Online Database for Prospective and Retrospective Scientific Evaluation of Surgical Results

Abstract

Objective: There is an increased need for evidence-based data in surgery. The scientific value of old-fashioned retrospective studies with a lot of inaccurate data nowadays is limited. A well-designed prospective trial needs a great amount of work and important financial support. We have designed a prospective system for collecting scientifically valuable data on a disease and/or surgical procedure. Our objective is to present and share this system with our colleagues. Methods: We have prepared the structure of a web-based system with well-designed questionnaires for different hand disorders. The questions are specific for the investigated problem. The number of questions is limited in order to make possible data collection and registration during the real-life patient care. Filling a questionnaire should be less than 2 minutes at a time. Privacy regarding patient and uploader (the only owner of the uploaded data) has the priority during all the process. As the questionnaires are uniform, the system makes it possible to compare the outcome data of the different users or institutes but only based on their decision and agreement of collaboration. Even small number of cases or rare conditions based on a multicenter upload of the system can provide statistically sufficient series in a relatively short period. Results: A pilot study using the aforementioned structure is already running for carpal tunnel syndrome, trigger finger, metacarpal fractures, and extensor tendon injuries, and there are several more condition protocols under construction. Only a few months of data collection for the carpal tunnel syndrome has demonstrated the unforeseen value of the system as in a few hours, 5 different hypotheses of this condition were able to be confirmed or denied. The easily achievable large number of patients makes possible the construction of several evidence-based data and conclusions in a relatively short time. Conclusions: By using our register with a little effort on filling a questionnaire at every patient meeting, the benefit will be almost the same as of a prospective trial. This way, the cost-benefit ratio can be changed to your favor. The information from the database could be used to evaluate your own results, compare them with other colleges, organize multicenter studies, and present them at live events or publishing them.