Abstract
BackgroundReal-world data (RWD) play important roles in evaluating treatment effectiveness in clinical research. In recent decades, with the development of more accurate diagnoses and better treatment options, inpatient surgery for cervical degenerative disease (CDD) has become increasingly more common, yet little is known about the variations in patient demographic characteristics associated with surgical treatment.ObjectiveThis study aimed to identify the characteristics of surgical patients with CDD using RWD collected from electronic medical records.MethodsThis study included 20,288 inpatient surgeries registered from January 1, 2000, to December 31, 2016, among patients aged 18 years or older, and demographic data (eg, age, sex, admission time, surgery type, treatment, discharge diagnosis, and discharge time) were collected at baseline. Regression modeling and time series analysis were conducted to analyze the trend in each variable (total number of inpatient surgeries, mean age at surgery, sex, and average length of stay). A P value <.01 was considered statistically significant. The RWD in this study were collected from the Orthopedic Department at Peking University Third Hospital, and the study was approved by the institutional review board.ResultsOver the last 17 years, the number of inpatient surgeries increased annually by an average of 11.13%, with some fluctuations. In total, 76.4% (15,496/20,288) of the surgeries were performed in patients with CDD aged 41 to 65 years, and there was no significant change in the mean age at surgery. More male patients were observed, and the proportions of male and female patients who underwent surgery were 64.7% (13,126/20,288) and 35.3% (7162/20,288), respectively. However, interestingly, the proportion of surgeries performed among female patients showed an increasing trend (P<.001), leading to a narrowing sex gap. The average length of stay for surgical treatment decreased from 21 days to 6 days and showed a steady decline from 2012 onward.ConclusionsThe RWD showed its capability in supporting clinical research. The mean age at surgery for CDD was consistent in the real-world population, the proportion of female patients increased, and the average length of stay decreased over time. These results may be valuable to guide resource allocation for the early prevention and diagnosis, as well as surgical treatment of CDD.
Highlights
BackgroundAccording to the evidence classification system for evidence-based medicine, the best evidence originates from randomized controlled trials (RCTs) and associated systematic evaluations
The mean age at surgery for cervical degenerative disease (CDD) was consistent in the real-world population, the proportion of female patients increased, and the average length of stay decreased over time
The trends can be characterized by an increase in the number of inpatient surgeries performed for CDD over the past 17 years in Peking University Third Hospital (PUTH), a consistent mean age at surgery, and a decreased average length of stay (LOS) for surgical treatment
Summary
BackgroundAccording to the evidence classification system for evidence-based medicine, the best evidence originates from randomized controlled trials (RCTs) and associated systematic evaluations. Real-world data (RWD), which are health care data that have been collected from different sources, including electronic health records, insurance payment and billing databases, disease registration databases, family monitoring equipment data, and mobile health devices, can be complementary sources of RCT data for establishing a more robust evidence base on the effectiveness of medicines, as well as the relative effectiveness as compared with existing products in clinical practice [2,3]. Recent studies have focused on designing and implementing evidence-based surgical safety information systems, and big data analytics on RWD can yield new and powerful insights into the effectiveness of different medicines and patient care [4,5,6]. Real-world data (RWD) play important roles in evaluating treatment effectiveness in clinical research. With the development of more accurate diagnoses and better treatment options, inpatient surgery for cervical degenerative disease (CDD) has become increasingly more common, yet little is known about the variations in patient demographic characteristics associated with surgical treatment
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