Speaker: Know the strengths, weaknesses of registry data

ByCasey Tingle

Fact checked byGina Brockenbrough, MA

Key takeaways:

Registries provide generalizable, valid data that allow surgeons to compare outcomes on different implants.
But registry data can be misunderstood and cannot completely replace randomized trials.

WAILEA, Hawaii — When it comes to using registries, orthopedic surgeons need to be aware of the strengths and weaknesses associated with data from these sources, according to a presenter here.

The strengths of registries include validity of the data, which can give similar results as randomized controlled trials, and generalizability of the data, according to Steven J. MacDonald, MD.

Trauma orthopedics — Registries provide generalizable, valid data that allow surgeons to compare outcomes on different implants. *Image: Adobe Stock*

“One of the powers of registries is the generalizability, because you do not want to wait in your practice if you are literally doing one hip or one knee a month to start seeing an outlying implant,” MacDonald said in his presentation at Orthopedics Today Hawaii. “You want to have the aggregate pool of thousands or tens of thousands quickly.”

MacDonald said registries also allow surgeons to compare outcomes between different types of implants and remove any implants that are underperforming, providing surgeons with an effective feedback loop.

However, MacDonald said registries cannot completely replace cohort studies and randomized trials.

“Registries are a surveillance technique, but it is better to study the [implants] properly before they are completely released,” MacDonald said.

He added that registry data can be misrepresented or misunderstood by being too simplified or not being implant specific. Registry data also only capture the learning curve of new implants, creating a biased advantage for established implants, according to MacDonald.

“Lastly, registries maximize focus on short-term results. Some outcomes need longer,” MacDonald said. “It may be valid to have a 1% higher failure rate early on to have a 5% lower failure rate later.”

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Sources/Disclosures

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Source:

MacDonald SJ. Understanding registries in 2024. Presented at: Orthopedics Today Hawaii; Jan. 7-11, 2024; Wailea, Hawaii.

Disclosures: MacDonald reports being a consultant for and receiving royalties from DePuy and Smith & Nephew; being a stockholder or having ownership in JointVue, Hip Innovations Technology, PSI, CLUE, CurvaFix, ARC Medical, Allay Therapeutics and Knimble Designs; and receiving institutional or educational support from DePuy, Smith & Nephew, Stryker and Zimmer.

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Speaker: Know the strengths, weaknesses of registry data

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