ETHER: a proposal for a European peri-operative data sharing and registry network.

Peri-operative medicine is a critical component of contemporary healthcare delivery. Despite significant advancements, peri-operative complications remain a relevant concern. Obtaining reliable risk estimates, identifying potential causes, and studying new interventions, revised policies or implementation of best practices to prevent complications, requires data from a large number of participants. Electronic Patient Record systems offer the opportunity to unlock these data, but the limited standardisation of databases and sharing frameworks available across Europe limit the effective use of the available data. We propose creating a European peri-operative shared data registry with continuous data collection, integrating clinical, bedside monitoring and outcome data in a collaborative network. Such network would facilitate outcomes research, could serve as a platform to optimise clinical practices by fostering quality improvement through benchmarking of care delivered by departments or individual physicians, and could be used to evaluate policy changes. This ESAIC initiative aligns well with the development of the European Health Data Space. This article provides examples of contemporary clinical research and practice evaluation questions to illustrate the need for a European collaborative data-sharing network, highlights inspiring examples of existing data-sharing initiatives and describes a road map to establish such network.