Developing a minimum common dataset for hip fracture audit to help countries set up national audits that can support international comparisons

Author:

Johansen Antony12,Ojeda-Thies Cristina3ORCID,Poacher Arwel T.4,Hall Andrew J.5ORCID,Brent Louise6,Ahern Emer C.7,Costa Matt L.8,

Affiliation:

1. University Hospital of Wales and School of Medicine, Cardiff University, Cardiff, UK

2. National Hip Fracture Database, Royal College of Physicians, London, UK

3. Hospital Universitario 12 de Octubre, Madrid, Spain

4. Trauma Unit, University Hospital of Wales, Cardiff, UK

5. Golden Jubilee National Hospital, Clydebank, UK

6. National Office of Clinical Audit, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland

7. Cork University Hospital, Cork, Ireland

8. Oxford Trauma and Emergency Care, Nuffield Department of Orthopaedics, Rheumatology & Musculoskeletal Sciences, University of Oxford, Oxford, UK

Abstract

Aims The aim of this study was to explore current use of the Global Fragility Fracture Network (FFN) Minimum Common Dataset (MCD) within established national hip fracture registries, and to propose a revised MCD to enable international benchmarking for hip fracture care. Methods We compared all ten established national hip fracture registries: England, Wales, and Northern Ireland; Scotland; Australia and New Zealand; Republic of Ireland; Germany; the Netherlands; Sweden; Norway; Denmark; and Spain. We tabulated all questions included in each registry, and cross-referenced them against the 32 questions of the MCD dataset. Having identified those questions consistently used in the majority of national audits, and which additional fields were used less commonly, we then used consensus methods to establish a revised MCD. Results A total of 215 unique questions were used across the ten registries. Only 72 (34%) were used in more than one national audit, and only 32 (15%) by more than half of audits. Only one registry used all 32 questions from the 2014 MCD, and five questions were only collected by a single registry. Only 21 of the 32 questions in the MCD were used in the majority of national audits. Only three fields (anaesthetic grade, operation, and date/time of surgery) were used by all ten established audits. We presented these findings at the Asia-Pacific FFN meeting, and used an online questionnaire to capture feedback from expert clinicians from different countries. A draft revision of the MCD was then presented to all 95 nations represented at the Global FFN conference in September 2021, with online feedback again used to finalize the revised MCD. Conclusion The revised MCD will help aspirant nations establish new registry programmes, facilitate the integration of novel analytic techniques and greater multinational collaboration, and serve as an internationally-accepted standard for monitoring and improving hip fracture services. Cite this article: Bone Joint J 2022;104-B(6):721–728.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Orthopedics and Sports Medicine,Surgery

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