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- OPEN ACCESS
- Carole A. Estabrooks,
- Sharon E. Straus,
- Colleen M. Flood,
- Janice Keefe,
- Pat Armstrong,
- Gail J. Donner,
- Véronique Boscart,
- Francine Ducharme,
- James L. Silvius, and
- Michael C. Wolfson
The Royal Society of Canada Task Force on COVID-19 was formed in April 2020 to provide evidence-informed perspectives on major societal challenges in response to and recovery from COVID-19. The Task Force established a series of working groups to rapidly develop policy briefings, with the objective of supporting policy makers with evidence to inform their decisions. This paper reports the findings of the COVID-19 Long-Term Care (LTC) working group addressing a preferred future for LTC in Canada, with a specific focus on COVID-19 and the LTC workforce. First, the report addresses the research context and policy environment in Canada’s LTC sector before COVID-19 and then summarizes the existing knowledge base for integrated solutions to challenges that exist in the LTC sector. Second, the report outlines vulnerabilities exposed because of COVID-19, including deficiencies in the LTC sector that contributed to the magnitude of the COVID-19 crisis. This section focuses especially on the characteristics of older adults living in nursing homes, their caregivers, and the physical environment of nursing homes as important contributors to the COVID-19 crisis. Finally, the report articulates principles for action and nine recommendations for action to help solve the workforce crisis in nursing homes. - OPEN ACCESS
- Andrea C. Tricco,
- Wasifa Zarin,
- Fiona Clement,
- Ahmed M. Abou-Setta,
- Janet A. Curran,
- Annie LeBlanc,
- Linda C Li,
- Christina Godfrey,
- Pertice Moffitt,
- David Moher,
- Heather Colquhoun,
- Ian D. Graham,
- Ivan D. Florez,
- Linda Wilhelm,
- Wanrudee Isaranuwatchaia,
- Jackie Mann,
- Marina Hamilton,
- Vasanthi Srinivasan,
- Stephen Bornstein, and
- Sharon E. Straus
This is the introductory paper in a collection of four papers on the Strategy for Patient-Oriented Research (SPOR) Evidence Alliance, a pan-Canadian research initiative that was funded by the Canadian Institutes of Health Research in September of 2017. Here, we introduce the SPOR enterprise in Canada, provide a rationale for the creation of the SPOR Evidence Alliance, provide information on the mandate and approach, and describe how the SPOR Evidence Alliance adds to the health research ecosystem in Canada and beyond. - OPEN ACCESS
- Carole Lunny,
- Wasifa Zarin,
- Sabrina Chaudhry,
- Sonia M. Thomas,
- Annie LeBlanc,
- Sophie Desroches,
- Tanya Horsley,
- Heather Colquhoun,
- Priscille-Nice Sanon,
- Minnie Downey,
- Zahra Goodarzi,
- Nancy N. Baxter,
- Kelly English,
- Elliot PausJenssen,
- Shanon McQuitty,
- Linda Wilhelm,
- Annette McKinnon,
- Alison M. Hoens,
- Linda C. Li,
- Fiona Clement,
- Janet A. Curran,
- Ahmed M. Abou-Setta,
- Christina Godfrey,
- David Moher,
- Pertice Moffitt,
- Jennifer Walker,
- Janet Jull,
- Cheryl Koehn,
- Wanrudee Isaranuwatchai,
- Sharon E. Straus, and
- Andrea C. Tricco
The Strategy for Patient Oriented Research (SPOR) Evidence Alliance is a research initiative in Canada whose mission is to promote the synthesis, dissemination, and integration of research results into health care and public health decision-making and clinical practice. The aim of this paper is to (i) outline the governance and committee structure of the SPOR Evidence Alliance, (ii) outline the procedures for patient and health system decision-maker engagement, and (iii) present the capacity-building strategy for governance members. The governance structure includes the following six standing committees: the International Advisory Committee, Steering Committee, Executive Committee, Knowledge Translation Committee, Partnerships Committee, and Training and Capacity Development Committee. The guiding principles embrace inclusiveness, support, mutual respect, transparency, and co-building. There are currently 64 committee members across the six committees, 13 patient and public partners, 8 health system decision-makers, 7 research trainees, and 36 researchers. A multi-disciplinary and diverse group of people in Canada are represented from all regions and at various levels of training in knowledge generation, exchange, and translation. This collaborative model makes the SPOR Evidence Alliance strong and sustainable by leveraging the knowledge, lived experiences, expertise, skills, and networks among its 342 members and 12 principal investigators. - OPEN ACCESS
- Wasifa Zarin,
- Carole Lunny,
- Sabrina Chaudhry,
- Sonia M. Thomas,
- Annie LeBlanc,
- Fiona Clement,
- Ahmed M. Abou-Setta,
- Janet A. Curran,
- Brian Hutton,
- Ivan D. Florez,
- Linda C. Li,
- Stephen Bornstein,
- Clayon B. Hamilton,
- Pertice Moffitt,
- Christina Godfrey,
- Louise Zitzelsberger,
- Leanne Gardiner,
- Christine Fahim,
- Sharon E. Straus, and
- Andrea C. Tricco
Canada has made great progress in synthesizing, disseminating, and integrating research findings into health systems and clinical decision-making; yet gaps exist in the research-to-practice continuum. The Strategy for Patient-Oriented Research (SPOR) Evidence Alliance aims to help close gaps by providing decision-makers with evidence that is timely, context sensitive, and demand driven to better inform patient-oriented practices and policies in health systems. In this article, we introduce a model established in Canada to support decision-maker needs for high-quality evidence that is patient oriented to enhance health systems performance. We provide an overview of how this model was implemented, who is involved, who it serves, as well as its organizational structure and remit. We discuss key milestones achieved to date and the impact this initiative has made within the health research community. The strength of the SPOR Evidence Alliance lies in its unique ability to simultaneously: (i) serve as a national platform for researchers to stay connected and collaborate to minimize duplication of efforts and (ii) facilitate access to research knowledge for patient partners and decision-makers. In doing so, the SPOR Evidence Alliance is supporting health policy and practice decisions that support and strengthen Canada’s dynamic health systems. - OPEN ACCESS
- Sharon E. Straus,
- Brian Hutton,
- David Moher,
- Shannon E. Kelly,
- George A. Wells, and
- Andrea C. Tricco
In 2009, the Canadian Institutes of Health Research, Health Canada, and other stakeholders established the Drug Safety and Effectiveness Network (DSEN) to address the paucity of information on drug safety and effectiveness in real-world settings. This unique network invited knowledge users (e.g., policy makers) to submit queries to be answered by relevant research teams. The research teams were launched via open calls for team grants focused in relevant methodologic areas. We describe the development and implementation of one of these collaborating centres, the Methods and Application Group for Indirect Comparisons (MAGIC). MAGIC was created to provide high-quality knowledge synthesis including network meta-analysis to meet knowledge user needs. Since 2011, MAGIC responded to 54% of queries submitted to DSEN. In the past 5 years, MAGIC produced 26 reports and 49 publications. It led to 15 trainees who entered industry, academia, and government. More than 10 000 people participated in courses delivered by MAGIC team members. Most importantly, MAGIC knowledge syntheses influenced practice and policy (e.g., use of biosimilars for patients with diabetes and use of smallpox vaccinations in people with contraindications) provincially, nationally, and internationally. - OPEN ACCESS
- Eric Kai-Chung Wong,
- Jennifer Watt,
- Hanyan Zou,
- Arthana Chandraraj,
- Alissa Wenyue Zhang,
- Jahnel Brookes,
- Ashley Verduyn,
- Anna Berall,
- Richard Norman,
- Katrina Lynn Piggott,
- Terumi Izukawa,
- Sharon E. Straus, and
- Barbara Arlena Liu
Atypical disease presentations are common in older adults with COVID-19. The objective of this study was to determine the prevalence of atypical and typical symptoms in older adults with COVID-19 through progressive pandemic waves and the association of these symptoms with in-hospital mortality. This retrospective cohort study included consecutive adults aged over 65 years with confirmed COVID-19 infection who were admitted to seven hospitals in Toronto, Canada, from 1 March 2020 to 30 June 2021. The median age for the 1786 patients was 78.0 years and 847 (47.5%) were female. Atypical symptoms (as defined by geriatric syndromes) occurred in 1187 patients (66.5%), but rarely occurred in the absence of other symptoms (n = 106; 6.2%). The most common atypical symptoms were anorexia (n = 598; 33.5%), weakness (n = 519; 23.9%), and delirium (n = 449; 25.1%). Dyspnea (adjusted odds ratio [aOR] 2.05; 95% confidence interval [CI] 1.62–2.62), tachycardia (aOR 1.87; 95% CI 1.14–3.04), and delirium (aOR 1.52; 95% CI 1.18–1.96) were independently associated with in-hospital mortality. In a cohort of older adults hospitalized with COVID-19 infection, atypical presentations frequently overlapped with typical symptoms. Further research should be directed at understanding the cause and clinical significance of atypical presentations in older adults. - OPEN ACCESS
- Sharon E. Straus,
- Robyn Beckett,
- Christine Fahim,
- Negin Pak,
- Danielle Kasperavicius,
- Tammy Clifford, and
- Bev Holmes
The Royal Society of Canada Working Group on Health Research System Recovery developed actionable recommendations for organizations to implement to strengthen Canada’s health research system. Recommendations were based on input from participants from G7 countries and Australia and New Zealand. Participants included health research funding agency leaders; research institute leaders; health, public health, and social care policy-makers; researchers; and members of the public. The recommendations were categorized using the World Health Organization’s framework for health research systems and include governance/stewardship: (1) Outline research logistics as part of emergency preparedness to streamline research in future pandemics. (2) Embed equity and inclusion in all research processes. (3) Facilitate streamlined, inclusive, and rigorous processes for grant application preparation and review. (4) Create knowledge mobilization infrastructure to support the generation and use of evidence. (5) Coordinate research efforts across local, provincial, national, and international entities. Financing: (6) Reimagine the funding of health research. Capacity building: (7) Invest in formative training opportunities rooted in equity, diversity, and anti-racism. (8) Support researchers’ career development throughout their career span. (9) Support early career researchers to establish themselves. Producing and using research: (10) Strengthen Indigenous health research and break down systemic barriers to its conduct. (11) Develop mechanisms to produce novel research. (12) Enhance research use across the health research ecosystem.