Learning from the past to plan for the future: A scoping review of musculoskeletal clinical research in Sweden 2010–2020

  • Elias Diarbakerli Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; and Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden https://orcid.org/0000-0002-4511-4349
  • Olof Thoreson Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden https://orcid.org/0000-0002-0978-541X
  • Martin Björklund Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden; and Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden https://orcid.org/0000-0001-7543-4397
  • Leif E. Dahlberg Department of Clinical Sciences Lund, Orthopaedics, Lund University, Lund, Sweden https://orcid.org/0000-0001-7838-9464
  • Martin Englund Clinical Epidemiology Unit, Orthopaedics, Department of Clinical Sciences Lund, Lund University, Lund, Sweden https://orcid.org/0000-0003-3320-2437
  • Paul Gerdhem Department of Clinical Sciences, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden; and Department of Orthopaedics, Karolinska University Hospital, Stockholm, Sweden https://orcid.org/0000-0001-8061-7163
  • Joanna Kvist Stockholm Sports Trauma Research Center, Department of Molecular Medicine & Surgery, Karolinska Institute, Solna, Sweden; and Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University https://orcid.org/0000-0003-3527-5488
  • Maziar Mohaddes Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden https://orcid.org/0000-0003-1848-9054
  • Anneli Peolsson Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University; and Occupational and Environmental Medicine Center, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Linköping University, Linköping, Sweden https://orcid.org/0000-0002-6075-4432
  • Ola Rolfson Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and Sahlgrenska University Hospital, Gothenburg, Sweden; and Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, Sweden https://orcid.org/0000-0001-6534-1242
  • Birgitta Öberg Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University https://orcid.org/0000-0001-8612-583X
  • Allan Abbott Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine, Unit of Physiotherapy, Linköping University; and Department of Orthopaedics, Linköping University Hospital, SE 581 83 Linköping, Sweden https://orcid.org/0000-0002-4318-9216
Keywords: Musculoskeletal disorders, clinical research, research design, research funding, primary health care, secondary health care, occupational health care, Sweden

Abstract

Background: The aims of this study are to 1) determine the scope of musculoskeletal (MSK)-related clinical research in Sweden; 2) collate the amount of first-tier funding received; 3) discuss strategies and infrastructure supporting future MSK clinical trials in Sweden.

Methods: A systematic scoping review protocol was applied in PubMed, Scopus, and SweCRIS databases. The articles were examined, and data were extracted in multiple stages by three blinded authors.

Results: The search strategy resulted in 3,025 publications from 479 Swedish-affiliated authors. Primary health care was the basis for 14% of the publications, 84% from secondary health care, and 2% from occupational health care with a similar proportional distribution of first-tier research grant financing. Approximately one in six publications were randomized controlled trials (RCTs), while the majority were of observational cohort design. The majority of publications in primary and occupational health care were related to pain disorders (51 and 67%, respectively), especially diagnosis, prognosis, and healthcare organizational-related interventions (34%) and rehabilitation (15%) with similar proportional distribution of first-tier research grant financing. In secondary health care, rheumatic inflammatory disorder-related publications were most prevalent (30%), most frequently concerning diagnosis, prognosis, and healthcare organizational-related interventions (20%), attracting approximately half of all first-tier funding. Publications related to degenerative joint disorders (25%), fractures (16%), and joint, tendon, and muscle injuries (13%) frequently concerned surgical and other orthopedic-related interventions (16, 6, and 8%, respectively). Pain disorder-related publications (10%) as well as bone health and osteoporosis-related publications (4%) most frequently concerned diagnosis, prognosis, and healthcare organizational-related interventions (5 and 3%, respectively).

Conclusions: Swedish-affiliated MSK disorder research 2010–2020 was predominantly observational cohort rather than RCT based. There was skewed first-tier funding allocation considering prevalence/incidence and burden of disease. Use of infrastructure supporting register-based RCTs, placebo-controlled RCTs, and hybrid effectiveness-implementation studies on prevention and clinical intervention is important strategies for the future in all healthcare sectors.

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Published
2022-09-30
How to Cite
Diarbakerli E., Thoreson O., Björklund M., Dahlberg L. E., Englund M., Gerdhem P., Kvist J., Mohaddes M., Peolsson A., Rolfson O., Öberg B., & Abbott A. (2022). Learning from the past to plan for the future: A scoping review of musculoskeletal clinical research in Sweden 2010–2020. Upsala Journal of Medical Sciences, 127(1). https://doi.org/10.48101/ujms.v127.8709