Local Validation of a National Orthopaedic Registry

BACKGROUND/OBJECTIVE

Registries are limited by the quality of the data they collect. We aimed to measure the data entry error rate at a regional orthopaedic unit in a national arthroplasty registry and to assess a proposed intervention of restricting data entry to senior trainees.

METHODS AND MATERIALS

A total of 200 primary and revision arthroplasty cases (119 hips, 81 knees) were randomly selected from a single year, 2020. The Irish National Orthopaedic Registry was examined for the grade of the trainee that populated the form and the accuracy of 24 parameters by comparison with data recorded elsewhere in the patient record.

RESULTS

The mean number of errors per form was 2.17 (95% confidence interval (CI): 1.95-2.39), giving an overall error rate of 9% (95% CI: 8%-10.0%). Eighty-seven percent of forms examined contained inaccuracies, ranging from one to nine errors (4%-38%). Some parameters were more prone to errors, ranging from 1% to 28%. There was no evidence of total errors varying by trainee grade (analysis of variance (ANOVA) p-value: 0.34).

CONCLUSIONS

Error rates were in line with the literature. Results did not support restricting data entry to senior trainees.

Critical Evaluation of Trends in Otolaryngology Resident Caseload by Subspecialty from 2005 to 2019

BACKGROUND

Subspecialty caseloads logged by otolaryngology residents over the last 15 years is currently unknown. This study examines the trends at the national level.

METHODS

Otolaryngology case log data was collected from the Accreditation Council for Graduate Medical Education (ACGME) from 2005 to 2019. Data were categorized according to the following surgical subspecialties: pediatrics, rhinology/skull base, head and neck, facial plastics, otology, and laryngology. Linear regression analyses were performed for each procedure within each subspecialty, total subspecialty means, and total caseload means across all years.

RESULTS

Overall surgical volume significantly increased between 2005 and 2019 (P < .0001); however, there was a significant decline in pediatrics procedures (R² = 0.80, P < .0001). Rhinology/skull base procedures increased the most drastically (R² = 0.96, P < .0001).

CONCLUSION

While total mean resident case logs have steadily increased between 2005 and 2019, pediatric cases have declined substantially due to fewer tympanostomy tube insertions and adenotonsillectomies. Rhinology/skull base procedures have increased most significantly secondary to an increase in endoscopic sinus surgeries. Despite changes in case volume amongst specialties, the annual increase in resident case load suggests that otolaryngology residents are meeting the demands of their graduate medical training.