Description
This department was originally established in 1968 and became part of the Institute of general practice and community health in 1990. It appears as though the department has a considerable teaching load, although there are two subunits with external funding for research. The department is largely clinical, and most staff are part-time employed in combination with part time work as general practitioners (GPs) elsewhere, with 43 individuals of which ½ are graduate students – representing 23 full-time employees (FTE). About 75% of the academic staff in permanent positions are above the age of 55, although the unit reports having successfully recruited several “younger” clinical (GP’s) PhD students, despite lower salaries. The rapid expansion of PhD students is to a large extent due to the two externally funded sub-units AFE and ASP. The unit has recently been able to recruit a biostatistician.
Research quality
The primary research focus is on medication prescriptions, e.g. of antibiotics. There is also a focus on using national surveys – again with a focus on prescriptions – as well as using the NorPD (prescription registry). The unit expresses wanting to strengthen the ability to extract data from electronic medical records.
However, the organization is very flat, with no clear strategy or leadership, and very few researchers trying to do too much. There is great potential, but the publication rate is only modest, with many of the publications in Norwegian journals.
Grade: Fair/Good Recommendations
The unit clearly needs to focus. There is great potential in developing research based on patient records, and possibly in antibiotic resistance. However, the unit should improve international collaboration (for instance with groups in the other Nordic countries, which have similar potential advantages). Furthermore, a more distinct research strategy should be developed, as well as encouragement to publish not only in Norwegian, but even international peer-reviewed journals.
Societal impact
The group clearly has the potential to make a societal impact, and publication in local medical journals is one indication of this.
University of Oslo and Oslo University Hospital
Institute of Clinical Medicine
Level 1 Description
Division of Medicine is the forum for the close collaboration between University of Oslo (UoO) and Oslo University Hospital (OUH). OUH is the result of a series of mergers of hospitals in the Oslo area during the period 2005-09. OUH has organized the activities in nine clinical divisions, which all span activities in more than one of the four major localizations.
The Faculty of Medicine has similarly reorganized its activities at OUH with Institute of Clinical Medicine (Clinmed). In the reorganization, steps have been taken to improve research collaboration between OUH and OoU, including strategic leadership meeting and establishment of working groups with participation from both institutions.
The evaluation units include scientist employed by UoO or by OUH, as well as scientists having a combined employment at both institutions. Almost all scientists employed by UoO belong to Clinmed. As part of the institutional reorganization, several of the major issues that were raised by the previous evaluation have been addressed by both institutions, including strengthening scientific leadership at all levels, and formation of research unit with more focused research. Since the last evaluations, three Centres of Excellence have been appointed by the RCN with UoO as the major host institution and UOH as the primary location.
OUH is responsible for approximately 50% of research in the health sector in Norway, including 110 finished PhD degrees in 2009 and 140 in 2010.
The present organization both at OUH and UoO was established in 2010, and the current research strategy is therefore also new. Important elements of the research strategy are:
Recruitment of the best talents in all positions, work for a 50/50 split between research and clinical work in all academic positions, work for project support as seeding money to new areas and areas with lower scientific output, strategically improve translational research and collaboration with basic sciences, and strengthening the research focus of the individual department to enhance the competitive profile.
1.Center for Shared Decision Making and Nursing Research Level 2
Description
Center for Shared Decision Making and Nursing research (CSDM) was established in 2002 to build a strong interdisciplinary research program on health information technologies, to support shared decision making, patient-provider partnerships and illness management, as means to improve patient care quality and patient outcomes. Today, CSDM has developed into an internationally recognized interdisciplinary research unit, which has been able to obtain approximately 60 million NOK in external funding. The Center has 32 employees
including 13 externally funded PhD students, four scientists with a doctoral degree (two full-time and two part-full-time), six systems developers, and research staff. CSDM collaborates with a considerably number of national and international research institutions. PhD students are strongly encouraged to spend 1-2 semesters abroad, and CSDM has agreements for student exchange with two high-ranking universities in the US.
The core activity consists of research combined with innovation, with the overall goal to improve illness management and prevention through support for patient self-management and patient-centered collaborative care. CSDM has gained considerable experience in developing, implementing and testing user-centered electronic support systems. These systems are now used in several hospitals in Norway, and one system is also used in research collaboration with universities in California. CSDM has also ongoing negotiations with IT companies to bring these systems to market in the Nordic countries.
The research strategy has developed with the growth of the center. CSDM is currently restructuring its research organization from four thematically defined research sections to a matrix organization with five complementary cores: 1. User-determined collaborative care; 2.
Self-management; 3. Implementation sciences; 4. Comparative effectiveness studies; and 5.
Information technology. Moreover, CSDM will continue its commitment towards doctoral and post-doctoral education.
Research quality
The research at CSDM has a high level, and the number of publications is high, especially when compared to the modest number of permanent positions. The Center has apparently managed to create a dynamic research milieu that can attract both PhD students and external funding. The four scientists with a doctoral degree are all between 55 and 60 years old, and recruitment of younger academic staff is recognized as a main problem in the coming years.
The recurrent reorganizations of the hospitals have also been a challenge in several ways.
Grade: Very Good.
Societal impact
The societal impact of the research at CSDM is evident, as support systems developed here are in use in several Norwegian hospitals. CSDM has also ongoing negotiations with commercial companies.
Recommendations
The Panel finds that evidence-based approaches to assessment of the performance of new methods should be strengthened further. Trials with long-term follow-up should evaluate if the new support systems also have a positive impact on disease progression and survival.
Such studies should compare new approaches with current best practice.
2. Unit of Biostatistics and Epidemiology