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INTRODUCTION

This JAMA Guide to Statistics and Methods provides an overview of the 11 most widely used surgical data sets, as well as a 10-item checklist that authors can use to improve the quality of their analyses.

Each year, JAMA Surgery receives hundreds of submissions that retrospectively analyze large surgical databases. Although many of these attempt to shed light on new and important questions, most do not get published. A majority of submissions are not even sent out for peer review because they have clear flaws in the data analytic techniques or they attempt to address a research question that cannot be adequately answered with the proposed data set. Of those that are sent out for peer review, many are recommended to be rejected by expert peer reviewers as they find major methodological flaws in the use of these otherwise powerful data sets. Articles that are published frequently come from a select group of investigators who have developed a mastery of specific data sets and the analytic techniques required to truly harness their potential.

This series is aimed at providing short, practical guides for investigators in the use of the most widely available surgical data sets that can be used across the research continuum, from conceptualization to peer-reviewed publication. To achieve this, JAMA Surgery partnered with the Surgical Outcomes Club (http://www.surgicaloutcomesclub.com).

The following chapters provide succinct overviews of the 11 most widely used data sets1-11 (Box 1), their specific features, strengths, limitations, and some important statistical considerations. In addition, we present a 10-item checklist (Box 2) that authors can use to ensure that they have covered what is “at minimum” expected from a manuscript that uses 1 of these databases. Finally, our biostatistician colleagues provide more in-depth information on statistical methodologies mentioned in the practical guides as well as potential pitfalls that need to be avoided.12

BOX 1 Databases Covered in This Series

  • Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project databases: National Inpatient Sample, State Inpatient Databases, and Kids’ Inpatient Database1

  • Surveillance, Epidemiology, and End Results Program2

  • Medicare Claims Data3

  • Military Health System Tricare Encounter Data4

  • Veterans Affairs Surgical Quality Improvement Program5

  • National Surgical Quality Improvement Program6

  • Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program7

  • National Cancer Database8

  • National Trauma Data Bank9

  • Society for Vascular Surgery Vascular Quality Initiative10

  • The Society of Thoracic Surgeons National Database11

BOX 2 Checklist to Elevate the Science of Surgical Database Research

  1. Have a solid research question and clear hypothesis. Consider using the FINER (Feasible, Interesting, Novel, Ethical, Relevant) or PICO (Patient, Population, or Problem; Intervention, Prognostic Factor, or Exposure; Comparison or Intervention; Outcome) criteria to develop these.

  2. Ensure compliance with the institutional review board and data use agreements.

  3. Conduct a thorough literature review. Use a reference management program ...

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