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2018 international consensus meeting on musculoskeletal infection: Research priorities from the general assembly questions

2018 international consensus meeting on musculoskeletal infection: Research priorities from the general assembly questions
2018 international consensus meeting on musculoskeletal infection: Research priorities from the general assembly questions

Musculoskeletal infections (MSKI) remain the bane of orthopedic surgery, and result in grievous illness and inordinate costs that threaten healthcare systems. As prevention, diagnosis, and treatment has remained largely unchanged over the last 50 years, a 2nd International Consensus Meeting on Musculoskeletal Infection (ICM 2018, https://icmphilly.com) was completed. Questions pertaining to all areas of MSKI were extensively researched to prepare recommendations, which were discussed and voted on by the delegates using the Delphi methodology. The questions, including the General Assembly (GA) results, have been published (GA questions). However, as critical outcomes include: (i) incidence and cost data that substantiate the problems, and (ii) establishment of research priorities; an ICM 2018 research workgroup (RW) was assembled to accomplish these tasks. Here, we present the result of the RW consensus on the current and projected incidence of infection, and the costs per patient, for all orthopedic subspecialties, which range from 0.1% to 30%, and $17,000 to $150,000. The RW also identified the most important research questions. The Delphi methodology was utilized to initially derive four objective criteria to define a subset of the 164 GA questions that are high priority for future research. Thirty-eight questions (23% of all GA questions) achieved the requisite > 70% agreement vote, and are highlighted in this Consensus article within six thematic categories: acute versus chronic infection, host immunity, antibiotics, diagnosis, research caveats, and modifiable factors. Finally, the RW emphasizes that without appropriate funding to address these high priority research questions, a 3rd ICM on MSKI to address similar issues at greater cost is inevitable.

costs, incidence, International Consensus Meeting, musculoskeletal infection, research priorities
0736-0266
997-1006
Schwarz, Edward M.
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Parvizi, Javad
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Gehrke, Thorsten
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Aiyer, Amiethab
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Battenberg, Andrew
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Brown, Scot A.
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Callaghan, John J.
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Citak, Mustafa
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Egol, Kenneth
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Garrigues, Grant E.
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Ghert, Michelle
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Goswami, Karan
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Green, Andrew
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Hammound, Sommer
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Kates, Stephen L.
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Mont, Michael A.
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Namdari, Surena
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Obremskey, William T.
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O'Toole, Robert
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Raikin, Steven
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Restrepo, Camilo
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Ricciardi, Benjamin
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Saeed, Kordo
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Sanchez-Sotelo, Joaquin
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Shohat, Noam
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Tan, Timothy
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Thirukumaran, Caroline P.
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Winters, Brian
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Schwarz, Edward M.
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Parvizi, Javad
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Gehrke, Thorsten
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Aiyer, Amiethab
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Battenberg, Andrew
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Brown, Scot A.
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Callaghan, John J.
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Citak, Mustafa
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Egol, Kenneth
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Garrigues, Grant E.
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Ghert, Michelle
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Goswami, Karan
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Green, Andrew
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Hammound, Sommer
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Kates, Stephen L.
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McLaren, Alex C.
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Mont, Michael A.
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Namdari, Surena
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Obremskey, William T.
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O'Toole, Robert
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Raikin, Steven
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Restrepo, Camilo
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Ricciardi, Benjamin
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Saeed, Kordo
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Sanchez-Sotelo, Joaquin
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Shohat, Noam
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Tan, Timothy
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Thirukumaran, Caroline P.
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Winters, Brian
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Schwarz, Edward M., Parvizi, Javad, Gehrke, Thorsten, Aiyer, Amiethab, Battenberg, Andrew, Brown, Scot A., Callaghan, John J., Citak, Mustafa, Egol, Kenneth, Garrigues, Grant E., Ghert, Michelle, Goswami, Karan, Green, Andrew, Hammound, Sommer, Kates, Stephen L., McLaren, Alex C., Mont, Michael A., Namdari, Surena, Obremskey, William T., O'Toole, Robert, Raikin, Steven, Restrepo, Camilo, Ricciardi, Benjamin, Saeed, Kordo, Sanchez-Sotelo, Joaquin, Shohat, Noam, Tan, Timothy, Thirukumaran, Caroline P. and Winters, Brian (2019) 2018 international consensus meeting on musculoskeletal infection: Research priorities from the general assembly questions. Journal of Orthopaedic Research, 37 (5), 997-1006. (doi:10.1002/jor.24293).

Record type: Review

Abstract

Musculoskeletal infections (MSKI) remain the bane of orthopedic surgery, and result in grievous illness and inordinate costs that threaten healthcare systems. As prevention, diagnosis, and treatment has remained largely unchanged over the last 50 years, a 2nd International Consensus Meeting on Musculoskeletal Infection (ICM 2018, https://icmphilly.com) was completed. Questions pertaining to all areas of MSKI were extensively researched to prepare recommendations, which were discussed and voted on by the delegates using the Delphi methodology. The questions, including the General Assembly (GA) results, have been published (GA questions). However, as critical outcomes include: (i) incidence and cost data that substantiate the problems, and (ii) establishment of research priorities; an ICM 2018 research workgroup (RW) was assembled to accomplish these tasks. Here, we present the result of the RW consensus on the current and projected incidence of infection, and the costs per patient, for all orthopedic subspecialties, which range from 0.1% to 30%, and $17,000 to $150,000. The RW also identified the most important research questions. The Delphi methodology was utilized to initially derive four objective criteria to define a subset of the 164 GA questions that are high priority for future research. Thirty-eight questions (23% of all GA questions) achieved the requisite > 70% agreement vote, and are highlighted in this Consensus article within six thematic categories: acute versus chronic infection, host immunity, antibiotics, diagnosis, research caveats, and modifiable factors. Finally, the RW emphasizes that without appropriate funding to address these high priority research questions, a 3rd ICM on MSKI to address similar issues at greater cost is inevitable.

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More information

Accepted/In Press date: 19 March 2019
e-pub ahead of print date: 12 April 2019
Published date: 1 May 2019
Keywords: costs, incidence, International Consensus Meeting, musculoskeletal infection, research priorities

Identifiers

Local EPrints ID: 430796
URI: http://eprints.soton.ac.uk/id/eprint/430796
ISSN: 0736-0266
PURE UUID: 00cf9c0d-6d18-4ca9-a445-14f2c6c92393
ORCID for Kordo Saeed: ORCID iD orcid.org/0000-0003-0123-0302

Catalogue record

Date deposited: 13 May 2019 16:30
Last modified: 16 Mar 2024 04:41

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Contributors

Author: Edward M. Schwarz
Author: Javad Parvizi
Author: Thorsten Gehrke
Author: Amiethab Aiyer
Author: Andrew Battenberg
Author: Scot A. Brown
Author: John J. Callaghan
Author: Mustafa Citak
Author: Kenneth Egol
Author: Grant E. Garrigues
Author: Michelle Ghert
Author: Karan Goswami
Author: Andrew Green
Author: Sommer Hammound
Author: Stephen L. Kates
Author: Alex C. McLaren
Author: Michael A. Mont
Author: Surena Namdari
Author: William T. Obremskey
Author: Robert O'Toole
Author: Steven Raikin
Author: Camilo Restrepo
Author: Benjamin Ricciardi
Author: Kordo Saeed ORCID iD
Author: Joaquin Sanchez-Sotelo
Author: Noam Shohat
Author: Timothy Tan
Author: Caroline P. Thirukumaran
Author: Brian Winters

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