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United States Bone and Joint Decade 2002-2011

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United States Bone and Joint Decade 2002-2011. What is the BJD, and why do we need a “Decade”? Where are we now? Where are we going? What should we be?. Why the Decade?. Musculoskeletal conditions - Under-recognized - Under-appreciated - Under-funded

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What is the BJD, and why

  • do we need a “Decade”?
  • Where are we now?
  • Where are we going?
  • What should we be?
why the decade
Why the Decade?
  • Musculoskeletal conditions

- Under-recognized

- Under-appreciated

- Under-funded

  • Affect one in seven Americans
  • Cost around $300 billion a year
  • Research around 2% of NIH budget

War on Cancer


osteoporosis fracture incidence heart attack stroke breast cancer


Heart Attack

Osteoporosis Fracture Incidence > Heart Attack + Stroke + Breast Cancer







250,000 forearm




250,000 other sites


250,000 other sites


750,000 vertebral



750,000 vertebral



Breast Cancer



bone and joint decade endorsements
Bone and Joint Decade Endorsements

60 countries (2006)

United Nations

Pope John Paul II

U.S. Presidential Proclamation

NOW, THEREFORE, I, GEORGE W. BUSH, President of the United States of America, by virtue of the authority vested in me by the Constitution and laws of the United States, do hereby proclaim the years 2002-2011, as National Bone and Joint Decade. I call upon the people of the United States to observe the decade with appropriate programs and activities; and I call upon the medical community to pursue research in this important area.

Dr. BrundtlandDirector General, WHO

what are the goals of the bone and joint decade
What are the goals of the Bone and Joint Decade?
  • Increase awareness
  • Empowering the public and patients(Prevention education)
  • Increase research
  • Improve diagnosis and treatment
the usbjd today
The USBJD Today
  • 100 healthcare professional, patient and public organizations
  • All 125 U.S. medical schools + colleges of medicine
  • Federal government + all 50 states
  • ~20 Corporations
guiding principles
Guiding Principles
  • The BJD aims to raise profile of musculoskeletal conditions for the benefit of all, including our
  • participating organizations and the general public
  • We want to maximize cooperation and partnership opportunities
  • The goal is to add value, not duplicate effort
  • We seek collaborative activities that benefit all (advocacy, communications, public education, research and professional education)
  • Washington, DC, Capitol Hill Meetings > Meeting July 2004 on osteoporosis> Meeting July 2005 on FOP (childhood)
  • Support for the Arthritis Prevention, Control and Cure Act of 2004
  • Input on Medical Innovations to FDA
  • Annual state initiatives
  • National Action Week - October 12-20(Same dates, every year)
      • Nationwide media campaign
      • State and local resolutions campaign
      • Local community awareness campaign
      • Nationwide program launches / expansion
  • Web site, Newsletter, eBroadcasts



Bones…It’s Your Decade!

What does the Future Hold and Are We Ready for It?

J. Bone Joint Surg. 84:133 (2002)

public education and prevention
Public Education and Prevention
  • PB&J – High School Education Program
  • Fit to a T - Osteoporosis public education program
  • Road safety initiatives with the American Automobile Association
public education
Public Education
  • PB&J – Protect Your Bones and Joints
  • High School Education Program
  • Highlights trauma (road safety and sports), arthritis, and osteoporosis
  • 15 schools to date (>1,500 students)
  • Media covered
  • Anatomical models
  • Outcomes measured
public education1
Public Education
  • Bone health and osteoporosis public education program
  • Public libraries, National Network of Libraries of Medicine, Churches, Corporations
  • Kansas KS, San Antonio TX, San Diego, Anaheim, Thousand Oaks/Newbury Park CA, Seattle WA, Flint MI, Rochester & Ithica, NY, Los Alamos NM, Chicago, IL, Milwaukee, WI , Hagerstown, MD
  • Hallmark Cards, LaSalle Bank
public education2
Public Education
  • Road safety initiatives with the American Automobile Association
  • First non healthcare organization to officially join USBJD network
  • 44 million members
  • Survey of healthcare professionals on seniors and road safety
  • Disseminating road safety patient education tools to USBJD participating organizations and their members

National Institutes of Health - USBJD meeting outcomes

  • Increase awareness
  • Musculoskeletal education at undergraduate level (Project 100)
  • Lack of pipeline of young investigators(Young Investigator Initiative)
  • Leverage actions of participating organizations to increase public awareness, education, respond to opportunities, ex. SG report
  • Improve sharing of knowledge of research by individual organizations & seek out opportunities for more multi-discipline and inter-institute collaboration

Musculoskeletal Education – Project 100

  • 100% of medical schools to offer formalized musculoskeletal education
  • 2003 – USBJD multidisciplinary meeting with Association of American Medical Colleges (AAMC)
  • 2004 – AAMC sets up expert panel to study undergraduate musculoskeletal learning objectives
  • 2005 - AAMC releases recommendations to medical schools on musculoskeletal curriculum learning objectives

Musculoskeletal Education – Project 100

  • 125 medical schools endorsed goals of the Decade
  • Next steps: Educator network and resources, awareness at AAMC regional meetings, incentives to schools to adopt AAMC recommendations /develop courses, curriculum content
  • Publication of Musculoskeletal Medicine (AAOS, AAFP, AAP) – adopted/being tested by ~20 schools.

Musculoskeletal Education – Project 100

  • National Board of Medical Examiners (NBME)
  • October 2003-2005 – Question-writing task force develops musculoskeletal questions for databank
  • USBJD to sponsor/underwrite development of musculoskeletal health subject examination
  • May 2006 meeting to select questions
  • Next steps: Beta-testing of subject examination
young investigators
Young Investigators
  • Few funded clinical research grants in MSK diseases held by Young Investigators (Assistant Professor level)
  • Perceived lack of mentoring – grant-writing skills – early career development
  • Subcommittee of USBJD Research Committee organized Young Investigators Initiative
  • Program of two weekend long workshops, 12 months apart, faculty mentor until funded - Multidisciplinary
young investigators1
Young Investigators
  • More than 140 applications – multi-disciplinary
  • 47 selected for program so far

Outcome measures:

No. of young investigators that attend workshop and:1. Obtain peer-reviewed funding2. Increased number of grant applications3. Remain academic medicine for 5 years / are promoted


Musculoskeletal Conditions in the United States

  • Used to determine burden of musculoskeletal conditions (U.S. & WHO)
  • Used to develop case statement for Decade
  • Used for advocacy efforts
  • Used to support research grants
  • Multi-disciplinary project well suited as Decade effort

Good Moves for Life

BJD Global Network Meeting USA 2009

Opportunity for U.S. to showcase musculoskeletal health


Good Moves for Life