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Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
Upper Limb Unit, Wrightington Hospital, Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, Wigan, UK.
Bone Joint J. 2024 Dec 1;106-B(12):1461-1468. doi: 10.1302/0301-620X.106B12.BJJ-2023-1372.R1.
The aim of this audit was to assess and improve the completeness and accuracy of the National Joint Registry (NJR) dataset for arthroplasty of the elbow.
It was performed in two phases. In Phase 1, the completeness was assessed by comparing the NJR elbow dataset with the NHS England Hospital Episode Statistics (HES) data between April 2012 and April 2020. In order to assess the accuracy of the data, the components of each arthroplasty recorded in the NJR were compared to the type of arthroplasty which was recorded. In Phase 2, a national collaborative audit was undertaken to evaluate the reasons for unmatched data, add missing arthroplasties, and evaluate the reasons for the recording of inaccurate arthroplasties and correct them.
Phase 1 identified 5,539 arthroplasties in HES which did not match an arthroplasty on the NJR, and 448 inaccurate arthroplasties from 254 hospitals. Most mismatched procedures (3,960 procedures; 71%) were radial head arthroplasties (RHAs). In Phase 2, 142 NHS hospitals with 3,640 (66%) mismatched and 314 (69%) inaccurate arthroplasties volunteered to assess their records. A large proportion of the unmatched data (3,000 arthroplasties; 82%) were confirmed as being missing from the NJR. The overall rate of completeness of the NJR elbow dataset improved from 63% to 83% following phase 2, and the completeness of total elbow arthroplasty data improved to 93%. Missing RHAs had the biggest impact on the overall completeness, but through the audit the number of RHAs in the NJR nearly doubled and completeness increased from 35% to 70%. The accuracy of data was 94% and improved to 98% after correcting 212 of the 448 inaccurately recorded arthroplasties.
The rate of completeness of the NJR total elbow arthroplasty dataset is currently 93% and the accuracy is 98%. This audit identified challenges of data capture with regard to RHAs. Collaboration with a trauma and orthopaedic trainees through the British Orthopaedic Trainee Association improved the completeness and accuracy of the NJR elbow dataset, which will improve the validity of the reports and of the associated research.
本次审核旨在评估并提高国家关节注册处（NJR）肘关节置换数据集的完整性和准确性。
审核分两个阶段进行。在第一阶段，通过比较2012年4月至2020年4月期间NJR肘关节数据集与英国国民健康服务体系（NHS）英格兰医院事件统计数据（HES）来评估完整性。为评估数据的准确性，将NJR中记录的每次关节置换的组成部分与所记录的关节置换类型进行比较。在第二阶段，开展了一项全国性合作审核，以评估数据不匹配的原因，补充缺失的关节置换信息，并评估记录不准确的关节置换的原因并加以纠正。
第一阶段在HES中识别出5539例关节置换手术与NJR上的关节置换不匹配，以及来自254家医院的448例记录不准确的关节置换手术。大多数不匹配的手术（3960例；71%）是桡骨头置换术（RHA）。在第二阶段，142家NHS医院，其中有3640例（66%）不匹配和314例（69%）记录不准确的关节置换手术，自愿参与评估其记录。很大一部分不匹配的数据（3000例关节置换手术；82%）被确认为NJR中缺失的数据。第二阶段后，NJR肘关节数据集的总体完整性率从63%提高到83%，全肘关节置换数据的完整性提高到93%。缺失的RHA对总体完整性影响最大，但通过审核，NJR中的RHA数量几乎翻了一番，完整性从35%提高到70%。数据的准确性为94%，在纠正448例记录不准确的关节置换手术中的212例后提高到98%。
NJR全肘关节置换数据集目前的完整性率为93%，准确性为98%。本次审核发现了RHA在数据采集方面的挑战。通过英国骨科住院医师协会与创伤及骨科住院医师合作，提高了NJR肘关节数据集的完整性和准确性，这将提高报告及相关研究的有效性。
