Increased Utilization of American Administrative Databases and Large-scale Clinical Registries in Orthopaedic Research, 1996 to 2016

Karlson, Nicholas; Nezwek, Teron A.; Menendez, Mariano E.; Tybor, David J.; Salzler, Matthew J.

doi:10.5435/jaaosglobal-d-18-00076

Cited by 21 publications

(22 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The finding that research based upon administrative databases has risen to over 17% of podium presentations is consistent with previous studies and clearly indicates the prominence of these studies in use today as well as some measure of their utility and general acceptance [1][2][3]. The ease with which researchers can access large sample sizes makes these databases appealing for researchers who wish to conduct studies in a timely manner while strengthening conclusions.…”

Section: Discussionsupporting

confidence: 83%

“…It is likely that the overall validity of these databases will remain controversial for some time. Many authors have cautioned about the generalizability of this type of data and the potential for significant bias [1][2][3][4][5]. The fact that these types of studies seem to be replacing single center studies is difficult to evaluate, but in the most recent year, there are still over 4 times as many single center studies as database studies reflecting a continued preference on the part of researchers or reviewers for the latter.…”

Section: Discussionmentioning

confidence: 99%

“…Clinicians and researchers have experienced a significant change in research being published and presented over the last decade. Largescale data has become more accessible over the years due to the rapidly expanding volume of computerized databases, with studies showing that orthopaedic researchers have increasingly utilized these databases [1][2][3][4][5]. Meta-analyses have also become popular as a statistical method for combining the data from multiple studies in order to hopefully reduce outcome bias by combining large groups of patients from multiple centers.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Trends in orthopedic research: An analysis of podium presentations at the AAOS annual meetings from 2008-2018

Hwang¹,

Boniello²,

Whicker³

et al. 2020

Trends in Res

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 83%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Trends in orthopedic research: An analysis of podium presentations at the AAOS annual meetings from 2008-2018

Hwang¹,

Boniello²,

Whicker³

et al. 2020

Trends in Res

View full text Add to dashboard Cite

“…The current study provides an update and new look at the state of orthopaedic literature, both trauma and non-trauma. One potential explanation for the difference in studies is the increased use of national databases in orthopaedic research, particularly since 2013 [14,15]. These databases can provide large volumes of retrospective data but are still considered level-III evidence.…”

Section: Discussionmentioning

confidence: 99%

Assessing the level of evidence in the orthopaedic literature, 2013–2018: a review of 3449 articles in leading orthopaedic journals

et al. 2020

View full text Add to dashboard Cite

Background: In biomedical research, level of evidence (LOE) indicates the quality of a study. Recent studies evaluating orthopaedic trauma literature between 1998 and 2013 have indicated that LOE in this field has improved. The objective of this study was to determine the validity of one such study by 1) comparing our results and how they relate to more recent years of publications; and 2) assessing how our findings may be used to estimate future changes. Methods: A total of 3449 articles published from 2013 to 2018 in The Journal of Orthopaedic Trauma (JOT); Journal of Bone and Joint Surgery, American Volume (JBJS-Am); and Clinical Orthopaedics and Related Research (CORR) were evaluated for their LOE. Articles published in JBJS-Am or CORR were classified as trauma or nontrauma studies; articles published in JOT were considered trauma studies. Articles were assigned a LOE using guidance published by JBJS-Am in 2015. Results: The percentage of total high-level (level I or II) trauma and nontrauma articles published in JOT, JBJS-Am, and CORR decreased from 2013 to 2018 (trauma 23.1 to 19.2%, p = 0.190; nontrauma 28.8 to 24.9%, p = 0.037). JBJS-Am published the highest percentage of level-I trauma studies, and CORR published the lowest percentage of level-IV studies. JBJS-Am and CORR published higher percentages of level-I trauma studies and lower percentages of level-IV nontrauma studies than all trauma studies. Conclusions: Based on our results we cannot validate the findings of previous studies as we found the overall LOE of both trauma and nontrauma orthopaedic literature has decreased in recent years. JBJS-Am published a greater percentage of high-level studies than did JOT and CORR. Although the number and percentage of high-level studies published in JOT increased during the study period, it still lagged behind JBJS-Am and CORR.

show abstract

“… 22 Such use of administrative databases for orthopaedic clinical research is rising steadily. 23 , 24 Our data suggest identification of patients requiring surgical treatment of metastatic bone disease of the femur using structured data alone is likely to produce biased results. The cohorts we identified in this way contained a high proportion of patients without metastatic disease.…”

Section: Discussionmentioning

confidence: 90%

Utility of the Current Procedural Terminology Codes for Prophylactic Stabilization for Defining Metastatic Femur Disease

et al. 2020

View full text Add to dashboard Cite

Introduction: Cohorts from the electronic health record are often defined by the Current Procedural Terminology (CPT) codes. The error prevalence of CPT codes for patients receiving surgical treatment of metastatic disease of the femur has not been investigated, and the predictive value of coding ontologies to identify patients with metastatic disease of the femur has not been adequately discussed. Methods: All surgical cases at a single academic tertiary institution from 2010 through 2015 involving prophylactic stabilization of the femur or fixation of a pathologic fracture of the femur were identified using the CPT and International Classification of Disease (ICD) codes. A detailed chart review was conducted to determine the procedure performed as documented in the surgical note and the patient diagnosis as documented in the pathology report, surgical note, and/or office visit notes. Results: We identified 7 CPT code errors of 171 prophylactic operations (4.1%) and one error of 71 pathologic fracture fixation s(1.4%). Of the 164 prophylactic operations that were coded correctly, 87 (53.0%) had metastatic disease. Of the 70 pathologic operations that were coded correctly, 41 (58%) had metastatic disease. Discussion: The error prevalence was low in both prophylactic stabilization and pathologic fixation groups (4.1% and 1%, respectively). The structured data (CPT and ICD-9 codes) had a positive predictive value for patients having metastatic disease of 53% for patients in the prophylactic stabilization group and 58% for patients in the pathologic fixation group. The CPT codes and ICD codes assessed in this analysis do provide a useful tool for defining a population in which a moderate proportion of individuals have metastatic disease in the femur at an academic medical center. However, verification is necessary.

show abstract

Increased Utilization of American Administrative Databases and Large-scale Clinical Registries in Orthopaedic Research, 1996 to 2016

Cited by 21 publications

References 24 publications

Trends in orthopedic research: An analysis of podium presentations at the AAOS annual meetings from 2008-2018

Trends in orthopedic research: An analysis of podium presentations at the AAOS annual meetings from 2008-2018

Assessing the level of evidence in the orthopaedic literature, 2013–2018: a review of 3449 articles in leading orthopaedic journals

Utility of the Current Procedural Terminology Codes for Prophylactic Stabilization for Defining Metastatic Femur Disease

Contact Info

Product

Resources

About