# The Benefit of an Umbrella Protocol: Reducing Challenges in Orthopedic Oncology Research

## TL;DR

This paper introduces an umbrella protocol to streamline ethical approvals and reduce administrative challenges in orthopedic oncology research.

## Contribution

The novel use of an umbrella protocol significantly reduces IRB review times and facilitates efficient research in musculoskeletal tumor studies.

## Key findings

- Implementation of the umbrella protocol reduced protocol review times from six-to-eight weeks to nearly instantaneous.
- The protocol achieved exemption status in 110 days after multiple IRB discussions and revisions.
- A dedicated orthopedic oncology patient registry was established to support future research.

## Abstract

Background: Orthopedic oncology research is hindered by the scarcity of musculoskeletal tumors and research administrative inefficiencies. This paper introduces observational research through an innovative institution-specific methodology—termed an umbrella protocol. This protocol outlines a comprehensive standard procedure to expedite ethical approval for future aligned studies, reducing administrative barriers to research. Methods: We developed an umbrella protocol at an academic center, involving meticulous methodological identification and coordination with the institutional review board (IRB) to adhere to local guidelines. The protocol encompasses identifying investigators, research objectives, study goals, and data and safety monitoring frameworks necessary for typical standards. Results: Implementation of the umbrella protocol took 110 days to achieve exemption status, following multiple discussions with the IRB and extensive revisions. At the authors institution, this protocol significantly reduces protocol review times from an average of six-to-eight weeks to nearly instantaneous, facilitating a streamlined research process. Additionally, we established a dedicated orthopedic oncology patient registry to enhance future research endeavors. Conclusions: The adoption of umbrella protocols represents a pioneering strategy in orthopedic oncology. This approach mitigates research administrative burdens and broadens research scope in the field. It underscores the necessity of IRB collaboration, methodological precision, and stringent data management. The article also reflects on the ethical implications and potential biases introduced by emerging technologies like artificial intelligence, advocating for diligent ethical oversight. The establishment of an umbrella protocol marks a significant step towards more efficient research methodologies, ultimately aiming to improve patient care and outcomes for individuals with rare musculoskeletal conditions.