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Hillier DR, Tang M, Clark W, MacDonald C, Connolly C, Large C, King M, Singer J, Levin A, Manns B, Konvalinka A, Scholey J, Rosenblum ND. A Framework to Ensure Patient Partners Have Equal and Contributing Voices Throughout the Research Program Evaluation Process. Can J Kidney Health Dis 2020; 7:2054358120970093. [PMID: 33294204 PMCID: PMC7705288 DOI: 10.1177/2054358120970093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 09/27/2020] [Indexed: 11/15/2022] Open
Abstract
PURPOSE OF PROGRAM Traditionally, peer review was a closed process conducted only by individuals working in the research field. To establish a more integrated and patient-centered approach, one of Canada's largest kidney research networks (Can-SOLVE CKD) has created a Research Operations Committee (ROC) that includes patients as key members. The ROC represents one way for achieving meaningful patient-oriented research (POR). SOURCE OF INFORMATION Can-SOLVE CKD, a network created as part of the Canadian Institutes of Health Research (CIHR) Strategy for Patient-Oriented Research (SPOR). METHODS The ROC consists of patients, physicians, scientists, Indigenous partners, experts in research methodology, and a member of Can-SOLVE CKD's operational team. On an annual basis, Can-SOLVE CKD's research teams provide the ROC with a review package, which incorporates information from patient engagement check-in calls and surveys, the project's knowledge translation plan and products, and a progress report written by the project team. The ROC evaluates the review package and provides feedback and recommendations accordingly. KEY FINDINGS The transparent nature of the process, regular feedback and review, along with an overt accountability and scoring system, has been embraced by both patients and researchers. As a result of the ROC process, the number of patient leads for each project has grown over a 3-year period and more researchers have received POR and cultural sensitivity training. LIMITATIONS While anecdotal evidence suggests this approach is beneficial for achieving POR, formal mechanisms of evaluation are currently lacking. IMPLICATIONS This ROC framework ensures patients are active contributors throughout the research process and could be adopted by other organizations to achieve a more patient-centered approach to research.
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Affiliation(s)
| | - Mila Tang
- The University of British Columbia,
Vancouver, Canada
| | - William Clark
- Department of Medicine, London Health
Sciences Centre, ON, Canada
| | | | | | | | | | - Joel Singer
- The University of British Columbia,
Vancouver, Canada
| | | | - Braden Manns
- University of Calgary, AB, Canada
- Foothills Medical Centre, Calgary, AB,
Canada
| | | | - James Scholey
- University of Toronto, ON, Canada
- University Health Network, Toronto, ON,
Canada
| | - Norman D. Rosenblum
- Department of Paediatrics, The
Hospital for Sick Children, Toronto, ON, Canada
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Hemmelgarn BR, Pannu N, Ahmed SB, Elliott MJ, Tam-Tham H, Lillie E, Straus SE, Donald M, Barnieh L, Chong GC, Hillier DR, Huffman KT, Lei AC, Villanueva BV, Young DM, Fowler EA, Manns BJ, Laupacis A. Determining the research priorities for patients with chronic kidney disease not on dialysis. Nephrol Dial Transplant 2018; 32:847-854. [PMID: 27190349 DOI: 10.1093/ndt/gfw065] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 02/23/2016] [Indexed: 01/12/2023] Open
Abstract
Background The importance of engaging key stakeholders, and patients in particular, in determining research priorities has been recognized. We sought to identify the top 10 research priorities for patients with non-dialysis chronic kidney disease (CKD), their caregivers, and the clinicians and policy-makers involved in their care. Methods We used the four-step James Lind Alliance process to establish the top 10 research priorities. A national survey of patients with non-dialysis CKD (estimated glomerular filtration rate <45 mL/min/1.73 m 2 ), their caregivers, and the clinicians and policy-makers involved in their care was conducted to identify research uncertainties. A Steering Group of patients, caregivers, clinicians and researchers combined and reduced these uncertainties to 30 through a series of iterations. Finally, a workshop with participants from across Canada (12 patients, 6 caregivers, 3 physicians, 2 nurses, 1 pharmacist and 1 policy-maker) was held to determine the top 10 research priorities, using a nominal group technique. Results Overall, 439 individuals responded to the survey and identified 1811 uncertainties, from which the steering group determined the top 30 uncertainties to be considered at the workshop. The top 10 research uncertainties prioritized at the workshop included questions about treatments to prevent progression of kidney disease (including diet) and to treat symptoms of CKD, provider- and patient-targeted strategies for managing CKD, the impact of lifestyle on disease progression, harmful effects of medications on disease progression, optimal strategies for treatment of cardiovascular disease in CKD and for early identification of kidney disease, and strategies for equitable access to care for patients with CKD. Conclusions We identified the top 10 research priorities for patients with CKD that can be used to guide researchers, as well as inform funders of health-care research.
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Affiliation(s)
- Brenda R Hemmelgarn
- Department of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Neesh Pannu
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Sofia B Ahmed
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | | | - Helen Tam-Tham
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Erin Lillie
- Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, ON, Canada
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Maoliosa Donald
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lianne Barnieh
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | | | | | | | | | | | | | | | - Braden J Manns
- Department of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Andreas Laupacis
- Li Ka Shing Knowledge Institute of St Michael's Hospital, Toronto, ON, Canada.,Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Elliott MJ, Straus SE, Pannu N, Ahmed SB, Laupacis A, Chong GC, Hillier DR, Huffman KT, Lei AC, Villanueva BV, Young DM, Tam-Tham H, Donald M, Lillie E, Manns BJ, Hemmelgarn BR. A randomized controlled trial comparing in-person and wiki-inspired nominal group techniques for engaging stakeholders in chronic kidney disease research prioritization. BMC Med Inform Decis Mak 2016; 16:113. [PMID: 27553026 PMCID: PMC4995639 DOI: 10.1186/s12911-016-0351-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 08/18/2016] [Indexed: 11/20/2022] Open
Abstract
Background Few studies have evaluated stakeholder engagement in chronic kidney disease (CKD) research prioritization. In this two-arm, parallel group randomized controlled trial, we sought to compare an in-person nominal group technique (NGT) approach with an online wiki-inspired alternative to determining the top 10 CKD research priorities, and to evaluate stakeholder engagement and satisfaction with each process. Methods Eligible participants included adults ≥18 years with access to a computer and Internet, high health literacy, and from one of the following stakeholder groups: patients with CKD not on dialysis, their caregivers, health care providers who care for patients with CKD, or CKD-related health policymakers. Fifty-six participants were randomized to a wiki-inspired modified NGT that occurred over 3 weeks vs. a 1-day in-person NGT workshop, informed by James Lind Alliance methodology, to determine the top 10 CKD-related research priorities. The primary outcome was the pairwise agreement between the two groups’ final top 10 ranked priorities, evaluated using Spearman’s correlation coefficient. Secondary outcomes included participant engagement and satisfaction and wiki tool usability. Results Spearman’s rho for correlation between the two lists was 0.139 (95 % confidence interval −0.543 to 0.703, p = 0.71), suggesting low correlation between the top 10 lists across the two groups. Both groups ranked the same item as the top research priority, with 5 of the top 10 priorities ranked by the wiki group within the top 10 for the in-person group. In comparison to the in-person group, participants from the wiki group were less likely to report: satisfaction with the format (73.7 vs.100 %, p = 0.011); ability to express their views (57.9 vs 96.0 %, p = 0.0003); and perception that they contributed meaningfully to the process (68.4 vs 84.0 %, p = 0.004). Conclusions A CKD research prioritization approach using an online wiki-like tool identified low correlation in rankings compared with an in-person approach, with less satisfaction and perceptions of active engagement. Modifications to the wiki-inspired tool are required before it can be considered a potential alternative to an in-person workshop for engaging patients in determining research priorities. Trial registration (ISRCTN18248625) Electronic supplementary material The online version of this article (doi:10.1186/s12911-016-0351-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Meghan J Elliott
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, Ontario, M5B 1T8, Canada. .,Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M6, Canada.
| | - Sharon E Straus
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, Ontario, M5B 1T8, Canada.,Department of Medicine, University of Toronto, Suite RFE 3-805, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4, Canada
| | - Neesh Pannu
- Department of Medicine, University of Alberta, 8440 112 Street, Edmonton, Alberta, T6G 2G3, Canada
| | - Sofia B Ahmed
- Department of Medicine, University of Calgary, 1403 29 Street NW, Calgary, Alberta, T2N 2T9, Canada
| | - Andreas Laupacis
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, Ontario, M5B 1T8, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College Street, Toronto, Ontario, M5T 3M6, Canada.,Department of Medicine, University of Toronto, Suite RFE 3-805, 200 Elizabeth Street, Toronto, Ontario, M5G 2C4, Canada
| | - George C Chong
- , Suite 200, 5970 Centre Street SE, Calgary, Alberta, T2H 0C1, Canada
| | | | - Kate T Huffman
- , 23-1140 Falcon Drive, Coquitlam, British Columbia, V3E 2J6, Canada
| | - Andrew C Lei
- , 4K Spadina Avenue, Suite 1820, Toronto, Ontario, M5V 3Y9, Canada
| | | | - Donna M Young
- , 31 Seligs Road, Prospect Village, Nova Scotia, B3T 2A6, Canada
| | - Helen Tam-Tham
- Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Maoliosa Donald
- Department of Medicine, University of Calgary, 1403 29 Street NW, Calgary, Alberta, T2N 2T9, Canada
| | - Erin Lillie
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, 209 Victoria Street, East Building, Toronto, Ontario, M5B 1T8, Canada
| | - Braden J Manns
- Department of Medicine, University of Calgary, 1403 29 Street NW, Calgary, Alberta, T2N 2T9, Canada.,Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
| | - Brenda R Hemmelgarn
- Department of Medicine, University of Calgary, 1403 29 Street NW, Calgary, Alberta, T2N 2T9, Canada.,Department of Community Health Sciences, University of Calgary, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada
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