Knowledge and insights from a maturing international clinical quality registry.

Since 2017, the TrueNTH Global Registry (TNGR) has aimed to drive improvement in patient outcomes for individuals with localized prostate cancer by collating data from healthcare institutions across 13 countries. As TNGR matures, a systematic evaluation of existing processes and documents is necessary to evaluate whether the registry is operating as intended. The main supporting documents: protocol and data dictionary, were comprehensively reviewed in a series of meetings over a 10-month period by an international working group. In parallel, individual consultations with local institutions regarding a benchmarking quality-of-care report were conducted. Four consensus areas for improvement emerged: updating operational definitions, appraisal of the recruitment process, refinement of data elements, and improvement of data quality and reporting. Recommendations presented were drawn from our collective experience and accumulated knowledge in operating an international registry. These can be readily generalized to other health-related reporting programs beyond clinical registries.

Erectile Dysfunction and Sexual Problems Two to Three Years After Prostatectomy Among American, Norwegian, and Spanish Patients.

BACKGROUND: The incidence of erectile dysfunction (ED) and sexual problems after radical prostatectomy has differed greatly in reports from different centers and countries; however, few studies have taken baseline factors into account. We compared the incidence of ED and sexual problems 2 to 3 years after radical prostatectomy in American, Norwegian, and Spanish men for whom selected clinically relevant demographic and medical pretreatment variables were available. PATIENTS AND METHODS: From 2003 to 2009, 1077 men (United States, n = 494; Norway, n = 472; and Spain, n = 111) scheduled for prostatectomy responded to an Expanded Prostate Cancer Index Composite questionnaire before treatment and 2 to 3 years after prostatectomy. On multivariate analysis, the odds ratios for ED and sexual problems were calculated, adjusted for the pretreatment variables found significant (P < .01) on univariate analysis. RESULTS: For all patients and for those without ED preoperatively, no statistically significant association was detected between the country of prostatectomy and the likelihood of reporting post-prostatectomy ED or sexual problems despite the significant differences among the 3 countries in the unadjusted analyses. CONCLUSION: Adjusting for important pretreatment variables, no intercountry differences were detected. Thus, a thorough knowledge about the pretreatment medical and demographic factors is essential for valid comparisons of the incidence of postprostatectomy ED and sexual problems among different studies.