Discuss research agendas, funding, cooperative opportunities

Members of the AAOS Research Development Committee (RDC) recently met with Elias A. Zerhouni, MD, and other prominent leaders from the National Institutes of Health (NIH) to discuss research agendas, funding, and cooperative opportunities.

The Committee had previously met with Dr. Zerhouni in 2005. At that time, Dr. Zerhouni encouraged the RDC to find new ways to educate Congress about the huge burden of musculoskeletal disease and its consequential impact on society, pointing out that although musculoskeletal conditions do not necessarily have a high mortality rate, they do have a tremendous impact on the public’s health and quality of life. He also emphasized the importance of patient advocacy and encouraged the formation of alliances with other like-minded organizations.

The RDC provided Dr. Zerhouni with an updated description of some of the work that has been undertaken by the AAOS and other societies within orthopaedics that have a strong interest in research, including the Orthopaedic Research Society (ORS), the Orthopaedic Research and Education Foundation (OREF), and the U.S. Bone and Joint Decade.

Among the proactive efforts of the AAOS in research advocacy and education highlighted by the RDC were the following: the patient stories book prepared for the 2007 Research Capitol Hill Days; the Journal of the AAOS (JAAOS) Extremity War Injuries (EWI) I special issue and the EWI II summary article; and the 2007 Journal of Bone and Joint Surgery summary article from the 2006 Developmental Biology in Orthopaedics Research Symposium.

Engaging and proactive
The RDC found Dr. Zerhouni to be very engaging. Our proactive tone focused on the most promising areas of musculoskeletal research. The discussion focused on the following four objectives:

• strategies to increase the number of people involved in musculoskeletal research
• recent efforts in research and collaboration regarding the extremity war injuries programs
• opportunities in musculoskeletal science for prevention, early diagnosis, and monitoring disease progress
• strategies that the orthopaedic surgery research community can use to assist Dr. Zerhouni’s vision and NIH initiatives

We first discussed interdisciplinary funding for musculoskeletal research and interpretation of NIH rules regarding time allocation for NIH-funded research, also referred to as “percentage effort.” NIH staff members are working with the Department of Health and Human Services Office of the Inspector General to find a mutually agreeable solution to the issue.

The RDC highlighted AAOS work on extremity war injuries research and noted the JAAOS publications highlighting future research directions. We invited Dr. Zerhouni and his staff to attend the upcoming 2008 EWI III research symposium on Challenges in Definitive Reconstruction, sponsored by the AAOS, the Orthopaedic Trauma Association, and the Society of Military Orthopaedic Surgeons.

Developing the next generation
We also discussed the development of young investigators and clinician scientists. Both issues are of paramount importance to the NIH. Dr. Zerhouni was interested in how the AAOS and specialty societies might expand our current work in the development of clinician scientists and encouraged cooperative efforts with other specialty societies to support clinician scientists. In particular, he recommended that young and mid-level clinician scientists should be paired with basic scientists to encourage and foster potential working relationships, which could lead to future research advances.

Craig King, a patient advocate for the AAOS Research Capitol Hill Days, also attended the meeting on behalf of the RDC. Mr. King, currently a grammar school teacher, described his battle with osteogenic sarcoma and the importance of patient advocacy. He described the impact that the condition has had on his life and the importance of telling his story on Capitol Hill for both the AAOS and the American Cancer Society. His experiences affected his positive outlook and prompted him to pursue a master’s degree in rehabilitation counseling. Dr. Zerhouni was impressed with the inclusion of patients in AAOS advocacy efforts and encouraged their continuation and expansion.

The NIH was particularly interested in AAOS assistance in recruiting clinicians to serve on study sections. The RDC noted that it is often difficult for clinicians to dedicate their time to study sections due to existing clinical responsibilities, geographic challenges, time commitments, and other factors. The AAOS did agree to help in recruiting interested participants to serve as reviewers. (See “Study section candidates needed,” page 43.)

These interactions with NIH leaders reinforced the RDC’s commitment to federal advocacy for musculoskeletal research. The meetings also emphasize the tremendous burden of disease associated with musculoskeletal disorders and the need for continued and increased investment into clinical and basic research in this area. The AAOS looks forward to enhanced collaborative relationships with the NIH as well as with individual institutes.

Denis R. Clohisy, MD, is chair of the Research Development Committee; Joshua J. Jacobs, MD, is chair of the Council on Research, Quality Assessment, and Technology. Disclosure information for Drs. Clohisy and Jacobs can be found at www.aaos.org/disclosure