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Publications

As official journal of the Surgical Outcomes Club, JAMA Surgery provides SOC members with free access to high-quality articles, multimedia, and learning tools. Click here to access them.

Big Data Research in Surgery

Best Practices for Big Data Sources and Methods

Arya S, Dossett LA, Kibbe MR. Best Practices for Big Data Sources and Methods in Surgery. JAMA Surgery. 2025, 160(3):245-246.

Guide to Statistics and Methods

Surgical Outcomes Club/JAMA Surgery Effective Use of Reporting Guidelines to Improve the Quality of Surgical Research

Brooke BS, Ghaferi AA, Kibbe MR. Effective Use of Reporting Guidelines to Improve the Quality of Surgical Research. JAMA Surgery. 2021, 156(6):515-516

The Methodology Toolbox

Surgical Outcomes Club/JAMA Surgery Health Services Research Methodology Series

Ghaferi AA, Haider AH, Kibbe MR. Maximizing the Impact of Surgical Health Services Research – The Methodology Toolbox. JAMA Surgery. 2020, 155(3):190-191

Practical Guides to Data Sets Series

Surgical Outcomes Club/JAMA Surgery Practical Guides to Data Sets Series

Haider AH, Bilimoria KY, Kibbe MR. A Checklist to Elevate the Science of Surgical Database Research. JAMA Surgery. 2018; 153(6):505-507.

Table 1. Clinical “Big Data” Sources (selection of datasets in the United States)
Data Source / Database Clinical Disciplines Organization(s) Patient Population Access Procedure & Diagnosis Codes Analytic Variables* Strengths Limitations
Electronic Health Record (EHR, e.g., Cerner, Epic) All Institution-specific All Institution-specific CPT, ICD-9/10 All Highly granular; opportunity for researcher to personally verify data accuracy and completeness; longitudinal data Social history often absent/outdated; free-text sociodemographic or lifestyle data often unavailable; structured/unstructured mix complicates research extraction
VA Clinical Data Warehouse (CDW) All Veterans' Administration All patients at VA Medical Centers Free to VA-employed or WOC investigators CPT, ICD-9/10 All 60+ integrated databases; data since early 1990s; longitudinal Requires programming expertise; analyses restricted to VA research environment
VA Surgical Quality Improvement Program (VASQIP) All Veterans' Administration VA surgical patients Free to VA-employed or WOC investigators CPT, ICD-9/10 All except Pharmacy and Cost; 30-day longitudinal Standardized nurse abstraction; high reliability; improved outcomes; linkable to CDW Limited to 30-day outcomes; lacks long-term follow-up without linkage
National Surgical Quality Improvement Program (NSQIP) All American College of Surgeons Patients at participating hospitals Volunteer institutions (~700) CPT, ICD-9/10 All except Pharmacy; 30-day longitudinal Modeled after VASQIP; rich perioperative variables; validated outcomes Participation cost; limited facility-level adjustment; 30-day outcomes only
All of Us Research Program All (EHR-based) NIH US volunteers (goal 1M) Tiered access via CDR CPT, ICD-9/10 All except cost; includes SDOH, PROs Inclusive recruitment; OMOP standardized data; genomics and biospecimens Analysis restricted to Researcher Workbench; complex data model
Epic Cosmos All (EHR-based) Epic 246M patients from Epic systems Free to contributing organizations CPT, ICD-9/10 All except cost; SES; longitudinal Unified cross-system patient records; SDOH included Epic-only bias; data quality depends on contributing systems
PCORnet All (EHR-based) PCORI 140M US patients Free to contributing members CPT, ICD-9/10 All except cost; SES Standardized Common Data Model; claims + PRO linkage Variable EHR quality; harmonization challenges
VA Million Veteran Program (MVP) All (EHR-based) Veterans' Administration US veteran volunteers Free to VA-employed or WOC investigators CPT, ICD-9/10 All; SES (Medicaid eligibility) Genomics, surveys, biospecimens, EHR, VA-Medicare linkage Administrative burden; VA population selection bias
Society of Thoracic Surgeons (STS) Databases Cardiac, Thoracic STS Patients at participating sites By request to STS CPT, ICD-9/10 All except cost; 30-day longitudinal High participation in cardiac surgery; rich covariates Procedure-based; limited long-term outcomes and PROs
Abdominal Core Health Quality Collaborative (ACHQC) Hernias ACHQC Patients of ACHQC surgeons Member-only CPT, ICD-9/10 All except Labs, Pharmacy, Cost Hernia-specific metrics; PROMIS and HerQLes PROs Strict reporting restrictions; limited generalizability
National Cancer Database (NCDB) Surgical Oncology ACS Commission on Cancer Patients at CoC-accredited programs Free to CoC facilities ICD-O-3 All except Labs, Pharmacy, Cost TNM staging; facility-level data; large coverage No recurrence data; hospital-based selection bias
Surveillance, Epidemiology, and End Results (SEER) Surgical Oncology NCI ~30% of US cancer cases Public (SEER*Stat) ICD-O-3 All except Labs, Pharmacy, Cost Population-based; incidence, mortality, survival trends No recurrence; limited treatment granularity
Standard Transplant Analysis and Research (STAR) Transplant Surgery UNOS / OPTN Transplant recipients and donors Public (fee) CPT, ICD-9/10 All except cost; graft survival Mandatory reporting; national transplant outcomes Limited access/context variables; reporting variability
ACS Trauma Quality Programs (NTDB) Trauma ACS Committee on Trauma 900+ trauma centers Public ICD-9/10 All except Pharmacy and Cost Largest trauma dataset; rare injury analysis Voluntary submission; missingness variability
Society of Vascular Surgery VQI Registries Vascular Surgery Society of Vascular Surgery US, Canada, Singapore Member-only CPT, ICD-9/10 All except Labs and Cost Procedure-specific registries No centralized event adjudication

* Analytic Variables include: Operative, Labs, Pharmacy, Cost, Age, Race, Ethnicity, Sex, SES, Longitudinal, Comorbidities, Vital Status.

Viewpoints

Archived Viewpoints

Kelz RR, Brooke B, Dossett L. Leveraging the Health Services Research Toolbox for Surgical Education Research. JAMA Surgery, 2022; 157(8):649-650.

Pitt SC, Dossett LA. Deimplementation of Low-Value Care in Surgery. JAMA Surgery, 2022; Epub Ahead of Print.

Massarweh NN, Ghaferi AA, Kelz RR. Achieving Critical Mass in Surgical Outcomes Research. The Changing Role of the Surgical Outcomes Club. JAMA Surgery, 2020; 155(10):911-912.