Challenges faced by musculoskeletal health research in Australia and New Zealand due to the COVID‐19 pandemic

Musculoskeletal conditions are among the most burdensome conditions globally. ¹ The reasons for this include their high prevalence, the fact that they often result in hospitalisation and that they incur large costs for both individuals and health systems. ²

In 2015, musculoskeletal researchers, clinicians and consumers from Australia and New Zealand established a binational collaborative research initiative known as the Australia and New Zealand Musculoskeletal (ANZMUSC) Clinical Trials Network. ³ The aim of the network is to support multicentre trials of the highest quality to provide definitive answers to the most pressing questions in the musculoskeletal field, such as whether spinal decompression is superior to placebo in patients with spinal stenosis ⁴ or whether surgery is more effective than conservative treatment for fractures in the distal radius in the elderly. ⁵

During 2020, the ANZMUSC network has been an excellent platform for understanding the impact of the COVID‐19 pandemic on musculoskeletal research in Australia and New Zealand. In March 2020, as the COVID‐19 case trajectory accelerated in these countries, universities, research institutes, local health districts and hospitals began severely restricting onsite research activity in response to state and federal government orders and social distancing. While it remains too early to assess the impact on musculoskeletal research output, the ANZMUSC network collected information about the effect of the COVID‐19 pandemic on musculoskeletal research activity within Australia and New Zealand.

Between June and August 2020, members of ANZMUSC who were conducting musculoskeletal clinical trials or planned to conduct such trials, provided feedback to a survey that was sent to all 388 members. Of the 109 responses, 46% of respondents said their professional life and/or their musculoskeletal research work had been impacted by the COVID‐19 pandemic. The majority (82%) indicated trial recruitment had been impacted, as had staff (62%) and data collection (67%). Thirty‐one percent indicated that funding had been impacted, while 57% reported that modifications to trial protocols had to be made due to the COVID‐19 pandemic. Over 40 trials were identified that were likely to be affected by the pandemic either because of problems with recruitment or because there are now insufficient funds to run the study and/or pay research staff.

These results provide preliminary evidence that important musculoskeletal clinical trials designed to answer the most pressing clinical questions in the field have been or will be affected by the COVID‐19 pandemic. In some instances, if further support is not provided, practice changing clinical trials may be abandoned or the results biased by small sample sizes and insufficient power to find an effect. A coordinated response from researchers, universities and funding bodies is urgently needed. We must ensure that the money already spent on these trials is sufficiently supplemented and remediation provided to ensure that these trials can be completed as planned.