Digital Health Systems to Improve Perioperative Patient Outcomes - Phase 3

Research Questions

Is it feasible to develop surgical registries in three African countries to allow linkage and shared data analysis?

What are the stakeholder views and perceptions on the use of digital health resources to improve quality of perioperative care?

Can national datasets from registries in three African countries be linked to produce an international epidemiological study with risk-adjusted comparisons of activity and outcomes?

Progress from Phase 2

Following regulatory approvals in all nations, we will undertake an international epidemiological study of perioperative care and patient outcomes across three African countries using registry data. Data will be pseudonymised and minimised prior to transfer using Secure File Transfer Protocol to a centralised data centre hosted by QMUL and accredited to international standards (ISO 9001, 14001). Differing resource levels at participating hospitals will be mapped to allow for context-relevant interpretation.

 The first analysis will describe surgical outcomes, case-mix and complication rates. We will adjust for potential confounding with mixed-effects multivariable logistic regression modelling. We will include random effects to account for differing hospital resource levels.


Outcomes at hospital and national level will be anonymised to allow constructive debate about the feasibility and value of international epidemiological studies and clinical audit in Africa. We will establish a sustainable data pipeline to enable regular updates to this international dataset, enabling further detailed epidemiological research, and efficient data-enabled clinical trials

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