LAUSR

Bone and joint infections (BJI) are a significant challenge for healthcare systems worldwide, but there are significant challenges in performing high quality BJI research, including heterogeneous presentations, low patient numbers at individual sites and ingrained clinical opinions. BJI research should be focused on specific, clinically relevant questions and driven by clinicianand patient-specific priorities. We aimed to determine clinicians’ research priorities by surveying a diverse group of doctors with a specific interest in this area at a national BJI conference. In March 2020, the inaugural Australasian Bone and Joint Infection conference was held in Newcastle, Australia. The meeting was attended by approximately 200 delegates including practicing clinical specialists and trainees in the fields of infectious diseases (ID), orthopaedic surgery and clinical microbiology. Prior to the conference, we asked all registered delegates to nominate two key BJI research priorities. We compiled these into a list of the eight most commonly suggested priorities and asked conference delegates to rank these in terms of priority (1 being the highest, and 8 being the lowest). For each of the eight topics, we assigned a score of 8 each time a delegate ranked it as number 1, 7 for number 2, 6 for number 3, down to 1 for number 8. We then summed the total score for each topic. This takes into account the number of votes each topic received as well as the priority given. We received a total of 69 responses (42 ID physicians/ trainees, 24 orthopaedic consultants/trainees and 3 from other backgrounds). The research question given the highest priority by clinicians overall was one versus two-stage revision for prosthetic joint infection (Table 1). There was a clear difference in research priorities between the ID and orthopaedic cohort, with ID physicians favouring questions relating to the choice or duration of antibiotics, and orthopaedic surgeons favouring questions of surgical strategy (Table 1). This difference emphasizes the need for increased and continuing dialogue and collaboration between these two key specialties in this field. A brief summary of the existing literature and proposed research for each of top three research priorities follows.