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. 2024 Dec 1;106-B(12):1461-1468.
doi: 10.1302/0301-620X.106B12.BJJ-2023-1372.R1.

The National Joint Registry Data Quality Audit of elbow arthroplasty

Zaid Hamoodi  1   2 , Joanne Shapiro  3   4 , Adrian Sayers  5 , Michael R Whitehouse  5   6 , Adam C Watts  2   7 ; NJR DQA-Elbows Collaborators; Jennifer Abbott  8 , Sarah Abbott  9 , Oliver Adebayo  10 , Kashif Ahmad  11 , Philip Ahrens  12 , Michael Akinfala  12 , Nawfal Al-Hadithy  13 , Majed Al-Najjar  14 , Rouin Amirfeyz  15 , Sudhi Ankarath  16 , Fiona Ashton  17 , Kelly Aulton  18 , Sunil Auplish  19 , Jane Austin  20 , Segun Ayeko  21 , Raja Azhar  22 , Rish Bahia  23 , Steven Baines  24 , Marisol Baldomir  25 , Sneha Barai  26 , Benjamin Barkham  27 , Emily Barrett  28 , Timothy Batten  29 , Luckshman Bavan  30 , Jonathan Baxter  30 , Sera Beaumont  31 , James Bentley  32 , Gev Bhabra  33 , Mahendar Bhat  34 , Ankit Bhatt  33 , Mahmoud Bhingraj  35 , Aqeel Bhutta  14 , Samuel Bingham  36 , Jenny Blastland  24 , David Boardman  37 , Michael Boateng  38 , Kasia Bojarska  39 , Khalis Boksh  40 , Simon Booker  41 , Sebastian Borreshi  42 , Michael Bould  15 , Lesley Boulton  43 , Linda Brannan  44 , Zarina Breidaka  20 , Rachel Brereton  45 , Mark Brinsden  46 , Joanne Brooker  47 , Sabine Brookes  48 , Cheryl Broux  38 , Elke Brown  49 , Jacqueline Browne  33 , Richard Bryant  50 , James Buchanan  51 , Lisa Buck  41 , Karen Burnett  45 , Melanie Burrows  52 , Jill Burt  53 , David Burton  52 , Usman Butt  14 , Barry Campaner  54 , Jaime Candal-Couto  17 , Hannah Carvell  44 , Jagannath Chakravarthy  55 , Somashree Chatterji  56 , Salma Chaudhury  57 , Govind S Chauhan  58 , Adrian Chojnowski  59 , Janani Cittambalam  25 , David Clark  60 , Malgorzata Gosia Clarke  61 , Ben Clarke  62 , Andrew Clelland  63 , Roz Cochrane  19   19 , Karen Colbridge  14 , Hayley Cook  64 , Becky Cooper  21 , Elizabeth Correa  54 , Joanna Craven  11 , Jason Crawford  55 , Sherri Curtis  62 , Rory Cuthbert  63 , Jeremy Dainton  21 , Lisa Dale  41 , Sammy Davies  65 , Joanne Davis  66 , Vicky Davis  9 , Ben Dean  57 , Tom Dehler  67 , Sonu Dennis  15 , Jacob Der Tavitian  22 , Aravind Desai  24 , Sukhraj S Dhillon  58 , Richard Dias  58 , Graham Dickinson  17 , Margo Dirckx  9 , Oliver Dixon  22 , Charles Docker  68 , Ronald Dodenhoff  23 , Peter Domos  12 , Kingsleypaul Draviaraj  50 , Steven Drew  33 , Caroline Duff  52 , Sarah Duffin  60 , Paula Durham  69 , Kirstie Earnshaw  70 , Jefin Edakalathur  65 , Michelle Edwards  71 , Zain Elahi  57 , Samantha Else  72 , Moustafa Emara  34 , Khemerin Eng  71 , Alireza Esfandiari  73 , Colin Esler  40 , Jon Evans  74 , Alicia Everall  11 , Alistair Eyre-Brook  41 , Muhamed Farhan-Alanie  33 , Simon Federer  47 , Sharon Ferdinandus  75 , Marie Finch  71 , Jochen Fischer  64 , Catherine Flood  76 , Christine Forde  77 , Justin Forder  78 , Lisa Fowler  68 , Marieta Franklin  66 , Hamez Gacaferi  57 , David Gamble  29 , Sunil Garg  79 , Vicki Gill  23 , Jean Ginley  16 , Emma Glancey  55 , Gemma Glanville  80 , Aimen Gmati  57 , Karen Goddard  81 , Jay Goel  57 , Carly Goldsmith  80 , Ben Gooding  32 , Fiona Goodwin  65 , Benjamin Goring  51 , Will Goude  18 , Paul Guyver  46 , Samuel Haines  82 , Aziz Haque  60 , Thomas Hardley  15 , Susan Haritonow  49 , Louise Harnett  67 , Joanna Harris  74 , Margaret Harris  71 , Jane Harrison  79 , Isabelle Hauffe  47 , Archie Hawken  83 , Dave Hawkes  66 , Stuart Hay  65 , Mia Haywood  84 , Siddhant Hedge  34 , Susan Hickey  37 , Anne Hickinson  24 , Deborah Higgs  85 , Richard Hill  47 , Sharyn Hill  53 , Jamie Hind  57 , Maria Hitchcock  28 , Terry Holdcroft  43 , Emily Holdcroft  11 , Ann Holliday  27 , Siobhan Hudson  32 , Hazel Hughes  23 , Rabia Imtiaz  20 , Sheeraz Iqbal  36 , Yamen Jabr  86 , Crystal Jackson  29 , Jackie Jameson  87 , Odette Jayme  38 , Andrew Jennings  52 , Cara Jenvey  21 , Elizabeth Jewitt  50 , Andreea Jimenez  16 , John Joby  62 , Adrian Jones  59 , Neil Jones  88 , Jadranka Jovanovic  25 , Vanessa Kabala  16 , Niel Kang  63 , Gulnaz Kausor  34 , Sarah Kaynes  41 , Conal Keane  52 , Lauren Keen  89 , Gaynor Kelly  19 , Matthew Kent  66 , Jonathan Kent  43 , Carla Kerr  90 , Julie Kerr  57 , Christina King  90 , Anthony Kinnair  88 , Gemma Kinsley  63 , Alastair Konarski  8 , Jacqueline Kord  91 , Hari Kumar  71 , Sachin Kumar  65 , Rebecca Lafferty  42 , Patrick Lancaster  27 , William Levitt  81 , Alexandria Lewin  46 , Yueyang Li  88 , Ignatius Liew  26 , Martin Yizhe Lim  74 , Stephen Lipscombe  70 , Edith Lynch  64 , Scott MacInnes  71 , Paula Madden  42 , Nick Maddocks  26 , Ravindra Mahajan  72 , Rachel Mahoney  48 , Sheraz Malik  8 , Syed Mannan  90 , Alexandros Maris  12 , Michael Markey  86 , Christy Martin  54 , Rebecca Martin  90 , Stanley Masunda  58 , George Mazis  10 , Anne-Marie Mcauliffe  92 , Tim McBride  58 , Amy McGowan  14 , Nicolee Mckeown  87 , George McLauchlan  61 , Debbie McNally  41 , Joel Melton  63 , Jane Miller  93 , Cathy Millyard  83 , Claire Mitchell  15 , Foad Mohamed  89 , Abdalla Mohamed  94 , Helen Charlotte Montgomery  32 , Darren Munn  83 , John Mutimer  81 , Rajesh Nanda  43 , Daniel Neen  36 , Lynne Newton  38 , Ashley Newton  42 , Aly Nicholl  78 , Jessica Nightingale  32 , Emma Ogden  60 , Peter Orton  56 , Lynda Oswald  30 , Kelly Page  10 , Maria Paius  44 , Madhavan Papanna  71 , Neelam Patel  8 , Claudia Paul  57 , Chris Peach  8 , Derek Pegg  11 , Sue Penfold  63 , Eleanore Phillips  60 , Greg Pickering  31 , Christos Plakogiannis  20 , Julie Platt  42 , Craig Pole  14 , Richard Potter  65 , Kate Povall  36 , Riten Pradhan  72 , Ganesh Prasad  66 , Karen Price  34 , Julie Pride  22 , Afnan Prins  34 , Layth Qazzaz  54 , Ajay Radhakrishnan  14 , Ashwanth Ramesh  8 , Adil Rashid  71 , Abbas Rashid  89 , Damir Rasidovic  33 , Emily Ratford  74 , Jan Rayner  75 , Jae Rhee  23 , Matthew Rice-Evans  72 , Martha Ricketts  85 , Deborah Roach  82 , Eve R Waters  63 , Simon Robinson  86 , Paul Robinson  26 , Samantha Rodgers  48 , Emma Rogers  44 , Aaron Rooney  59 , Dan Rossouw  12 , Bibhas Roy  8 , Maseh Sadiqi  57 , Markus Sagmeister  78 , David Samy  86 , Paige Sanders  57 , Kelly Sanderson  56 , Dilraj Sandher  56 , Nastaran Sargazi  66 , Mark Saunders  43 , Nicky Saunders  85 , Kim Savage  10 , Seif Sawalha  91 , Melissa Schouw  77 , Gareth Scott  88 , Gunther Selzer  18 , Lucia Sepesiova  70 , Sohan Shah  66 , Shantanu Shahane  84 , Grant Shaw  77 , Suzani Shrestha  57 , John Shutt  52 , Nashat Siddiqui  27 , Sijin Sidharthan  37 , Adrian Simons  58 , Vera Simpson  40 , Pierre Sinclair  54 , Paul Siney  42 , Jagwant Singh  35 , Bijayendra Singh  76 , Harvinder Singh  40 , Apurv Sinha  84 , Callum Smith  14 , Christopher Smith  74 , Kerry Smith  46 , Brinda Somanchi  49 , Muhab Soufan  51 , Cynthia Southgate  44 , Jeremy Southgate  44 , Nicola Spearpoint  76 , Rebecca Stainer  95 , Richard Stevens  84 , Batya Stimler  88 , Andrew Stone  47 , Danielle Suter  72 , Charlie Talbot  94 , Tareq Tareef  22 , Kanthan Theivendran  48 , Beverely Thomas  57 , William Thomas  74 , Andrew Thompson  63 , Jackie Thompson  96 , Elizabeth Thornhill  41 , Andrew Titchener  57 , Michael Townley  8 , Tina Tozer  13 , Jennie Truman  19 , Adam Truss  64 , Rob Turner  23 , Lee Van Rensburg  63 , Vinayak Venugopal  70 , Sam Vollans  75 , Louise Waller  20 , Anna Walsh  8 , Aleena Waraich  70 , Nicholas Wei  43 , William James White  29 , Mark Wilkinson  12 , Daniel Williams  88 , Philip Williams  84 , Nicola Williams  58 , Stephanie Wilson  65 , David Wood  84 , Shirley Yadu  26 , Tejas Yarashi  66 , Julian Zeolla  31 , Nasri H Zreik  70 , Ben Ollivere  32
Affiliations

The National Joint Registry Data Quality Audit of elbow arthroplasty

Zaid Hamoodi et al. Bone Joint J. .

Abstract

Aims: The aim of this audit was to assess and improve the completeness and accuracy of the National Joint Registry (NJR) dataset for arthroplasty of the elbow.

Methods: It was performed in two phases. In Phase 1, the completeness was assessed by comparing the NJR elbow dataset with the NHS England Hospital Episode Statistics (HES) data between April 2012 and April 2020. In order to assess the accuracy of the data, the components of each arthroplasty recorded in the NJR were compared to the type of arthroplasty which was recorded. In Phase 2, a national collaborative audit was undertaken to evaluate the reasons for unmatched data, add missing arthroplasties, and evaluate the reasons for the recording of inaccurate arthroplasties and correct them.

Results: Phase 1 identified 5,539 arthroplasties in HES which did not match an arthroplasty on the NJR, and 448 inaccurate arthroplasties from 254 hospitals. Most mismatched procedures (3,960 procedures; 71%) were radial head arthroplasties (RHAs). In Phase 2, 142 NHS hospitals with 3,640 (66%) mismatched and 314 (69%) inaccurate arthroplasties volunteered to assess their records. A large proportion of the unmatched data (3,000 arthroplasties; 82%) were confirmed as being missing from the NJR. The overall rate of completeness of the NJR elbow dataset improved from 63% to 83% following phase 2, and the completeness of total elbow arthroplasty data improved to 93%. Missing RHAs had the biggest impact on the overall completeness, but through the audit the number of RHAs in the NJR nearly doubled and completeness increased from 35% to 70%. The accuracy of data was 94% and improved to 98% after correcting 212 of the 448 inaccurately recorded arthroplasties.

Conclusion: The rate of completeness of the NJR total elbow arthroplasty dataset is currently 93% and the accuracy is 98%. This audit identified challenges of data capture with regard to RHAs. Collaboration with a trauma and orthopaedic trainees through the British Orthopaedic Trainee Association improved the completeness and accuracy of the NJR elbow dataset, which will improve the validity of the reports and of the associated research.

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Conflict of interest statement

Z. Hamoodi reports research fellowship funding from Royal College of Surgeons, National Joint Registry, and The John Charnley Trust, related to this study. A. Sayers is senior statistician on the HQIP/NJR Lot 2 contract. M. R. Whitehouse is the principal investigator for the HQIP/NJR Lot 2 contract to provide statistical support, analysis and associated services to the NJR, related to this study, and reports multiple grants or contracts from the NIHR and Ceramtec, royalties or licenses from Taylor & Frances, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Heraeus, all of which are unrelated to this study. A. C. Watts reports royalties or licenses and patents planned, issued or pendingfrom Adler, consulting fees from Medartis, payment or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from Medartis, Stryker, and Arthrex, all of which are unrelated to this study, and is also a member of the editorial boards of the National Joint Registry and The Bone & Joint Journal.

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