Streamlining ethics review for multisite quality and safety initiatives: national bariatric surgery registry experience

Wendy A Brown, Brittany R Smith, Melissa Boglis, Dianne L Brown, Margaret Anderson, Paul E O'Brien, John J McNeil and Ian D Caterson
Med J Aust 2016; 205 (5): 200-201. || doi: 10.5694/mja16.00027

The current ethics review process is inappropriate for clinical quality registries

Rigorous methods for assessing and improving the quality of health care have proven difficult to develop by traditional research approaches.1 Clinical quality registries (CQRs) systematically collect an agreed minimum dataset of data across multiple sites on clinically relevant outcome measures. Data are analysed, comparing procedures, providers and institutions.2 Feedback to practitioners has been shown to drive performance improvement, especially if the data are perceived to be high quality.3

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  • Wendy A Brown1,2
  • Brittany R Smith1
  • Melissa Boglis1
  • Dianne L Brown1
  • Margaret Anderson1
  • Paul E O'Brien1
  • John J McNeil1
  • Ian D Caterson3

  • 1 Monash University, Melbourne, VIC
  • 2 The Alfred Hospital, Melbourne, VIC
  • 3 University of Sydney, Sydney, NSW



Funding for the Bariatric Surgery Registry comes from the Australian Government, Applied Medical, Allergan, Apollo Endosurgical, Covidien and Gore.

Competing interests:

The Bariatric Surgery Registry is funded by a grant from the Australian Government and has received support from Johnson and Johnson, Applied Medical, Allergan, Apollo Endosurgical, Covidien and Gore. Wendy Brown and Paul O'Brien declare that their research group, the Centre for Obesity Research and Education, receives funding from the manufacturer of the LapBand (Allergan and Apollo Endosurgical) as well as from Applied Medical. Paul O'Brien is also the author of a book used by patients undergoing bariatric surgery.

  • 1. Walshe K. Pseudoinnovation: the development and spread of healthcare quality improvement methodologies. Int J Qual Health Care 2009; 21: 153-159.
  • 2. Levay C. Policies to foster quality improvement registries: lessons from the Swedish case. J Intern Med 2016. 279: 160-172.
  • 3. van der Veer SN, de Keizer NF, Ravelli AC, et al. Improving quality of care. A systematic review on how medical registries provide information feedback to health care providers. Int J Med Inform 2010; 79: 305-323.
  • 4. National Health and Medical Research Council. Ethical considerations in quality assurance and evaluation activities. Canberra: NHMRC, 2014. (accessed July 2016).
  • 5. Australian Commission on Safety and Quality in Healthcare. Operating principles and technical standards for Australian clinical quality registries. Canberra: ACSQH, 2008. (accessed July 2016).
  • 6. Evans SM, Bohensky M, Cameron PA, McNeil J. A survey of Australian clinical registries: can quality of care be measured? Intern Med J 2011; 41: 42-48.
  • 7. Casarett D, Karlawish JH, Sugarman J. Determining when quality improvement initiatives should be considered research: proposed criteria and potential implications. JAMA 2000; 283: 2275-2280.


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