The Canadian Orthopaedic Trauma Society

Area of Science:

• Orthopaedic surgery
• Trauma research
• Clinical trials methodology

Background:

• The Canadian Orthopedic Trauma Society (COTS) has a 30-year history of research in orthopaedic trauma.
• Randomized controlled trials (RCTs) are crucial for advancing evidence-based practice in orthopaedic trauma.
• Understanding factors influencing trial timelines is essential for improving research efficiency.

Purpose of the Study:

• To review 30 years of COTS research.
• To identify factors that delay or accelerate the completion of orthopaedic trauma RCTs.
• To inform future strategies for efficient trial conduct.

Main Methods:

• Methodological review of all COTS-affiliated publications.
• Data extraction included study characteristics (year, journal, type, sites, sample size) and timeline milestones (proposal to publication).
• Analysis focused on factors affecting study duration and time to publication.

Main Results:

• 13 RCTs were published by COTS over 30 years, involving 1,423 patients across an average of six centers.
• Studies took a mean of nearly ten years from concept to publication, with a mean enrollment period of 63 months.
• A higher number of clinical sites was associated with decreased enrollment length (p=0.041), but neither sample size nor enrollment length impacted total publication time.

Conclusions:

• COTS has successfully produced high-quality evidence through multicenter RCTs over three decades.
• Future research efficiencies may be gained by increasing clinical sites, enhancing site connectivity, and streamlining national ethics processes.
• Optimizing these factors can lead to faster dissemination of critical findings in orthopaedic trauma care.