There are currently 23 academic and community sites across eight provinces participating in C-NeST projects. This collaboration helps to improve the
generalizability of research findings beyond academic centres.
C-NeST is a national partnership of community and university-based researchers for multicentre, investigator-initiated clinical studies.
As a sub-network under SkIN Canada, C-NeST has created an initial partnership of study sites and data infrastructure
Follow-up of Cutaneous SCC (FOCS)
A multicentre study of follow-up practices for patients diagnosed with squamous cell carcinoma (SCC). Due to a lack of evidence and diverse recommendations across organizations including the AAD and BAD, there is likely substantial variability amongst dermatologist practices. As such, we hope to better understand the practice patterns amongst Canadian dermatologists to help establish the baseline landscape and identify opportunities for improvement. Study objectives are outlined below. We currently have over 10 community and academic dermatologists from across Canada involved in this project. Study Aims and Hypotheses: a) To characterize the practice patterns for follow up of immunocompetent patients by dermatologists after a diagnosis of primary invasive cutaneous SCC. Hypothesis: Variation will be seen in the frequency and duration of follow-up. b) To identify factors associated with the time to the first follow-up skin exam after SCC diagnosis. Hypothesis: Patients who are at higher risk of recurrence, metastasis, or additional skin cancers (older age, advanced tumour stage) will be followed more frequently for skin exam.
Effect of allergy testing on atopic dermatitis in adults (EAT-AD)
Atopic dermatitis (eczema) is frequently associated with food and environmental allergies, but the impact of allergy testing and management on skin disease severity in people with atopic dermatitis is unclear. We will create electronic surveys to evaluate current practices regarding allergy testing for adults with atopic dermatitis and interest in participating in studies of allergy testing. The survey responses will be anonymous; clinicians may provide contact information for future studies. We will ask local, provincial, and national dermatology societies to disseminate the survey via e-mail and social media. The patient survey will be shared via Eczema Society of Canada and Canadian Skin Patient Alliance email lists and social media channels. We will calculate the proportion of responses for each question item, and open-ended responses will be summarized into themes. We will document patterns of care and interest in research on allergy testing as an intervention for atopic dermatitis. These results will further our understanding of current practices among dermatologists and capture the perspectives of adults with atopic dermatitis regarding different types of allergy testing in the management of atopic dermatitis. These results may inform future research on allergy testing for patients with atopic dermatitis.
Canadian Morphea Registry (C-MORE)
Morphea is a chronic relapsing autoimmune disease characterized by scarring of the skin/subcutaneous tissue. It affects ~75,000 Canadians. Several clinical subtypes exist, and severe forms (linear, generalized, pansclerotic) have a high risk of extracutaneous involvement, pain, disfigurement, and disability. Many clinical/research gaps in morphea remain. Only 2 single-center registries exist (Morphea in Adults and Children (Texas), National Registry for Childhood-Onset Scleroderma (Pittsburgh)). Current studies are limited by small patients’ number, unequal ethnocultural representation, retrospective data collection, and use of invalidated classifications, making data interpretation/clinical translation difficult. We created the first national morphea patients’ registry (C-MORE) comprised of 36 multidisciplinary physicians across 17 academic sites, aimed to understand morphea’s clinical characteristics, triggers, severity and burden in Canadian patients. The aim of this study is to characterize morphea patients in Canada, their demographics, disease severity/complications, to elucidate the impact of morphea on patients' lives and the risk factors associated with worse disease. This data will be directly relevant to patients as it will instruct clinicians about which patients are at higher risk of complications and should be followed/investigated more thoroughly. Better understanding the burden of disease will help to stimulate research and development in morphea.
Canadian Atopic dermatitis Cohort for Translational Immunology and imaging (CACTI) BRONTE trial (BROadband vs Narrowband phototherapy for eczema)
The CACTI project is a multicenter observational prospective cohort study based at three Canadian institutions (Women’s College Hospital/University of Toronto, McGill University Health Science Centre, University of British Columbia). It will enroll patients with severe atopic dermatitis with inadequate control from topical therapy and collect biospecimens (blood, microbial swabs, skin biopsies) from consenting participants. It also contains a nested randomized controlled trial comparing two types of phototherapy. This project requires a secure online data platform to collect and centrally store unidentified longitudinal clinical data for participants across the three sites. The central study site is Women’s College Hospital, making a partnership with SkIN Canada seamless. Each site will enter their own data into the database. The platform must also be able to randomize patients eligible for the nested randomized controlled trial. It must also be able to document and track biospecimens collected at the different sites. It should also be able to track storage and laboratory analyses of these samples.
The C-NeST Committee is composed of several researchers and patient partners
- Drucker A, Kleiner O, Manion R, Philip A, Dutz J, Barnard K, et al. Top ten research priorities for psoriasis, atopic dermatitis and hidradenitis suppurativa: the SkIN Canada Priority Setting Initiative. J Cutan Med Surg. 2023. doi: 10.1177/12034754231156103
- Kim KS, Chan AW, Belley-Côté EP, Drucker AM. Noninferiority randomized controlled trials. J Invest Dermatol. 2022 Jul;142(7):1773–7. doi: 10.1016/j.jid.2022.04.015
- Mirali S, Tang E, Drucker AM, Turchin I, Gooderham M, Levell
N, et al. Follow-up of patients with keratinocyte carcinoma: A systematic review of clinical practice guidelines. JAMA Dermatol. 2022 Nov 2. doi: 10.1001/jamadermatol.2022.4590
In order to submit your project, you need to fill in the intake form first.
C-NeST Management Committee will review the application and get back to you.
A major goal of C-NeST is to connect dermatologists around the country with opportunities to participate in clinical trials. If you are interested in participating in a particular trial or would like to know more about current or future opportunities please email firstname.lastname@example.org
Positions on the C-NeST Committee turn over every few years; this is staggered at first in the years after we launched our network. If you are interested in being a future member of the C-NeST committee, please email email@example.com
The short answer: YES.
The long answer depends on what your project is about. C-NeST prioritizes clinical trials/projects, in addition to any project that fits with the top ten list of research priorities
You can participate in all available Training Committee activities, including Workshops and Webinars. If you wish to participate in the Training Committee itself, the fastest way to check if there is an opening is to email Kenneth Finnson, the Training Committee Coordinator at firstname.lastname@example.org
YES absolutely you can