahmed Taher, Elena Greenfeld, Abdul Noor, Hanna Faghfoury, Jennifer Taher, Yvonne Bombard, Jordan Lerner-Ellis, Brendan Dickson, Anne-Claude Gingras, Lee W. Goneau, Tony Mazzulli, Allison McGeer, Shelley McLeod, Trevor J. Pugh, Jared Simpson. A Genomic Counseling Model for Population-Based Sequencing: A Pre-Post Intervention Study. Genetics in Medicine. Volume 26, Issue 12, 2024. https://doi.org/10.1016/j.gim.2024.101272. Coauthor
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Morgan Gregory, Casalino Selina, Chowdhary Sunakshi, Frangione Erika, Fung Chun Yiu Jordan, Lapadula Elisa, Arnoldo Saranya, Bearss Erin, Binnie Alexandra, Borgundvaag Bjug, Briollais Laurent, Dagher Marc, Devine Luke, Friedman Steven M, Khan Zeeshan, Mighton Chloe, Nirmalanathan Konika, Richardson David, Stern Seth, Taher Ahmed, Wolday Dawit, Lerner-Ellis Jordan, Taher Jennifer. COVID-19 vaccine reactogenicity among participants enrolled in the GENCOV study. Vaccine, 2024. ISSN 0264-410X. https://doi.org/10.1016/j.vaccine.2024.03.030. Coauthor
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COVID-19 Host Genetics Initiative. A second update on mapping the human genetic architecture of COVID-19. Nature. 2023 Sep;621(7977):E7-E26. doi: 10.1038/s41586-023-06355-3. Epub 2023 Sep 6. PMID: 37674002; PMCID: PMC10482689. Collaborator
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Kavsak PA, Clark L, Arnoldo S, Lou A, Shea JL, Eintracht S, Lyon AW, Bhayana V, Thorlacius L, Raizman JE, Tsui A, Djiana R, Chen M, Huang Y, Haider A, Booth RA, McCudden C, Yip PM, Beriault D, Blank D, Fung AWS, Taher J, St-Cyr J, Sharif S, Belley-Cote E, Abramson BL, Friedman SM, et al. Imprecision of high-sensitivity cardiac troponin assays at the female 99th-percentile. Clin Biochem. 2024 Mar;125:110731. doi: 10.1016/j.clinbiochem.2024.110731. Epub 2024 Feb 13. PMID: 38360198. Coauthor.
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Keerat Grewal, Clare L. Atzema, Rinku Sutradhar, Winnie Yu, Lucas B. Chartier, Steven M. Friedman, Megan Landes, Bjug Borgundvaag, Shelley L. McLeod. Hospital admission from the emergency department for selected emergent diagnoses during the first year of the COVID-19 pandemic in Ontario: a retrospective population-based study. CMAJ OpenSep 2023, 11 (5) E969-E981; DOI: 10.9778/cmajo.20230017. Coauthor
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Morgan G, Casalino S, Chowdhary S, Frangione E, Fung CYJ, Haller S, Lapadula E, Scott M, Wolday D, Young J,Arnoldo Saranya, Aujla Navneet, Bearss Erin, Binnie Alexandra, Bombard Yvonne, Borgundvaag Bjug, Briollais Laurent, Dagher Marc, Devine Luke, Faghfoury Hanna , Friedman Steven M, et al. Characterizing Risk Factors for Hospitalization and Clinical Characteristics in a Cohort of COVID-19 Patients Enrolled in the GENCOV Study. Viruses. 2023; 15(8):1764. https://doi.org/10.3390/v15081764. Coauthor
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Gregory Morgan, Laurent Briollais, Marc Clausen, Selina Casalino, Chloe Mighton, Sunakshi Chowdhary, Erika Frangione, Chun Yiu Jordan Fung, Saranya Arnoldo, Erin Bearss, Alexandra Binnie, Bjug Borgundvaag, Marc Dagher, Luke Devine, Steven M Friedman, et al. Public knowledge of SARS-CoV-2 serological and viral lineage laboratory testing and result interpretation: A GENCOV study cross-sectional survey. Clinical Biochemistry, 2023,110607, ISSN 0009-9120, https://doi.org/10.1016/j.clinbiochem.2023.110607. Coauthor
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Kavsak PA, Clark L, Arnoldo S, Lou A, Shea JL, Eintracht S, Lyon AW, Bhayana V, Thorlacius L, Raizman JE, Tsui AKY, Djiana R, Chen M, Huang Y, Booth RA, McCudden C, Lavoie J, Beriault DR, Blank DW, Fung AWS, Hoffman B, Taher J, St-Cyr J, Yip PM, Belley-Cote EP, Abramson BL, Borgundvaag B, Friedman SM, et al. Analytic result variation for high-sensitivity cardiac troponin: Interpretation and consequences. Can J Cardiol. 2023 Apr 22:S0828-282X(23)00361-6. doi: 10.1016/j.cjca.2023.04.013. Epub ahead of print. PMID: 37094710. Coauthor
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Casalino S, Frangione E, Chung M, MacDonald G, Chowdhary S, Mighton C, Faghfoury H, Bombard Y, Strug L, Pugh TJ, Simpson J, Arnoldo S, Aujla N, Bearss E, Binnie A, Borgundvaag B, Chertkow H, Clausen M, Dagher M, Devine L, Di Iorio D, Friedman SM et al. Genome screening, reporting, and genetic counseling for healthy populations. Hum Genet. 2022 Nov 4:1–12. doi: 10.1007/s00439-022-02480-7. Epub ahead of print. PMID: 36331656; PMCID: PMC9638226. Coauthor
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Biondi MJ, Hirode G, Capraru C, Vanderhoff A, Karkada J, Wolfson-Stofko B, Smookler D, Friedman SM, Bates K, Mazzulli T, Juan JV, Shah H, Hansen BE, Feld JJ, Janssen H. Birth cohort hepatitis C antibody prevalence in real-world screening settings in Ontario. Can Liver J. 2022 Aug 16;5(3):362-371. doi: 10.3138/canlivj-2021-0036. PMID: 36133900; PMCID: PMC9473558. Coauthor
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Varriano B, Porplycia D, Friedman SM. Unhelmeted Injured Cyclists in a Canadian Emergency Department: Cycling Behavior and Attitudes Towards Helmet Use. Inquiry. 2022 Jan-Dec;59:469580221083276. doi: 10.1177/00469580221083276. PMID: 35357244; PMCID: PMC8977697. Senior Responsible Author
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Taher J, Mighton C, Chowdhary S, Friedman SM et al .Implementation of serological and molecular tools to inform COVID-19 patient management: protocol for the GENCOV prospective cohort study. BMJ Open 2021;11:e052842. doi: 10.1136/bmjopen-2021-052842. Coauthor
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Chartier. L, Masood S, Choi J, McGovern B, Casey S, Friedman SM et al. A blueprint for building an emergency department quality improvement and patient safety committee. Canadian Journal of Emergency Medicine. Can J Emerg Med (2022). https://doi.org/10.1007/s43678-021-00252-2. Co-Principal author
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Taher J, Mighton C, Chowdhary S, Friedman SM et al .Implementation of serological and molecular tools to inform COVID-19 patient management: protocol for the GENCOV prospective cohort study. BMJ Open 2021;11:e052842. doi: 10.1136/bmjopen-2021-052842 Coauthor
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Kirubarajan A, Khan S, Got T, Yau M, Bryan J, Friedman SM. Mask shortage during epidemics and pandemics: a scoping review of interventions to overcome limited supply BMJ Open 2020;10:e040547. doi: 10.1136/bmjopen-2020-040547. Senior Responsible Author
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STAR-EM: Summer Training and Research in Emergency Medicine: Design and evaluation of an innovative summer research program for medical students. SM Friedman, D Porplycia. Can J Emerg Med, July 2020 pp. 519-522 1-4. doi:10.1017/cem.2020.366 Principal Author
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D Wiercigroch D, M Ben-Yakov, SM Friedman. Regional anesthesia in Canadian emergency departments: emergency physician practices, perspectives and barriers to use. Can J Emerg Med 22(4) July 2020 pp 499-503 doi:10.1017/cem.2020.51. Senior Responsible Author
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Hosford K, Winters M, Gauvin L, Camden A, Dubé AS, Friedman SM, Fuller D. Evaluating the impact of implementing public bicycle share programs on cycling: the International Bikeshare Impacts on Cycling and Collisions Study (IBICCS). International Journal of Behavioural Nutrition and Physical Activity. 2019. Coauthor
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Tara O'Brien, Noah Ivers, Onil Bhattacharyya, Andrew Calzavara, Laura Pus, Geetha Mukerji, Steven Friedman, Howard Abrams, Ian Stanaitis, Gillian Hawker, Pauline Pariser. A multifaceted primary care practice-based intervention to reduce ED visits and hospitalization for complex medical patients: a mixed methods study. PLOS ONE. Jan 2, 2019. Coauthor
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Friedman, SM., Al-Den, A., & Porplycia, D. (2018). P051: Management of subcutaneous abscesses in the emergency department. CJEM, 20(S1), S74-S75. doi:10.1017/cem.2018.249. Senior Responsible Author
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Friedman SM, Adamson M, Cleiman P, Arenovich T, Oleksak K, Ta R, Reiter K, Mohabir IM. Helmet wearing practices and barriers to use in Toronto bike-share (Bixi) users: A case-control study. Can J Emerg Med. June, 2015. 18(1):1-9. Principal Author
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Cripton PA, Shen H, Brubacher JR, Chipman M, Friedman SM, Harris MA, Winters M, Reynolds CCO, Cusimano MD, Babul S, Teschke K. Severity of urban cycling injuries and the relationship with personal, trip, route and crash characteristics: Analyses using four severity metrics. BMJ Open 2015; 5:e006654. Coauthor
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Teschke K, Frendo T, Shen H, Harris MA, Reynolds CCO, Cripton PA, Brubacher JR, Cusimano MD, Friedman SM, Hunte G, Monro M, Vernich L, Babul S, Chipman M, Winters M. Bicycling crash circumstances vary by route type: A cross-sectional study. BMC Public Health 2014. Nov 22; 14:1205. Coauthor
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Fuller, D., Gauvin, L., Dubé, A-S., Winters, M., Teschke, K., Russo, E. T., Camden, A., Mee, C., Friedman, S. M. (2014). Evaluating the impact of environmental interventions across 2 countries: The International Bikeshare Impacts on Cycling and Collisions Study (IBICCS) Study protocol. BMC Public Health. 2014 Oct 25;14(1):1103 Coauthor
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Letovsky E, Rowe B, Friedman SM, Snider C, Sullivan E. CAEP Position Statement: Improving bicycle safety in Canada. Canadian Journal of Emergency Medicine. June 2014. 16(4) DOI 10.2310/8000.2014.201402. Coauthor
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Friedman SM, Vallipuram J, Baswick B. Incidental findings of elevated random plasma glucose in the ED as a prompt for outpatient diabetes screening: a retrospective study. BMJ Open 2013;3:e003486, December 18, 2013 (10.1136/bmjopen-2013-003486). Principal Author & Senior Responsible Author
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Friedman SM, Merman E, Chopra A. Clinical Impact of diagnostic imaging discrepancy by radiology trainees in an urban teaching hospital emergency department. Int J Emerg Med. 2013 July 16;6(1):24. Senior Responsible Author
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Harris M.A., Reynolds C.C.O., Winters M, Cripton P.A., Shen H., Chipman M., Cusimano M.D., Babul S., Brubacher J.R., Friedman S.M., Hunte G., Monro M., Vernich L., Teschke K. Comparing the effects of infrastructure on bicycling injury at intersections and non-intersections using a case-crossover design. Injury Prevention. Published Online first: 14 Feb 2013. Coauthor
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Teschke K, Harris MA, Reynolds CCO, Winters M, Babul S, Chipman M, Cusimano MD, Brubacher J, Friedman SM, Hunte G, Monro M, Shen H, Vernich L, Cripton PA. Route infrastructure and the risk of injuries to bicyclists: A case-crossover study. American Journal of Public Health 2012, Oct 18. Coauthor
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Winters M, Babul S, Becker HJEH, Brubacher JR, Chipman M, Cripton PA, Cusimano MD, Friedman SM, Harris MA, Hunte G, Monro M, Reynolds CCO, Shen H, Teschke K. Safe cycling: How do risk perceptions compare with observed risk? Canadian Journal of Public Health 2012;103:S42-S47. Coauthor
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Teschke K, Brubacher JR, Friedman SM, Cripton PA, Harris MA, Reynolds CCO, Shen H, Monro M, Hunte G, Chipman M, Cusimano MD, Smith Lea N, Babul S, Winters M. Personal and trip characteristics associated with safety equipment use by injured adult bicyclists: A cross-sectional study. BMC Public Health 2012; 2012 Sep 11;12(1):765. Coauthor
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Friedman S, Guo R. Invited Commentary: In Support of a Journey of Metacognition. Academic Emergency Medicine. 2011 May;18(5):549-50. Principal Author
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Friedman S, Sowerby RJ, Guo R, Bandiera G. Emergency resident perceptions regarding competence, adverse events and reporting to supervisors: a nationwide survey. Can. J. Emerg Med. 2010;12(6): 491-499 Principal Author
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Friedman S Vergel de Dios J, Hanneman, K. Noncompletion of referrals to outpatient specialty clinics among patients discharged from the emergency department: a prospective cohort study. CJEM. July 2010;12(4):325–330. Senior Responsible Author
Read more about Dr. Friedman’s research here: ​
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Connect with Dr. Friedman
Dr. Steven Marc Friedman
@emergmd