Canada's Strategy for Patient-Oriented Research - Long Descriptions

Figure 1: Processes for Developing versus Comparing Clinical Interventions

This figure outlines the processes for developing new therapies and comparing clinical interventions.

There are six steps involved in the development of new therapies. The first step is Health Innovation, which leads to a New Treatment or Diagnostic Test. Phase One to Three Testing comes next, followed by Regular Approval, and then Investor Initiated Studies. Dissemination into practice is the final step in the process for developing new therapies.

There are also six steps involved in comparing existing therapies. The first step is Existing Treatments, which in-turn leads to Documenting Practice Variation. After Documenting Practice Variation, the next step is to Document Care Gaps. Systematic Reviews (Existing Care options) proceeds, and is followed by Pilot Studies. Large Clinical Trials are the final process for Comparing Existing Therapies.

Regular Approval, Investor Initiated Studies, and Dissemination into Practice, which are the last three steps for the Development of New Therapies, lead to Existing Treatments, which is the first step in Comparing Existing Therapies. All these steps lead to Improved Health Outcomes.

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Figure 2: Canada's Scientific Impact in the Health Field in the International Context

Country POR Health POR/Health
China 0.83 0.72 1.2
Canada 1.42 1.24 1.2
Sweden 1.34 1.19 1.1
Denmark 1.38 1.24 1.1
Brazil 0.71 0.64 1.1
Belgium 1.38 1.25 1.1
Australia 1.23 1.13 1.1
Netherlands 1.38 1.29 1.1
UK 1.29 1.24 1.0
Italy 1.03 0.99 1.0
US 1.36 1.31 1.0
Spain 0.87 0.86 1.0
Switzerland 1.39 1.38 1.0
France 1.03 1.02 1.0
Germany 1.13 1.12 1.0
Turkey 0.45 0.47 1.0
Taiwan 0.63 0.66 1.0
India 0.44 0.47 0.9
Israel 0.90 0.96 0.9
Japan 0.65 0.75 0.9
World 1.00 1.00 1.00

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Figure 3: The Two Valleys of the Research-to-Practice Continuum

Figure three depicts the Research-to-Practice Continuum in Canada. This continuum is comprised of three hills and two valleys. The first hill is Basic Biomedical Research,the second hill is Clinical Science and Knowledge and the third hill is Health Decision Making and Clinical Practice. Valley 1 illustrates the gap between basic biomedical research and clinical science and knowledge. It is 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. Valley 2 illustrates the gap between clinical science and knowledge and health decision making and clinical practice, It is the limited capacity to synthesize, disseminate and integrate research results more broadly into health care decision-making and clinical practice. Valleys 1 and 2 must be bridged if Canada is to bring evidence to bear to enhance health outcomes and ensure a sustainable health care system.

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Figure 4: Total Training and Salary Awards from CIHR

Category 2004-2005 2005-2006 2006-2007 2007-2008 2008-2009
Non-Clinician 466 513 576 612 711
Nurse 19 19 27 32 21
Other 0 0 0 0 0
Other Clinician 124 148 151 172 223
Physician 113 162 154 142 111

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Figure 7: Types of Clinical Studies

Figure 7 outlines the types of clinical studies, highlighting that clinical studies encompass more than just clinical trials. There are two types of observations studies: descriptive and analytical. Analytical studies are further divided into cohort or case-control studies. There are also two types of experimental (intervention) studies: uncontrolled (which have one group) or controlled (which have two groups). Controlled studies can be either non-randomized, meaning they have a control group and no random allocation, or randomized, meaning they have a control group with random allocation.

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