title: PAIN OUT: an international acute pain registry supporting clinicians in decision making and in quality improvement activities.
abstract: OBJECTIVE
  Management of post-operative pain is unsatisfactory worldwide. An estimated 240 million patients undergo surgery each year. Forty to 60% of these patients report clinically significant pain. Discrepancy exists between availability of evidence-based medicine (EBM)-derived knowledge about management of perioperative pain and increased implementation of related practices versus lack of improvement in patient-reported outcomes (PROs). We aimed to assist health care providers to optimize perioperative pain management by developing and validating a medical registry that measures variability in care, identifies best pain management practices and assists clinicians in decision making.
  
  
  METHODS
  PAIN OUT was established from 2009 to 2012 with funding from the European Commission. It now continues as a self-sustaining, not-for-profit project, targeting health care professionals caring for patients undergoing surgery.
  
  
  RESULTS
  The growing registry includes data from 40 898 patients, 60 hospitals and 17 countries. Collaborators upload data (demographics, clinical, PROs) from patients undergoing surgery in their hospital/ward into an Internet-based portal. Two modules make use of the data: (1) online, immediate feedback and benchmarking compares PROs across sites while offline analysis permits in-depth analysis; and (2) the case-based clinical decision support system offers practice-based treatment recommendations for individual patients; it is available now as a prototype. The Electronic Knowledge Library provides succinct summaries on perioperative pain management, supporting knowledge transfer and application of EBM.
  
  
  CONCLUSIONS
  PAIN OUT, a large, growing international registry, allows use of 'real-life' data related to management of perioperative pain. Ultimately, comparative analysis through audit, feedback and benchmarking will improve quality of care.
authors.affiliation: Department of Anesthesiology and Intensive Care, Friedrich-Schiller University Hospital, Jena, Germany.
authors.forename: Ruth
authors.initials: R
authors.lastname: Zaslansky
authors.forename: Judith
authors.initials: J
authors.lastname: Rothaug
authors.forename: Richard C
authors.initials: RC
authors.lastname: Chapman
authors.forename: Ragnar
authors.initials: R
authors.lastname: Backström
authors.forename: Silviu
authors.initials: S
authors.lastname: Brill
authors.forename: Christoph
authors.initials: C
authors.lastname: Engel
authors.forename: Dominique
authors.initials: D
authors.lastname: Fletcher
authors.forename: Lucian
authors.initials: L
authors.lastname: Fodor
authors.forename: Peter
authors.initials: P
authors.lastname: Funk
authors.forename: Debra
authors.initials: D
authors.lastname: Gordon
authors.forename: Marcus
authors.initials: M
authors.lastname: Komann
authors.forename: Christoph
authors.initials: C
authors.lastname: Konrad
authors.forename: Andreas
authors.initials: A
authors.lastname: Kopf
authors.forename: Yigal
authors.initials: Y
authors.lastname: Leykin
authors.forename: Esther
authors.initials: E
authors.lastname: Pogatzki-Zahn
authors.forename: Margarita
authors.initials: M
authors.lastname: Puig
authors.forename: Narinder
authors.initials: N
authors.lastname: Rawal
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwenkglenks
authors.forename: Rod S
authors.initials: RS
authors.lastname: Taylor
authors.forename: Kristin
authors.initials: K
authors.lastname: Ullrich
authors.forename: Thomas
authors.initials: T
authors.lastname: Volk
authors.forename: Maryam
authors.initials: M
authors.lastname: Yahiaoui-Doktor
authors.forename: Winfried
authors.initials: W
authors.lastname: Meissner
mesh_terms: D059787:Acute Pain / Q000175:diagnosis / Q000188:drug therapy; D019985:Benchmarking; D003657:Decision Making; D020000:Decision Support Systems, Clinical; D005060:Europe; D019317:Evidence-Based Medicine; D005246:Feedback; D005260:Female; D006801:Humans; D007391:International Cooperation; D008297:Male; D008969:Molecular Sequence Data; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis* / Q000628:therapy*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends; D058996:Quality Improvement; D011788:Quality of Life; D012042:Registries; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: audit and review; clinical; continuous quality improvement; decision support; health care quality improvement; patient-reported outcomes