The Impact of National Orthopaedic Fracture Registries: A Systematic Review.

Abstract

Purpose: Large-scale registry data efforts are common in orthopaedic surgery; however, there is wide variation between registries and little known about registry impact. The purpose of this study was to assess the publication or "scholarly" impact of current national trauma/fracture registries.

Methods: A search was executed to identify potential national and international trauma/fracture registries and create a comprehensive list of registries. Thirty-four relevant national registries were identified. Searches were executed to identify any published articles published by or affiliated with the selected registries. Over 13,000 abstracts were screened by at least 2 reviewers. The full text of 650 articles were screened by at least 2 reviewers, and data were extracted from 383 articles. Citations were excluded if they were reviews and meta-analyses; referencing non-trauma-specific, insurance, institutional, or state-wide databases; describing facial, spine, or rib trauma; reporting nonregistry data; and did not report on fracture patients. Data were collected at the article level and registry level.

Results: The median number of articles per registry was 3.5 (range: 1-66) with a median impact factor of 3.2 (range per registry: 1.4-11.0). The National Hip Fracture Database (United Kingdom) had the highest publication rate per year of any registry (3.9). Twenty-four percent of registries had a publication rate of greater than 1 article per year, whereas only 8.8% had a publication rate over 2 per year. Only 8 registries had 10 or more publications in total. The National Trauma Data Bank (United States) had the highest number of fracture-specific publications overall (66) and an average citation rate of 29 per publication. The National Hip Fracture Database had the second highest number of article (62) with an average citation per article of 23.6.

Conclusion: With the exception of a few registries, most national trauma/fracture registries have low yearly publication and citation rates. Researchers must consider the utility of resources needed to sustain registry efforts in the context of the impact of registry data. Future studies will seek to identify salient features of the highest impact registries.