31st JULY 2017! NEWSLETTER!

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Highlights

•  732pa.entssofar(54inJuly).•  Lastnewdiagnosis30thSEPTEMBER2017.•  WorldChocolateDay–thewinners.

•  Medialepicondyleauditdrivestrialapplica>on.•  BOSSConsentedStudygrowingfast.

“Thefinalpushisontoboostnumbers,andmaximisedataquality–that’smyjob!”

DrEmmaCwiklinskiBOSSStudyManager

MonthlyCaseConfirma.onWeaskeveryhospitaltoclicktoconfirmcaseuploadseachmonth–thisistoconfirmpeoplearelookingforcases(toconfirmatrueincidence).

112sitesconfirmedthattheywereup-to-datelastmonth.(upfrom108lastmonth).

AberdeenAiredaleAneurinBevanBasingstokeBarnsleyHospitalBarnetandChaseBarkingBartsBasildonBedfordBetsiCadwaladrBirminghamBlackpoolBoltonBordersGeneralBuckinghamshireCalderdaleCalderdaleCardiffChesterChesterfieldColchesterCoventryCrosshouseCwmTafDerbyDudleyDoncasterDorsetCountyDumfriesDurhamEast&NorthHertsEastKentEastLancashireEpsomEdinburghFrimley

LET’S ALL GO GREEN BY THE END OF RECRUITMENT!

GloucesterGreatWesternHairmyresHarrogateHeartOfEnglandHinchinbrookHomertonHullImperialIpswichJamesPagetKeWeringKingsCollegeLancashireLeicesterLincolnshireLiverpoolLeedsLutonMaidstoneManchesterMedwayMidCheshireMidYorkshireMonklands&WishMorecambeBayNewcastleNorthamptonNorthCumbriaNorthMidlandsNorthMiddlesexNo[nghamOxfordPennine(NthManc)Pennine(Oldham)PeterboroughPoole

PortsmouthRobertJonesRotherhamRoyalAlexandriaRoyalBerkshireRoyalCornwallRoyalFreeRoyalSurreyRoyalUnitedBathSalisburySandwellScarboroughShrewsburySouthManchesterSouthportSouthamptonSouthTeesStGeorgesStHelensStockportSunderlandTamesideTauntonTaysideUCLWarringtonWestMiddlesexWestSuffolkWexhamParkWhippsCrossWhi[ngtonWirralWorthingWrigh>ngtonYorkWinchesterWolverhamptonWyeValley

MISSEDLASTMONTHBradfordBrightonGlasgowGreatOrmondStGuys(Evelina)LewishamMiltonKeynesNorfolkandNorwichNorthernDevonRaigmoreSheffieldSouthDevonWestHerts

MISSED2MONTHSEastSussexForthValleyMid-EssexRoyalNa>onalOrthoSwanseaWesternIsles

MISSED3MONTHS+BristolChelseaHillingdonInverclydeNthLincolnshire&GoolePrincessAlexandraQEHosptl,WoolwichNorthWestLondonNorthumbriaRoyalDevonWorcestershire

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Whohasrecruitedsofar?

•  Airedale•  AneurinBevan•  Barking•  Barnsley•  Barts•  Bath•  Basildon•  Bedford•  Birmingham•  Bradford•  Brighton•  Bristol•  Buckinghamshire•  Cambridge•  Calderdale•  Cardiff•  Chelsea•  Chester•  Colchester•  Coventry•  Crosshouse•  CwmTaf•  Derby•  Doncaster•  Dudley•  Durham•  East&NthHerts•  EastKent•  EastLancs•  EastSussex

“116 UK SITES NOW RECRUITED”

LastMonth’sTop5

BirminghamFrimley

GloucesterLeeds

RoyalCornwall

•  Edinburgh•  Epsom•  Frimley•  ForthValley•  Glasgow•  Gloucester•  GreatWestern•  GreatOrmondSt•  Guys•  Hillingdon•  Hinchinbrooke•  Hull•  Imperial•  Ipswich•  KeWering•  Kings•  Lancashire•  Leicester•  Lewisham•  Leeds•  Liverpool•  Luton•  No[ngham•  Manchester•  Maidstone•  Medway•  Mid-Essex•  MiltonKeynes•  MidYorks•  MorecambeBay

•  Newcastle•  NorthMidlands•  Northampton•  Northumbria•  NorthDevon•  NorthMiddlesex•  Norwich•  No[ngham•  Oxford•  Pennine(Oldham)•  Peterborough•  Plymouth•  Poole•  Portsmouth•  PrincessAlexandra•  Raigmore•  RobertJones•  Rotherham•  RoyalAberdeen•  RoyalAlexandria•  RoyalBerks•  RoyalCornwall•  RoyalDevon&Exeter•  RoyalFree•  RoyalNa>onalOrth•  RoyalBerks•  RoyalSurrey•  Sandwell•  Sheffield•  Southport

•  SouthDevon•  SouthTees•  Southampton•  Stockport•  StGeorges•  Sunderland•  Swansea•  Tameside•  Taunton•  Tayside•  UnitedLincoln•  Warrington•  WestHerts•  WestMiddlesex•  WestSuffolk•  WexhamPark•  Whi[ngton•  Wirral•  Wishaw•  Wolverhampton•  Worcester•  Worthing•  Wrigh>ngton

32sitesrecruitedinJuly2017–ChocolatesforWorldChocolateDayonwaysoon!

Wolverhampton&SouthDevonforthefirst>me–thankyou!

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Inves.gatorsMee.ng:CaseDefini.on:SlippedEpiphysis-Allnewcasesofdiseaseagerfixa>on.Perthes’Disease–Allnewcasespresen>ngtodefini>vecareclinician(i.e.maybediagnosed6monthsagobuttakensome>metobereferredtothepersonmakingdecisionsaboutmanagement).

FOLLOW-UPREMINDERSHowtofollow-upcases-Themonthlye-mailwillremindyouaboutwhoisduefollow-up.Tofollow-upcases,pleasegointoRedCap(thelinkfromwww.BOSS.surgeryusingamobilephone/tabletcomputeriseasiest).Ratherthanclicking“addnewcase”,selectthepa>ent’snumber(i.e.12-1)andthen“3monthf/u”.Ifyoudoaccidentallyaddanincorrectnewcasethenpleaseno>fyBOSSstudycoordinatoratboss@liv.ac.uk.

ThankstoallthosewhoaWendedtheWebinars.WewillputalinktotherecordedWebinaronBOSS.surgery–andalinkisinthismonth‘se-mail.

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DataQueries:PaulTate,theBOSSdatamanager,willbecheckingafewthingsthroughtheweb-versionofRedCap.Pleasehelpoutbyloggingintocheckthem.

MonthlyEmail.Pleaseconfirmcaseuploadsbyclickingthelinkinthee-mail,ratherthane-mailingus–itissimplertomanage(andtakesabout10secs).AccrualNumbers…There are 732 records in REDCap, howeversomeareineligiblepar>cipants(includedinthegraph for the surveillance cohort), or cases forwhomeligibilityqueriesneed tobe raised.Wewillcontactsurgeonsdirectlytoaddressqueriesrelated to theeligibility. Thank you forhelpingustoresolvethesequeries.ConsentFormsPleasesendconsentformsalongwiththeconsenttrackingformv3(previousversionsarenolongerused).

ConsentedCohort……Why?Gainingconsentforlong-termfollowupandthecollec>onofpa>entreportedoutcomesisafundamentalpartofBOSS.ThisexaminestheuseofPROMSinthispopula>on,andgivesaclearerideaofoutcomes.Who?Everyhospitalcanenrollconsentedpa>ents,thoughthisrequiresaddi>onalsetup(contactboss@liverpool.ac.uk).Pa.entscanbeenrolledatany.meduringthestudy-eveniftheywererecruitedintotheconsentedcohortlastyear.Trials?Gainingconsents>mulatesthedevelopmentoflocalinfrastructureinpaediatricorthopaedicunitsbeforeothertrialsbegin(researchunitsgetanaddi>onal‘accrual’foreachpa>entconsented).

Surveillanceonlysites,weneedyourhelp!…Inordertoallowmeaningfulanalysisoftheresults,weneedasmanyaspossibleineachdiseasegroup.Atpresent,wehave165pa>entsacrossbothSCFEandPerthes’disease.Ifyourcentreisnotopentorecruittotheconsentedcohort,thenpleasepointpa>ents(atanystageoftheir

follow-up)totheBOSSwebsite(www.BOSS.surgery).Pa>entscanregistertopar>cipateintheconsentedcohortthroughthewebsite,andaresearchnurseatAlderHeywillcontactthem.

Everypa.entcanhavetheopportunitytopar.cipateinthesurveillanceandconsentedcohort.

MessagesfromEmma…(boss@liverpool.ac.uk)!Pa.entconfiden.alityPleasedon’tshareanyconfiden>alpa>entdatawiththeBOSSteam.Amendment09From4/8/2017allhospitalsshouldbeworkingtoV5.0(30thMarch2017)oftheprotocol(unlessyourR&Dhassaidtheyneedmore>me).Youshouldreceiveacopyofthecontactcardsandposterinthenextfewdays.Wewillmakealinktotheprotocolonthewebsite.HospitalTransfersIf a pa>ent permanently moves hospital agerbeing enrolled in the study - for whateverr e a s o n , t h e n p l e a s e c o n t a c t(boss@liverpool.ac.uk). Please include thepa>entstudyIDnumber,andthenewhospital.(Remember – we are not allowed to knowpa>entnamesandfullDOBetc.).Wewill liaisewith thenewhospital toensure that follow-upispossible.

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The44hospitalscurrentlywithpermission(i.e.whohavegonethroughtheprocesstotakeresearchconsent)arelistedbelow…

Consen.nghospitals…

Hospitalswithgoodconsentratesoverthenext6monthswillbeinvitedfirsttopar.cipateinforthcomingtrials-establishedinfrastructureisvitaltomaximisetrialdelivery.Hospitalshavetheafewmonthstobecome100%ers! 7

SiteName Percent

Bedford 100

Kejering 100

Maidstone 100

AbertaweBroMorgannwg(Swansea) 100

MorecambeBay 100

WestMiddlesex 100

LancashireTeachingHospitals(Preston) 88

EastLancashire 87

NorfolkandNorwich 73

RobertJonesandAgnesHunt 73

Plymouth 67

AlderHey 62

RoyalNa.onalOrthopaedic 60

NewcastleUponTyneHospitals 60

NorthMidlands(Stoke) 53

LeedsGeneralInfirmary 50

RoyalBerkshire 43

Southampton 41

CoventryandWarwick 36

DarlingtonNHS 33

MidYorkshire 33

NorthamptonGeneral 33

NoonghamUniversity 29

ColchesterHospital 25

EastSussex 25

NHSGreaterGlasgowandClyde 9

Barking,HaveringandRedbridge 0

Barnsley 0

Barts 0

BasildonandThurrock 0

BrightonandSussex 0

Buckinghamshire 0

Cardiff 0

Manchester 0

Doncaster 0

GreatOrmondStreet 0

LutonandDunstable 0

Oxford 0

Peterborough 0

Sheffield 0

Shrewsbury 0

Bristol 0

HeartOfEngland 0

Wrigh>ngton,WiganandLeigh 0

MedialEpicondyleTrial…fixornot?ANIHRexpressionofinterestfor£1mtodeliveratrialhasbeensubmiWed–weknowmanyofyouarekeentobepartofthis…

Geta“luxury”BOSSMugs–JulywinnerTBCsoon!

ToprecruiterstotheconsentedstudyinAugust….

TrialFeasibility-Traineesin30centrescarriedoutanauditof3yearsofmanagement–theheadlines…•  Fewfracturestoanyunit(but507combined).•  Widespreaddisagreementintx(strongevidenceofequipoise).•  Overall-45%fixed(228),55%(279)treatedconserva>vely.•  Atrialispossiblewithalargenumberofunits.•  Traineecollabora>veimportanttodelivertrial.