Revised 30 September, 2013
Marcello Tonelli welcomed the CTFPHC members and other participants and thanked them for attending the meeting. A round table of introductions was held.
CTFPHC members reviewed the minutes from the February 2013 meeting. No errors or omissions were noted. Gabriela Lewin moved to accept the minutes of the February 2013 meeting and Dr. Paula Brauer seconded the motion. Approved
CTFPHC members reviewed the list of actions stemming from their previous meeting.
CTFPHC members reviewed the meeting agenda. There were no revisions noted.
Karen Grimsrud provided a brief update regarding the work of the OCTFPHC. She reported that Kim Elmsley has been appointed as Acting Assistant Deputy Minister of Health. Her position at PHAC has been filled by Rodney Ghali. Karen also reported that approval has been provided to develop a business plan for a Task Force on Public Health Guidelines. Sarah Connor Gorber was recognized for recently winning a federal government People Management Award for her exceptional skills as a manager.
The Developmental Delay Working Group has been established and has conducted a scoping review. The CTFPHC reviewed preliminary PICO and exclusions and provided preliminary thoughts on key questions and other issues such as the role of schools and day cares. It was also noted that this issue is closely connected to the social determinants of health.
Paula Brauer provided an update on the ongoing development of guidelines on screening, prevention, and treatment of overweight/obesity for adults. The analytic framework on prevention and treatment interventions for normal weight, overweight, and obese adults has been revised and key questions have also been refined. Analysis is expected to take place in August and draft recommendations should be ready for the October 2013 CTFPHC meeting.
Patricia Parkin reviewed the key questions and reported that the ERSC has completed draft forest and funnel plots and draft GRADE tables.
Maria Bacchus provided an update regarding the work of the colorectal cancer working group. The protocol review has been completed and the final protocol has been developed based on feedback from reviewers and CTFPHC members. Ongoing work is underway to determine a relationship with potential partners.
Rick Birtwhistle reported that there have been a number of issues regarding the CTFPHC mobile app and it is not yet ready for usability testing. More discussion is needed regarding the purpose of the mobile app and its specifications.
Donna Ciliska and Donna Fitzpatrick-Lewis provided an update on the work of the ERSC including the publication of ERSC papers.
A debrief was held regarding the release of the updated guideline on depression screening in primary care settings. The guideline was published in the CMAJ on Monday May 13, 2013 and distributed to national media on the same day. Coverage from the outreach totalled more than 25 million media impressions across Canada. The coverage was balanced with key messages, spokesperson quotes, and guideline changes prominent in the stories.
A new format has been generated for appraisals and existing reports have been reformatted. 10 additional topics have been selected from the 2013 top 1 topic list.
The CTFPHC reviewed and discussed several completed appraisals as follows:
This guideline was placed on hold for further development.
This guideline was placed on hold until further adjustments could be made.
It was unanimously agreed that this guideline would be adopted.
This guideline will not be definitively endorsed. More detail will be added and linkages made with the existing guideline.
There was discussion about the harms and benefits of recommending this guideline and agreed that comments will be send to the USPSTF.
Further work will be carried out on this guideline (e.g., it should be suggested that practitioners remain alert to people with undetected risk factors).
Although this is an important guideline for family physicians, it was agreed that this guideline was not well-founded for use in Canada.
This guideline did not meet CTFPHC criteria for high quality due to a lack of systematic review.
This guideline did not meet CTFPHC criteria for high quality.
Sarah Connor Gorber reviewed the list of published guidelines since the last CTFPHC meeting as well as those in progress. She also outlined recent presentations and topic under consideration, such as costing, scope, the use of GRADE tables, and surrogate outcomes.
Amanda Shane reviewed the current system for literature surveillance and shared a sample summary report.
Neil Bell and Ali Usman provided an extensive review of the evidence regarding the prostate cancer screening Key Questions. It was noted that there is a lack of research studies that meet the inclusion criteria and the CTFPHC members discussed a range of issues, such as alternate screening tools, harms/benefits, and possible options for recommendations. It was noted that mortality from prostate cancer has dropped however it is difficult to determine what proportion is due to screening or improvements in treatment.
Julia Moore provided an update on the work of the Knowledge Translation Working Group including the development of tools regarding the depression and type 2 diabetes guidelines. They also reported that an internal evaluation is underway to assess CTFPHC activities and impact. Dawn provided an overview of website hits from June 2012 to June 2013.
Sarah Connor Gorber reviewed the top 10 topics 2013 rankings noting that lung cancer and cognitive impairment were carried over from 2012. The development of recommendations on screening for lung cancer and cognitive impairment is currently on hold for a USPSTF update.
Cardiovascular disease CVD was placed at the top of the prioritization list for future topics to be developed by the CTFPHC. A two-month scoping exercise regarding cardiovascular disease has been completed and some options have emerged regarding how to approach a CVD guideline. It was noted that the C-CHANGE Initiative was underway and will have an impact at the provincial and national level.
Alejandra Jaramillo confirmed that SharePoint was selected as the new file sharing system and the CTFPHC was provided with an overview and walk-through from Joel Hill, Executive Director. Aljeandra reviewed two reports: a Gantt chart with current estimated completion and launch dates and adjustments to timeline from September 2012 to June 2013. She also provided a summary of time adjustments for each guideline.
Kevin Pottie provided a brief presentation regarding his attendance at a meeting of the USPSTF. Karen Grimsrud also presented information about her recent visit to the USPSTF/ARHQ in March 2013. A meeting was held with ARHQ staff to discuss the processes used to support the USPSTF and potential areas of collaboration between the CTFPHC and USPSTF. It was agreed that the CTFPHC consider ways to better connect on joint projects with the USPSTF.
Karen Grimsrud reviewed a document entitled “Towards developing an approach to incorporating patient and public involvement in CTFPHC’s clinical practice guidelines” and members reviewed options to increase the input of public/patients into the work of the CTFPHC.
Jim Dickinson and Marcello Tonelli provided a brief update regarding the ongoing issue of cervical cancer guidelines.
Marcello Tonello pointed out that there were two membership vacancies on the CTFPHC and a number of applicants and potential applicants were under review. Marcello also thanked Liz and Michel for their hard work and participation at past meetings.
Marcello reminded members that there had been suggestions for some changes to make meetings more effective. Members discussed this issue and made a number of suggestions.
Marcello Tonelli and Richard Birtwhistle thanked all present for their hard work and contributions. The next meeting will take place in Ottawa on October 7–8.