Everard Munting, President of EUROSPINE, explains why sharing knowledge about spinal treatments on a global scale is the most effective way to develop best practice and enable early interventions
In the UK alone 100 million workdays are lost every year due to back pain. An estimated 540 million people across the globe suffering with is any one time. Providing excellence in spinal treatments is not limited to the procedure only. It’s about being able to see the whole patient journey and using proven insight to determine which treatment plan will give the most effective outcome. The 2019 GIRFT report on Spinal Services highlights that the specialism lags behind other disciplines in collecting data on the benefits of new technologies being developed in the field as well as highlighting the need for better data to inform clinical practice.
By not doing so, we are missing an opportunity.
If we had a platform for sharing anonymised data from across national registries, this would create an international evidence base detailing which treatments options, surgical and non- surgical work best for which condition and which set of patients. Harnessing broader insight would be enormously beneficial to doctors, hospitals and their patients.
Medical advances seldom flourish in silos and neither does excellence in clinical practice.
In the UK, the Cumberlege Review highlighted the dangers of disjointed and siloed working within healthcare settings. The issues raised in the report revealed the need for greater information to be shared to inform decision making and improve patient care.
The sharing of national data is widely considered to be essential to enable doctors to see which treatments and which medical devices will secure the best outcomes for patients.
However, sharing evidence on a global scale would provide the highest level of assurance and evidence. It would reveal variations in practices, processes, effectiveness of devices and procedures that due to the volume of data, would present the bigger picture, not just a national snapshot.
The insight would present doctors, hospitals and medical device manufacturers, with independent real-world evidence from across the globe. It would help them to understand which treatments and implants are the most effective for which patients and why.
SIRIS, the Foundation for Quality Assurance in Implant Surgery in Switzerland, has set up a national registry with the longer term aim of being able to share information on a wider scale.
It is tracking and monitoring outcomes of patients undergoing spinal treatment. But rather than creating a new registry from scratch, SIRIS is using an established international registry platform, Spine Tango, delivered by Northgate Public Services. This means SIRIS will easily be able to compare treatments and outcomes with other international centres already participating in the Spine Tango registry.
The coronavirus pandemic has shown us how important it is to pool data on a global level to accelerate the development of knowledge and understanding. The sheer scale of the research and co-operation of those involved in clinical drug trials, or battling to save lives in intensive care settings and then sharing life saving techniques with colleagues around the world underlines the importance of sharing real-world evidence in real time.
Unfortunately a by-product of the lockdowns has been the inevitable decrease in activity which is exacerbating back pain for many. Thankfully not all those suffering will require surgical intervention; however, the evidence points to an ongoing upward trajectory due to increasingly sedentary lifestyles and aging populations.
Backing the evidence
The global spinal implants and devices market is projected to increase to over $15 billion by 2027. As so many new technologies and devices are being developed and pioneered, it can be hard to know with any degree of certainty, which ones might work best for individual patients and why. However, if clinicians, manufacturers and medical regulators from around the world could amalgamate and share their collective knowledge, it would help drive up standards, improve patient care and enable early interventions.
A shared international platform that draws upon the insight from national registries is the way forward as not only does it give powerful insight; it can also reduce the burden of data capture for staff in hospitals. Classifying and recording implants in a common way through a global, implant library ensures that data captured in different hospitals and different countries can be compared, improving research and analysis in the specialism, which in turn can improve patient outcomes. Sharing intelligence on this scale, reduces the risks of failing implants or poor surgical procedures going unnoticed and enables early intervention.
The speciality needs international knowledge to predict the long-term success and viability of treatments, which will underpin a global understanding of best clinical practices and procedures. This kind of global analysis will foster transparency and openness and ensure there is a common understanding of the bigger picture, which will help to drive up clinical standards and improve the safety and effectiveness of medical implants.