Collaborative multicenter trials in Latin America
challenges and opportunities in orthopedic and trauma surgery
Keywords:
Multicenter study [publication type], Fractures, bone, Traumatology, Orthopedics, Latin AmericaAbstract
CONTEXT AND OBJECTIVE: Orthopedic research agendas should be considered from a worldwide perspective. Efforts should be planned as the means for obtaining evidence that is valid for health promotion with global outreach. DESIGN AND SETTING: Exploratory study conducted at Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil, and McMaster University, Hamilton, Canada. METHODS: We identified and analyzed collaborative and multicenter research in Latin America, taking into account American and Canadian efforts as the reference points. We explored aspects of the data available from official sources and used data from traffic accidents as a model for discussing collaborative research in these countries. RESULTS: The evaluation showed that the proportion of collaborative and multicenter studies in our setting is small. A brief analysis showed that the death rate due to traffic accidents is very high. Thus, it seems clear to us that initiatives involving collaborative studies are important for defining and better understanding the patterns of injuries resulting from orthopedic trauma and the forms of treatment. Orthopedic research may be an important tool for bringing together orthopedic surgeons, researchers and medical societies for joint action. CONCLUSIONS: We have indicated some practical guidelines for initiatives in collaborative research and have proposed some solutions with a summarized plan of action for conducting evidence-based research involving orthopedic trauma.
Downloads
References
Fayaz HC, Jupiter JB, Pape HC, et al. Challenges and barriers to improving care of the musculoskeletal patient of the future - a debate article and global perspective. Patient Saf Surg. 2011;5:23.
Mathew G, Hanson BP. Global burden of trauma: Need for effective fracture therapies. Indian J Orthop. 2009;43(2):111-6.
World Health Organization. Global status report on road safety: time for action. Geneva: World Health Organization; 2009. Available from: http://www.who.int/violence_injury_prevention/road_safety_status/report/cover_and_front_matter_en.pdf. Accessed in 2012 (Dec 18).
World Health Organization. First Global Ministerial Conference on Road Safety: Time for Action. Moscow, 19-20 November 2009. Moscow Declaration. Available from: http://www.who.int/roadsafety/ministerial_conference/declaration_en.pdf. Accessed in 2012 (Dec 26).
Fraser B. Traffic accidents scar Latin America’s roads. Lancet. 2005;366(9487):703-4.
Court-Brown CM, Bugler KE, Clement ND, Duckworth AD, McQueen MM. The epidemiology of open fractures in adults. A 15-year review. Injury. 2012;43(6):891-7.
Bhandari M, Sprague S, Schemitsch EH; International Hip Fracture Research Collaborative. Resolving controversies in hip fracture care: the need for large collaborative trials in hip fractures. J Orthop Trauma. 2009;23(6):479-84.
Grady D, Applegate W, Bush T, et al. Heart and Estrogen/progestin Replacement Study (HERS): design, methods, and baseline characteristics. Control Clin Trials. 1998;19(4):314-35.
McMurray J, Køber L, Robertson M, et al. Antiarrhythmic effect of carvedilol after acute myocardial infarction: results of the Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction (CAPRICORN) trial. J Am Coll Cardiol. 2005;45(4):525-30.
Ridker PM, Danielson E, Fonseca FA, et al. Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial. Lancet. 2009;373(9670):1175-82.
Brophy RH, Smith MV, Latterman C, et al. Multi-investigator collaboration in orthopaedic surgery research compared to other medical fields. J Orthop Res. 2012;30(1)):1523-8.
Moraes VY, Belloti JC, Moraes FY, et al. Hierarchy of evidence relating to hand surgery in Brazilian orthopedic journals. Sao Paulo Med J. 2011;129(2):94-8.
Moraes VY, Moreira CD, Tamaoki MJS, Faloppa F, Belloti JC. Ensaios clínicos randomizados na ortopedia e traumatologia: avaliação sistemática da evidência nacional [Randomized controlled trials in orthopedics and traumatology: systematic analysis of the national evidence]. Rev Bras Ortop. 2010;45(6):601-5.
Odero W, Garner P, Zwi A. Road traffic injuries in developing countries: a comprehensive review of epidemiological studies. Trop Med Int Health. 1997;2(5):445-60.
Nantulya VM, Reich MR. Equity dimensions of road traffic injuries in low- and middle-income countries. Inj Control Saf Promot. 2003; 10(1-2):13-20.
Wright JG, Gebhardt MC. Multicenter clinical trials in orthopaedics: time for musculoskeletal specialty societies to take action. J Bone Joint Surg Am. 2005;87(1):214-7.
Wright JG, Katz JN, Losina E. Clinical trials in orthopaedics research. Part I. Cultural and practical barriers to randomized trials in orthopaedics. J Bone Joint Surg Am. 2011;93(5):e15.
Sprague S, Matta JM, Bhandari M, et al. Multicenter collaboration in observational research: improving generalizability and efficiency. J Bone Joint Surg Am. 2009;91 Suppl 3:80-6.
