Background – Strategy for Patient-Oriented Research
Canada already has strong foundation on which to build excellence in the domain of patient-oriented research; including its basic biomedical research community; its clinical workforce distributed across the country and across disciplines; a highly qualified, internationally respected clinical and health services research workforce; and, world-leading expertise in systematic reviews. Large provincial and national administrative and clinical databases have enabled researchers to assess existing care patterns, make important associations between interventions and outcomes, and observe practice variations. Canada also has extensive experience in multi-disciplinary and cross-disciplinary clinical research networks.Despite these undisputable strengths, Canada faces a dual challenge in the research-to-practice continuum, often referred to as the two "Death Valleys" in the healthcare landscape.
- Valley 1 refers to the decreased capacity to translate the results of discoveries generated by basic biomedical research in the laboratory to the bedside or careside as well as to successfully commercialize health discoveries. This negatively impacts Canada's clinical research and knowledge base and its international competitiveness.
- Valley 2 refers to the limited capacity to synthesize, disseminate and integrate research results more broadly into clinical practice and health care decision-making. These two valleys must be bridged if Canada is to bring evidence to bear to enhance health outcomes and ensure a sustainable healthcare system.
A number of factors contribute to the gaps in the research-to-practice continuum, including:
- Lack of clinical investigators, methodologists such as biostatisticians, clinical epidemiologists and health economists, and other needed experts;
- Complicated coordination of large, multi-centre clinical because of requirements for multiple ethics reviews by each individual institution and the lack of standardized contracts;
- Underfunding of patient-oriented research when compared to many other countries;
- A decentralized federation structure, making research coordination difficult;
- Deficiencies in the development and dissemination of guidelines and their adoption into practice, despite their proven value; and
- The limited role of patients in patient-oriented research.