Introduction iabetes is a noncommunicable disease with worldwide distribution. It meets all the three criteria for a public health disorder: • A high disease burden; • Changing burden suggesting preventability; and • Fear that things are unknown and out of control. On the other hand, it is one of the major causes of death and disability, so it leads to the important area of research on prevention, screening, and early intervention. – 3 Iranian Ministry of Health (MoH) has designed a health system for more equitable allocation of health resources based on Primary Health Care (PHC). It is an integrated and stratified health care system, and national or multicentric preventive programs should be implemented in this system. According to MoH reports in 2004, 5,513 physicians worked in the PHC system. As the health systems moves towards greater coverage with more addressees, the traditional approaches to clinical research will fail. 3, 4 Research without systematic planning dissipates resources and intellectual investments and must be barred by a managed network. Now (after a four-year period of implementation of our research network) we are going to report the findings and profits, the lessons learned from our experience, the obstacles we encountered, and future directions. Background and structure Having considered the above-mentioned problem, Endocrinology and Metabolism Research Center (EMRC) — a research center with 13 years experience, which is affiliated to Tehran University of Medical Sciences and is a member of International Diabetes Federation — invited local (provincial) research centers that were active in diabetes surveys to enter into a session for proposing solutions for systematic planning. EMRC suggested that a national diabetes research network be created as a preliminary project. So, Iranian National Diabetes Research Network (INDIRAN) Project has emerged as the infrastructure for research in diabetes. Deputy for Research and the National Advisory Committee on Noncommunicable Diseases of MoH endorsed the network in 2002. In primary sessions, the executive framework and the approval protocol for research projects were established. Then, in regular sessions, research priorities were approved for designing of common projects according to Figure 1. INDIRAN is a group of research centers throughout Iran, which collaborate in diabetes research projects with cooperation of international and ministerial advisors. Permanent secretariat is located in EMRC. Sessions held regularly twice a year to make direct contact between the members and advisors and also to provide opinion sharing. But in the other times, there is a two-side relation between the provincial members and network secretariat while observant organizations and international advisors connect EMRC directly. The descriptive organization chart is shown in Figure 2.
[1]
S. Woolf.
Practice guidelines, a new reality in medicine. II. Methods of developing guidelines.
,
1992,
Archives of internal medicine.
[2]
S. Heller,et al.
A clinical research network in diabetes for the UK
,
2004,
Diabetic medicine : a journal of the British Diabetic Association.
[3]
Lawrence A Leiter,et al.
1998 clinical practice guidelines for the management of diabetes in Canada. Canadian Diabetes Association.
,
1998,
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.
[4]
D. Whynes,et al.
Collaborating with a primary care-based research network.
,
2001,
Journal of evaluation in clinical practice.
[5]
C. Squire,et al.
Clinical Oncology Information Network (COIN)
,
1994,
Clinical oncology (Royal College of Radiologists (Great Britain)).
[6]
B. Zinman,et al.
New guidelines for the management of diabetes: a physician's guide. Steering Committee for the Revision of the Clinical Practice Guidelines for the Management of Diabetes in Canada.
,
1998,
CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.
[7]
C. van Weel,et al.
Longitudinal Research and Data Collection in Primary Care
,
2005,
The Annals of Family Medicine.