How to Create an Orthopaedic Arthroplasty Administrative Database Project: A Step-by-Step Guide Part I: Study Design

Area of Science:

• Orthopaedic Surgery
• Health Services Research
• Biostatistics

Background:

• Clinical and administrative databases are increasingly utilized in orthopaedic surgery research, with database studies comprising approximately 10% of published lower extremity arthroplasty research.
• This review aims to provide a comprehensive guide for conducting and critically evaluating orthopaedic administrative database arthroplasty projects.

Approach:

• Part I of this review focuses on developing research questions and selecting appropriate databases, discussing the pros and cons of commonly used resources like the National Inpatient Sample, Medicare, and National Surgical Quality Improvement Program.
• Advantages of database studies include accessibility, cost-effectiveness, large sample sizes, and the ability to identify trends across multiple healthcare systems.

Key Points:

• Commonly used databases in orthopaedic research include the National Inpatient Sample, Medicare, National Surgical Quality Improvement Program, and PearlDiver.
• Key advantages encompass accessibility, affordability, ease of use, large sample sizes, and trend identification.
• Key disadvantages include retrospective observational design, coding limitations, short follow-up, confounding variable challenges, and lack of patient-reported outcomes.

Conclusions:

• This guide serves as a starting point for researchers interested in conducting or evaluating lower extremity arthroplasty studies using administrative databases.
• It emphasizes the importance of understanding both the strengths and limitations of these data sources for robust research outcomes.