Collaborative multicenter trials in Latin America: challenges and opportunities in orthopedic and trauma surgery

CONTEXT AND OBJECTIVE Orthopedic research agendas should be considered from a worldwide perspective. Efforts should be planned as the means for obtaining evidence that is valid for health promotion with global outreach. DESIGN AND SETTING Exploratory study conducted at Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil, and McMaster University, Hamilton, Canada. METHODS We identified and analyzed collaborative and multicenter research in Latin America, taking into account American and Canadian efforts as the reference points. We explored aspects of the data available from official sources and used data from traffic accidents as a model for discussing collaborative research in these countries. RESULTS The evaluation showed that the proportion of collaborative and multicenter studies in our setting is small. A brief analysis showed that the death rate due to traffic accidents is very high. Thus, it seems clear to us that initiatives involving collaborative studies are important for defining and better understanding the patterns of injuries resulting from orthopedic trauma and the forms of treatment. Orthopedic research may be an important tool for bringing together orthopedic surgeons, researchers and medical societies for joint action. CONCLUSIONS We have indicated some practical guidelines for initiatives in collaborative research and have proposed some solutions with a summarized plan of action for conducting evidence-based research involving orthopedic trauma.

研究背景与目的
骨科研究议题应从全球视角加以考量。相关研究工作应规划为获取可支撑面向全球健康促进的有效证据的路径。

研究设计与研究地点
本研究为探索性研究，实施地点为巴西圣保罗的圣保罗联邦大学（Universidade Federal de São Paulo, Unifesp）以及加拿大汉密尔顿的麦克马斯特大学（McMaster University）。

研究方法
我们以美国及加拿大的相关研究作为参照基准，对拉丁美洲的协作性多中心研究进行识别与分析。我们对官方来源的现有数据维度进行了探索，并以道路交通事故数据为范例，探讨了上述国家的协作性研究开展情况。

研究结果
评估结果显示，本研究覆盖范围内的协作性多中心研究占比偏低。简要分析表明，道路交通事故致死率极高。据此我们明确认识到，开展协作性研究对于明确并深入理解骨科创伤所致损伤模式与治疗方式具有重要意义。骨科研究可作为联结骨科医师、科研人员与医学社团开展协同行动的重要纽带。

研究结论
本研究为协作性研究相关行动提出了若干实用指南，并针对开展骨科创伤相关循证研究，拟定了行动方案概要以提出相应解决策略。