Canada’s Approach: Canadian Institutes of Health Research

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  • 1. 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)
  • 2. Population 32.8 million
  • 3. 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
  • 4. 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
  • 5.
    • 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…”
  • 6. 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
  • 7. 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
  • 8. 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 .
  • 9. 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
  • 10. 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
  • 11. 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)
  • 12.  
  • 13. 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
  • 14. 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
  • 15. 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
  • 16. 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
  • 17.  
  • 18. [email_address] http://www.cihr-irsc.gc.ca/e/29418.html Thank you