Canada’s Approach: Canadian Institutes of Health Research

Canada’s Approach: Canadian Institutes of Health Research Ian D Graham PhD June 28 th , 2008 Vice President, Knowledge Translation Portfolio Canadian Institutes of Health Research (CIHR)

Population 32.8 million

Canada’s health care system
a publicly funded health care system
an interlocking set of ten provincial and three territorial health insurance plans
the system provides access to universal, comprehensive coverage for medically necessary hospital and physician services
services are administered and delivered by the provincial and territorial (i.e., state or regional) governments, and are provided free of charge

Canada and health research funding
Health research funding organizations can be funded:
By the federal government
By provincial governments
By health charities and voluntary health organizations
Similarly, synthesis can be funded by the same array of organizations

CIHR:
is Government of Canada’s health research funding agency
supports 11,000 researchers and trainees
takes a problem-based and multidisciplinary approach to the health challenges facing Canadians
multi-faceted approach encompasses research in four areas: biomedical, clinical, health systems and services, population and public health
fosters commercialization, moving research discoveries from academic setting to the marketplace
allocates 94 cents of every dollar to fund Canadian health researchers
CIHR: Overview CIHR Mandate “ To excel, according to internationally accepted standards of scientific excellence, in the creation of new knowledge and its translation into improved health for Canadians, more effective health services and products and a strengthened Canadian health care system…”

CIHR: The Organization
CIHR reports to Parliament through the Minister of Health
CIHR President – Dr. Alain Beaudet
Governing Council
Voluntary body that oversees organization
Comprises of 20 Canadians representing a wide range of backgrounds and disciplines who have been appointed by Order in Council to renewable three-year terms
Deputy Minister of Health ( ex-officio and non-voting member)
3 Vice-Presidents & CFO report to President
13 Scientific Directors: one for each Research Institute

CIHR Approach 13 Research Institutes Population and Public Health Gender and Health Aboriginal Peoples’ Health Health Services and Policy Research Genetics Infection and Immunity Nutrition, Metabolism and Diabetes Cancer Research Neurosciences, Mental Health and Addiction Aging Musculoskeletal Health and Arthritis Circulatory and Respiratory Health Human Development, Child and Youth Health

Knowledge Translation at CIHR
KT is a dynamic and iterative process that includes synthesis , dissemination, exchange and ethically sound application of knowledge to improve the health of Canadians, provide more effective health services and products and strengthen the health care system.
This process takes place within a complex system of interactions between researchers and knowledge users which may vary in intensity, complexity and level of engagement depending on the nature of the research and the findings as well as the needs of the particular knowledge user .

CIHR and Synthesis
CIHR funds the Canadian Cochrane Collaboration
Institutes and “corporate” co-fund to the tune of $1.5 million per year
Currently in year 3 of a 5 year commitment
Why do we do this?
Synthesis is part of our definition of knowledge translation
Belief in the benefits to society of synthesized research results
Advantage of leveraging the international Cochrane network
Health information infrastructure needs to be supported

CIHR and Synthesis
Several funding mechanisms for traditional systematic reviews as well as other forms of synthesis
Twice a year applicants can apply to conduct a systematic review through our open grants competition (KTE panel)
Can also apply twice a year to the Knowledge Synthesis funding opportunity
Funds all forms of syntheses
Requires a knowledge user co-applicant

CIHR and Rapid Response Syntheses
New development: “Evidence on Tap”
Two components:
Best Brain Consultations :
Provincial decision makers will submit a priority topic for which they need immediate and high-level advice then CIHR brings together 3-4 of the “best brains” around a table for a one day “in camera” consultation
Expedited Research Synthesis : Provincial decision makers submit a priority synthesis topic - CIHR will pre-screen researchers for “expedited research synthesis status” and then invite the pre-screened researchers to apply for the project (have had past success with wait times rapid syntheses)

Other Syntheses Response Capabilities
Syntheses and health technology assessments are also be funded by other federal as well as provincial agencies:
Alberta Heritage Foundation for Medical Research AHFMR
Newfoundland and Labrador Centre for Applied Health Research NLCAHR
The Ontario Ministry of Health and Long Term Care has funded synthesis unit at St Michael’s Hospital (Toronto)
Provincial HTA agencies

Syntheses and HTA in Canada
Three AHRQ evidence-based practice centres in Canada
McMaster, University of Ottawa and University of Alberta
Also have capacity to conduct policy syntheses:
Canadian Health Services Research Foundation CHSRF
Canadian Population Health Initiative CPHI
Government departments and agencies do this as well, e.g. Status of Women in Canada, Industry Canada, Health Canada

The Canadian Approach to Synthesis
First observation: there is a lot of activity in Canada
Range from full Cochrane-style systematic reviews and HTAs to rapid reviews and policy syntheses
Multiplicity of approaches by different stakeholders (federal, provincial, government agencies) suggests synthesis considered a valuable resource
Second observation:
With this eclectic approach to synthesis in Canada comes a possibility of collaboration – of mapping out areas in need of synthesis and sharing the results

Health Syntheses and HTA in Canada
Third observation:
Syntheses “driven” by knowledge users have the greatest potential to influence decision making
Knowledge users can drive the priority setting exercise – and should
Fourth observation:
The Canadian hybrid approach comprising the Canadian Cochrane Collaboration and Network, health technology agencies, CIHR syntheses funding opportunities, and other groups exemplifies a viable decentralized model

[email_address] http://www.cihr-irsc.gc.ca/e/29418.html Thank you

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