News at Medicine - May 2009 - Finding answers to health research questions

Finding answers to health research questions
May 14, 2009
Health system decision-makers in Newfoundland and Labrador are faced with many important questions on a daily basis. The Contextualized Health Research Synthesis Program (CHRSP) of the Newfoundland and Labrador Centre for Applied Health Research (NLCAHR) aims to provide answers to some of these questions by identifying the highest quality research and then interpreting it in light of the unique geographic, economic, demographic and other characteristics.

To date, CHRSP has produced three reports. The first, Examining Options for Dialysis Services in Rural and Remote Newfoundland and Labrador, was released in 2008.

A new report on childhood overweight and obesity asked the research question “What types of effective non-clinical interventions might be helpful for prevention and treatment of childhood overweight and obesity in Newfoundland?”

This question is of obvious importance for health care in the province. Rates of obesity and overweight are increasing for youth in Newfoundland and Labrador and are, along with adult rates, the highest among the Canadian provinces. As with adults, overweight and obese children have increased rates of physical and psychological co-morbidities and decreased educational attainment. Since overweight tends to persist into adulthood, these trends forecast significant challenges to the population health and health care resources of the province.

Current research is demonstrating that the causes of overweight and obesity are many, complex and inter-related. Obesity is influenced by factors that are genetic, behavioural, nutritional, social, cultural, economic, and environmental.

The CHRSP report concluded that addressing the problem will require interventions that tackle the multiple and linked causes, and that increasing physical activity and/or reducing sedentary behaviour is key. Details on promising practices in obesity prevention, and examples of treatment components that have demonstrated positive outcomes, are included in the report.

In 2007/08, the Government o Newfoundland and Labrador indicated its intention to purchase a Positron Emission Tomography (PET) scanner within the next four years. Today, PET scanners are most often available as a “hybrid” model that includes Computed Tomography (CT). PET/CT technology is used primarily for oncology, brain and cardiac imaging. At present, patients who require a PET/CT scan travel out of the province to access this service.

The second new CHRSP report aims to assist in the development of this planned PET/CT Program by answering the research question “Given the geographic, demographic, fiscal and political context of Newfoundland and Labrador, what is the most appropriate, effective, and efficient way to operate a PET/CT program so that the population derives the maximum benefit at the best possible cost?

The report discusses planning and operational considerations for the implementation of the PET/CT. These include the purchase and use of associated equipment, the best location for the program, management of referrals, and human resources and regulatory requirements.

NLCAHR’s Contextualized Health Research Synthesis Program is a collaborative effort of researchers and health system leaders from the Department of Health and Community Services and the four regional health authorities. CHRSP teams conduct the research and contextualization, and disseminate the results to decision makers. NLCHR is working with these stakeholders, as well as with health economists, experts in research synthesis and subject experts, to identify and address some health research issues that are of pressing interest to Newfoundland and Labrador.

CHRSP uses only high-level research, including meta-analyses, systematic reviews and health technology assessments. For each topic that is selected, a team is created to gather and synthesize the findings of this research and then contextualize it to the requirements, resources, and circumstances of Newfoundland and Labrador. This contextualization process is one of the first of its kind in the world. Before the report is finalized, an external reviewer assesses the work of the project team, providing feedback to ensure validity.

For further information on CHRSP visit