CNODES has been divided into a Coordinating Centre and four teams; Database, Methods, Training, and Knowledge Translation.
The database team helps determine the feasibility of the research question with the available data, decides which provinces will participate and selects a project team. It is critical that this team has both methods expertise and content expertise (projects have included individuals with understanding of the pathophysiology of the disease, and the pharmacokinetics and pharmacodynamics of the drug).
The Database team currently has access to the Canadian administrative health data repositories supplemented by data from the United Kingdom’s General Practice Research Database. For the two initial projects data from the Thomson Reuter MarketScan® Research Databases was purchased.
The methods team provides leadership and advice on innovative study design and rigorous methodological approaches. It supports the development of the scientific and analytical protocols for each project. Each project involves a meta-analysis to allow for the pooling of regional study results. The team also provides information on the bias, precision and validity of study results as well as limitations allowing the user to understand the degree of certainty related to the results.
The training team works with the methods team in order that researchers and analysts learn to apply both standard and innovative pharmacoepidemiology approaches to population research (for example: high dimensional propensity analysis, nested case-control analysis with propensity score adjustment to minimize confounding by indication and protopathic bias). Currently, CNODES has employed trainees in a number of regional centres
Knowledge Translation Team
“Knowledge derived from research and experience may be of little value unless it is put into practice”. CNODES has adopted a strategy of integrated knowledge translation (iKT), by involving regulatory bodies such as Health Canada, provincial drug regulators, drug benefit funders, as well as clinicians at various points of CNODES projects and knowledge translation processes. The Knowledge Translation (KT) team develops the rigorous dissemination strategy by which CNODES targets actionable messages to receptive stakeholders.
Collaborative messaging has become an active process for CNODES, involving clinicians, pharmacists, and researchers. The KT team is also in the process of formulating ways of approaching elements deemed critical for effective health research translation, through stakeholder analysis, the development of a procedure guideline, the exploration of communication of risk and uncertainty, and more.