Registries as a Fundamental Tool to Improve Quality of Care

pp 81-83

Abstract

Randomized clinical trials (RCTs) are fundamental to demonstrate the efficacy of a particular intervention, but are subject to a design based on ideal conditions, with the resulting introduction of selection biases of patients in the participant centers, biases in the use of subgroup analyses that were not originally planned and publication bias. (1, 2) Therefore, once clinical trials have demonstrated the efficacy of a clinical intervention, the path is open for registries and observational studies to test the impact of such intervention in real practice. (3) Thus, registries are essential to verify if health care is delivered according to the recommendations of Clinical
Practice Guidelines (CPG), completing the loop between clinical research (CR), guideline development and their implementation into clinical practice. In summary, RCTs demonstrate efficacy, while registries show effectiveness, efficiency and safety, and constitute a tool of inestimable value towards continuous quality improvement. This happens with the treatment of STEMI using primary percutaneous coronary intervention (PCI), which has proved to be the most effective reperfusion strategy when it is performed within a determined time interval.