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Featured Research Team News
Dr. Deborah Marshall is co-hosting the International Academy of Health Preference Research (IAHPR) 15th Annual Meeting
Deborah Marshall named as a Royal Society of Canada Fellow
On Sept. 3, the Royal Society of Canada (RSC) announced the election of five UCalgary faculty members as new Fellows. The RSC recognizes outstanding scholarly, scientific, and artistic achievement; elected by their peers, it is the highest honour an individual can achieve in the arts, social sciences and sciences. Dr. Deborah Marshall was among the five UCalgary faculty members named.
Deborah Marshall has made significant contributions to lead and shape the field of patient-oriented research, patient preferences and the science of patient engagement in research. Her highly cited research on innovative methods to engage patients, measure quantitatively what matters to patients and the trade-offs in healthcare decisions have had global impact on research practices, patient centred
healthcare and outcomes, and health policy. Her research findings have influenced the integration of patient voices to improve healthcare decision-making.
One Child Every Child will foster research excellence in three strategic areas: Better Beginnings, Precision Health and Wellness, Vulnerable to Thriving.
- Better beginnings will explore the health and wellbeing of mothers and children, giving babies and pre-schoolers the best start in life.
- Precision health and wellness will improve diagnosis and treatment for children with chronic and medically complex illnesses.
- Vulnerable to thriving will investigate how to help children with neurodevelopmental and mental health conditions.
We will also incorporate Indigenous ways of knowing, comprehensive data, transdisciplinary training, equity, diversity and inclusion best practices and technology solutions in their work while mobilizing knowledge for the greatest impact.
From bench to bedside to backyard, we will investigate the biomedical, social, emotional, societal, economic, and structural determinants of change. If we could reduce the number of children with medically complex conditions by just 15%, which we feel is achievable, over time it would save $104 billion in direct and indirect costs.
Deborah Marshall is Lead Impact & Value Investigator for One Child Every Child research initiative
In 2020, UNICEF ranked Canada 30th out of 38 wealthy countries in child health and wellness outcomes. Canada has consistently failed to prioritize strategic investments in child health and wellness – until now.
The Canadian government is investing $125 million in University of Calgary’s One Child Every Child initiative (OCEC). First announced in Montreal on April 28, 2023, OCEC is the largest research grant in the University of Calgary’s history (and one of the largest ever awarded to a university in Alberta).
Canada First Research Excellence Fund invests in the research strengths of postsecondary institutions so they can achieve global change. By bringing together researchers, health-care providers, educators and Indigenous communities, OCEC will dramatically improve the lives of children across Canada and beyond.
Barbara Wright
One Child Every Child harnesses UCalgary’s innovation ecosystem to accelerate positive outcomes for child health and wellness. This initiative balances investments in health and research with socio-economic factors, establishing a wrap-around research approach. It also enables us to design new diagnostic tools for Canadian hospitals and build national training platforms for health-care professionals.
By advancing knowledge and build capacity, health and policy leaders will be able to make informed decisions that support better health outcomes. Further, by addressing the broad economic and social impacts, results can feed back into the network to broaden our research impact.
Research by PhD student from our team, Dr. Luiza Grazziotin, featured in Arthritis Society Canada Top 10 Research Advances of 2022.
Every year, the Arthritis Society Canada spotlights publications in their annual Top 10 Research Advances. We are thrilled to share that one of Dr. Luiza Grazziotin’s thesis articles was included in this year’s list!
Dr. Grazziotin (supervisor Dr. Deborah A. Marshall) completed her PhD in 2022. Her thesis focused on personalized care for juvenile idiopathic arthritis (JIA) and examined health care costs, treatment patterns and health-related quality of life of children with JIA and their parents. This work was conducted as part of the Understanding Childhood Arthritis: Canada-Netherlands Personalized Medicine Network in Childhood Arthritis and Rheumatic Diseases (UCAN CAN-DU).
The Arthritis Society Canada is featuring the publication entitled “Real‑world data reveals the complexity of disease modifying anti‑rheumatic drug treatment patterns in juvenile idiopathic arthritis: an observational study”. It is the first study to assess treatment patterns for the different drug classes currently prescribed to JIA patients in Canada.
Juvenile Idiopathic Arthritis (JIA) is one of the most common chronic musculoskeletal disorder in children, and affects about one in 1,000 children in Canada. Conventional disease modifying anti-rheumatic drugs (c-DMARDs), and biologic DMARDs (b-DMARDs) are recommended by the 2019 American College of Rheumatology (ACR) JIA treatment guidelines: c-DMARDs as a first-line treatment and b-DMARDS as a secondary therapy for more severe JIA cases.
Despite guidelines, the current real-world prescription patterns of DMARDS, including treatment trajectories may differ based on setting, treatment approval and treatment accessibility. Using medical chart and administrative health data, Grazziotin and co-authors conducted a retrospective cohort study to gain a better understanding of DMARD treatment patterns in JIA.
Analyzing the prescriptions of c-DMARDs and b-DMARDs in 325 patients newly diagnosed with JIA between 2011 and 2019, the research team identified 112 unique treatment sequences.
Among patients taking b-DMARDs, the majority (95%) were initially prescribed tumor necrosis factor inhibitors (TNFis). Most of those patients were then switched to a second TNFi.
Although recommended by the ACR and providing important health benefits to patients, DMARDs are expensive. By shedding light on real-life treatment patterns, Grazziotin, et al laid the groundwork for future effectiveness and economic evaluation studies.
More information about Dr. Grazziotin’s thesis research:
Grazziotin LR, Currie G, Twilt M, IJzerman MJ, Kip MMA, Koffijberg H, Benseler SM, Swart JF, Vastert SJ, Wulffraat NM, Yeung RSM, Marshall DA. Real-world data reveals the complexity of disease modifying anti-rheumatic drug treatment patterns in juvenile idiopathic arthritis: an observational study. Pediatric Rheumatology, 20, 25 (2022) https://doi.org/10.1186/s12969-022-00682-x
Grazziotin LR, Currie G, Twilt M, IJzerman MJ, Kip MMA, Koffijberg H, Bonsel G, Benseler SM, Swart JF, Vastert SJ, Wulffraat NM, Yeung RSM, Armbrust W, van den Berg M, Marshall DA. Factors associated with care-and health-related quality of life of caregivers of children with juvenile idiopathic arthritis. Pediatric Rheumatology 2022;20:51. https://doi.org/10.1186/s12969-022-00713-7
Grazziotin LR, Currie G, Twilt M, Ijzerman MJ, Kip MMA, Koffijberg H, Benseler SM, Swart JF, Vastert SJ, Wulffraat NM, Yeung RSM, Johnson N, Luca NJ, Miettunen PM, Schmeling H, Marshall DA. Evaluation of real-world healthcare resource utilization and associated costs in children with Juvenile Idiopathic Arthritis: A Canadian retrospective cohort study. Rheumatology and Therapy. Sept 2021;8(3):1303-1322. https://doi.org/10.1007/s40744-021-00331-x
Grazziotin LR, Currie G, Kipp MMA, Ijzerman MJ, Twilt M, Lee R, Marshall DA. Health State Utility Values in Juvenile Idiopathic Arthritis: What is the Evidence? Pharmacoeconomics. May 2020; 28:913-926. http://doi.org/10.1007/s40273-020-00921-7
Other Marshall team health economics UCAN CAN-DU research:
Currie GR, Groothuis-Oudshoorn K, Twilt M, Kip MM, IJzerman MJ, Benseler SM, Swart JF, Vastert SJ, Wulffraat NM, Yeung RS, Marshall DA and on behalf of UCAN CAN-DU and UCAN CURE Consortium. What matters most to pediatric rheumatologists in deciding whether to withdraw biologics in a child with juvenile idiopathic arthritis: a best-worst scaling study. 28th European Paediatrics Rheumatology Congress, September 20-23 2022, Prague, Czech Republic. (Poster)
Grazziotin L, Currie GR, Cantarutti S, Benseler SM, Swart JF, Kip MM, IJzerman MJ, Twilt M, Vastert SJ, Wulffraat NM, Yeung RS, Marshall DA and on behalf of UCAN CAN-DU and UCAN CURE Consortium. Present and accounted for: the workplace productivity loss for parents of children with juvenile idiopathic arthritis. 28th European Paediatrics Rheumatology Congress, September 20-23 2022, Prague, Czech Republic. (Poster)
Van Til JA, Kip MMA, Twilt M, Schatorjé E, Groothuis-Oudshoorn K, Currie G, Marshall DA, Swart JF, Yeung RSM, Benseler SM, Vastert SJ, Wulffraat N, IJzerman MJ, and on behalf of UCAN CAN-DU and UCAN CURE Consortium. Preferences of pediatric rheumatologists for tapering biologic DMARDs in children with juvenile idiopathic arthritis (JIA) – results of a clinical vignette study. 28th European Paediatrics Rheumatology Congress, September 20-23 2022, Prague, Czech Republic. (Poster)
Florax AA, Doeleman MJH, de Roock S, Van der Linden N, Schatorje E, Currie G, Marshall DA, IJzerman MJ, Yeung RSM, Benseler SM, Vastert SJ, Wulffraat M, Swart JF, Kip MMA, and on behalf of UCAN CAN-DU and UCAN CURE Consortium. Quantifying cost impact of withdrawing biologic DMARDs in children with JIA. 28th European Paediatrics Rheumatology Congress, September 20-23 2022, Prague, Czech Republic. (Poster)
Kip MMA, de Roock S, Currie G, Marshall DA, Grazziotin LR, Twilt M, Yeung RSM, Benseler SM, Vastert SJ, Wulffraat N, Swart JF, IJzerman MJ. Pharmacological treatment patterns in patients with juvenile idiopathic arthritis in the Netherlands: a real-world data analysis. Rheumatology, 2022; keac299, https://doi.org/10.1093/rheumatology/keac299
Currie GR, Pham T, Twilt M, Ijzerman MJ, Hull PJ, Kip MMA, Benseler S, Hazlewood GS, Yeung R, Wulffraat N, Swart JF, Vastert SJ, Marshall DA Perspectives of Pediatric Rheumatologists on Initiating and Tapering Biologics in Patients with Juvenile Idiopathic Arthritis: A Formative Qualitative Study. Patient (2022). https://doi.org/10.1007/s40271-022-00575-x
Kip MMA, de Roock S, van den Berg I, Currie G, Marshall DA, Grazziotin LR, Twilt M, Yeung RSM, Benseler SM, Vastert SJ, Wulffraat N, Swart JF, IJzerman MJ. Costs of hospital-associated care for patients with juvenile idiopathic arthritis in the Dutch healthcare system. Arthritis Care and Research. 2021 May 02. https://doi.org/10.1002/acr.24621. E-pub ahead of print.
Kip MMA, Currie G, Marshall DA, Grazziotin Lago L, Twilt M, Vastert SJ, Sward JF, Wulffraat N, Yeung RSM, Benseler SM, Ijzerman M. Seeking the state of the art in standardized measurement of health care resource use and costs in juvenile idiopathic arthritis: A scoping review. Pediatric Rheumatology. May 2019;17:20 https://doi.org/10.1186/s12969-019-0321-x
Barber CE, Twilt M, Pham T, Currie GR, Benseler S, Yeung RSM, Batthish M, Blanchette N, Guzman J, Lang B, LeBlanc C, Levy DM, O’Brin C, Schmeling H, Soon G, Spiegel L, Whitney K, Marshall DA. A Canadian evaluation framework for quality improvement in childhood arthritis: key performance indicators of the process of care. Arthritis Research and Therapy, March 2020;22(1):53 https://doi.org/10.1186/s13075-020-02151-w
Highlights from 2023
Deborah Marshall is Leading Prestigious National Cohort Training Program