The BOSS Study
Research type
Research Study
Full title
The British Orthopaedic Surgery Surveillance Study: A nationwide service evaluation, and nested-cohort study.
IRAS ID
190754
Contact name
Daniel C Perry
Contact email
Duration of Study in the UK
4 years, 0 months, 1 days
Research summary
Clinical trials randomly allocating treatments in rare orthopaedic diseases are challenging. Perhaps the biggest challenges arise due to the infrequency of disease, and often emergent nature of treatment. Where interventions are surgical, individual surgeons are likely to develop expertise in and therefore preference for one particular technique. Establishing clinical equipoise, a point at which clinicians are truly uncertain which is the best treatment option and a prerequisite for a randomised trial, can be very difficult since evidence of effectiveness is usually based on case series from individual centres. Multicentre randomised controlled trials of surgical interventions can therefore be very difficult to establish.
There are many clinical management decisions in such situations which cannot be informed by randomised controlled trials, simply because this evidence does not exist. Robust, population based prospective observational studies can provide an alternative form of high quality evidence to inform policy and practice. Retrospective studies using data collected for administrative purposes, for example hospital admissions databases, cannot provide this quality of evidence, since they do not provide sufficient detail of the timing and type of management strategies used.
The British Orthopaedic Surgery Surveillance (BOSS) Study is a system through which to collect information about individuals with specific orthopaedic conditions, or undergoing specific orthopaedic procedures. BOSS uses the same methodology as a similar successful reporting mechanisms in obstetrics and gynaecology (United Kingdom Obstetric Surveillance System - UKOSS). BOSS will study the risk factors, diagnostic methods and treatments and relate these to outcomes of Perthes' Disease and Slipped Capital Femoral Epiphysis (though we hope to extend the diseases studied in time) on a national basis in order to make recommendations for best practice to improve outcomes.
The research will be conducted at the University of Liverpool and is funded as part of a Clinician Scientist Award.
REC name
London - City & East Research Ethics Committee
REC reference
15/LO/2202
Date of REC Opinion
20 Jan 2016
REC opinion
Further Information Favourable Opinion