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Papers by Donna Claire Angus

Research Integrity and Peer Review, 2017

Background: Health research funding agencies are placing a growing focus on knowledge translation... more Background: Health research funding agencies are placing a growing focus on knowledge translation (KT) plans, also known as dissemination and implementation (D&I) plans, in grant applications to decrease the gap between what we know from research and what we do in practice, policy, and further research. Historically, review panels have focused on the scientific excellence of applications to determine which should be funded; however, relevance to societal health priorities, the facilitation of evidence-informed practice and policy, or realizing commercialization opportunities all require a different lens. Discussion: While experts in their respective fields, grant reviewers may lack the competencies to rigorously assess the KT components of applications. Funders of health research-including health charities, non-profit agencies, governments, and foundations-have an obligation to ensure that these components of funding applications are as rigorously evaluated as the scientific components. In this paper, we discuss the need for a more rigorous evaluation of knowledge translation potential by review panels and propose how this may be addressed. Conclusion: We propose that reviewer training supported in various ways including guidelines and KT expertise on review panels and modalities such as online and face-to-face training will result in the rigorous assessment of all components of funding applications, thus increasing the relevance and use of funded research evidence. An unintended but highly welcome consequence of such training could be higher quality D&I or KT plans in subsequent funding applications from trained reviewers.

Otolaryngology - Head and Neck Surgery, 2010

Journal of Evaluation in Clinical Practice, 2010

Rationale, aims and objectives A collaborative, multidisciplinary guideline adaptation process wa... more Rationale, aims and objectives A collaborative, multidisciplinary guideline adaptation process was developed to construct a single overarching, evidence-based clinical practice guideline (CPG) for all primary care practitioners responsible for the management of low back pain (LBP) to curb the use of ineffective treatments and improve patient outcomes. Methods The adaptation strategy, which involved multiple committees and partnerships, leveraged existing knowledge transfer connections to recruit guideline development group (GDG) members and ensure that all stakeholders had a voice in the guideline development process. Videoconferencing was used to coordinate the large, geographically dispersed GDG. Information services and health technology assessment experts were used throughout the process to lighten the GDG's workload. Results The GDG reviewed seven seed guidelines and drafted an Alberta-specific guideline during 10 half-day meetings over a 12-month period. The use of ad hoc subcommittees to resolve uncertainties or disagreements regarding evidence interpretation expedited the process. Challenges were encountered in dealing with subjectivity, guideline appraisal tools, evidence source limitations and inconsistencies, and the lack of sophisticated evidence analysis inherent in guideline adaptation. Strategies for overcoming these difficulties are discussed. Conclusion Guideline adaptation is useful when resources are limited and good-quality seed CPGs exist. The Ambassador Program successfully utilized existing stakeholder interest to create an overarching guideline that aligned guidance for LBP management across multiple primary care disciplines. Unforeseen challenges in guideline adaptation can be overcome with credible seed guidelines, a consistently applied and transparent methodology, and clear documentation of the subjective contextualization process. Multidisciplinary stakeholder input and an open, trusting relationship among all contributors will ensure that the end product is clinically meaningful.

Journal of Continuing Education in the Health Professions, 2009

Health care practitioners and managers often report difficulty keeping up with new health care re... more Health care practitioners and managers often report difficulty keeping up with new health care research and may lack the skills to use research evidence in their workplace, and researchers often report constrained time and opportunity to exchange ideas with those who can benefit from their work. Although studies suggest micro ~one-on-one! and meso ~organizational0group! engagement are effective research translation strategies for addressing these barriers, less attention has been given to the role of macrolevel structures, such as networks, in facilitating micro and meso interchange. As a structure that connects many individuals, organizations, and groups, networks can act as key information-delivery and capacity-building arrangements, promoting connections and interpersonal development between health care practitioners, administrators, and researchers who may not otherwise interact. Why We Undertook This Initiative

Rationale, aims and objectives The Alberta Ambassador Program (AAP) adapted seven clinical practi... more Rationale, aims and objectives The Alberta Ambassador Program (AAP) adapted seven clinical practice guidelines on low back pain (LBP) into a single guideline spanning the continuum of care from prevention and diagnosis through to treatment. The Ambassador adaptation process was evaluated to 1 Identify the major challenges encountered and successful strategies utilized; 2 Assess strengths and weaknesses by benchmarking it with the ADAPTE framework; and 3 Identify opportunities for improvement. Method External consultants reviewed the Ambassador and ADAPTE materials and conducted semi-structured telephone interviews with 29 participants from the AAP committees. All participants were asked about the major challenges encountered and potential areas for improvement. Results The response rate was 83% (29/35). There was strong consensus that the Ambassador guideline adaptation process was sound and rigorous all respondents indicated willingness to participate in further iterations of the Program. Key elements of success were identified. The main steps and sequence of the process were closely aligned with the ADAPTE framework, although the AAP incorporated additional enhancements which augmented the process. The main divergences between the two frameworks centred on the organizational structure and the methods used to overcome methodological difficulties. Conclusion The AAP successfully utilized existing stakeholder interest to create an overarching guideline for managing LBP across multiple primary care disciplines. The study highlighted the strengths and weaknesses of the Program, and identified practical strategies for improvement. Evaluating guideline adaptation processes is pivotal to ensuring that they continue to be an efficient, rigorous and practicable option for producing contextualized, clinically relevant guidelines. bs_bs_banner

Research Integrity and Peer Review, 2017

Background: Health research funding agencies are placing a growing focus on knowledge translation... more Background: Health research funding agencies are placing a growing focus on knowledge translation (KT) plans, also known as dissemination and implementation (D&I) plans, in grant applications to decrease the gap between what we know from research and what we do in practice, policy, and further research. Historically, review panels have focused on the scientific excellence of applications to determine which should be funded; however, relevance to societal health priorities, the facilitation of evidence-informed practice and policy, or realizing commercialization opportunities all require a different lens. Discussion: While experts in their respective fields, grant reviewers may lack the competencies to rigorously assess the KT components of applications. Funders of health research-including health charities, non-profit agencies, governments, and foundations-have an obligation to ensure that these components of funding applications are as rigorously evaluated as the scientific components. In this paper, we discuss the need for a more rigorous evaluation of knowledge translation potential by review panels and propose how this may be addressed. Conclusion: We propose that reviewer training supported in various ways including guidelines and KT expertise on review panels and modalities such as online and face-to-face training will result in the rigorous assessment of all components of funding applications, thus increasing the relevance and use of funded research evidence. An unintended but highly welcome consequence of such training could be higher quality D&I or KT plans in subsequent funding applications from trained reviewers.

Otolaryngology - Head and Neck Surgery, 2010

Journal of Evaluation in Clinical Practice, 2010

Rationale, aims and objectives A collaborative, multidisciplinary guideline adaptation process wa... more Rationale, aims and objectives A collaborative, multidisciplinary guideline adaptation process was developed to construct a single overarching, evidence-based clinical practice guideline (CPG) for all primary care practitioners responsible for the management of low back pain (LBP) to curb the use of ineffective treatments and improve patient outcomes. Methods The adaptation strategy, which involved multiple committees and partnerships, leveraged existing knowledge transfer connections to recruit guideline development group (GDG) members and ensure that all stakeholders had a voice in the guideline development process. Videoconferencing was used to coordinate the large, geographically dispersed GDG. Information services and health technology assessment experts were used throughout the process to lighten the GDG's workload. Results The GDG reviewed seven seed guidelines and drafted an Alberta-specific guideline during 10 half-day meetings over a 12-month period. The use of ad hoc subcommittees to resolve uncertainties or disagreements regarding evidence interpretation expedited the process. Challenges were encountered in dealing with subjectivity, guideline appraisal tools, evidence source limitations and inconsistencies, and the lack of sophisticated evidence analysis inherent in guideline adaptation. Strategies for overcoming these difficulties are discussed. Conclusion Guideline adaptation is useful when resources are limited and good-quality seed CPGs exist. The Ambassador Program successfully utilized existing stakeholder interest to create an overarching guideline that aligned guidance for LBP management across multiple primary care disciplines. Unforeseen challenges in guideline adaptation can be overcome with credible seed guidelines, a consistently applied and transparent methodology, and clear documentation of the subjective contextualization process. Multidisciplinary stakeholder input and an open, trusting relationship among all contributors will ensure that the end product is clinically meaningful.

Journal of Continuing Education in the Health Professions, 2009

Health care practitioners and managers often report difficulty keeping up with new health care re... more Health care practitioners and managers often report difficulty keeping up with new health care research and may lack the skills to use research evidence in their workplace, and researchers often report constrained time and opportunity to exchange ideas with those who can benefit from their work. Although studies suggest micro ~one-on-one! and meso ~organizational0group! engagement are effective research translation strategies for addressing these barriers, less attention has been given to the role of macrolevel structures, such as networks, in facilitating micro and meso interchange. As a structure that connects many individuals, organizations, and groups, networks can act as key information-delivery and capacity-building arrangements, promoting connections and interpersonal development between health care practitioners, administrators, and researchers who may not otherwise interact. Why We Undertook This Initiative

Rationale, aims and objectives The Alberta Ambassador Program (AAP) adapted seven clinical practi... more Rationale, aims and objectives The Alberta Ambassador Program (AAP) adapted seven clinical practice guidelines on low back pain (LBP) into a single guideline spanning the continuum of care from prevention and diagnosis through to treatment. The Ambassador adaptation process was evaluated to 1 Identify the major challenges encountered and successful strategies utilized; 2 Assess strengths and weaknesses by benchmarking it with the ADAPTE framework; and 3 Identify opportunities for improvement. Method External consultants reviewed the Ambassador and ADAPTE materials and conducted semi-structured telephone interviews with 29 participants from the AAP committees. All participants were asked about the major challenges encountered and potential areas for improvement. Results The response rate was 83% (29/35). There was strong consensus that the Ambassador guideline adaptation process was sound and rigorous all respondents indicated willingness to participate in further iterations of the Program. Key elements of success were identified. The main steps and sequence of the process were closely aligned with the ADAPTE framework, although the AAP incorporated additional enhancements which augmented the process. The main divergences between the two frameworks centred on the organizational structure and the methods used to overcome methodological difficulties. Conclusion The AAP successfully utilized existing stakeholder interest to create an overarching guideline for managing LBP across multiple primary care disciplines. The study highlighted the strengths and weaknesses of the Program, and identified practical strategies for improvement. Evaluating guideline adaptation processes is pivotal to ensuring that they continue to be an efficient, rigorous and practicable option for producing contextualized, clinically relevant guidelines. bs_bs_banner