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So we're going to start the second session with the presentation from Zied Hammoudi. Um, we best worked, uh, with the n j r. With Botha through the Royal College of Surgeons on a really important project for for all of us, really on improving the data set for elbow arthroplasty, Uh, and Zaid really lead that project from the front. So I introduced side to come and tell you all about it and feedback to you what all of your hard work did. Mhm. So hi, My name is edema. Liverpool trainee. I'm an s C seven and then J R fellow. I was actually really excited to come here today to thank all the trainees. I've taken part in the audit. So many you have left already. They've gone today, uh, and also to share with you the results so far, are we off to? Okay, So the improving data quality, I mean, remains a strategic priority for the N. J R. And for that reason, the live audit prospective audit has been included in the elbow data sets since 2020. However, the data between 2012 and 2022 is not assessed in the past. For that reason, we started with NGR elbow data set to look at the missing data and any inaccuracies in the data set. Uh, and for the missing data, we compare the NGR data to the heads data. Any data? That's any procedures that's on Head's. Not on NJ are we want to catch. Want to make sure that it gets added to the N Jr for mismatches. We looked at the procedures and the implants, and if there's a mismatch between the procedure and the implant is marked as inaccurate, we can't use it for analysis. And for that reason we need to correct the procedure or actually curricular implants. This is a collaborative audit national between both and n g. R. Mainly, and the straight trainees will lead it forward and make sure it happened. And we're very grateful for that. And the way it worked. We said to we sent to collection tools one for an accurate data, one for missing data to each hospital, and they registered the audit locally, and a team of an NGR hospital data manager, a trainee and a consultant would undertake the audit and the consultant mainly a supervising role. Mhm. So when we compared heads to NGR, there were over 5000 procedures that were on Head's, not on NJ are in 220 for NHS hospitals, and there were 448 inaccurate procedures. Out of those, we were able to audit 61% so far, and out of those 61% 78 were confirmed as missing. The rest of those procedures were not in ngr procedures and the non arthroplasty. So if you do a or if it's coded wrongly, uh, on the head or they are an NGR procedure submitted previously. But they are mismatched because of the different date or the different surgeon, and after those were able to add to add 85% of the procedures. So the majority of the procedures were primary radial head replacements, and the majority of the revision procedures that we're missing are a total Alberta vision replacement surgery. As you can see here that we managed to increase the elbow data set for that period between 2012 to 2020 by 33% and the largest increases actually in the radial head replacement more than doubled for that period. But that increased awareness between trainees and clinician surgeons of the of the elbow data set and the fact they have to add add all these procedures. And now we have 11,000 elbow procedures on the NJ are an increased by 69% since the start of the audit. Okay, you can see here the completeness of the elbow data set for that period, and it's improved from 61% to 80%. That is now improved even further to 84% from the washout effect. The for the, uh, time after the audit. Yeah, for the missing procedures so far, we're able to audit 308 procedures. The majority where there's an implant arrest. So there's an implant missing. There were 71 procedures wrongly wrongly coded to an NJ are so majority of them were hemiarthroplasty has been reported as total elbow replacement, and all of these have been corrected by the work of the trainees. Okay, so in conclusion, you can see that we, by the work of the trainees and the collaboration with Botha, we improve improve the completeness of the injury elbow data set from 61% to 84% and improve the accuracy from 93 to 98%. And this showed that working in collaboration with Botha is very effective and successful way to take future collaborative research. I'm going to leave this. I expected more Chinese to be here, but you can scan this and you will see if you've taken part in the audit, you will have your acknowledgement there and that is published on the n G R. Website now. So all the people taking part. And if if you haven't taken part and your hospital there's a list of hospitals that haven't taken part in the in the audit, if you can get in touch with me, we want to reach that 90% mark. Uh, completeness. Thank you. Thanks very much, Zaid. Any questions for Zied About that? Yes. Added to the n j r. Or is this that resort? No, this is this is all done on behalf of the National Joint Registry, isn't it? So if you want to, uh, talk, talk more about that and how it's yes. So we we did this through the n g R. Data quality Committee. So it's not our work alone. Is that N Jr. Who actually wanted this to get forward and Professor Demises involve the NGR data Quality committee? So it's all working with the N j R. And the N G R team is the one who compared Hester NGR and they're the ones who compared the components of the procedures. And by working closely with N g r and the trainees speaking to the MGM all these days has been edited inputted into the mg are now increasing the NGR data set. So if anyone applies for a project will have access to this data. Is the rest of it prospective? We entered it. Use retrospectively. Yeah, from from 2020 there's a prospective audit to check what has been added, but from 2. 2012 to between 2012 and 2020. This, uh, this At that time, it's not compulsory to put the mg are data, and we weren't sure how complete it is, so we couldn't come with conclusions, But now we have much better data set. So is the prospectively collected data. What is a retrospective study? Well, it would actually it would be a registry study, which is different again. Um, so, um, the the The point is that there's an internal validation of the data that's entered. So we've been through this process to make sure that it's correct. Uh, within the when the data is analysed, we ensure that the implants that have put in match with the records that are entered and that's been partly what What's that been correcting? So it's really about bringing the accuracy and the completeness up to a minimum level. We're aiming for 90% as a as a sort of basic standard, so that you can then rely more on your analysis when you when you're looking at the data. Does that make sense? I might say it's not me who's doing as you guys are doing it. It's all the trainees that put all the effort because it's been hard work, and it's much appreciated. So thank you all very much. And thank you. Thank you. That's brilliant. Um, so