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Evidence and practice in spine registries A systematic review, and recommendations for future design of registries

机译:脊柱注册管理机构的证据和实践系统审查以及对注册管理机构未来设计的建议

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摘要

Background and purpose-We performed a systematic review and a survey in order to (1) evaluate the evidence for the impact of spine registries on the quality of spine care, and with that, on patient-related outcomes, and (2) evaluate the methodology used to organize, analyze, and report the "quality of spine care" from spine registries.Methods-To study the impact, the literature on all spinal disorders was searched. To study methodology, the search was restricted to degenerative spinal disorders. The risk of bias in the studies included was assessed with the Newcastle-Ottawa scale. Additionally, a survey among registry representatives was performed to acquire information about the methodology and practice of existing registries.Results-4,273 unique references up to May 2014 were identified, and 1,210 were eligible for screening and assessment. No studies on impact were identified, but 34 studies were identified to study the methodology. Half of these studies (17 of the 34) were judged to have a high risk of bias. The survey identified 25 spine registries, representing 14 countries. The organization of these registries, methods used, analytical approaches, and dissemination of results are presented.Interpretation-We found a lack of evidence that registries have had an impact on the quality of spine care, regardless of whether intervention was non-surgical and/or surgical. To improve the quality of evidence published with registry data, we present several recommendations. Application of these recommendations could lead to registries showing trends, monitoring the quality of spine care given, and ultimately improving the value of the care given to patients with degenerative spinal disorders.
机译:背景与目的-我们进行了系统的审查和调查,以(1)评估脊柱注册管理机构对脊柱护理质量的影响的证据,并以此来评估与患者相关的结果,以及(2)评估方法用于组织,分析和报告脊柱注册处的“脊柱护理质量”。方法-为研究其影响,检索了所有脊柱疾病的文献。为了研究方法,搜索仅限于变性脊柱疾病。用纽卡斯尔-渥太华量表评估纳入研究的偏倚风险。此外,还对注册管理机构代表进行了一项调查,以获取有关现有注册管理机构的方法和实践的信息。截至2014年5月,共鉴定出4,273项独特的参考文献,有1,210项可以进行筛选和评估。未确定影响的研究,但确定了34项研究以研究该方法。这些研究中的一半(34项中的17项)被认为具有偏见的高风险。该调查确定了代表14个国家的25个脊椎注册管理机构。本文介绍了这些注册管理机构的组织,使用的方法,分析方法以及结果的传播。解释-我们发现缺乏证据表明注册管理机构对脊柱护理质量产生了影响,无论干预是否为非手术和/或外科手术。为了提高使用注册表数据发布的证据的质量,我们提出了一些建议。这些建议的应用可能会导致注册管理机构显示趋势,监视脊柱护理的质量,并最终提高对退行性脊柱疾病患者的护理价值。

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