The Canadian government has unveiled a patient-oriented research strategy designed, inter alia, to establish an integrated clinical research infrastructure across the country and to strengthen organisational, regulatory and financial support for clinical studies in Canada.

The strategy, mapped out in a document drawn up by a 12-member President’s Advisory Board under the leadership of the Canadian Institutes of Health Research (CIHR), was announced yesterday by Minister of Health Leona Aglukkaq.

The CIHR, which is the federal government’s health research investment agency, described the strategy as a “transformative research initiative that places patients at the centre of healthcare”.

A focus on patient-oriented research was at the heart of CIHR’s 2009/10 Health Research Roadmap, which outlined the Institutes’ strategic direction over the next five years.

The strategy was developed by CIHR in collaboration with the Canadian provinces and territories, health charities, academic healthcare organisations and industry representatives.

It built on “an overall vision of how the federal government will work with provincial and territorial health ministries and partners to ensure that the right patient receives the right treatment at the right time”, CHIR noted.

“By putting patients first, we are making sure that research will have a greater impact on treatments and services provided in clinics, hospitals and doctors’ offices throughout Canada,” Aglukkaq stated. "Better integration of research evidence and clinical practice means improved health outcomes and a better healthcare system in Canada.”

Series of consultations

The President’s Advisory Board on the Strategy for Patient-Oriented Research met between January 2009 and August 2010, holding a series of consultations on an earlier version of the current document with a range of stakeholders between February and June 2010.

Along with the final strategy document, Aglukkaq announced the membership of a National Steering Committee, comprising national and international partners from both the public and private sectors, which will implement the Strategy while encouraging “collective engagement and ownership”.

The Committee’s inaugural meeting is planned for 3 October 2011.

Research continuum

The strategy document describes patient-oriented research as “a continuum of research, from initial studies in humans to comparative effectiveness and outcomes research, and the integration of this research into the healthcare system and clinical practice”.

That should better ensure the translation of innovative diagnostic and therapeutic approaches to the point of care, as well as helping the Canadian provinces and territories meet the challenge of delivering high-quality, cost-effective healthcare, the Strategy adds.

The vision underpinning the Strategy for Patient-Oriented Research is of a demonstrable improvement in health outcomes, coupled with an enhanced healthcare experience for patients, to be achieved through  “integration of evidence at all levels in the healthcare system”.

Dual challenge

Despite strong foundations including the biomedical research community, a multidisciplinary clinical workforce, a “highly qualified, internationally respected” clinical and health services research workforce, “world-leading” expertise in systematic reviews, and extensive experience in multi- and cross-disciplinary clinical research networks, Canada faces a dual challenge in the research-to-practice continuum, the preface to the strategy document points out.

These two ’Death Valleys’ in the healthcare landscape are reduced capacity to translate basic biomedical research discoveries from the laboratory to the bedside, or to commercialise successfully health discoveries; and limited capacity to synthesise, disseminate and integrate research results more broadly into clinical practice and healthcare decision-making. 

Among the factors seen as contributing to gaps in the research-to-practice continuum are:

-     lack of clinical investigators, methodologists (e.g., biostatisticians, clinical epidemiologists, health economists) and other needed experts;               


-     complications with co-ordinating large, multicentre clinical trials, due to “requirements for multiple ethics reviews by each individual institution and the lack of standardised contracts”;    


-     underfunding of patient-oriented research compared with many other countries;

Overarching goals

The Strategy for Patient-Oriented Research sets out five overarching goals to achieve the vision outlined above:

-     Creating a collaborative, pan-Canadian process for identifying, establishing and addressing patient-oriented research priorities    


-     Establishing an integrated, leading-edge pan-Canadian clinical research infrastructure “along the full continuum of patient-oriented research”                            

-     Developing Canada's capacity to attract, train and mentor healthcare professionals and health researchers, as well as creating sustainable career paths in patient-oriented research        


-     Strengthening organisational, regulatory and financial support for clinical studies in Canada, as well as enhancing patient and clinician engagement in these studies        


-     Improving processes for the early identification of best practices, expediting their development and harmonisation into guidelines for patient care, and supporting their adoption by clinicians, caregivers and patients.

Dr. Jeff Turnbull, president of the Canadian Medical Association, said the Strategy would  “create clinical research infrastructure, identify the most pressing research priorities, and help improve patient recruitment and funding for clinical trials”.

The full document is available on CIHR’s website at: