The implementation of the South African Orthopaedic Registry (SAOR): factors that improve usage

Abstract

Background: Registries have been created to accrue comprehensive clinical data for evaluation, with purported benefits for clinical governance, public health and scientific investigation. As has been the experience internationally, orthopaedic surgeon contribution to data collection for the South African Orthopaedic Registry (SAOR) has been moderate. Due to this response, several awareness initiatives were implemented by the South African Orthopaedic Association (SAOA) to encourage surgeons to engage with SAOR. This study aimed to evaluate the efficacy of these initiatives.

Methods: This retrospective study evaluated SAOR’s operational data between 1 August 2019 and 30 June 2022. For each month, the number of new surgeons registering, new patients captured, and new registry pathways initiated were evaluated. These monthly increases were evaluated relative to the implementation of several awareness initiatives. Multiple linear regression was performed to determine if any initiative significantly increased recruitment rates. The Strengthening the Reporting of Observational studies in Epidemiology (STROBE) checklist was used for reporting.

Results: Thirty-five months of SAOR operational data were analysed. The cumulative number of surgeons enrolled to use the registry by June 2022 was 108, the number of patients captured 9 992, and the number of pathways initiated 9 585. Thirty-three awareness initiatives of four types took place in the period from January 2021 until June 2022. No interventions increased the recruitment of surgeons. Group promotional sessions and virtual group demonstrations significantly increased the number of patients captured on the registry. Group promotional sessions significantly increased the number of pathways initiated.

Conclusion: The SAOR was established in 2019 by the SAOA with the intent to improve orthopaedic practice in South Africa. Several awareness initiatives have been implemented to engage surgeon contributions to the registry, none of which increased enrolment of new surgeons, but some of which increased the number of patients captured and pathways initiated. Ways to improve surgeon engagement with registries should be the focus of future research.

Level of evidence: Level 4