At the time of this report, one BADER-funded study has
been completed. BADER research efforts have led to
five
published manuscripts, six pending publications, and 44 pub-
lished abstracts. Thirteen grant proposals have been submitted
to various agencies for external funding. These submissions
have resulted in six externally funded projects having a net
value of $3.5 million and an additional $7.9 million in pend-
ing grant submissions.
In 2013, the Defense Health Board (DHB) was tasked
with reviewing the full spectrum of amputee care and de
fining
a strategy for preserving and continuing the advancements.
1
BADER Consortium leadership provided one of many DHB
briefs and support materials leading to the April 8, 2015,
DHB report titled,
“Sustainment and Advancement of Ampu-
tee Care.
” Following an extensive review, the DHB described
BADER Consortium as
“central to the ARCs’ research
capabilities and current efforts.
” The DHB also found that
the Consortium
“significantly enhanced and facilitated” the
research capabilities of the ARCs.
1
DISCUSSION
The BADER Consortium is uniquely positioned among its
partner programs to advance the orthopaedic rehabilitation
research agenda. It uses a clinical research capacity-building
component that supports research team building and the suc-
cessful identi
fication and establishment of impactful and
sustainable research initiatives. Key research infrastruc-
tures have been established in support of BADER-funded,
externally funded, and MTF-supported clinical research pro-
jects. However, not all partner organizations have uniformly
embraced Consortium-centric components.
The Consortium CRADA is a Consortium-centric mecha-
nism that is used to rapidly onboard study sites and research
projects. It provides a uniform standard operating procedure
that addresses the broad range of policies related to research
partnerships. Adoption of the Consortium-centric CRADA
has been mixed across branches of the military, although
readily embraced by academic, industrial, and select govern-
ment partners. As a result, natural separations have begun to
form between Consortium CRADA partners and nonpartners.
Such divisions are disadvantageous and Consortium activities
would be enhanced by the broad acceptance of a uni
fied
CRADA mechanism.
While BADER Consortium
’s research infrastructures and
project activities are seen as
“central” to the ARCs’ mission,
they should not be viewed as complete. BADER
’s opera-
tional model was originally designed to focus primarily in
three component areas
—capacity-building, research-support,
FIGURE 3.
Primary (beige shaded) and emerging (gray shaded) components of the BADER Consortium operations model. Green-shaded elements indicate
primary collaboration sites (acronym de
finitions in text). Also shown are the four BADER-supported stages that DoD and VA research sites undergo to
obtain research independence and clinical impact.
MILITARY MEDICINE, Vol. 181, November/December Supplement 2016
18
BADER Consortium: Partnering for Optimal Orthopaedic Rehabilitation Outcomes
and initiative-launching studies. As the result of our observa-
tions and direct requests for assistance, BADER support
has transitioned limited resources to assist with technology
translation, research subject recruitment, and research part-
nership activities (Fig. 3). Clearly, the development and
sustainment of large-scale research subject recruitment capa-
bilities focused on military personnel and civilians is an
additional desired infrastructure, considering the goal of sus-
taining world-class research and patient care efforts during
periods of reduced con
flict.
1
Streamlining the transition of new technologies into clinical
research and patient care is facilitated by an understanding
and implementation of the science behind team science.
13
As the breadth of orthopaedic rehabilitation gap areas grows
to encompass critical outcomes determinants in clinical acute
care and early intervention focus areas, infrastructures for
the rapid establishment and sustainment of dynamic research
partnerships are also warranted.
CONCLUSION
The BADER Consortium is a highly effective network for
enhancing orthopaedic rehabilitation research capacities at
MTF and VA sites, establishing research areas in key gap
areas and supporting an array of clinical studies in partner-
ship with government, academia, and industry. Through its
partnership with the EACE and cooperative agreement with
CDMRP, the BADER Consortium is addressing important
gaps in clinical orthopaedic rehabilitation research and patient
care. Structures and activities of the BADER Consortium have
become
“central” to the ARCs’ research capabilities and cur-
rent efforts to strengthen and sustain evidence-based ortho-
paedic rehabilitation care that results in optimal functional
outcomes for wounded warriors.
1
ACKNOWLEDGMENTS
Support for the BADER Consortium was provided by the Congressionally
Directed Medical Research Program (CDMRP), Peer Reviewed Orthopaedic
Research Program (PRORP) via award number W81XWH-11-2-0222; the
NIH-NIGMS (P20 GM103446); the NIH-NICHD through a collaboration
agreement; and the University of Delaware, College of Health Sciences.
Finally, none of this work would be possible without the courage and drive
of wounded warriors whose desire to continue serving and actively engage
life is beyond inspirational.
REFERENCES
1. Defense Health Board Reports
—Sustainment and Advancement of
Amputee Care. April 8, 2015. Available at http://www.health.mil/About-
MHS/Other-MHS-Organizations/Defense-Health-Board/Reports; accessed
August 3, 2015.
2. Reznick JS, Gambel JM, Hawk AJ: Historical perspectives on the care
of service members with limb amputations. In: Care of the Combat
Amputee, pp 19
–40. Edited by Pasquina P, Cooper RA. Washington,
Of
fice of the Surgeon General at TMM Publications, Borden Institute,
Walter Reed Army Medical Center, 2009.
3. Pasquina PF: Optimizing care for combat amputees: experiences at
Walter Reed Army Medical Center. JRRD 2004; 41(Suppl 3a): vii
–xii.
4. Extremity Trauma and Amputation Center of Excellence
—EACE. Available
at http://www.health.mil/About-MHS/Other-MHS-Organizations/Extremity-
Trauma-and-Amputation-Center-of-Excellence; accessed August 3, 2015.
5. Clifton M: Amputee Achieves Goal: Returns to Iraq. DoD News. Avail-
able at http://www.defense.gov/news/newsarticle; accessed July 17, 2015.
6. Sanchez J: Revolutionizing prosthetics. Defense Advanced Research
projects Agency
—Program Information—Revolutionizing Prosthetics.
Available at http://www.darpa.mil/program/revolutionizing-prosthetics;
accessed August 3, 2015.
7. Pottol KS: Armed Forces Institute of Regenerative Medicine
—Annual
Report 2013. Available at http://www.a
firm.mil/assets/documents/annual_
report_2013.pdf; accessed July 15, 2015.
8. Bosse MJ, MacKenzie EJ: METRC Major Extremity Trauma Research
Consortium
—2013 Annual Report. Available at http://www.prioriti-mtf
.org/pdfs/2013_METRC_Annual_Report.pdf; accessed July 15, 2015.
9. Program Announcement, Department of Defense Congressionally Directed
Medical Research Programs, Peer Reviewed Orthopaedic Research
Program, Orthopaedic Rehabilitation Clinical Consortium Award.
Available at http://cdmrp.mil/funding/pa/10prorporcca_pa.pdf; accessed
August 3, 2015.
10. Advancing Rehabilitative Care: Center for Rehabilitation Sciences
Research
—CRSR. Available at: http://crsr.org/?page_id=35; accessed
August 3, 2015.
11. BADER Consortium: Bridging Advanced Developments for Exceptional
Rehabilitation. Available at http://bader-c.org/; accessed August 3, 2015.
12. Groospe R: Introducing the Institutional Development Award (IDeA)
Program. NIGMS Feedback Loop Blog. Available at http://loop.nigms
.nih.gov/2012/05/introducing-the-institutional-development-award-idea-
program-2/; accessed August 3, 2015.
13. Falk-Krzesinkski HJ, Borner K, Contractor N, et al. Advancing the science
of team science. Clin Trans Sci 2010; 263
–66.
MILITARY MEDICINE, Vol. 181, November/December Supplement 2016
19
BADER Consortium: Partnering for Optimal Orthopaedic Rehabilitation Outcomes