Commercially Sponsored Section

ABSTRACT PURPOSE: To demonstrate how the large quantity of uniformly collected data available to a corporate refractive surgery provider, Optical Express, is applied to drive improvements in patient outcomes. METHODS: Optical Express employs a skilled team of biostatisticians to analyze the information in its electronic medical records database of over 5,500,000 patient records. The techniques used to ensure high data quality and the selection of statistical methods used in making data-driven clinical decisions are described. The importance of appropriate statistical methods is demonstrated in an example in which the effect of age on refractive outcomes in low myopes is studied. The use of a corporate database in prospective and retrospective analyses is detailed. RESULTS: By providing the resources necessary to interpret the information in Optical Express' medical records database, the biostatistics department has helped Optical Express refi ne its procedures and improve surgical protocols and patient outcomes. CONCLUSIONS: Biostatistical analyses help transform the large quantities of uniformly collected clinical data available to a corporate surgery provider into information that can be applied to improve clinical practice. Such datadriven process improvements play a key role in improving patient outcomes. [J Refract Surg. 2009;25:S651-S654.] doi:10.3928/1081597X-20090611-05 W ith data on over 5,500,000 patients, the Optical Express clinical outcomes database has the potential to shed light on a wide range of medical and surgical questions. In addition to evaluating the performance of individual surgeons, this database is used to answer broad questions about the safety and effi cacy of various refractive surgery procedures and the factors infl uencing patient outcomes. Optical Express employs a biostatistics department that ensures the appropriateness of statistical methodology and the quality of data. By ensuring that the conclusions drawn from this data are statistically valid, the biostatistics department is essential to the company's effort to answer a range of questions about both the science and business of refractive surgery. ENHANCING OUTCOMES WITH DATA-DRIVEN DECISIONS The primary function of data analysis is to promote evidence-based decisions that improve patient care. By analyzing data from tens of thousands of patients, statistical models can be developed that identify the key factors that impact surgical outcomes. Surgeons can then use these models to modify treatment variables and improve patient outcomes. In addition to helping with the large-scale analyses reported in this supplement, the biostatistics department performs a variety of other assessments. For example, surgeon reviews are performed biannually to provide quality control information about each surgeon's performance. As part of these reviews, surgeons' performance is compared in a way that takes into account the patient population that each surgeon treats and the types of procedures he or she performs. Thus, the scoring system developed by the biostatistics department gives a valid "apples to apples" comparison. Finally, the biostatistics department responds to queries regarding the merits of anecdotal information. For example