Investigator Studies Program (MISP): Perioperative Care
Effective September 2018, the Surgery Investigator Studies Program (MISP) Committee will accept proposals within our current areas of interest (AOI) as noted below. This is a competitive process that will be conducted by the Surgery MISP in 2019. Decisions will be made on the basis of scientific merit and strategic fit within the AOI. Please review the critical activities and abide by the timelines as outlined below.

The following areas are of interest to the Investigator Studies Program Committee:

  • NEUROMUSCULAR BLOCKADE (NMB):
    • Impact of NMB (including deep block1) on surgical conditions, including intra-abdominal pressure, and other intra-operative outcomes for a variety of procedures, especially abdominal minimally invasive, robotic, ENT, ocular, orthopedic joint manipulation, thoracic, and neurosurgical.
    • Impact of NMB (including deep block1) on peri-operative outcomes (see procedures above), including pulmonary, pain, nausea, vomiting, neurohumoral response, cardiac function, cognition, ambulation, swallowing, and overall patient or surgeon satisfaction.
  • RESIDUAL NMB:
    • Impact of residual NMB on postoperative recovery and/or other perioperative outcomes overall, and in special populations2
    • Identify special populations2 at risk for postoperative pulmonary and other complications
    • Impact of subjective vs. objective neuromuscular monitoring on achieving complete recovery at extubation and/or the rate of residual paralysis
    • Develop clinical or digital methods to detect residual block
  • EFFICIENCY and COMPARATIVE EFFECTIVENESS:
    • Impact of reversal of NMB on efficiency and/or quality of patient care, including: time in the operating room, PACU, ICU, or hospital in various scenarios or in specific procedures; relevant hospital quality metrics; costs in various scenarios (inpatient; outpatient, other); patient populations2 and procedures; relevant clinical effectiveness endpoints
    • Develop and/or validate methods to measure efficiency and/or quality
  • ENHANCED RECOVERY PROTOCOLS:
    • Contribution of neuro-muscular relaxant reversal and/or NMB (including deep block) on patient outcomes in specific surgical protocols.

1deep block = post-tetanic count of 1 or 2 twitches

2Special populations include but are not limited to: children, elderly, obese, those with burns, those with cardiac and/or pulmonary disease, those in special settings (intensive care, ambulatory, other), those with neuromuscular or psychiatric disorders.

NOTE: Proposals specifying use of a TOF-watch device should consider the following country specific information: The EU and USA have no restrictions on TOF-watch use. Device registration will expire in China on 12Nov2019 and in Thailand on 28Oct2018. Investigators in other countries unsure of the status should contact their local MSD office.

Please complete a full protocol and detailed budget via Visiontracker, the Company's on-line study management system (in US) or your MSD country representative (outside US). The proposals will be collectively reviewed and selected by the Surgery MISP Committee.

Critical Activities and Timelines:
Activity 1st Review Cycle 2nd Review Cycle 3rd Review Cycle 4th Review Cycle 5th Review Cycle
Full Protocol Submission with Detailed Budget Jan 1, 2019 Mar 1, 2019 May 1, 2019 Jul 1, 2019 Sep 2, 2019
Final Comments to Investigator Feb 8, 2019 Apr 3, 2019 Jun 7, 2019 Aug 2, 2019 Oct 9, 2019
Final Protocol Submission by Investigator Feb 15, 2019 Apr 19, 2019 Jun 14, 2019 Aug 16, 2019 Oct 18, 2019
Final Protocol Approval by Committee Feb 22, 2019 Apr 24, 2019 Jun 21, 2019 Aug 23, 2019 Oct 29, 2019


MISP Information
This site is intended for US investigators only. Investigators outside of the US interested in submitting research proposals to the Investigator Studies Program should contact their local MSD office.