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  • Review Article
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Setting the research agenda for improving health care in musculoskeletal disorders

Nature Reviews Rheumatology volume 11, pages 597–605 (2015)Cite this article

Subjects

Key Points

  • Funding of musculoskeletal research should match the enormous global health-care burden of musculoskeletal conditions

  • Evidence relating to interventions for musculoskeletal conditions has not been translated into practice, a common problem being the overuse of expensive tests and treatments that are unnecessary, ineffective, or both

  • The field would arguably benefit from a coordinated approach to clinical research, with emphasis on performing implementation studies

  • The burden of disease and the needs of patients and populations should inform the research agenda, to ensure that appropriate trials are performed, in a way that provides definitive answers

  • Improvements in uptake of research findings could be achieved by optimizing clinician buy-in, and alignment of studies—such as clinical trials—with gaps in evidence, or between evidence and practice

  • For some issues, regulatory and policy changes might be required to achieve improvements in clinical care and patient outcomes

Abstract

Despite a substantial contribution to the global burden of disease, musculoskeletal conditions are under-represented in clinical research, and that which is performed is often wasteful and lacking clinical relevance. Even clinically relevant musculoskeletal research might not lead to timely or adequate changes in clinical practice and associated improvements in patient outcomes. The formulation of clinical recommendations alone is usually insufficient to bring about changes in practice patterns. Research exploring how to improve the translation of evidence-based recommendations into practice, as well as the identification and removal of barriers to practice change, is necessary in order for the promise of musculoskeletal research to be realized in improved health outcomes. These goals can be achieved by improvements in the coordination of research activities, the resourcing and allocation of funding, and the involvement of clinicians and patients.

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Figure 1: Improving research relevance and changing practice.

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Acknowledgements

R.B. is funded by an Australian National Health and Medical Research Council (NHMRC) Senior Principal Research Fellowship. C.M. is funded by an NHMRC Senior Research Fellowship.

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Authors and Affiliations

  1. Monash Department of Clinical Epidemiology, Cabrini Institute and Monash University, Suite 41 Cabrini Medical Centre, 183 Wattletree Road, Malvern, 3144, VIC, Australia

    Rachelle Buchbinder

  2. The George Institute for Global Health, University of Sydney, GPO Box 5389, Sydney, 2001, NSW, Australia

    Chris Maher

  3. Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Level 2, 1 Campbell Street, Liverpool, 2170, NSW, Australia

    Ian A. Harris

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  1. Rachelle Buchbinder
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  2. Chris Maher
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  3. Ian A. Harris
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All authors contributed to researching data for the article, discussion of content, writing the manuscript, and reviewing and editing the manuscript before submission.

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Correspondence to Rachelle Buchbinder.

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Competing interests

C.M. declares that he has received supplementary research funding from GlaxoSmithKline and Pfizer for two investigator-initiated, National Health and Medical Research Council (NHMRC)-funded clinical trials. R.B. and I.H. declare no competing interests.

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Buchbinder, R., Maher, C. & Harris, I. Setting the research agenda for improving health care in musculoskeletal disorders. Nat Rev Rheumatol 11, 597–605 (2015). https://doi.org/10.1038/nrrheum.2015.81

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