Public record of meeting, 29 November, 2010

MINUTES

1. CPHO Opening Remarks

Dr. David Butler Jones, Chief Public Health Officer of PHAC, and Kim Elmslie, Director General of the Centre for Chronic Disease Prevention and Control, joined the CTFPHC Members and provided remarks about the current activities and directions of the Public Health Agency of Canada. Dr. Butler Jones expressed his support of the important work of the CTFPHC and thanked the members for the wisdom and experience they bring to their work.

2. Review of June 28, 2010 Meeting Minutes and Terms of Reference

Members reviewed the minutes of the previous meeting and noted action items that were completed. Members also reviewed their Terms of Reference and were reminded to disclose any conflict of interest if it should arise.

3. Knowledge Transfer and Exchange

Dr. Sharon Straus provided an overview of the knowledge transfer and exchange framework that had been developed for the CTFPHC. Members provided feedback and discussed the importance of knowledge to action and ways to involve a variety of media (e.g. print and television) as necessary.

4. ERSC: Lessons Learned

Dr. Donna Ciliska, Donna Fitzpatrick-Lewis and Mary Gauld provided a detailed presentation about lessons learned by the ERSC as they progressed with detailed searches for the topics identified by the Task Force. They also outlined a number of challenges such as the development of key questions, communication and meeting scheduling, timelines, use of grade, and version control and integration of comments. Task Force members provided feedback and expressed their appreciation of the quality of ERSC’s work.

5. Evidence for Breast Cancer Review

Dr. Donna Ciliska and Marcello Tonelli provided a review of the work done to provide an update of the 2001 CTFPHC recommendations on breast cancer screening and provided an overview of search results for preference and values.

6. Final Discussion and Vote on Breast Cancer

After extensive discussion and review of the evidence, CTFPHC Members developed and voted on recommendation statements for routine screening in women; as well as recommendations for clinical breast exam and breast self exam.

7. CTFPHC Office: Update on Activities

Nancy Hajal and Catherine Makris provided an update on the activities of the CTFPHC Office and introduced several new staff members.

8. Working Group Break Out Sessions

During day one and day two of the meeting, CTFPHC Working Groups held brief meetings during two separate break-out sessions.

9. Performance Measurement

Dr. Patrice Lindsay presented information about linking clinical practice guidelines to performance measurement in health care. During discussion, members stressed that there was a grey area between performance measurement and knowledge translation and recommended ways to align this work with the knowledge to action cycle.

10. Electronic Medical Records EMRs

Dr. Jay Mercer joined the meeting to present information about Electronic Medical Records (EMRs) in surveillance and prevention. He stressed that EMRs is a data management engine in its earliest stages and still in need of certain requirements such as standards for electronic data reporting, functional specification for EMRs plug in, standards for guidelines and privacy policies. He encouraged the CTFPHC needed to think about how their recommendations could be enhanced by EMRs.

11. Working Group Presentations

11.1 Methods

Marcello Tonelli discussed admissible study designs for CTFPHC evidence reviews, considerations for expanding to observational data and outlined a process for endorsing guidelines from other organizations.

11.2 Cervical Cancer Screening

Jim Dickinson reported that the Cervical Cancer Screening Working Group had set up questions and a search outline and would be finalising a protocol and arranging for external reviewers. He shared the analytical framework and covered several issues that had been identified.

11.3 Depression

Michel Joffres outlined a proposed work plan / timeline to develop guidelines for screening for depression. He presented key questions for a staged review and outcomes for a GRADE ranking.

11.4 Hypertension

Patty Lindsay shared the Hypertension Working Group’s Protocol overview. The goal of the Working Group is to determine the effectiveness and efficacy of screening for hypertension in achieving better control of blood pressure and reducing vascular morbidity and mortality. Their review will also attempt to determine the methods for screening and target populations that will lead to the greatest benefit.

11.5 Diabetes

Kevin Pottie reminded members of the evidence protocol for Diabetes and presented several key questions, contextual questions and inclusion/exclusion criteria. Currently 65% of citations have been screened and studies have been selected for data abstraction.

11.6 Topic Prioritization

Sarah Connor Gorber outlined the proposed topics for 2011 shortlisted in ranked order. She also provided an overview of the prioritization process and outlined considerations related to considering all criteria equally and the goal of balancing the annual portfolio.