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Research within ISOC. Jörg Goldhahn, MD, MAS On behalf of the outcome working group. 3rd ISOC Meeting in Bologna. Outline. Challenges Analysis of member clinics ISOC Facts Possible approaches. International Society of Orthopaedic Centers (ISOC). Mission - PowerPoint PPT Presentation
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Obere Extremität
Research within ISOC
Jörg Goldhahn, MD, MAS
On behalf of the outcome working group
3rd ISOC Meeting in Bologna
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Outline
Challenges
Analysis of
member clinics
ISOC Facts
Possible
approaches
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International Society of Orthopaedic Centers (ISOC)
Mission• Facilitate exchange of ideas and best
practices among premier specialty orthopaedic institutions
• Collaborate on patient care, education and research-based programs
• Advance improvements in orthopaedic care on a global scale
Global Orthopaedic Think Tank
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Need for collaboration
Kolling C, Herren DB, Simmen BR, Goldhahn J. Changes in surgical intervention patterns in rheumatoid arthritis over 10 years in one centre. Ann Rheum Dis. 2009 Aug;68(8):1372-3
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Challenges
• More competition for funding
• Large numbers in clinical trials
• Interdisciplinary problems require multiple and different ressources
• Need for harmonization of measures, e.g. in outcome research
• Conflicts of interests with industry
• New research areas, e.g. socioeconomic investigations
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Challenges
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Analysis of member clinics
• To explore the research potential
• To find common research topics
• To identify potential for collaboration, synergies and added value
• To learn more about research organization
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Methods
• Visits
• Survey
• websites
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Findings
• Research in collaboration with teams of professionals of varying size
• Different percentage of third-party funding
• Similar main topics but different technologies and core competencies
• Organization of research differs• Independent research team, e.g. HSS• Embedded in core research facilities, e.g, Mayo• Affilliated with clinic, e.g. Schulthess
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ISOC facts
No. scientists No. articlesFunding(Million $)
Summe 387 1524 38.44
Mean 35 139 5.49
Range 1-156 4-300 0,1-21,8
Median 16 70.5 1.5 Mill. USD
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Role of academic partnersexample
• Access to extensive research platform
• Linked to further partners
• Enable academic environment
• Offer further possibilities for funding
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Common findings
• Discussions about the value of research in the clinical environmente.g. Endoklinik and Schulthess Klinik
• Restructuring programs in several centers e.g. Joint Academic Plan of RNOH
• Ideas to focus research, e.g. at Instituto Nacional De Rehabilitacion, Mexico
• Interdisciplinary collaborations, e.g. with rheumatology or engineering
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Questions for collaboration
• What are current trends in surgical practice?
• How do different centers tackle hygenic challenges?
• How do different rehabilitation protocols affect outcome?
• How do socio-economic boundary conditions, e.g. health care system, influence decision-making, clinical pathways and subsequent outcome after orthopaedic interventions, e.g. influence of DRG’s on length of stay?
• Are their significant differences in treatment strategies based on region-specific training programs or thought schools, e.g. perioperative use of DMARD’s?
• How do implants perform in different entities of patients all over the world, e.g. Caucasian vs. Asian?
• How does cultural background influence patient and surgeon expectations for orthopaedic interventions?
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Use of the network
• Multicenter studies• Common indications with large numbers• Rare indications with reasonable numbers
• Synchronized prospective data collection
• Technological synergies
• Knowledge exchange
• Joint applications, e.g. to NIH or EU
• Surveys, e.g. about surgical practice
• Position statements
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Next steps
Databases
• Identification of prospective data collections at different sites
• Indications including inclusion and exclusion criteria, Core data sets, Intervals and follow-up schemes, Technological basis
• Establishing of a steering committee that ensures
• Data quality at each participating site, legal aspects, scientific quality
• Implementation of a harmonization process
• Regarding data quality, e.g. according to FDA requirements, protocols
• Start of pilot projects within a core group of ISOC
Clinical studies• Identification of sites with
common interest and infrastructure
• E.g. Orthopaedics and Rheumatology
• Development of a joint study protocol
• Applicable to all sites
• Application for external funding• WHO, EU, NIH
• IRB approval at each site
• Establishement of joint infrastructure
• Internet-based, skype conferences etc.
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Next stepsIdentification of relevant questionDiscussion of appropriate methodologyIdentification of necessary technology/ressourcesFormation of an ad-hoc working group
Identification legal aspects Need for harmonization Establishing communication Research proposal
Approval from the ISOC boardJoint application for fundingReport at the next ISOC meeting (hopefully)
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Thank you