Li Ka Shing Knowledge Institute, Toronto ON
Dr. Tonelli welcomed all participants to the meeting and introduced new members Dr. Scott Klaranbach and Dr. Brenda Wilson. He also introduced Dr. Anne Marie Ugnat from the Public Health Agency who would be replacing Dr. Sarah Connor Gorber who had accepted a new position with the CIHR. Dr. Tonelli welcomed additional staff of the Evidence Review and Synthesis Centre (ERSC) who had joined the meeting and noted that Dr. Jim Dickinson would not be attending as he was visiting the Galapagos.
Dr. Birtwhistle made a motion to approve the February 2015 CTFPHC Meeting Minutes and PROM. This motion was seconded by Dr. Tonelli and unanimously passed. There were no comments or changes to either document. CTFPHC members reviewed the list of action items from February 2015 meeting as well as the agenda and expectations for the June 2015 meeting. Dr. Tonelli mentioned that a Gant chart/spreadsheet had been posted on SharePoint which provided timelines for CTFPHC members’ term and that some minor changes had been made to the Terms of Reference to reflect the new Contribution Agreement.
Dr. Grimsrud provided an update regarding the work of PHAC’s Prevention Guidelines Division. She acknowledged the work of Dr. Connor Gorber and welcomed her replacement, Dr. Anne Marie Ugnat. She also stated that a memorandum of understanding has been negotiated with the Province of Nova Scotia and an RFA has been issued to undertake evidence planning and review services for the CTFPHC.
Dr. Birtwhistle provided a report on CTFPHC eHealth Working Group activities. He reviewed the process of EMR vendor engagement, provided a summary of the InfoClin presentation and reviewed next steps. CTFPHC Members discussed a variety of issues regarding the development of a mobile app and made several recommendations regarding partnering with another organization and the importance of patient preferences and values.
Dr. Thombs and Singh reported that work is continuing on the development of Tobacco and AAA guidelines.
Dr. Grad provided an update on the work of the Hepatitis C Working Group. He reviewed progress to date, key issues, systematic review, screening questions, treatment questions and patient participation. The CTFPHC reviewed the screening questions, treatment questions and the question of whether Hepatitis C screening expansion is justified. Dr. Grad also noted that the Canadian Agency for Drugs and Technologies (CADTH) in Health is currently conducting a review on treatment for Hepatitis C. This review will include economic considerations.
Dr. Pottie provided an update on the work of the Cognitive Impairment in the Elderly Working Group. He reviewed key points, scientific methods, background issues, key questions from the treatment systematic review, proposed recommendations and research gaps. The CTFPHC discussed several issues and made recommendations regarding further review and quality assurance. Those absent will be asked for their votes and the full guideline will be sent to all members of the CTFPHC for a final vote.
Ms. Collier provided a brief review of the main SharePoint functionalities. Throughout the meeting, members consulted individually with Ms. Collier to trouble shoot issues.
Mr. Rodier presented a report regarding the CTFPHC Child Obesity Prevention and Management Media Coverage. He noted that the release generated more than 42 million media impressions and that the guideline announcement also received an estimated 233,477 impressions on Twitter. Spokespersons Dr. Brauer and Dr. Parkin gave excellent interviews and presented with expertise, credibility and empathy. The CTFPHC discussed a variety of issues and made several recommendations.
Guest Dr. Melissa Brouwers provided a verbal presentation regarding the Guideline Program at the CCO. The CTFPHC examined differences in process and methodology between the two groups and considered ways to liaise with the CCO in the development of future guidelines. It was agreed that a potential “road map” for collaborative work between the CCO and the CTFPHC might be established.
Ms. Kretschmer presented a report regarding the CTFPHC guideline timelines.
Dr. Connor Gorber presented a report regarding a new guideline adaptation/adoption process. She provided an historical perspective, current context and a description of the process using the ACP Pelvic Screening Exam as an example. The CTFPHC considered a number of issues and recommended that the new process should be piloted with a few simple guidelines.
Dr. Sherifali provided a brief report regarding the work of the ERSC. She noted that additional members of the team were attending Day One of the CTFPHC meeting as this provided a valuable opportunity for them to observe how the CTFPHC functions. She also mentioned that the ERSC had moved its location and as a result was enjoying synergies with other similar research institutes.
Dr. Birtwhistle provided an update on the work of the Periodic Health Exam Working Group. The CTFPHC discussed the ongoing development of a statement regarding the PHE and recommended that a paper be developed on this process. The importance of patient preferences in this matter was also discussed.
Dr. Lewin presented a report regarding the development of recommendations for screening for lung cancer. She reviewed key questions, contextual questions, methodology, proposed recommendations, benefits vs. harms, key points, research gaps and other guideline recommendations. CTFPHC Members made a number of comments and recommendations on several key issues.
Ms. Quirk provided a detailed presentation on the development of an evidence-informed, theory-driven program to implement CTFPHC guidelines. CTFPHC members commented on this process and stressed the importance of health system issues and key barriers and facilitators.
Ms. Quirk also shared information about the Rx for Change Database developed by Jeremy Grimshaw and run by CADTH.
At the end of Day One, the Lung Cancer, AAA, Hepatitis C and the Developmental Delay Working Groups held brief meetings.
Dr. Tonelli updated the CTFPHC regarding the work of the Developmental Delay Working Group. He covered key questions, search parameters, recommendations and evidence regarding screening, treatment and diagnostic properties. CTFPHC members discussed the issues of autism, harms and patient/family preferences. There was extensive discussion regarding the harms of labeling.
Dr. Bacchus presented the final version of the Colorectal Cancer Guidelines. She reviewed key information regarding the recommended ages for screening, the pros and cons for splitting and/or combining the age groups and the extrapolation of study results. Polyps and economic analysis were also considered. CTFPHC Members discussed the issues of combining or splitting the recommendations by age groups and the effectiveness of the current screening tests
Ms. Kretschmer provided an update on the activities of the Knowledge Translation Working Group. She reviewed the development of the Child Obesity KT tool, cervical cancer CME, future CMEs, patient engagement, social media, GRADE project, conferences, sustaining change and the development of Cantonese breast and cervical cancer screening tools. The CTFPHC discussed the importance of patient and stakeholder engagement.
Dr. Bashir presented information about the CTFPHC’s 2014 annual evaluation. She reviewed the CTFPHC’s goals, the evaluation objectives, methodology, results regarding reach, awareness and perceptions, practice changes and limitations, as well as opportunities for improvement. The CTFPHC stressed the importance of understanding different provincial recommendations across Canada.
This issue was tabled for a future monthly meeting.
Dr. Connor Gorber presented information about the critical appraisal process. She reviewed the objectives of critical appraisal, guideline selection criteria, potential topics for critical appraisal and PICO assessment. It was agreed that a document should be produced by the CTFPHC Office to test the process.
The next meeting will be held on October 19 – 20, 2015 in Calgary.