Design, Conduct, and Interpretation of Nonrandomized Orthopaedic Studies--A Practical Approach   |    
Multicenter Collaboration in Observational Research: Improving Generalizability and Efficiency
Sheila Sprague, MSc1; Joel M. Matta, MD2; Mohit Bhandari, MD, MSc, FRCSC,1
1 Departments of Clinical Epidemiology and Biostatistics (S.S. and M.B.) and Surgery (M.B.), McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON L8L 8E7, Canada. E-mail address for M. Bhandari: bhandam@mcmaster.ca
2 Hip and Pelvis Institute, Saint John's Health Center, Orthopedic Center, 2001 Santa Monica Boulevard #1090, Santa Monica, CA 90404
View Disclosures and Other Information
ATHAC Investigators:
Steering Committee: Joel M. Matta, MD (Chair), Mohit Bhandari, MD, MSc, FRCSC, and David Dodgin, MD
Study Concept and Design: Mohit Bhandari, MD, MSc, FRCSC, Joel M. Matta, MD, Stefan Kreuzer, MD, David Dodgin, MD, and Gary Bradley, MD
Study Coordination: Mohit Bhandari, MD, MSc, FRCSC (Chair), Sheila Sprague, MSc (Project Manager), Natalie Sidorkiewicz, BSc (Research Coordinator), and Tashay Mignott, BA (Research Assistant)
Writing Committee: Mohit Bhandari, MD, MSc, FRCSC (Chair), Joel M. Matta, MD, David Dodgin, MD, Charles R. Clark, MD, Phil Kregor, MD, Gary Bradley, MD, and Lester Little, MD
Participating Surgeons: Gary Bradley, MD, Santa Barbara, CA; Jim Grimes, MD, Bakersfield, CA; John Masonis, MD, Charlotte, NC; Stefan Kreuzer, MD, Houston, TX; Andrew Yun, MD, Inglewood, CA; Gary Matthys, MD, Fargo, ND; Brian Jewett, MD, Eugene, OR; Michael Bellino, MD, Palo Alto, CA; and Joel M. Matta, MD, Santa Monica, CA
Disclosure: In support of their research for or preparation of this work, one or more of the authors received, in any one year, outside funding or grants in excess of $10,000 from DePuy. In addition, one or more of the authors or a member of his or her immediate family received, in any one year, payments or other benefits in excess of $10,000 or a commitment or agreement to provide such benefits from commercial entities (Stryker, DePuy, Mizuho OSI).

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 May 01;91(Supplement 3):80-86. doi: 10.2106/JBJS.H.01623
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Utilizing a multicenter approach in observational clinical research allows for improved generalizability of the results, a larger sample size, and, consequently, improved efficiency. This paper highlights important issues with regard to the organization of multicenter observational studies in orthopaedic research. Specifically, we emphasize the development of trial committees, stress the importance of having a methods center for the purpose of coordinating day-to-day study activities, and describe the roles of the participating clinical sites. The successful conduct of multicenter studies requires careful study organization, a dedicated and experienced methods center, and motivated participating surgeons and study staff at the clinical sites. To illustrate the organization of a multicenter initiative, we use the example of a total hip arthroplasty collaborative.

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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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