BETTER-ED

Patient-oriented research to better prepare Canadian emergency services for health crises such as pandemics and climate-induced disasters

The COVID-19 pandemic demonstrated that Canada did not have a system in place for research to save patients’ lives. The pandemic has also demonstrated that involving patients in research is more relevant than ever, especially for marginalized patients who have been hardest hit. Climate change also adds new challenges in hospital emergencies. Appropriate research infrastructure to ensure better preparedness for climate change is required. The United Kingdom (UK) has demonstrated that a well-functioning health system can integrate research into practice through innovative “clinical trial platforms”.

The benefits of adaptive platform clinical trials include: (1) multiple emerging issues can be assessed simultaneously; and (2) the data already collected can be used to increase the probability that patients are randomized to receive the treatments most likely to be beneficial. However, adaptive platform trials are creating new challenges on how to meaningfully involve patients in planning their care and also in how to obtain informed consent from patients.

The Canadian Emergency Department Research Network (CEDRN (formerly CCEDRRN), pronounced “sedrin”) was created during the pandemic. This is a pan-Canadian multi-site observation registry that was created to harmonize the collection of COVID-19 data in Canada in order to answer questions from decision makers and patient partners. The CEDRN patient partners committee guided the network’s research questions and methods. Building on the experience of the UK, the new CEDRN network aims to pivot its research infrastructure, including its patient partner committee, to support future adaptive clinical trial platforms in order to better prepare for pandemics and climate change.

The main objective of this project is to increase patient-oriented research capacity in Canadian emergency rooms to enable rapid implementation of adaptive clinical trial platforms relevant to emergency medicine to prepare for future pandemics and climate-related disasters. Specific objectives are: (1) Building an equitable, diverse and inclusive patient-centred emergency services research capacity; (2) Identify patient-centered research priorities that are suitable for future trial platforms in emergency departments; (3) Explore consent models that may be acceptable to emergency patients in Canada.

Research activities

Our partner patient engagement committee (PEC) has 7 members from 4 provinces.

Consensus Report #1: This report presents the preliminary research priorities identified by CEP members and researchers from the Canadian Emergency Research Network in February 2024.

Terms of reference: The CEP approved its terms of reference in August 2024.

Adaptive Platform Trials in Emergency Medicine in Canada: Canadian Association of Emergency Physicians Academic Symposium, June 2024, Saskatoon, SK.

CAEP 2024 Academic Symposium: adaptive platform trials
in emergency medicine

For any questions: Martyne Audet, Research Coordinator / / martyne.audet.cisssca@ss.gouv.qc.ca