OsNET: Network Approach

The focus of this platform is on mechanisms of bone adaptation leading to translational research. It includes bone, muscle, fat, joint, and neural interactions related to musculoskeletal health for common bone disorders and rare bone diseases spanning childhood to older age. There is an emphasis on the identification of new pharmacological targets and novel use of drugs already available. Technologies such as imaging, biomechanics, and machine learning are important and link to clinical research.

Ranging from small clinical trials to large, national cohorts and registries, this platform will focus on developing tools for fracture prediction and prevention, optimizing fracture healing plus structural and functional recovery from bone disorders, testing of new therapies for the treatment of rare and common bone diseases (both pharmacological and non-pharmacological) in order to optimize disease-related skeletal and extra-skeletal health outcomes, and the impact of rehabilitation and orthopaedic interventions. There are enormous opportunities to integrate new technologies using emerging imaging modalities, biomechanical testing, blood and urine biomarker analyses, and genomics. We will explore machine learning applications ranging from technical problems such as image segmentation for opportunistic screening, to applied challenges such as integrating administrative databases with novel outcome measures for fracture (and other bone health outcome) predictions, will be employed.

The delivery of improved bone health care is established using existing and assessing new pathways that integrate novel technologies for application across our national health care systems. Quality of care is a key theme, while ensuring equitable access to appropriate care in urban and rural/remote settings for Canadians. Important methodological decisions impact the validity of drug and device benefits and harms in the real-world and this will be studied using observational methods. 

OsNET provides a fertile environment for trainees who are interested in bone health research, support junior scientists as they leap to the next stage of their career, and mentor junior faculty in their early career development. The national network provides multi-site and multidisciplinary training for specific skills and offers an innovative curriculum and team environment that will foster a career-long commitment to conducting bone health research. Our partners include academic institutions, patient organizations, and industry that together will illuminate a range of attractive and vibrant career pathways. 

Meaningful engagement with patient partners and community partners across stages of development and conduct of clinical research is a key part of OsNet. Patient partners are team members with input on priorities, design, recruitment, evaluation, interpretation, and knowledge mobilization. OsNET is building an active patient-partner program and has engaged a significant number of patient representatives in the formation of this proposal. The patient partner program is building through recruitment, selection, and training. 

Dissemination of knowledge emerging from OsNET includes appropriate sharing of high-quality evidence and guided by a communication strategy that promotes high impact journals publications. Patient Partners and Organizations are responsible for co-building the knowledge platform with KT experts and participate in the creation of knowledge transfer applications (phone apps, web pages), and uptake and implementation of new knowledge. 

Technology underpins much of the work across the network, and there is significant opportunity for sharing expertise and resources. The network establishes national standards for collection of patient information through validated instruments/questionnaires and standardization of collection methods. A common data capture and storage platform will be established for bone researchers in Canada, which will facilitate collection of high-quality data, support multi-centre national trials, and establish baseline information across the country.