In the last 20 years, big data have become increasingly important in orthopedics. This field began with the development of orthopedic registries in Europe and expanded to include multiple musculoskeletal registries and databases worldwide that contain data on the outcomes of total joint replacement, ligament reconstruction, spine surgery and the incidence of trauma, among information that pertains to a host of other orthopedic procedures.
“[Big data has] become certainly popularized more recently due to an interest in making our health care system perform more predictably for an individual. We must find ways to reduce variability and cost drivers,” Frank J. Schwab, MD, chief of the Spine Center at Hospital for Special Surgery, told Orthopedics Today.
Right now, the main difference between large-scale orthopedic registries and databases in countries like Australia, New Zealand, Sweden and the United Kingdom and those in the United States is that the United States does not yet have a 100% capture rate, according to sources interviewed.
“In the United States, [data collection is] truly voluntary with the American Joint Replacement Registry (AJRR), and so it is not 100%,” Ryan M. Nunley, MD, associate professor in the department of orthopedic surgery at Washington University School of Medicine in St. Louis, said.
He noted patients may receive a joint replacement at a hospital that participates in the AJRR, but they have a revision procedure at a hospital that does not participate in the AJRR. That gap in the data may skew the data.
However, that does not necessarily mean all U.S. registries have low capture rates, Nunley said.
“There are some health systems within the United States that do have much better registries, including the Kaiser [Permanente] system, the California Registry, [the] Michigan Registry, where they are becoming more sophisticated,” he said.
Image Credit: Robert Essel