The CANadian Pediatric Weight management Registry (CANPWR): lessons learned from developing and initiating a national, multi-centre study embedded in pediatric clinical practice.
BACKGROUND
There is increasing recognition of the value of "real-world evidence" in evaluating health care services. Registry-based, observational studies conducted in clinical settings represent a relevant model to achieve this directive. Starting in 2010, we undertook a longitudinal, observational study (the CANadian Pediatric Weight management Registry [CANPWR]), which is embedded in 10 multidisciplinary, pediatric weight management clinics across Canada. The objective of this paper was to share the lessons our team learned from this multi-centre project.


METHODS
Data sources included a retrospective review of minutes from 120 teleconferences with research staff and investigators, notes taken during clinical site visits made by project leaders, information from quality control processes to ensure data accuracy and completeness, and a study-specific survey that was sent to all sites to solicit feedback from research team members (n = 9). Through an iterative process, the writing group identified key themes that surfaced during review of these information sources and final lessons learned were developed.


RESULTS
Several key lessons emerged from our research, including the (1) value of pilot studies and central research coordination, (2) need for effective and regular communication, (3) importance of consensus on determining outcome measures, (4) challenge of embedding research within clinical practice, and (5) difficulty in recruiting and retaining participants. The sites were, in spite of these challenges, enthusiastic about the benefits of participating in multi-centre collaborative studies.


CONCLUSION
Despite some challenges, multi-centre observational studies embedded in pediatric weight management clinics are feasible and can contribute important, practical insights into the effectiveness of health services for managing pediatric obesity in real-world settings.
['Morrison|Katherine M|KM|0000-0002-1737-256X', 'Ball|Geoff D C|GDC|', 'Ho|Josephine|J|', 'Mackie|Pam|P|', 'Buchholz|Annick|A|', 'Chanoine|Jean-Pierre|JP|', 'Hamilton|Jill|J|', 'Laberge|Anne-Marie|AM|', 'Legault|Laurent|L|', 'Thabane|Lehana|L|', 'Tremblay|Mark|M|', 'Zenlea|Ian|I|']
D002170:Canada D002648:Child D002662:Child Health Services D003142:Communication D032921:Consensus D006801:Humans D008137:Longitudinal Studies D018579:Patient Selection D063766:Pediatric Obesity D010865:Pilot Projects D011446:Prospective Studies D012042:Registries D057170:Translational Research, Biomedical D061217:Weight Reduction Programs
Pediatric Weight management Cardiometabolic health outcomes Childhood obesity Cohort study Research methodology Treatment