Background: Almost all deaths from breast cancer are due to metastasis. People living with metastatic breast cancer (MBC) and their loved ones have been concerned about the lack of research progress. ...The purposes of this paper were to analyze breast cancer research spending in Canada, and to evaluate whether MBC research was aligned with patient priorities. The results from the MBC Priority Setting Partnership (MBC PSP) were used as an approximation of patient priorities. Methods: The data source was the Canadian Cancer Research Survey. MBC projects were identified and mapped to the patient priorities.Results: This analysis found that 18% of breast cancer research investment was directed to MBC, with a large proportion of this research investment focused on the biology of metastasis. Four of the top 10 MBC PSP priorities had not been addressed: optimal sequence of therapy, role of continuous versus intermittent treatment, benefits of early palliative care, and best methods for patient education. Conclusion: These figures provide a baseline from which any increases in MBC research and improved alignment to patient priorities can be measured. A cooperative effort by funders, researchers, patients, caregivers, and health care providers is needed to address research gaps.
Although patient partners have been part of grant review panels, they are rarely given decision-making authority and never given sole responsibility for determining what research to fund. In ...patient-oriented research, however, patient partners may be in the best position to determine what is needed and whether the proposed research will engage patients in meaningful ways. The objective of this case study was to demonstrate that patient partners can adjudicate patient-oriented research proposals without the inclusion of researcher/expert reviewers.
Abstract Introduction To inform funding strategies for research in metastatic breast cancer (MBC), knowledge of the current research landscape and identification of potential gap areas requiring ...additional research are essential. In 2014, the Metastatic Breast Cancer Alliance (MBCA) published an analysis that showed that between 2000 and 2013, only 7% of all funds for breast cancer research were devoted to metastasis. As more people are living with MBC, addressing research priorities for those living with the disease is important, as is understanding gaps in the current funding landscape of MBC research to appropriately target investment. Methods A collaborative effort between funders and patients was undertaken to analyze breast cancer projects funded between 2014 and 2020 from the International Cancer Research Partnership database, the Health Resource Alliance database, and MBCA members, representing grants from 83 non-profit organizations worldwide. Project titles, abstracts, and classifications of these grants were extracted from these databases. Next, to identify research projects in the databases that are related to metastasis, a classification tool that uses a machine learning algorithm was built, trained on manually coded grants from the 2000-2013 analysis, and validated by expert coders. Projects were then coded according to a pre-established metastasis classification policy to categories such as type of research (e.g., treatment), genes or proteins studied, site of metastasis, breast cancer subtype, and patient priority questions. In terms of the latter, MBCA members living with MBC were surveyed about research priorities. Member advocates ranked survey questions according to highest patient priority, and these were converted to language that could be queried with the tool. Results Investment in MBC research nearly doubled from 2014 to 2020. Research into understanding and overcoming treatment resistance, which was the highest patient priority question, increased from 15% in 2014 to 26% of the MBC portfolio in 2020; this was a statistically significant increase above the rate of inflation. In terms of treatment resistance according to subtype, the highest number of projects focused on triple-negative MBC (>300). By contrast, < 20 projects were focused on overcoming treatment resistance in metastatic invasive lobular breast cancer. Of the six categories evaluated (e.g. biology and detection/diagnosis/prognosis), the largest increase in investment was for treatments. Discussion The coding tool allows for ongoing complex queries such as identification of funded research relevant to areas identified as important by MBC advocates (Table) and provides a funders’ ‘dashboard’ to identify gap areas in need of further research funding. This collaborative effort between funders and patient advocates, and the resulting current and future analyses, can be used to focus advocacy efforts to drive research funding of priorities and understudied areas of MBC. Despite the increase in funding, the investment in metastatic research–the primary cause of death from breast cancer–remains insufficient. Table. Research Priorities of MBC Patient Advocates Citation Format: Margaret Flowers, Teri Pollastro, Kari Wojtanik, Katherine McKenzie, Kimberly Badovinac, Medha Deoras-Sutliff, Lynne Davies. Analysis of Trends in Funding of Metastatic Breast Cancer Research abstract. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-05-10.
This article describes two workshops on health‐promoting policy change, developed and delivered to more than 1,000 public and community health practitioners across one Canadian province. The ...workshops were designed to increase knowledge about the process of policy change and provide opportunities for skill development. Three basic instructional methods‐mini‐lectures, individual pen‐and‐paper exercises, and small‐group activities—were used. Workshops were delivered using a host organization arrangement, meaning organizations willing to host workshops could do so if they provided the venue and invited members of other organizations in the community. Initial evaluations indicate that practitioners find the workshops useful and that many have integrated the information into their day‐to‐day work. To the author's knowledge, no other workshops of this nature have been delivered in this systematic way.
The Victim Impact Panel is a forum in which a group of victims of impaired driving relate how their lives have been affected by the sudden loss of a loved one. The goal of the panel is to affect the ...audience on an emotional level and change their attitudes about drinking-driving. Changes in attitudes, behavioral intentions and empathie responsiveness were examined for incarcerated offenders who had been exposed to panel presentations. Responses were compared to those obtained from a control group and indicated several statistically significant positive attitude shifts and changes in behavioral intentions. However, no increases in empathy were found.
Over the past decade, clinical studies and clinical practice guidelines have suggested the use of higher small solute clearance targets for patients on peritoneal dialysis (PD). This study asks ...whether these recommendations have translated into changes in clinical prescription of PD.
Data were collected annually from 1996 to 1999 on all prevalent dialysis patients in 24 Canadian centers, accounting for approximately 40% of the Canadian chronic dialysis population. Approximately a third of these patients were on PD. Full details of each patient's prescription were recorded, with particular attention to dwell volumes and frequency of exchanges for continuous ambulatory PD (CAPD) and to total treatment volumes and day dwells for automated PD (APD). The most recent Kt/V and creatinine clearance values available were recorded for each patient and the overall results for each year were compared to present treatment recommendations.
24 university- and community-based hospitals.
From 1996 to 1999, the use of APD, relative to CAPD, grew from 14% to 28% of all PD patients. Among CAPD patients, the proportion using dwell volumes greater than 2 L rose from 14% to 32%, and the proportion doing more than 4 dwells per day rose from 16% to 28%. The mean daily volume of prescribed fluid for CAPD patients increased from 8.3 to 9.1 L. As a result, the proportion of patients achieving a weekly Kt/V above 2.0 rose from 54% to 72%, and those receiving a Kt/V less than 1.7 fell from 22% to 10%. For creatinine clearance, those exceeding 60 L per week rose from 63% to 73%. For APD, the mean treatment volume rose from 11.8 L in 1996 to plateau at about 13.4 L in 1998 and 1999. However, the proportion of patients receiving more than 1 day dwell grew from 31% in 1998 to 40% in 1999, and the proportion that were "day dry" fell from 25% to 17%. For APD, the proportion of patients with a Kt/V above 2.0 rose from 67% to 77%, and with a creatinine clearance above 60 L, from 62% to 70%. The proportion with no recent clearance value recorded fell during the course of the study, from 45% to 27%.
There was a marked change in PD prescription practices in Canada during the second half of the 1990s. This occurred in response to clinical studies and publication of guidelines. There is room for further improvement, especially with respect to the proportion of patients that did not have regular clearance measurements made.
PDF
