20 years “Dachverband Osteologie” 1999 – 2019 by Andreas Kurth, chairman of the DVO and Peyman Hadji, vice chairman of the DVO

The “Dachverband Osteologie” (DVO – http://www.dv-osteologie.org) is a tri-national umbrella association of currently 21 medical and scientific societies from Austria, Germany and Switzerland. The DVO covers the whole breadth of the field of bone diseases. Over the last 20 years, the DVO has established a concept for quality care regarding diagnostics and treatment for patients with bone disorders. Hereby, the widespread disease of osteoporosis with 6-7 million patients affected in Germany, plays a central role, but other bone disorders as well, such as Paget’s disease, bone metastases, primary benign and malignant bone tumors, and rare bone diseases, are addressed.

Mission Statement of the DVO

Our objective is to advance the field of osteology and the knowledge of the musculo-skeletal system and its interrelationships with other organs in health and disease.

Our strength is the interdisciplinary networking of medical and scientific expertise and the translation of scientifically founded insights into medical care.

Our goal is the general availability of the best possible prevention and therapy of osteological diseases.

In order to meet our mission statement, the DVO is based on three important pillars.

– Development of guidelines for the routine care of patients

– Educational concept for the “Osteologist DVO”

– Establishment and certification of Osteology Centers, both for clinical care and for research.

History of the DVO: a steadily increasing number of member societies

join forces for the development of clinical guidelines

The DVO was founded 20 years ago because of a huge gap in knowledge and care in the treatment of patients with bone diseases. For example, there were various therapy recommendations from different specialist disciplines for the diagnosis and therapy of osteoporosis. These were only partly evidence-based but largely eminence-based.

The inaugural meeting of the DVO took place on 24 February 1999 in Göttingen. The foundation of the DVO was decided and the founding societies were The German Society for Osteology, DGO, Austrian Society for Bone and Mineral Metabolism, ÖGEKM, Orthopaedic Society for Osteology OGO, German Academy of Osteological-Rheumatological Sciences, DAdorW, German Society for Endocrinology DGE. Prof. Johannes Pfeilschifter served as the 1st chairman. In the same year the German Society for Rheumatology DGRh joined the DVO as did the Swiss Association against Osteoporosis SVGO in 2000.

In the same year a guideline committee was established and the development of the evidence-based S3 guideline for osteoporosis by the DVO started. (coordinator Prof. Dr. J. Pfeilschifter)

In 2001 the German Society for Gynecological Endocrinology DGGEF, the German Menopause Society DMG, and of the DGOOT (later DGOOC, German Society for Orthopaedic and Orthopaedic Surgery) became member societies of the DVO. To date there are 21 member societies listed in table 1. At the Osteology Congress 2003 in Göttingen, the first version of the S 3 guidelines for the diagnosis and therapy of postmenopausal osteoporosis and glucocorticoid-induced osteoporosis was presented.

Over the past 17 years, these guidelines have been widely accepted and used in the medical care of patients with osteoporosis in Germany, Austria and Switzerland. The S3 Osteoporosis Guideline of the DVO was recommended after a scientific evaluation procedure as a basis for a politically initiated Disease Management Program (DMP) Osteoporosis for Germany. A government working group has thus developed the program, which will be implemented for Germany in 2020.

In addition to the work on S 3 guidelines for the diagnosis and therapy of osteoporosis, which are updated regularly at 3-year intervals, other guideline groups dealt with diseases such as Paget’s disease, osteonecrosis of the femoral head, benign and malignant bone tumors and rare bone diseases.

Table 1 Member societies of the Dachverband Osteologie (DVO) covering societies from Germany, Austria and Switzerland.

Education

Currently, about 6-7 million people in Germany alone are affected by osteoporosis. Demographic change means that this number will rise continuously over the next few years and osteoporosis will play a role in almost all medical disciplines. This requires a well-developed network of specialists. The “Dachverband Osteologie” (DVO) and its 21 member societies have made it their mission to meet this challenge with their comprehensive certification curriculum. As a second pillar besides the guidelines, in 2003 the structured osteological education of physicians to become a certified “Osteologe DVO” (coordinator Dr. H. Schwarz) was founded. Over the last 16 years, more than 1600 bone specialists have passed through the certification process for physicians to carry the certificate “Osteologin DVO / Osteologe DVO”. In order to maintain the quality of care for bone diseases at the highest level, a re-certification must be approved every 5 years.

As a second pillar a newly designed basic course concept in osteology on the subject of “General Osteoporosis Care” supplements the Osteologist DVO.,A new course series and certification curriculum was launched in December 2017, which will allow access to further osteological training even before the completion of residency training. Specialists in primary care medicine can also obtain a qualification that guarantees and documents a high level of competence in the care of patients with osteoporosis. So to date there are three levels of DVO certification:

“Expert for general osteoporosis care” (Certificate B)

“Expert for special osteoporosis care” (Certificate A)

“Osteologist DVO”

The term “Osteologin DVO / Osteologe DVO” continues to stand for the highest level of specialist knowledge and quality of care in the field of osteology and certifies that graduates have special qualifications in the diagnosis and therapy of diseases of the skeletal system. In 2019, for example, 11 DVO courses were held (6 basic courses, the special basic course II and III as well as three special courses) with a total number of 916 participants. With this concept, the DVO also wants to approach the next generation of medical professionals and inplement a broad medical care concept for osteoporosis and bone diseases. The combination of proven experience in knowledge transfer and new approaches are essential for maintaining and expanding the osteology care structure.

Expert centers in osteology

In order to facilitate patient access to highly qualified osteology centers, a program to certify such centers was developed. The first “Osteology focus Centers” were certified in 2005. They may have different specializations and can be certified as clinic-based centers (61), outpatient-based centers (131) and osteological research centers (22).

Journal “Osteology / Osteology – Bone Metabolism and Skeletal Diseases”

Osteologie/Osteology is an interdisciplinary journal for education and training in the field of osteology. Founded 28 years ago, it now serves as the official journal of the DVO with 4 issues published annually. The focus is on thematic reviews  but it also includes original articles, case studies, and short communications in German and English.  This includes experimental or clinical studies on musculo-skeletal research (including sports medicine), diseases of the musculo-skeletal system, especially bone, muscle and joint diseases, and research on method development in these areas. The long-standing editor-in-chief Prof. Dr. Peter Burckhardt (Lausanne) will hand over his task to Prof. Dr. Franz Jakob (Würzburg) in 2020.

Annual Congress

Every year since the founding of the DVO member societies meet for the Annual Osteology Congress, attended by about 1000 participants and including an industrial exhibition. Over the years the annual congress covered many topic topics including the diagnosis and therapy of bone diseases, osteo-oncology, pediatric osteology, geriatric traumatology, osteoarthritis and others. Speakers combine the expertise of the DVO’s 21 professional member societies from Germany, Austria and Switzerland. In 2019 “Healthy Aging – Bone and Joint” was the motto of the OSTEOLOGIE 2019 (www.osteologie19.de) in Frankfurt am Main (fig. 1). 1,130 participants from several European countries participated in this congress. The OSTEOLOGIE 2020 will take place in Salzburg / Austria in March 2020.

Fig. 1 Professor Peyman Hadji (vice chairman of the DVO ) and Prof. Andreas Kurth (chairman of the DVO) at a presentation on fragility fractures in high risk patients at the „Osteologie Congress“.

Governance and management

The activities of the DVO are guided by the DVO Board (table 2) and the representatives of the member societies. The In order to manage the various activities of the DVO, a subsidiary service company of the DVO was founded early on: the Osteology Academy GmbH (OSTAK – www.ostak.de) operates the association’s office, organizes educational courses and congresses, and covers public relations and certification on behalf fo the DVO.

Table 2. Past and current chairpersons of the DVO and current members of the DVO Board.