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Summary Introduction Gomco clamp and Plastibell ring are common methods of office circumcision. While they possess similar features, the Plastibell is retained after the procedure which could impact perceived and true outcomes of the procedure. Objective This study evaluated differences in complications, interventions, and healthcare utilization between Gomco and Plastibell office circumcision techniques. Study design We retrospectively reviewed urology office performed circumcisions (January 2015–August 2018), limiting analysis to patients with follow-up. Patient demographics and circumcision technique were recorded. Complications, interventions, phone calls, emergency department (ED)/urgent care (UC) visits, and unplanned office visits directly related to the circumcision were recorded. Descriptive statistics for the number of patients experiencing an event and the number of days to event were summarized. Survival analysis with inverse probability of treatment weights was used to estimate hazard and incidence rate ratios (HR and IRR, respectively). Results 746 patients were included for analysis. Median time of follow-up was 2.7 weeks (interquartile range 2–5). 257 (34%) patients underwent Gomco circumcision; 489 (66%) underwent Plastibell circumcision. The techniques did not significantly differ for complications (HR = 0.9, p = 0.497), interventions (HR = 0.89, p = 0.498), and hospital visits (HR = 1.0, p = 0.985) (Table), although Plastibell patients presented to the ED/UC more (odds ratio = 1.6, p = 0.02). Plastibell patients generated proportionally more post-procedural phone calls (63 vs. 52%), though not significantly (IRR = 1.11; p = 0.426). Discussion Overall, the type of device used for office circumcision, between Gomco clamp and Plastibell ring, does not appear to impact the outcome of circumcision. Providers should perform the method of office circumcision with which they are familiar and comfortable. There is an overall reliance on healthcare resources suggesting poor family preparation of the post-procedural course regardless of the technique, necessitating better patient education. Limitations of this study include its retrospective nature, variability in follow-up between techniques, and variety of providers, limited to pediatric urologists, performing circumcision. Conclusions Gomco and Plastibell office circumcision techniques do not significantly differ in post-procedural complications, interventions, unplanned hospital visits, and office phone calls. Plastibell patients do present more often to the ED/UC perhaps as a result of increased anxiety and perceived immediacy of concerns with the device. Table . Recurrent event Cox proportional hazard survival model results for complications, interventions, and unplanned hospital visits Event Predictor Level Hazard Ratio Lower CI Upper CI p-value Complication Technique Gomco Reference Plastibell 0.9 0.67 1.21 0.497 Intervention Technique Gomco Reference Plastibell 0.89 0.64 1.24 0.498 Unplanned hospital visit Technique Gomco Reference Plastibell 1.0 0.66 1.53 0.985

Informatics researchers often need to combine data from many different sources to increase statistical power and study subtle or complicated effects. Perfect overlap of measurements across academic studies is rare since virtually every dataset is collected for a unique purpose and without coordination across parties not-at-hand (i.e., informatics researchers in the future). Thus, incomplete concordance of measurements across datasets poses a major challenge for researchers seeking to combine public databases. In any given field, some measurements are fairly standard, but every organization collecting data makes unique decisions on instruments, protocols, and methods of processing the data. This typically denies literal concatenation of the raw data since constituent cohorts do not have the same measurements (i.e., columns of data). When measurements across datasets are similar prima facie, there is a desire to combine the data to increase power, but mixing non-identical measurements could greatly reduce the sensitivity of the downstream analysis. Here, we discuss a statistical method that is applicable when certain patterns of missing data are found, namely, it is possible to combine datasets that measure the same underlying constructs (or latent traits) when there is only partial overlap of measurements across the constituent datasets. Our method, ROSETTA empirically derives a set of common latent trait metrics for each related measurement domain using a novel variation of factor analysis to ensure equivalence across the constituent datasets. The advantage of combining datasets this way is the simplicity, statistical power, and modeling flexibility of a single joint analysis of all the data. Three simulation studies show the performance of ROSETTA on datasets with only partially overlapping measurements (i.e., systematically missing information), benchmarked to a condition of perfectly overlapped data (i.e., full information). The first study examined a range of correlations, while the second study was modeled after the observed correlations in a well-characterized clinical, behavioral cohort. Both studies consistently show significant correlations &gt, 0.94, often &gt, 0.96, indicating the robustness of the method and validating the general approach. The third study varied within and between domain correlations and compared ROSETTA to multiple imputation and meta-analysis as two commonly used methods that ostensibly solve the same data integration problem. We provide one alternative to meta-analysis and multiple imputation by developing a method that statistically equates similar but distinct manifest metrics into a set of empirically derived metrics that can be used for analysis across all datasets.