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Big Data and Total Hip Arthroplasty: How Do Large Databases Compare?

Nicholas A Bedard1, Andrew J Pugely1, Michael A McHugh1

  • 1The Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa.

The Journal of Arthroplasty
|October 12, 2017
PubMed
Summary
This summary is machine-generated.

Orthopedic research databases show significant differences in patient demographics, comorbidities, and total hip arthroplasty complication rates. Researchers must consider these variations when analyzing data and developing risk adjustment models.

Keywords:
administrative claimsbig dataclaims-based dataclinical registrydatabasetotal hip arthroplasty

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Area of Science:

  • Orthopedic Surgery
  • Health Services Research
  • Data Science

Background:

  • Large databases are increasingly utilized in orthopedic research.
  • Databases differ in data capture methods and represented populations.
  • Variations can impact research findings and clinical interpretations.

Purpose of the Study:

  • To evaluate differences in reported demographics, comorbidities, and postoperative complications for primary total hip arthroplasty (THA) patients across major research databases.
  • To inform critical evaluation of database research in orthopedics.

Main Methods:

  • Identified primary THA patients in National Surgical Quality Improvement Programs (NSQIP), Nationwide Inpatient Sample (NIS), Medicare Standard Analytic Files (MED), and Humana administrative claims (HAC).
  • Matched NSQIP comorbidity and complication definitions to ICD-9/CPT codes for querying other databases.
  • Compared demographics, comorbidities, and postoperative complications across the four databases.

Main Results:

  • Significant variations observed in comorbidity prevalence and postoperative complication rates among databases.
  • Obesity rates were more than double in NSQIP compared to NIS.
  • Diabetes prevalence was more than double in HAC and MED compared to NSQIP.
  • Rates of deep infection and stroke within 30 days post-THA showed more than a 2-fold difference across databases.

Conclusions:

  • Considerable variation exists in total hip arthroplasty complication rates depending on the database used for orthopedic research.
  • Awareness of these database-specific differences is crucial for critically appraising research findings.
  • These variations must be accounted for in risk adjustment models, especially with the implementation of bundled payments.