Possibilities and limits of Internet-based registers

The Internet is an inexpensive platform for the investigation of medical questions in case of low prevalence. By accessing www.ao-nailregister.org, every interested participant may participate in the English-language survey of the complications specific to the femoral nail. The address data of the participant, the anonymised key data of the patients and the medical parameters are entered. In real time, these data are checked for plausibility, evaluated and published on the Internet where they are freely accessible immediately. Because of national differences, data acquisition caused considerable difficulties at the beginning. In addition, wrong data were entered because of linguistic or contextual misunderstandings. After having reworked the questionnaire completely, facilitating data input and implementing an automated plausibility check, these difficulties could be cleared. In a next step, the automatic evaluation of the data was implemented. Only very few data still have to be checked for plausibility manually to exclude wrong entries, which cannot be verified by the computer. The effort required for data acquisition and evaluation of the Internet-based femoral nail register was reduced distinctly. The possibility of free international participation as well as the freely accessible representation of the results offers transparency.