Registries in acute care What can they provide?

Registries are an important tool for quality management and health serviced research especially in acute care where classical clinical studies are often difficult to perform. The present review considers the TraumaRegister DGU (R) for severely injured patients and the German Resuscitation Registry of the DGAI as examples for such registries. A registry is a prospective, standardized collection of (usually routine) data from a specified population, with predefined aims. Most registries are used for external quality control and management. Outcome comparisons, however, require adjustments for case-mix. Validated scores are used to compare observed outcomes with predicted outcomes. Data quality in registries has three dimensions: completeness of cases, completeness of data, and correctness of data. Completeness of cases would require a complete coverage of all respective patients, or at least a representative subset of them. Completeness of data is easily available and should be part of any feed-back. Correctness of data could be enhanced by technical support such as automated cross and range checks, or by digital data collection. Participation in a registry not only allows the quality of care within a certain institution to be systematically assessed but also allows adjusted comparison with others. Registry data should also be made available to the public. Those who collect, keep, and analyze data in registries have specific responsibilities regarding data protection. National laws should enable the use of routine data for quality management.