The Nordic countries are world leading in the field of National Quality Registers. The registries concerning implant surgery are frequently cited in the international literature and considered to be “role models” for the efforts to initiate similar registries in other countries.
Despite the fact that the mission for the registers has been clinical improvement work, there has also been a high research activity. A national observational study has some obvious advantages compared to a RCT: a large number of patients, high statistical power, possibility to perform adequate analyses of uncommon complications and the ability to avoid performance bias.
The Nordic Arthroplasty Register Association (NARA) was established in 2007. The network’s main target is to further improve and facilitate the Nordic research concerning implant surgery. The first project has been completed, it consists of a compilation of anonymous data for total hip replacement (THR) surgery from Norway, Denmark and Sweden (1995-2006) containing 280,000 THRs.
NARA aims to perform analyses of the patient demographics of the participating countries, outcome in general and for specific implants and try to construct a standardised “case-mix indicator” to be used in comparisons. Furthermore, to stimulate the PhD students from the different countries to use the unique Nordic data in their research activity.