Main research interests
Schulthess Klinik has a long-standing tradition of research. Prof. Norbert Gschwend laid the foundation for outcome research back in 1972 by introducing internal registries for hip and knee prostheses. Ever since then, research at Schulthess Klinik has been continuing to develop systematically. Find out about the main research interests of our Research department and doctors.
«Outcome» refers to the result of a treatment, such as an operation. Outcome research investigates the success of treatment from the patient’s perspective. The main aim is to draw on outcome research to constantly improve treatments, make them safer and guarantee patient satisfaction. That is why we have conducted over 153,000 patient surveys since 2004.
In order to assess a patient’s condition following treatment, at Schulthess Klinik we collect both objective data, such as strength and mobility, and subjective data, such as the level of pain from the patient’s perspective. All data is gathered and stored in registries so that important comparisons can be drawn at a later point in time.
This is our standard approach to measuring treatment outcomes from the patient’s perspective and developing decision-making aids for surgeons based on predictive models. We also test which measurement instruments are suitable for this purpose.
Schulthess Klinik records the health-related personal data routinely collected in daily clinical practice in medical registries. These registries are used to systematically assess disease progression across all patients.
Registries make it easier to bundle and quickly provide information that is essential for scientific purposes, clinical decision-making and quality control. Recording patients’ baseline status and treatment outcomes is critical to assessing the efficacy of a treatment from a patient’s perspective, which is why it has been an important cornerstone of our research for many years now. Medical registries therefore form the basis for outcome research.
At Schulthess Klinik, research groups work closely with doctors to carry out clinical trials in a variety of fields. The objective is to assess the efficacy and safety of health-related interventions, treatments, medicinal products and medical devices. The findings of these trials are integrated into daily clinical practice, which is the only way we can continue to optimise the treatments we offer.
Before a trial is conducted and patients may be recruited, every clinical trial must be approved by the ethics commission, which involves assessing patient, data and product safety.
The implementation of each clinical trial entails various phases. Find out more under Study phases.
A principal objective of prognostic studies is being able to make a prognosis regarding the development of the disease based on a variety of factors that are known at the time of the prognosis.
Doctors take on a huge amount of responsibility when deciding on treatment. The best treatment outcome possible for all patients is at the forefront of every decision. The most precise prediction possible of the outcome of a medical intervention can make the decision surrounding treatment much easier.
Modern prognostic models
At Schulthess Klinik, we use prognostic models to determine the effect of treatment from the reported patient-specific and disease-specific characteristics. Possible risk factors can also be identified. In this way, prognostic models for patients with lumbar disc herniation can be created from our own database, allowing us to set realistic expectations of the outcome of an operation and increase patient satisfaction thereafter.
Disorders of the musculoskeletal system are a significant challenge for our increasingly ageing society. A high quality of life, the preservation of mobility and an active lifestyle – even amongst the elderly – a few of our clinic’s primary objectives. Biomechanical studies help to foster better understanding of the function of the musculoskeletal system and the causes of musculoskeletal disorders. In the extensive field of fundamental research, we are concerned with the three fields specified below:
- Development of movement models
- Device and technology design
- Examination of tissues and structures
Clinical movement analysis
With the objective of improving treatment outcomes and patient satisfaction, at Schulthess Klinik we investigate the movements of people with various orthopaedic disorders (e.g. those with joint replacement). Clinical movement analysis helps us to understand the link between the characteristics of those concerned (e.g. age or sex), the treatment option selected (e.g. implant type, rehabilitation programme) and the surgical result (e.g. gains in mobility).
With the help of 3D cameras, force plates, electromyography (EMG) systems and a range of other technologies, we assess and investigate movements during various activities. These analyses help us determine how implant designs and operation techniques affect movement and patients’ well-being.
Researching the skeletal muscles
Researching the skeletal muscles is an essential component in the development of new rehabilitation processes and surgical methods. An important part of this involves using precise and objective methods to measure the impairment of muscle function. It is only when we identify the possible causes and consequences of restricted muscle function that we can develop new interventions which can, in turn, be used to examine the effectiveness of operations and rehabilitation programmes.
Development of joint prostheses
Our experienced surgeons work closely with specialists from the engineering industry to develop new joint prostheses. Shoulder joint, elbow joint and proximal interphalangeal joint implants are successful examples of artificial joints developed at Schulthess Klinik.
The first stages of development entail simulating designs on a computer, followed by the construction of prototypes. The prototypes are then subjected to various biomechanical tests in the laboratory and put through extensive testing. At a later stage, we use the prototypes on patients under close supervision and as part of a clinical trial. In order to guarantee personal safety, we also document and evaluate the durability of joint prostheses in our registries.
Analyses of costs, effectiveness and benefits
Many scientific studies highlight the medical benefits of operations. This information is useful and particularly interesting to patients. But what about the economic benefits of an operation of this kind? Increasing health costs have been a big issue on a global scale for a number of years. As a result, the demand for proven cost efficiency is becoming increasingly significant. Research into health costs is still uncommon in the field of orthopaedics and only a few studies involving cost data have been carried out in Switzerland to date. It is for precisely this reason that Schulthess Klinik is conducting a series of comprehensive cost-benefit studies.
In order for us to be able to evaluate the cost effectiveness of a treatment, we record all the medical expenses incurred by a large number of patients as part of a cost-benefit study. It is necessary to collaborate with major health insurance providers to do this. On the basis of actual data from daily clinical practice, we are therefore able to calculate and verify the cost efficiency of a treatment.