Department of Orthopaedic Surgery, University of British Columbia, 198 Waddington Drive, Kamloops, Vancouver, BC, V2E 1M4, Canada.
Clin Orthop Relat Res. 2010 Oct;468(10):2592-7. doi: 10.1007/s11999-010-1442-1.
The global burden of injury is receiving recognition as a major public health problem but inadequate information delays many proposed solutions. Many attempts to collect reliable data on orthopaedic trauma have been unsuccessful. The Surgical Implant Generation Network (SIGN) database is one of the largest collections of fracture cases from lower and middle income countries.
QUESTIONS/PURPOSES: We describe the information in the SIGN database then address two questions: In the context of the design and implementation of a global trauma database, what lessons does the SIGN database teach? Does the SIGN program have a role in the evolution of a wider global system?
The SIGN database is Internet based. After treating a patient with a SIGN nail surgeons enter radiographs and details of the case.
Over 26000 cases are in the SIGN database. The database has been used as a source of cases for followup studies. Analysis shows the data are of sufficient quality to allow studies of fracture patterns but not for outcome studies or bone measurement. WHERE DO WE NEED TO GO?: A global database with more comprehensive coverage of injuries, causes, treatment modalities and outcomes is needed. HOW DO WE GET THERE?: The SIGN database itself will not become a global trauma database (GTD) but the personnel of the SIGN program have much to offer in the design and adoption of a GTD. Studies of suitable methods of data collection and the incentive to use them are required.
全球范围内的伤害负担正逐渐被视为一个主要的公共卫生问题，但信息不足阻碍了许多建议的解决方案的实施。许多人试图收集可靠的骨科创伤数据，但都没有成功。SIGN（外科植入物研究网络）数据库是从中低收入国家收集到的最大的骨折病例数据库之一。
问题/目的：我们首先描述 SIGN 数据库中的信息，然后回答两个问题：在全球创伤数据库的设计和实施方面，SIGN 数据库有哪些经验教训？SIGN 项目在更广泛的全球系统的发展中是否发挥作用？
SIGN 数据库是基于互联网的。在使用 SIGN 钉治疗患者后，外科医生会输入 X 光片和病例的详细信息。
SIGN 数据库中已有超过 26000 例病例。该数据库已被用作后续研究的病例来源。分析表明，这些数据的质量足以允许进行骨折模式研究，但不足以进行结局研究或骨测量。
我们需要去哪里？需要一个具有更全面的损伤、病因、治疗方式和结局数据的全球数据库。
我们如何到达那里？SIGN 数据库本身不会成为全球创伤数据库（GTD），但 SIGN 项目的人员在 GTD 的设计和采用方面有很多值得借鉴的地方。需要研究合适的数据收集方法和使用这些方法的激励措施。
