ASBMR. Institute of Musculoskeletal Health and Arthritis (IMHA) Dr. Hani El-Gabalawy Scientific Director Canadian Institutes of Health Research

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1 Institute of Musculoskeletal Health and Arthritis (IMHA) ASBMR October 6, 2013 Dr. Hani El-Gabalawy Scientific Director Canadian Institutes of Health Research

2 Welcome Our goals: Introduce our team Provide an overview of IMHA and the research we fund Outline our process for developing a new strategic plan Share some of the feedback we ve received Hear from the bone research community on how we can move forward 2

3 3 IMHA comes to Winnipeg

4 IMHA Areas of Focus Arthritis Research MSK Rehabilitation Sciences Bone Research Skeletal Muscle Research Skin Research Oral Health Research 4

5 5 IMHA s Current Strategic Research Priorities and Objectives Pain, Disability and Chronic Disease Genetic and environmental causes, optimal treatment and elimination of pain and disability. Relationship between chronic diseases and conditions within IMHA's mandate. The impact on general health and well-being. Tissue Injury, Repair and Replacement Causes of and prevention of the physical, psychological, psychosocial and economic impacts of acute and chronic injury and prostheses. Physical Activity, Mobility and Health Relationships among physical activity, mobility and MSK, oral and skin health at every level. Psychosocial aspects of exercise, activity and sports on populations.

6 CIHR Funding under IMHA s Mandate 6 CIHR spending in IMHA mandate continues to increase. Majority of spending in biomedical, followed by clinical, and pop health/health systems.

7 Bone Team Grants 5 year grant providing up to $500,000/yr 3 successful teams early 2012 PI Institution Project Title Michael Glogauer Joy MacDermid Robert Young University of Toronto McMaster University Simon Frasier University (Burnaby, B.C.) Identifying novel markers of alveolar bone loss: developing new diagnostic approaches for the most prevalent forms of bone loss Evidence-based fracture management supports to optimize fracture recovery, future bone health and optimal physical activity after distal radius fracture New mechanisms, therapeutic targets and technologies for bone health 7

8 Growth of IMHA Researchers Growth of researchers under IMHA s mandate is greater than that of CIHR s total growth of researchers. 8

9 IMHA s Growth Growth in IMHA s mandate is consistently greater than CIHR s total expenditure growth, particularly in the last few years. 9

10 CIHR Expenditures in IMHA s Mandate for Bone Health The majority of bone research is biomedical, with increases in clinical research in last years, and a big jump in 2011/12. Minimal spending in health systems and pop health. 10

11 Bone Research Success in OGP Core success rate of bone applications has increased in the last 2 fiscal years from 22% in Number of applications have been consistent in the last 5 years. 11

12 Reforms to OOGP Foundation Grants Project Grants 12

13 Objectives of the reform The objectives of the reform of CIHR s investigator-driven strategy are to: Capture excellence across all four research pillars, from knowledge creation to knowledge translation Capture innovative, original and breakthrough research Integrate new talent to sustain Canada s pipeline of health researchers Improve sustainability of the long-term research enterprise 13

14 Objectives of the reform In meeting these objectives, the reform is also meant to address a number of current operational challenges: Workload and costs for applicants Peer review burden Lack of consistency and efficiency of peer review process Growing discrepancy between research evolution and committee structure Program complexity 14

15 The Foundation Scheme The Foundation Scheme is designed to contribute to a sustainable foundation of health research leaders. It is expected to: Support a broad base of research leaders across career stages, areas and disciplines relevant to health; Develop and maintain Canadian capacity; Provide flexibility to pursue new, innovative lines of inquiry; Contribute to the creation and use of health-related knowledge. The Foundation Scheme will have one competition a year. 15

16 The Foundation Scheme The specific review criteria are still under development. The requirements for enhanced 16 institutional support are also still evolving.

17 The Project Scheme The Project Scheme is designed to capture ideas with the greatest potential for important advances It is expected to: Support a diverse portfolio of health-related research and knowledge translation projects at any stage, from discovery to application, including commercialization; Promote relevant collaborations across disciplines, professions and sectors; Contribute to the creation and use of health-related knowledge. The Project Scheme will have two competitions per year 17

18 The Project Scheme As a result of community feedback, the Project Scheme will use a twostage process for review. 18 The specific review criteria are still under development

19 Roadmap Signature Initiatives CIHR s Signature Initiatives are addressing complex problems that typically require multi-disciplinary and multi-sectoral engagement A CIHR Signature Initiative is: An implementation tool used to meet CIHR s Roadmap strategic priorities Co-designed by multiple CIHR Institutes to address a key gaps/build on an opportunity Dependent on partner engagement to be successful Typically large, with a long-term vision and longer-term investments Expected to achieve significant impact Consistent with and complementary to the national Patient- Oriented Research Strategy (SPOR)

20 Roadmap Signature Initiatives CIHR Research Priority Areas Enhance Patient-Oriented Care and Improve Clinical Results through Scientific and Technological Innovations Support a High-Quality, Accessible and Sustainable Health-Care System Reduce Health Inequities of Aboriginal Peoples and other Vulnerable Populations Prepare For and Respond To Existing and Emerging Threats to Health Roadmap Signature Initiatives: 1. Strategy for Patient-Oriented Research (SPOR) 2. Personalized Medicine 3. Community Based Primary Health Care 4. Pathways to Health Equity for Aboriginal Peoples 5. International Collaborative Research Strategy for Alzheimer s Disease 6. Canadian Epigenetics, Environment and Health Research Consortium 7. Inflammation in Chronic Disease 8. Evidence-Informed Health Care Renewal Promote Health and Reduce the Burden of Chronic Disease and Mental Illness 20

experience or innovations in our health care system MAJOR BARRIER: Research is

21 Canada s Strategy for Patient-Oriented Research (SPOR): Background ISSUE: Translating health research into improved health outcomes, enhanced patient experience or innovations in our health care system MAJOR BARRIER: Research is often too far removed from clinicians, policymakers, patients, and other key stakeholders

22 SPOR SOLUTION: SPOR is a coalition of federal, provincial and territorial partners (patient advocates, provincial health authorities, academic health centres, charities, pharmaceutical sector, etc.) dedicated to the integration of research evidence into care; The objective of the Strategy is to foster evidence-informed health care by bringing innovative diagnostic and therapeutic approaches to the point-of-care so as to ensure greater quality, accountability and accessibility of care; Stakeholder cooperation, including on the funding front, will be key to the successful deployment of the strategy.

23 SPOR Core Elements Support for People and Patient-Oriented Research and Trials (SUPPORT) Units SPOR Networks Training and capacity development Improving the clinical trials environment Patient/consumer engagement

24 SPOR Principles Decision-makers and clinicians involved throughout the entire research process to ensure integration into policy and practice Patients/consumers involved in all aspects of research to ensure questions and results are relevant and integrated into practice 1:1 matching investment formula between CIHR and nonfederal government partners to ensure relevance and applicability Multi-disciplinary approach Everyone responsible for pushing or pulling the results into decision-making and practice including researchers, policy-makers and clinicians

25 Discussion Points Strategy for Patient Oriented Research (SPOR) What are the most compelling patient-oriented research questions? How do we examine these questions using a multidisciplinary/multisectoral approach? What support is required to encourage translational research? 25

26 Institute of Musculoskeletal Health and Arthritis (IMHA) ASBMR October 6, 2013 Dr. Jodi Cullum Assistant Director Winnipeg office

27 Strategic Planning Current strategic Plan Strategic Directions 1. Research excellence with impact 2. Canadian Health and Canadian Healthcare system 3. Health and socio-economic benefits Flagship theme Physical activity and mobility across the lifespan 27

28 Strategic Planning Listening for direction Summer Winter 2014 Fall 2013 Spring 2014 Sharing ideas Multistakeholder & partner forum/cihr corporate Fall

30 Listening Bone Health Research Consensus Conference (2009) Research priorities Optimized prevention of bone attacks Optimized fracture risk prediction tools Optimized fracture management (sequelae intervention treatment) Bone and other diseases (commonalities, bidirectional relationships) New optimized models of care 30

31 Listening Bone Health Research Consensus Conference (2009) Research enablers 31 Common message for all health professionals and patients to improve bone health Holistic systems approach to bone health (including patients) Piggyback on existing longitudinal epidemiological studies National fracture registry linking to other outcome databases and large study cohorts Capacity and training development Partnerships and funding

32 Listening Research Survey (2012) Invited all CIHR-funded NPI, co-pi and co-applicants 479 responses 164 (34.2%) bone research Open and closed-ended questions Data currently being analyzed at a more granular level 32

33 Challenges in Bone Research Acquiring funding Time commitment for proposals Limited opportunities Competition (especially for operating grants) Finding funding for research that does not clearly fall into one area Applying for funding as an early career researcher/less established 33

34 Challenges/Gaps in Bone Research Available resources Cost of equipment, space to conduct research Increasing collaboration - Between clinicians and researchers - Between institutions - Across disciplines Translational research 34

35 Promising Areas for Research Biology/mechanisms underlying disease & injury Prevention Risk identification Use of diagnostic imaging Early intervention Translational research Treatment (clinical trials, RCTs) Rehabilitation Health care policy and delivery Administrative data sets/infrastructure development Patient-oriented Cohort studies Burden of disease 35

36 If you could pick ONE research priority Chronic disease management Pain and disability Clinical care Arthritis Osteoporosis Tissue and joint repair/regeneration/replacement Prevention/promotion Physical activity Injury prevention 36 Health care delivery/system (efficient, effective, accessible) Physiology Normal and abnormal development Biopsychosocial approach Rare diseases

37 37

38 Discussion Points

39 Discussion Points Where are the opportunities to further bone research? Biomedical, clinical, health services, pop. health? Collaborations? Partnerships? Should the focus be on identifying/filling research gaps or building on existing strengths? Where is additional capacity needed? 39

40 Thank you Dr. Hani El-Gabalawy Dr. Jodi Cullum

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