Annual Report 2010-2011

Moving Forward

[ Table of Contents ]

Accelerating the Capture of Health and Economic Benefits of Health Research

Realizing the Returns on Health Research Investments

CIHR's responsibility to Canadians does not end at funding excellent health research. Along with enabling exceptional investigators to generate new knowledge, there is a duty to ensure that knowledge improves Canadians' health and health care.

Knowledge translation means realizing benefits by facilitating the use of research results in the creation of better health products and services, smarter health policies and more effective health-care systems. Translating knowledge into practice is how Canadians reap returns on their investment in health research.

How knowledge translation is accomplished varies. It can mean making sure health-care practitioners and their patients know about successful new therapies. It can mean ensuring policy makers are aware of better ways to marshal resources for maximum impact — and that researchers are cognizant of decision makers' information needs and policy issues as they commence their investigations.

Knowledge translation also means assisting researchers in overcoming obstacles that stand in the way of commercializing their breakthroughs so that they can be marketed to the most people to do the most good and deliver the maximum benefit to the Canadian economy. No matter what form it takes, knowledge translation is essential to putting research to work.

PubMed Central Canada - Timely access to peer-reviewed reports

The digital revolution has made it possible to deliver information instantly to those who can put it to timely use.

Access to knowledge is shifting from a privilege shared by a few to a right demanded by all. Nowhere is this more important than in health research.

In April 2010, PubMed Central (PMC) Canada's online manuscript submission system began streamlining the process for CIHR researchers to contribute to a growing, free repository of health research. PMC Canada was created in 2009 in partnership with the National Research Council's Canada Institute for Scientific and Technical Information and the U.S. National Library of Medicine as a free digital archive of biomedical and life sciences literature.

CIHR has been an early and steadfast leader of the "open access" movement to share research results. Since 2008, CIHR grants have required investigators to make their peer-reviewed articles freely available through open access journals or online archives within six months of publication. This means the fruits of their taxpayer-supported work are easily accessible to other researchers, clinicians, policy makers and the private sector.

"From a research point of view, the people you're trying to get are not just other researchers, but those who will use the results of research — the patients and students and teachers and entrepreneurs," said Dr. James Till, the Canadian co-discoverer of stem cells with Dr. Ernest McCulloch. "They may not have access to a major university library. They go online and can see a whole bunch of interesting abstracts and say, 'That might be interesting, but I have to pay $35 or $40 to see the whole thing.' It can run into quite large costs to do a thorough exploration of the literature."

Dr. Till, a long-time advocate for open access, chaired the national task force whose work led to the creation of CIHR's open access policy. He sees PMC Canada as a significant advance in transferring knowledge into the public domain.

"It's a way of fostering open access to research literature, particularly to giving visibility to publications that have come out of work supported by CIHR. There is evidence that more people look at an article and read it through open access than if it comes out in a toll-access journal. A wider variety of people look at these articles now because they can," said Dr. Till.

PubMed Central Canada by the Numbers (April 28, 2010, to February 15, 2011)

Cochrane Collaboration - Enabling Evidence-Based Decision Making

CIHR is helping ensure that health-care providers and patients in Canada get the very best evidence-based information available.

A Google search of "heart disease," for example, produces 34 million results. Sorting and separating high-quality, credible material from the avalanche of search results presents a major challenge. The Cochrane Collaboration helps people make well-informed decisions about health care by preparing, updating and promoting Cochrane Reviews and publishing them online.

Through ongoing support of the Canadian Cochrane Centre, including a 2010 commitment of $9.6 million for five years, CIHR is helping ensure that health-care providers and patients in Canada and across the world get the very best evidence-based information available.

BBC News has called the Cochrane Collaboration "the world's leading independent assessor of medical interventions and medical research." The organization has 28,000 contributors worldwide. They evaluate and synthesize research in all areas of health care and present the results online in Cochrane Systematic Reviews that Dr. Jeremy Grimshaw, Director of the Canadian Cochrane Centre, calls "the gold standard in health research."

To further disseminate this knowledge to French-speaking communities in Canada and around the world, CIHR announced in 2011 that it would provide co-funding, in collaboration with funding partners in Quebec and France, for the French translation of Cochrane Reviews. The support will be used to translate existing abstracts and plain language summaries of approximately 3,000 Reviews, with funds set aside for future translations.

"We are delighted that CIHR recognizes the value in Cochrane Canada and the larger Cochrane Collaboration," said Dr. Grimshaw, who is a senior scientist with the Clinical Epidemiology Program at the Ottawa Health Research Institute and a Canada Research Chair in Health Knowledge Transfer and Uptake. "We are determined to utilize this funding in the best possible manner and produce even more Cochrane Reviews to help influence the way medicine is practised in Canada and inform health policy."

Canadian Cochrane Centre by the Numbers

Online tool helps MDs decide if patient is a candidate for epilepsy surgery

Uncontrolled epilepsy can lead to progressive memory difficulties, injuries and even death. While surgery can improve a patient's seizures and quality of life, many patients go years without the treatment. Now, thanks to a study that CIHR helped to fund, a user-friendly online tool can help doctors identify potential candidates for epilepsy surgery. The University of Calgary's Dr. Nathalie Jetté and colleagues conducted an extensive literature review, summarizing more than 700 articles related to partial epilepsy and epilepsy surgery. Neurological experts read the review and rated more than 2,500 possible patient scenarios to determine which patients would benefit from an epilepsy surgery evaluation. The result is a tool that produces a 1-9 rating based on patient characteristics such as age, duration of epilepsy, seizure type, severity of seizures, the number of anti-epileptic drugs tried, side effects of current treatment and results of tests, including magnetic resonance imaging (MRI). The tool is available at http://www.epilepsycases.com/. The patients with the highest ratings are the best candidates for the surgery.

Social Media - Capitalizing on an Information-Sharing Phenomenon

Social media has changed the knowledge translation game. As the YouTube video Social Media Revolution illustrates, it took radio 38 years to reach 50 million users. It took television 13 years. The Internet did it in four, the iPod in three. Facebook, in comparison, had 200 million users in less than a year.

Today, millions of Canadians search for and exchange information in formats that didn't even exist when CIHR was founded only a decade ago. That's why CIHR is on YouTube, to capitalize on social media's application for knowledge translation. So far, CIHR has posted more than 20 videos in the past year highlighting research results. More material — such as profiles of researchers and expert alerts — will appear regularly as CIHR helps more researchers become video savvy in presenting the results of their work.

CIHR is also on Facebook, where, as of early 2011, the Health Research in Canada page had attracted more than 125,000 fans (English and French combined). Almost 12,000 fans from all over the world have also flagged the Banting Postdoctoral Fellowships program's Facebook page. Facebook is not only a forum for publicizing health research developments, it also encourages those keen to find out more to interact.

Twitter has also become an excellent vehicle for getting timely information to a wider — and younger — audience. CIHR uses Twitter to post the latest information about Café Scientifique topics and locations and to alert audiences about other upcoming events or relevant research. As well, Flickr has provided a platform for an online database of pictures related to health research.

Social media, clearly, is not a fad. CIHR is riding the crest of this information-sharing phenomenon to further efforts and extend the reach in knowledge translation.

Twitter traffic could help track disease

What do you get when you blend information technology, social media and epidemiology? Dr. Gunther Eysenbach of the Centre for Global eHealth Innovation at the University Health Network coined the term infodemiology. Infodemiology describes the science of capturing and analyzing data about how people use the Internet to obtain and exchange information concerning the spread of disease and to monitor health and inform public policy. In 2007, Dr. Eysenbach demonstrated how Google searches for the words "flu" and "influenza" correlated with outbreaks of influenza. He is also studying Twitter traffic patterns during the 2010 H1N1 outbreak, collecting some 2 million tweets and analyzing them to create a picture of what people were reading, thinking about and planning to do during the pandemic. While the Twitter study is retrospective, lessons learned from the way people used the technology during the pandemic could help create "real-time" reports during the next public health crisis that would keep authorities informed and enable them to respond to public concerns quickly.

Best Brains Exchanges - Bringing Researchers and Decision Makers Together

Throughout 2010-11, CIHR has coordinated a series of one-day, in camera meetings for CIHR-sponsored researchers and health ministry officials to discuss high-priority challenges.

The sessions, called Best Brains Exchanges, are aimed at helping decision makers formulate policy and improve health care. The Exchanges emerged from the Evidence on Tap program that CIHR initiated to share high-quality, timely evidence with provincial and territorial health-care leaders. Initially a pilot project, the Exchanges have been so successful that they are expanding to other provinces and now include federal Best Brain Exchanges.

CIHR organized three pilot Best Brains Exchanges with Saskatchewan's Ministry of Health as it began work to adopt a patient- and family-centred care approach within its health-care system. The sessions were a definite success, said Pauline Rousseau, Executive Director of Saskatchewan Health's Policy and Planning Branch. "They triggered decisions about strategic directions for the health system and actions that we have taken," she said. "They triggered connections, networks and ongoing collaborations."

The University of Ottawa's Dr. Annette O'Connor, a world leader in patient decision aids, took part in one of Saskatchewan's early Best Brains Exchanges and is now, with Dr. Dawn Stacey, providing "very practical, research-based support as they move forward" said Dr. O'Connor. "For example, Saskatchewan needed to examine existing decision aids for priority clinical areas. So our knowledge translation team used our online database to produce a report on the available decision aids and the extent to which they met current international standards. This customized 'just in time' information will help them to decide about the best tools for their needs."

Ms. Rousseau said Saskatchewan has plans for more Exchanges. "It will be part of how we do business. I'm hoping that we can regularize it to the point that we do two or three a year. This is the most important research initiative targeted at bringing together the research and policy communities that I have seen in decades."

From the researcher's point of view, the Exchanges represent "a golden opportunity to see the fruits of your labour make a difference to the health of people," said Dr. O'Connor.

Best Brains Exchanges Topics 2010-11

Study's findings used in guidelines to stop spread of C. difficile

Findings from CIHR-funded research into the efficacy of alcohol-based hand disinfection versus washing with soap and water have been incorporated in the 2010 update of Clinical Practice Guidelines for Clostridium difficile Infection in Adults. McGill University's Dr. Michael Libman conducted the study using volunteer health workers whose hands were exposed to a harmless form of C. difficile. He found that because alcohol-based hygiene products are ineffective at removing C. difficile spores, hand washing with soap and water is the best way to prevent infection from the diarrhea-causing bacteria. "Alcohol-based hand disinfectants do a great job on just about everything else," said Dr. Libman, "but because you need to remove the spores from the skin, hand-washing is needed." The Guidelines are published by the Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America.

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