The Use of Patient Registries in Breast Surgery

Abstract

The TOPS and NSQIP capture significantly different patient populations, with TOPS' self-reported data allowing for the inclusion of private practices. This self-reporting limits TOPS' ability to identify medical complications; surgical complications and readmissions, however, were not underreported. Many surgical complications are captured by TOPS at a higher rate due to its broader definitions, and others are not captured by NSQIP at all. The TOPS and NSQIP provide complementary information with different strengths and weakness that together can guide evidence-based decision making in plastic surgery.

A Comparison of Common Plastic Surgery Operations Using the NSQIP and TOPS Databases

“…As has been highlighted in previous literature, the NSQIP and TOPS exhibit unique strengths and weaknesses. 20 , 28 , 29 The validity of the NSQIP has been documented extensively. It has been shown that there is very limited (<2%) disagreement among data collectors and auditors of the NSQIP when considering nearly all of the multiple hundred variables included in the dataset.…”

“…It has been shown that there is very limited (<2%) disagreement among data collectors and auditors of the NSQIP when considering nearly all of the multiple hundred variables included in the dataset. 3 , 20 , 31 , 32 Moreover, rates of surgical outcomes have been validated in single-institution studies. 31 Importantly, the NSQIP sampling methodology produces what can be considered a random sample of surgical cases conducted at US hospitals, making results interpretable and generalizable to a national population of surgical cases.…”

“…21 Though not used nearly as extensively, recent research has validated outcomes in TOPS through cross-validation with CosmetAssure and the NSQIP database across several procedures. 20 , 33 …”

“…As has been discussed in previous research, TOPS suffers from extensive missing data. 20 With the goal of generalizing TOPS surgical complications to the population represented by NSQIP, we sought to eliminate patients with any field of missing demographic or preoperative clinical information from the analysis. To understand bias induced by including only complete TOPS cases, we summarized the extent of missing data across the datasets.…”

“… 12 – 18 An alternative database, the American Society of Plastic Surgeons (ASPS)—Tracking Operations and Outcomes for Plastic Surgeons (TOPS) has recently been considered for outcomes research specifically in plastic surgery but has a less well-understood patient population. 19 , 20 …”