The Outcomes Research Consortium (stylized as OUTCOMES RESEARCH) is an international clinical research group that focuses on the perioperative period (during and after surgery), along with critical care and pain management. The Consortium's aim is to improve the quality of care for surgical, critical care, and chronic pain patients and to "Provide the evidence for evidence-based practice." Members of the Consortium are especially interested in testing simple, low-risk, and inexpensive treatments that have the potential to markedly improve patients' surgical experiences. The 25-year anniversary of the Consortium and its accomplishments were celebrated in an editorial in Anesthesiology. The editorial starts:
Imagine a research group made up of more than 100 members working both independently and collaboratively across many countries having no legal standing, no bank account, and loosely organized, but devoted to the goal of improving health care through the understanding of the results of health care practices. Furthermore, imagine that members of this organization have published more than 900 full journal articles since its inception and publish a new full paper every 5 days. It may be hard to believe that such a unique organization exists, but it does. It is known as the Outcomes Research Consortium.
History The Outcomes Research Group was formed in 1990 at the University of California San Francisco, and thus celebrated its 25th anniversary in 2015. The Consortium now includes about 130 university-based investigators at more than 20 hospitals in 10 countries. The primary requirement for membership is ongoing active collaboration with Consortium members. It is by far the world's largest and most productive clinical anesthesia research group. The Consortium's administrative center is the Department of Outcomes Research in the Anesthesiology Institute at the Cleveland Clinic in Cleveland, Ohio, United States. The director is Daniel I. Sessler, MD and the associate director is Andrea Kurz, MD. The Consortium differs from many organizations in not being a society, association, or foundation. Nor it is a company. In fact, the Consortium does not legally exist. A consequence is that grant funding always flows directly to members' institutions, an intentionally unusual structure designed to prevent members from having perceived conflicts of commitment between the Consortium and their academic institutions.
Research highlights
The Consortium coordinates more than 100 clinical studies, including large multi-center outcome studies. Among the Consortium's more than 900 full papers, about 200 papers were in Anesthesiology and a comparable number were in Anesthesia & Analgesia; well over a dozen were published in The New England Journal of Medicine or The Lancet. The Consortium's papers have been cited about 30,000 times. Since 2008, nineteen of the Consortium's articles have been features on the covers of Anesthesiology or Anesthesia & Analgesia. Consortium members were among the first anesthesia investigators to conduct large-scale outcome trials. That is, randomized trials with meaningful "hard" primary outcomes. Large outcome trials remain a focus for the group. They were also among the first anesthesia investigators to conduct large-scale registry research. Taking advantage of dense interconnected registries at the Cleveland Clinic, along with half-a-dozen national databases, the group has conducted hundreds of cohort, case-control, and health policy analyses. For example, they have developed several accurate risk-stratification models which permit accurate comparisons across divergent patient groups (i.e., risk-adjusted comparisons amongst hospitals).
Temperature regulation during surgery Body temperature is normally tightly regulated to about 37 °C (98.6 °F), with women being slightly warmer than men.
The Consortium is perhaps best known for perioperative thermoregulation, with members having published far more on the subject than all other investigators combined. In a series of several hundred studies, for example, Consortium members identified dose-dependent effects of every major anesthetic
and sedative
on thermoregulatory control, and consequent alterations in heat balance.
Impaired temperature control, combined with a cold operating room environment, makes most unwarmed surgical patients hypothermic by 1-3 °C.
In contrast, patients warmed with forced-air are usually normothermic by the end of surgery.
Randomized trials by the Consortium have shown that just a 1-2 °C reduction in body temperature markedly increases the risk of wound infection, prolongs recovery and hospitalization,
increases blood loss and transfusion requirement,
and slows drug metabolism.
Because hypothermia causes so many serious complications, The Surgical Care Improvement Project (SCIP) and Physicians Quality Forum have each made perioperative normothermia an outcome measure for hospital quality. Consortium thermoregulatory research has been covered by the Cleveland Plain Dealer, the Philadelphia Inquirer, Reuters Health, and United Press International.
Red hair and anesthesia
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