Are we throwing the baby out with the bath water?

We applaud the Journal of Shoulder and Elbow Surgery's endorsement of the RECORD (REporting of studies Conducted using Observational Routinely-collected health Data) standards in the November 2016 editorial by John E. Kuhn and William J. Mallon. There is significant variation in the quality of observational studies using a variety of different data sources. Similar to randomized controlled trials (RCTs), observational studies need to be evaluated on the basis of their merits according to internationally accepted standards. The editorial focuses on large administrative databases and their limitations, which is helpful to the Journal's readers. However, the omission of clinical registries in the editorial may lead readers to believe that registries have the same limitations as these large administrative databases. Therefore, it is critical to highlight differences in administrative databases vs. clinical registries, which have a long history of improving clinical care based on prospective collection of clinically relevant data...