Will registries slow down or accelerate innovation?

[摘要] Surgical registries provide an observational assessment of either surgical techniques or, more commonly, surgical implants and have become increasingly commonly used over the past 20–30 years. Observational studies are generally ranked lower than experimental studies in the hierarchy of evidence. However, they do have several potential advantages over randomized controlled trials including lower cost, quicker results and involvement of a more representative, or real-world, population of patients. The disadvantages of registries include an inherent tendency to bias and confounding, which makes it difficult to compare different surgical techniques or different implants. Generally speaking observational studies and registries are best used to identify risk factors and prognostic indicators in circumstances where randomized controlled trials would either be unethical or impossible to undertake. Comparisons made in the 1970s and 1980s between observational studies and randomized trials demonstrated that observational studies often inflate positive treatment effects compared to randomized studies.1,2 In 2015, David Sackett, one of the founders of evidencebased medicine, described four worries regarding the quality of clinical evidence.

[学科分类] 神经科学

[关键词] evaluate;innovation;joint registry