Funding excellence in health research starts with a rigorous process of reviewing and evaluating applications to our funding programs. Our reviewers are instrumental to this process, so when it came to evaluating applications to our patient-oriented research (POR) funding programs, we knew we had to be innovative with reviewer recruitment.
At SHRF, health research funding is decided by committees of active researchers and health professionals who use a rating scale of excellence to assess research proposals, answering the following questions:
• Is it relevant and original?
• Is it feasible and ethical?
• Does it adhere to the objectives and priorities of the funding program?
• Does the researcher or team have the expertise and support to conduct the research?
But how do you evaluate a research proposal when patient engagement is not only encouraged, but a requirement?
Patient involvement in research is not new to the health research landscape, however, in recent years there has been a national focus on engaging patients at every step of the research process. The Canadian Strategy for Patient-Oriented Research (SPOR) ensures that the questions asked and investigated are patient-identified priorities with the ultimate goal of improving patient outcomes.
SHRF has taken patient engagement further with the introduction of the first Patient Review Committee. Patient Family Advisors (PFAs) met and were trained as patient reviewers to review and rank applications for both our Sprout and POR Leadership grants.
Our two patient-oriented research programs, offered in partnership with the Saskatchewan Centre for Patient-Oriented Research (SCPOR), require health researchers to actively engage patients throughout the research process. In asking this of our researchers, we also needed to look at how we were going to evaluate not only the extent of patient involvement, but if their participation was meaningful to the research being proposed.
In 2017-18 we did this by having two PFAs sit in on the review of applications. They provided feedback to the peer review committee on aspects of the proposal that outlined how patients would be involved in the planning, conducting and knowledge sharing aspects of the research project.
This was a great step, however, taking feedback into account from all involved, we decided to push further and strengthen the patient voice in the review process.
To do this, we developed review criteria based off the Patient-Oriented Research Evaluation Tool created by SCPOR and PFAs.
“This tool came out of PFAs saying ‘We need a tool that would help us measure the level of patient engagement’” says PFA Janet Gunderson. “It was rewarding to be involved in developing this tool that is now gaining interest at the national level.”
The tool helps identify the degree to which patients are engaged throughout the proposed research.
Using this tool as a guide, the following criteria was developed to evaluate if the research was truly patient-oriented:
• Patients as partners: PFAs are engaged in various aspects of the research project, from the planning stages to knowledge sharing
• Patient-identified priorities: PFAs have helped shape the research question
• Patient-reported outcomes: Outcomes have been identified as relevant to PFAs overall health or quality of life
• Integrating knowledge into practice: PFAs and end-users will use this knowledge to improve health care systems and practices
Prior to the grant review period, SHRF and SCPOR held a training session for the patient reviewers. This session introduced them to the tool, outlined the specific review criteria, detailed the steps of a review process and defined terminology specific to patient-oriented research.
It’s been a positive learning experience for all involved. “We had an enthusiastic response from patients with varying backgrounds and experiences as a PFA interested in reviewing for us,” says SHRF program manager, Olesya Hursky. “Reviewing applications is a lot of work, and these patient reviewers have volunteered and committed their time to help us ensure we are funding the best, truly patient-driven research.”
“I truly believe in patients helping set research goals and being a part of the teams that are driving these questions forward,” says Gunderson. “Patients have a lot to offer, even down to reviewing applications. It’s worthwhile to participate because the patient voice can influence how research is done.”
As with any new approach or process, there are growing pains and learning curves. With every program SHRF offers, we invite feedback from those involved and strive for continuous improvements.
This first patient review committee fulfilled the instrumental role and offered their feedback on how they think our process can be improved to further empower the patient voice, provide meaningful engagement of PFAs and patient reviewers, and ultimately improve patient outcomes. Using this feedback, we will make changes that will continue to strengthen the patient voice in health research and drive patient-oriented research forward in Saskatchewan.