Abstract
BackgroundTechnological advances have led to the generation of large amounts of data, both in surgical research and practice. Despite this, it is unclear how much originates in low‐ and middle‐income countries (LMICs) and what barriers exist to the use of such data in improving surgical care. The aim of this review was to capture the extent and impact of programmes that use large volumes of patient data on surgical care in LMICs.MethodsA PRISMA‐compliant systematic literature review of PubMed, Embase and Google Scholar was performed in August 2018. Prospective studies collecting large volumes of patient‐level data within LMIC settings were included and evaluated qualitatively.ResultsA total of 68 studies were included from 71 LMICs, involving 708 032 patients. The number of patients in included studies varied widely (from 335 to 428 346), with 25 reporting data on 3000 or more LMIC patients. Patient inclusion in large‐data studies in LMICs has increased dramatically since 2015. Studies predominantly involved Brazil, China, India and Thailand, with low patient numbers from Africa and Latin America. Outcomes after surgery were commonly the focus (33 studies); very few large studies looked at access to surgical care or patient expenditure. The use of large data sets specifically to improve surgical outcomes in LMICs is currently limited.ConclusionLarge volumes of data are becoming more common and provide a strong foundation for continuing investigation. Future studies should address questions more specific to surgery.
Highlights
The concept of ‘big data’ describes the use of unstructured digital information, usually from multiple sources, that is often collected with no clearly defined purpose for future use[1]
Country-specific patient numbers were reported in 60 studies but were absent from six[50,51,52,57,62,83] and two[33,55] provided total low- and middle-income countries (LMICs) patient numbers only
Studies using big data were well represented across the 10-year analysis period; a dramatic increase in study and patient numbers was seen from 2015 onwards (Fig. 3a)
Summary
The concept of ‘big data’ describes the use of unstructured digital information, usually from multiple sources, that is often collected with no clearly defined purpose for future use[1]. Big data in surgery can be defined as the amalgamation and integration of various data sources along the patient pathway to produce a rich matched data set[3] (Fig. 1). Technological advances have led to the generation of large amounts of data, both in surgical research and practice. It is unclear how much originates in low- and middle-income countries (LMICs) and what barriers exist to the use of such data in improving surgical care. Prospective studies collecting large volumes of patient-level data within LMIC settings were included and evaluated qualitatively. The use of large data sets to improve surgical outcomes in LMICs is currently limited.
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