Research Networks

The Canadian Association of Interventional Cardiology (CAIC) Clinical trials network is a network composed of interventional cardiologists from across Canada who are aimed at improving the care of patients with cardiovascular disease through research and innovation.  The network works with academic peer reviewed funding as well as industry sources.  The network has broad national representation from both community and academic centres also aims to be inclusive. The network is also focused on mentoring the next generation of researchers in interventional cardiology.

CCADN combines two existing networks: AllerGen Clinical Investigator Collaborative (CIC) and Canadian Cohort Obstructive Lung Disease (CanCOLD) network. Allergen which began in 2008 includes six Canadian universities (McMaster, Quebec, Calgary, Saskatoon, Edmonton, and UBC) funded by the AllerGen Network of Centers of Excellence (NCE), to investigate new treatments for asthma. To date, CIC completed 34 early-phase clinical trials. Its successes include the identification of Tezepelumab, an anti TSLP mAB, recently approved for severe asthma. CanCOLD which began in 2009 includes nine universities (McGill, Quebec, Ottawa, Kingston, Toronto, Saskatoon, Calgary, Vancouver, and Halifax), funded through support from governments (FRQS, CIHR, and Foundations) and global pharmaceutical companies attracting support for a total of $15M, and the only network on COPD in Canada. Its successes are measured in its high number of ancillary studies (~75) and peer reviewed publications (~60) but as importantly, by substantive knowledge translation into clinical practice, in national (CTS) and international (GOLD) guidelines, and into health policies for the benefit of COPD patients.

Patients presenting to hospital with emergency general surgery (EGS) conditions such as appendicitis, biliary disease, bowel obstructions, and intestinal perforations represent 11% of all annual hospital admissions in Canada. Compared to their elective surgical counterparts, EGS patients have significantly higher morbidity and more than five times the rate of mortality. The advent of the Acute Care Surgery (ACS) service model in Canada recognizes that patients with EGS conditions require dedicated and coordinated systems of care to optimize outcomes, and has been associated with greater access to timely operative intervention, which in turn, has translated into better outcomes for many EGS conditions. In this relatively new field, research supporting the ideal structure and function of ACS services and modern clinical guidelines for management of common pathologies has lagged behind. As a result, there is a noticeable absence of high-quality clinical trials to guide evidence-based clinical practice in ACS. The significant shift from individual-surgeon focused EGS care to this new model – with admission of EGS patients to a single ACS service at most medium-large community hospitals and all academic hospitals in Canada –is a significant structural improvement in our ability to identify and conduct research on ACS patients.

Surgical research has historically been conducted using primarily observational methodologies. While there is an important role for observational studies – indeed, the majority of our early work has been observational in nature – evidence from large well-conducted clinical trials is needed to truly change practice. Despite an exponential increase in the number of ACS publications (from just 4 in 2005 to over 800 in 2023), the number of randomized controlled trials (RCTs) has not changed substantially. Given the diversity in EGS patients and conditions, collaboration with multiple centers is imperative to ensure trials are both adequately powered and representative of the target population to which we aim to extrapolate the results. Compared to our counterparts across the world, the collaborative nature and long-standing relationships amongst the ACS leaders in Canada affords us a significant advantaged in idea generation, trial conduct, and knowledge translation.

As in the rest of the world, the leaders in ACS in Canada have emerged from leaders in trauma surgery as the clinical specialties have merged. Indeed, we have much to learn from the parallels drawn to the advent of trauma systems in the 1970s, where a recognition of the need to coordinate care, as well as measure and report on epidemiology and outcomes, has led to a significant decrease in morbidity and mortality after injury throughout the world. Although EGS care has been practiced since the advent of modern medicine, ACS is just now reaching a place of system-level organization where we are able to entertain a similar level of commitment to data and inquiry. It was, in fact, a natural evolution from the key contributing EGS and trauma surgeons representing both the Canadian Association of General Surgeons (CAGS) Acute Care Surgery Committee, and the Trauma Association of Canada (TAC) Research Committee, that led to the creation of the Canadian Collaborative on Urgent Care Surgery (CANUCS) in 2019. CANUCS represents a grass roots alliance amongst surgeons who were already regularly collaborating on research and educational initiatives relating to the growing field of ACS. Since inception, members of CANUCS have collaborated on over 20 research projects, including two pilot RCTs. To our knowledge, there are currently no similar networks completing research in the ACS space in Canada. Given the large number of patients presenting with EGS conditions, and the morbidity associated with these common but complex problems, there is an urgent need to support research that can translate to improved care and outcomes for ACS patients.

CCEDRRN is a collaborative network of 50 Canadian emergency departments who have been systematically collecting data on patients tested for SARS-CoV-2. It is the third largest COVID-19 research registry in the world, with over 200,000 patients enrolled since March 2020, and a current monthly enrolment rate of close to 3,000 patients. CCEDRRN data has been used to: develop diagnostic and prognostic risk scores for emergency department patients with COVID-19; to evaluate health system and public health responses to the pandemic; to validate diagnostic algorithms for venous thromboembolism in patients with suspected COVID-19; and to identify risk factors for post COVID conditions (long COVID).

CCCTG is a pan-Canadian partnership of multi-disciplinary, inter-professional researchers in acute and critical care, rehabilitation, and outpatient care. It is the world’s first investigator-led and peer-funded acute and critical care research consortium. It has served as a model for the creation of trials groups in Critical Care Medicine around the world, and as a model for many other trials groups in Canada. The CCCTG has led clinical trials and pandemic research for over 30 years, converting CIHR investment into lives and healthcare dollars saved, while mentoring and serving as a template for many other Canadian and international research networks. It is the lead organization for the recently extended COVID-19 Network of Clinical Trials Networks. The CCCTG’s 400 members (patient partners, clinical and translational scientists, health care professionals, research coordinators, and trainees) at pediatric and adult healthcare centres across Canada are engaged in over 150 research programs in various areas of critical care. The CCCTG has over 400 publications, including 20 in the New England Journal of Medicine.

The Canadian Donation and Transplantation Research Program (CDTRP) was founded in 2013 with the mission of harnessing the power of research and collaboration to fulfill every donation opportunity and turn transplantation into a cure. CDTRP brought together the distinct solid organ, hematopoietic cell, and donation research communities through funded research projects, and transitioned in 2018 to become a national network of infrastructure to support research.

The CDTRP rapidly became the ‘go to’ platform in Canada for donation and transplantation research. Through the network, CDTRP investigators bring new ideas, find collaborators and partners, and receive resources and infrastructure to strengthen their research and increase their success. The network has grown to include more than 340 member researchers, trainees, and patient, family and donor partners at 37 sites across Canada, with 70+ partner organizations in Canada and around the world. The research community’s ability to produce, synthesize, and mobilize evidence, work together flexibly with partners, and connect people and organizations is forging the path to health, social, and economic benefits. Indeed, connectivity is the most-valued aspect of the CDTRP: connecting researchers to each other, with the network of partner organizations and stakeholders, and with PFD partners.

The CHF Alliance is a pan-Canadian, patient-driven research network dedicated to overcoming the challenges of heart failure (HF) to improve its prediction, prevention, diagnosis and management. It brings together Canada’s most innovative HF researchers and clinical experts, together with patients with lived experience, Indigenous elders and knowledge holders, government, policy makers, knowledge users, not-for-profit organizations, health care providers, academic institutions and industry partners. CHF Alliance is funded by CIHR and Heart and Stroke ($5M), with over $20M from industry, charitable foundations, and universities. The Alliance spans the patient lifecycle, from rural to urban, across geographic and socioeconomic barriers. CHF Alliance is led by Dr. Jean Rouleau (Montreal) and Mr. Marc Bains (Vancouver) a heart transplant recipient and the Vice President of HeartLife,  and co-led by Dr. Salim Yusuf (Hamilton) and Dr. Anique Ducharme (Montreal). It comprises 150 participants (including 26 early career investigators), 30 collaborators, 25 patient and family partners, 14 industry partners, and over 20 trainees. CHF Alliance is organized around four national Research Teams, two Collaborative Research Projects/Programs, seven Cross Cutting Themes, and five supporting Platforms.

The CIRN Clinical Trials Network (CTN), led out of the Canadian Center for Vaccinology (CCfV), is Canada's only national network for infectious disease related vaccine clinical trials. CTN was purposefully designed at the time of the H1N1 pandemic to conduct rapid vaccine trials to address critical public health questions with a focus on safety, immunogenicity, and mechanisms of immunity. CTN's 49 participating co-investigators are national leaders in the field of infectious diseases and immunization, and are based at sites in Vancouver, Penticton, Kamloops, Calgary, Winnipeg, Hamilton, Toronto, Ottawa, Montreal, Quebec City, Saint John, and Halifax. The Network includes dedicated support from ~40 key staff for research coordination and nursing, project and financial management, data management and biostatistics, and laboratory sciences. Since 2008, the network has successfully conducted more than 20 national trials in Canada and one large multi-site international trial with partners in Africa. CTN provides a critical capacity for specialized early Phase studies for new vaccines (Ebola, Coronavirus) through to Phase 3 efficacy studies in large populations (Influenza, CMV, Hepatitis B). CTN provides a unique forum for collaboration and has obtained significant funding support from government and NGO partners (PHAC, CIHR, IDRC, CEPI) as well as global industry players including Merck, GlaxoSmithKline, Sanofi, Medicago, VBI Vaccines, VIDO and Sequiris.

CADeN is a pan-Canadian organization comprised of clinicians from across all provinces (hundreds), patient partners (N=5-10), policy makers (N=5) and academic researchers (N=20+) working together to mobilize knowledge and study medication appropriateness. CADeN researchers have led multiple trials (N=8) having randomized thousands (N>10,000) of patients. Some research endeavors are now reimbursed as a part of provincial policies for drug safety (e.g., SaferMedsNL and MedSafer LTC, a Canadian made software for deprescribing). The Network has strong, established partnerships with US, Australian, and European counterparts, with the capacity to scale up Canadian-led medication appropriateness trials internationally. CADeN Scientific Director (McDonald; co-PA on ACT; member of the ACT Operations Committee) ran the largest ever randomized controlled trial of deprescribing (N=5698 participants; 11 centers), published in JAMA Internal Medicine. The Network trains the next generation of researchers in medication safety and currently hosts several HQPs: graduate students (MSc, PhD), visiting international graduate and postgraduate research fellows, and CIHR funded Health System Impact Fellows.

CNTN is the largest pan-Canadian bilingual nephrology trials network consisting of more than 130 Canadian investigators across 14 centers, bringing together nephrologists, investigators and patients to deliver high quality national and international clinical trials. In the last three years alone, despite the negative impact of COVID-19 on clinical research, the network provided in-depth peer review to eight clinical studies of which four received endorsement and three received national peer-reviewed funding, emphasizing the strength of our network in supporting clinical trials of broad national importance. The CNTN is under the governance of Can-SOLVE CKD, a CIHR pan-Canadian SPOR supported patient oriented research network. Thus, the CNTN emphasizes direct engagement of patients and Indigenous peoples, both as members and co-leaders of our network committees. In doing so, we ensure that the clinical trials we support place the patient at the forefront.

Seventy-five percent of mental disorders emerge before age 25. At any given time, 1 in every 8 people under the age of 18 years, living in a high-income country, has a mental disorder requiring specialised health services. Globally, mental disorders are a leading cause of disability among children and youth, with the burden increasing into young adulthood. This burden is compounded by multimorbidity (> 1 mental disorder and/or a concurrent medical diagnosis) and complexity (profound, interacting needs in other areas such as gender and structural racism, relationships, sleep, education), which are common complications. By and large, the child and youth mental health (CYMH) field lacks a suite of effective interventions personalized to individual need and informed by robust clinical trial evidence. A research network for CYMH RCTs does not yet exist in Canada unlike other high-income countries such as the UK and Australia, but would provide critical infrastructure for Canadian trialists to develop high-quality studies that reflect real-world complexities, recruit diverse and representative CYMH populations, and conduct multi-centre trials across the country Reflecting on this lack of infrastructure, as of January 2024, in clinicaltrials.gov, there are 25 active CYMH trials in Canada: 5 are drug trials with 3 led by Canadian PIs at single centres, and 20 are psychosocial trials with 6 being conducted across multiple sites, and of these, just 2 are being conducted in more than one province by a Canadian PI. The only way that CYMH outcomes will improve for Canada’s children and youth is to develop a national network and evidence base of interventions that work in Canadian contexts.

Our goal is to establish a pan-Canadian RCT network that is regarded as the network for conducting CYMH trials in Canada. We will develop sustainable infrastructure that optimises and supports the development, conduct, and reporting of CYMH RCTs across the country through: 1) high-quality input into trial design and planning, including feasibility, engagement (youth, family, Indigenous partners), and IDEA (inclusion, diversity, equity, accessibility); 2) efficient mobilisation of shared resources and standardised approaches; 3) collaboration with specialist networks and knowledge translation activities with decision/policy-makers; and 4) mentorship and training to build and sustain trials capacity.

The network will align with international recommendations, emerging CYMH frameworks, and trial standards to place Canadian trialists at the international forefront of robust testing of original ideas and attract investment. In accordance, the network will support: (1) Personalised and precision trials (e.g., staging and stepped care models) with adaptive designs (e.g., multi-arm, multi-stage RCTs) to address heterogeneity of treatment effect and complexity. (2) RCTs of transdiagnostic interventions (e.g., basket trials) that expand treatment generalisability by targeting symptoms that span disorders and syndromes rather than narrow diagnoses, or stratifying treatment by multimorbidity or complexity. (3) Trials with concurrent treatment and implementation evaluation (e.g., stepped wedge or hybrid RCTs) and harmonised (core) outcome measures to explore effects within and across patients and settings.

PIRN is an emerging hospital-based national network focused on generating scientific knowledge to improve the outcomes of hospitalized children and youth in general pediatric inpatient units (GPIU). Founded in 2019, PIRN includes all academic children’s hospitals across Canada and nine large Ontario community hospitals, and is playing a critical role in advancing the field of pediatric hospital medicine. Our established national PIRN team of researchers, clinicians, parents, quality improvement leaders, and stakeholders, positions us well to conduct high-quality multi-centre randomized controlled trials (RCTs) in real-world settings, inform practice guidelines, disseminate findings, and change practice and policy. PIRN holds key partnerships, including with the Maternal Infant Child and Youth Research Network (MICYRN)’s ACT CTU, SPOR Support Units, hospital Patient and Family Advisory councils, and with other networks such as Pediatric Emergency Research Canada (PERC).

Since PIRN’s inception, pediatric hospitalist scientists and investigators have successfully been awarded grants as principal applicants, but the network has not received any dedicated funding for its infrastructure or development. PIRN investigators and sites have been actively involved in generating evidence in multiple clinical areas. For example, PIRN is the lead of the Inpatient Medicine pillar for POPCORN (Paediatric Outcome ImProvement through Collaboration Of Research Networks), a pan-Canadian CIHR-funded observational research platform using COVID-19 as a proof of concept for answering important questions. Currently, there are >15 active PIRN studies taking place at multiple sites in Canada, and collaborations have been formed with international pediatric inpatient networks including PRIS (US), CIRCAN (Australia/New Zealand) and GAPRUKI (UK). PIRN investigators are highly productive academically, with >15 network publications to-date. Moreover, PIRN is heavily involved in the research mentorship and education of new clinicians and researchers to build the next generation of child health clinician researchers in pediatric hospital care.

CanStim’s mission to advance non-invasive brain stimulation (NIBS) technologies for the improvement of brain health through research, education, and knowledge translation is supported by  developing brain stimulation protocols and technologies informed by a mechanistic understanding of how brain stimulation techniques can shape the brain in health and diseases. CanStim provides an integrated bench-to-bedside platform, consisting of a national clinical trial network for multicenter studies (CanStim-Clin) and an applied pre-clinical research platform (CanStim-Pre) to facilitate collaboration of clinical and pre-clinical researchers from project inception. While the CanStim research and development vision can be applied to multiple different neurological diseases and other NIBS modalities, the platform is currently focused on advancing NIBS for post-stroke recovery to leverage existing trial networks, infrastructure and NIBS expertise in Canada.

The CanStim clinical trial network comprises eight sites across Canada. CanStim published guidelines for conducting NIBS trials and has positioned itself as opinion leader through knowledge dissemination initiatives. CanStim lead PIs have been invited to participate in an International Roundtable convened by the International Stroke Recovery and Rehabilitation Alliance to develop consensus recommendations for the translation of non-invasive brain stimulation techniques in to clinical practice. As a device-testing platform, CanStim is the Canadian partner for the stimulation device industry from early device development stages through all phases of clinical trials.

Established in 2019, the CRN-ACHDi brings together 15 clinical experts and researchers from five provinces (AB, BC, MB, ON, QC) and eight centers. The Canadian Congenital Heart Alliance (CCHA) is our patient partner organization. We started the first RCT in the world that will compare three devices for transcatheter closure of atrial septal defects (Trio ASD, NCT04291898), initiated a study to evaluate the effect of patent foramen ovale on the risk of perioperative stroke (CAPPRES, NCT05592301), and are now designing i) an RCT to evaluate the effectiveness of patent foramen closure in elderly, and ii) a platform trial to evaluate novel device therapies for pulmonary valve implantation patients with Tetralogy of Fallot. Our prospective registry of adult congenital heart disease interventions (C-ACHDiR, NCT04288596) now incorporates patient-reported outcomes and experiences. The Network fosters a strong collaborative and multidisciplinary research environment to promote multisite, high-quality studies in this rare population.

The CSC is the national professional association for stroke physicians that addresses advocacy, education, and clinical stroke research. The majority of CSC members are active in clinical trials that represent over 30 stroke centers across Canada. Over 90% of all fellowship-trained stroke neurologists are full members of the organization. The CSC has established a strong partnership with the biotech industry within Canada and abroad through collaboration on many industry led clinical trials and knowledge translation activities over many decades. Industry knows to come to CSC early in the process when trial design advice and enrolment is needed because of the CSC’s well-established trial review process to assist the biotech industry.

Novel contributions to ACT that CSC would bring include: a well developed certification program for fellows within a two year Scholar framework with established activities including research days and minimal academic requirements; a CSC-funded pan-Canadian EVT/thrombolysis registry that has been successfully used to complete a registry-based randomized trial; a multi-decade tested model of sustainable pan-Canadian trial network activity funded without assistance from federal agencies; a multi-decade trial review process to assist biotech industry partners (large or small) with design, feasibility and site selection within Canada; integration with stroke recovery trial networks CanStroke and CanStim with members involved in multiple organizations allowing regular communication and collaboration.

Canadian Stroke Prevention Intervention Network (C-SPIN) (formerly CAF-SPIN) network was established to conduct research studies to determine how to prevent stroke due to a common heart rhythm condition called atrial fibrillation (AF). This network has successfully designed and funded six major clinical research studies and over a dozen smaller studies, all aimed at reducing the number of strokes in Canada due to AF. C-SPIN has achieved a presence on the world academic stage with over 200 scientific publications in this area, including some in the very top medical journals, like the New England Journal of Medicine; scientific results from C-SPIN studies have been included in clinical practice guidelines and help physicians around the world deliver better care to patients. C-SPIN has made important linkages with external organizations in several countries, including the AFNET in Germany, and was a founding member of the international AF-SCREEN organization, which is an organization of doctors, patients, and policy makers who seek to find cost-effective ways to prevent stroke in the community through screening for AF.

The CTRC is a pan-Canadian collaborative research network created to enhance research capacity amongst Canadian scientists working on different aspects of the continuum of care for traumatic brain injury (TBI) patients, including prevention, acute care, up to rehabilitation and long-term care. The network, established in 2015 with support of the CIHR, is formed of over 150researchers and 300 trainees or research coordinators/associates from over 70institutions across Canada. Over the years, several investigator-led large-scale multicenter pan-Canadian and international trials have been developed within the network. The CTRC is a model of collaborative research group within the TBI research community globally.

The CanStroke Recovery Trials Platform began in 2017 with funding from Brain Canada and the Canadian Partnership for Stroke Recovery. The network has clinical trial sites across Canada and includes some of the highest ranked principal investigators in the field of stroke recovery and rehabilitation research (e.g., Dr. Janice Eng, Dr. Robert Teasell, Dr. Mark Bayley, Dr. Marilyn MacKay Lyons, Dr. Michelle Ploughman, and Dr. Sean Dukelow). Team members from a mix of backgrounds including: physical therapy, occupational therapy, speech language pathology, physical medicine and rehabilitation, neurology, and neuroscience. Over the last five years, CanStroke has trained more than 250 trainees, conducted several multi-site randomized controlled trials, and attracted national and international funding to run multi-centre pharmaceutical trials. The nature of Canstroke trials range from physical and cognitive therapies to technology and medication-based interventions. Trials networks in stroke recovery and rehabilitation are rare worldwide and the CanStroke team has established itself as a force to reckon with in the stroke recovery field.

Members of the Cardiometabolic Health, Diabetes, and Obesity Research Network (CMDO) have been involved in several major trials in cardiovascular co-morbidities associated with obesity (lipids, diabetes, hypertension) conducted over the last decade as designers, leaders, coordinators and/or recruiters. The CMDO network is currently performing a RCT at PHRI to definitively answer the question as to whether weight loss through bariatric surgery decreases mortality as well as adverse cardiac outcomes. BRAVE is a multi-centre, parallel-arm, open-label randomized controlled trial with blinded endpoint evaluation of bariatric surgery vs. medical weight management in patients with severe obesity and high-risk CVD. Drs. Mehran Anvari and Salim Yusuf, PHRI's Executive Director, are the co-chairs of BRAVE - bringing complementary skills of CVD, clinical trials, and obesity together.

Dr. Anvari is a professor of surgery at McMaster, an expert in bariatric surgery, and the chair of the Ontario Bariatric Network (OBN) which was established in 2009 as part of the Ontario Bariatric services strategy initiated by the Ministry of Health and Long-Term Care of Ontario. He is the lead Principal Investigator for the Ontario Bariatric Registry, with local principal investigators.

Dr. Paul Poirier is the chair of the medical management committee of the BRAVE trial. He is a cardiologist and professor of pharmacy at the Institut de cardiologie et de pneumologie de Québec, Université Laval. He has chaired the Obesity Committee of the Council on Nutrition, Physical Activity and Metabolism of the American Heart Association and has been involved in obesity research for several decades.

CANet is a leading cardiovascular multidisciplinary and multi-sectoral pan-Canadian network focused on patient-driven discovery and innovation. The network has over 250 investigators across 31 university/research institutions and has funded 70 research projects producing 1472 peer-reviewed publications resulting in numerous practice and guideline changes. CANet has helped to train over 550 trainees and launch 147 new careers in public and private sectors. CANet is supported by a $43M investment by the Federal Government matched with $55M across CANet's 200 partners from industry, government, and academic institutes.

CPN is the first chronic pain research network in Canadian history and has had a remarkable impact on both research and federal health policy. By implementing the practice of patient engagement in research across the country, the CPN has changed the way in which pain research is conducted. Patient-derived priorities for pain research have been developed across the lifespan, and these have further informed priorities for a newly created research network focusing on chronic pain in veterans. The people with lived experience who are partnering with the CPN were called upon to inform Health Canada as it revised its approach to the opioid crisis. This in turn led to the creation of the Canadian Pain Task Force by the Federal Health Minister. The Task Force has made sweeping recommendations for a national “Action Plan for Pain in Canada” including continuing to support the CPN’s ‘Clinical Research Network’ (CRN), created as a collaboration amongst 10 academic pain centres and has now grown to include 24 academic pain centres across the country, collaborating in local and multi site clinical trials in pain.

There is a paucity of evidence guiding care practices in this very frail and unique population living in long-term care (LTC) homes. This is in large part due to a lack of research coordination at the pan-Canadian level. The proposed research network aims to address gaps in LTC clinical research by involving a coalition of LTC homes from 8 provinces and a network of researchers dedicated to conducting high-quality, multi-centre interventional studies. We have a unique opportunity to be the first major LTC research network undertaking large-scale interventional studies in the world. In doing so, we capitalize on the public and private investments in the sector post-COVID-19 pandemic.

Progress to date and links to ACT: We have developed partnerships with LTC homes (chains and communities of practice) and provincial and national organizations who will support this initiative. We have undertaken extensive consultations with residents, caregivers, organizational stakeholders, and researchers. Through these consultations, we have developed the necessary partnerships, governance models, and research collaborations to launch this network. We have also developed our data platform strategy, supported by CIHI and HDRN (an ACT entity), and begun to develop foci of work with research theme leads. We have also executed data sharing agreements with 200 LTC homes in Ontario, allowing the collection of standardized data and facilitating large, multi-centre trials; we are in the process of securing additional data partnerships in NB and AB. We have also developed partnerships with biotechnology companies, including Pfizer and Moderna (vaccines in LTC), CANHealth (aging and public health technology), and PointClickCare (largest LTC EMR provider in Canada), in line with Canada’s Biomanufacturing and Life Sciences Strategy. Finally, we have established collaborations with existing ACT networks, including the PCPCRC (palliative care), CCCTG (critical care), and Ottawa Methods Centre (trials unit).

Members of the DCTN have been involved in almost all of the major international diabetes trials conducted over the last decade as designers, leaders, coordinators, and/or recruiters. These include the effect of three landmark trials of more versus less intense glucose lowering effects on clinical outcomes (the DCCT in type 1 diabetes, and the ACCORD and ADVANCE trial in type 2 diabetes), more than 40 large landmark outcomes trials of glucose, lipid, and blood pressure therapies in type 2 diabetes, trials of type 2 diabetes remission, and many trials of insulin pump therapy and the artificial pancreas in type 1 diabetes. Collectively these trials have changed diabetes, lipid and blood pressure guidelines and indeed the whole approach to the care of type 1 and type 2 diabetes. The DCTN is chaired by Dr. Hertzel Gerstein, Senior Scientist and Deputy Director, PHRI.

The IMAGINE network is a supported CIHR Strategy for Patient Orientated Research network that has strong patient engagement. Patients have identified the microbiome and diet as two important under researched areas on gastrointestinal disease. Reacting to this, we conducted the world’s first RCT evaluating fecal microbiota transplant in ulcerative colitis and found it induced remission with similar efficacy to biologic therapy. This has since been replicated by other researchers. We were also the first in the world to conduct an RCT that showed a specific probiotic can improve depression and anxiety in patients suffering from irritable bowel syndrome (IBS). Both these papers are in the top 1% of cited articles in their class. The group has also done seminal RCTs showing that IBS patients responding to a low FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet can be predicted in those harbouring high histamine producing microbiota, suggesting approaches to personalized medicine.

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INFORM RARE is a CIHR SPOR-funded innovative clinical trials network to evaluate new and existing therapies for children with rare inherited diseases. Our first three trials focus on spinal muscular atrophy (SMA), mucopolysaccharidoses (MPS), and phenylketonuria (PKU). Our program of research is co-designed by more than 65 investigators, including patients and families, health care providers, policy-makers, methodologists, and research ethicists. We are developing cross-cutting methods in the design of registry-based randomized trials, including developing longitudinal core outcomes-oriented patient registries to serve as a platform for trials, and addressing ethical issues related to the sharing of patient-reported outcomes between research and clinical care. We have a strong multilayered patient engagement strategy that engages both parents and youth.

MICYRN is a federal not-for-profit, charitable organization founded in 2006 to build capacity for high quality, applied health research. The network links 21 maternal and child health research member organizations based at academic health centers in Canada. MICYRN is affiliated with more than 25 practice-based research networks, provides support to new and emerging teams, and has established strong national and international partnerships. The mission of MICYRN is to catalyze advances in maternal and child healthcare by connecting minds and removing barriers to high-quality health research. MICYRN is working towards building a national infrastructure to attract and facilitate the conduct of maternal-child investigator-initiated and industry-sponsored, multicenter clinical trials. Although clinical trial activity is a key focus for MICYRN, the network also prioritizes quality improvement initiatives, supports training and mentorship programs for emerging investigators and new trainees, and leverages national partnerships to lead advocacy initiatives for regulatory and ethical pathways in Canada.

The Ontario Clinical Oncology Group (OCOG) is an academic based clinical trials development and coordination organization. OCOG is affiliated with the Department of Oncology, Faculty of Health Sciences, McMaster University, and works with investigators to conceive, design, coordinate, conduct, analyze and publish practice changing clinical trials in Oncology. Along with our provincial and national team of investigators we have led a diverse portfolio of clinically relevant trials of radiation fractionation in breast, prostate, and lung cancer patients. Our series of trials evaluating the clinical role of PET scans has informed the provincial funding criteria in Ontario. In addition, we have evaluated other types of technology, quality of life trials, and various pharmaceutical studies. Our ultimate goal is to impact and improve patient care.

The OCOG Coordinating and Methods Centre (CMC), located at the Hamilton Health Sciences Juravinski Hospital and Cancer Centre, in Hamilton, Ontario, includes a number of individuals including methodologists, clinician researchers, statisticians, research coordinators, data management staff, IT personnel, and access to financial and contracts specialists.

The Orthopedic Surgical Trials Network includes 30 centers in Canada (350 centers worldwide). Considered a pioneering trials group in orthopaedic surgery, our work has garnered multiple scientific awards with a global reputation, which is second to none. With a focus on trauma and fracture care, we have recruited over 50,000 surgical patients conducting milestone implant and biological innovation trials in hip fractures and complex lower extremity fractures. We have received over $60M in funding with publications in top tier journals including New England Journal of Medicine and the Lancet.

Valvular Heart Disease (VHD) has been described as ‘the next cardiac epidemic’ and is the second most frequent cardiovascular condition after hypertension and coronary heart disease in high outcome countries, and the first most frequent worldwide. Canadian investigators and centers have been at the forefront of research, innovation, and knowledge translation in the field of VHD for the past three decades and are thus in excellent position to maintain and expand their leadership for the realization of clinical trials in VHD in Canada and internationally. The ACT Canada consortium will be key to achieve this goal and will considerably accelerate and enhance the capacity of this VHD trial network (PACT-V) for the realization of trials in patients with VHD to validate new interventional or pharmacological therapies for these frequent and serious diseases.

The Pan-Canadian Palliative Care Research Collaborative is a national network of researchers, healthcare providers, community stakeholders, and patient and caregiver partners who are passionate about palliative care research. In just four years, we have grown into a network of over 100 people involved in more than 25 funded programs of research focused on novel therapeutics, applied health services research, and pandemic-related end-of-life care. Our membership has been very successful in peer-reviewed grant competitions, and we are deeply grateful to have received $2.9 million in funding from Health Canada to support practice-changing programs of research through the PCPCRC.

The Perioperative Care Network consists of 32 investigators from across Canada, spanning from Nova Scotia to British Columbia. The Co-Chairs are Drs. Emmanuelle Duceppe, General Internal Medicine, University of Montreal, Early Career Researcher and Manoj Lalu, Anesthesiology, University of Ottawa. This group had led >10 major perioperative trials that have randomized >40,000 patients in >200 centres in >30 countries. Many of these trials have changed clinical practice world-wide (e.g., POISE-1, POISE-2, POISE-3, SIRS, BART).

Home mechanical ventilation (HMV) users are dependent on medical technology for the vital life function of breathing. Although the HMV population is relatively small, the incidence of HMV initiation and associated healthcare utilization and costs are increasing, yet mortality rates are elevated and not decreasing over time. Despite the medical complexity of these patients and their intense healthcare service utilization and associated costs, there have been few randomized controlled trials (RCTs) in Canadian HMV users. Barriers to conducting high quality HMV Canadian RCTs include inadequate sample sizes within single centers, inequitable access to participation in under-represented groups, lack of comparability among data due to heterogeneity in clinical practice, few Canadian HMV trialists, as well as an absence of existing national infrastructure to support HMV clinicians to engage in research and train the next generation of HMV researchers. A comprehensive infrastructure will allow stakeholders to share expertise and resources, facilitate training and mentorship and develop common tools to capture datasets that can be analyzed across HMV populations. This will catalyze RCT driven research and improve care delivery while ensuring patient engagement, equity, diversity, inclusion, Indigeneity, and accessibility (EDIIA).

CanHMVr’s aim is to develop, evaluate and implement innovative strategies and healthcare system delivery models to improve the health and healthcare experience of the HMV population from the perspective of patients and families and the healthcare system.