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Research within ISOC

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

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Research within ISOC

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  1. Research within ISOC Jörg Goldhahn, MD, MAS On behalf of the outcome working group 3rd ISOC Meeting in Bologna

  2. Outline • Challenges • Analysis of member clinics • ISOC Facts • Possibleapproaches

  3. 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

  4. 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

  5. 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

  6. Challenges

  7. 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

  8. Methods • Visits • Survey • websites

  9. 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

  10. ISOC facts

  11. Role of academic partnersexample • Access to extensive research platform • Linked to further partners • Enable academic environment • Offer further possibilities for funding

  12. 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

  13. 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?

  14. 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

  15. Next steps Databases 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. • 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

  16. Next steps • Identification of relevant question • Discussion of appropriate methodology • Identification of necessary technology/ressources • Formation of an ad-hoc working group • Identification legal aspects • Need for harmonization • Establishing communication • Research proposal • Approval from the ISOC board • Joint application for funding • Report at the next ISOC meeting (hopefully)

  17. Thank you

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