In 1993 Sir Dennis Paterson wrote an editorial on the International Documentation and Evaluation System (IDES) [9]. He outlined the principles of IDES as consensus, hierarchical information, radiographic evaluation and acceptability. IDES was established by the International Society of Orthopaedic Surgery and Traumatology (SICOT) Standing Committee on Documentation and Evaluation, which was founded in 1990 with Prof. M.E. Müller as chairman, and presented at the American Association of Orthopedic Surgeons (AAOS) 61st annual meeting in 1994. The nomenclature used on the three IDES sheets for primary total hip arthroplasty (THA), revision THA and followup is based on the consensus paper by the Hip Society, the SICOT Commission on Documentation and Evaluation and the Task Force on Outcome Studies of the AAOS [6]. This consensus paper provided a terminology named CART (Clinical and Radiographic Terminology), in which each term, whether applying to a functional or radiographic parameter, was specifically defined to have a constant meaning. The initial impulse to create such a terminology was already given in 1985 when J. Galante [4] called for a uniform method of evaluating and reporting the results of hip-replacement surgery in order to compare the results on a common standardized basis.In this article the authors report their 10-years experience with the IDES system, which has been the basis of a European-wide hip arthroplasty registry, and describe the influence of the initially stated axioms-consensus, hierarchical information, radiographic evaluation, and ac-ceptability-on the documentation system and introduce the newly developed version of the IDES documentation system with Internet technology.-Consensus: The parameters of IDES represent the probably broadest consensus ever achieved in the discussion about documentation of hip arthroplasty. A global committee consisting of representatives of the major orthopaedic societies had agreed on the clinical, functional and radiographic parameters to be recorded. These parameters cover the three most important influential factors on the outcome of THA-the patient, the surgical measures and techniques, and the implanted components. When financial pressures and legal needs for postmarket implant surveillance, the principles of evidence-based medicine and the outcomes movement initiated a broader discussion about outcome documentation, not only were the earlier made efforts and agreements ignored but also the focus was significantly shifted towards a more patientbased assessment. This is in favor of the busy clinicians, since documentation burden is reduced and assigned to the patient. Unfortunately, the few parameters left for description of implants and details of intervention mostly represent a minimal data set, which is suitable for comparison of component survival but not for quality assessment of hospitals and treatment methods. As opposed to the achieved standardization of patient questionnaires like the Western Ontario and McMaster Universities Arthritis Index (WOM...
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