Excerpt

The 2009 systematic literature review “Treatments of Common Hip Fractures” was conducted for the American Academy of Orthopaedic Surgeons to provide input for their development of clinical guidelines for surgical procedures for implantable devices. The nominator was interested in understanding the interaction between patient factors, types of hip fractures, types of surgical implantable devices, and outcomes. The subsequent systematic review conducted by the Minnesota Evidence-based Practice Center (EPC) was unable to fully address the research questions with the existing literature because of (a) the limited perspective of discipline-specific investigations (i.e. orthopaedic or epidemiology), which tended to use incomplete sets of important independent variables in study designs and models, and (b) the generally low quality of hip fracture outcome studies to date, where specific populations were poorly defined, and the use of inconsistent outcome variables and assessment tools prevented aggregating or even comparing results. The objective of this project was to work with stakeholder groups with an interest in improving hip fracture patient outcomes to examine, refine, and prioritize research questions and methodological approaches that would fill the existing research knowledge gaps in hip fracture treatment.

Contents

• Preface
• Stakeholders
• Executive Summary
  • Background
  • Methods
  • Results
  • Conclusions
• Background
  • Research Gaps
• Methods
  • Identifying Ongoing Studies
  • Engaging Stakeholders, Researchers, and Funders
  • Handling Conflicts of Interest
  • Determining Appropriate and Feasible Study Designs
  • Prioritizing Research
• Results
  • Contribution of Ongoing Studies and Recent Publications
  • Recommended Research
  • Dissemination of Research Recommendations
• Discussion
• Conclusions
• References
• Abbreviations
• Appendixes
  • Appendix A Search Strategy for Recently Published and Ongoing Studies
  • Appendix B List of Ongoing and Recently Published Studies
  • Appendix C Prioritization Methods and Tools

Acknowledgments: We would like to thank Marilyn Eells for her help with editing and formatting.

AHRQ Contacts: Carolyn M Clancy, MD, Director, Agency for Healthcare Research and Quality; Stephanie Chang, MD, MPH, Director, Evidence-based Practice Center Program, Agency for Healthcare Research and Quality; Jean Slutsky, PA, MSPH, Director, Center for Outcomes and Evidence, Agency for Healthcare Research and Quality; Karen Siegel, PT MA, Associate Director and Task Order Officer, Evidence-based Practice Center Program, Agency for Healthcare Research and Quality

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services, Contract No. 290-2007-10064-I. Prepared by: Minnesota Evidence-based Practice Center, Minneapolis, MN

Suggested citation:

Butler M, Forte ML, Kane RL, Swiontkowski MF. Future Research Needs for the Treatment of Common Hip Fractures. Future Research Needs Paper No. 2. (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290-2007-10064-I.) AHRQ Publication No. 10-EHC071-EF. Rockville, MD: Agency for Healthcare Research and Quality. September 2010. Available at: www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Minnesota Evidence-based Practice Center (EPC) under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10064-I). The findings and conclusions in this document are those of the author(s), who are responsible for its contents; the findings and conclusions do not necessarily represent the views of AHRQ. Therefore, no statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help health care researchers and funders of research make well-informed decisions in designing and funding research and thereby improve the quality of health care services. This report is not intended to be a substitute for the application of scientific judgment. Anyone who makes decisions concerning the provision of clinical care should consider this report in the same way as any medical research and in conjunction with all other pertinent information, i.e., in the context of available resources and circumstances.

This report may be used, in whole or in part, as the basis for research design or funding opportunity announcements. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.

This information does not represent and should not be construed to represent a determination or policy of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services.

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.

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