Frequently Asked Questions
What is SPOR?
Canada's Strategy for Patient-Oriented Research (SPOR) is a national coalition of federal, provincial and territorial partners (patients and caregivers, researchers, health practitioners, policy makers, provincial/territorial health authorities, academic institutions, charities, pharmaceutical sector, etc.) dedicated to the integration of research into care.
What is the objective of SPOR?
The objective is to foster evidence-informed health care by evaluating innovative diagnostic and therapeutic approaches and bringing them to the point of care.
What is patient-oriented research?
Patient-oriented research is about putting patients first. Research is informed by patients and focuses on what is important to patients. It produces information for decision makers and health care providers that will improve health care practices, therapies and policies. It ensures that new and innovative diagnostic and therapeutic approaches are applied where they are needed.
Why is SPOR needed?
Canadian research excellence is recognized globally and the country ranks amongst the top in the world in terms of scientific impact of its health research. Yet, evidence shows that 50% of patients do not get treatments of proven effectiveness and up to 25% get care that is not needed or potentially harmful.
Incentives for health research are not focused on these problems – bringing research and decision-makers/patients together requires a change in culture and approach. The challenge is to develop and apply research that will ensure a more effective use of existing health resources and the introduction of more cost-effective diagnostic and treatment strategies, so as to curb costs while offering high quality care.
This integration of research into care is what SPOR has set out to achieve.
How will SPOR benefit Canadians?
SPOR will lead to:
- Improved health for Canadians by ensuring that the best research evidence moves into practice, enhancing the health care experience for patients and improving health outcomes for Canadians.
- Economic benefits by optimizing spending on health care systems, reinvesting resources where the evidence shows greatest impact, and attracting private investments in evaluative research.
- Innovation in patient-centred care in areas such as ehealth, implementation science and clinical practice.
- More clinical research by improving the environment for clinical research in Canada.
- Collaboration among provinces and territories by providing jurisdictions with opportunities to learn from each other, translating best practices in patient-centred care across Canada, to the benefit of all Canadians.
How is this different than traditional approaches to research?
SPOR involves researchers working collaboratively with the provinces and partners, and putting patients and health care professionals at the heart of the process. It involves leveraging resources to support transformational research. It is about more than discovering new diagnostic approaches and therapies. It is about evaluating the effectiveness of these approaches and sharing the results with health professionals across the country, to create change throughout Canada's health care system.
How will SPOR be delivered?
The strategy identifies a number of critical elements that will help achieve the vision for SPOR. These include:
- SUPPORT Units;
- Capacity building (training, mentoring and career development);
- Improving the environment for clinical research; and
- Patient/caregiver/public engagement.
How is SPOR governed?
A National Steering Committee serves as the oversight body for SPOR. It consists of two Co-Chairs, plus representation reflecting the breadth of experience and expertise required to effectively address SPOR's mandate. Members include leaders from amongst the health research funders, universities, health care organizations and authorities, clinical researchers, health charities, industry, federal and provincial/territorial governments, and patients/citizens.
SPOR's original focus appeared to be on clinical research. Has this changed?
Clinical research remains an important aspect of SPOR. The vision of SPOR is to demonstrably improve health outcomes and enhance patients' health care experience through integration of evidence at all levels in the health care system. To achieve this vision, clinical research is a key component in informing and influencing needed improvements.
More specifically, the goals to achieve this vision are to:
- create a collaborative, pan-Canadian process for identifying, establishing and addressing patient-oriented research priorities;
- establish an integrated, leading-edge pan-Canadian clinical research infrastructure along the full continuum of patient-oriented research;
- grow Canada's capacity to attract, train and mentor health-care professionals and health researchers, as well as to create sustainable career paths in patient-oriented research;
- strengthen organizational, regulatory and financial support for clinical studies in Canada and enhance patient and clinician engagement in these studies; and
- improve processes for the early identification of best practices, expedite their development and harmonization into guidelines for patient care and support their adoption by clinicians, care-givers and patients.
Further, SPOR recognizes that Canada faces a challenge in the research-to-practice continuum, often referred to as the two "Death Valleys". 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 health care decision-making and clinical practice. These two valleys must be bridged if Canada is to bring evidence to bear to enhance health outcomes and ensure a sustainable health care system.
What are SPOR Networks?
SPOR Networks are a formal collaboration of patients, health professionals, decision makers, health researchers and their partners from across Canada. These patient-oriented research networks bridge the gap between research evidence and health care practice.
What are the objectives of SPOR Networks?
The objectives of SPOR Networks are to:
- Generate evidence and innovations that will lead to transformative and measurable improvements in health outcomes and health care.
- Establish priorities and develop a nation-wide agenda of outcomes-oriented research
- Develop and implement evidence-informed practices, policies, services, products, and programs to improve the quality, efficiency, and effectiveness of care.
- Accelerate the translation of new knowledge into clinical applications, practice, and policy.
- Strengthen the capacity to conduct patient-oriented research through training and mentoring initiatives.
How is the research area of a SPOR network determined?
CIHR has implemented a multi-pronged approach to inform SPOR National Steering Committee decisions around emerging priority areas for future SPOR Networks.
First, CIHR conducted an extensive scan of provincial and territorial priorities related to health. Second, patients and consumers were consulted to identify their top health-related priorities. The information gathered from these two processes was synthesized into a list of emerging priority areas.
A third step included an Expression of Interest process. CIHR launched this process on behalf of the SPOR National Steering committee to gather information from the broader research community on potential areas of research networks and related existing or emerging network capacity.
Taken together, these processes provide valuable information that will inform the SPOR National Steering Committee as they make decisions regarding future network areas.
What SPOR networks have already been launched?
The first SPOR network was announced in October 2012, and is focused in the area of youth and adolescent mental health. The application process for this network is now underway.
In November 2013, a second SPOR network was launched in Primary and Integrated Health Care Innovations. This network has foundations in Community Based Primary Health Care (CBPHC) and focuses in the area of primary and integrated health care innovations.
How are SPOR networks funded?
SPOR networks are based on a 1:1 funding requirement – 50% from the Government of Canada, 50% from one or more partners.
What other SPOR networks will be funded?
The process for identifying future SPOR Networks is a comprehensive and multi-pronged approach. CIHR has examined in detail the health priorities of the provinces and territories, as well as engaged patients and the public through a consultative process to identify priorities that matter the most to them. CIHR has also worked closely with the research community to gather input on emerging priorities. Through these processes, a broad list of emerging health priorities has been established.
In parallel, on behalf of the SPOR National Steering Committee, CIHR requested that the research community provide information about existing and emerging research networks that align with the objectives of a SPOR network. The feedback from the research community has provided the SPOR National Steering Committee with valuable information about the interest and capacity of research networks across Canada.
Are networks with an international scope eligible?
Research is not a national endeavour. CIHR recognizes that research that is conducted in Canada can influence practice and policy in other countries, and vice versa. Networks with an international scope may be considered; however, it is important for SPOR networks to have a significant Canadian presence given the unique Canadian health care landscape.
Where is there alignment between SPOR networks and CIHR's Signature Initiatives?
SPOR is a CIHR Signature Initiative. The broad focus of SPOR will enable CIHR to leverage and build on the existing research and capacity that is being developed by the suite of Signature Initiatives.
For example, the Network in Primary and Integrated Health Care Innovations is a key part of the Community-Based Primary Health Care (CBPHC) Signature Initiative. This SPOR Network will support evidence-informed transformation and delivery of more cost-effective and integrated health care to improve clinical, population health, health equity, and health system outcomes.
What kind of Networks will be considered as part of the SPOR initiative (e.g., research, research and practice, policy)?
SPOR Networks are by definition collaborative research networks. Knowledge translation is also an integral component of these networks and that is why patients, decision makers, policy makers, and researchers will be active participants in these networks. The involvement of these key stakeholders will ensure that the knowledge generated by these networks will directly influence practice, programs, and policy.
What is a SUPPORT Unit?
A SUPPORT Unit is a provincial and/or regional centre designed to support those engaged in patient-oriented research. The acronym "SUPPORT" stands for "Support for People and Patient-Oriented Research and Trials."
What is the goal of these SUPPORT Units?
The goal is to establish state-of-the-art core and specialized research service centres that provide and develop the necessary (and often highly-specialized) methodological expertise to those engaged in patient-oriented research. In addition, they facilitate decision-making within the health services setting and facilitate the implementation of best practices
Who can apply for a SUPPORT Unit?
Only provinces and territories can apply for a SUPPORT Unit. However, these Units are managed through a collaborative leadership model, involving patients/public, health care professionals, policy makers/funders/health authorities, and researchers.
How are SUPPORT Units funded?
SUPPORT Units are based on a 1:1 funding model. Each province/territory (or grouping of provinces/territories) develops a business plan which identifies the required level of investment (generally in the range of $2 million to $6 million). The region and CIHR will each contribute 50% of the funding.
What are the functions of a SUPPORT Unit?
The core functions are:
- Data platforms and services;
- Methods support and development;
- Health systems, knowledge translation, and implementation;
- Real world clinical trials;
- Career development in methods and health services research;
- Consultation and research services.
What are the specific objectives of SUPPORT Units?
The objectives are:
- To provide a critical mass of highly-specialized and multi-disciplinary methodological expertise to those engaged in themes 2, 3, and 4 patient-oriented research. (Includes: clinical epidemiologists, biostatisticians, social scientists, health economists and clinical trialists, research support staff including research coordinators, research associates and assistants, data collectors and data analysts).
- To provide Canada with state-of-the-art Units for advancing methods and training in comparative effectiveness research and developing the next generation of methodologists (building support where it does not now exist and enhance it where it is not sufficient).
- To assist investigators to design relevant research studies (including observational and interventional studies), conduct biostatistical analyses, manage data, provide and teach project management skills, and ensure studies meet all relevant regulatory standards.
- To conduct world-class patient-oriented research taking into account local expertise and the priorities of the jurisdiction for research.
- To address research questions and the needs of knowledge users by producing solutions-focused answers and supporting these users in the application of solutions.
- To create capacity to provide timely access to linked data (administrative data to clinical data), and to integrate existing or new databases with lab, drug, imaging, and diagnostic data.
How is peer review conducted for SUPPORT Units?
An international panel of experts reviews the final business plan submitted by each jurisdiction. To ensure that the panel of experts has a comprehensive understanding of each jurisdiction's business plan, an interactive, iterative review process is used.
When will the SUPPORT Units be established?
In the coming months, an international adjudication panel will be evaluating the first set of business plans submitted by jurisdictions ready to commence activities. Once the process is complete, funding will be provided as early as May 2013.
How will SUPPORT Units support SPOR networks?
Once SUPPORT Units are established, they are expected to facilitate patient-oriented research by providing methodological support to those already engaged in or wishing to be engaged in patient-oriented research. They are also expected to assist investigators with the design of relevant research studies, provide timely access to linked data and help address research questions/needs of knowledge users. As Networks are established, and their needs are determined, they will be able to access the support and services offered by SUPPORT Units. Details of how this will be achieved will be developed over the coming months.
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