In this issue of JAMA Surgery, Rios-Diaz et al1 present a large retrospective population database study highlighting the importance and power of statewide databases. Perhaps one of the most important aspects of this work is the approach used to integrate data on trauma patients, including the nearly impossible task of obtaining long-term follow-up in this challenging population. These methods hopefully will be replicated in future trials to facilitate greater understanding of the long-term consequences created by our operative decisions.