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The call for evidence-based research is getting louder. The American Recovery and Reinvestment Act (ARRA) contains $1.1 billion for evidence-based research—or what the Obama administration has termed comparative effectiveness research (CER). According to the U.S. Department of Health & Human Services (HHS) website, this funding will "support research assessing the comparative effectiveness of healthcare treatments and strategies, through efforts that conduct, support, or synthesize research that compares the clinical outcomes, effectiveness, and appropriateness of items, services, and procedures that are used to prevent, diagnose, or treat diseases, disorders, and other health conditions…."
Although the O&P profession is taking steps along various paths to answer the call for evidence-based research, the fact remains that right now, the research base in O&P is relatively thin, and the ability to secure significant research funding remains elusive at best.
"There is not enough research in our field," says Peter Rosenstein, executive director of the American Academy of Orthotists and Prosthetists (the Academy). "There are not that many researchers in the field of O&P…and there is an even more limited number of people with PhDs who are also certified in orthotics and prosthetics. It's nearly impossible to get [research] grants directly from NIH [National Institutes of Health] at this point. If you don't have something to start with, they won't even look at you."
So it seems that O&P is in the throes of a vicious circle. It needs outcomes-based research, but because of its relatively undeveloped research core, it lacks the credibility to obtain funding to conduct that very research. If O&P wants to establish a solid base of research, it has to begin from within the profession.
And now there's a mechanism in place to help make that happen. Just over one year ago, the Orthotic and Prosthetic Education and Research Foundation (OPERF) was established "to promote the profession of orthotics and prosthetics through education [and] research," according to the OPERF website.
A small endowment has been started with funds donated from several Academy chapters, industry individuals, and the Academy's College Fund, a fund set up several years ago by former presidents of the Academy. The Academy board voted to close the College Fund and transfer its resources—$125,000—to OPERF, so that they could be used to stimulate new research in the field.
Rosenstein says that one of the primary concerns in setting up a foundation of this type was to ensure that the research sponsored by OPERF funds would be accepted as reliable and independent. Furthermore, the foundation would need to be able to make decisions that were solely in the best interest of O&P education and research, independent of any umbrella organization. To ensure its autonomy, the foundation was established as an independent entity. It applied for 501(c)3 status, and OPERF was founded and incorporated as a nonprofit education and research foundation. The Academy board voted unanimously to offer administrative support to the foundation "in an effort to stimulate its growth and ensure that funds donated to OPERF in its infancy were fully leveraged to support research and education," says Brian Hafner, PhD, who serves on the OPERF board of directors and is chair of the OPERF research committee.
The OPERF board of directors, which includes both Academy and other professional members, recently voted to expand to include six additional members, for a total of 11, in order to ensure that the research and educational activities sponsored by OPERF represented the needs of the profession as a whole. "One of our goals is to fill our board with individuals who have a broad perspective on O&P and can identify all the needs of the profession from different angles," Hafner says.
In addition to its board of directors, OPERF consists of an advisory board, as well as research and education committees. The foundation's board of directors and advisory board represent "a broader spectrum of experience within the field of O&P," says OPERF advisory board member David Adams, vice president of product development for Trulife North America, Poulsbo, Washington.
Through its two committees, the foundation supports the education and research endeavors of O&P professionals and researchers from the time they are students all the way through their professional careers. The research and education committees are tasked with structuring the rules and the application and review processes for the various grants and monetary prizes awarded by the foundation. While the education committee is still being formed, the research committee is well into its second year of work.
At the Academy Annual Meeting this past March, OPERF awarded its first prize—the Tamarack Prize—to Gary Horton, CO, FAAOP. The $10,000 award, which was supported by funds donated by an individual sponsor, was designed to recognize an orthotist who had participated in research that had a significant impact on orthotic technology. (Editor's note: See related story in the sidebar of this month's Industry Review article). "It is the foundation's hope that the Tamarack prize will not be a one-time award, but that funds will be secured to make this a recurring award," Hafner says.
After the Tamarack prize was awarded, OPERF announced its 2009 Awards Program, which includes three levels of awards. According to the OPERF website, the first level—the Resident Travel Award—is designated to support O&P residents to travel to the Academy national meeting and present their NCOPE-required residency research project. Two $1,000 Resident Travel Awards will be offered in 2009.
The second level is the Fellowship Award, which is a $5,000 fellowship to be given to qualified graduate students to support their graduate research. Two fellowship awards will be offered in 2009.
The top level is the Small Grant Award—a $25,000 grant awarded to a "qualified and capable investigator to conduct novel and clinically relevant O&P research." One Small Grant Award will be offered in 2009.
OPERF will seek to sponsor not only research proposed by O&P professionals and researchers, but also targeted, independent research recommended by manufacturers. The review process, according to Hafner, was modeled after those used at NIH and the National Institute on Disability and Rehabilitation Research (NIDRR), the U.S. Department of Education's Research Branch. "This type of review process ensures that the highest quality proposals are funded," Hafner says.
Perhaps one of the most unique aspects of the OPERF awards program is that investigators have the opportunity to go through the peer-review process before they begin their research. "We give every applicant feedback on his or her grant application," Hafner says. "The idea here is not only to score them and say, ‘yes' or ‘no' but also to help them improve the quality of the research before they even get started."
Though Hafner says that OPERF strongly recommends that investigators who win OPERF awards publish their work, there is no requirement to do so, nor is there a stipulation dictating in what publication the research must be published. Award winners are, however, required to attend the Academy annual meeting and present their research, and the Academy has donated to the foundation speaking slots at its annual meeting to facilitate this requirement. "We'll also be looking for other organizations that want to offer up a similar opportunities," Hafner says.
Rosenstein says he doesn't know if the foundation will ever reach the point where it will be giving out million-dollar grants, but it is one of the many steps the O&P profession has taken to recognize the importance of evidence-based research. Hafner agrees. "One of the aspects of being a profession is to identify the need for research in your own area and then being able not only to promote it but also to sponsor it and support it," he says. "I believe OPERF can contribute to that vision."
The deadline to submit abstracts and proposals for the 2009 OPERF awards program is Friday, May 15. For more information, visit www.operf.org
Karen Henry can be reached at
