{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T22:19:20Z","timestamp":1783203560997,"version":"3.54.6"},"reference-count":19,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T00:00:00Z","timestamp":1777075200000},"content-version":"vor","delay-in-days":114,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite widespread clinical use, the long-term performance of breast implants remains debated. Current evidence is limited by small sample sizes and inconsistent methodologies. National breast device registries provide valuable real-world data, yet their impact is constrained by heterogeneity in variable definitions, data structures, and analytical approaches. The International Collaboration of Breast Registry Activities (ICOBRA) initiative established a harmonized dataset utilized by several countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Evaluate the implementation of the dataset of the ICOBRA across national registries, identify inconsistencies in data definitions and structures, and develop an updated international dataset supporting standardized, federated analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Datasets from 5 national breast implant registries utilizing the harmonized dataset were systematically reviewed. Variations in data points and definitions were identified and discussed through a series of in-person and online consensus meetings. Structured voting was used to finalize revisions and establish the updated international core dataset.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Key discrepancies were identified in the classification of surgical indications, inclusion of implant types, and variable definitions across registries. As a result, more than half of the original core variables required revision, reclassification, or removal to enable multinational analyses. A federated analysis model was proposed to accommodate privacy regulations and registry diversity while supporting standardized, risk-adjusted analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The updated international breast implant registry dataset represents a crucial step toward integrated global surveillance. Together with standardized statistical methods within a federated data model, it enables robust pooled analyses without requiring uniform registry structures. Countries are encouraged to adopt the revised dataset and contribute to a collaborative framework that enhances patient safety through structured, large-scale data collection and analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 5 (Therapeutic)<\/jats:title>\n                    <jats:p>For image description, please refer to the figure legend and surrounding text.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/asjof\/ojag070","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T11:29:49Z","timestamp":1776770989000},"source":"Crossref","is-referenced-by-count":1,"title":["Toward Successful International Pooling of Breast Implant Registry Data: The Role of Dataset Uniformity"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3415-3051","authenticated-orcid":false,"given":"Uwe","family":"Von 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