New opportunities for anesthesia research in Canada

Top ten priorities for anesthesia and perioperative research: a report from the Canadian Anesthesia Research Priority Setting Partnership

PURPOSE

The purpose of the Canadian Anesthesia Research Priority Setting Partnership (CAR PSP) was to identify a top ten list of shared priorities for research in anesthesia and perioperative care in Canada.

METHODS

We used the methods of the James Lind Alliance to involve patients, caregivers, healthcare professionals, and researchers in determining the research priorities in Canada. In a first survey, participants submitted questions that they want research to answer about anesthesia and perioperative care. We summarized those responses into a longlist of questions. We reviewed the literature to see if any of those questions were already answered. In a second survey, participants chose up to ten questions from the longlist that they thought were most important to be answered with research. From that list, the highest ranking questions were discussed and assigned a final rank at an in-person workshop.

RESULTS

A total of 254 participants submitted 574 research suggestions that were then summarized into 49 questions. Those questions were checked against the literature to be sure they were not already adequately addressed, and in a second survey of those 49 questions, participants chose up to 10 that they thought were most important. A total of 233 participants submitted their priorities, which were then used to choose 24 questions for discussion at the final workshop. At the final workshop, 22 participants agreed on a top ten list of priorities.

CONCLUSION

The CAR PSP top ten priorities reflect a wide variety of priorities captured by a broad spectrum of Canadians who receive and provide anesthesia care. The priorities are a tool to initiate and guide patient-oriented research in anesthesia and perioperative care.

Declining randomized clinical trials from Canadian anesthesia departments?

PURPOSE

The research productivity was estimated by publications from anesthesiology departments at Canadian universities over a five-year period, and the articles published were classified into several study designs.

METHODS

In this observational study, the MEDLINE database was searched for publications listed by anesthesiology departments at Canadian universities as the primary corresponding source from 2000-2004. Abstracts were reviewed and each publication categorized into its respective methodological design. Impact factors of the journals in which the articles appeared were taken into consideration. "Total impact score" was defined as the total number of articles from a particular journal in a particular year multiplied by the impact factor value. Changes in overall publication numbers over the five-year period were compared and analyzed using Pearson correlation coefficients.

RESULTS

Total Canadian anesthesia publications remained constant from 2000-2004. In this five-year time frame, the University of Toronto had the highest number of publications (271) followed by the University of Montreal (86), and McGill University (84). These universities conducted primarily randomized controlled trials (RCTs) whereas smaller Canadian universities mainly published case reports, reviews, and cohort studies. The number of RCTs conducted seems to be decreasing whereas the number of case reports and reviews being published are remaining constant over the five-year period.

CONCLUSION

Although overall numbers in anesthesia publications do not suggest a significant decline, the number of RCTs decreased during the years 2000-2004. The quality of anesthesia research appears to be comparable to those in other medical specialties, with larger institutions conducting RCTs and smaller institutions publishing more case reports.

Research awards program of the Canadian Anesthesiologists' Society/Canadian Anesthesia Research Foundation: survey of past recipients

PURPOSE

To review the effectiveness of the Research Grants, Career Scientist Award and Fellowship Program (RGCSFP) of the Canadian Anesthesiologists' Society (CAS)/Canadian Anesthesia Research Foundation (CARF) by surveying past recipients.

METHODS

The CAS Research Committee database of past RGCSFP recipients was reviewed to identify all past award recipients from the time of program inception in 1985 until the year 2005. A questionnaire was mailed to all past recipients with retrievable addresses. The questionnaire asked specific questions regarding past and current research, publications, grant procurement and mentoring of trainees. In addition, opinions regarding the program's effectiveness were solicited.

RESULTS

Of the 100 mailed survey forms, 66 (66%) were completed and returned. The number of original published articles per respondent was 30.1 +/- 28.5 (mean +/- SD) at the time of the survey, and the life-time number of all publication types was 38.5 +/- 34.6. Cumulative research funding increased in relation to the number of years in research, and amongst past recipients with > 15 years in research, individual research funding from all sources was $585,747 +/- $773,716. Ninety-six percent of respondents agreed or strongly agreed that the program was valuable.

CONCLUSIONS

The RGCSFP has supported a large number of new and established anesthesia investigators in Canada, and these individuals have demonstrated high research productivity. The program is considered to be very valuable according to past recipients.

The changing pattern of anesthesia, 1954-2004: a review based on the content of theCanadian Journal of Anesthesia in its first half-century

PURPOSE

In order to review changes and progress in anesthesiology in the second half of the 20th century, and to recognize the first half-century of the Journal's existence.

SOURCE

The content of the Journal from its inauguration in 1954 through 2004 was reviewed.

RESULTS

Although the data base is that of the Canadian Journal, many of the contributions were from other countries, and for this reason the findings will have relevance both in Canada and elsewhere. The review suggests that anesthesiology evolved in two phases in this period: from 1954 to 1978 and from 1979 to 2004. The first was characterized by the introduction of new drugs and adaptation to new surgical techniques; the second, by a greater emphasis on clinical excellence, outcome, quality patient care both in the operating room and elsewhere in the hospital, and research.

CONCLUSIONS

Although profound advances in knowledge, techniques, and relationships, have shaped the pattern and practice of anesthesiology in this half-century, the basic concerns of anesthesiologists relating to the practice of anesthesia and to their patients remained unchanged. At the same time, the many advances that have shaped anesthesiology in this half-century have extended the understanding of the phenomenon of anesthesia and enhanced the quality of patient care, which gives rise to the hope that anesthesiologists will continue to fully achieve these twin goals in the next half-century.