Disease registry

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Disease or patient registries are collections of secondary data related to patients with a specific diagnosis, condition, or procedure. In its simplest form, a disease registry could consist of a collection of paper cards kept inside "a shoe box" by an individual physician. Most frequently registries vary in sophistication from simple spreadsheets that only can be accessed by a small group of physicians to very complex databases that are accessed online across multiple institutions. [1] Registries are different from indexes in that they contain more extensive data. They can help to hypothesize risk factors and allow scientific research. They provide health care providers (or patients) with reminders to check certain tests in order to reach certain quality goals. They play a role in epidemiological research, drug safety and post marketing surveillance of pharmaceuticals and devices.

Contents

Definition

A disease registry is a data collection related to persons with a specific diagnosis, condition, or procedure. [1] Registries can be sponsored by a government agency, nonprofit organization, health care facility, or private company. Data ownerhip and data access as well as goals vary accordingly. [2]

Registries have traditionally been less complex and simpler to set up than electronic medical records, which according to a 2008 survey were only used by 9% of small US practices, where almost half of the US doctors work. [3]

Types

Many measures registries track are based on evidence-based medicine and are defined and standardized by national organizations like the NCQA.

Medical conditions tracked

As of November 2025, the NIH listed 80 disease registries on its website. [4] The lastest one to be launched in the US was the autism registry. [5]

Registries target certain conditions because medical expenses are unevenly distributed: most health care expenses are spent treating patients with a few chronic diseases. [6] As of 2011 more than 130 million Americans lived with chronic diseases and chronic diseases accounted for 70% of all deaths in the US. "The medical care costs of people with chronic diseases account for more than 75% of the nation's $2 trillion medical care costs." [7]

Diabetes is one of the conditions tracked by registries. Diabetes is also amenable to this because there is a defined target population and there is evidence that certain tests like retina exams, LDL levels, HgbA1c levels correlate with quality of care in diabetes. [8]

New York City created a HbA1C Registry (NYCAR) to help health providers keep track of patients with diabetes. [9]

Another example of disease registry is the New York State CABG Registry that tracks all cardiac bypass surgery performed in the state of New York. [10]

The Australian cerebral palsy register represents an example of a recognized disease register. [11] The aim of the Australian CP register is to conduct surveillance or constant observation of cerebral palsy prevalence, clinical patterns and complications. It is also tasked with providing recommendations to public health policy makers and improving health service delivery to individuals with cerebral palsy. [12] More recently, several developing countries such as Bangladesh and Sri lanka have established cerebral palsy registers geared toward achieving the same above-noted aims. [13] [14] [15]

Tests like Pap smears are also useful to keep track in registries[ citation needed ] because there is evidence that when done annually in women of certain ages groups can detect and prevent cervical cancer. [16]

International

Below is a small list of international patient registries.

Medical devices

Countries like Australia, Britain, Norway, Sweden, [23] and America [24] have a national joint replacement registry to track patients with artificial joints.

"The use of joint registries has proven beneficial abroad. In Australia, regulators use such data to force manufacturers to justify why poorly performing hips or knees should remain available, and products have been withdrawn as a result. In Sweden several years ago, surgeons alerted by their national registry stopped using a badly flawed hip long before their American counterparts did. A few medical organizations in the USA, like Kaiser Permanente, operate their own registries to good effect and the Hospital for Special Surgery in New York has recently set up a registry. Experts say that the United States wastes billions of dollars annually on medical treatments which may not work. But the financial and human consequences are also large when evidence exists but is not collected." [25]

Goals

Registries can be used for epidemiological research, evaluating for risk factors or outcomes.

Patient registries are particularly useful for evaluating drug safety, particularly orphan drugs in specific populations. [26] As of 2023, it was getting more and more common to use data of different healthcare and disease registries for different purposes such as for generating evidence for healthcare efficiency and market access planning. [27]

Quality improvement

They can provide health providers (or patients) with reminders to check certain tests in order to reach certain quality goals. They play a role in post marketing surveillance of pharmaceuticals. [28]

Improve cost-effectiveness

The cost-effectiveness of a disease registry is related with the cost-effectiveness of prevention of specific medical conditions. Increasing compliance through a registry with preventive measures like children vaccination or colonoscopy screening can actually be a cost-saving measure. [29] "A mammogram every 2 years for women aged 50–69 costs only about $9,000 per year of life saved. This cost compares favorably with other widely used clinical preventive services." [30]

Pay-for-performance (P4P)

Registries can be associated with pay-for-performance (P4P) quality based contracts for individualhealth care providers, groups of or even all doctors in a country. For example, the United Kingdom, rewards physicians according to 146 quality measures related with 10 chronic diseases that are tracked electronically. [31]

In 2017 in the United States, Medicare started a 1.5% P4P contract based on health measures that can be tracked by disease registries. [32]

Technical aspects of data tracking

The quality of a disease registry is contingent on the quality of its data and all the processes involved in updating it and keeping its integrity. In every registry there is always a risk of "garbage in, garbage out". Issues that can affect a registry and its acceptance by a physician group:


See also

References

  1. 1 2 "ACP Observer, September 2005 - Patient registries: a key step to quality improvement". Archived from the original on 2012-07-31.
  2. "List of Registries National Institutes of Health (NIH)". www.nih.gov. March 4, 2025. Retrieved 2025-11-04.
  3. DesRoches, Catherine M.; Campbell, Eric G.; Rao, Sowmya R.; Donelan, Karen; Ferris, Timothy G.; Jha, Ashish; Kaushal, Rainu; Levy, Douglas E.; Rosenbaum, Sara; Shields, Alexandra E.; Blumenthal, David (3 July 2008). "Electronic Health Records in Ambulatory Care — A National Survey of Physicians". New England Journal of Medicine. 359 (1): 50–60. doi: 10.1056/NEJMsa0802005 . PMID   18565855.
  4. "List of Registries | National Institutes of Health (NIH)". www.nih.gov. March 4, 2025. Retrieved 2025-11-04.
  5. Mandell, David S. (November 1, 2025). "Why We Should Be Concerned About an Autism Registry". JAMA Pediatrics. 179 (11): 1147. doi:10.1001/jamapediatrics.2025.3459. ISSN   2168-6203.
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  7. "Chronic Diseases and Health Promotion". Archived from the original on 2011-07-26. Retrieved 2008-07-09.
  8. Association, American Diabetes (1 January 2003). "Standards of Medical Care for Patients With Diabetes Mellitus". Diabetes Care. 26 (suppl 1): s33 –s50. doi: 10.2337/diacare.26.2007.S33 . PMID   12502618 via care.diabetesjournals.org.
  9. The NYC Hemoglobin A1C Registry (NYCAR) : Diabetes Prevention and Control Program : NYC DOHMH Archived June 9, 2007, at the Wayback Machine
  10. Hannan, Edward L.; Racz, Michael J.; Walford, Gary; Jones, Robert H.; Ryan, Thomas J.; Bennett, Edward; Culliford, Alfred T.; Isom, O. Wayne; Gold, Jeffrey P.; Rose, Eric A. (26 May 2005). "Long-Term Outcomes of Coronary-Artery Bypass Grafting versus Stent Implantation". New England Journal of Medicine. 352 (21): 2174–2183. doi: 10.1056/NEJMoa040316 . PMID   15917382.
  11. "Australian Cerebral Palsy Register Bulletin Birth years 1995-2018, March 2025" (PDF). Retrieved 28 April 2025.
  12. Register, C. P. "Home | CP Register". Australian CP Register website. Retrieved 28 April 2025.
  13. "Cerebral Palsy Register". srilanka.cpregister.com.
  14. Heiyanthuduwage, Thilini Madushika; Sumanasena, Samanmali P; Kitnasamy, Gopi; Smithers Sheedy, Hayley; Khandaker, Gulam; Fernando, Romaniya; Wijesekara, Saraji; Jagoda, Jayatri; Ratnayake, Pyara; Wanigasinghe, Jithangi; Mclntyre, Sarah; Goldsmith, Shona; Waight, Emma; Badawi, Nadia; Muhit, Mohammad; Muttiah, Nimisha (August 2020). "Protocol for the Sri Lankan Cerebral Palsy Register pilot study". BMJ Open. 10 (8) e039353. doi:10.1136/bmjopen-2020-039353. PMC   7443274 . PMID   32820001.
  15. Khandaker, Gulam; Smithers-Sheedy, Hayley; Islam, Johurul; Alam, Monzurul; Jung, Jenny; Novak, Iona; Booy, Robert; Jones, Cheryl; Badawi, Nadia; Muhit, Mohammad (December 2015). "Bangladesh Cerebral Palsy Register (BCPR): a pilot study to develop a national cerebral palsy (CP) register with surveillance of children for CP". BMC Neurology. 15 (1). doi: 10.1186/s12883-015-0427-9 . PMC   4582618 . PMID   26407723.
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  21. "Home page - Vasotens Registry". VASOTENS.
  22. "TREAT-NMD: List of registries by disease". www.treat-nmd.eu. Retrieved 2018-06-13.
  23. Larsson, Stefan; Lawyer, Peter; Silverstein, Martin B. (November 2010). "From Concept to Reality: Putting Value-Based Health Care into Practice in Sweden". Boston Consulting Group. Retrieved 2011-07-06.
  24. "American Joint Replacement Registry - Improving orthopaedic care through data". ajrr.net. Archived from the original on 2016-02-08. Retrieved 2016-02-03.
  25. Meier, Barry (2008-07-29). "A call for a warning system on artificial joints". The New York Times .
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