Archives
Creation of a Canadian Institute of Vision Health Research

MARCH 99
    A CIVHR ? 

      
    Our efforts in this project must be oriented towards the creation of a structure that brings together in Canada all research that is Vision Research.  The dispersion as we now know it, is unacceptable and has been severely detrimental to Vision Health Research. 

    The preoccupation of obtaining a selfstanding Canadian Institute of Vision Health Research (CIVHR) appears essential but is second to reuniting research efforts of all disciplines.  Even part of another Institute, if we succeed in networking Vision Research and getting our fair share in the new concept of research funding, we will have succeeded. 

    It must however be  stressed that Peer Review of research really means reviewed by Peers.  If we at least can have that, whatever the packaging, we will have accomplished something worthwhile. 

I. THE SOCIAL DUTY OF DEVELOPING VISION RESEARCH

A. Socio-cultural impact of research

  1. It must be understood by the administrators of CIHR that the system can not deprive a whole sector of its share of developement.  Research is essential to the quality of academia, training of future health care deliverers and consequently treating patients.
  2. Precisely because the previous conditions of distributing research funds has left us underdeveloped, it is not by favoring those who can present the most  favorable state that justice will be done.  The funding of the fittest is not the solution because the socioeconomic price is too high to pay.
  3. We should not approach the request for a fair deal begging but demanding it.   It is our duty to do so.
II. STATED AND MUTUALLY ACCEPTED PRINCIPLES
These are principles that have been mutually accepted by the Minister and the Task Force that prepared the CIHR Project.  Refer to appended WWW documents references


A. CIHR mandate in 1999 budget:

  1. Promote the creation and translation of new knowledge into better health, health care and economic developement
  2. Forge an integrated health research agenda across disciplines; fostre collaboration with voluntary, community and private sectors
  3. Create a robust research environment; keep best and brightest in Canada; use peer review to determine excellence
  4. Anticipate emerging health threats, accelerate discoveries
  5. Promote economic growth, job creation and commercialisation

B. CIHR research to be inclusive of all four primary divisions of health research:

  1. Biomedical
  2. Applied Clinical
  3. Health Sevices and Health systems
  4. Society, Culture and Health of Population

C.  CIHR Organisational Cross cutting Processes

  1. Peer Review
  2. Knowledge management
  3. Ethics
  4. Business Developement
III. GUIDING PRINCIPLES FOR THE PREPARATION OF OUR PROJECT DERIVING FROM STATED PRINCIPLES
In devising a project for a national network we must bear in mind the following principles deriving from the stated policies.

A. Conceptualise a project of national scope, including all aspects of vision health research and vision health care in all regions:

B. The project we will submit must cover a 3 years period of activity
The first year can be the preparation, evaluation and setting up of the network.  This is a realistic position that should be considered. We are asked to help build a new research approach.  If it was all done allready, the CIHR project would not be needed

C. Brain drain is a national preoccupation.  There is one that is severe although not spontaneously evident. We must stop the brain drain of talent from Clinical Vision Research, and consequently academic life, to lucrative private practice. We must be allowed to train and recruit and be able to offer them conditions to keep young talents in Academic Life. This is one true brain drain, the clinical academic one.


D. We must mobilise the whole of our national Vision Research Capacity. This includes the actual funded projects, those that rated well but have not been funded and also  new projects not yet submitted or modified versions.

  1. Identify investigators
  2. Obtain a brief description of projects in order to classify
  3. Establish means of contact
E. In doing this we will be able to manage succesfully multidisciplinarity

F. Define national priorities


G. Initiate or develop sectors that are deemed important to develop.

  1. Clinical Research
  2. Basic research
  3. Other sectors in response to our priorities
H. Coordinate the ensemble in a functional network and generate cooperation.

I. Establish a useful system of communications and exchanges.

J. Provide a pool of consultants available to all in devising the network, in preparing applications and executing projects.


K. Remain in full contact with our Stakeholders.  This is accomplished by maintaining full activity at the level of the Vision Health Research Council and its implication with other Stakeholder structures.

  1. Initiate or support an important public awareness campaign
  2. Maintain active collaboration with Prevent Blindness Canada and MEDEC
IV. SUBMITTING OUR PROJECT: GENERAL PRINCIPLES
A. Funded and accepted but unfunded projects should be refurbished in the new CIHR fashion if they will benefit fully of the system.

B. New projects and revised unfunded projects should be presented in the same point point of view.


C. All the usual items of research funding should be considered: it essential that we devise programs or participate in CIHR programs that cover all aspects of research.

  1. Training fellowships
  2. Recruiting of new investigators; provision of career support
  3. Programs for salary sources  for investigators
  4. Equipments; specially shared utilisation
  5. Supplies
  6. Resources administration
  7. Etc
D. Multidisciplinarity and  clinical / basic cohesiveness


E. Think in terms of Networking

  1. Emerging domains
  2. Teams: x number of individuals working in same surrounding
  3. Groups: x number of teams in different localisations
  4. Networks: teams and groups devoted to same projects.
  5. Individuals can belong to many teams or Institutes etc

F. Communications are essential and cover many aspects.

  1. Maintain a valid Website
  2. Straithforward communications; directories, news letter, Email service etc
  3. Communications of clinical research data
    a. Dedicated terminals and communication lines.
    b. Ethics of confidentiality
  4. Telemedicine projects: distant regions and aboriginal consultation access.

G. Consultants pool.
It is part of our mandate to build a Clinical Research National Network.  The project must define its needs to do so.

a. Recruit in projects local experts and make them available to team, group or network.
(1) Clinical epidemiologists
(2) Methodology experts

b. Have the possibility of identifying and funding expert consultants in very specialised fields.
(1) Outcome evaluation
(2) Health care providing and administration
(3) Economists in health care providing
(4) Applied Computer science and Programming
V. TENTATIVE CLASSIFICATION OF RESEARCH

From Clinical Research

  1. Clinical Epidemiology
  2. New technologies
  3. Outcome Evaluation
  4. Clinical Trials
  5. Physiopathology of diseases: understanding the pathological process
    a. Clinical: research on humans
    b. Scientific; Experimental
  6. Experimental utilisation of Human Materials
  7. Animal Models of human diseases
  8. Investigator initiated Research:Priorities related
  9. Investigator Initiated Research
     To fully Basic Research
VI. SPECIFIC ASPECTS: CLINICAL RESEARCH, EXAMPLES OF POSSIBLE PROJECTS.

A. Clinical Epidemiology

  1. Production of usable data
  2. Produce new markers, methods and instruments for obtaining data
  3. Identify and measure target populations
  4. Provide access of data
    a. to investigators
    b. to government and hospital administrations

B. New technologies

  1. Evaluate
    a. Diagnostic, therapeutic and prognostic
    (1) new instruments
    (2) new technologies
  2. Devise
    a. Diagnostic, therapeutic and prognostic
    (1) new techniques
    (2) new equipments
  3. Relate with Industry

C. Outcome

  1. Evaluation
    a. Economics of Drugs use
    b. Quality/cost evaluation
    c. Of procedures
    d. Of equipments
    e. Rationalisation of equipments and facilities distribution   
    f. Regional models of care delivery   
    g. Evaluate the use/risks ratio of first line prroviders
    h. Use of health problems awareness programs
    i. Use of House Care Delivery
  2. Investigation of Methods of contacting and influencing government and hospital administration.

D. Clinical Trials

  1. Create multicentric studies facilities
  2. Provide expert consultants
  3. Relate to Industry
  4. Obtain mutual support of Food and Drug government Institutions

E. Physiopathology of diseases

  1. Study of patients and normals to understand specified aspects of diseases
  2. Heredity and family studies of diseases
  3. Etc
References

1- CIHR Web Site ( http://www.cihr.org/ )
LIBRARY / A New Approach to Health Research for the 21st Century:

 2- CIHR Web Site ( http://www.cihr.org/ )
LIBRARY / Proposed Governance Structure for the Canadian Institutes of Health Research

 3- CIHR Web Site ( http://www.cihr.org/ )
 WHAT'S NEW A /  Excerpt from the Federal Budget Plan

 4- NIH Web Site ( http://www.nih.gov/index.html )
http://www.nih.gov/news/ResPriority/priority.htm     HOW THE NIH FUNDS   MEDICAL RESEARCH / Setting Research Priorities at the National Institutes of Health

5- NEI Web Site (http://www.nei.nih.gov/index.htm )
A national plan:  1999-2003. ( http://www.nei.nih.gov/publications/plan/plan.htm )