Outcomes Research Consortium

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OUTCOMES RESEARCH Consortium is an international, non-profit, research organization. Its mission is to evaluate low-risk, inexpensive, medical interventions that are easy to implement and will likely improve patient outcomes. By focusing on the period before, during, and after surgery, their research seeks to optimize baseline medical, anesthetic, and surgical techniques in the operating room as well as optimize critical care and pain management in postoperative recovery. The outcomes or end results of these medical interventions are those that patients and medical practitioners care about most, such as improved physical function, enhanced quality of life, and reduced mortality. By linking treatment to outcomes, OUTCOMES RESEARCH Consortium provides sound scientific evidence for medical interventions, resulting in improved patient care and recovery.

1 Growth and goals
2 Research funding
3 Publications and research highlights
4 Administrative structure
5 References
6 External links

[edit] Growth and goals

]The OUTCOMES RESEARCH Group was formed in 1990 at the University of California San Francisco and since that time has grown to the OUTCOMES RESEARCH Consortium with more than 100 university-based investigators at more than 20 hospitals in 10 countries, including the United States, Austria, Germany, Ireland, Switzerland, Japan, and Australia. Its administrative center is located in the Department of OUTCOMES RESEARCH in the Anesthesiology Institute at the Cleveland Clinic in Cleveland, Ohio, U.S.

The Consortium’s primary goal is to facilitate collaboration in clinical research design, implementation, and analysis, as well as to foster communication among its members and the wider medical community. Members also work with corporate partners to evaluate new medical devices and pharmaceuticals, and thus provide critical research data that support regulatory applications to the Food and Drug Administration. As a result of their efforts, the Consortium typically coordinates about 100 clinical trials at any given time, including large multi-center outcome trials. The results of these studies are disseminated in peer-reviewed medical journals and with time are incorporated into medical practice.

[edit] Research funding

All medical research requires funding; however funding is intensely competitive. Yet, according to its 2007 Annual Report, [1] Consortium members had $7.1 million from the National Institutes of Health and other peer-reviewed funding agencies, such as the Swiss National Foundation and the Foundation for Anesthesia Education and Research, and another $1.5 million from corporate sponsors. Thus, in 2007 alone, members of OUTCOMES RESEARCH Consortium had active grants totaling $8.6 million.

[edit] Publications and research highlights

Research results are typically complied, analyzed, and submitted in the form of a written manuscript to an appropriate medical journal. Following peer review, accepted papers are published and thus shared with the medical community and general public. In 2007 Consortium members published 45 original research papers, mostly in the anesthesia literature.[2] Because approximately 1,200 anesthesia clinical research papers are published each year, Consortium members were thus responsible for a full 4% of the world’s clinical research in anesthesia.

These publications often provide a rational basis to change clinical practice in an attempt to improve patient care. For example, research by members of OUTCOMES RESEARCH Consortium, which was published in the New England Journal of Medicine and the Journal of the American Medical Association,showed that if surgical patients were kept warm [3][4] or received supplemental oxygen, [5][6] then the risk of post-surgical infection was markedly reduced. Previously, there was little consensus regarding the use of warming devices or supplemental oxygen during surgery; however, following the publication of this and similar studies, they are now routinely employed in operating rooms around the world.

Other research suggested that general anesthesia during cancer surgery and postoperative opioid (e.g., morphine) analgesia following surgery can have long-term, detrimental consequences and that minor improvements in anesthetic management can ameliorate these effects and even improve survival. A 2006 study, by Consortium members [7] and published in the journal Anesthesiology, reviewed the medical histories of women who had breast cancer surgery and showed that paravertebral anesthesia and analgesia reduced the risk of cancer recurrence or metastasis during the initial years of follow-up compared with women who received general anesthesia and opioid analgesia. Based on this and other research, prospective clinical trials were initiated to test the hypothesis that recurrence after breast, colon, or prostate cancer surgery is lower in patients randomized to regional anesthesia and analgesia than to general anesthesia and opioid analgesia. These are large multi-center clinical trials requiring hundreds of patients and taking several years to complete; studies are ongoing. However, confirming this hypothesis will indicate that a small modification to anesthetic management, one that can be implemented with little risk or cost, will reduce the risk of cancer recurrence — a complication that is often ultimately lethal.

Still other research by Consortium members indicated an association between the age of transfused blood and complications after cardiac surgery. In an article published in the New England Journal of Medicine, transfusion of red cells stored for more than two weeks was linked with a significantly increased risk of postoperative complications following cardiac surgery. [8] In particular, the relative risk of death was increased by 30% in patients receiving blood greater than two weeks old. These results call into question current blood banking practices, and underscore the need to further understand and, if possible, prevent deterioration of stored blood and to design and implement other blood donation and transfusion strategies. This article was covered in 80 newspapers, including an article on the front page of the Boston Globe, [9] along with 400 other news outlets. Dozens of previous articles by Consortium members have also been covered by major newspapers and television, including CNN and Good Morning America.

These brief summaries represent only a small fraction of the research published by members of the OUTCOMES RESEARCH Consortium; a full bibliography is available at the organization’s administrative center. [10]

[edit] Administrative structure

The Director of the OUTCOMES RESEARCH Consortium is Daniel I. Sessler, MD. He is currently Chair and Professor in the Department of OUTCOMES RESEARCH at the Cleveland Clinic. Dr. Sessler has published a book on therapeutic hypothermia [11] and more than 350 research papers.[12] Andrea Kurz, MD,is Associate Director of OUTCOMES RESEARCH Consortium and Vice Chair of the Department of OUTCOMES RESEARCH at the Cleveland Clinic; Dr. Kurz has published nearly 100 research papers. Additionally, site directors administer the most active Consortium affiliates in Louisville, Dublin, Tel-Aviv, Vienna, Melbourne, Tokyo, and Dallas.