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What are the essential features of a successful surgical registry? a systematic review
  1. Rishi Mandavia1,
  2. Alec Knight2,
  3. John Phillips3,
  4. Elias Mossialos4,
  5. Peter Littlejohns2,
  6. Anne Schilder1
  1. 1 evidENT team, UCL Ear Institute, Royal National Throat, Nose and Ear Hospital, London, UK
  2. 2 Department of Primary Care and Public Health Sciences, King’s College London, London, UK
  3. 3 Department of Ear Nose and Throat Surgery, Norfolk and Norwich University Hospital, Norwich, UK
  4. 4 Centre for Health Policy, Imperial College London, St Mary’s Hospital, London, UK
  1. Correspondence to Rishi Mandavia; rishimandavia{at}


Objective The regulation of surgical implants is vital to patient safety, and there is an international drive to establish registries for all implants. Hearing loss is an area of unmet need, and industry is targeting this field with a growing range of surgically implanted hearing devices. Currently, there is no comprehensive UK registry capturing data on these devices; in its absence, it is difficult to monitor safety, practices and effectiveness. A solution is developing a national registry of all auditory implants. However, developing and maintaining a registry faces considerable challenges. In this systematic review, we aimed to identify the essential features of a successful surgical registry.

Methods A systematic literature review was performed adhering to Preferred Reporting Items for Systematic Review and Meta-Analysis recommendations. A comprehensive search of the Medline and Embase databases was conducted in November 2016 using the Ovid Portal. Inclusion criteria were: publications describing the design, development, critical analysis or current status of a national surgical registry. All registry names identified in the screening process were noted and searched in the grey literature. Available national registry reports were reviewed from registry websites. Data were extracted using a data extraction table developed by thematic analysis. Extracted data were synthesised into a structured narrative.

Results Sixty-nine publications were included. The fundamentals to successful registry development include: steering committee to lead and oversee the registry; clear registry objectives; planning for initial and long-term funding; strategic national collaborations among key stakeholders; dedicated registry management team; consensus meetings to agree registry dataset; established data processing systems; anticipating challenges; and implementing strategies to increase data completion. Patient involvement and awareness of legal factors should occur throughout the development process.

Conclusions This systematic review provides robust knowledge that can be used to inform the successful development of any UK surgical registry. It also provides a methodological framework for international surgical registry development.

  • registry
  • otolaryngology
  • health informatics
  • surgery

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  • Contributors RM and JP conducted the title, abstract and full-text review for this study and performed the data extraction. All authors were involved in drafting the manuscript. RM, AK, AS, EM, PL developed the search strategy. All authors were involved in conceiving the idea for this study and drafted major parts of the manuscript. All authors read and approved the final manuscript.

  • Funding RM was supported by a NICE Scholarship, a NIHR Academic Clinical Fellowship and a UCL Public Policy Grant. AS was supported by a NIHR Research Professorship. AK and PL were supported by the NIHR Collaboration for Leadership in Applied Health Research and Care South London at King’s College Hospital NHS Foundation Trust. Funders were not involved in study design, data collection, data analysis, manuscript preparation or publication. All authors had complete access to the study data that support the publication. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data are available.

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