Should “garbage in–garbage out” be replaced by “little in–little out”? Questionnaire response rates need to be improved in surgical quality registries!

Excerpt

Surgical quality registries are important tools for both performing research and improving clinical practice. The Swedish National Knee Ligament Registry (SNKLR) has collected patient-reported and surgical data on more than 90% of the anterior cruciate ligament (ACL) reconstructions in Sweden. There has year-by-year been an increasing number of publications using data from SNKLR and the Scandinavian counterparts since their inceptions in 2004–2005 [3]. To date, approximately 50 studies have been published using data from the SNKLR. The primary intent of these knee ligament registries has been to observe the outcome of the surgery and to detect inferior results/failures, and several arguments for why registries are needed are fairly uncontroversial [2]. The major advantage with registry data is the large number of procedures collected in a short period of time, but the saying “garbage in–garbage out” is also particularly true for registry data with potentially lesser control of data quality compared with studies using data collected directly by a specific research group. However, a “little in–little out” situation is sometimes at least as deleterious as illustrated in the example below. …