title: Evidence and practice in spine registries.
abstract: OBJECTIVE
  We performed a systematic review and a survey in order to (1) evaluate the evidence for the impact of spine registries on the quality of spine care, and with that, on patient-related outcomes, and (2) evaluate the methodology used to organize, analyze, and report the "quality of spine care" from spine registries.
  
  
  METHODS
  To study the impact, the literature on all spinal disorders was searched. To study methodology, the search was restricted to degenerative spinal disorders. The risk of bias in the studies included was assessed with the Newcastle-Ottawa scale. Additionally, a survey among registry representatives was performed to acquire information about the methodology and practice of existing registries.
  
  
  RESULTS
  4,273 unique references up to May 2014 were identified, and 1,210 were eligible for screening and assessment. No studies on impact were identified, but 34 studies were identified to study the methodology. Half of these studies (17 of the 34) were judged to have a high risk of bias. The survey identified 25 spine registries, representing 14 countries. The organization of these registries, methods used, analytical approaches, and dissemination of results are presented.
  
  
  CONCLUSIONS
  We found a lack of evidence that registries have had an impact on the quality of spine care, regardless of whether intervention was non-surgical and/or surgical. To improve the quality of evidence published with registry data, we present several recommendations. Application of these recommendations could lead to registries showing trends, monitoring the quality of spine care given, and ultimately improving the value of the care given to patients with degenerative spinal disorders.
authors.affiliation: a 1Sint Maartenskliniek, Nijmegen.|b 2 Dutch Institute for Clinical Auditing (DICA) , Leiden.
authors.forename: Miranda L
authors.initials: ML
authors.lastname: van Hooff
authors.affiliation: c 3 Leiden University Medical Center , Leiden.
authors.forename: Wilco C H
authors.initials: WC
authors.lastname: Jacobs
authors.affiliation: d 4 Maastricht UMC , Maastricht.
authors.forename: Paul C
authors.initials: PC
authors.lastname: Willems
authors.affiliation: b 2 Dutch Institute for Clinical Auditing (DICA) , Leiden.|e 5 NKI-AVL , Amsterdam.
authors.forename: Michel W J M
authors.initials: MW
authors.lastname: Wouters
authors.affiliation: a 1Sint Maartenskliniek, Nijmegen.|f 6 VU University Medical Center , Amsterdam.
authors.forename: Marinus
authors.initials: M
authors.lastname: de Kleuver
authors.affiliation: c 3 Leiden University Medical Center , Leiden.
authors.forename: Wilco C
authors.initials: WC
authors.lastname: Peul
authors.affiliation: g 7 Department of Health Sciences and Department of Epidemiology and Biostatistics, VU University , Amsterdam , the Netherlands.
authors.forename: Raymond W J G
authors.initials: RW
authors.lastname: Ostelo
authors.affiliation: h 8 Ryhov Hospital Neuro-Orthopedic Department , Futurum Academy, Jönköping , Sweden.
authors.forename: Peter
authors.initials: P
authors.lastname: Fritzell
mesh_terms: D006801:Humans; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D012042:Registries / Q000706:statistics & numerical data*; D013122:Spinal Diseases / Q000628:therapy*; D016896:Treatment Outcome