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The Evidence Speaks

The Evidence Speaks (April 2017)

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We’re proud to introduce our Evidence Speaks series, a recurring feature highlighting the latest in CHÉOS research. This series features summaries of select publications as well as in-depth features on the latest work from our investigators. In the early days of CHÉOS, the Centre had a series known as “The Evidence Speaks,” a monograph series to keep media and the research community up-to-date with CHÉOS’ current research results in the health outcomes field.

Kirwan JR, De Wit M, Frank L, Haywood KL, Salek S, Brace-McDonnell S, Lyddiatt A, Barbic SP, Alonso J, Guillemin F, Bartlett SJ. Emerging guidelines for patient engagement in research. Value Health. 2017 Mar;20(3):481-6.

CHÉOS Scientist Dr. Skye Barbic recently collaborated with researchers from across Canada and Europe to draft suggestions for guidelines on patient engagement in research. The article, published in Value in Health, outlines the experiences of patient engagement from the perspectives of researchers, a patient research partner (PRP), and a funder. The principles identified by the authors include: supportive institutional polices; shared goals and strong communication; respect and reciprocity; adequate and appropriate training for team members; resources and advanced planning; and recognizing the value of partnerships across all stages of the research process. This work is an initial step toward the creation of guidelines for patient engagement, and the authors suggest that further development should focus on the values, systems, and resources that make research partnerships successful.

Ramsook AH, Mitchell RA, Bell T, Calli S, Kennedy C, Lehmann J, Thompson M, Puyat JH, Guenette JA. Is parasternal intercostal EMG an accurate surrogate of respiratory neural drive and biomarker of dyspnea during cycle exercise testing? Respir Physiol Neurobiol. 2017 Mar 20 epub ahead of print. doi:10.1016/j.resp.2017.03.003.

Dr. Joseph Puyat, in collaboration with the Center for Heart Lung Innovation and the Department of Physical Therapy at UBC, published an article estimating the accuracy of an alternative method for measuring dyspnea (breathlessness). Dyspnea is a clinically important symptom and is thought to be a result of increased neural respiratory drive (NRD). A typical surrogate estimation of NRD can be taken by measuring diaphragmatic electromyography (EMGdi) using an esophageal catheter however, this technique is relatively invasive and technically demanding. As an alternative, the research team tested the accuracy of surface EMG (EMGs) on the intercostal muscles compared to EMGdi during an upright cycling exercise test. Specifically, the researchers wanted to see if use of the handlebars during cycling would affect the EMGs reading. As hypothesized, the use of the handlebars during cycling contaminated the EMGs reading meaning that this technique is not appropriate for estimating dyspnea during this type of exercise. However, the use of surface intercostal EMG may be useful during reclined cycling or exercise where the upper body stays relaxed.

Hutton HL, Levin A, Gill J, Djurdjev O, Tang M, Barbour SJ. Cardiovascular risk is similar in patients with glomerulonephritis compared to other types of chronic kidney disease: a matched cohort study. BMC Nephrol. 2017 Mar 20;18(1):95.

As part of the CanPREDDICT Study, three CHÉOS Scientists were part of a team that estimated the risk of cardiovascular diseases (CVD) in patients with different types of chronic kidney disease (CKD). Publishing in BMC Nephrology, Drs. Sean Barbour, Jagbir Gill, and Adeera Levin sought to compare the risk of CVD between people with glomerulonephritis (GN) and other CKD. Patients with GN often develop CKD and experience increased CVD risk however it is unclear whether this increased risk is due to GN alone or as a result of a combination of CKD-related and traditional risk factors. Using the CanPREDDICT Study population of over 2000 CKD patients, the researchers compared cardiovascular events (heart failure, heart attack etc.), comorbidities, blood and urine biomarkers, and other factors between patients with and without GN. The study authors found that GN is not associated with an increase in risk of CVD compared to non-GN CKD and that the risk of a CV event was comparable between the matched groups. The researchers also found that the strongest biomarkers for predicting CVD risk may be different between patients with GN and non-GN CKD, confirmation of this finding, however, requires a larger, targeted study.