How can I find out if my research question is already being investigated by another MPOG team, and what options do I have if that is the case?
You can check the Current Projects page on the MPOG website to see if your research question is already being investigated by another MPOG team. If your question is already under investigation, you may consider collaborating with the existing team or modifying your research question to explore a different aspect of the topic with the intent of developing a separate journal manuscript submission. For further guidance, we recommend scheduling a research consult via this Form. The MPOG research directors can help navigate overlap and are usually able to find a win-win solution, with teams either collaborating on a single project or developing two distinct original research projects that each team may still choose to collaborate with one another on. You can also reach out to the MPOG team at mpog-research@med.umich.edu at any time.
Who can submit a research consultation request?
Only colleagues with full appointments from active MPOG sites can submit a research consultation request. Only people with full appointments from active MPOG sites can submit a research consultation request. Please note that each MPOG site has a Site Principal Investigation (PI), who should be made aware that you are submitting a consultation request and given the opportunity to discuss details with you. The MPOG site’s Principal Investigator (PI) is responsible for reviewing all consultation requests before submission.
What happens to my project, if I switch institutions after my PCRC proposal is approved but before analyses are complete?
The MPOG team must be informed about any changes in your institutional affiliation to ensure a smooth transition. If you switch institutions after your PCRC proposal is approved but before analyses are complete, the project can continue. However, you would need to ensure that your new institution is an active MPOG site and that you have the necessary IRB approvals in place at your new institution. You will need to have signed approval from authorized signing officials at both the previous and new institutions (e.g. department chair, research director, etc.) who take responsibility/liability for the researcher handling the case-level data with PHI. You would also need to coordinate with the MPOG team to ensure that your access to the MPOG stats server is transferred at your new institution.
If going to an institution which is not an active MPOG site, you need to have a plan for who at your previous MPOG site will be accessing the case-level data/running additional analyses, and hand over responsibility to them.
Following completion of the analyses I detailed in my PCRC proposal, I’ve realized that splitting the work across two (or several) manuscripts might be the best approach. Is this acceptable?
We recognize that occasionally the scope of a project might expand based on the results of analyses obtained. We recommend communicating with the MPOG central research team about how to best proceed. In some cases, it is acceptable to split the work across multiple manuscripts, and in such cases, an informational update to the PCRC community during a future PCRC meeting can be provided by the research team. In other cases, in which the additional manuscripts do not reflect the original intent of the PCRC proposal, separate additional PCRC proposals must be created, presented, and approved for additional intended manuscripts. This approach provides clarity on what is being voted on, allows for more focused feedback, and aligns better with the preferred one-to-one relationship between proposal and manuscript.
I am a member of an active MPOG institution, and I have colleagues at a non-MPOG institution who I’d like to collaborate with on this project. What would they be permitted to do?
Your colleagues at a non-MPOG institution can participate in study design, interpretation of the results, and manuscript writing. However, they will not have direct access to case-level data; rather, all data analyses must be conducted by a team member at an active MPOG institution. This is to ensure data security and compliance with MPOG regulations. Also, the first author or senior author of the manuscript must be at an active MPOG institution and project-specific IRB approval must be in place at each site.
Who qualifies as a co-author of my project?
To qualify as a co-author on your MPOG-related project, individuals must meet all four of the International Committee of Medical Journal Editors (ICMJE) criteria for authorship:
- Substantial contributions to the conception or design of the work, or the acquisition, analysis, or interpretation of data for the work
- Drafting the work or revising it critically for important intellectual content
- Final approval of the version to be published
- Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved
If someone does not meet all four criteria but has significantly contributed to the work, they may be listed as a collaborator. Collaborators could include individuals who provided meaningful feedback during the PCRC process, such as through comments on a proposal or during meetings, or those who made substantial contributions to data validation, IT support, or the writing process.
For more detailed guidance on authorship and collaboratorship in relation to your MPOG project, please visit the “Authorship and Contributorship” section of the ICMJE website or consult the specific journal to which you are submitting for their policies on authorship and collaborators.
If you need further assistance regarding authorship criteria for MPOG projects or have more questions, feel free to reach out to the MPOG staff at mpog-research@med.umich.edu.
How long does it take to get data?
After a proposal is approved at the PCRC meeting or after moderator adjudication, it takes about 2-3 months to get your data from MPOG, varying based upon the complexity of the data query and the number of previous data queries in the MPOG central programmer work queue.
I work with a data analyst and statistician at a non-MPOG site. Would they be able to perform my analyses?
The first author and the person(s) with IRB approval to access the data, which typically includes the statistician, must be from an active MPOG institution. If your statistician is not from an active MPOG site, they could still provide consultation on statistical analysis design, help share code, etc. but they would not be able to access case-level data.
What type of data can be found in the MPOG database?
Details regarding MPOG data types, including their completeness and accuracy, can be found on the MPOG Tips & Tricks Module, “Developing a Research Question Answerable with MPOG Data”. The following data table gives a snapshot of the higher and lower quality categories of data available in MPOG, as well as data that is not available: 
What types of research questions are ideal for an investigative team new to using MPOG data?
For an investigative team new to using MPOG data, there are several types of research questions that are particularly well-suited. The following are examples of research questions that are less complex, and may have a higher chance of successful execution:
- Descriptive Studies – These studies aim to describe variation in anesthesia practice patterns or trends over time, which can be substantially less confounded than studies examining associations of practice patterns with outcomes and are therefore relatively simpler to analyze and interpret.
- Study based on data solely in the Standardized Data File (SDF)- The SDF is designed to streamline the research process, by providing an already-curated, high-quality perioperative dataset available for research purposes once a proposal has been approved.
Additional tips:
- Start Small: Begin with a manageable project scope to become familiar with the MPOG data structure and analysis tools.
- Leverage Available Resources: Utilize MPOG’s Tips and Tricks videos and seek guidance from the Coordinating Center research team.
- Focus on High-Quality Data: Choose data elements known to have high reliability and completeness within the MPOG dataset.
- Collaborate with Experienced Researchers: Engage with colleagues who have prior experience with MPOG data to gain insights and avoid common pitfalls.
How often is physiologic data recorded in MPOG?
Intraoperative physiological data in MPOG is typically recorded every minute, providing a highly granular view of patient status during surgery. However, the frequency and quality of this data may vary between institutions and based on the specific physiologic monitoring source used. Algorithms addressing physiologic monitoring artifact, missing data, and conflicting data (e.g. multiple blood pressure sources during the same minute) have been developed and are available on the MPOG phenotype browser (example: Blood Pressure Observations).
What is the Standardized Data File?
The Standardized Data File (SDF) is a pre-curated MPOG dataset of cases within a specified time frame that is ready to distribute quickly after an approved PCRC proposal. The data file contains commonly requested, validated case-level phenotypes (i.e. summary variables computed or derived from raw data) for each included case, as well as raw administrative data associated with the patient. A new standardized data file is released annually with additional data from new MPOG centers, more recent cases, and additional validated phenotypes. If you use the SDF, the timeline may be shorter for getting an MPOG research project to publication, given the lesser amount of data curation needed compared to a project querying raw, commonly messy, EHR data.
What is DataDirect and how do I get access to this tool?
DataDirect allows users to create queries using data submitted to MPOG. The tool provides filters for identifying a specific cohort of patients and allows users to download a sample file from your own institution with the appropriate IRB approvals. Researchers can use DataDirect to identify patient, case, and institution counts for the cohort they are interested in studying. To obtain access to DataDirect, complete an MPOG DataDirect Attestation. You will obtain access as long as the following conditions are met:
- You are a faculty or staff with a full appointment at an active MPOG institution; adjunct appointments are not included
- You review/Sign/Submit the affidavit
- Obtain permission and signature to this document of your Authorized Hospital Leader (i.e., Anesthesiology Chair or Director of Clinical Research)
Additional details are outlined in the attestation form and can be found in the DataDirect User Guide.
Can I download multicenter data from DataDirect?
No, you cannot download multicenter data from DataDirect. In addition, while it is possible to obtain multicenter case counts from DataDirect, you cannot use these case counts in a manuscript. All projects using multicenter MPOG data need to go through the formal PCRC process to obtain approval from sites at PCRC meetings. Once the proposal is approved, the study team will get access to the data. However, all data analysis must be performed within a secure enclave on MPOG coordinating center servers, and the data cannot leave the secure MPOG servers.
Can I add or remove data from my project specific folder in the MPOG server?
No, you cannot add or remove data from the MPOG server. All data analysis for MPOG research projects must be conducted on the secure MPOG servers to ensure compliance with data security policies and protect patient confidentiality. The secure computing environments, such as the Secure Enclave Server (SES), are designed to allow for the analysis of data within a controlled and secure infrastructure. Any extraction or modification of the data outside this environment is not permitted. If you require additional data or need to make changes to the dataset for your research, you should discuss this with the MPOG Central team and follow the appropriate procedures for data requests or amendments to your research protocol.
What is the analytic platform that I will be working with once I get my data?
The MPOG coordinating center team facilitates the data extraction process and provides the necessary datasets, while the study team is responsible for the analysis and interpretation of the data. The study team can use statistical software of their choice for data analysis. If the statistical software you desire to work with is not available on our stats server, please reach out to our team at mpog-research@med.umich.edu.
Can I use STS, NSQIP or other surgical registry data?
Yes, you can use the STS-ACSD (Society of Thoracic Surgeons Adult Cardiac Surgical Database), STS-GTSD (Society of Thoracic Surgeons General Thoracic Surgical Database), NSQIP (National Surgical Quality Improvement Program) or other surgical registry data in conjunction with the MPOG anesthesia data as long as your site contributes that type of data. MPOG has a tool that allows sites to merge the surgical data abstracted for STS or NSQIP with the MPOG anesthesia data for comprehensive analysis. The data extracted from STS or NSQIP can be merged locally with your institution’s data and then transmitted to the MPOG central database without patient identifiers. It is important to follow the respective processes and guidelines, including adhering to the Data Use Agreement (DUA). For detailed instructions on how to export STS of NSQIP data or if you require further assistance, you can contact MPOG support at support@mpog.zendesk.com, and for information regarding the DUA process, please contact Tory Lacca at lacca@med.umich.edu.
For the most current updates and procedures, please refer to the MPOG website or reach out via the contact provided.
I have received PCRC approval and now have access to my multicenter dataset. What might be some good initial first steps?
We strongly recommend doing a thorough inspection of your MPOG dataset, which should include running frequencies on each data element and inspecting the data by year and by institution (looking for odd patterns in the data, unusual missingness, and other issues). It is common for study teams to exclude entire institutions, or date ranges for particular institutions, from their final analytic dataset due to data quality or missingness issues related to their specific variables of interest.
Following PCRC approval and access to the multicenter dataset, I’ve realized that there are additional MPOG concepts/phenotypes necessary to adequately perform my analysis. What should I do?
If you realize that additional MPOG concepts/phenotypes are necessary for your analysis after receiving PCRC approval, you should reach out to the MPOG Central team. They can help you identify the additional data elements you need and guide you through revising your research proposal, if needed. It’s important to remember that any substantial changes to your research plan may need to be re-approved by the PCRC. Projects requiring a data query, or expansion of centers included in the initial data query, more than one year after approval require re-review by the PCRC community per the following protocol:
- Between 1-2 years after approval – require verbal communication during a PCRC meeting via a 2-3 minute informational update
- Greater than 2 years after approval – re-presentation at PCRC with a new PCRC community vote
Does the MPOG umbrella IRB cover my project, or do I need a project specific IRB?
You will need a project-specific IRB for each PCRC project in addition to the main MPOG umbrella IRB. The main IRB covers the transmission of your data to the MPOG coordinating center. The project specific IRB is required for data analysis. The IRB should specify and allow for a limited dataset since the dataset is not fully deidentified. The IRB application should be pending or approved by the time you present a proposal at PCRC. Template language for the IRB is available on the Downloads page of the MPOG website.
What are each of the MPOG tools used for?
MPOG has several tools to facilitate research projects:
- MPOG DataDirect: This tool is used to: (1) obtain initial case counts for a proposed multicenter study and begin to evaluate a research question; and (2) obtain single center data (up to 100K cases) for a single center research project or to provide single center data analyses in a multicenter project proposal.
- MPOG Quality Measure: Quality measures are used to disseminate feedback on best practices to anesthesiologists, such as hemoglobin levels prior to transfusion. These measures can be leveraged for research or quality projects.
- Secure Enclave Services (SES): This is a HIPAA compliant, Windows-based computing platform that allows for the secure analysis of data for MPOG research projects. It is pre-loaded with many common statistical and programming language software.
- Concept Browser: A comprehensive, searchable list of MPOG concepts available for institution variable mapping. Active sites can also receive a login that allows them access the counts by institution for each individual concept ID.
- Phenotype Browser: MPOG uses shareable, pre-computed phenotypes to transform messy real-world health data into structured, clinically useful inferences. A comprehensive list and detailed specifications of all phenotypes are available for MPOG research.
- Tips and Tricks Modules: These modules available on the MPOG website guide users on how to utilize research tools and processes to their full potential for high-impact research.
Which MPOG tools require a login?
The MPOG tools that require a login include the Secure Enclave Services (SES) and DataDirect. Both tools are used for secure data access. It’s important to ensure that the person accessing these tools is from an active MPOG institution due to data security and legal agreement requirements. To obtain access to DataDirect, complete an MPOG DataDirect Attestation. You will gain access to the MPOG stats server (SES) once your project is approved at the PCRC meeting or following moderator adjudication.
Additionally, logging into Concept Browser allows you to view other institutions’ use of concepts. Finally, you need to log in to the Current Projects page of the MPOG website to view MPOG research projects that have been presented at PCRC meetings. To obtain access to the Current Projects page and Concept Browser, complete this attestation: MPOG Website login.
What is a realistic timeline for getting a manuscript to publication?
The timeline for getting a manuscript to publication can vary significantly depending on a number of factors, including the complexity of the data query, the time it takes to analyze the data, the writing process, and the peer review process at the journal. Generally, it can take anywhere from several months to over a year from the time the research is completed until the manuscript is published. It is important to note that this timeline can be extended if revisions or additional analyses are required during the peer review process. However, it is always best to plan for a longer timeline to ensure sufficient time for all steps of the process.
Can I write a manuscript with my research team without MPOG being involved?
Any research project that uses multicenter MPOG data must get approval from the PCRC members. The approval process entails presenting a research proposal to the Perioperative Clinical Research Committee (PCRC) meeting, obtaining approval, and adhering to the processes outlined for data analysis, manuscript drafting, and collaboration.
However, if you are only using your own institution’s data for research, you have more flexibility in how you manage and analyze the data. If you are using MPOG data for internal QI projects, you do not need to obtain PCRC or MPOG Central approval. You can access your institution’s data through DataDirect or your local MPOG technical contact.
My manuscript has just been published. Do I need to let MPOG Central know?
Yes, it is important to inform MPOG Central when your manuscript has been published. You should send an email notification to the MPOG Central Research Team at mpog-research@med.umich.edu with the details of the publication. This allows the team to keep track of each proposal’s status that results in a publication. Your publication will be added to the publication page of the website. Sharing your published work with the MPOG community can contribute to the dissemination of knowledge and may inspire further research within the group. Congratulations on your publication!