Grant: Foundation Grant

Crohn'S Disease; Environment; Epidemiology; Geriatrics; Health Services Research; Inflammatory Bowel Disease; Pediatrics; Population Health; Pregnancy; Ulcerative Colitis

<html> <body> <p>Inflammatory bowel disease (IBD) is a chronic incurable gastrointestinal disorder in which inflammation affects the bowel and other systems. IBD is increasing worldwide, and Canada has among the highest rates in the world, representing significant burden to the health system. The reason for the increased incidence is uncertain, but may result from early life environmental exposures. Canadian health administrative data (supplemented by clinical and biological data) hold great potential to discovering the causes of this increase, and to determine ways of improving the care for Canadians living with IBD.</p> <p>The Canadian Gastro-Intestinal Epidemiology Consortium (CanGIEC) is a network of clinician-researchers and methodologists in 6 provinces using administrative data to develop a national picture of IBD. The CIHR Foundation Grant will allow for development of our network to examine and improve the care of people living with IBD, as well as determine causes of the high rate in Canada. Since IBD affects people of all ages, we will conduct research across the age spectrum. However, the incidence is rising most rapidly in children, the elderly represent the fastest growing group living with the disease, and IBD is most commonly diagnosed in people of child-bearing age. Therefore, our current research plan examines people of specific populations in whom IBD may greatly burden the patient&rsquo;s life, the health system, and the economy. This application is focused on five aims:<br> 1. Pediatric IBD: In children, the fastest growing incident group, we will determine the direct and indirect costs to the economy, health system, and families. We will collaborate with the Canadian Children IBD Network, a population-based inception cohort study collecting clinical and biological data, linking these data to administrative data, and incorporating direct assessments of family impact.<br> 2. Elderly IBD: In people at greater risk for adverse events, we will assess whether comorbidity burden is associated with the use of immunomodulator and biologic medications, and adverse effects of these treatments.<br> 3. Materno-Fetal: In collaboration with MORe-CaRe IBD, a clinical network focused on pregnancy outcomes, we will describe the pregnancy rates, pregnancy complications, and outcomes of newborns of women with IBD. We will determine whether IBD disease severity is associated with these outcomes.<br> 4. Environmental Factors: To explain Canada&rsquo;s high prevalence, we will determine early life factors which are predisposed to development of IBD, and factors associated with need for surgery after diagnosis.<br> 5. Methodological: We will improve the methods used to conduct research using routinely collected health data, increasing the capacity for research using these data in other fields.</p> <p>CanGIEC research will also increase capacity by training students, mentoring junior clinician investigators, and developing a skilled network of data analysts experienced in distributed network analysis of provincial health data. In addition, we have linked with partners and patient groups to develop our research plans, and to translate the results of the research to policy-makers and the public. Our clinical partner networks will move our results from the population level to the bedside by implementing change based on our findings. Therefore, we anticipate that CanGIEC will provide tangible advancements to benefit to patients with IBD, the health system, clinicians, and researchers.</p> </body> </html>