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A Comprehensive Cohort Study of Patients with Fracture of the Proximal Femur.



Fractures of the proximal femur (hip fractures) are one of the greatest challenges facing the medical community. In 1990, a global incidence of 1.31 million was reported and was associated with 740,000 deaths. Hip fractures constitute a heavy socioeconomic burden worldwide. The cost of this clinical problem is estimated at 1.75 million disability adjusted life years lost, 1.4% of the total healthcare burden in established market economies.

Lay Summary

Fragility fractures typically affect people over 60 years of age because as we get older, our bones get weaker and break more easily. One type of fragility fracture that presents one of the greatest challenges for the medical community is the fracture of the neck of femur, or hip fracture. Over 70,000 hip fractures occur each year in the UK and the total cost of care is over £2 billion. Acute NHS Trust hospitals collect data on patients admitted with a hip fracture as a part of the National Hip Fracture Audit. The WHiTE study is an observational study that aims to supplement this data with information that is important to patients, such as their mobility after their injury, ability to do usual activities, self-care, pain, and fear of falling. We also collect information about the cost of care to patients and the NHD post-surgery. The WHiTE Study is currently recruiting in over 25 acute hospitals across the UK.

Aims and objectives

This study aims to capture data relating to quality of life and resource use from a cohort of patients representative of the national UK hip fracture population.  Patients will be enrolled to this cohort either in isolation (i.e. they only enrol to the cohort) or their data will be included in this cohort as a results of enrolment in one of the associated randomised clinical trials on hip fracture. 

Study design

This is a Cohort study accruing data on hip fracture patients in a selection of NHS trusts in the UK (referred to as WHiTE centres). Data collection for the Cohort is facilitated through two different routes: 1) hip fracture patients who are enrolled solely to the Cohort study or 2) hip fracture patients who are enrolled into an RCT associated with the WHiTE research (referred to as a WHiTE RCT) and have agreed to their data being used in the Cohort.

WHiTE Committees

WHiTE Oversight Committee:

Name: Role:
John Keating Chair – Trauma & Orthopaedic Surgeon
Anthony Johansen Independent Member - Orthogeriatrician
Iain Moppett Independent Member – Anaesthetist
Karen May Independent Lay Member - PPI
Richard Grant Independent Lay Member - PPI

Data Committee:

Name: Role:
Alan Johnstone Chair – Trauma & Orthopaedic Surgeon
Michael Dewey Independent Member - Statistician
Ada Keding Independent Member - Statistician
May Cleary Independent Member - Trauma & Orthopaedic Surgeon

Scientific Committee:

Name: Role:
Chris Boulton Governance
Josephine Rowling PPI
Mark Baxter Orthogeriatrics
Philip Bell PPI
Rafa Pinedo-Villanueva Health Economics
Sallie Lamb Trial Design
Stu White Anaesthetics
Tim Chesser Orthopaedics
Andy Judge Statistics
Jenny Gould PPI
Celia Gregson Epidemiologist
Becky Kearney Physiotherapist

For participants: What happens to my personal data?

We may share limited personal information (e.g. your NHS number, sex, date of birth and postcode) with appropriate organisations (including, but not limited to, NHS Digital, Office of National Statistics, Clinical Practice Research Datalink) in order to link your study data to specific records related to the research held in other databases. We will use the records from these databases to get information about mortality, as part of the main outcome of the study, to find out about other medical conditions so that we can take this into account when analysing the results of the study, and to look at NHS resource use. We plan to compare the results of our study with other national and international hip fracture studies. We will also share information with the National Hip Fracture Database. All information that is collected during the course of the research will be used and stored in accordance with the most up to date data protection legislation.


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