Research

Recent work has been the BSSH Research Prioritisation Project. This intend to help shape the future of UK hand surgery research. After asking the membership to rank their top current research uncertainties, based on the existing 2017 BSSH James Lind Alliance Priority Setting Partnership Top Ten.

It was found the top questions that were prioritized in the survey were:

• Regarding patient and cost benefits, which interventions (e.g., movement-preserving surgeries such as joint or cartilage replacement, fusion operations permanently stiffening the joint, and novel therapies) give the best results in the treatment of painful joints in the hand/wrist?
• What are the most effective non-surgical methods for treating early arthritis in the hand and fingers?
• Which hand/finger/thumb injuries would benefit from surgical intervention over hand therapy or no formal treatment, considering both functional outcomes and societal cost?

A workshop was held to come together and create specific questions for upcoming multicentre studies in hand surgery. Hand surgeons, therapists, methodologists, and patient representatives worked together to develop specific research questions on treatments for painful hand/wrist joints and osteoarthritis. These questions will be presented to the NIHR and other funders to inform commissioned calls for NIHR HTA trials and other multi-centre studies.

This process aims to ensures future research is co-developed with key stakeholders from the start, making it more feasible, relevant, and likely to have a strong clinical impact.

Read more

The BEST Guidelines for Management of Thumb Base Osteoarthritis 

The BEST Guidelines for UCL of Thumb Injuries

The BEST Guidelines on Trigger Digits

British Society for Surgery of the Hand Evidence for Surgical Treatment (BEST)

The BEST Process Manual

The BSSH has also funded a Clinical Professor of Hand Surgery at the University of Nottingham, who set up the Centre for Evidence Based Hand Surgery and Hand Fracture Research Group.

In 2017 the BSSH funded James Lind Alliance (JLA) Priority Setting Partnership on hand and wrist conditions published their top 10 research priorities.

Surgical Specialty Leads (SSLs) have responsibility both for the development of clinical networks to deliver multi-centre studies as well as ensuring that the studies are relevant to their subspecialty and their patients.

Surgical Specialty Leads work with the Surgical Trials Centres (STCs) to develop clinical networks, train surgical investigators and deliver the clinical trials in a timely fashion. Each SSL will be affiliated to a specialist surgical society, with whom they will work to develop the clinical trials and clinical networks.

BSSH provide funding for an SSL in Hand

More information on RCSEng Surgical Specialty Leads (SSL)

National Institute for Health Research

BSSH is an NIHR RDN Non-commercial Partner. This means the studies that we fund may be eligible to access the NIHR Study Support Service which is provided by the NIHR Research Delivery Network within the NHS, and the wider public health and social care environment, across England. The NIHR Clinical Research Network can now support health and social care research taking place in non-NHS settings, such as studies running in care homes or hospices, or public health research taking place in schools and other community settings. Read the full policy: Eligibility Criteria for NIHR Clinical Research Network Support.

In partnership with your local R&D office, we encourage you to involve your regional NIHR Research Delivery Network team in discussions as early as possible when planning your study. This will enable you to fully benefit from the support available through the NIHR Study Support Service. Find out more about the Study Support Service.

If your study involves NHS sites in England you will need to apply for Health Research Authority (HRA) Approval. Guidance on submitting an application for approvals is available on the HRA website.

Reconstructive Surgery Trial Network

Clinical trials are the foundation for evidence-based medicine. Currently, less than 2% of government funding for medical research goes into surgical areas, despite the fact that a third of hospital admissions involve surgery. In 2012 the Royal College of Surgeons of England (RCS) launched a clinical trials initiative to increase the quantity and quality of clinical surgical research.

Since then, the proportion of National Institute of Health Research (NIHR) funding allocated to hand surgery has been rising. In the six years after 2013, NIHR funding for hand surgery research totalled £12.4 million of the £2.5 billion awarded overall.

The BSSH, along with the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), supported the clinical trials initiative by appointing a Surgical Specialty Lead. The surgical specialty lead works with the six UK Surgical Trials Centres to develop clinical networks, train surgical investigators and deliver the clinical trials in a timely fashion.

Along with the Surgical Specialty Lead, the creation of the Reconstructive Surgery Trials Network (RSTN) in 2013 has enabled access to methodological support from the Surgical Trials Centres and established the infrastructure to deliver high quality, multicentre studies. The RSTN has also provided a platform for surgical trainees to get involved in research, based on a collaborative model.

• Visit the RSTN website to find out about current trials or suggest one yourself.

Find out more about BSSH involvement with RSTN here