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Sprague S, O'Hara NN, Slobogean G. Skin Antisepsis before Surgical Fracture Fixation. Reply. N Engl J Med 2024; 390:1533. [PMID: 38657252 DOI: 10.1056/nejmc2403234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
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Sprague S, Slobogean G, Wells JL, O'Hara NN, Thabane L, Mullins CD, Harris AD, Wood A, Viskontas D, Apostle KL, O'Toole RV, Joshi M, Johal H, Al-Asiri J, Hymes RA, Gaski GE, Pilson HT, Carroll EA, Babcock S, Halvorson JJ, Romeo NM, Matson CA, Higgins TF, Marchand LS, Bergin PF, Morellato J, Van Demark RE, Potter GD, Gitajn IL, Chang G, Phelps KD, Kempton LB, Karunakar M, Jaeblon T, Demyanovich HK, Domes CM, Kuhn GR, Reilly RM, Gage MJ, Weaver MJ, von Keudell AG, Heng M, McTague MF, Alnasser A, Mehta S, Donegan DJ, Natoli RM, Szatkowski J, Scott AN, Shannon SF, Jeray KJ, Tanner SL, Marmor MT, Matityahu A, Fowler JT, Pierrie SN, Beltran MJ, Thomson CG, Lin CA, Moon CN, Scolaro JA, Amirhekmat A, Leonard J, Pogorzelski D, Bzovsky S, Heels-Ansdell D, Szasz OP, Gallant JL, Della Rocca GJ, Zura RD, Hebden JN, Patterson JT, Lee C, O'Hara LM, Marvel D, Palmer JE, Friedrich J, D'Alleyrand JCG, Rivera JC, Mossuto F, Schrank GM, Guyatt G, Devereaux PJ, Bhandari M. Skin Antisepsis before Surgical Fixation of Extremity Fractures. N Engl J Med 2024; 390:409-420. [PMID: 38294973 DOI: 10.1056/nejmoa2307679] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
BACKGROUND Studies evaluating surgical-site infection have had conflicting results with respect to the use of alcohol solutions containing iodine povacrylex or chlorhexidine gluconate as skin antisepsis before surgery to repair a fractured limb (i.e., an extremity fracture). METHODS In a cluster-randomized, crossover trial at 25 hospitals in the United States and Canada, we randomly assigned hospitals to use a solution of 0.7% iodine povacrylex in 74% isopropyl alcohol (iodine group) or 2% chlorhexidine gluconate in 70% isopropyl alcohol (chlorhexidine group) as preoperative antisepsis for surgical procedures to repair extremity fractures. Every 2 months, the hospitals alternated interventions. Separate populations of patients with either open or closed fractures were enrolled and included in the analysis. The primary outcome was surgical-site infection, which included superficial incisional infection within 30 days or deep incisional or organ-space infection within 90 days. The secondary outcome was unplanned reoperation for fracture-healing complications. RESULTS A total of 6785 patients with a closed fracture and 1700 patients with an open fracture were included in the trial. In the closed-fracture population, surgical-site infection occurred in 77 patients (2.4%) in the iodine group and in 108 patients (3.3%) in the chlorhexidine group (odds ratio, 0.74; 95% confidence interval [CI], 0.55 to 1.00; P = 0.049). In the open-fracture population, surgical-site infection occurred in 54 patients (6.5%) in the iodine group and in 60 patients (7.3%) in the chlorhexidine group (odd ratio, 0.86; 95% CI, 0.58 to 1.27; P = 0.45). The frequencies of unplanned reoperation, 1-year outcomes, and serious adverse events were similar in the two groups. CONCLUSIONS Among patients with closed extremity fractures, skin antisepsis with iodine povacrylex in alcohol resulted in fewer surgical-site infections than antisepsis with chlorhexidine gluconate in alcohol. In patients with open fractures, the results were similar in the two groups. (Funded by the Patient-Centered Outcomes Research Institute and the Canadian Institutes of Health Research; PREPARE ClinicalTrials.gov number, NCT03523962.).
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Affiliation(s)
- Sheila Sprague
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Gerard Slobogean
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Jeffrey L Wells
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Nathan N O'Hara
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Lehana Thabane
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - C Daniel Mullins
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Anthony D Harris
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Amber Wood
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Darius Viskontas
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Kelly L Apostle
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Robert V O'Toole
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Manjari Joshi
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Herman Johal
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Jamal Al-Asiri
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Robert A Hymes
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Greg E Gaski
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Holly T Pilson
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Eben A Carroll
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Sharon Babcock
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Jason J Halvorson
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Nicholas M Romeo
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Christopher A Matson
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Thomas F Higgins
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Lucas S Marchand
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Patrick F Bergin
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - John Morellato
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Robert E Van Demark
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - G David Potter
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - I Leah Gitajn
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Gerard Chang
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Kevin D Phelps
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Laurence B Kempton
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Madhav Karunakar
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Todd Jaeblon
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Haley K Demyanovich
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Christopher M Domes
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Gabrielle R Kuhn
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Rachel M Reilly
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Mark J Gage
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Michael J Weaver
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Arvind G von Keudell
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Marilyn Heng
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Michael F McTague
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Ahmad Alnasser
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Samir Mehta
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Derek J Donegan
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Roman M Natoli
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Jan Szatkowski
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Alesha N Scott
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Steven F Shannon
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Kyle J Jeray
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Stephanie L Tanner
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Meir T Marmor
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Amir Matityahu
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Justin T Fowler
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Sarah N Pierrie
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Michael J Beltran
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Cameron G Thomson
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Carol A Lin
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Charles N Moon
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - John A Scolaro
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Arya Amirhekmat
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Jordan Leonard
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - David Pogorzelski
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Sofia Bzovsky
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Diane Heels-Ansdell
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Olivia P Szasz
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Jodi L Gallant
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Gregory J Della Rocca
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Robert D Zura
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Joan N Hebden
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Joseph T Patterson
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Christopher Lee
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Lyndsay M O'Hara
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Debra Marvel
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Jana E Palmer
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Jeff Friedrich
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Jean-Claude G D'Alleyrand
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Jessica C Rivera
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Franca Mossuto
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Gregory M Schrank
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Gordon Guyatt
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - P J Devereaux
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
| | - Mohit Bhandari
- From the Division of Orthopedic Surgery, Department of Surgery (S.S., H.J., J.A.-A., J.L., D.P., S. Bzovsky, O.P.S., J.L.G., M.B.), and the Department of Health Research Methods, Evidence, and Impact (L.T., D.H.-A., G.G.), McMaster University, Hamilton Health Sciences Hospital, General Site (F.M.), and the Population Health Research Institute (P.J.D.), Hamilton, ON, and the Department of Orthopedic Surgery, University of British Columbia, Vancouver (D.V., K.L.A.) - all in Canada; the Center for Orthopedic Injury Research and Innovation, Department of Orthopedics, University of Maryland School of Medicine (G.S., N.N.O.), and the Division of Infectious Diseases (M.J.) and the Division of Orthopedic Traumatology, Department of Orthopedics (G.S., M.J.G., R.V.O.), R. Adams Cowley Shock Trauma Center, the Trauma Survivors Network (J.L.W.) and Patient Representative (D.M., J.E.P., J.F.), University of Maryland Baltimore, the University of Maryland School of Pharmacy (C.D.M.), the Departments of Epidemiology and Public Health (A.D.H., J.N.H., L.M.O.) and of Medicine (G.M.S.), University of Maryland School of Medicine, Baltimore, and the Division of Orthopedic Traumatology, Department of Orthopedics, University of Maryland Capital Region Health, Largo (T.J., H.K.D.) - all in Maryland; the Association of periOperative Registered Nurses, Denver (A.W.); the Department of Orthopedic Surgery, Inova Fairfax Medical Campus, Fairfax, VA (R.A.H., G.E.G.); the Department of Orthopedic Surgery and Rehabilitation, Wake Forest University School of Medicine, Winston-Salem (H.T.P., E.A.C., S. Babcock, J.J.H.), the Division of Orthopedic Trauma, Atrium Health, Charlotte (K.D.P., L.B.K., M.K.), and the Department of Orthopedic Surgery, Duke University, Durham (R.M.R.) - all in North Carolina; the Department of Orthopedic Surgery, MetroHealth Medical Center, Cleveland (N.M.R., C.A.M.); the Department of Orthopedic Surgery, University of Utah, Salt Lake City (T.F.H., L.S.M.); the Department of Orthopedic Surgery and Rehabilitation, University of Mississippi Medical Center, Jackson (P.F.B., J.M.); the Division of Orthopedic Surgery, Sanford Health USD Medical Center, Sioux Falls, SD (R.E.V.D.); the Division of Orthopedic Surgery, Northwest Texas Healthcare System, Amarillo (G.D.P.); the Department of Orthopedic Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, NH (I.L.G., G.C.); the Department of Orthopedics and Rehabilitation, University of Wisconsin, Madison (C.M.D., G.R.K.); the Department of Orthopedic Surgery, Brigham and Women's Hospital, Harvard Medical School (M.J.W., A.G.K.), Carl J. Shapiro Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center (M.F.M.), and the Department of Orthopedic Surgery, Harvard Medical School (A. Alnasser) - all in Boston; the Department of Orthopedics, Miller School of Medicine, University of Miami, Miami (M.H.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, University of Pennsylvania, Philadelphia (S.M., D.J.D.); the Division of Orthopedic Trauma, Department of Orthopedic Surgery, Indiana University School of Medicine, Indianapolis (R.M.N., J.S.); Bryan Health, Lincoln, NE (A.N.S., S.F.S.); the Department of Orthopedic Surgery, Prisma Health-Upstate, Greenville, SC (K.J.J., S.L.T.); the Department of Orthopedic Surgery, University of California, San Francisco, San Francisco (M.T.M., A.M.), the Department of Orthopedic Surgery, Cedars-Sinai Medical Center (C.A.L., C.N.M.), the Department of Orthopedic Surgery, Keck School of Medicine of the University of Southern California (J.T.P.), and the Department of Orthopedic Surgery, UCLA (C.L.), Los Angeles, and the Department of Orthopedic Surgery, University of California, Irvine, Irvine (J.A.S., A. Amirhekmat) - all in California; the Department of Orthopedic Surgery, Brooke Army Medical Center (J.T.F., J.C.R.), and the Department of Orthopedic Surgery, San Antonio Military Medical Center (S.N.P.) - both in Fort Sam Houston, TX; the Department of Orthopedic Surgery and Sports Medicine, University of Cincinnati, Cincinnati (M.J.B.); the Department of Orthopedics, Warren Alpert Medical School, Brown University, Providence, RI (C.G.T.); the Department of Orthopedic Surgery, University of Missouri, Columbia (G.J.D.R.); Louisiana State University Health Sciences Center Orthopedics New Orleans, New Orleans (R.D.Z.); and the Department of Orthopedic Surgery, Landstuhl Regional Medical Center, Landstuhl, Germany (J.-C.G.D.)
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Gouveia K, Sprague S, Gallant J, Del Fabbro G, Leonard J, Bzovsky S, McKay P, Busse JW. In-person cognitive behavioural therapy vs. usual care after surgical management of extremity fractures: an unsuccessful feasibility trial. Pilot Feasibility Stud 2024; 10:2. [PMID: 38184642 PMCID: PMC10770933 DOI: 10.1186/s40814-023-01430-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 12/19/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND Extremity fractures are common, and most are managed operatively; however, despite successful reduction, up to half of patients report persistent post-surgical pain. Furthermore, psychological factors such as stress, distress, anxiety, depression, catastrophizing, and fear-avoidance behaviors have been associated with the development of chronic pain. The purpose of this pilot study was to examine the feasibility of a randomized controlled trial to determine the effect of in-person cognitive behavioral therapy (CBT) vs. usual care on persistent post-surgical pain among patients with a surgically managed extremity fracture. METHODS Eligible patients were randomized to either in-person CBT or usual care. We used four criteria to judge the composite measure of feasibility: 1) successful implementation of CBT at each clinical site, 2) 40 patients recruited within 6 months, 3) treatment compliance in a minimum 36 of 40 participants (90%), and 4) 32 of 40 participants (80%) achieving follow-up at one year. The primary clinical outcome was persistent post-surgical pain at one year after surgery. RESULTS Only two of the four participating sites were able to implement the CBT regimen due to difficulties with identifying certified therapists who had the capacity to accommodate additional patients into their schedule within the required timeframe (i.e., 8 weeks of their fracture). Given the challenges associated with CBT implementation, only one site was able to actively recruit patients. This site screened 86 patients and enrolled 3 patients (3.5%) over a period of three months. Participants were unable to comply with the in-person CBT, with no participants attending an in-person CBT session. Follow-up at one year could not be assessed as the pilot study was stopped early, three months into the study, due to failure to achieve the other three feasibility criteria. CONCLUSION Our pilot trial failed to demonstrate the feasibility of a trial of in-person CBT versus usual care to prevent persistent pain after surgical repair of traumatic long-bone fractures and re-enforces the importance of establishing feasibility before embarking on definitive trials. Protocol modifications to address the identified barriers include the delivery of our intervention as a therapist-guided, remote CBT program. TRIAL REGISTRATION ClinicalTrials.gov (Identifier NCT03196258); Registered June 22, 2017, https://clinicaltrials.gov/ct2/show/NCT03196258.
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Affiliation(s)
- Kyle Gouveia
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada.
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
| | - Jodi Gallant
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - Gina Del Fabbro
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - Jordan Leonard
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - Paula McKay
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - Jason W Busse
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Department of Anesthesia, Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
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Pogorzelski D, Wells JL, Marvel D, Palmer JE, Mullins CD, Medeiros M, Gallant JL, Spicer E, Bergin PF, Gitajn IL, Mullin DS, Gaski GE, Hymes R, Bzovsky S, Slobogean GP, Sprague S. Pragmatic design and inclusion of patient-partner representatives improves participant experience in clinical research. OTA Int 2023; 6:e287. [PMID: 37860179 PMCID: PMC10583267 DOI: 10.1097/oi9.0000000000000287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/21/2023] [Indexed: 10/21/2023]
Abstract
Objectives Patient engagement in the design and implementation of clinical trials is necessary to ensure that the research is relevant and responsive to patients. The PREP-IT trials, which include 2 pragmatic trials that evaluate different surgical preparation solutions in orthopaedic trauma patients, followed the patient-centered outcomes research (PCOR) methodology throughout the design, implementation, and conduct. We conducted a substudy within the PREP-IT trials to explore participants' experiences with trial participation. Methods At the final follow-up visit (12 months after their fracture), patients participating in the PREP-IT trials were invited to participate in the substudy. After providing informed consent, participants completed a questionnaire that asked about their experience and satisfaction with participating in the PREP-IT trials. Descriptive statistics are used to report the findings. Results Four hundred two participants participated in the substudy. Most participants (394 [98%]) reported a positive experience, and 376 (94%) participants felt their contributions were appreciated. The primary reasons for participation were helping future patients with fracture (279 [69%]) and to contribute to science (223 [56%]). Two hundred seventeen (46%) participants indicated that their decision to participate was influenced by the minimal time commitment. Conclusions Most participants reported a positive experience with participating in the PREP-IT trials. Altruism was the largest motivator for participating in this research. Approximately half of the participants indicated that the pragmatic, low-participant burden design of the trial influenced their decision to participate. Meaningful patient engagement, a pragmatic, and low-burden protocol led to high levels of participant satisfaction.
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Affiliation(s)
- David Pogorzelski
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Jeffrey L. Wells
- Trauma Survivors Network, University of Maryland Baltimore, Baltimore, MD
| | - Debra Marvel
- Patient Representative, R Adams Cowley Shock Trauma Center, Baltimore, MD
| | - Jana E. Palmer
- Patient Representative, R Adams Cowley Shock Trauma Center, Baltimore, MD
| | - C. Daniel Mullins
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
| | - Michelle Medeiros
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD
| | - Jodi L. Gallant
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Ella Spicer
- Division of Orthopaedics, Fraser Health Authority, New Westminster, BC, Canada
| | | | - I. Leah Gitajn
- Dartmouth-Hitchcock Medical Center, Dartmouth Geisel School of Medicine, Lebanon, NH
| | - Devin S. Mullin
- Dartmouth-Hitchcock Medical Center, Dartmouth Geisel School of Medicine, Lebanon, NH
| | - Greg E. Gaski
- Department of Orthopaedic Surgery, Inova Fairfax Medical Campus, Falls Church, VA
| | - Robert Hymes
- Department of Orthopaedic Surgery, Inova Fairfax Medical Campus, Falls Church, VA
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Gerard P. Slobogean
- Department of Orthopaedics, University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
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5
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Adhikari NKJ, Hashmi M, Tirupakuzhi Vijayaraghavan BK, Haniffa R, Beane A, Webb SA, Angus DC, Gordon AC, Cook DJ, Guyatt GH, Berry LR, Lorenzi E, Mouncey PR, Au C, Pinto R, Ménard J, Sprague S, Masse MH, Huang DT, Heyland DK, Nichol AD, McArthur CJ, de Man A, Al-Beidh F, Annane D, Anstey M, Arabi YM, Battista MC, Berry S, Bhimani Z, Bonten MJM, Bradbury CA, Brant EB, Brunkhorst FM, Burrell A, Buxton M, Cecconi M, Cheng AC, Cohen D, Cove ME, Day AG, Derde LPG, Detry MA, Estcourt LJ, Fagbodun EO, Fitzgerald M, Goossens H, Green C, Higgins AM, Hills TE, Ichihara N, Jayakumar D, Kanji S, Khoso MN, Lawler PR, Lewis RJ, Litton E, Marshall JC, McAuley DF, McGlothlin A, McGuinness SP, McQuilten ZK, McVerry BJ, Murthy S, Parke RL, Parker JC, Reyes LF, Rowan KM, Saito H, Salahuddin N, Santos MS, Saunders CT, Seymour CW, Shankar-Hari M, Tolppa T, Trapani T, Turgeon AF, Turner AM, Udy AA, van de Veerdonk FL, Zarychanski R, Lamontagne F. Intravenous Vitamin C for Patients Hospitalized With COVID-19: Two Harmonized Randomized Clinical Trials. JAMA 2023; 330:1745-1759. [PMID: 37877585 PMCID: PMC10600726 DOI: 10.1001/jama.2023.21407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 10/02/2023] [Indexed: 10/26/2023]
Abstract
Importance The efficacy of vitamin C for hospitalized patients with COVID-19 is uncertain. Objective To determine whether vitamin C improves outcomes for patients with COVID-19. Design, Setting, and Participants Two prospectively harmonized randomized clinical trials enrolled critically ill patients receiving organ support in intensive care units (90 sites) and patients who were not critically ill (40 sites) between July 23, 2020, and July 15, 2022, on 4 continents. Interventions Patients were randomized to receive vitamin C administered intravenously or control (placebo or no vitamin C) every 6 hours for 96 hours (maximum of 16 doses). Main Outcomes and Measures The primary outcome was a composite of organ support-free days defined as days alive and free of respiratory and cardiovascular organ support in the intensive care unit up to day 21 and survival to hospital discharge. Values ranged from -1 organ support-free days for patients experiencing in-hospital death to 22 organ support-free days for those who survived without needing organ support. The primary analysis used a bayesian cumulative logistic model. An odds ratio (OR) greater than 1 represented efficacy (improved survival, more organ support-free days, or both), an OR less than 1 represented harm, and an OR less than 1.2 represented futility. Results Enrollment was terminated after statistical triggers for harm and futility were met. The trials had primary outcome data for 1568 critically ill patients (1037 in the vitamin C group and 531 in the control group; median age, 60 years [IQR, 50-70 years]; 35.9% were female) and 1022 patients who were not critically ill (456 in the vitamin C group and 566 in the control group; median age, 62 years [IQR, 51-72 years]; 39.6% were female). Among critically ill patients, the median number of organ support-free days was 7 (IQR, -1 to 17 days) for the vitamin C group vs 10 (IQR, -1 to 17 days) for the control group (adjusted proportional OR, 0.88 [95% credible interval {CrI}, 0.73 to 1.06]) and the posterior probabilities were 8.6% (efficacy), 91.4% (harm), and 99.9% (futility). Among patients who were not critically ill, the median number of organ support-free days was 22 (IQR, 18 to 22 days) for the vitamin C group vs 22 (IQR, 21 to 22 days) for the control group (adjusted proportional OR, 0.80 [95% CrI, 0.60 to 1.01]) and the posterior probabilities were 2.9% (efficacy), 97.1% (harm), and greater than 99.9% (futility). Among critically ill patients, survival to hospital discharge was 61.9% (642/1037) for the vitamin C group vs 64.6% (343/531) for the control group (adjusted OR, 0.92 [95% CrI, 0.73 to 1.17]) and the posterior probability was 24.0% for efficacy. Among patients who were not critically ill, survival to hospital discharge was 85.1% (388/456) for the vitamin C group vs 86.6% (490/566) for the control group (adjusted OR, 0.86 [95% CrI, 0.61 to 1.17]) and the posterior probability was 17.8% for efficacy. Conclusions and Relevance In hospitalized patients with COVID-19, vitamin C had low probability of improving the primary composite outcome of organ support-free days and hospital survival. Trial Registration ClinicalTrials.gov Identifiers: NCT04401150 (LOVIT-COVID) and NCT02735707 (REMAP-CAP).
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Affiliation(s)
- Neill K J Adhikari
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Madiha Hashmi
- Department of Critical Care Medicine, Ziauddin University, Karachi, Pakistan
| | | | - Rashan Haniffa
- Centre for Inflammation Research, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, Scotland
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Abi Beane
- Centre for Inflammation Research, Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, Scotland
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, Thailand
| | - Steve A Webb
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- St John of God Health Care, Perth, Australia
| | - Derek C Angus
- University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
- University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anthony C Gordon
- Division of Anaesthetics, Pain Medicine, and Intensive Care, Imperial College London, London, England
- St Mary's Hospital, Imperial College Healthcare NHS Trust, London, England
| | - Deborah J Cook
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Critical Care, St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Paul R Mouncey
- Intensive Care National Audit and Research Centre, London, England
| | - Carly Au
- Intensive Care National Audit and Research Centre, London, England
| | - Ruxandra Pinto
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Julie Ménard
- Research Centre of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - Sheila Sprague
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Marie-Hélène Masse
- Research Centre of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | - David T Huang
- School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Daren K Heyland
- Department of Critical Care Medicine, Queen's University, Kingston, Ontario, Canada
| | - Alistair D Nichol
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Australia
- University College Dublin, Dublin, Ireland
- Alfred Health, Melbourne, Australia
| | - Colin J McArthur
- Department of Critical Care Medicine, Auckland City Hospital, Auckland, New Zealand
| | - Angelique de Man
- Department of Intensive Care Medicine, Amsterdam University Medical Centers, Amsterdam, the Netherlands
| | | | - Djillali Annane
- UVSQ University Paris Saclay, Institut-Hospitalo Universitaire Prometheus, Paris, France
- Médecine Intensive-Réanimation, Hôpital Raymond-Poincaré, Garches, France
| | - Matthew Anstey
- Sir Charles Gairdner Hospital, Nedlands, Australia
- University of Western Australia, Perth
| | - Yaseen M Arabi
- King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
| | - Marie-Claude Battista
- Research Centre of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
| | | | - Zahra Bhimani
- St Michael's Hospital, Unity Health Toronto, Toronto, Ontario, Canada
| | - Marc J M Bonten
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
- European Clinical Research Alliance on Infectious Diseases, Utrecht, the Netherlands
| | | | - Emily B Brant
- Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Frank M Brunkhorst
- Department of Anaesthesiology and Intensive Care Medicine, Jena University Hospital, Jena, Germany
| | - Aidan Burrell
- Alfred Health, Melbourne, Australia
- Australian and New Zealand Intensive Care Research Centre, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Meredith Buxton
- Global Coalition for Adaptive Research, Larkspur, California
| | - Maurizio Cecconi
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
- IRCCS Humanitas Research Hospital, Milan, Italy
| | - Allen C Cheng
- Monash Infectious Disease, Monash Health and School of Clinical Sciences, Monash University, Clayton, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Dian Cohen
- Bishop's University, Sherbrooke, Quebec, Canada
- Massawippi Valley Foundation, Ayer's Cliff, Quebec, Canada
| | - Matthew E Cove
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Andrew G Day
- Kingston Health Sciences Centre and Queen's University, Kingston, Ontario, Canada
| | - Lennie P G Derde
- European Clinical Research Alliance on Infectious Diseases, Utrecht, the Netherlands
- Intensive Care Centre, University Medical Centre Utrecht, Utrecht, the Netherlands
| | | | - Lise J Estcourt
- Department of Haematology, NHS Blood and Transplant, Bristol, England
- Radcliffe Department of Medicine, University of Oxford, Oxford, England
| | | | | | - Herman Goossens
- Laboratory of Medical Microbiology, University of Antwerp, Antwerp, Belgium
| | - Cameron Green
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Alisa M Higgins
- Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | | | - Nao Ichihara
- Department of Cardiovascular Surgery, School of Medicine, Jikei University, Tokyo, Japan
| | | | - Salmaan Kanji
- Ottawa Hospital, Ottawa, Ontario, Canada
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | | | - Patrick R Lawler
- University Health Network, Toronto, Ontario, Canada
- University of Toronto, Toronto, Ontario, Canada
- McGill University Health Centre, Montreal, Quebec, Canada
| | | | - Edward Litton
- Fiona Stanley Hospital, Department of Intensive Care Unit, University of Western Australia, Perth
| | - John C Marshall
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Daniel F McAuley
- Queen's University of Belfast, Belfast, Northern Ireland
- Centre for Infection and Immunity, Royal Victoria Hospital, Belfast, Northern Ireland
| | | | - Shay P McGuinness
- Medical Research Institute of New Zealand, Wellington
- Auckland City Hospital, Cardiothoracic and Vascular Intensive Care Unit, Auckland, New Zealand
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
| | | | - Bryan J McVerry
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Srinivas Murthy
- Department of Pediatrics, University of British Columbia, Vancouver, Canada
| | - Rachael L Parke
- Medical Research Institute of New Zealand, Wellington
- Auckland City Hospital, Cardiothoracic and Vascular Intensive Care Unit, Auckland, New Zealand
- School of Nursing, University of Auckland, Auckland, New Zealand
| | - Jane C Parker
- Faculty of Medicine, Nursing, and Health Sciences, Monash University, Clayton, Australia
| | - Luis Felipe Reyes
- Department of Infectious Diseases, Universidad de La Sabana, Chia, Colombia
- Department of Critical Care Medicine, Clinica Universidad de La Sabana, Chia, Colombia
| | - Kathryn M Rowan
- Intensive Care National Audit and Research Centre, London, England
| | - Hiroki Saito
- Department of Emergency and Critical Care Medicine, St Marianna University Yokohama Seibu Hospital, Yokohama, Japan
| | - Nawal Salahuddin
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Marlene S Santos
- Department of Critical Care, St Michael's Hospital, Toronto, Ontario, Canada
| | | | - Christopher W Seymour
- Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Manu Shankar-Hari
- Institute for Regeneration and Repair, University of Edinburgh, Edinburgh, Scotland
- Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, Scotland
| | - Timo Tolppa
- National Intensive Care Surveillance, Colombo, Sri Lanka
| | - Tony Trapani
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
| | - Alexis F Turgeon
- Department of Anesthesiology and Critical Care, Université Laval, Quebec City, Quebec, Canada
- Population Health and Optimal Health Practices Research Unit, Departments of Traumatology, Emergency Medicine, and Critical Care Medicine, Université Laval Research Center, CHU de Québec-Université Laval, Quebec City, Quebec, Canada
| | - Anne M Turner
- Medical Research Institute of New Zealand, Wellington
| | - Andrew A Udy
- Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, Australia
- Department of Intensive Care and Hyperbaric Medicine, Alfred Hospital, Melbourne, Australia
| | | | - Ryan Zarychanski
- Department of Internal Medicine, University of Manitoba, Winnipeg, Canada
| | - François Lamontagne
- Research Centre of the Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Quebec, Canada
- Department of Medicine, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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6
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Joeris A, Sprague S, Blauth M, Gosch M, Wattanapanom P, Jarayabhand R, Poeze M, Wong MK, Kwek EBK, Hegeman JH, Perez-Uribarri C, Guerado E, Revak TJ, Zohner S, Joseph D, Phillips MR. Cost-effectiveness analysis of the Geriatric Fracture Center (GFC) concept: a prospective multicentre cohort study. BMJ Open 2023; 13:e072744. [PMID: 37918921 PMCID: PMC10626854 DOI: 10.1136/bmjopen-2023-072744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/15/2023] [Indexed: 11/04/2023] Open
Abstract
INTRODUCTION Geriatric Fracture Centers (GFCs) are dedicated treatment units where care is tailored towards elderly patients who have suffered fragility fractures. The primary objective of this economic analysis was to determine the cost-utility of GFCs compared with usual care centres. METHODS The primary analysis was a cost-utility analysis that measured the cost per incremental quality-adjusted life-year gained from treatment of hip fracture in GFCs compared with treatment in usual care centres from the societal perspective over a 1-year time horizon. The secondary analysis was a cost-utility analysis from a societal perspective over a lifetime time horizon. We evaluated these outcomes using a cost-utility analysis using data from a large multicentre prospective cohort study comparing GFCs versus usual care centres that took place in Austria, Spain, the USA, the Netherlands, Thailand and Singapore. RESULTS GFCs may be cost-effective in the long term, while providing a more comprehensive care plan. Patients in usual care centre group were slightly older and had fewer comorbidities. For the 1-year analysis, the costs per patient were slightly lower in the GFC group (-$646.42), while the quality-adjusted life-years were higher in the usual care centre group (+0.034). The incremental cost-effectiveness ratio was $18 863.34 (US$/quality-adjusted life-year). The lifetime horizon analysis found that the costs per patient were lower in the GFC group (-$7210.35), while the quality-adjusted life-years were higher in the usual care centre group (+0.02). The incremental cost-effectiveness ratio was $320 678.77 (US$/quality-adjusted life-year). CONCLUSIONS This analysis found that GFCs were associated with lower costs compared with usual care centres. The cost-savings were greater when the lifetime time horizon was considered. This comprehensive cost-effectiveness analysis, using data from an international prospective cohort study, found that GFC may be cost-effective in the long term, while providing a more comprehensive care plan. A greater number of major adverse events were reported at GFC, nevertheless a lower mortality rate associated with these adverse events at GFC. Due to the minor utility benefits, which may be a result of greater adverse event detection within the GFC group and much greater costs of usual care centres, the GFC may be cost-effective due to the large cost-savings it demonstrated over the lifetime time horizon, while potentially identifying and treating adverse events more effectively. These findings suggest that the GFC may be a cost-effective option over the lifetime of a geriatric patient with hip fracture, although future research is needed to further validate these findings. LEVEL OF EVIDENCE Economic, level 2. TRIAL REGISTRATION NUMBER NCT02297581.
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Affiliation(s)
| | - Sheila Sprague
- Division of Orthopaedics, McMaster University, Hamilton, Ontario, Canada
| | - Michael Blauth
- Department of Trauma Surgery and Sports Medicine, Medical University Innsbruck, Innsbruck, Austria
| | - Markus Gosch
- Department of Internal Medicine, Paracelsus Universitat Nurnberg, Nuremberg, Germany
| | | | - Rahat Jarayabhand
- Department of Orthopedics, Bhumibol Adulyadej Hospital, Bangkok, Thailand
| | - Martijn Poeze
- Department of Surgery, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Merng K Wong
- Department of Orthopedic Surgery, Singapore General Hospital, Singapore
| | - Ernest B K Kwek
- Department of Orthopedic Surgery, Tan Tock Seng Hospital, Singapore
| | | | - Carlos Perez-Uribarri
- Department of Orthopedics and Trauma Surgery, Hospital Son Llatzer, Palma de Mallorca, Spain
| | - Enrique Guerado
- Department of Orthopaedic Surgery and Traumatology Hospital Universitario Costa del Sol, Faculty of Medicine, University of Malaga, Malaga, Spain
| | - Thomas J Revak
- Department of Orthopaedic Surgery-Division of Orthopedic Trauma, Saint Louis University, Saint Louis, Missouri, USA
| | - Sebastian Zohner
- Klinik für Unfallchirurgie und Sporttraumatologie, Kepler Universitätsklinikum Med Campus III, Linz, Austria
| | - David Joseph
- Department of Orthopedics, Elmhurst Hospital Center, Elmhurst, New York, USA
| | - Mark R Phillips
- Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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7
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Schemitsch EH, Kumar A, Heels-Ansdell D, Sprague S, Bhandari M, Guyatt G, Sanders DW, Swiontkowski M, Tornetta P, Walter S. Reamed compared with unreamed nailing of tibial shaft fractures: Does the initial method of nail insertion influence outcome in patients requiring reoperations? Can J Surg 2023; 66:E384-E389. [PMID: 37442585 PMCID: PMC10355994 DOI: 10.1503/cjs.012222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Patients with a tibial shaft fracture experiencing their first postoperative complication following treatment with intramedullary nails may be at greater risk of subsequent complications than the whole population. We aimed to determine whether the initial method of nail insertion influences outcome in patients with a tibial shaft fracture requiring multiple reoperations. METHODS Using the Study to Prospectively Evaluate Reamed Intramedullary Nails in Tibial Shaft Fractures trial data, we categorized patients as those not requiring reoperation, those requiring a single reoperation and those requiring multiple reoperations, and we compared them by nail insertion technique (reamed v. unreamed) and fracture type (open v. closed). We then determined the number of patients whose first reoperation was in response to infection, and we compared other clinical outcomes between the reamed and unreamed groups. RESULTS Among 1226 patients included in this analysis, 175 (14.27%) experienced a single reoperation and 44 patients (3.59%) underwent multiple reoperations. Nail insertion techniques (reamed v. unreamed) did not play a role in the need to perform multiple reoperations. Seventy-five percent of patients requiring multiple reoperations had open tibial shaft fractures. An equal number of these were reamed and unreamed insertions. The majority of patients had their course complicated by infection and almost 50% of patients whose first reoperation was for infection required more than 2 reoperations for management. The rest required multiple procedures for nonunion or bone loss. CONCLUSION Our findings corroborate those of other studies, in which open fracture type rather than nail insertion technique was found to be the cause of morbidity following intramedullary nailing of tibial fractures. CLINICAL TRIAL REGISTRATION www. CLINICALTRIALS gov, no. NCT00038129.
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Affiliation(s)
- Emil H Schemitsch
- Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Ashesh Kumar
- Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Diane Heels-Ansdell
- Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Sheila Sprague
- Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Gordon Guyatt
- Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - David W Sanders
- Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Marc Swiontkowski
- Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Paul Tornetta
- Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Stephen Walter
- Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); Division of Orthopaedics, St. Michael's Hospital, Toronto, Ont. (Kumar); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Heels-Ansdell, Sprague, Bhandari, Guyatt, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bhandari); the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
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8
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Comeau-Gauthier M, Bzovsky S, Axelrod D, Poolman RW, Frihagen F, Bhandari M, Schemitsch E, Sprague S. Is the use of bipolar hemiarthroplasty over monopolar hemiarthroplasty justified? A propensity score-weighted analysis of a multicentre randomized controlled trial. Bone Jt Open 2023; 4:370-377. [PMID: 37203362 DOI: 10.1302/2633-1462.45.bjo-2023-0026.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Aims Using data from the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial, we sought to determine if a difference in functional outcomes exists between monopolar and bipolar hemiarthroplasty (HA). Methods This study is a secondary analysis of patients aged 50 years or older with a displaced femoral neck fracture who were enrolled in the HEALTH trial and underwent monopolar and bipolar HA. Scores from the Western Ontario and McMaster University Arthritis Index (WOMAC) and 12-Item Short Form Health Survey (SF-12) Physical Component Summary (PCS) and (MCS) were compared between the two HA groups using a propensity score-weighted analysis. Results Of 746 HAs performed in the HEALTH trial, 404 were bipolar prostheses and 342 were unipolar. After propensity score weighting, adequate balance between the bipolar and unipolar groups was obtained as shown by standardized mean differences less than 0.1 for each covariable. A total of 24 months after HA, the total WOMAC score and its subcomponents showed no statistically significant difference between the unipolar and bipolar groups. Similarly, no statistically significant difference was found in the PCS and MCS scores of the SF-12 questionnaire. In participants aged 70 years and younger, no difference was found in any of the functional outcomes. Conclusion From the results of this study, the use of bipolar HA over unipolar design does not provide superior functional outcomes at 24 months postoperatively. The theoretical advantage of reduced acetabular wear with bipolar designs does not appear to influence functional outcomes in the first two years postoperatively.
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Affiliation(s)
- Marianne Comeau-Gauthier
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Daniel Axelrod
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Rudolf W Poolman
- Department of Orthopedic Surgery, OLVG, Amsterdam and LUMC, Leiden, the Netherlands
| | - Frede Frihagen
- Department of Orthopaedic Surgery, Østfold Hospital Trust, Grålum, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Emil Schemitsch
- Department of Surgery, University of Western Ontario, London, Ontario, Canada
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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9
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Reis G, Dos Santos Moreira Silva EA, Silva DCM, Thabane L, de Souza Campos VH, Ferreira TS, Quirino Dos Santos CV, Ribeiro Nogueira AM, Figueiredo Guimaraes Almeida AP, Cançado Monteiro Savassi L, de Figueiredo Neto AD, Bitarães C, Cruz Milagres A, Diniz Callegari E, Campos Simplicio MI, Barra Ribeiro L, Oliveira R, Harari O, Wilson LA, Forrest JI, Ruton H, Sprague S, McKay P, Guo CM, Guyatt GH, Rayner CR, Boulware DR, Ezer N, Lee TC, McDonald EG, Bafadhel M, Butler C, Silva JR, Dybul M, Mills EJ. Oral Fluvoxamine With Inhaled Budesonide for Treatment of Early-Onset COVID-19 : A Randomized Platform Trial. Ann Intern Med 2023; 176:667-675. [PMID: 37068273 PMCID: PMC10111398 DOI: 10.7326/m22-3305] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Previous trials have demonstrated the effects of fluvoxamine alone and inhaled budesonide alone for prevention of disease progression among outpatients with COVID-19. OBJECTIVE To determine whether the combination of fluvoxamine and inhaled budesonide would increase treatment effects in a highly vaccinated population. DESIGN Randomized, placebo-controlled, adaptive platform trial. (ClinicalTrials.gov: NCT04727424). SETTING 12 clinical sites in Brazil. PARTICIPANTS Symptomatic adults with confirmed SARS-CoV-2 infection and a known risk factor for progression to severe disease. INTERVENTION Patients were randomly assigned to either fluvoxamine (100 mg twice daily for 10 days) plus inhaled budesonide (800 mcg twice daily for 10 days) or matching placebos. MEASUREMENTS The primary outcome was a composite of emergency setting retention for COVID-19 for more than 6 hours, hospitalization, and/or suspected complications due to clinical progression of COVID-19 within 28 days of randomization. Secondary outcomes included health care attendance (defined as hospitalization for any cause or emergency department visit lasting >6 hours), time to hospitalization, mortality, patient-reported outcomes, and adverse drug reactions. RESULTS Randomization occurred from 15 January to 6 July 2022. A total of 738 participants were allocated to oral fluvoxamine plus inhaled budesonide, and 738 received placebo. The proportion of patients observed in an emergency setting for COVID-19 for more than 6 hours or hospitalized due to COVID-19 was lower in the treatment group than the placebo group (1.8% [95% credible interval {CrI}, 1.1% to 3.0%] vs. 3.7% [95% CrI, 2.5% to 5.3%]; relative risk, 0.50 [95% CrI, 0.25 to 0.92]), with a probability of superiority of 98.7%. No relative effects were found between groups for any of the secondary outcomes. More adverse events occurred in the intervention group than the placebo group, but no important differences between the groups were detected. LIMITATION Low event rate overall, consistent with contemporary trials in vaccinated populations. CONCLUSION Treatment with oral fluvoxamine plus inhaled budesonide among high-risk outpatients with early COVID-19 reduced the incidence of severe disease requiring advanced care. PRIMARY FUNDING SOURCE Latona Foundation, FastGrants, and Rainwater Charitable Foundation.
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Affiliation(s)
- Gilmar Reis
- ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative, Stanford, California; Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil; Department of Medicine, Pontifícia Universidade Católica de Minas Gerais, Minas Gerais, Brazil; and Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (G.R.)
| | - Eduardo Augusto Dos Santos Moreira Silva
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil, and Department of Medicine, Pontifícia Universidade Católica de Minas Gerais, Minas Gerais, Brazil (E.A.d.S.M.S., D.C.M.S., V.H.d.S.C., C.V.Q.d.S.)
| | - Daniela Carla Medeiros Silva
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil, and Department of Medicine, Pontifícia Universidade Católica de Minas Gerais, Minas Gerais, Brazil (E.A.d.S.M.S., D.C.M.S., V.H.d.S.C., C.V.Q.d.S.)
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (L.T., S.S., P.M., G.H.G.)
| | - Vitoria Helena de Souza Campos
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil, and Department of Medicine, Pontifícia Universidade Católica de Minas Gerais, Minas Gerais, Brazil (E.A.d.S.M.S., D.C.M.S., V.H.d.S.C., C.V.Q.d.S.)
| | - Thiago Santiago Ferreira
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil (T.S.F., M.I.C.S., L.B.R., R.O.)
| | - Castilho Vitor Quirino Dos Santos
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil, and Department of Medicine, Pontifícia Universidade Católica de Minas Gerais, Minas Gerais, Brazil (E.A.d.S.M.S., D.C.M.S., V.H.d.S.C., C.V.Q.d.S.)
| | | | | | | | | | - Carina Bitarães
- Public Health, Mental and Family Medicine Department, Ouro Preto Federal University, Minas Gerais, Brazil, and Public Health Care Division, City of Ibirité, Brazil (C.B., A.C.M.)
| | - Aline Cruz Milagres
- Public Health, Mental and Family Medicine Department, Ouro Preto Federal University, Minas Gerais, Brazil, and Public Health Care Division, City of Ibirité, Brazil (C.B., A.C.M.)
| | - Eduardo Diniz Callegari
- Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, City of Montes Claros, Brazil, and Public Health Care Division, City of Brumadinho, Brazil (E.D.C.)
| | - Maria Izabel Campos Simplicio
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil (T.S.F., M.I.C.S., L.B.R., R.O.)
| | - Luciene Barra Ribeiro
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil (T.S.F., M.I.C.S., L.B.R., R.O.)
| | - Rosemary Oliveira
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil (T.S.F., M.I.C.S., L.B.R., R.O.)
| | - Ofir Harari
- Cytel, Vancouver, British Columbia, Canada (O.H., H.R.)
| | - Lindsay A Wilson
- Platform Life Sciences, Vancouver, British Columbia, Canada (L.A.W., J.I.F., C.M.G., J.R.S.)
| | - Jamie I Forrest
- Platform Life Sciences, Vancouver, British Columbia, Canada (L.A.W., J.I.F., C.M.G., J.R.S.)
| | - Hinda Ruton
- Cytel, Vancouver, British Columbia, Canada (O.H., H.R.)
| | - Sheila Sprague
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (L.T., S.S., P.M., G.H.G.)
| | - Paula McKay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (L.T., S.S., P.M., G.H.G.)
| | - Christina M Guo
- Platform Life Sciences, Vancouver, British Columbia, Canada (L.A.W., J.I.F., C.M.G., J.R.S.)
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada (L.T., S.S., P.M., G.H.G.)
| | - Craig R Rayner
- Certara, Princeton, New Jersey, and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia (C.R.R.)
| | - David R Boulware
- Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, Minnesota (D.R.B.)
| | - Nicole Ezer
- Department of Medicine, Division of Respiratory Medicine, McGill University Health Centre, Montréal, Québec, Canada (N.E.)
| | - Todd C Lee
- Division of Infectious Diseases, Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada (T.C.L.)
| | - Emily Gibson McDonald
- Division of General Internal Medicine, Department of Medicine, McGill University Health Centre, Montréal, Québec, Canada (E.G.M.)
| | - Mona Bafadhel
- School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King's College London, London, United Kingdom (M.B.)
| | - Christopher Butler
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom (C.B.)
| | - Josue Rodrigues Silva
- Platform Life Sciences, Vancouver, British Columbia, Canada (L.A.W., J.I.F., C.M.G., J.R.S.)
| | - Mark Dybul
- Global Health Institute, Georgetown University, Washington, DC (M.D.)
| | - Edward J Mills
- ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative, Stanford, California; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Cytel, Vancouver, British Columbia, Canada; and Platform Life Sciences, Vancouver, British Columbia, Canada (E.J.M.)
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10
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Dijkstra H, Oosterhoff JHF, van de Kuit A, IJpma FFA, Schwab JH, Poolman RW, Sprague S, Bzovsky S, Bhandari M, Swiontkowski M, Schemitsch EH, Doornberg JN, Hendrickx LAM. Development of machine-learning algorithms for 90-day and one-year mortality prediction in the elderly with femoral neck fractures based on the HEALTH and FAITH trials. Bone Jt Open 2023; 4:168-181. [PMID: 37051847 PMCID: PMC10032237 DOI: 10.1302/2633-1462.43.bjo-2022-0162.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
To develop prediction models using machine-learning (ML) algorithms for 90-day and one-year mortality prediction in femoral neck fracture (FNF) patients aged 50 years or older based on the Hip fracture Evaluation with Alternatives of Total Hip arthroplasty versus Hemiarthroplasty (HEALTH) and Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trials. This study included 2,388 patients from the HEALTH and FAITH trials, with 90-day and one-year mortality proportions of 3.0% (71/2,388) and 6.4% (153/2,388), respectively. The mean age was 75.9 years (SD 10.8) and 65.9% of patients (1,574/2,388) were female. The algorithms included patient and injury characteristics. Six algorithms were developed, internally validated and evaluated across discrimination (c-statistic; discriminative ability between those with risk of mortality and those without), calibration (observed outcome compared to the predicted probability), and the Brier score (composite of discrimination and calibration). The developed algorithms distinguished between patients at high and low risk for 90-day and one-year mortality. The penalized logistic regression algorithm had the best performance metrics for both 90-day (c-statistic 0.80, calibration slope 0.95, calibration intercept -0.06, and Brier score 0.039) and one-year (c-statistic 0.76, calibration slope 0.86, calibration intercept -0.20, and Brier score 0.074) mortality prediction in the hold-out set. Using high-quality data, the ML-based prediction models accurately predicted 90-day and one-year mortality in patients aged 50 years or older with a FNF. The final models must be externally validated to assess generalizability to other populations, and prospectively evaluated in the process of shared decision-making.
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Affiliation(s)
- Hidde Dijkstra
- Department of Orthopaedic Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Department of Geriatric Medicine, University Medical Center of Groningen, University of Groningen, Groningen, The Netherlands
| | - Jacobien H F Oosterhoff
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Department of Engineering Systems and Services, Faculty Technology Policy Management, Delft University of Technology, Delt, Netherlands
| | - Anouk van de Kuit
- Department of Orthopaedic Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Frank F A IJpma
- Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Joseph H Schwab
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Rudolf W Poolman
- Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands
- Department of Orthopaedic Surgery, Onze Lieve Vrouw Gasthuis, Amsterdam, The Netherlands
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Marc Swiontkowski
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Job N Doornberg
- Department of Orthopaedic Surgery, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands
| | - Laurent A M Hendrickx
- Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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11
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Boissonneault A, O Hara N, Pogorzelski D, Marchand L, Higgins T, Gitajn L, Gage MJ, Natoli RM, Sharma I, Pierrie S, O'Toole RV, Sprague S, Slobogean G. The impact of heterotopic ossification prophylaxis after surgical fixation of acetabular fractures: national treatment patterns and related outcomes. Injury 2023; 54:S0020-1383(23)00197-3. [PMID: 37002119 PMCID: PMC10480339 DOI: 10.1016/j.injury.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 03/04/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Heterotopic ossification (HO) is a common complication after surgical fixation of acetabular fractures. Numerous strategies have been employed to prevent HO formation, but results are mixed and optimal treatment strategy remains controversial. The purpose of the study was to describe current national heterotopic ossification (HO) prophylaxis patterns among academic trauma centers, determine the association between prophylaxis type and radiographic HO, and identify if heterogeneity in treatment effects exist based on outcome risk strata. METHODS We used data from a subset of participants enrolled in the Pragmatic Randomized Trial Evaluating Pre-Operative Alcohol Skin Solutions in Fractured Extremities (PREPARE) trial. We included only patients with closed AO-type 62 acetabular fractures that were surgically treated via a posterior (Kocher-Langenbeck), combined anterior and posterior, or extensile exposure. PREPARE Clinical Trial Registration Number: NCT03523962 Patient population This cohort study was nested within the Pragmatic Randomized Trial Evaluating Pre-Operative Alcohol Skin Solutions in Fractured Extremities (PREPARE) trial. The PREPARE trial is a multicenter cluster-randomized crossover trial evaluating the effectiveness of two alcohol-based pre-operative antiseptic skin solutions. All PREPARE trial clinical centers that enrolled at least one patient with a closed AO-type 62 acetabular fracture were invited to participate in the nested study. RESULTS 277 patients from 20 level 1 and level 2 trauma centers in the U.S. and Canada were included in this study. 32 patients (12%) received indomethacin prophylaxis, 100 patients (36%) received XRT prophylaxis, and 145 patients (52%) received no prophylaxis. Administration of XRT was associated with a 68% reduction in the adjusted odds of overall HO (OR 0.32, 95% CI, 0.14 - 0.69, p = 0.005). The overall severe HO (Brooker classes III or IV) rate was 8% for the entire cohort; XRT reduced the rate of severe HO in high-risk patients only (p=0.03). CONCLUSION HO prophylaxis patterns after surgical fixation of acetabular fractures have changed dramatically over the last two decades. Most centers included in this study did not administer HO prophylaxis. XRT was associated with a marked reduction in the rate of overall HO and the rate of severe HO in high-risk patients. Randomized trials are needed to fully elucidate the potential benefit of XRT. PREPARE Clinical Trial Registration Number: NCT03523962.
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Affiliation(s)
- Adam Boissonneault
- R Adams Cowley Shock Trauma Center, University of Maryland, MD, 22 S Greene St, Baltimore, MD 21201, USA.
| | - Nathan O Hara
- R Adams Cowley Shock Trauma Center, University of Maryland, MD, 22 S Greene St, Baltimore, MD 21201, USA
| | - David Pogorzelski
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Lucas Marchand
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
| | - Thomas Higgins
- Department of Orthopaedic Surgery, University of Utah, Salt Lake City, UT, USA
| | - Leah Gitajn
- Department of Orthopaedics, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA
| | - Mark J Gage
- Department of Orthopaedic Surgery, Section of Orthopaedic Trauma, Duke University, Durham, North Carolina
| | - Roman M Natoli
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Ishani Sharma
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sarah Pierrie
- Department of Orthopaedic Surgery, San Antonio Military Medical Center, San Antonio, TX, USA
| | - Robert V O'Toole
- R Adams Cowley Shock Trauma Center, University of Maryland, MD, 22 S Greene St, Baltimore, MD 21201, USA
| | - Sheila Sprague
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
| | - Gerard Slobogean
- R Adams Cowley Shock Trauma Center, University of Maryland, MD, 22 S Greene St, Baltimore, MD 21201, USA
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12
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Reis G, Moreira Silva EAS, Medeiros Silva DC, Thabane L, Campos VHS, Ferreira TS, Santos CVQ, Nogueira AMR, Almeida APFG, Savassi LCM, Figueiredo-Neto AD, Dias ACF, Freire Júnior AM, Bitarães C, Milagres AC, Callegari ED, Simplicio MIC, Ribeiro LB, Oliveira R, Harari O, Wilson LA, Forrest JI, Ruton H, Sprague S, McKay P, Guo CM, Limbrick-Oldfield EH, Kanters S, Guyatt GH, Rayner CR, Kandel C, Biondi MJ, Kozak R, Hansen B, Zahoor MA, Arora P, Hislop C, Choong I, Feld JJ, Mills EJ, Glenn JS. Early Treatment with Pegylated Interferon Lambda for Covid-19. N Engl J Med 2023; 388:518-528. [PMID: 36780676 PMCID: PMC9933926 DOI: 10.1056/nejmoa2209760] [Citation(s) in RCA: 74] [Impact Index Per Article: 74.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
BACKGROUND The efficacy of a single dose of pegylated interferon lambda in preventing clinical events among outpatients with acute symptomatic coronavirus disease 2019 (Covid-19) is unclear. METHODS We conducted a randomized, controlled, adaptive platform trial involving predominantly vaccinated adults with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Brazil and Canada. Outpatients who presented with an acute clinical condition consistent with Covid-19 within 7 days after the onset of symptoms received either pegylated interferon lambda (single subcutaneous injection, 180 μg) or placebo (single injection or oral). The primary composite outcome was hospitalization (or transfer to a tertiary hospital) or an emergency department visit (observation for >6 hours) due to Covid-19 within 28 days after randomization. RESULTS A total of 933 patients were assigned to receive pegylated interferon lambda (2 were subsequently excluded owing to protocol deviations) and 1018 were assigned to receive placebo. Overall, 83% of the patients had been vaccinated, and during the trial, multiple SARS-CoV-2 variants had emerged. A total of 25 of 931 patients (2.7%) in the interferon group had a primary-outcome event, as compared with 57 of 1018 (5.6%) in the placebo group, a difference of 51% (relative risk, 0.49; 95% Bayesian credible interval, 0.30 to 0.76; posterior probability of superiority to placebo, >99.9%). Results were generally consistent in analyses of secondary outcomes, including time to hospitalization for Covid-19 (hazard ratio, 0.57; 95% Bayesian credible interval, 0.33 to 0.95) and Covid-19-related hospitalization or death (hazard ratio, 0.59; 95% Bayesian credible interval, 0.35 to 0.97). The effects were consistent across dominant variants and independent of vaccination status. Among patients with a high viral load at baseline, those who received pegylated interferon lambda had lower viral loads by day 7 than those who received placebo. The incidence of adverse events was similar in the two groups. CONCLUSIONS Among predominantly vaccinated outpatients with Covid-19, the incidence of hospitalization or an emergency department visit (observation for >6 hours) was significantly lower among those who received a single dose of pegylated interferon lambda than among those who received placebo. (Funded by FastGrants and others; TOGETHER ClinicalTrials.gov number, NCT04727424.).
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Affiliation(s)
- Gilmar Reis
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Eduardo A S Moreira Silva
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Daniela C Medeiros Silva
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Lehana Thabane
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Vitoria H S Campos
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Thiago S Ferreira
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Castilho V Q Santos
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Ana M R Nogueira
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Ana P F G Almeida
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Leonardo C M Savassi
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Adhemar D Figueiredo-Neto
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Ana C F Dias
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Adelino M Freire Júnior
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Carina Bitarães
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Aline C Milagres
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Eduardo D Callegari
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Maria I C Simplicio
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Luciene B Ribeiro
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Rosemary Oliveira
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Ofir Harari
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Lindsay A Wilson
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Jamie I Forrest
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Hinda Ruton
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Sheila Sprague
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Paula McKay
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Christina M Guo
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Eve H Limbrick-Oldfield
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Steve Kanters
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Gordon H Guyatt
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Craig R Rayner
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Christopher Kandel
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Mia J Biondi
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Robert Kozak
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Bettina Hansen
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - M Atif Zahoor
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Paul Arora
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Colin Hislop
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Ingrid Choong
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Jordan J Feld
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Edward J Mills
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
| | - Jeffrey S Glenn
- From ViRx@Stanford, Stanford Biosecurity and Pandemic Preparedness Initiative (G.R., J.S.G., E.J.M.), and the Departments of Medicine (Division of Gastroenterology and Hepatology) and Microbiology and Immunology, Stanford University School of Medicine (J.S.G.), Stanford, and the Veterans Affairs Medical Center (J.S.G.) and Eiger BioPharmaceuticals (C.H., I.C.), Palo Alto - all in California; the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., T.S.F., C.V.Q.S., M.I.C.S., L.B.R., R.O.), the Department of Medicine, Pontifícia Universidade Católica de Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., V.H.S.C., C.V.Q.S.), and Target Medicina de Precisão (A.C.F.D., A.M.F.J.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (L.C.M.S., C.B., A.C.M.), the Public Health Care Division, Ibirité (C.B., A.C.M.), the Department of Public Health at UNIFIPMoc and Family Medicine Fellowship Program, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.-N.), and the Public Health Care Division, Brumadinho (E.D.C., B.H.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (G.R., L.T., S.S., P.M., G.H.G., E.J.M.), Cytel (O.H., H.R., P.A., E.J.M.), Platform Life Sciences (L.A.W., J.I.F., C.M.G., E.J.M.), and RainCity Analytics (E.H.L.-O., S.K.), Vancouver, BC, Michael Garron Hospital (C.K.) and the Toronto Centre for Liver Disease, University Health Network (M.A.Z., J.J.F.), University of Toronto, the School of Nursing, York University (M.J.B.), and Sunnybrook Health Sciences Centre (R.K.), Toronto - all in Canada; Certara, Princeton, NJ (C.R.R.); Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.); and Erasmus University Rotterdam, Rotterdam, the Netherlands (B.H.)
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Turkstra LS, Salanki K, MacIntyre E, Kim N, Jin J, Sprague S, Scott T, Bhandari M. What Is the Prevalence of Intimate Partner Violence and Traumatic Brain Injury in Fracture Clinic Patients? Clin Orthop Relat Res 2023; 481:132-142. [PMID: 36200843 PMCID: PMC9750668 DOI: 10.1097/corr.0000000000002329] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 06/28/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Individuals in violent intimate relationships are at a high risk of sustaining both orthopaedic fractures and traumatic brain injury (TBI), and the fracture clinic may be the first place that concurrent intimate partner violence (IPV) and TBI are recognized. Both IPV and TBI can affect all aspects of fracture management, but prevalence of TBI and comorbid TBI and IPV is unknown. QUESTIONS/PURPOSES (1) What are the previous-year and lifetime prevalence of IPV and TBI in women presenting to an outpatient orthopaedic fracture clinic? (2) What are the conditional probabilities of TBI in the presence of IPV and the reverse, to explore whether screening for one condition could effectively identify patients with the other? (3) Do patients with TBI, IPV, or both have worse neurobehavioral symptoms than patients without TBI and IPV? METHODS The study was completed in the fracture clinic at a community Level 1 trauma center in Southern Ontario from July 2018 to March 2019 and included patients seen by three orthopaedic surgeons. Inclusion criteria were self-identification as a woman, age 18 years or older, and the ability to complete forms in English without assistance from the person who brought them to the clinic (for participant safety and privacy). We invited 263 women to participate: 22 were ineligible (for example, they were patients of a surgeon who was not on the study protocol), 87 declined before hearing the topic of the study, and data from eight were excluded because the data were incomplete or lost. Complete data were obtained from 146 participants. Participants' mean age was 52 ± 16 years, and the most common diagnosis was upper or lower limb fracture. Prevalence of IPV was calculated as the number of women who answered "sometimes" or "often" to direct questions from the Woman Abuse Screening Tool, which asks about physical, emotional, and sexual abuse in the past year or person's lifetime. The prevalence of TBI was calculated as the number of women who reported at least one head or neck injury that resulted in feeling dazed or confused or in loss of consciousness lasting 30 minutes or less on the Ohio State University Traumatic Brain Injury Identification Method, a standardized procedure for eliciting lifetime history of TBI through a 3- to 5-minute structured interview. Conditional probabilities were calculated using a Bayesian analysis. Neurobehavioral symptoms were characterized using the Neurobehavioral Symptom Inventory, a standard self-report measure of everyday emotional, somatic, and cognitive complaints after TBI, with total scores compared across groups using a one-way ANOVA. RESULTS Previous-year prevalence of physical IPV was 7% (10 of 146), and lifetime prevalence was 28% (41 of 146). Previous-year prevalence of TBI was 8% (12 of 146), and lifetime prevalence was 49% (72 of 146). The probability of TBI in the presence of IPV was 0.77, and probability of IPV in the presence of TBI was 0.36. Thus, screening for IPV identified proportionately more patients with TBI than screening for TBI, but the reverse was not true. Neurobehavioral Symptom Inventory scores were higher (more symptoms) in patients with TBI only (23 ± 16) than those with fractures only (12 ± 11, mean difference 11 [95% CI 8 to 18]; p < 0.001), in those with IPV only (17 ± 11) versus fractures only (mean difference 5 [95% CI -1 to -11]; p < 0.05), and in those with both TBI and IPV (25 ± 14) than with fractures only (mean difference 13 [95% CI 8 to 18]; p < 0.001) or those with IPV alone (17 ± 11, mean difference 8 [95% CI -1 to 16]; p < 0.05). CONCLUSION Using a brief screening interview, we identified a high self-reported prevalence of TBI and IPV alone, consistent with previous studies, and a novel finding of high comorbidity of IPV and TBI. Given that the fracture clinic may be the first healthcare contact for women with IPV and TBI, especially mild TBI associated with IPV, we recommend educating frontline staff on how to identify IPV and TBI as well as implementing brief screening and referral and universal design modifications that support effective, efficient, and accurate communication patients with TBI-related cognitive and communication challenges. LEVEL OF EVIDENCE Level II, prognostic study.
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Affiliation(s)
- Lyn. S. Turkstra
- School of Rehabilitation Science, McMaster University, Hamilton, ON, Canada
- Centre for Advanced Research in Experimental and Applied Linguistics, McMaster University, Hamilton, ON, Canada
| | - Krista Salanki
- Centre for Advanced Research in Experimental and Applied Linguistics, McMaster University, Hamilton, ON, Canada
| | - Emily MacIntyre
- Centre for Advanced Research in Experimental and Applied Linguistics, McMaster University, Hamilton, ON, Canada
| | - Noel Kim
- Centre for Advanced Research in Experimental and Applied Linguistics, McMaster University, Hamilton, ON, Canada
| | - Jonathan Jin
- Centre for Advanced Research in Experimental and Applied Linguistics, McMaster University, Hamilton, ON, Canada
| | - Sheila Sprague
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Taryn Scott
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Mohit Bhandari
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
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14
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Slobogean GP, Bzovsky S, O'Hara NN, Marchand LS, Hannan ZD, Demyanovich HK, Connelly DW, Adachi JD, Thabane L, Sprague S, Sprague S, Adachi JD, Bhandari M, Thabane L, Holick MF, Bzovsky S, Simunovic N, Madden K, Scott T, Duong A, Heels‐Ansdell D, Hannan ZD, Connelly DW, Rudnicki J, Pollak AN, O'Toole RV, LeBrun C, Nascone JW, Sciadini MF, Degani Y, Pensy R, Manson T, Eglseder WA, Langhammer CG, Johnson AJ, O'Hara NN, Demyanovich H, Howe A, Marinos D, Mascarenhas D, Reahl G, Ordonio K, Isaac M, Udogwu U, Baker M, Mulliken A, Atchison J, Schloss MG, Zaidi SMR, McKegg PC, DeLeon GA, Ghulam QM, Camara M, Marchand LS. Effect of Vitamin D 3 Supplementation on Acute Fracture Healing: A Phase II Screening Randomized Double-Blind Controlled Trial. JBMR Plus 2022; 7:e10705. [PMID: 36699638 PMCID: PMC9850434 DOI: 10.1002/jbm4.10705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 11/20/2022] Open
Abstract
Nearly half of adult fracture patients are vitamin D deficient (serum 25-hydroxyvitamin D [25(OH)D] levels <20 ng/mL). Many surgeons advocate prescribing vitamin D supplements to improve fracture healing outcomes; however, data supporting the effectiveness of vitamin D3 supplements to improve acute fracture healing are lacking. We tested the effectiveness of vitamin D3 supplementation for improving tibia and femur fracture healing. We conducted a single-center, double-blinded phase II screening randomized controlled trial with a 12-month follow-up. Patients aged 18-50 years receiving an intramedullary nail for a tibia or femoral shaft fracture were randomized 1:1:1:1 to receive (i) 150,000 IU loading dose vitamin D3 at injury and 6 weeks (n = 27); (ii) 4000 IU vitamin D3 daily (n = 24); (iii) 600 IU vitamin D3 daily (n = 24); or (iv) placebo (n = 27). Primary outcomes were clinical fracture healing (Function IndeX for Trauma [FIX-IT]) and radiographic fracture healing (Radiographic Union Score for Tibial fractures [RUST]) at 3 months. One hundred two patients with a mean age of 29 years (standard deviation 8) were randomized. The majority were male (69%), and 56% were vitamin D3 deficient at baseline. Ninety-nine patients completed the 3-month follow-up. In our prespecified comparisons, no clinically important or statistically significant differences were detected in RUST or FIX-IT scores between groups when measured at 3 months and over 12 months. However, in a post hoc comparison, high doses of vitamin D3 were associated with improved clinical fracture healing relative to placebo at 3 months (mean difference [MD] 0.90, 80% confidence interval [CI], 0.08 to 1.79; p = 0.16) and within 12 months (MD 0.89, 80% CI, 0.05 to 1.74; p = 0.18). The study was designed to identify potential evidence to support the effectiveness of vitamin D3 supplementation in improving acute fracture healing. Vitamin D3 supplementation, particularly high doses, might modestly improve acute tibia or femoral shaft fracture healing in healthy adults, but confirmatory studies are required. The Vita-Shock trial was awarded the Orthopaedic Trauma Association's (OTA) Bovill Award in 2020. This award is presented annually to the authors of the most outstanding OTA Annual Meeting scientific paper. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Gerard P. Slobogean
- R Adams Cowley Shock Trauma Center, Department of OrthopaedicsUniversity of Maryland School of MedicineBaltimoreMDUSA
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of SurgeryMcMaster UniversityHamiltonCanada
| | - Nathan N. O'Hara
- R Adams Cowley Shock Trauma Center, Department of OrthopaedicsUniversity of Maryland School of MedicineBaltimoreMDUSA
| | | | - Zachary D. Hannan
- R Adams Cowley Shock Trauma Center, Department of OrthopaedicsUniversity of Maryland School of MedicineBaltimoreMDUSA
| | - Haley K. Demyanovich
- R Adams Cowley Shock Trauma Center, Department of OrthopaedicsUniversity of Maryland School of MedicineBaltimoreMDUSA
| | - Daniel W. Connelly
- R Adams Cowley Shock Trauma Center, Department of OrthopaedicsUniversity of Maryland School of MedicineBaltimoreMDUSA
| | | | - Lehana Thabane
- Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonCanada
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of SurgeryMcMaster UniversityHamiltonCanada,Department of Health Research Methods, Evidence, and ImpactMcMaster UniversityHamiltonCanada
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15
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van de Kuit A, Oosterhoff JHF, Dijkstra H, Sprague S, Bzovsky S, Bhandari M, Swiontkowski M, Schemitsch EH, IJpma FFA, Poolman RW, Doornberg JN, Hendrickx LAM. Patients With Femoral Neck Fractures Are at Risk for Conversion to Arthroplasty After Internal Fixation: A Machine-learning Algorithm. Clin Orthop Relat Res 2022; 480:2350-2360. [PMID: 35767811 PMCID: PMC9653184 DOI: 10.1097/corr.0000000000002283] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 05/31/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Femoral neck fractures are common and are frequently treated with internal fixation. A major disadvantage of internal fixation is the substantially high number of conversions to arthroplasty because of nonunion, malunion, avascular necrosis, or implant failure. A clinical prediction model identifying patients at high risk of conversion to arthroplasty may help clinicians in selecting patients who could have benefited from arthroplasty initially. QUESTION/PURPOSE What is the predictive performance of a machine-learning (ML) algorithm to predict conversion to arthroplasty within 24 months after internal fixation in patients with femoral neck fractures? METHODS We included 875 patients from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial. The FAITH trial consisted of patients with low-energy femoral neck fractures who were randomly assigned to receive a sliding hip screw or cancellous screws for internal fixation. Of these patients, 18% (155 of 875) underwent conversion to THA or hemiarthroplasty within the first 24 months. All patients were randomly divided into a training set (80%) and test set (20%). First, we identified 27 potential patient and fracture characteristics that may have been associated with our primary outcome, based on biomechanical rationale and previous studies. Then, random forest algorithms (an ML learning, decision tree-based algorithm that selects variables) identified 10 predictors of conversion: BMI, cardiac disease, Garden classification, use of cardiac medication, use of pulmonary medication, age, lung disease, osteoarthritis, sex, and the level of the fracture line. Based on these variables, five different ML algorithms were trained to identify patterns related to conversion. The predictive performance of these trained ML algorithms was assessed on the training and test sets based on the following performance measures: (1) discrimination (the model's ability to distinguish patients who had conversion from those who did not; expressed with the area under the receiver operating characteristic curve [AUC]), (2) calibration (the plotted estimated versus the observed probabilities; expressed with the calibration curve intercept and slope), and (3) the overall model performance (Brier score: a composite of discrimination and calibration). RESULTS None of the five ML algorithms performed well in predicting conversion to arthroplasty in the training set and the test set; AUCs of the algorithms in the training set ranged from 0.57 to 0.64, slopes of calibration plots ranged from 0.53 to 0.82, calibration intercepts ranged from -0.04 to 0.05, and Brier scores ranged from 0.14 to 0.15. The algorithms were further evaluated in the test set; AUCs ranged from 0.49 to 0.73, calibration slopes ranged from 0.17 to 1.29, calibration intercepts ranged from -1.28 to 0.34, and Brier scores ranged from 0.13 to 0.15. CONCLUSION The predictive performance of the trained algorithms was poor, despite the use of one of the best datasets available worldwide on this subject. If the current dataset consisted of different variables or more patients, the performance may have been better. Also, various reasons for conversion to arthroplasty were pooled in this study, but the separate prediction of underlying pathology (such as, avascular necrosis or nonunion) may be more precise. Finally, it may be possible that it is inherently difficult to predict conversion to arthroplasty based on preoperative variables alone. Therefore, future studies should aim to include more variables and to differentiate between the various reasons for arthroplasty. LEVEL OF EVIDENCE Level III, prognostic study.
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Affiliation(s)
- Anouk van de Kuit
- Department of Orthopaedic Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Jacobien H. F. Oosterhoff
- Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Orthopaedic Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Hidde Dijkstra
- Department of Trauma Surgery, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Sheila Sprague
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Mohit Bhandari
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Marc Swiontkowski
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA
| | | | - Frank F. A. IJpma
- Department of Trauma Surgery, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
| | - Rudolf W. Poolman
- Department of Orthopaedic Surgery, University Medical Center Leiden, Leiden University, Leiden, the Netherlands
| | - Job N. Doornberg
- Department of Orthopaedic Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
- Department of Trauma Surgery, University Medical Centre Groningen, University of Groningen, Groningen, the Netherlands
- Department of Orthopaedic and Trauma Surgery, Flinders Medical Centre, Flinders University, Adelaide, Australia
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16
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O'Hara NN, Wu J, Rolle N, Sprague S, Devereaux PJ, Borges FK, Slobogean GP. Hip Fracture With Elevated Troponin: Harbinger of Mortality or Need for Accelerated Surgery? J Orthop Trauma 2022; 36:604-609. [PMID: 36037426 DOI: 10.1097/bot.0000000000002444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To determine the association of elevated troponin levels with time to surgery and the risk of mortality and other key clinical outcomes among elderly patients with hip fracture who had measured troponin levels at hospital admission. DESIGN Retrospective cohort study. SETTING Single academic trauma center. PATIENTS We included 299 consecutive patients 60 years of age or older with a hip fracture and cardiac troponin levels measured at the time of hospital admission. INTERVENTION Patients with elevated cardiac troponin levels at hospital admission (n = 43) compared with patients with normal troponin levels at admission (n = 256). MAIN OUTCOME MEASURES Time to surgery, 90-day mortality, and major complications within 90 days of injury. RESULTS The median age of the cohort was 80 years (interquartile range, 70-87 years), 59% were female, and 86% were living independently before their injury. Elevated troponin levels were associated with a 21-hour [95% confidence interval (CI), 12 to 32, P < 0.001] increase in the median time from admission to surgery (43 vs. 22 hours). Elevated troponin levels were also associated with a 14% (95% CI, 0% to 29%, P = 0.01) absolute increase in 90-day mortality (28% vs. 14%). Patients with elevated troponins were 15% (95% CI, -1% to 30%, P = 0.06) more likely to have a major complication (37% vs. 23%); however, the difference did not reach statistical significance. CONCLUSIONS Among patients with a hip fracture and measured troponin levels, elevated troponin levels were associated with significant delays in surgery and increased 90-day mortality. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Nathan N O'Hara
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD
| | - Jocelyn Wu
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD
| | - Nicholas Rolle
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD
| | - Sheila Sprague
- Department of Surgery, McMaster University, Hamilton, ON; and
| | - P J Devereaux
- Population Health Research Institute, McMaster University, Hamilton, ON
| | - Flavia K Borges
- Population Health Research Institute, McMaster University, Hamilton, ON
| | - Gerard P Slobogean
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD
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17
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Bogoch E, Marcano-Fernández FA, Schemitsch EH, Zhou Q, Bzovsky S, Bhandari M, Schneider PS, Swiontkowski M, Sprague S. High Rates of Imminent Subsequent Fracture After Femoral Neck Fracture in the Elderly. J Bone Joint Surg Am 2022; 104:1984-1992. [PMID: 36017942 DOI: 10.2106/jbjs.22.00088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Fragility fractures of the hip are known to be followed frequently by subsequent fragility fractures, including second hip fractures. Data on subsequent fractures are available for aggregated index femoral neck and intertrochanteric femoral fractures, grouped generically as hip fractures, but not specifically for femoral neck fractures. There is increasing recognition that a subsequent fracture often occurs early after a hip fracture in the elderly, creating an emphasis on the concept of "imminent fracture risk." Since 2000, there have been many reports on the care gap in interventions after a fragility fracture, with concern regarding the slow uptake of appropriate systemic treatments designed to prevent a subsequent fracture in high-risk patients. METHODS As planned a priori, we performed an analysis of subsequent fractures after an index femoral neck fracture in 2 prospective clinical trials involving 2,520 patients from 90 sites on 5 continents. We recorded the incidence and time of occurrence of all secondary fragility fractures as well as the reported use of bone-protective medication in all subjects. RESULTS In the 24 months following the index femoral neck fracture, 226 (9.0%) of 2,520 patients sustained at least 1 subsequent fragility fracture, including 113 hip fractures (4.5%). The median interval from the index fracture to a subsequent fracture was approximately 9.0 months. Only 25.2% (634) of the 2,520 patients reported using bone-protective medications at any time during follow-up. Female patients, those with nondisplaced index fractures, and those treated with arthroplasty, were more likely to have received protective medication. CONCLUSIONS Subsequent fractures, including second hip fractures, occurred frequently and early following an index femoral neck fracture in 2 large global cohorts. Interventions to prevent a subsequent fracture were instituted in only 1 of 4 patients, even though a focused directive was included in both study protocols. LEVEL OF EVIDENCE Prognostic Level II . See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Earl Bogoch
- Department of Surgery, University of Toronto, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada
| | - Francesc A Marcano-Fernández
- Orthopaedic Department, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Emil H Schemitsch
- Department of Surgery, University of Western Ontario, London, Ontario, Canada
| | - Qi Zhou
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Mohit Bhandari
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Prism S Schneider
- Division of Orthopaedic Trauma, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Marc Swiontkowski
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minnesota
| | - Sheila Sprague
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
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18
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Gitajn IL, Werth P, Fernandes E, Sprague S, O'Hara NN, Bzovsky S, Marchand LS, Patterson JT, Lee C, Slobogean GP. Association of Patient-Level and Hospital-Level Factors With Timely Fracture Care by Race. JAMA Netw Open 2022; 5:e2244357. [PMID: 36449289 PMCID: PMC9713603 DOI: 10.1001/jamanetworkopen.2022.44357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
IMPORTANCE Racial disparities in treatment benchmarks have been documented among older patients with hip fractures. However, these studies were limited to patient-level evaluations. OBJECTIVE To assess whether disparities in meeting fracture care time-to-surgery benchmarks exist at the patient level or at the hospital or institutional level using high-quality multicenter prospectively collected data; the study hypothesis was that disparities at the hospital-level reflecting structural health systems issues would be detected. DESIGN, SETTING, AND PARTICIPANTS This cohort study was a secondary analysis of prospectively collected data in the PREP-IT (Program of Randomized trials to Evaluate Preoperative antiseptic skin solutions in orthopaedic Trauma) program from 23 sites throughout North America. The PREP-IT trials enrolled patients from 2018 to 2021, and patients were followed for 1-year. All patients with hip and femur fractures enrolled in the PREP-IT program were included in analysis. Data were analyzed April to September 2022. EXPOSURES Patient-level and hospital-level race, ethnicity, and insurance status. MAIN OUTCOMES AND MEASURES Primary outcome measure was time to surgery based on 24-hour time-to-surgery benchmarks. Multilevel multivariate regression models were used to evaluate the association of race, ethnicity, and insurance status with time to surgery. The reported odds ratios (ORs) were per 10% change in insurance coverage or racial composition at the hospital level. RESULTS A total of 2565 patients with a mean (SD) age of 64.5 (20.4) years (1129 [44.0%] men; mean [SD] body mass index, 27.3 [14.9]; 83 [3.2%] Asian, 343 [13.4%] Black, 2112 [82.3%] White, 28 [1.1%] other) were included in analysis. Of these patients, 834 (32.5%) were employed and 2367 (92.2%) had insurance; 1015 (39.6%) had sustained a femur fracture, with a mean (SD) injury severity score of 10.4 (5.8). Five hundred ninety-six patients (23.2%) did not meet the 24-hour time-to-operating-room benchmark. After controlling for patient-level characteristics, there was an independent association between missing the 24-hour benchmark and hospital population insurance coverage (OR, 0.94; 95% CI, 0.89-0.98; P = .005) and the interaction term between hospital population insurance coverage and racial composition (OR, 1.03; 95% CI, 1.01-1.05; P = .03). There was no association between patient race and delay beyond 24-hour benchmarks (OR, 0.96; 95% CI, 0.72-1.29; P = .79). CONCLUSIONS AND RELEVANCE In this cohort study, patients who sought care from an institution with a greater proportion of patients with racial or ethnic minority status or who were uninsured were more likely to experience delays greater than the 24-hour benchmarks regardless of the individual patient race; institutions that treat a less diverse patient population appeared to be more resilient to the mix of insurance status in their patient population and were more likely to meet time-to-surgery benchmarks, regardless of patient insurance status or population-based insurance mix. While it is unsurprising that increased delays were associated with underfunded institutions, the association between institutional-level racial disparity and surgical delays implies structural health systems bias.
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Affiliation(s)
| | - Paul Werth
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
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19
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Busse JW, Sprague S. Cognitive Behavioural Therapy to Optimize Post-Operative Fracture Recovery (COPE): protocol for a randomized controlled trial. Trials 2022; 23:894. [PMID: 36273187 PMCID: PMC9587572 DOI: 10.1186/s13063-022-06835-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/10/2022] [Indexed: 11/20/2022] Open
Abstract
IMPORTANCE Chronic, non-cancer pain affects approximately 20-30% of the population in North America, Europe, and Australia, with surgery and trauma frequently cited as inciting events. Prospective studies of fracture patients have demonstrated an association between somatic pre-occupation, poor coping, and low recovery expectations following surgery with persistent pain, functional limitations, and lower rates of return to work. Psychological interventions, such as cognitive behavioural therapy (CBT), that are designed to modify unhelpful beliefs and behaviours have the potential to reduce persistent post-surgical pain and its associated effects among trauma patients. OBJECTIVE To determine whether online CBT, versus usual care, reduces the prevalence of moderate to severe persistent post-surgical pain among participants with an open or closed fracture of the appendicular skeleton. DESIGN, SETTING, AND PARTICIPANTS The Cognitive Behavioural Therapy to Optimize Post-Operative Fracture Recovery (COPE) protocol will be followed to conduct a multi-centre randomized controlled trial. Participants undergoing surgical repair of a long bone fracture will be randomized to receive either (1) online CBT modules with asynchronous therapist feedback or (2) usual care. The primary outcome will be the prevalence of moderate to severe persistent post-surgical pain over 12 months post-fracture. Secondary outcomes include the Short Form-36 Physical and Mental Component Summary scores, return to function, pain severity and pain interference over 12 months post-fracture, and the proportion of patients prescribed opioid class medications (and average dose) at 6 and 12 months post-fracture. The COPE trial will enroll 1000 participants with open and closed fractures of the appendicular skeleton from approximately 10 hospitals in North America. DISCUSSION If CBT is effective in improving outcomes among patients with traumatic fractures, our findings will promote a new model of care that incorporates psychological barriers to recovery. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04274530. Registered on 14 February 2020.
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Affiliation(s)
- Jason W. Busse
- grid.25073.330000 0004 1936 8227Department of Anesthesia, Michael G. DeGroote School of Medicine, McMaster University, HSC-2V9, 1280 Main St. West, Hamilton, L8S 4K1 Canada
| | - Sheila Sprague
- 293 Wellington St. N, Suite 110, Hamilton, ON L8L 8E7 Canada
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Slobogean GP, Sprague S, Wells JL, Bhandari M, Harris AD, Mullins CD, Thabane L, Wood A, Della Rocca GJ, Hebden JN, Jeray KJ, Marchand LS, O'Hara LM, Zura RD, Lee C, Patterson JT, Gardner MJ, Blasman J, Davies J, Liang S, Taljaard M, Devereaux PJ, Guyatt G, Heels-Ansdell D, Marvel D, Palmer JE, Friedrich J, O'Hara NN, Grissom F, Gitajn IL, Morshed S, O'Toole RV, Petrisor B, Mossuto F, Joshi MG, D'Alleyrand JCG, Fowler J, Rivera JC, Talbot M, Pogorzelski D, Dodds S, Li S, Del Fabbro G, Szasz OP, Bzovsky S, McKay P, Minea A, Murphy K, Howe AL, Demyanovich HK, Hoskins W, Medeiros M, Polk G, Kettering E, Mahal N, Eglseder A, Johnson A, Langhammer C, Lebrun C, Nascone J, Pensy R, Pollak A, Sciadini M, Degani Y, Phipps H, Hempen E, Johal H, Ristevski B, Williams D, Denkers M, Rajaratnam K, Al-Asiri J, Gallant JL, Pusztai K, MacRae S, Renaud S, Adams JD, Beckish ML, Bray CC, Brown TR, Cross AW, Dew T, Faucher GK, Gurich Jr RW, Lazarus DE, Millon SJ, Moody MC, Palmer MJ, Porter SE, Schaller TM, Sridhar MS, Sanders JL, Rudisill Jr LE, Garitty MJ, Poole AS, Sims ML, Walker CM, Carlisle R, Hofer EA, Huggins B, Hunter M, Marshall W, Ray SB, Smith C, Altman KM, Pichiotino ER, Quirion JC, Loeffler MF, Cole AA, Maltz EJ, Parker W, Ramsey TB, Burnikel A, Colello M, Stewart R, Wise J, Anderson M, Eskew J, Judkins B, Miller JM, Tanner SL, Snider RG, Townsend CE, Pham KH, Martin A, Robertson E, Bray E, Sykes JW, Yoder K, Conner K, Abbott H, Natoli RM, McKinley TO, Virkus WW, Sorkin AT, Szatkowski JP, Mullis BH, Jang Y, Lopas LA, Hill LC, Fentz CL, Diaz MM, Brown K, Garst KM, Denari EW, Osborn P, Pierrie SN, Kessler B, Herrera M, Miclau T, Marmor MT, Matityahu A, McClellan RT, Shearer D, Toogood P, Ding A, Murali J, El Naga A, Tangtiphaiboontana J, Belaye T, Berhaneselase E, Pokhvashchev D, Obremskey WT, Jahangir AA, Sethi M, Boyce R, Stinner DJ, Mitchell PP, Trochez K, Rodriguez E, Pritchett C, Hogan N, Fidel Moreno A, Hagen JE, Patrick M, Vlasak R, Krupko T, Talerico M, Horodyski M, Pazik M, Lossada-Soto E, Gary JL, Warner SJ, Munz JW, Choo AM, Achor TS, Routt ML“C, Kutzler M, Boutte S, Warth RJ, Prayson MJ, Venkatarayappa I, Horne B, Jerele J, Clark L, Boulton C, Lowe J, Ruth JT, Askam B, Seach A, Cruz A, Featherston B, Carlson R, Romero I, Zarif I, Dehghan N, McKee M, Jones CB, Sietsema DL, Williams A, Dykes T, Guerra-Farfan E, Tomas-Hernandez J, Teixidor-Serra J, Molero-Garcia V, Selga-Marsa J, Porcel-Vazquez JA, Andres-Peiro JV, Esteban-Feliu I, Vidal-Tarrason N, Serracanta J, Nuñez-Camarena J, del Mar Villar-Casares M, Mestre-Torres J, Lalueza-Broto P, Moreira-Borim F, Garcia-Sanchez Y, Marcano-Fernández F, Martínez-Carreres L, Martí-Garín D, Serrano-Sanz J, Sánchez-Fernández J, Sanz-Molero M, Carballo A, Pelfort X, Acerboni-Flores F, Alavedra-Massana A, Anglada-Torres N, Berenguer A, Cámara-Cabrera J, Caparros-García A, Fillat-Gomà F, Fuentes-López R, Garcia-Rodriguez R, Gimeno-Calavia N, Martínez-Álvarez M, Martínez-Grau P, Pellejero-García R, Ràfols-Perramon O, Peñalver JM, Salomó Domènech M, Soler-Cano A, Velasco-Barrera A, Yela-Verdú C, Bueno-Ruiz M, Sánchez-Palomino E, Andriola V, Molina-Corbacho M, Maldonado-Sotoca Y, Gasset-Teixidor A, Blasco-Moreu J, Fernández-Poch N, Rodoreda-Puigdemasa J, Verdaguer-Figuerola A, Cueva-Sevieri HE, Garcia-Gimenez S, Viskontas DG, Apostle KL, Boyer DS, Moola FO, Perey BH, Stone TB, Lemke HM, Spicer E, Payne K, Hymes RA, Schwartzbach CC, Schulman JE, Malekzadeh AS, Holzman MA, Gaski GE, Wills J, Pilson H, Carroll EA, Halvorson JJ, Babcock S, Goodman JB, Holden MB, Williams W, Hill T, Brotherton A, Romeo NM, Vallier HA, Vergon A, Higgins TF, Haller JM, Rothberg DL, Olsen ZM, McGowan AV, Hill S, Dauk MK, Bergin PF, Russell GV, Graves ML, Morellato J, McGee SL, Bhanat EL, Yener U, Khanna R, Nehete P, Potter D, VanDemark III R, Seabold K, Staudenmier N, Coe M, Dwyer K, Mullin DS, Chockbengboun TA, DePalo Sr. PA, Phelps K, Bosse M, Karunakar M, Kempton L, Sims S, Hsu J, Seymour R, Churchill C, Mayfield A, Sweeney J, Jaeblon T, Beer R, Bauer B, Meredith S, Talwar S, Domes CM, Gage MJ, Reilly RM, Paniagua A, Dupree J, Weaver MJ, von Keudell AG, Sagona AE, Mehta S, Donegan D, Horan A, Dooley M, Heng M, Harris MB, Lhowe DW, Esposito JG, Alnasser A, Shannon SF, Scott AN, Clinch B, Weber B, Beltran MJ, Archdeacon MT, Sagi HC, Wyrick JD, Le TT, Laughlin RT, Thomson CG, Hasselfeld K, Lin CA, Vrahas MS, Moon CN, Little MT, Marecek GS, Dubuclet DM, Scolaro JA, Learned JR, Lim PK, Demas S, Amirhekmat A, Dela Cruz YM. Aqueous skin antisepsis before surgical fixation of open fractures (Aqueous-PREP): a multiple-period, cluster-randomised, crossover trial. Lancet 2022; 400:1334-1344. [PMID: 36244384 DOI: 10.1016/s0140-6736(22)01652-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/18/2022] [Accepted: 08/23/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Chlorhexidine skin antisepsis is frequently recommended for most surgical procedures; however, it is unclear if these recommendations should apply to surgery involving traumatic contaminated wounds where povidone-iodine has previously been preferred. We aimed to compare the effect of aqueous 10% povidone-iodine versus aqueous 4% chlorhexidine gluconate on the risk of surgical site infection in patients who required surgery for an open fracture. METHODS We conducted a multiple-period, cluster-randomised, crossover trial (Aqueous-PREP) at 14 hospitals in Canada, Spain, and the USA. Eligible patients were adults aged 18 years or older with an open extremity fracture treated with a surgical fixation implant. For inclusion, the open fracture required formal surgical debridement within 72 h of the injury. Participating sites were randomly assigned (1:1) to use either aqueous 10% povidone-iodine or aqueous 4% chlorhexidine gluconate immediately before surgical incision; sites then alternated between the study interventions every 2 months. Participants, health-care providers, and study personnel were aware of the treatment assignment due to the colour of the solutions. The outcome adjudicators and data analysts were masked to treatment allocation. The primary outcome was surgical site infection, guided by the 2017 US Centers for Disease Control and Prevention National Healthcare Safety Network reporting criteria, which included superficial incisional infection within 30 days or deep incisional or organ space infection within 90 days of surgery. The primary analyses followed the intention-to-treat principle and included all participants in the groups to which they were randomly assigned. This study is registered with ClinicalTrials.gov, NCT03385304. FINDINGS Between April 8, 2018, and June 8, 2021, 3619 patients were assessed for eligibility and 1683 were enrolled and randomly assigned to povidone-iodine (n=847) or chlorhexidine gluconate (n=836). The trial's adjudication committee determined that 45 participants were ineligible, leaving 1638 participants in the primary analysis, with 828 in the povidone-iodine group and 810 in the chlorhexidine gluconate group (mean age 44·9 years [SD 18·0]; 629 [38%] were female and 1009 [62%] were male). Among 1571 participants in whom the primary outcome was known, a surgical site infection occurred in 59 (7%) of 787 participants in the povidone-iodine group and 58 (7%) of 784 in the chlorhexidine gluconate group (odds ratio 1·11, 95% CI 0·74 to 1·65; p=0·61; risk difference 0·6%, 95% CI -1·4 to 3·4). INTERPRETATION For patients who require surgical fixation of an open fracture, either aqueous 10% povidone-iodine or aqueous 4% chlorhexidine gluconate can be selected for skin antisepsis on the basis of solution availability, patient contraindications, or product cost. These findings might also have implications for antisepsis of other traumatic wounds. FUNDING US Department of Defense, Canadian Institutes of Health Research, McMaster University Surgical Associates, PSI Foundation.
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21
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Pogorzelski D, McKay P, Weaver MJ, Jaeblon T, Hymes RA, Gaski GE, Fraifogl J, Ahn JS, Bzovsky S, Slobogean G, Sprague S, Slobogean GP, Sprague S, Wells J, Bhandari M, O'Toole RV, D'Alleyrand JC, Eglseder A, Johnson A, Langhammer C, Lebrun C, Nascone J, Pensy R, Pollak A, Sciadini M, Slobogean GP, Degani Y, Demyanovich HK, Howe A, O'Hara NN, Phipps H, Hempen E. The impact of COVID-19 restrictions on participant enrollment in the PREPARE trial. Contemp Clin Trials Commun 2022; 29:100973. [PMID: 35989898 PMCID: PMC9384338 DOI: 10.1016/j.conctc.2022.100973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/13/2022] [Accepted: 08/07/2022] [Indexed: 11/09/2022] Open
Abstract
Background At the initiation of the COVID-19 pandemic, restrictions forced researchers to decide whether to continue their ongoing clinical trials. The PREPARE (Pragmatic Randomized Trial Evaluating Pre-Operative Alcohol Skin Solutions in Fractured Extremities) trial is a pragmatic cluster-randomized crossover trial in patients with open and closed fractures. PREPARE was enrolling over 200 participants per month at the initiation of the pandemic. We aim to describe how the COVID-19 research restrictions affected participant enrollment. Methods The PREPARE protocol permitted telephone consent, however, sites were obtaining consent in-person. To continue enrollment after the initiation of the restrictions participating sites obtained ethics approval for telephone consent scripts and the waiver of a signature on the consent form. We recorded the number of sites that switched to telephone consent, paused enrollment, and the length of the pause. We used t-tests to compare the differences in monthly enrollment between July 2019 and November 2020. Results All 19 sites quickly implement telephone consent. Fourteen out of nineteen (73.6%) sites paused enrollment due to COVID-19 restrictions. The median length of enrollment pause was 46.5 days (range, 7–121 days; interquartile range, 61 days). The months immediately following the implementation of restrictions had significantly lower enrollment. Conclusion A pragmatic design allowed sites to quickly adapt their procedures for obtaining informed consent via telephone and allowed for minimal interruptions to enrollment during the pandemic.
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Affiliation(s)
- David Pogorzelski
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Paula McKay
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Michael J Weaver
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Todd Jaeblon
- Department of Orthopaedics, University of Maryland, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Robert A Hymes
- Department of Orthopaedic Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Greg E Gaski
- Department of Orthopaedic Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Joanne Fraifogl
- Department of Orthopaedics, The MetroHealth System, Cleveland, OH, USA
| | - James S Ahn
- Department of Orthopaedic Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Gerard Slobogean
- Department of Orthopaedics, University of Maryland, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | | | | | | | - Robert V O'Toole
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Jean-Claude D'Alleyrand
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Andrew Eglseder
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Aaron Johnson
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Christopher Langhammer
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Christopher Lebrun
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Jason Nascone
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Raymond Pensy
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Andrew Pollak
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Marcus Sciadini
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Gerard P Slobogean
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Yasmin Degani
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Haley K Demyanovich
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Andrea Howe
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Nathan N O'Hara
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Heather Phipps
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
| | - Eric Hempen
- University of Maryland School of Medicine, R Adams Cowley Shock Trauma Center, Baltimore, MD, USA
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22
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O'Hara NN, Heels-Ansdell D, Bzovsky S, Dodds S, Thabane L, Bhandari M, Guyatt G, Devereaux PJ, Slobogean GP, Sprague S. A pragmatic randomized trial evaluating pre-operative aqueous antiseptic skin solutions in open fractures (Aqueous-PREP): statistical analysis plan. Trials 2022; 23:772. [PMID: 36096826 PMCID: PMC9465853 DOI: 10.1186/s13063-022-06541-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/12/2022] [Indexed: 11/21/2022] Open
Abstract
Background Approximately 1 in 10 patients with a surgically treated open fracture will develop a surgical site infection. The Aqueous-PREP trial will investigate the effect of 10% povidone-iodine versus 4% chlorhexidine in aqueous antiseptic solutions in reducing infections after open fracture surgery. The study protocol was published in April 2020. Methods and design The Aqueous-PREP trial is a pragmatic, multicenter, open-label, randomized multiple period cluster crossover trial. Each participating cluster is randomly assigned in a 1:1 ratio to provide 1 of the 2 study interventions on all eligible patients during a study period. The intervention periods are 2 months in length. After completing a 2-month period, the participating cluster crosses over to the alternative intervention. We plan to enroll a minimum of 1540 patients at 14 sites. Results The primary outcome is surgical site infection guided by the Centers for Disease Control and Prevention’s National Healthcare Safety Network reporting criteria (2017). All participants’ surgical site infection surveillance period will end 30 days after definitive fracture management surgery for superficial infections and 90 days after definitive fracture management surgery for deep incisional or organ/space infections [1]. The secondary outcome is an unplanned fracture-related reoperation within 12 months of the fracture. Conclusion This manuscript serves as the formal statistical analysis plan (version 1.0) for the Aqueous-PREP trial. The statistical analysis plan was completed on February 28, 2022.
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Affiliation(s)
- Nathan N O'Hara
- R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD, USA
| | - Diane Heels-Ansdell
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Shannon Dodds
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Mohit Bhandari
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - P J Devereaux
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.,Department of Medicine, McMaster University, Hamilton, Ontario, Canada.,Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada
| | - Gerard P Slobogean
- R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD, USA
| | - Sheila Sprague
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada. .,Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.
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23
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Frihagen F, Comeau-Gauthier M, Axelrod D, Bzovsky S, Poolman R, Heels-Ansdell D, Bhandari M, Sprague S, Schemitsch E. Who, if anyone, may benefit from a total hip arthroplasty after a displaced femoral neck fracture? Bone Jt Open 2022; 3:611-617. [PMID: 35909342 PMCID: PMC9422900 DOI: 10.1302/2633-1462.38.bjo-2022-0074.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Aims The aim of this study was to explore the functional results in a fitter subgroup of participants in the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial to determine whether there was an advantage of total hip arthroplasty (THA) versus hemiarthroplasty (HA) in this population. Methods We performed a post hoc exploratory analysis of a fitter cohort of patients from the HEALTH trial. Participants were aged over 50 years and had sustained a low-energy displaced femoral neck fracture (FNF). The fittest participant cohort was defined as participants aged 70 years or younger, classified as American Society of Anesthesiologists grade I or II, independent walkers prior to fracture, and living at home prior to fracture. Multilevel models were used to estimate the effect of THA versus HA on functional outcomes. In addition, a sensitivity analysis of the definition of the fittest participant cohort was performed. Results There were 143 patients included in the fittest cohort. Mean age was 66 years (SD 4.5) and 103 were female (72%). No clinically relevant differences were found between the treatment groups in the primary and sensitivity analyses. Conclusion This analysis found no differences in functional outcomes between HA and THA within two years of displaced low-energy FNF in a subgroup analysis of the fittest HEALTH patients. These findings suggest that very few patients above 50 years of age benefit in a clinically meaningful way from a THA versus a HA early after injury. Cite this article: Bone Jt Open 2022;3(8):611–617.
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Affiliation(s)
- Frede Frihagen
- Department of Orthopaedic Surgery, Østfold Hospital Trust, Grålum, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | | | - Daniel Axelrod
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada
| | - Rudolf Poolman
- Department of Orthopedic Surgery, OLVG, Leiden, the Netherlands
| | - Diane Heels-Ansdell
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Emil Schemitsch
- Department of Surgery, University of Western Ontario, London, Canada
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Nguyen MP, Gannon NP, Paull TZ, Bakker C, Bzovsky S, Sprague S, Swiontkowski MF. Outcomes of arthroscopic-assisted lateral tibial plateau fixation: a systematic review. Eur J Orthop Surg Traumatol 2022:10.1007/s00590-022-03339-3. [PMID: 35867167 DOI: 10.1007/s00590-022-03339-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/05/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE The purpose of this study is to evaluate and summarize the current literature on outcomes of arthroscopic-assisted tibial plateau fixation (AATPF) when applied for only lateral tibial plateau fractures. METHODS A comprehensive search of nine databases was conducted: ClinicalTrials.gov, Cochrane Library via Wiley, Embase and MEDLINE via Ovid, Global Index Medicus, PubMed, Scopus, SPORTDiscus via EBSCO, and Web of Science Core Collection. The study was performed in concordance with PRISMA guidelines. Studies eligible for inclusions included Schatzker I-III lateral tibial plateau fractures with a minimum of 6-month follow-up. Data extraction was performed by two authors independently using a predesigned form. RESULTS A total of 17 studies, 7 prospective and 10 retrospective, including 565 patients (age 15-82 years old) treated with AATPF were included in this review with follow-up ranging from 6 to 138 months. All 10 studies that used categorical functional outcomes demonstrated excellent/very good or good outcomes in > 90% of patients. When compared to patients managed with the traditional open reduction internal fixation (ORIF), patients treated with AATPF had statistically significantly better range of motion mean difference [5.21° (95% CI - 2.50 to 12.92, p < 0.0001)], lower blood loss [66.19 mL (95% confidence interval (CI) 32.54-99.84 mL, p < 0.0001)], shorter hospital stay [- 1.41 days (95% CI - 3.39 to 0.58 days, p < 0.0001)], better Hospital Special Surgery score [11.31 (95% CI 6.49-16.12, p < 0.0001)], and higher Rasmussen radiographic score [1.26 (95% CI - 0.72 to 3.23, p < 0.0001)]. CONCLUSION AATPF is a promising treatment of lateral tibial plateau fractures with some advantages over the traditional ORIF. LEVEL OF EVIDENCE Therapeutic Level III.
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Affiliation(s)
- Mai P Nguyen
- Regions Hospital, 640 Jackson Street, Saint Paul, MN, 55101, USA.
- University of Minnesota, 2450 Riverside Ave, Suite R200, Minneapolis, MN, 55455, USA.
| | - Nicholas P Gannon
- University of Minnesota, 2450 Riverside Ave, Suite R200, Minneapolis, MN, 55455, USA
| | - Thomas Z Paull
- Regions Hospital, 640 Jackson Street, Saint Paul, MN, 55101, USA
- University of Minnesota, 2450 Riverside Ave, Suite R200, Minneapolis, MN, 55455, USA
| | - Caitlin Bakker
- University of Minnesota, 2450 Riverside Ave, Suite R200, Minneapolis, MN, 55455, USA
| | - Sofia Bzovsky
- McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Sheila Sprague
- McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Marc F Swiontkowski
- University of Minnesota, 2450 Riverside Ave, Suite R200, Minneapolis, MN, 55455, USA
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25
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Lamontagne F, Masse MH, Menard J, Sprague S, Pinto R, Heyland DK, Cook DJ, Battista MC, Day AG, Guyatt GH, Kanji S, Parke R, McGuinness SP, Tirupakuzhi Vijayaraghavan BK, Annane D, Cohen D, Arabi YM, Bolduc B, Marinoff N, Rochwerg B, Millen T, Meade MO, Hand L, Watpool I, Porteous R, Young PJ, D'Aragon F, Belley-Cote EP, Carbonneau E, Clarke F, Maslove DM, Hunt M, Chassé M, Lebrasseur M, Lauzier F, Mehta S, Quiroz-Martinez H, Rewa OG, Charbonney E, Seely AJE, Kutsogiannis DJ, LeBlanc R, Mekontso-Dessap A, Mele TS, Turgeon AF, Wood G, Kohli SS, Shahin J, Twardowski P, Adhikari NKJ. Intravenous Vitamin C in Adults with Sepsis in the Intensive Care Unit. N Engl J Med 2022; 386:2387-2398. [PMID: 35704292 DOI: 10.1056/nejmoa2200644] [Citation(s) in RCA: 117] [Impact Index Per Article: 58.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Studies that have evaluated the use of intravenous vitamin C in adults with sepsis who were receiving vasopressor therapy in the intensive care unit (ICU) have shown mixed results with respect to the risk of death and organ dysfunction. METHODS In this randomized, placebo-controlled trial, we assigned adults who had been in the ICU for no longer than 24 hours, who had proven or suspected infection as the main diagnosis, and who were receiving a vasopressor to receive an infusion of either vitamin C (at a dose of 50 mg per kilogram of body weight) or matched placebo administered every 6 hours for up to 96 hours. The primary outcome was a composite of death or persistent organ dysfunction (defined by the use of vasopressors, invasive mechanical ventilation, or new renal-replacement therapy) on day 28. RESULTS A total of 872 patients underwent randomization (435 to the vitamin C group and 437 to the control group). The primary outcome occurred in 191 of 429 patients (44.5%) in the vitamin C group and in 167 of 434 patients (38.5%) in the control group (risk ratio, 1.21; 95% confidence interval [CI], 1.04 to 1.40; P = 0.01). At 28 days, death had occurred in 152 of 429 patients (35.4%) in the vitamin C group and in 137 of 434 patients (31.6%) in the placebo group (risk ratio, 1.17; 95% CI, 0.98 to 1.40) and persistent organ dysfunction in 39 of 429 patients (9.1%) and 30 of 434 patients (6.9%), respectively (risk ratio, 1.30; 95% CI, 0.83 to 2.05). Findings were similar in the two groups regarding organ-dysfunction scores, biomarkers, 6-month survival, health-related quality of life, stage 3 acute kidney injury, and hypoglycemic episodes. In the vitamin C group, one patient had a severe hypoglycemic episode and another had a serious anaphylaxis event. CONCLUSIONS In adults with sepsis receiving vasopressor therapy in the ICU, those who received intravenous vitamin C had a higher risk of death or persistent organ dysfunction at 28 days than those who received placebo. (Funded by the Lotte and John Hecht Memorial Foundation; LOVIT ClinicalTrials.gov number, NCT03680274.).
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Affiliation(s)
- François Lamontagne
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Marie-Hélène Masse
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Julie Menard
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Sheila Sprague
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Ruxandra Pinto
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Daren K Heyland
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Deborah J Cook
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Marie-Claude Battista
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Andrew G Day
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Gordon H Guyatt
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Salmaan Kanji
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Rachael Parke
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Shay P McGuinness
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Bharath-Kumar Tirupakuzhi Vijayaraghavan
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Djillali Annane
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Dian Cohen
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Yaseen M Arabi
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Brigitte Bolduc
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Nicole Marinoff
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Bram Rochwerg
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Tina Millen
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Maureen O Meade
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Lori Hand
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Irene Watpool
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Rebecca Porteous
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Paul J Young
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Frederick D'Aragon
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Emilie P Belley-Cote
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Elaine Carbonneau
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - France Clarke
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - David M Maslove
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Miranda Hunt
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Michaël Chassé
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Martine Lebrasseur
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - François Lauzier
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Sangeeta Mehta
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Hector Quiroz-Martinez
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Oleksa G Rewa
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Emmanuel Charbonney
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Andrew J E Seely
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Demetrios J Kutsogiannis
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Remi LeBlanc
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Armand Mekontso-Dessap
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Tina S Mele
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Alexis F Turgeon
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Gordon Wood
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Sandeep S Kohli
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Jason Shahin
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Pawel Twardowski
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
| | - Neill K J Adhikari
- From the Departments of Medicine (F. Lamontagne, M.-C.B., H.Q.M.) and Anesthesiology (F.D.), Université de Sherbrooke, the Department of Pharmacy (B.B.), Centre de Recherche du CHU de Sherbrooke, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke (F. Lamontagne, M.-H.M., J.M., F.D., E. Carbonneau), and Bishop's University (D.C.), Sherbrooke, QC, the Division of Orthopaedic Surgery, Department of Surgery (S.S.), the Department of Medicine (D.J.C., G.H.G., B.R., T.M., M.O.M., E.P.B.-C., S.S.K.), the Department of Health Research Methods, Evidence, and Impact (D.J.C., G.H.G., B.R., M.O.M., L.H., E.P.B.-C., F.C.), and the Population Health Research Institute (E.P.B.-C.), McMaster University, the Department of Critical Care, St. Joseph's Healthcare Hamilton (D.J.C.), the Intensive Care Unit, Juravinski Hospital (T.M.), and Respiratory Therapy, Hamilton Health Sciences (L.H.), Hamilton, ON, the Department of Critical Care Medicine, Sunnybrook Health Sciences Centre (R. Pinto, N.M., N.K.J.A.), the Interdepartmental Division of Critical Care Medicine, University of Toronto (S.M., N.K.J.A.), and Sinai Health System (S.M.), Toronto, the Departments of Critical Care Medicine (D.K.H., D.M.M., M.H.), Public Health Sciences (A.G.D.), and Medicine (D.M.M.), Queen's University, and Kingston Health Sciences Centre (A.G.D., D.M.M.), Kingston, ON, the Department of Pharmacy, Ottawa Hospital (S.K.), Ottawa Hospital Research Institute (S.K., I.W., R. Porteous), and the Department of Surgery, University of Ottawa (A.J.E.S.), Ottawa, ON, the Massawippi Valley Foundation, Ayer's Cliff, QC (D.C.), the Department of Medicine, Université de Montréal (M.C.), the Centre Hospitalier de l'Université de Montréal (M.C., M.L., E. Charbonney), the Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal (E. Charbonney), and the Departments of Medicine and Critical Care, McGill University Health Centre (J.S.), Montreal, QC, the Department of Medicine (F. Lauzier) and the Division of Critical Care Medicine, Department of Anesthesiology and Critical Care (F. Lauzier, A.F.T.), Université Laval, the Critical Care Medicine Service (F. Lauzier, A.F.T.), and the Research Center (F. Lauzier, A.F.T.), CHU de Québec-Université Laval, Quebec, QC, the Department of Critical Care Medicine, University of Alberta, Edmonton (O.G.R., D.J.K.), the Division of Intensive Care, Department of Medicine, CHU Dr. Georges L. Dumont, Moncton, NB (R.L.), the Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, ON (T.S.M.), the Division of Intensive Care Medicine, Island Health Authority, Victoria, BC (G.W.), and the Department of Medicine, Halton Healthcare, Oakville, ON (S.S.K.) - all in Canada; the Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital (R. Parke, S.P.M.), and the School of Nursing, University of Auckland (R. Parke), Auckland, the Medical Research Institute of New Zealand, Newtown (R. Parke, S.P.M., P.J.Y.), the Intensive Care Unit, Wellington Hospital, Wellington (P.J.Y.), and the Department of Surgical Sciences, University of Otago, Dunedin (P.T.) - all in New Zealand; the Department of Critical Care Medicine, Apollo Hospitals, Chennai, and George Institute for Global Health, New Delhi - both in India (B.K.T.V.); the Department of Intensive Care Medicine, Raymond-Poincaré Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), and Fédération Hospitalo-Universitaire SEPSIS, Garches (D.A.), Institut National de la Santé et de la Recherche Médicale, University Paris-Saclay Campus UVSQ, Versailles (D.A.), and Service de Médecine Intensive Réanimation, AP-HP, Hôpitaux Universitaires Henri-Mondor, Groupe de Recherche Clinique CARMAS, and Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Créteil (A.M.-D.) - all in France; the College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, and the Department of Intensive Care, King Abdulaziz Medical City, Ministry of National Guard Health Affairs - all in Riyadh, Saudi Arabia (Y.M.A.); and the Australian and New Zealand Intensive Care Research Centre, Monash University, Melbourne, VIC, Australia (R. Parke, S.P.M., P.J.Y.)
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Miclau T, MacKechnie MC, Born CT, MacKechnie MA, Dyer GSM, Yuan BJ, Dawson J, Lee C, Ishmael CR, Schreiber VM, Tejwani NC, Ulmer T, Shearer DW, Agarwal-Harding KJ, Johal H, Khormaee S, Sprague S, Whiting PS, Roberts HJ, Coughlin R, Gosselin R, Rosenwasser MP, Johnson A, Babu JM, Dworkin M, Makhni MC, McClellan T, Nwachuku CO, Miclau E, Morshed S. International Orthopaedic Volunteer Opportunities in Low and Middle-Income Countries. J Bone Joint Surg Am 2022; 104:e44. [PMID: 34932526 DOI: 10.2106/jbjs.21.00948] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Globally, the burden of musculoskeletal conditions continues to rise, disproportionately affecting low and middle-income countries (LMICs). The ability to meet these orthopaedic surgical care demands remains a challenge. To help address these issues, many orthopaedic surgeons seek opportunities to provide humanitarian assistance to the populations in need. While many global orthopaedic initiatives are well-intentioned and can offer short-term benefits to the local communities, it is essential to emphasize training and the integration of local surgeon-leaders. The commitment to developing educational and investigative capacity, as well as fostering sustainable, mutually beneficial partnerships in low-resource settings, is critical. To this end, global health organizations, such as the Consortium of Orthopaedic Academic Traumatologists (COACT), work to promote and ensure the lasting sustainability of musculoskeletal trauma care worldwide. This article describes global orthopaedic efforts that can effectively address musculoskeletal care through an examination of 5 domains: clinical care, clinical research, surgical education, disaster response, and advocacy.
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Affiliation(s)
- Theodore Miclau
- Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California
| | - Madeline C MacKechnie
- Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California
| | - Christopher T Born
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Michael A MacKechnie
- Department of Orthopaedic Surgery, Cleveland Clinic Martin Health, Stuart, Florida
| | - George S M Dyer
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - John Dawson
- Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, Texas
| | - Cassandra Lee
- Department of Orthopaedic Surgery, University of California at Davis Health, Sacramento, California
| | - Chad R Ishmael
- Department of Orthopaedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California
| | | | | | - Todd Ulmer
- Adventist Medical Center, Oregon Health Sciences University, Portland, Oregon
| | - David W Shearer
- Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California
| | - Kiran J Agarwal-Harding
- Harvard Global Orthopaedics Collaborative, Massachusetts General Hospital/Harvard Combined Orthopaedic Residency Program, Boston, Massachusetts
| | - Herman Johal
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | | | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | | | - Heather J Roberts
- Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California
| | - Richard Coughlin
- Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California
| | - Rich Gosselin
- Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California
| | | | - Anthony Johnson
- Department of Surgery and Perioperative Care, University of Texas at Austin, Austin, Texas
| | - Jacob M Babu
- Orthopaedic Division of Spine Surgery, Johns Hopkins University, Baltimore, Maryland
| | - Myles Dworkin
- Department of Orthopaedic Surgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Melvin C Makhni
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Trigg McClellan
- Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California
| | | | - Elizabeth Miclau
- Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California
| | - Saam Morshed
- Orthopaedic Trauma Institute, Institute for Global Orthopaedics and Traumatology, Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California
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Reis G, Silva EASM, Silva DCM, Thabane L, Milagres AC, Ferreira TS, Dos Santos CVQ, Campos VHS, Nogueira AMR, de Almeida APFG, Callegari ED, Neto ADF, Savassi LCM, Simplicio MIC, Ribeiro LB, Oliveira R, Harari O, Forrest JI, Ruton H, Sprague S, McKay P, Guo CM, Rowland-Yeo K, Guyatt GH, Boulware DR, Rayner CR, Mills EJ. Effect of Early Treatment with Ivermectin among Patients with Covid-19. N Engl J Med 2022; 386:1721-1731. [PMID: 35353979 PMCID: PMC9006771 DOI: 10.1056/nejmoa2115869] [Citation(s) in RCA: 114] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The efficacy of ivermectin in preventing hospitalization or extended observation in an emergency setting among outpatients with acutely symptomatic coronavirus disease 2019 (Covid-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is unclear. METHODS We conducted a double-blind, randomized, placebo-controlled, adaptive platform trial involving symptomatic SARS-CoV-2-positive adults recruited from 12 public health clinics in Brazil. Patients who had had symptoms of Covid-19 for up to 7 days and had at least one risk factor for disease progression were randomly assigned to receive ivermectin (400 μg per kilogram of body weight) once daily for 3 days or placebo. (The trial also involved other interventions that are not reported here.) The primary composite outcome was hospitalization due to Covid-19 within 28 days after randomization or an emergency department visit due to clinical worsening of Covid-19 (defined as the participant remaining under observation for >6 hours) within 28 days after randomization. RESULTS A total of 3515 patients were randomly assigned to receive ivermectin (679 patients), placebo (679), or another intervention (2157). Overall, 100 patients (14.7%) in the ivermectin group had a primary-outcome event, as compared with 111 (16.3%) in the placebo group (relative risk, 0.90; 95% Bayesian credible interval, 0.70 to 1.16). Of the 211 primary-outcome events, 171 (81.0%) were hospital admissions. Findings were similar to the primary analysis in a modified intention-to-treat analysis that included only patients who received at least one dose of ivermectin or placebo (relative risk, 0.89; 95% Bayesian credible interval, 0.69 to 1.15) and in a per-protocol analysis that included only patients who reported 100% adherence to the assigned regimen (relative risk, 0.94; 95% Bayesian credible interval, 0.67 to 1.35). There were no significant effects of ivermectin use on secondary outcomes or adverse events. CONCLUSIONS Treatment with ivermectin did not result in a lower incidence of medical admission to a hospital due to progression of Covid-19 or of prolonged emergency department observation among outpatients with an early diagnosis of Covid-19. (Funded by FastGrants and the Rainwater Charitable Foundation; TOGETHER ClinicalTrials.gov number, NCT04727424.).
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Affiliation(s)
- Gilmar Reis
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Eduardo A S M Silva
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Daniela C M Silva
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Lehana Thabane
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Aline C Milagres
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Thiago S Ferreira
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Castilho V Q Dos Santos
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Vitoria H S Campos
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Ana M R Nogueira
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Ana P F G de Almeida
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Eduardo D Callegari
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Adhemar D F Neto
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Leonardo C M Savassi
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Maria I C Simplicio
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Luciene B Ribeiro
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Rosemary Oliveira
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Ofir Harari
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Jamie I Forrest
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Hinda Ruton
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Sheila Sprague
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Paula McKay
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Christina M Guo
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Karen Rowland-Yeo
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Gordon H Guyatt
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - David R Boulware
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Craig R Rayner
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
| | - Edward J Mills
- From the Research Division, Cardresearch-Cardiologia Assistencial e de Pesquisa (G.R., E.A.S.M.S., D.C.M.S., T.S.F., C.V.Q.S., V.H.S.C., M.I.C.S., L.B.R., R.O.), and the Department of Medicine, Pontifical Catholic University of Minas Gerais (G.R., E.A.S.M.S., D.C.M.S., C.V.Q.S., V.H.S.C.), Belo Horizonte, the Department of Public Health and Mental and Family Medicine, Ouro Preto Federal University, Ouro Preto (A.C.M., L.C.M.S.), the Public Health Care Division, Ibirité (A.C.M.), the Department of Public Health and the Family Medicine Fellowship Program, UNIFIPMoc, Montes Claros (A.M.R.N., A.P.F.G.A.), the Public Health Care Division, Brumadinho (E.D.C.), and the Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares (A.D.F.N.) - all in Brazil; the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON (L.T., S.S., P.M., G.H.G., E.J.M.), and Cytel (O.H., H.R., E.J.M.) and Platform Life Sciences (J.I.F., C.M.G., E.J.M.), Vancouver, BC - all in Canada; Certara, Princeton, NJ (K.R.-Y., C.R.R.); the Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis (D.R.B.); and Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia (C.R.R.)
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Adhikari NK, Pinto R, Day AG, Masse MH, Ménard J, Sprague S, Annane D, Arabi YM, Battista MC, Cohen D, Cook DJ, Guyatt GH, Heyland DK, Kanji S, McGuinness SP, Parke RL, Kumar Tirupakuzhi Vijayaraghavan B, Charbonney E, Chassé M, Del Sorbo L, Kutsogiannis DJ, Lauzier F, Leblanc R, Maslove DM, Mehta S, Mekontso Dessap A, Mele TS, Rochwerg B, Rewa OG, Shahin J, Twardowski P, Young PJ, Lamontagne F. Lessening Organ dysfunction with VITamin C (LOVIT): statistical analysis plan. JMIR Res Protoc 2022; 11:e36261. [PMID: 35420994 PMCID: PMC9166642 DOI: 10.2196/36261] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 03/24/2022] [Accepted: 04/14/2022] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Lessening Organ Dysfunction with VITamin C (LOVIT) is a blinded multicentre randomized clinical trial that compared high-dose intravenous vitamin C to placebo in patients admitted to the intensive care unit with proven or suspected infection as the main diagnosis and receiving a vasopressor. OBJECTIVE To describe a pre-specified statistical analysis plan (SAP) for LOVIT, written prior to unblinding and locking of the trial database. METHODS The SAP was designed by the LOVIT principal investigators and statisticians and approved by the steering committee and coinvestigators. The SAP defines the primary and secondary outcomes and describes the planned primary, secondary, and subgroup analyses. RESULTS The SAP includes a draft participant flow diagram, tables, and planned figures. The primary outcome is a composite of mortality and persistent organ dysfunction (receipt of mechanical ventilation, vasopressors or new renal replacement therapy) at 28 days, where day 1 is the day of randomization. All analyses will use a frequentist statistical framework. The analysis of the primary outcome will estimate the risk ratio and 95% confidence interval in a generalized linear mixed model with binomial distribution and log link and considering site as a random effect. We will perform a secondary analysis adjusting for pre-specified baseline clinical variables. Subgroup analyses will include age, sex, frailty, severity of illness, Sepsis-3 definition of septic shock, baseline ascorbic acid level, and COVID-19 status. CONCLUSIONS We have developed a SAP for the LOVIT trial and will adhere to it in the analysis phase. CLINICALTRIAL ClinicalTrials.gov identifier: NCT03680274 (21 September 2018).
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Affiliation(s)
- Neill Kj Adhikari
- Sunnybrook Health Sciences Centre, 2075 Bayview AveRoom D1 08, Toronto, CA
| | - Ruxandra Pinto
- Department of Critical Care Medicine, Sunnybrook Health Sciences Centre, Toronto, CA
| | | | - Marie-Hélène Masse
- Research Centre of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, CA
| | - Julie Ménard
- Research Centre of the Centre hospitalier universitaire de Sherbrooke, Sherbrooke, CA
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, CA.,St-Joseph's Healthcare, Hamilton, CA
| | | | - Yaseen M Arabi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, SA.,King Abdullah International Medical Research Center, Riyadh, SA.,Intensive Care Department, King Abdulaziz Medical City, Riyadh, SA
| | | | - Dian Cohen
- This author is a patient partner, North Hatley, CA
| | | | | | - Daren K Heyland
- Department of Critical Care Medicine, School of Medicine, Queen's University, Kingston, CA.,Kingston General Health Research Institute, Kingston Health Sciences Centre, Kingston, CA.,Clinical Evaluation Research Unit, Kingston General Hospital, Kingston, CA
| | - Salmaan Kanji
- Clinical Epidemiology Program, The Ottawa Hospital Research Institute, Ottawa, CA.,Division of Critical Care, Department of Medicine, University of Ottawa, Ottawa, CA
| | - Shay P McGuinness
- Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, NZ
| | - Rachael L Parke
- Cardiothoracic and Vascular Intensive Care Unit, Auckland City Hospital, Auckland, NZ.,Wellington Hospital, Wellington, NZ.,School of Nursing, Faculty of Medical and Health Sciences, University of Auckland, Auckland, NZ
| | | | | | - Michael Chassé
- Centre hospitalier de l'Université de Montréal, Montreal, CA
| | | | | | - Francois Lauzier
- CHU de Québec-Université Laval, Hôpital de l'Enfant-Jésus, Quebec, CA
| | | | | | | | | | | | | | | | | | | | | | - François Lamontagne
- Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie - Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, CA
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29
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Kay J, Simunovic N, Ayeni OR, Bhandari M, Bedi A, Järvinen T, Musahl V, Naudie D, Seppänen M, Slobogean G, Thabane L, Duong A, Skelly M, Shanmugaraj A, Crouch S, Sprague S, Heels-Ansdell D, Buckingham L, Ramsay T, Lee J, Kousa P, Carsen S, Choudur H, Sim Y, Johnston K, Wong I, Murphy R, Sparavalo S, Whelan D, Khan R, Wood GC, Howells F, Grant H, Zomar B, Pollock M, Willits K, Firth A, Wanlin S, Remtulla A, Kaniki N, Belzile EL, Turmel S, Jørgensen U, Gam-Pedersen A, Sihvonen R, Raivio Sihvonen M, Toivonen Sihvonen P, Pirjetta Routapohja M. Effect of Osteochondroplasty on Time to Reoperation After Arthroscopic Management of Femoroacetabular Impingement: Analysis of a Randomized Controlled Trial. Orthop J Sports Med 2022; 10:23259671211041400. [PMID: 35400136 PMCID: PMC8988676 DOI: 10.1177/23259671211041400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 07/26/2021] [Indexed: 11/29/2022] Open
Abstract
Background: A subset of patients with femoroacetabular impingement (FAI) fail arthroscopic management. It is not clear which patients will fail surgical management; however, several surgical and patient factors, such as type of procedure and age, are thought to be important predictors. Purpose: This time-to-event analysis with a 27-month follow-up analysis compared the effect of (1) arthroscopic osteochondroplasty with or without labral repair versus (2) arthroscopic lavage with or without labral repair on the time to reoperation in adults aged 18 to 50 years with FAI. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: Eligible participants had been randomized in a previous study trial to a treatment of arthroscopic osteochondroplasty or arthroscopic lavage with or without labral repair. Using the comprehensive data set from the Multinational Femoroacetabular Impingement Randomized controlled Trial, all reoperations until 27 months after surgery were identified. The analysis was conducted using a Cox proportional hazards model, with percentage of patients with a reoperation evaluated in a time-to-event analysis as the outcome. The independent variable was the procedure, with age and impingement subtype explored as potential covariates. The effects from the Cox model were expressed as the hazard ratio (HR). All tests were 2-sided, with an alpha level of .05. Results: A total of 108 patients in the osteochondroplasty group and 106 patients in the lavage group were included. The mean age of the patients included in the study was 36 ± 8.5 years. Overall, 27 incident reoperations were identified within the 27-month follow-up, with an incidence rate of 6 per 100 person-years. Within the osteochondroplasty group, 8 incident reoperations were identified (incidence rate, 3.4 per 100 person-years), while within the lavage group, 19 incident reoperations were identified (incidence rate, 8.7 per 100 person-years). The hazard of reoperation for patients undergoing osteochondroplasty was 40% of that of patients undergoing lavage (HR, 0.40 [95% CI, 0.17-0.91] P = .029). Conclusion: This study demonstrated that for adults between the ages of 18 and 50 years with FAI, arthroscopic osteochondroplasty was associated with a 2.5-fold decrease in the hazard of reoperation at any point in time compared with arthroscopic lavage. Registration: NCT01623843 (ClinicalTrials.gov identifier).
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Affiliation(s)
| | | | - Olufemi R. Ayeni
- Olufemi R. Ayeni, MD, PhD, McMaster University Medical Centre, 1200 Main Street West, 4E15, Hamilton, Ontario L8N 3Z5, Canada ()
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DeAngelis RD, Stein MK, Minutillo GT, Mehta NG, Schemitsch EH, Bzovsky S, Sprague S, Bhandari M, Swiontkowski M, Donegan DJ, Mehta S. Subspecialty Fellowship Training Is Not Associated With Better Outcomes in Fixation of Low-Energy Femoral Neck Fractures-An Analysis of the Fixation Using Alternative Implants for the Treatment of Hip Fractures Database. J Orthop Trauma 2022; 36:208-212. [PMID: 34483325 PMCID: PMC8882705 DOI: 10.1097/bot.0000000000002264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To compare risk of reoperation for femoral neck fracture patients undergoing fixation with cancellous screws (CSs) or sliding hip screws based on surgeon fellowship (trauma-fellowship-trained vs. non-trauma-fellowship-trained). DESIGN Retrospective review of Fixation using Alternative Implants for the Treatment of Hip fractures data. SETTING Eighty-one centers across 8 countries. PATIENTS/PARTICIPANTS Eight hundred nineteen patients ≥50 years old with low-energy hip fractures requiring surgical fixation. INTERVENTION Patients were randomized to CS or sliding hip screw group in the initial dataset. MAIN OUTCOME MEASUREMENTS The primary outcome was risk of reoperation. Secondary outcomes included death, serious adverse events, radiographic healing, discharge disposition, and use of ambulatory devices postoperatively. RESULTS There was no difference in risk of reoperation between the 2 surgeon groups (P > 0.05). Patients treated by orthopaedic trauma surgeons were more likely to be overweight/obese and have major medical comorbidities (P < 0.05). There was a higher risk of serious adverse events, higher likelihood of radiographic healing, and higher odds of discharge to a facility for patients treated by trauma-fellowship-trained surgeons (P < 0.05). CONCLUSIONS Based on these data, risk of reoperation for low-energy femoral neck fracture fixation is equivalent regardless of fellowship training. The higher likelihood of radiographic healing noted in the trauma-trained group does not seem to have a major clinical implication because it did not affect risk of reoperation between the 2 groups. Patient-specific factors present preinjury, such as body habitus and medical comorbidities, may account for the lower odds of discharge to home and higher risk of postoperative medical complications for patients treated by orthopaedic trauma surgeons. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Ryan D. DeAngelis
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Matthew K. Stein
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Gregory T. Minutillo
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Nikhilesh G. Mehta
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Emil H. Schemitsch
- Department of Surgery, University of Western Ontario, London, Ontario, Canada
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Marc Swiontkowski
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, United States
| | - Derek J. Donegan
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, United States
| | - Samir Mehta
- Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, United States
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Stewart CC, O'Hara NN, Bzovsky S, Bahney CS, Sprague S, Slobogean GP. Bone turnover markers as surrogates of fracture healing after intramedullary fixation of tibia and femur fractures. Bone Joint Res 2022; 11:239-250. [PMID: 35442058 PMCID: PMC9057525 DOI: 10.1302/2046-3758.114.bjr-2021-0226.r1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aims Bone turnover markers (BTMs) follow distinct trends after fractures and limited evidence suggests differential levels in BTMs in patients with delayed healing. The effect of vitamin D, and other factors that influence BTMs and fracture healing, is important to elucidate the use of BTMs as surrogates of fracture healing. We sought to determine whether BTMs can be used as early markers of delayed fracture healing, and the effect of vitamin D on BTM response after fracture. Methods A total of 102 participants aged 18 to 50 years (median 28 years (interquartile range 23 to 35)), receiving an intramedullary nail for a tibial or femoral shaft fracture, were enrolled in a randomized controlled trial comparing vitamin D3 supplementation to placebo. Serum C-terminal telopeptide of type I collagen (CTX; bone resorption marker) and N-terminal propeptide of type I procollagen (P1NP; bone formation marker) were measured at baseline, six weeks, and 12 weeks post-injury. Clinical and radiological fracture healing was assessed at three months. Results CTX and P1NP concentrations peaked at six weeks in all groups. Elevated six-week CTX and P1NP were associated with radiological healing at 12 weeks post-injury (odds ratio (OR) 10.5; 95% confidence interval 2.71 to 53.5, p = 0.002). We found no association between CTX or P1NP and functional healing. Baseline serum 25(OH)D showed a weak inverse relationship with P1NP (p = 0.036) and CTX (p = 0.221) at 12 weeks, but we observed no association between vitamin D supplementation and either BTM. Conclusion Given the association between six-week BTM concentrations and three-month radiological fracture healing, CTX and P1NP appear to be potential surrogate markers of fracture healing. Cite this article: Bone Joint Res 2022;11(4):239–250.
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Affiliation(s)
- Christopher C Stewart
- Department of Orthopaedic Surgery, University of California, San Francisco, California, USA
| | - Nathan N O'Hara
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada
| | - Chelsea S Bahney
- Steadman Philippon Research Institute, Center for Regenerative & Personalized Medicine, Vail, Colorado, USA.,Department of Orthopaedic Surgery, Orthopaedic Trauma Institute, University of California, San Francisco, California, USA
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
| | - Gerard P Slobogean
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
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O'Hara NN, Carullo J, Joshi M, Banoub M, Claeys KC, Sprague S, Slobogean GP, O'Toole RV. Does cumulative topical antibiotic powder use increase the risk of drug induced acute kidney injury in fracture patients? Bone Jt Open 2022; 3:284-290. [PMID: 35363046 PMCID: PMC9044090 DOI: 10.1302/2633-1462.34.bjo-2022-0009.r1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIMS There is increasing evidence to support the use of topical antibiotics to prevent surgical site infections. Although previous research suggests a minimal nephrotoxic risk with a single dose of vancomycin powder, fracture patients often require multiple procedures and receive additional doses of topical antibiotics. We aimed to determine if cumulative doses of intrawound vancomycin or tobramycin powder for infection prophylaxis increased the risk of drug-induced acute kidney injury (AKI) among fracture patients. METHODS This cohort study was a secondary analysis of single-centre Program of Randomized Trials to Evaluate Pre-operative Antiseptic Skin Solutions in Orthopaedic Trauma (PREP-IT) trial data. We included patients with a surgically treated appendicular fracture. The primary outcome was drug-induced AKI. The odds of AKI per gram of vancomycin or tobramycin powder were calculated using Bayesian regression models, which adjusted for measured confounders and accounted for the interactive effects of vancomycin and tobramycin. RESULTS Of the 782 included patients (mean age 48 years (SD 20); 59% male), 83% (n = 648) received at least one vancomycin dose (cumulative range 1 to 12 g). Overall, 45% of the sample received at least one tobramycin dose (cumulative range 1.2 to 9.6 g). Drug-induced AKI occurred in ten patients (1.2%). No association was found between the cumulative dose of vancomycin and drug-induced AKI (odds ratio (OR) 1.08 (95% credible interval (CrI) 0.52 to 2.14)). Additional doses of tobramycin were associated with a three-fold increase in the adjusted odds of drug-induced AKI (OR 3.66 (95% CrI 1.71 to 8.49)). Specifically, the risk of drug-induced AKI rose substantially after 4.8 g of tobramycin powder (7.5% (95% CrI 1.0 to 35.3)). CONCLUSION Cumulative doses of vancomycin were not associated with an increased risk of drug-induced AKI among fracture patients. While the risk of drug-induced AKI remains less than 4% with three or fewer 1.2 g tobramycin doses, the estimated risk increases substantially to 8% after four cumulative doses. Level of evidence: Therapeutic Level III Cite this article: Bone Jt Open 2022;3(4):284-290.
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Affiliation(s)
- Nathan N. O'Hara
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Jessica Carullo
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Manjari Joshi
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Mary Banoub
- Department of Pharmacy, University of Maryland Medical Center, Baltimore, Maryland, USA
| | - Kimberly C. Claeys
- Department of Pharmacy Practice and Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
| | - Sheila Sprague
- Department of Surgery, McMaster University, Hamilton, Canada
| | - Gerard P. Slobogean
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Robert V. O'Toole
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - PREP-IT Investigators
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA
- Department of Pharmacy, University of Maryland Medical Center, Baltimore, Maryland, USA
- Department of Pharmacy Practice and Sciences, University of Maryland School of Pharmacy, Baltimore, Maryland, USA
- Department of Surgery, McMaster University, Hamilton, Canada
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Madden K, Sprague S, Petrisor B, Schneider PS, Kleinlugtenbelt YV, Hackenberg EAM, Garcia-Sanchez Y, Hall JA, Bzovsky S, Thabane L, Bhandari M. Intimate Partner Violence During Recovery from an Orthopaedic Injury: An Exploratory, Prospective, Multicenter, Observational Cohort Study. J Bone Joint Surg Am 2022; 104:512-522. [PMID: 35041623 DOI: 10.2106/jbjs.21.00421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Orthopaedic injuries may lead to an increased incidence of intimate partner violence (IPV) during recovery as people dependent on others' help are at a higher risk for abuse. Additionally, there is a lack of understanding of how IPV affects injury recovery. In women being treated for an orthopaedic injury, we aimed to determine the number of new IPV disclosures in the 12 months after an injury and to explore the impact of IPV on recovery. METHODS We enrolled 250 female participants from 6 orthopaedic fracture clinics in Canada, the Netherlands, Spain, and Finland. IPV disclosure and clinical outcomes were assessed at the initial visit and during the 12-month follow-up period. RESULTS Of 250 participants, 81 (32.4% [95% confidence interval (CI), 26.6% to 38.2%]) had a history of IPV in their lifetime and disclosed this at their initial orthopaedic clinic appointment. Twenty-one participants (12.4% [95% CI, 7.5% to 17.8%]) who did not disclose abuse at the initial visit disclosed IPV during the follow-up. In our a priori unadjusted analysis, disclosure of IPV at the initial appointment or a subsequent follow-up appointment was associated with a 32% lower likelihood of returning to a pre-injury level of function with no restrictions regarding responsibilities at home (hazard ratio, 0.68 [95% CI, 0.46 to 0.99]; p = 0.046). Participants disclosing IPV had lower health-related quality of life on the EuroQol-5 Dimensions (EQ-5D) at the 6-month-follow-up, with adjusted mean differences of -5.3 (95% CI, -10.2 to -0.4, p = 0.04) for the visual analog scale and -0.06 (95% CI, -0.11 to -0.01; p = 0.02) for the Function Index. They also had lower Function Index scores at the final 12-month follow-up visit, with an adjusted mean difference of -0.06 (95% CI, -0.10 to -0.02; p = 0.006). CONCLUSIONS A surprisingly high percentage of women disclosed IPV within 12 months after the injury. Our exploratory results suggest that women who disclose IPV may have lower health-related quality of life. This study supports the need to optimize orthopaedic clinics to provide appropriate support for asking about and assisting individuals who experienced IPV. Additional research is warranted to further explore these findings. LEVEL OF EVIDENCE Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Kim Madden
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sheila Sprague
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Brad Petrisor
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Prism S Schneider
- Division of Orthopaedic Trauma, Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Ydo V Kleinlugtenbelt
- Department of Orthopedic and Trauma Surgery, Deventer Ziekenhuis, Deventer, the Netherlands
| | - Elisa A M Hackenberg
- Department of Orthopaedics and Traumatology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Yaiza Garcia-Sanchez
- Department of Orthopedic Surgery and Traumatology, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Jeremy A Hall
- Division of Orthopaedic Surgery, Department of Surgery, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Mohit Bhandari
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
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Atwan Y, Sprague S, Slobogean GP, Bzovsky S, Jeray KJ, Petrisor B, Bhandari M, Schemitsch E. Does negative pressure wound therapy reduce the odds of infection and improve health-related quality of life in patients with open fractures? Bone Jt Open 2022; 3:189-195. [PMID: 35236110 PMCID: PMC8965780 DOI: 10.1302/2633-1462.33.bjo-2021-0199.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aims To evaluate the impact of negative pressure wound therapy (NPWT) on the odds of having deep infections and health-related quality of life (HRQoL) following open fractures. Methods Patients from the Fluid Lavage in Open Fracture Wounds (FLOW) trial with Gustilo-Anderson grade II or III open fractures within the lower limb were included in this secondary analysis. Using mixed effects logistic regression, we assessed the impact of NPWT on deep wound infection requiring surgical intervention within 12 months post-injury. Using multilevel model analyses, we evaluated the impact of NPWT on the Physical Component Summary (PCS) of the 12-Item Short-Form Health Survey (SF-12) at 12 months post-injury. Results After applying inverse probability treatment weighting to adjust for the influence of injury characteristics on type of dressing used, 1,322 participants were assessed. The odds of developing a deep infection requiring operative management within 12 months of initial surgery was 4.52-times higher in patients who received NPWT compared to those who received a standard wound dressing (95% confidence interval (CI) 1.84 to 11.12; p = 0.001). Overall, 1,040 participants were included in our HRQoL analysis, and those treated with NPWT had statistically significantly lower mean SF-12 PCS post-fracture (p < 0.001). These differences did not reach the minimally important difference for the SF-12 PCS. Conclusion Our analysis found that patients treated with NPWT had higher odds of developing a deep infection requiring operative management within 12 months post-fracture. Due to possible residual confounding with the worst cases being treated with NPWT, we are unable to determine if NPWT has a negative effect or is simply a marker of worse injuries or poor access to early soft-tissue coverage. Regardless, our results suggest that the use of this treatment requires further evaluation. Cite this article: Bone Jt Open 2022;3(3):189–195.
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Affiliation(s)
- Yousif Atwan
- Department of Surgery, Western University, London, Ontario, Canada
| | - Sheila Sprague
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Gerard P. Slobogean
- R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Kyle J. Jeray
- Department of Orthopaedic Surgery, Prisma Health Upstate, Greenville, South Carolina, USA
| | - Brad Petrisor
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Mohit Bhandari
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Canada
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Emil Schemitsch
- Department of Surgery, Western University, London, Ontario, Canada
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Reis G, Dos Santos Moreira Silva EA, Medeiros Silva DC, Thabane L, Cruz Milagres A, Ferreira TS, Quirino Dos Santos CV, de Figueiredo Neto AD, Diniz Callegari E, Monteiro Savassi LC, Campos Simplicio MI, Barra Ribeiro L, Oliveira R, Harari O, Bailey H, Forrest JI, Glushchenko A, Sprague S, McKay P, Rayner CR, Ruton H, Guyatt GH, Mills EJ. Effect of early treatment with metformin on risk of emergency care and hospitalization among patients with COVID-19: The TOGETHER randomized platform clinical trial. Lancet Reg Health Am 2022; 6:100142. [PMID: 34927127 PMCID: PMC8668402 DOI: 10.1016/j.lana.2021.100142] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Observational studies have postulated a therapeutic role of metformin in treating COVID-19. We conducted an adaptive platform clinical trial to determine whether metformin is an effective treatment for high-risk patients with early COVID-19 in an outpatient setting. Methods The TOGETHER Trial is a placebo-controled, randomized, platform clinical trial conducted in Brazil. Eligible participants were symptomatic adults with a positive antigen test for SARS-CoV-2. We enroled eligible patients over the age of 50 years or with a known risk factor for disease severity. Patients were randomly assigned to receive either placebo or metformin (750 mg twice daily for 10 days or placebo, twice daily for 10 days). The primary outcome was hospitalization defined as either retention in a COVID-19 emergency setting for > 6 h or transfer to tertiary hospital due to COVID-19 at 28 days post randomization. Secondary outcomes included viral clearance at day 7, time to hospitalization, mortality, and adverse drug reactions. We used a Bayesian framework to determine probability of success of the intervention compared to placebo. Findings The TOGETHER Trial was initiated June 2, 2020. We randomized patients to metformin starting January 15, 2021. On April 3, 2021, the Data and Safety Monitoring Committee recommended stopping enrollment into the metformin arm due to futility. We recruited 418 participants, 215 were randomized to the metformin arm and 203 to the placebo arm. More than half of participants (56.0%) were over the age of 50 years and 57.2% were female. Median age was 52 years. The proportion of patients with the primary outcome at 28 days was not different between the metformin and placebo group (relative risk [RR] 1.14[95% Credible Interval 0.73; 1.81]), probability of superiority 0.28. We found no significant differences between the metformin and placebo group on viral clearance through to day 7 (Odds ratio [OR], 0.99, 95% Confidence Intervals 0.88–1.11) or other secondary outcomes. Interpretation In this randomized trial, metformin did not provide any clinical benefit to ambulatory patients with COVID-19 compared to placebo, with respect to reducing the need for retention in an emergency setting or hospitalization due to worsening COVID-19. There were also no differences between metformin and placebo observed for other secondary clinical outcomes. Funding The trial was supported by FastGrants and The Rainwater Foundation.
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Affiliation(s)
- Gilmar Reis
- Research Division, Cardresearch Cardiologia Assistencial e de Pesquisa, Pontifícia Universidade Católica de Minas Gerais, Rua Domingos Vieira 300, Sala 606 Santa Efigenia, Belo Horizonte, Minas Gerais, Brazil.,Department of Medicine, Pontifícia Universidade Católica de Minas Gerais, Brazil
| | | | | | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Aline Cruz Milagres
- Public Health Care Division, Ibirité, Brazil.,Family Medicine, Mental and Public Health Department, Ouro Preto Federal University, Ouro Preto, Brazil
| | - Thiago Santiago Ferreira
- Research Division, Cardresearch Cardiologia Assistencial e de Pesquisa, Pontifícia Universidade Católica de Minas Gerais, Rua Domingos Vieira 300, Sala 606 Santa Efigenia, Belo Horizonte, Minas Gerais, Brazil
| | - Castilho Vitor Quirino Dos Santos
- Research Division, Cardresearch Cardiologia Assistencial e de Pesquisa, Pontifícia Universidade Católica de Minas Gerais, Rua Domingos Vieira 300, Sala 606 Santa Efigenia, Belo Horizonte, Minas Gerais, Brazil.,Department of Medicine, Pontifícia Universidade Católica de Minas Gerais, Brazil
| | - Adhemar Dias de Figueiredo Neto
- Public Health Fellowship Program, Governador Valadares Public Health Authority, Brazil.,Department of Medicine, Juiz de Fora Federal University, Juiz de Fora, Brazil
| | | | - Leonardo Cançado Monteiro Savassi
- Public Health Care Division, Ibirité, Brazil.,Family Medicine, Mental and Public Health Department, Ouro Preto Federal University, Ouro Preto, Brazil
| | - Maria Izabel Campos Simplicio
- Research Division, Cardresearch Cardiologia Assistencial e de Pesquisa, Pontifícia Universidade Católica de Minas Gerais, Rua Domingos Vieira 300, Sala 606 Santa Efigenia, Belo Horizonte, Minas Gerais, Brazil
| | - Luciene Barra Ribeiro
- Research Division, Cardresearch Cardiologia Assistencial e de Pesquisa, Pontifícia Universidade Católica de Minas Gerais, Rua Domingos Vieira 300, Sala 606 Santa Efigenia, Belo Horizonte, Minas Gerais, Brazil
| | - Rosemary Oliveira
- Research Division, Cardresearch Cardiologia Assistencial e de Pesquisa, Pontifícia Universidade Católica de Minas Gerais, Rua Domingos Vieira 300, Sala 606 Santa Efigenia, Belo Horizonte, Minas Gerais, Brazil
| | - Ofir Harari
- Cytel Inc., Vancouver, British Columbia, Canada
| | | | - Jamie I Forrest
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alla Glushchenko
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sheila Sprague
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Paula McKay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Craig R Rayner
- Research Division, Cardresearch Cardiologia Assistencial e de Pesquisa, Pontifícia Universidade Católica de Minas Gerais, Rua Domingos Vieira 300, Sala 606 Santa Efigenia, Belo Horizonte, Minas Gerais, Brazil.,Certara Inc. NJ, USA
| | - Hinda Ruton
- Cytel Inc., Vancouver, British Columbia, Canada
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Edward J Mills
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Forrest JI, Rawat A, Duailibe F, Guo CM, Sprague S, McKay P, Reis G, Mills EJ. Resilient Clinical Trial Infrastructure in Response to the COVID-19 Pandemic: Lessons Learned from the TOGETHER Randomized Platform Clinical Trial. Am J Trop Med Hyg 2022; 106:389-393. [PMID: 34996047 PMCID: PMC8832890 DOI: 10.4269/ajtmh.21-1202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/02/2021] [Indexed: 11/07/2022] Open
Abstract
In response to the COVID-19 pandemic, clinical research groups across the world developed trial protocols to evaluate the safety and efficacy of treatments for COVID-19. Despite this initial enthusiasm, only a small portion of these protocols were implemented. Of those implemented, a fraction successfully recruited their target sample size to analyze and disseminate findings. More than a year and a half into the COVID-19 pandemic, only a few clinical trials evaluating treatments for COVID-19 have generated new evidence. Productive randomized platform clinical trials evaluating COVID-19 treatments may attribute their success to intentional investments in developing resilient clinical trial infrastructures. Health system resiliency discourse provides a conceptual framework for characterizing attributes for withstanding shocks. This framework may also be useful for contextualizing the attributes of productive clinical trials evaluating COVID-19 therapies. We characterize the successful attributes and lessons learned in developing the TOGETHER Trial infrastructure using a health system resiliency framework. This framework may be considered by clinical trialists aiming to build resilient trial infrastructures capable of responding rapidly and efficiently to global health threats.
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Affiliation(s)
- Jamie I Forrest
- Platform Life Sciences, Vancouver, Canada.,University of British Columbia, Vancouver, Canada
| | - Angeli Rawat
- University of British Columbia, Vancouver, Canada
| | | | - Christina M Guo
- Platform Life Sciences, Vancouver, Canada.,University of Aberdeen, Aberdeen, Scotland
| | | | | | - Gilmar Reis
- CardResearch, Belo Horizonte, Brazil.,Pontifica Católica Universidade de Minas Gerais, Belo Horizonte, Brazil
| | - Edward J Mills
- Platform Life Sciences, Vancouver, Canada.,McMaster University, Hamilton, Canada
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Madden K, Sprague S. Cochrane in CORR: Strategies to Improve Retention in Randomised Trials. Clin Orthop Relat Res 2022; 480:23-28. [PMID: 34699387 PMCID: PMC8673993 DOI: 10.1097/corr.0000000000002028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Kim Madden
- Research Institute of St. Joseph’s Healthcare, Hamilton, ON, Canada
- Department of Surgery, McMaster University, Hamilton, ON, Canada
| | - Sheila Sprague
- Department of Surgery, McMaster University, Hamilton, ON, Canada
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Reis G, Silva EADSM, Silva DCM, Thorlund K, Thabane L, Guyatt GH, Forrest JI, Glushchenko AV, Chernecki C, McKay P, Sprague S, Harari O, Ruton H, Rayner CR, Mills EJ. A multi-center, adaptive, randomized, platform trial to evaluate the effect of repurposed medicines in outpatients with early coronavirus disease 2019 (COVID-19) and high-risk for complications: the TOGETHER master trial protocol. Gates Open Res 2021. [DOI: 10.12688/gatesopenres.13304.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: There remains a need for an effective and affordable outpatient treatment for early COVID-19. Multiple repurposed drugs have shown promise in treating COVID-19. We describe a master protocol that will assess the efficacy of different repurposed drugs as treatments for early COVID-19 among outpatients at a high risk for severe complications. Methods: The TOGETHER Trial is a multi-center platform adaptive randomized, placebo-controlled, clinical trial. Patients are included if they are at least 18 years of age, have a positive antigen test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and have an indication for high risk of disease severity, including co-morbidities, older age, or high body mass index. Eligible patients are randomized with equal chance to an investigational product (IP) or to placebo.The primary endpoint is hospitalization defined as either retention in a COVID-19 emergency setting for greater than 6 hours or transfer to tertiary hospital due to COVID-19. Secondary outcomes include mortality, adverse events, adherence, and viral clearance. Scheduled interim analyses are conducted and reviewed by the Data and Safety Monitoring Committee (DSMC), who make recommendations on continuing or stopping each IP. The platform adaptive design go-no-go decision rules are extended to dynamically incorporate external evidence on COVID-19 interventions from ongoing independent randomized clinical trials. Discussion: Results from this trial will assist in the identification of therapeutics for the treatment of early diagnosed COVID-19. The novel methodological extension of the platform adaptive design to dynamically incorporate external evidence is one of the first of its kind and may provide highly valuable information for all COVID-19 trials going forward. Clinicaltrials.gov registration: NCT04727424 (27/01/2021)
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Gitajn IL, Werth PM, Sprague S, O’Hara N, Della Rocca G, Zura R, Marmor M, Domes CM, Hill LC, Churchill C, Townsend C, Van C, Hogan N, Girardi C, Slobogean GP, Slobogean GP, Sprague S, Wells J, Bhandari M, D'Alleyrand JC, Harris AD, Mullins DC, Thabane L, Wood A, Della Rocca GJ, Hebden J, Jeray KJ, Marchand L, O'Hara LM, Zura R, Gardner MJ, Blasman J, Davies J, Liang S, Taljaard M, Devereaux PJ, Guyatt GH, Heels-Ansdell D, Marvel D, Palmer J, Friedrich J, O'Hara NN, Grissom F, Gitajn IL, Morshed S, O'Toole RV, Petrisor BA, Camara M, Mossuto F, Joshi MG, Fowler J, Rivera J, Talbot M, Dodds S, Garibaldi A, Li S, Nguyen U, Pogorzelski D, Rojas A, Scott T, Del Fabbro G, Szasz OP, McKay P, Howe A, Rudnicki J, Demyanovich H, Little K, Boissonneault A, Medeiros M, Polk G, Kettering E, Hale D, Mahal N, Eglseder A, Johnson A, Langhammer C, Lebrun C, Manson T, Nascone J, Paryavi E, Pensy R, Pollak A, Sciadini M, Degano Y, Demyanovich HK, Joseph K, Phipps H, Hempen E, Johal H, Ristevski B, Williams D, Denkers M, Rajaratnam K, Al-Asiri J, Leonard J, Marcano-Fernández FA, Gallant J, Persico F, Gjorgjievski M, George A, McGaugh SM, Pusztai K, Piekarski S, Lyons M, Gennaccaro J, Natoli RN, Gaski GE, McKinley TO, Virkus WW, Sorkin AT, Szatkowski JP, Baele JR, Mullis BH, Jang Y, Hill LC, Hudgins A, Fentz CL, Diaz MM, Garst KM, Denari EW, Osborn P, Pierrie S, Martinez E, Kimmel J, Adams JD, Beckish ML, Bray CC, Brown TR, Cross AW, Dew T, Faucher GK, Gurich RW, Lazarus DE, Millon SJ, Palmer MJ, Porter SE, Schaller TM, Sridhar MS, Sanders JL, Rudisill LE, Garitty MJ, Poole AS, Sims ML, Carlisle RM, Adams-Hofer E, Huggins BS, Hunter MD, Marshall WA, Bielby Ray S, Smith CD, Altman KM, Bedard JC, Loeffler MF, Pichiotino ER, Cole AA, Maltz EJ, Parker W, Ramsey TB, Burnikel A, Colello M, Stewart R, Wise J, Moody MC, Anderson M, Eskew J, Judkins B, Miller JM, Tanner SL, Snider RG, Townsend CE, Pham KH, Martin A, Robertson E, Skyes JW, Kandemir U, Marmor M, Matityahu A, McClellan RT, Meinberg E, Miclau T, Shearer D, Toogood P, Ding A, Donohue E, Murali J, El Naga A, Tangtiphaiboontana J, Belaye T, Berhaneselase E, Paul A, Garg K, Pokhvashchev D, Gary JL, Warner SJ, Munz JW, Choo AM, Schor TS, Routt ML"C, Rao M, Pechero G, Miller A, Kutzler M, Hagen JE, Patrick M, Vlasak R, Krupko T, Sadasivan K, Talerico M, Horodyski M, Koenig C, Bailey D, Wentworth D, Van C, Schwartz J, Pazik M, Dehghan N, Jones CB, Watson JT, McKee M, Karim A, Sietsema DL, Williams A, Dykes T, Obremsky WT, Jahangir AA, Sethi M, Boyce R, Mitchell P, Stinner DJ, Trochez K, Rodriguez A, Gajari V, Rodriguez E, Pritchett C, Hogan N, Moreno AF, Boulton C, Lowe J, Wild J, Ruth JT, Taylor M, Askam B, Seach A, Saeed S, Culbert H, Cruz A, Knapp T, Hurkett C, Lowney M, Featherston B, Prayson M, Venkatarayappa I, Horne B, Jerele J, Clark L, Marcano-Fernández F, Jornet-Gibert M, Martinez-Carreres L, Marti-Garin D, Serrano-Sanz J, Sanchez-Fernandez J, Sanz-Molero M, Carballo A, Pelfort X, Acerboni-Flores F, Alavedra-Massana A, Anglada-Torres N, Berenguer A, Camara-Cabrera J, Caparros-Garcia A, Fillat-Goma F, Fuentes-Lopez R, Garcia-Rodriguez R, Gimeno-Calavia N, Graells-Alonso G, Martinez-Alvarez M, Martinez-Grau P, Pellejero-Garcia R, Rafols-Perramon O, Penalver JM, Domenech MS, Soler-Cano A, Velasco-Barrera A, Yela-Verdú C, Bueno-Ruiz M, Sánchez-Palomino E, Andriola V, Molina-Corbacho M, Maldonado-Sotoca Y, Gasset-Teixidor A, Blasco-Moreu J, Fernández-Poch N, Rodoreda-Puigdemasa J, Verdaguer-Figuerola A, Enrique Cueva-Sevieri H, Garcia-Gimenez S, Guerra-Farfan E, Tomas-Hernandez J, Teixidor-Serra J, Molero-Garcia V, Selga-Marsa J, Antonio Porcel-Vasquez J, Vicente Andres-Peiro J, Minguell-Monyart J, Nuñez-Camarena J, del Mar Villar-Casares M, Mestre-Torres J, Lalueza-Broto P, Moreira-Borim F, Garcia-Sanchez Y, Romeo NM, Vallier HA, Breslin MA, Fraifogl J, Wilson ES, Wadenpfuhl LK, Halliday PG, Heimke I, Viskontas DG, Apostle KL, Boyer DS, Moola FO, Perey BH, Stone TB, Lemke HM, Zomar M, Spicer E, Fan C"B, Payne K, Phelps K, Bosse M, Karunakar M, Kempton L, Sims S, Hsu J, Seymour R, Churchill C, Bartel C, Mayberry RM, Brownrigg M, Girardi C, Mayfield A, Sweeney J, Pollock H, Hymes RA, Schwartzbach CC, Schulman JE, Malekzadeh AS, Holzman MA, Wills J, Ramsey L, Ahn JS, Panjshiri F, Das S, English AD, Haaser SM, Cuff JAN, Pilson H, Carroll EA, Halvorson JJ, Babcock S, Goodman JB, Holden MB, Bullard D, Williams W, Hill T, Brotherton A, Higgins TF, Haller JM, Rothberg DL, Marchand LS, Neese A, Russell M, Olsen ZM, McGowan AV, Hill S, Coe M, Dwyer K, Mullin D, Reilly CA, DePalo P, Hall AE, Dabrowski RE, Chockbengboun TA, Heng M, Harris MB, Smith RM, Lhowe DW, Esposito JG, Bansal M, McTague M, Alnasser A, Bergin PF, Russell GV, Graves ML, Morellato J, Champion HK, Johnson LN, McGee SL, Bhanat EL, Thimothee J, Serrano J, Mehta S, Donehan D, Ahn J, Horan A, Dooley M, Kuczinski A, Iwu A, Potter D, VanDemark R, Pfaff B, Hollinsworth T, Atkins K, Weaver MJ, von Keudell AG, Allen EM, Sagona AE, Jaeblon T, Beer R, Bauer B, Meredith S, Stone A, Gage MJ, Reilly RM, Sparrow C, Paniagua A. Association of COVID-19 With Achieving Time-to-Surgery Benchmarks in Patients With Musculoskeletal Trauma. JAMA Health Forum 2021; 2:e213460. [PMID: 35977160 PMCID: PMC8727030 DOI: 10.1001/jamahealthforum.2021.3460] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 08/31/2021] [Indexed: 11/14/2022] Open
Abstract
Question Were resource constraints due to the COVID-19 pandemic associated with a delay in urgent fracture surgery beyond national time-to-surgery benchmarks? Findings In this cohort pre-post study that included 3589 patients, there was no association between time to surgery and COVID-19 in either open fracture or closed femur/hip fracture cohorts. Meaning Despite concerns that the unprecedented challenges associated with the COVID-19 pandemic would delay acute management of urgent surgery, many hospital systems within the US were able to implement strategies in keeping with time-to-surgery standards for orthopedic trauma. Importance In response to the COVID-19 pandemic, many hospital systems were forced to reduce operating room capacity and reallocate resources. The outcomes of these policies on the care of injured patients and the maintenance of emergency services have not been adequately reported. Objective To evaluate whether the COVID-19 pandemic was associated with delays in urgent fracture surgery beyond national time-to-surgery benchmarks. Design, Setting, and Participants This retrospective cohort study used data collected in the Program of Randomized Trials to Evaluate Preoperative Antiseptic Skin Solutions in Orthopaedic Trauma among at 20 sites throughout the US and Canada and included patients who sustained open fractures or closed femur or hip fractures. Exposure COVID-19–era operating room restrictions were compared with pre–COVID-19 data. Main Outcomes and Measures Surgery within 24 hours after injury. Results A total of 3589 patients (mean [SD] age, 55 [25.4] years; 1913 [53.3%] male) were included in this study, 2175 pre–COVID-19 and 1414 during COVID-19. A total of 54 patients (3.1%) in the open fracture cohort and 407 patients (21.8%) in the closed hip/femur fracture cohort did not meet 24-hour time-to-surgery benchmarks. We were unable to detect any association between time to operating room and COVID-19 era in either open fracture (odds ratio [OR], 1.40; 95% CI, 0.77-2.55; P = .28) or closed femur/hip fracture (OR, 1.01; 95% CI, 0.74-1.37; P = .97) cohorts. In the closed femur/hip fracture cohort, there was no association between time to operating room and regional COVID-19 prevalence (OR, 1.07; 95% CI, 0.70-1.64; P = .76). Conclusions and Relevance In this cohort study, there was no association between meeting time-to-surgery benchmarks in either open fracture or closed femur/hip fracture during the COVID-19 pandemic compared with before the pandemic. This is counter to concerns that the unprecedented challenges associated with managing the COVID-19 pandemic would be associated with clinically significant delays in acute management of urgent surgical cases and suggests that many hospital systems within the US were able to effectively implement policies consistent with time-to-surgery standards for orthopedic trauma in the context of COVID-19–related resource constraints.
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Affiliation(s)
| | - Paul M. Werth
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | - Nathan O’Hara
- University of Maryland School of Medicine, Baltimore
| | | | - Robert Zura
- Louisiana State University Medical Center, New Orleans
| | | | | | | | - Christine Churchill
- Carolinas Medical Center, Atrium Health Musculoskeletal Institute, Charlotte, North Carolina
| | | | - Chi Van
- University of Florida, Gainesville
| | | | - Cara Girardi
- Carolinas Medical Center, Atrium Health Musculoskeletal Institute, Charlotte, North Carolina
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- for the PREP-IT Investigators
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Reis G, Dos Santos Moreira-Silva EA, Silva DCM, Thabane L, Milagres AC, Ferreira TS, Dos Santos CVQ, de Souza Campos VH, Nogueira AMR, de Almeida APFG, Callegari ED, de Figueiredo Neto AD, Savassi LCM, Simplicio MIC, Ribeiro LB, Oliveira R, Harari O, Forrest JI, Ruton H, Sprague S, McKay P, Glushchenko AV, Rayner CR, Lenze EJ, Reiersen AM, Guyatt GH, Mills EJ. Effect of early treatment with fluvoxamine on risk of emergency care and hospitalisation among patients with COVID-19: the TOGETHER randomised, platform clinical trial. Lancet Glob Health 2021; 10:e42-e51. [PMID: 34717820 PMCID: PMC8550952 DOI: 10.1016/s2214-109x(21)00448-4] [Citation(s) in RCA: 234] [Impact Index Per Article: 78.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 09/16/2021] [Accepted: 09/21/2021] [Indexed: 12/17/2022]
Abstract
Background Recent evidence indicates a potential therapeutic role of fluvoxamine for COVID-19. In the TOGETHER trial for acutely symptomatic patients with COVID-19, we aimed to assess the efficacy of fluvoxamine versus placebo in preventing hospitalisation defined as either retention in a COVID-19 emergency setting or transfer to a tertiary hospital due to COVID-19. Methods This placebo-controlled, randomised, adaptive platform trial done among high-risk symptomatic Brazilian adults confirmed positive for SARS-CoV-2 included eligible patients from 11 clinical sites in Brazil with a known risk factor for progression to severe disease. Patients were randomly assigned (1:1) to either fluvoxamine (100 mg twice daily for 10 days) or placebo (or other treatment groups not reported here). The trial team, site staff, and patients were masked to treatment allocation. Our primary outcome was a composite endpoint of hospitalisation defined as either retention in a COVID-19 emergency setting or transfer to tertiary hospital due to COVID-19 up to 28 days post-random assignment on the basis of intention to treat. Modified intention to treat explored patients receiving at least 24 h of treatment before a primary outcome event and per-protocol analysis explored patients with a high level adherence (>80%). We used a Bayesian analytic framework to establish the effects along with probability of success of intervention compared with placebo. The trial is registered at ClinicalTrials.gov (NCT04727424) and is ongoing. Findings The study team screened 9803 potential participants for this trial. The trial was initiated on June 2, 2020, with the current protocol reporting randomisation to fluvoxamine from Jan 20 to Aug 5, 2021, when the trial arms were stopped for superiority. 741 patients were allocated to fluvoxamine and 756 to placebo. The average age of participants was 50 years (range 18–102 years); 58% were female. The proportion of patients observed in a COVID-19 emergency setting for more than 6 h or transferred to a teritary hospital due to COVID-19 was lower for the fluvoxamine group compared with placebo (79 [11%] of 741 vs 119 [16%] of 756); relative risk [RR] 0·68; 95% Bayesian credible interval [95% BCI]: 0·52–0·88), with a probability of superiority of 99·8% surpassing the prespecified superiority threshold of 97·6% (risk difference 5·0%). Of the composite primary outcome events, 87% were hospitalisations. Findings for the primary outcome were similar for the modified intention-to-treat analysis (RR 0·69, 95% BCI 0·53–0·90) and larger in the per-protocol analysis (RR 0·34, 95% BCI, 0·21–0·54). There were 17 deaths in the fluvoxamine group and 25 deaths in the placebo group in the primary intention-to-treat analysis (odds ratio [OR] 0·68, 95% CI: 0·36–1·27). There was one death in the fluvoxamine group and 12 in the placebo group for the per-protocol population (OR 0·09; 95% CI 0·01–0·47). We found no significant differences in number of treatment emergent adverse events among patients in the fluvoxamine and placebo groups. Interpretation Treatment with fluvoxamine (100 mg twice daily for 10 days) among high-risk outpatients with early diagnosed COVID-19 reduced the need for hospitalisation defined as retention in a COVID-19 emergency setting or transfer to a tertiary hospital. Funding FastGrants and The Rainwater Charitable Foundation. Translation For the Portuguese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Gilmar Reis
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil; Department of Medicine, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil.
| | - Eduardo Augusto Dos Santos Moreira-Silva
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil; Department of Medicine, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
| | - Daniela Carla Medeiros Silva
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil; Department of Medicine, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Aline Cruz Milagres
- Family Medicine, Mental and Public Health Department, Ouro Preto Federal University, Ouro Preto, Brazil; Public Health Care Division, City of Ibirité, Brazil
| | - Thiago Santiago Ferreira
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil
| | - Castilho Vitor Quirino Dos Santos
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil; Department of Medicine, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
| | - Vitoria Helena de Souza Campos
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil; Department of Medicine, Pontifícia Universidade Católica de Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | - Adhemar Dias de Figueiredo Neto
- Juiz de Fora Federal University, Juiz de Fora, Brazil; Public Health Fellowship Program, Governador Valadares Public Health Authority, Governador Valadares, Brazil
| | | | | | - Luciene Barra Ribeiro
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil
| | - Rosemary Oliveira
- Research Division, Cardresearch - Cardiologia Assistencial e de Pesquisa, Belo Horizonte, Brazil
| | | | | | | | - Sheila Sprague
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Paula McKay
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Alla V Glushchenko
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Craig R Rayner
- Certara, Princeton, NJ, USA; Monash Institute of Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia
| | - Eric J Lenze
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Angela M Reiersen
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Gordon H Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Edward J Mills
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
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Slobogean GP, Sprague S, Bzovsky S, Scott T, Thabane L, Heels-Ansdell D, O'Toole RV, Howe A, Gaski GE, Hill LC, Brown KM, Viskontas D, Zomar M, Della Rocca GJ, O'Hara NN, Bhandari M. Fixation using Alternative Implants for the Treatment of Hip Fractures (FAITH-2): The Exploratory Health-Related Quality of Life and Patient-Reported Functional Outcomes of a Multi-Centre 2 × 2 Factorial Randomized Controlled Pilot Trial in Young Femoral Neck Fracture Patients. Injury 2021; 52:3051-3059. [PMID: 33618847 DOI: 10.1016/j.injury.2021.02.030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/25/2020] [Accepted: 02/12/2021] [Indexed: 02/02/2023]
Abstract
PURPOSE Femoral neck fractures in young patients are typically managed with internal fixation using either cancellous screws or a sliding hip screw (SHS). Although fixation preserves the hip joint, patients are still at risk of complications and poor clinical outcomes which lead to diminished function and health related quality of life (HRQL). The Fixation using Alternative Implants for the Treatment of Hip Fractures (FAITH-2) pilot randomized controlled factorial trial evaluated the effect of surgical fixation (cancellous screws vs. SHS) and vitamin D supplementation vs. placebo on patient-reported function and HRQL. METHODS Patients between the ages of 18-60 years with a femoral neck fracture requiring surgical fixation were eligible. Eligible patients were randomized to receive either a sliding hip screw or cancellous screws for fracture fixation AND vitamin D3 4,000 IU or placebo daily for 6 months. Patient-reported function (Hip Outcome Score) and HRQL (Short Form-12) were assessed at standardized time points in the 12 months following their fixation surgery. Patient-reported function and HRQL were summarized using means, SD, and 95% confidence intervals (CIs), or percentages and counts. Longitudinal data analysis with mixed models was used to explore the effect of treatment group and time on the patient-reported function and HRQL. RESULTS 86 of the 91 patients randomized into the FAITH-2 pilot study were deemed eligible. There were no significant differences in patient-reported function or HRQL between the treatment groups at 12 months post-fracture. At the 6- and 9-month assessments, a potential benefit in hip function was seen in the cancellous screw group. In all treatment groups, participants reported lower function and HRQL at 12 months post-fracture as compared to their pre-injury assessment. CONCLUSIONS Few differences were found in function and HRQL among the treatment groups in the FAITH-2 pilot study. Despite modern implants and vitamin D supplementation, neither function nor HRQL returns to baseline in this population. Additional efforts to improve the outcomes of these challenging injuries are still needed. LEVEL OF EVIDENCE Therapeutic Level II.
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Affiliation(s)
- Gerard P Slobogean
- R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, Maryland, 21201, USA.
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada
| | - Taryn Scott
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada
| | - Diane Heels-Ansdell
- Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada
| | - Robert V O'Toole
- R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, Maryland, 21201, USA
| | - Andrea Howe
- R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, Maryland, 21201, USA
| | - Greg E Gaski
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | - Lauren C Hill
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | - Krista M Brown
- Department of Orthopaedic Surgery, Indiana University School of Medicine, Indianapolis, Indiana, 46202, USA
| | - Darius Viskontas
- Department of Orthopaedics, University of British Columbia, New Westminster, British Columbia, V6T 1Z4, Canada
| | - Mauri Zomar
- Division of Orthopaedics, Fraser Health Authority, New Westminster, British Columbia, V3L 3W2, Canada
| | - Gregory J Della Rocca
- Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri, 65212, USA
| | - Nathan N O'Hara
- R Adams Cowley Shock Trauma Center, Department of Orthopaedics, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, Maryland, 21201, USA
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, 1280 Main Street West, Hamilton, Ontario, L8S 4L8, Canada
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Reis G, Silva EADSM, Silva DCM, Thorlund K, Thabane L, Guyatt GH, Forrest JI, Glushchenko AV, Chernecki C, McKay P, Sprague S, Harari O, Ruton H, Rayner CR, Mills EJ. A multi-center, adaptive, randomized, platform trial to evaluate the effect of repurposed medicines in outpatients with early coronavirus disease 2019 (COVID-19) and high-risk for complications: the TOGETHER master trial protocol. Gates Open Res 2021. [DOI: 10.12688/gatesopenres.13304.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Although vaccines are currently available for coronavirus disease 2019 (COVID-19), there remains a need for an effective and affordable outpatient treatment for early COVID-19. Multiple repurposed drugs have shown promise in treating COVID-19. We describe a master protocol that will assess the efficacy of different repurposed drugs as treatments for early COVID-19 among outpatients at a high risk for severe complications. Methods: The TOGETHER Trial is an international (currently in Brazil and Africa), multi-center platform adaptive randomized, placebo-controlled, clinical trial. Patients are included if they are at least 18 years of age, have a positive antigen test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and have an indication for high risk of disease severity, including co-morbidities, older age, or high body mass index. Eligible patients are randomized with equal chance to an investigational product (IP) or to placebo. The primary endpoint is hospitalization due to clinical worsening of COVID-19 or emergency room required observation for more than 6 hours up to 28 days after randomization. Key secondary endpoints include viral clearance, clinical improvement, hospitalization for any cause, mortality for any cause, and safety and tolerability of each IP. Scheduled interim analyses are conducted and reviewed by the Data and Safety Monitoring Committee (DSMC), who make recommendations on continuing or stopping each IP. The platform adaptive design go-no-go decision rules are extended to dynamically incorporate external evidence on COVID-19 interventions from ongoing independent randomized clinical trials. Discussion: Results from this trial will assist in the identification of therapeutics for COVID-19 that can easily be scaled in low- and middle-income settings. The novel methodological extension of the platform adaptive design to dynamically incorporate external evidence is one of the first of its kind and may provide highly valuable information for all COVID-19 trials going forward. Clinicaltrials.gov registration: NCT04727424 (27/01/2021)
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Comeau-Gauthier M, Zura RD, Bzovsky S, Schemitsch EH, Axelrod D, Avram V, Manjoo A, Poolman RW, Frihagen F, Heels-Ansdell D, Bhandari M, Sprague S. Heterotopic Ossification Following Arthroplasty for Femoral Neck Fracture. J Bone Joint Surg Am 2021; 103:1328-1334. [PMID: 33764913 PMCID: PMC8388546 DOI: 10.2106/jbjs.20.01586] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Heterotopic ossification (HO) is a frequent complication following hip surgery. Using data from the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial, we aimed to (1) determine the prevalence of HO following total hip arthroplasty (THA) for femoral neck fracture in patients ≥50 years of age, (2) identify whether HO is associated with an increased risk of revision surgery within 24 months after the fracture, and (3) determine the impact of HO on functional outcomes. METHODS We performed a multivariable Cox regression analysis using revision surgery as the dependent variable and HO as the independent variable. We compared Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores between participants with and those without HO at 24 months. RESULTS Of 1,441 participants in the study, 287 (19.9%) developed HO within 24 months. HO was not associated with subsequent revision surgery. Grade-III HO was associated with statistically significant and clinically relevant deterioration in the total WOMAC score, which was mainly related to the function component of the score, compared with grade I or II. CONCLUSIONS The impact of grade-III HO on the functional outcomes and quality of life after THA for hip fracture is clinically important, and HO prophylaxis for selected high-risk patients may be appropriate. LEVEL OF EVIDENCE Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
| | - Robert D. Zura
- Department of Orthopedic Surgery, Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - Sofia Bzovsky
- Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Emil H. Schemitsch
- Department of Surgery, University of Western Ontario, London, Ontario, Canada
| | - Daniel Axelrod
- Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Victoria Avram
- Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Ajay Manjoo
- Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Rudolf W. Poolman
- Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, and OLVG (Onze Lieve Vrouwe Gasthuis), Amsterdam, the Netherlands
| | - Frede Frihagen
- Department of Orthopaedic Surgery, Østfold Hospital Trust, Grålum, Norway,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Diane Heels-Ansdell
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Mohit Bhandari
- Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sheila Sprague
- Division of Orthopaedics, Department of Surgery, McMaster University, Hamilton, Ontario, Canada,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Swiontkowski M, Teague D, Sprague S, Bzovsky S, Heels-Ansdell D, Bhandari M, Schemitsch EH, Sanders DW, Tornetta P, Walter SD. Impact of centre volume, surgeon volume, surgeon experience and geographic location on reoperation after intramedullary nailing of tibial shaft fractures. Can J Surg 2021; 64:E371-E376. [PMID: 34222771 PMCID: PMC8410470 DOI: 10.1503/cjs.004020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Tibial shaft fractures are the most common long-bone injury, with a reported annual incidence of more than 75 000 in the United States. This study aimed to determine whether patients with tibial fractures managed with intramedullary nails experience a lower rate of reoperation if treated at higher-volume hospitals, or by higher-volume or more experienced surgeons. Methods: The Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT) was a multicentre randomized clinical trial comparing reamed and nonreamed intramedullary nailing on rates of reoperation to promote fracture union, treat infection or preserve the limb in patients with open and closed fractures of the tibial shaft. Using data from SPRINT, we quantified centre and surgeon volumes into quintiles. We performed analyses adjusted for type of fracture (open v. closed), type of injury (isolated v. multitrauma), gender and age for the primary outcome of reoperation using multivariable logistic regression. Results: There were no significant differences in the odds of reoperation between high- and low-volume centres (p = 0.9). Overall, surgeon volume significantly affected the odds of reoperation (p = 0.03). The odds of reoperation among patients treated by moderate-volume surgeons were 50% less than those among patients treated by very-low-volume surgeons (odds ratio [OR] 0.50, 95% confidence interval [CI] 0.28–0.88), and the odds of reoperation among patients treated by high-volume surgeons were 47% less than those among patients treated by very-low-volume surgeons (OR 0.53, 95% CI 0.30–0.93). Conclusion: There appears to be no significant additional patient benefit in treatment by a higher-volume centre for intramedullary fixation of tibial shaft fractures. Additional research on the effects of surgical and clinical site volume in tibial shaft fracture management is needed to confirm this finding. The odds of reoperation were higher in patients treated by very-low-volume surgeons; this finding may be used to optimize the results of tibial shaft fracture management. Clinical trial registration: ClinicalTrials.gov, NCT00038129
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Affiliation(s)
- Marc Swiontkowski
- From the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. (Teague); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Sprague, Heels-Ansdell, Bhandari, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bzovsky, Bhandari); the Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); and the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - David Teague
- From the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. (Teague); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Sprague, Heels-Ansdell, Bhandari, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bzovsky, Bhandari); the Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); and the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Sheila Sprague
- From the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. (Teague); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Sprague, Heels-Ansdell, Bhandari, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bzovsky, Bhandari); the Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); and the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Sofia Bzovsky
- From the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. (Teague); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Sprague, Heels-Ansdell, Bhandari, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bzovsky, Bhandari); the Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); and the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Diane Heels-Ansdell
- From the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. (Teague); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Sprague, Heels-Ansdell, Bhandari, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bzovsky, Bhandari); the Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); and the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Mohit Bhandari
- From the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. (Teague); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Sprague, Heels-Ansdell, Bhandari, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bzovsky, Bhandari); the Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); and the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Emil H. Schemitsch
- From the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. (Teague); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Sprague, Heels-Ansdell, Bhandari, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bzovsky, Bhandari); the Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); and the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - David W. Sanders
- From the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. (Teague); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Sprague, Heels-Ansdell, Bhandari, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bzovsky, Bhandari); the Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); and the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Paul Tornetta
- From the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. (Teague); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Sprague, Heels-Ansdell, Bhandari, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bzovsky, Bhandari); the Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); and the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
| | - Stephen D. Walter
- From the Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, Minn. (Swiontkowski); the Department of Orthopedic Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Okla. (Teague); the Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ont. (Sprague, Heels-Ansdell, Bhandari, Walter); the Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ont. (Sprague, Bzovsky, Bhandari); the Division of Orthopaedic Surgery, London Health Sciences Centre and Western University, London, Ont. (Schemitsch, Sanders); and the Department of Orthopedic Surgery, Boston Medical Center, Boston, Mass. (Tornetta)
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- London Health Sciences Centre/University of Western Ontario: David W. Sanders, Mark D. Macleod, Timothy Carey, Kellie Leitch, Stuart Bailey, Kevin Gurr, Ken Konito, Charlene Bartha, Isolina Low, Leila V. MacBean, Mala Ramu, Susan Reiber, Ruth Strapp, Christina Tieszer; Sunnybrook Health Sciences Centre/University of Toronto: Hans Kreder, David J.G. Stephen, Terry S. Axelrod, Albert J.M. Yee, Robin R. Richards, Joel Finkelstein, Richard M. Holtby, Hugh Cameron, John Cameron, Wade Gofton, John Murnaghan, Joseph Schatztker, Beverly Bulmer, Lisa Conlan; Hôpital du Sacré-Coeur de Montréal: Yves Laflamme, Gregory Berry, Pierre Beaumont, Pierre Ranger, Georges-Henri Laflamme, Alain Jodoin, Eric Renaud, Sylvain Gagnon, Gilles Maurais, Michel Malo, Julio Fernandes, Kim Latendresse, Marie-France Poirier, Gina Daigneault; St. Michael’s Hospital/University of Toronto: Emil H. Schemitsch, Michael M. McKee, James P. Waddell, Earl R. Bogoch, Timothy R. Daniels, Robert R. McBroom, Robin R. Richards, Milena R. Vicente, Wendy Storey, Lisa M. Wild; Royal Columbian Hospital/University of British Columbia, Vancouver: Robert McCormack, Bertrand Perey, Thomas J. Goetz, Graham Pate, Murray J. Penner, Kostas Panagiotopoulos, Shafique Pirani, Ian G. Dommisse, Richard L. Loomer, Trevor Stone, Karyn Moon, Mauri Zomar; Wake Forest Medical Center/Wake Forest University Health Sciences, Winston-Salem, NC: Lawrence X. Webb, Robert D. Teasdall, John Peter Birkedal, David F. Martin, David S. Ruch, Douglas J. Kilgus, David C. Pollock, Mitchel Brion Harris, Ethan R. Wiesler, William G. Ward, Jeffrey Scott Shilt, Andrew L. Koman, Gary G. Poehling, Brenda Kulp; Boston Medical Center/Boston University School of Medicine: Paul Tornetta III, William R. Creevy, Andrew B. Stein, Christopher T. Bono, Thomas A. Einhorn, T. Desmond Brown, Donna Pacicca, John B. Sledge III, Timothy E. Foster, Ilva Voloshin, Jill Bolton, Hope Carlisle, Lisa Shaughnessy; Wake Medical Center, Raleigh, NC: William T. Ombremsky, C. Michael LeCroy, Eric G. Meinberg, Terry M. Messer, William L. Craig III, Douglas R. Dirschl, Robert Caudle, Tim Harris, Kurt Elhert, William Hage, Robert Jones, Luis Piedrahita, Paul O. Schricker, Robin Driver, Jean Godwin, Gloria Hansley; Vanderbilt University Medical Center, Nashville, Tenn.: William T. Obremskey, Philip J. Kregor, Gregory Tennent, Lisa M. Truchan, Marcus Sciadini, Franklin D. Shuler, Robin E. Driver, Mary Alice Nading, Jacky Neiderstadt, Alexander R. Vap; MetroHealth Medical Center, Cleveland: Heather A. Vallier, Brendan M. Patterson, John H. Wilber, Roger G. Wilber, John K. Sontich, Timothy A. Moore, Drew Brady, Daniel R. Cooperman, John A. Davis, Beth Ann Cureton; Hamilton Health Sciences, Hamilton, Ont.: Scott Mandel, R. Douglas Orr, John T.S. Sadler, Tousief Hussain, Krishan Rajaratnam, Bradley Petrisor, Mohit Bhandari, Brian Drew, Drew A. Bednar, Desmond C.H. Kwok, Shirley Pettit, Jill Hancock, Natalie Sidorkewicz; Regions Hospital, Saint Paul, Minn.: Peter A. Cole, Joel J. Smith, Gregory A. Brown, Thomas A. Lange, John G. Stark, Bruce Levy, Marc Swiontkowski, Julie Agel, Mary J. Garaghty, Joshua G. Salzman, Carol A. Schutte, Linda (Toddie) Tastad, Sandy Vang; University of Louisville School of Medicine, Louisville, Ky.: David Seligson, Craig S. Roberts, Arthur L. Malkani, Laura Sanders, Sharon Allen Gregory, Carmen Dyer, Jessica Heinsen, Langan Smith, Sudhakar Madanagopal; Memorial Hermann Hospital, Houston: Kevin J. Coupe, Jeffrey J. Tucker, Allen R. Criswell, Rosemary Buckle, Alan Jeffrey Rechter, Dhiren Shaskikant Sheth, Brad Urquart, Thea Trotscher; Erie County Medical Center/University of Buffalo, Buffalo, NY: Mark J. Anders, Joseph M. Kowalski, Marc S. Fineberg, Lawrence B. Bone, Matthew J. Phillips, Bernard Rohrbacher, Philip Stegemann, William M. Mihalko, Cathy Buyea; University of Florida – Jacksonville: Stephen J. Augustine, William Thomas Jackson, Gregory Solis, Sunday U. Ero, Daniel N. Segina, Hudson B. Berrey, Samuel G. Agnew, Michael Fitzpatrick, Lakina C. Campbell, Lynn Derting, June McAdams; Academic Medical Center, Amsterdam: J. Carel Goslings, Kees Jan Ponsen, Jan Luitse, Peter Kloen, Pieter Joosse, Jasper Winkelhagen, Raphaël Duivenvoorden; University of Oklahoma Health Science Center, Oklahoma City: David C. Teague, Joseph Davey, J. Andy Sullivan, William J.J. Ertl, Timothy A. Puckett, Charles B. Pasque, John F. Tompkins II, Curtis R. Gruel, Paul Kammerlocher, Thomas P. Lehman, William R. Puffinbarger, Kathy L. Carl; University of Alberta/University of Alberta Hospital, Edmonton: Donald W. Weber, Nadr M. Jomha, Gordon R. Goplen, Edward Masson, Lauren A. Beaupre, Karen E. Greaves, Lori N. Schaump; Greenville Hospital System, Greenville, SC: Kyle J. Jeray, David R. Goetz, Davd E. Westberry, J. Scott Broderick, Bryan S. Moon, Stephanie L. Tanner; Foothills General Hospital, Calgary: James N. Powell, Richard E. Buckley, Leslie Elves; Saint John Regional Hospital, Saint John, NB: Stephen Connolly, Edward P. Abraham, Donna Eastwood, Trudy Steele; Oregon Health & Science University, Portland: Thomas Ellis, Alex Herzberg, George A. Brown, Dennis E. Crawford, Robert Hart, James Hayden, Robert M. Orfaly, Theodore Vigland, Maharani Vivekaraj, Gina L. Bundy; San Francisco General Hospital: Theodore Miclau III, Amir Matityahu, R. Richard Coughlin, Utku Kandemir, R. Trigg McClellan, Cindy Hsin-Hua Lin; Detroit Receiving Hospital: David Karges, Kathryn Cramer, J. Tracy Watson, Berton Moed, Barbara Scott; Deaconess Hospital Regional Trauma Center and Orthopaedic Associates, Evansville, Ind.: Dennis J. Beck, Carolyn Orth; Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ont.: David Puskas, Russell Clark, Jennifer Jones; Jamaica Hospital, Jamaica, NY: Kenneth A. Egol, Nader Paksima, Monet France; Ottawa Hospital – Civic Campus: Eugene K. Wai, Garth Johnson, Ross Wilkinson, Adam T. Gruszczynski, Liisa Vexler
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Johal H, Axelrod D, Sprague S, Petrisor B, Jeray KJ, Heels-Ansdell D, Bzovsky S, Bhandari M. The effect of time to irrigation and debridement on the rate of reoperation in open fractures : a propensity score-based analysis of the Fluid Lavage of Open Wounds (FLOW) study. Bone Joint J 2021; 103-B:1055-1062. [PMID: 34058873 DOI: 10.1302/0301-620x.103b6.bjj-2020-2289.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AIMS Despite long-standing dogma, a clear relationship between the timing of surgical irrigation and debridement (I&D) and the development of subsequent deep infection has not been established in the literature. Traditionally, I&D of an open fracture has been recommended within six hours of injury based on animal studies from the 1970s, however the clinical basis for this remains unclear. Using data from a multicentre randomized controlled trial of 2,447 open fracture patients, the primary objective of this secondary analysis is to determine if a relationship exists between timing of wound I&D (within six hours of injury vs beyond six hours) and subsequent reoperation rate for infection or healing complications within one year for patients with open limb fractures requiring surgical treatment. METHODS To adjust for the influence of patient and injury characteristics on the timing of I&D, a propensity score was developed from the dataset. Propensity-adjusted regression allowed for a matched cohort analysis within the study population to determine if early irrigation put patients independently at risk for reoperation, while controlling for confounding factors. Results were reported as odds ratios (ORs), 95% confidence intervals (CIs), and p-values. All analyses were conducted using STATA 14. RESULTS In total, 2,286 of 2,447 patients randomized to the trial from 41 orthopaedic trauma centres across five countries had complete data regarding time to I&D. Prior to matching, the patients managed with early I&D had a higher proportion requiring reoperation for infection or healing complications (17% vs 13%; p = 0.019), however this does not account for selection bias of more severe injuries preferentially being treated earlier. When accounting for propensity matching, early irrigation was not associated with reoperation (OR 0.71 (95% CI 0.47 to 1.07); p = 0.73). CONCLUSION When accounting for other variables, late irrigation does not independently increase risk of reoperation. Cite this article: Bone Joint J 2021;103-B(6):1055-1062.
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Affiliation(s)
- Herman Johal
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Ontario, Canada
| | - Daniel Axelrod
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Ontario, Canada
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Ontario, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Brad Petrisor
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Ontario, Canada
| | - Kyle J Jeray
- Department of Orthopaedic Surgery, Prisma Health-Upstate, Greenville, South Carolina, USA
| | - Diane Heels-Ansdell
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Sofia Bzovsky
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Ontario, Canada
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Ontario, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Gitajn IL, Werth PM, Sprague S, Bzovsky S, Petrisor BA, Jeray KJ, O'Hara NN, Bhandari M, Slobogean G. Effect of Tourniquet Use During Surgical Treatment of Open Fractures. J Bone Joint Surg Am 2021; 103:860-868. [PMID: 33877068 DOI: 10.2106/jbjs.20.01458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND We sought to evaluate whether tourniquet use, with the resultant ischemia and reperfusion, during surgical treatment of an open lower-extremity fracture was associated with an increased risk of complications. METHODS This is a retrospective cohort study of 1,351 patients who had an open lower-extremity fracture at or distal to the proximal aspect of the tibia and who participated in the FLOW (Fluid Lavage of Open Wounds) trial. The independent variable was intraoperative tourniquet use, and the primary outcome measures were adjudicated unplanned reoperation within 1 year of the injury and adjudicated nonoperative wound complications. RESULTS Unplanned reoperation and nonoperative wound complications were roughly even between the no-tourniquet (18.7% and 19.1%, respectively) and tourniquet groups (17.8% and 20.8%) (p = 0.78 and p = 0.52). Following matching, as determined by model interactions, tourniquet use was a significant predictor of unplanned reoperation in Gustilo Type-IIIA (odds ratio, 3.60; 95% confidence interval, 1.16 to 11.78) and IIIB fractures (odds ratio, 16.61; 95% confidence interval, 2.15 to 355.40). CONCLUSIONS The present study showed that tourniquet use did not influence the likelihood of complications following surgical treatment of an open lower-extremity fracture. However, in cases of severe open fractures, tourniquet use was associated with increased odds of unplanned reoperation; surgeons should be cautious with regard to tourniquet use in this setting. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
| | - Paul M Werth
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | | | | | | | | | - Nathan N O'Hara
- University of Maryland School of Medicine, Baltimore, Maryland
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Russell J, Sprague S, Harper S, Green M, Bhandari M. An early cost analysis of magnetic bone growth stimulation in England. Expert Rev Pharmacoecon Outcomes Res 2021; 22:139-145. [PMID: 33890846 DOI: 10.1080/14737167.2021.1920402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Fracture nonunions impact on morbidity and health care costs and are associated with substantial pain, reduced mobility, prolonged morbidity, and a lower quality of life. CMF OrthoLogic 1000 (OL1000) is a bone growth stimulator used to promote fracture healing potentially reducing the need for surgical intervention. A cost analysis comparing CMF OL1000 versus surgical care for patients with nonunion tibial fractures was conducted.Methods: A Markov model was developed to compare the difference in costs between CMF OL1000 versus surgical care within the English National Health Service over a 2-year time horizon. The effectiveness of CMF OL1000 was based on recently published registry data. Cost data were derived from published sources and national cost databases. Sensitivity and scenario analyses were conducted.Results: The use of CMF OL1000 is estimated to lead to cost-savings of £1,104 per patient, a reduction in average healing time of 2.1 months and a relative risk of infection of 0.19 compared to immediate surgical intervention (standard of care). The results of the model are robust to most changes in input parameters and scenarios considered.Conclusions: This early analysis shows cost-savings for CMF OL1000 compared with surgical intervention for individuals with nonunion tibial fractures.
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Affiliation(s)
- Joel Russell
- York Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, York, UK
| | - Sheila Sprague
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Sam Harper
- York Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, York, UK
| | - Michelle Green
- York Health Economics Consortium, Enterprise House, Innovation Way, University of York, Heslington, York, UK
| | - Mohit Bhandari
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
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Lin CA, O'Hara NN, Sprague S, O'Toole RV, Joshi M, Harris AD, Warner SJ, Johal H, Natoli RM, Hagen JE, Jeray KJ, Fowler JT, Phelps KD, Pilson HT, Gitajn IL, Bhandari M, Slobogean GP. Low Adherence to Recommended Guidelines for Open Fracture Antibiotic Prophylaxis. J Bone Joint Surg Am 2021; 103:609-617. [PMID: 33411466 DOI: 10.2106/jbjs.20.01229] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Prompt administration of antibiotics is a critical component of open fracture treatment. Traditional antibiotic recommendations have been a first-generation cephalosporin for Gustilo Type-I and Type-II open fractures, with the addition of an aminoglycoside for Type-III fractures and penicillin for soil contamination. However, concerns over changing bacterial patterns and the side effects of aminoglycosides have led to interest in other regimens. The purpose of the present study was to describe the adherence to current prophylactic antibiotic guidelines. METHODS We evaluated the antibiotic-prescribing practices of 24 centers in the U.S. and Canada that were participating in 2 randomized controlled trials of skin-preparation solutions for open fractures. A total of 1,234 patients were evaluated. RESULTS All patients received antibiotics on the day of admission. The most commonly prescribed antibiotic regimen was cefazolin monotherapy (53.6%). Among patients with Type-I and Type-II fractures, there was 61.1% compliance with cefazolin monotherapy. In contrast, only 17.2% of patients with Type-III fractures received the recommended cefazolin and aminoglycoside therapy, with an additional 6.7% receiving piperacillin/tazobactam. CONCLUSIONS There is moderate adherence to the traditional antibiotic treatment guidelines for Gustilo Type-I and Type-II fractures and low adherence for Type-III fractures. Given the divergence between current practice patterns and prior recommendations, high-quality studies are needed to determine the most appropriate prophylactic protocol.
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Affiliation(s)
- Carol A Lin
- Cedars-Sinai Medical Center, Los Angeles, California
| | - Nathan N O'Hara
- University of Maryland School of Medicine, Baltimore, Maryland
| | | | | | - Manjari Joshi
- University of Maryland School of Medicine, Baltimore, Maryland
| | | | | | | | - Roman M Natoli
- Indiana University School of Medicine, Indianapolis, Indiana
| | | | | | | | | | - Holly T Pilson
- Wake Forest Baptist Medical Center, Winston-Salem, North Carolina
| | - I Leah Gitajn
- Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire
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Medeiros M, Love TR, Slobogean GP, Sprague S, Perfetto EM, O'Hara NN, Mullins CD. Patient and stakeholder engagement learnings: PREP-IT as a case study. J Comp Eff Res 2021; 10:439-442. [PMID: 33759556 DOI: 10.2217/cer-2020-0266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Michelle Medeiros
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore 21201, USA
| | - T Rosie Love
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore 21201, USA
| | - Gerard P Slobogean
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore 21201, USA
| | - Sheila Sprague
- Department of Surgery, Division of Orthopaedic Surgery, McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Eleanor M Perfetto
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore 21201, USA.,National Health Council, Washington, DC 20036, USA
| | - Nathan N O'Hara
- Department of Orthopaedics, University of Maryland School of Medicine, Baltimore 21201, USA
| | - C Daniel Mullins
- Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore 21201, USA
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50
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Sprague S, Guyatt P, Bzovsky S, Nguyen U, Bhandari M, Thabane L, Petrisor B, Johal HS, Leonard J, Dodds S, Mossuto F, O'Toole RV, Howe A, Demyanovich HK, Camara M, O'Hara NN, Slobogean GP. Pragmatic randomized trial evaluating pre-operative aqueous antiseptic skin solution in open fractures (Aqueous-PREP): the feasibility of a cluster randomized crossover study. Pilot Feasibility Stud 2021; 7:61. [PMID: 33648577 PMCID: PMC7919062 DOI: 10.1186/s40814-021-00800-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 02/16/2021] [Indexed: 11/24/2022] Open
Abstract
Background Preoperative antiseptic skin solutions are used prior to most surgical procedures; however, there is no definitive research comparing infection-related outcomes following use of the various solutions available to orthopedic trauma surgeons. The objective of this pilot study was to test the feasibility of a cluster randomized crossover trial that assesses the comparative effectiveness of a 10% povidone-iodine solution versus a 4% chlorhexidine gluconate solution for the management of open fractures. Methods Two orthopedic trauma centers participated in this pilot study. Each of these clinical sites was randomized to a starting solution (povidone-iodine solution or chlorhexidine gluconate) then subsequently crossed over to the other treatment after 2 months. During the 4-month enrollment phase, we assessed compliance, enrollment rates, participant follow-up, and accurate documentation of the primary clinical outcome. Feasibility outcomes included (1) the implementation of the interventions during a run-in period; (2) enrollment of participants during two 2-month enrollment phases; (3) application of the trial interventions as per the cluster randomization crossover scheme; (4) participant follow-up; and (5) accurate documentation of the primary outcome (surgical site infection). Feasibility outcomes were summarized using descriptive statistics reported as means (standard deviation) or medians (first quartile, third quartile) for continuous variables depending on their distribution and counts (percentage) for categorical variables. Corresponding 95% confidence intervals (CIs) were also reported. Results All five of the criteria for feasibility were met. During the run-in phase, all 18 of the eligible patients identified at the two clinical sites received the correct cluster-assigned treatment. A total of 135 patients were enrolled across both sites during the 4-month recruitment phase, which equates to 92% (95% CI 85.9 to 96.4%) of eligible patients being enrolled. Compliance with the assigned treatment in the pilot study was 98% (95% CI 93.5 to 99.8%). Ninety-eight percent (95% CI 93.5 to 99.8%) of participants completed the 90-day post-surgery follow-up and the primary outcome (SSI) was accurately documented for 100% (95% CI 96.6 to 100.0%) of the participants. Conclusions These results confirm the feasibility of a definitive study comparing antiseptic solutions using a cluster randomized crossover trial design. Building upon the infrastructure established during the pilot phase, a definitive study has been successfully initiated. Trial registration ClincialTrials.gov, number NCT03385304. Registered December 28, 2017.
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Affiliation(s)
- Sheila Sprague
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada. .,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
| | - Paige Guyatt
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Sofia Bzovsky
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Uyen Nguyen
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Mohit Bhandari
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Brad Petrisor
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Herman S Johal
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Jordan Leonard
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Shannon Dodds
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Franca Mossuto
- Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Robert V O'Toole
- R Adams Cowley Shock Trauma Center, Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Andrea Howe
- R Adams Cowley Shock Trauma Center, Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Haley K Demyanovich
- R Adams Cowley Shock Trauma Center, Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Megan Camara
- R Adams Cowley Shock Trauma Center, Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Nathan N O'Hara
- R Adams Cowley Shock Trauma Center, Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Gerard P Slobogean
- R Adams Cowley Shock Trauma Center, Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD, USA
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