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Working with SMART

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How to build a SMART Registry for research

output

Publications using the SMART Registry

people

Meet the researchers working on the Registry

creating the

smart registry

data collection

As of the 31st of December 2020, the SMART Registry contains data from 14,686 arthroplasty procedures performed at St Vincent’s Hospital Melbourne in 10,844 patients.  Data collection has been prospective since 1st of January 2005, with retrospective data collection for procedures performed between 1998 and 2004.

Data collected includes patient demographics, current diagnoses and history of comorbidities, relevant clinical observations, prosthesis-specific and operation-specific information, surgical complications, revisions and reoperations, and patient-reported outcome measures (PROMs).  Participant recruitment, data collection and follow-up are ongoing and currently includes up to 20 years follow-up date. 

data linkage

The SMART Registry is linked annually with Medicare Benefits Schedule (MBS) and Pharmaceutical Benefits Scheme (PBS) by the Australian Institute of Health and Welfare Data Linkage Unit. The linked SMART, MBS and PBS data provide an overall understanding of the timing and nature of healthcare utilisation of arthroplasty patients including rehabilitation, rehospitalisation and emergency department presentations, and the use of medications before and after surgery. A probabilistic data linkage method is used to link the data sets, and past linkage rates have exceeded 97%. The linked data are de-identified and housed in the Sax Institute’s Secured Unified Research Environment (SURE) which facilitates the sharing of these data between researchers in our team whilst ensuring the data is highly protected.

The SMART Registry data linkage portfolio is expanding with links scheduled with the Australasian Rehabilitation Outcomes Centre (AROC) and National Death Index (NDI) within the next 12 months. Efforts to link SMART with private health insurance data and other Victorian hospital data are also being investigated.

registry at work

publications

To date, 46 publications have arisen from the SMART Registry.  These include studies focussing on clinical outcomes (e.g complications, range of motion, transfusion, prosthetic joint infection, radiographic outcomes), health behaviours, health economics and patient-reported outcomes.  A full list of publications is provided below.

Klem NR, et al., (2020). What influences patient satisfaction after total knee replacement: A qualitative investigation. Clin Ortho Rel Res.478(8):1850-1866

Bunzli S, et al. (2020). Misconceived expectations: Patient reflections on the total knee replacement journey. Musculoskeletal Care. 2020.

Tew et al. 2020 – Co-morbidities and sex differences in long-term quality-of-life outcomes among patients with and without diabetes after total knee replacement: Five-year data from registry study.

Tew et al. 2020 – Exploring the Impact of Quality of Life on Survival: A Case Study in Total Knee Replacement Surgery Med Decis Making.

Dowsey et al. 2018 – Body Mass Index Is Associated With All-cause Mortality After THA and TKA.

Dowsey et al. 2017 – Variations in pain and function before and after total knee arthroplasty: a comparison between Swedish and Australian cohorts.

Schilling et al. 2017 – Predicting the long-term gains in health-related quality of life after total knee arthroplasty.

Scarlato et al. 2017 – What is the role of catheter antibiotic prophylaxis for patients undergoing joint arthroplasty?

Singh et al. 2017 – Patient Endorsement of the Outcome Measures in Rheumatology (OMERACT) Total Joint Replacement (TJR) clinical trial draft core domain set.

Schilling et al. 2016 – Using patient-reported outcomes for economic evaluation: getting the timing right.

Knowles et al. 2016 – Using the common sense model of illness to examine interrelationships between symptom severity and health outcomes in end-stage osteoarthritis patients

Aboltins et al. 2016 – Good quality of life outcomes after treatment of prosthetic joint infection with debridement and prosthesis retention

Dowsey et al. 2016 – Associations between pre-operative radiographic osteoarthritis severity and pain and function after total hip replacement: Radiographic OA severity predicts function after THR

Anderson et al. 2016 – Effect of re-transfusion systems on physiotherapy participation and transfusion in total knee joint arthroplasty

Dowsey et al. 2016 – Development of a prognostic nomogram for
predicting the probability of nonresponse to total knee arthroplasty 1 year after surgery

Wilson et al. 2016 – Impact of surgical experience on outcomes in total joint arthroplasties

Balasubramaniam et al. 2016 – Functional and clinical outcomes following anterior hip replacement: a 5- year comparative study versus posterior approach

Peel et al. 2015 – Direct hospital cost determinants following hip and knee arthroplasty

Dowsey et al. 2015 – Latent class growth analysis predicts long term pain and function trajectories in total knee arthroplasty: a study of 689 patients

Large et al. 2014 – Physiotherapy-led arthroplasty review clinic: a preliminary outcomes analysis

Dowsey et al. 2014 – Outcomes following large joint arthroplasty: does socio-economic status matter?

Dowsey et al. 2014 – Prospective analysis of rural–urban differences in demographic patterns and outcomes following total joint replacement

Petterwood et al. 2014 – The immediate post-operative
radiograph is an unreliable measure of coronal plane alignment in total knee replacement

Carroll et al. 2014 – Risk factors for superficial wound complications in hip and knee arthroplasty

Peel et al. 2013 – Cost analysis of debridement and retention for management of prosthetic joint infection

Babazadeh et al. 2013 – The effect of tibio-femoral over-distraction in primary knee arthroplasty

Dowsey et al. 2013 – Predictors of pain and function following total joint replacement

Babazadeh et al. 2013 – The long leg radiograph is a reliable method of assessing alignment when compared to computer-assisted navigation and computer tomography

Aboltins et al. 2013 – Early prosthetic hip joint infection treated with debridement, prosthesis retention and biofilm-active antibiotics: functional outcomes, quality of life and complications

Peel et al. 2013 – Outcome of debridement and retention in prosthetic joint infections by methicillin- resistant staphylococci, with special reference to rifampin and fusidic acid combination therapy

Dowsey et al. 2012 – Associations between pre-operative radiographic changes and outcomes after total knee joint replacement for osteoarthritis

Babazadeh et al. 2012 – The accuracy of retrospectively measured range of motion in knee arthroplasty

Dowsey et al. 2011 – Economic burden of obesity in primary total knee arthroplasty

Aboltins et al. 2011 – Gram-negative prosthetic joint infection treated with debridement, prosthesis retention and antibiotic regimens including a fluoroquinolone

Peel et al. 2011 – Risk factors for prosthetic hip and knee infections according to arthroplasty site

Swan et al. 2011 – Significance of sentinel infective events in haematogenous prosthetic knee infections

Buckland et al. 2010 – Periprosthetic bone remodeling using a triple-taper polished cemented stem in total hip arthroplasty

Murphy et al. 2018 – The impact of older age on patient outcomes following primary total knee arthroplasty

Murphy et al. 2018 – What is the Impact of Advancing Age on the Outcomes of Total Hip Arthroplasty?

Dowsey et al. 2010 – The impact of obesity on weight change and outcomes at 12 months in patients undergoing total hip arthroplasty

Dowsey et al. 2010 – The impact of pre-operative obesity on weight change and outcome in total knee replacement: a prospective study of 529 consecutive patients

Dowsey et al. 2009 – Outcomes of total knee arthroplasty in English-versus non–English-speaking patients

Dowsey et al. 2009 – Obese diabetic patients are at substantial risk for deep
infection after primary TKA

Ek et al. 2008 – Comparison of functional and radiological outcomes after computer-assisted versus conventional total knee arthroplasty: a matched-control retrospective study

Dowsey et al. 2008 – Obesity is a major risk factor for prosthetic infection after
primary hip arthroplasty

Choong et al. 2007 – Risk factors associated with acute hip prosthetic joint infections and outcome of treatment with a rifampin-based regimen

our data linkage

Committee

This data governance committee is a forum for decision-making regarding the SMART Registry.  The committee meets quarterly to discuss matters relating to data entry, storage, extraction, linkage and usage.  Our group consists of members with extensive experience in the management of data registries as well as up-and-coming researchers in this space.

a/prof michelle dowsey

Data custodian of the SMART Registry

ms Sharmala thuraisingam

Chair of the OPUS Data Linkage Committee

prof anthony scott

prof maria inacio

dr jason trieu

mr sid rele

Ms ELise naufal

dr myles davaris

ms claire weeden

Mr Daniel Gould

mr cade shadbolt

dr yushy zhou

dr chris schilling

prof Philip clarke

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