President's Perspective April 2018

John S. Steinberg, DPM, FACFAS

Reinventing Our Role in Surgical Outcomes Research: Patient Registry & Big Data
John S. Steinberg, DPM, FACFAS
ACFAS President

We are riding high…just as we should be after an incredibly successful ACFAS Annual Scientific Conference in Nashville. However, just as quickly as the lecture halls have cleared, we at ACFAS have quickly begun the work for the year in front of us. New committees and chairs are in place, and there is so much great work to accomplish!

There has never been a better time to assume the role as President of this College. The volunteer leadership we have in place is composed of dedicated and talented individuals who stand to bring even more success to our committees and our Board. We are fortunate to have a strong professional staff at our office in Chicago who provide consistency and support to all our endeavors. We as volunteers are charged with coming up with the ideas and setting the direction of the organization, but it is of course our staff who implement these ideas and put in the hours to follow them to completion. I think each of you would be proud to see the dedication and efficiency of our professional staff who work for you.

It’s What You Learn AFTER You Know It All That Counts…!
—Coach John Wooden

One key area of need in our profession is meaningful surgical outcomes research. There have been outcries for this in many online forums, and most of us have pointed to this real need for years. Now is the time to put our money and actions where our mouth is and to take the aggressive steps necessary to begin this work. Your ACFAS Board of Directors is prepared to allocate significant financial resources and staff support to this cause.

The Promise of Patient Registries to Inform Care
We gain more insights from the shared experiences of fellow clinicians rather than crunched numbers of the unrealistic patient population in clinical trials. Today, we in the foot and ankle surgical community realize the benefit of sharing our own data and experience. Forming and participating in registries is now a top agenda item for many institutions. Registries collect and consolidate the data from real-world patients and real-world clinical care. With the help of registries, we can see what is working, in what environment and in what patient population. We can stop looking for a “silver bullet” treatment and instead apply real-world findings to real-world patients. Since a registry uses prospectively collected data on a broad patient population, there is much less concern for selection bias or investigational error.

We can improve patient outcomes by creating validated scoring systems based on hundreds of thousands of patients. We can look at comparative efficacy. We can gain insights into what types of  interventions work best in what types of patients, in real-world practice. Registries can enable these strides forward. This type of data is good for providers, health systems, payers, and most importantly, for our patients.

You will be hearing a lot about this new research endeavor throughout the year. This project will not be quick or without sacrifice, but we will be laying the foundation for the next decade of meaningful research in foot and ankle surgery…and it is your College that is making it happen!

Educational Opportunities