USING A DYNAMIC REVIEW PROCESS FOR ORTHOPAEDIC HAND RESEARCH

Description/Abstract

With less time available, greater multicentre collaboration and increased researcher mobility, our aim was to design, build and test tools to manage a robust academic research process in orthopaedics. A secure environment built upon ‘web’ services, allowed users access to these tools via a conventional Internet browser, providing instant access to the multimedia library resources, simulation, clinical trials, and case logs using extensible mark-up language (XML). Users see a customized view of the system based upon their expertise and privileges. They can match their clinical, educational and research experience to specific trials and relevant background information. They then prepare & store gestational draft papers in a protected environment with a focused discussion forum. These are automatically generated from material collected, in accordance with the advice to authors for selected journals and the SPSS generated statistics, selected by the authors' analysis of the collected data. Evaluation was initially completed using ‘on-line’ forms, with structured data incorporating standard orthopaedic outcome test scores. One trial with over 2800 patients, demonstrated the scalability of the system. The user interface, accessing clinical trials, surgical logbooks and technical paper drafts, demonstrated 87% (n=18) ‘good’ or ‘very good’ usability performance. Planned evaluation with 100+ clinicians is ongoing, adapting the system to the field of upper limb surgery. By integrating scoring systems such as DASH, ASES and Constant, it is possible to ensure that data is collected that can be mined after the event and incorporated into trials where variables can be tested regularly to identify when results become significant. Results are then managed in the secure environment by the research team so that they can prepare prepublication drafts for collaboration. The system provides a distributed architecture for institutions to manage multiple centres, advancing surgical standards through research and education. The tools are generic, applicable across laboratory and clinical disciplines. Orthopaedic trainees validated the trials, which is now being implemented regionally. It lends itself to ongoing data collection for longitudinal studies, managing larger and larger databases allowing greater stratification of the data. The system provides a working environment for secure academic discussion of the non-repudiable traceable results.