The International Multicentre Project Auditing COVID-19 in Trauma & Orthopaedics (IMPACT) was established in March 2020 to provide information about COVID-19 in orthopaedic patients.1 The IMPACT Hip Fracture Audits included two national and one international multicentre retrospective cohort studies, and a worldwide survey of clinical service disruption during the summer of 2020.2-4 A systematic review and meta-analysis examined the existing literature,5 and a number of observational studies examined COVID-19 in general and planned orthopaedics.6,7
IMPACT reported important findings that included: mortality risk associated with COVID-19 at the time of injury; risk factors for acquiring and dying of the disease; and the role of nosocomial transmission.8 This global collaboration highlighted practical lessons that might guide the research and audit response to future specialty-wide issues. Reporting standards for future studies are suggested and include adequate reporting of pathogen, healthcare, and patient factors.
Rapid collaboration and effective data-sharing were central to producing a dataset of sufficient size and diversity to answer urgent questions relating to COVID-19. A strategy for establishing collaborative clinical audits is outlined in order to improve the quality and robustness of future studies, facilitate audit-based investigation of topical issues using existing and common datasets, and permit a modern approach to health research using the meta-audit principles.9,10
These lessons are relevant to improving the evidence-based management of communicable disease outbreaks, including further COVID-19 waves, novel diseases, and seasonal viral illnesses such as norovirus and influenza. They will also inform the examination of wider topical issues, such as periprosthetic femur fractures, orthopaedic infection, and major geriatric trauma.
Fig. 1_1
References
1. Hall AJ . Scotland Makes an IMPACT on Global Clinical Audit . 2021 . https://www.shfa.scot.nhs.uk/Reports/_docs/2021/shfa-annual-report-2021-scotland-makes-an-impact.pdf ( date last accessed 12 May 2022 ). Google Scholar
2. Hall AJ , Clement ND , Farrow L , et al. IMPACT-scot report on COVID-19 and hip fractures: A multicentre study assessing mortality, predictors of early SARS-cov-2 infection, and the effects of social lockdown on epidemiology . Bone Joint J . 2020 ; 102-B ( 9 ): 1219 – 1228 . Crossref Google Scholar
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Author contributions
A. J. Hall: Conceptualization, Project administration, Visualization, Writing – original draft, Writing – review & editing.
N. D. Clement: Conceptualization, Writing – review & editing, Supervision.
A. M. J. MacLullich: Writing – review & editing.
A. H. R. W. Simpson: Writing – review & editing.
A. Johansen: Writing – review & editing.
T. O. White: Writing – review & editing.
A. D. Duckworth: Conceptualization, Writing – review & editing, Supervision.
ICMJE COI statement
A. H. R. W. Simpson is the Editor-in-Chief of Bone & Joint Research, and reports institutional grants from RCUK, Charities, and Stryker, unrelated to this article. A. D. Duckworth reports research grants from NIHR, OTA, and SORT-IT, institutional grants from Stryker, Smith & Nephew, and Acumed, royalties from Elsevier and Taylor & Francis, a speaker payment from AgNovos Healthcare, all unrelated to this article. A. D. Duckworth is also an editorial board member of The Bone & Joint Journal, Bone & Joint Research, and Bone & Joint 360, an Associate Editor for Trials, OTAI, and JBJS Case Connector, and sits on the research committees for OTA Research and OTS Research. T. White reports royalties from Elsevier, unrelated to this article, and is President Elect of the Orthopaedic Trauma Society. A. J. Hall is an Honorary Research Fellow at the Scottish Hip Fracture Audit.
Follow A. J. Hall @andrewhallortho, @IMPACTaudits
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© 2022 Author(s) et al.This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (CC BY-NC-ND 4.0) licence, which permits the copying and redistribution of the work only, and provided the original author and source are credited. See https://creativecommons.org/licenses/by-nc-nd/4.0/
