What should compensation schemes know about researchers?

Alex Collie1,2, Pauline Zardo1,2 & Gillian Syres1

1.Institute for Safety Compensation and Recovery Research2.Department of Epidemiology and Preventive Medicine, Monash Unviersity

Presentation to 1st Australasian Compensation Health Research Forum13-14th October 2011, Melbourne, Australia.

Outline

• The problem

• What motivates researchers?

• Some other observations

• Implications for policy makers

The problem

•Only 8 - 15% of research evidence contributes to a change in policy or practice (Best & Holmes 2010)

•In one jurisdiction, references to published academic research comprised 2.1% of all references to evidence in injury compensation ‘treatment payment’ policies (Zardo & Collie, 2011)

''It's a feel. That's what a lot of our evidence would consist of.”

(Higgins et al, 2011)

The problem – by way of example (i)

1601 – Lancaster shows that lemon juice can eliminate scurvy amongst sailors.

1747 – Lind demonstrates the same for citrus juice.

1795 – British Navy first uses citrus juice for sailors (194 years after discovery).

1854 – British Board of Trade begins using citrus juice for sailors (253 years after discovery).

The problem – by way of example (ii)

2003 – Roberts-Yates reports that aspects of the compensation process in South Australian workers comp system lead to poor client satisfaction. (Roberts-Yates C. Disab & Rehab, 2003)

2004 – Strunin & Boden report similar findings in USA workers compensation. (Strunin L & Boden L. Am J Ind Med, 2004)

2005 – Sager & James report similar findings in NSW workers compensation. (Sager L & James C. Aust Occ Therapy Journal, 2005)

2006 – Lippel replicates and extends findings in Quebec workers compensation system. (Lippel K, Int J Psychiatry & Law, 2006)

2011 – Murgatroyd et al report similar findings in NSW motor accident compensation system. (Murgatroyd D et al, Injury Prevention 2011)

Question – The response? Have we altered the process? Are we even considering altering the process?

What research is likely to be used?

Source: WHO, 2004

Actionable messages

Synthesis of research evidence

Individual studies, articles and reports

Basic science, theoretical and methodological innovations

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What motivates academic researchers?

What motivates academic researchers?

•Academic performance standards:

• Research output (publication)

• Research income (grants)

• Research training (doctoral students)

•Interesting questions & important issues

•Research being used (impact)

•Recognition of expertise

University research funding in Australia

•HERDC research income categories• Category 1 – Australian competitive grants• Category 2 – Other public sector research income (incl. state government)• Category 3 – Industry and other research income• Category 4 – CRC research income

•Research Infrastructure Block Grants (RIBG)• “provides block grants, on a calendar year basis, to eligible Australian higher

education providers (HEP) to enhance the development and maintenance of research infrastructure.”

• Funding formula based on HERDC Category 1 research income, publication, higher degree student completions, student load and research staff numbers.

University research funding in Australia

NH&MRC of Australia 09/10Canadian Institutes of Health Research 10/11

$AUD millions

% research expenditure

$CAD millions

% research expenditure

Creaton of new knowledge 466.7 66 449.5 47

People support / capacity building

183.8 26 201.6 21

Research translation 56.6 8 257.8 27

Commercialisation - - 46.2 5

Total Research Expenditure 707.1 100 955.1 100

Monash research-only position descriptors

Level D (Senior Research Fellow) duties may include:•the conduct of independent research in which the academic may work as part of a team and the production of conference and seminar papers and publications from that research; •supervision of research-support and administrative staff; •a major role in all aspects of major research projects including management and/or leadership of large research projects or teams; •supervision of the research of less senior research-only Academic staff; •promotion of research links with outside bodies; •preparation of research proposal submissions to external bodies; •responsibility for the oversight of financial management of grants; •involvement in professional activities including, subject to availability of funds, attendance at conferences and seminars in the field of expertise; •occasional contributions to the teaching program within the field of the staff member's research; •supervision of major honours or postgraduate research projects;•etc… Source: www.monash.edu

“I’m not in it for the money”

•Academic research salaries are modest, but academic appointments offer an opportunity to pursue own interests.

•Importance is relative:• Contract research = someone else’s question • Investigator-initiated research = my question

Need to align researcher and policy organisation interests.

•Important questions require rigorous investigation• time & cost implications

Engage researchers on big picture, long-term initiatives.

Use it or lose it

''We felt it sank like a stone”…beyondblue...had treated the report like a ''grubby little secret''.

A/Prof Anne Mitchel, La Trobe University (report author) quoted in “The Age”, 1 October 2011

•Researchers want to see their work used and valued.

•Recent local example:• “Feeling Queer and Blue” report into depression among the gay, lesbian and

bisexual community. • Commissioned by beyondblue but withheld from publication for 6 months post

completion.

Some other observations

Research-speak, Policy-speak

•Research has its own language, but so do compensation and insurance systems.

•There is a movement for plain language in research, but it is rare.

Plain language means different things to different people. Be very specific in what you ask for.

“Double-blind, placebo-controlled, pseudo-randomised controlled trial of….blah blah...”

“Actuarial release”, “scheme viability”, “funding ratio” etc…

Choose wisely

•Fit for purpose = “methods that are appropriate for the problem, the context and available resources” (Wren J, 2011).

•Research training is discipline specific.

•Most researchers have a dominant / preferred methodology.

Don’t ask an epidemiologist to answer a sociological question.

•Most researchers are trained to disseminate not translate.

•Research is usually a part-time profession (teaching, clinical duties, administration)

Implications for injury compensation systems?

Implications for injury compensation organisations

There is a lot of relevant research. You just need to know how to access it.

Your money is less valuable than other people’s money.

Meaningful interaction with industry / government is uncommon in academic research.

Set research questions collaboratively - engage researchers early in a project

Restrictions on publishing are substantial barriers to engaging with researchers.

Research funding that supports training (e.g., PhD projects) is attractive.

Implications for injury compensation organisations

Identify researchers with interests aligned to your policy needs.

Identify researchers with experience and expertise appropriate to the issue you want addressed.

Engage researchers on big picture, long term projects and/or establish an ongoing relationship.

Show how research evidence is being, or will be, used.

Provide opportunities for researchers to interact with your staff and key decision makers.

Don’t use jargon and don’t accept jargon-laden reports or presentations.