Description
In this informative presentation, Dan Perry introduces Amar Rangan, a professor at York, to discuss the UK FROST trial, which focuses on frozen shoulder treatments. Amar stresses the trial's secrecy prior to its publication, reminding attendees not to share any presentation details until the findings are officially released on October 2nd and in print on October 3rd.
Amar elaborates on the collaborative nature of the trial involving multiple coordinating centers and a large team across 35 UK locations. He provides context on frozen shoulder, a common, painful, and often debilitating condition predominantly affecting women in their working years and emphasizes the need for effective treatment comparisons due to existing uncertainties and varying degrees of success with current interventions.
The trial aimed to evaluate three distinct treatment methods: physiotherapy, manipulation under anesthesia, and arthroscopic capsular release, based on prior surveys indicating these were the most commonly utilized approaches in secondary care. The design process included extensive consultation with clinicians and a Delphi consensus method to establish a standardized treatment pathway for physiotherapy.
Amar outlines the methodology of the trial, including patient randomization and the thorough assessment of outcomes such as the Oxford Shoulder Score. He highlights that the trial exceeded its recruitment target of 500 patients, achieving 503. Upon discussing these details, he reviews the primary analysis outcomes, showing that while none of the interventions stood out significantly over the others at 12 months, there are insights regarding diabetic populations who tend to have poorer outcomes.
Perry and Rangan also touch upon the cost-effectiveness analysis, revealing that manipulation under anesthesia emerged as the most cost-effective intervention when contrasted with physiotherapy pathways, despite similar clinical outcomes across treatments. The conversation culminates with remarks on the implications of the trial's findings for shared decision-making processes between clinicians and patients, particularly regarding the potential overuse of capsular release treatments in practice.
Overall, the trial appears to offer significant insights into the treatment of frozen shoulder, suggesting that while all methods have merit, a careful evaluation of risks and benefits is necessary to guide clinical decisions.