New HSS Center to Translate Patient and Registry Data into Helpful Outcome Studies

Hospital for Special Surgery (HSS) in New York recently formed a new
Center for Musculoskeletal Outcomes and Patient Oriented Research to translate
information collected from extensive patient populations into clinical studies
that will guide experts in preventing, diagnosing and treating musculoskeletal
conditions, according to a HSS press release.

  Louis A. Shapiro
  Louis A. Shapiro

“Through this new center, Hospital for Special Surgery will report
on the effectiveness of orthopedic and rheumatology treatments, so physicians,
government agencies, medical device and drug companies, health insurance
companies and, most importantly, patients have the facts they need to make the
best informed health care decisions,” Louis A. Shapiro, HSS president and
chief executive officer, stated in the release.

The mission of the center is to incorporate rigorous research
investigation into the delivery of orthopedic and rheumatology patient care and
the outcomes of that care. Such research will result in the publication of
peer-reviewed health reports discussing the prevention, diagnosis and treatment
of bone, joint, muscle and autoimmune disorders, according to HSS.

“The center will provide the resources and environment within which
basic, clinical, translational and health researchers can collaborate in
identifying treatments, clinical pathways and quality measures that can lead to
significant improvements in musculoskeletal health,” Steven R. Goldring,
MD, HSS chief scientific officer stated.

Timothy Wright, PhD, who co-heads the center with Art Sedrakyan, MD,
PhD, formerly with the FDA, views the new center as an avenue for improving the
quality of musculoskeletal clinical research conducted at HSS.

“The idea here is to take what we have done in terms of building
our registries and begin to build an academic center around it,” he said.
“This is a way to leverage our size to answer some really interesting

Last year about 26,000 surgeries were completed and about 300,000
patient visits were conducted at HSS, Wright said.

  Timothy Wright, PhD, said HSS will take a leadership role in harmonizing data by spearheading the International Consortium of Orthopedic Registries effort.
  Timothy Wright, PhD, said HSS
will take a leadership role in harmonizing data by spearheading the
International Consortium of Orthopedic Registries effort.
  Image: Hospital for Special

“Through these registries, clinicians and researchers collect more
than demographic and clinical information. They also gather patient reports
about outcomes after surgery, such as satisfaction with treatment, quality of
life and return to activities,” Thomas P. Sculco, MD, surgeon-in-chief,
stated in the release.

According to Wright, one of the initial activities of the center’s
researchers, which is already underway, involves leading the development of an
International Consortium of Orthopedic Registries (ICOR). The ICOR project is
the result of an FDA-awarded contract that HSS received in 2010.

Through HSS leadership, the international consortium will work toward
creating a
registry network to provide a worldwide view of orthopedic
patient outcomes and to compare differences among treatment options, HSS noted
in the release.

“This is the first international network of orthopedic device
registries that will help us better understand the safety and effectiveness of
orthopedic devices in a real-world setting,” ICOR project co-leader Danica
Marinac-Dabic, MD, PhD, director of the FDA Center for Devices and Radiological
Health’s Division of Epidemiology, stated in the release.

Sedrakyan, co-leader of the ICOR project and director of the Comparative
Effectiveness Program at HSS and Weill Cornell Medical College, noted that the
consortium will serve as a model for other medical device registries.

“The objective here is not to pull data in from other registries
and hone it somewhere and have it sitting somewhere. It’s to have a
distributed network and to reach into the registries with mutual approval from
all the registries to answer questions,” Wright said. — by Susan
M. Rapp


Evidence-based practice is fueled by research, and research is fueled by
data. Outcome measures in health care and registries like ICOR have an
important utility: they can be used to answer research questions that have not
yet been asked. In the future, new questions will emerge that require a
retrospective look at a large bank of data.

  Mark D. Geil
  Mark D. Geil

The challenge in O&P is that we are only just beginning the routine
collection of uniform outcome measures. The sooner we start, the better. And,
as the data collection becomes more and more widespread, the time lag leading
to the critical mass necessary for thorough research can be reduced.

Since O&P is only beginning this cycle, it is essential that the
measures we collect be thoughtful, forward-focused, and thoroughly validated.
Good work along those lines is already underway.

— Mark D. Geil, PhD
Associate professor of
biomechanics, Georgia State University and member, O&P Business
Practitioner Advisory Council

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