Development of an annually updated Japanese national clinical database for chest surgery in 2014

Shunsuke Endo,Koichi Yoshida,Yukio Sato,Masayuki Chida,Munetaka Masuda,Kohei Yokoi,Jun Nakajima,Shinichi Toyooka,Norihiko Ikeda,Takashi Kondo,Hiroaki Miyata,Masami Sato,Yoshinori Okada,Haruhiko Kondo,Koji Chihara,Meinoshin Okumura

doi:10.1007/s11748-016-0697-1

Abstract

ObjectivesA national clinical database (NCD) adopted an “Internet-based collection” in 2011. An NCD specializing in chest surgery was launched based on the NCD system in 2014. The system was linked to the board certification as the second level in the hierarchy of the specialty of chest surgery and accreditation of educational institutions for chest surgery. Here, we report the status of the NCD for chest surgery in 2014 and clarified its registration rate and its accuracy.MethodsChest surgeries undertaken in Japan since January 1st, 2014 until the end of the same year were registered through an Internet-based system until April 8th, 2015. The registration rate was compared with the annual survey conducted by the Japanese Association for Thoracic Surgery (JATS) from 2011 to 2014. The rate of accurate inputting was measured by an Internet-based audit in reference to 563 anonymous operative notes of patients presented by 106 chest surgeons at the time of renewal for board certification for chest surgery.ResultsA total of 88,112 chest-surgical procedures were registered from 1000 chest surgery units (CSUs). Distribution of procedures by thoracic disease was almost identical to that of the annual survey conducted by JATS. However, the NCD had 4260 more registered procedures compared with the annual survey. The Internet-based audit showed that inter-rater agreement between Internet-based data and operative notes in any item was >94 %.ConclusionsThe NCD system can sustainably provide important and up-to-date information relating to preoperative status, oncology, and best practice for chest surgery in Japan.

Highlights

Inclusion and exclusion criteriaClinical databases can be evaluated according to the quantity/quality of data, ‘‘updatability’’ and database size
Distribution of patient numbers according to each thoracic disease in the national clinical database (NCD) for chest surgery was almost identical to the annual survey by Japanese Association for Thoracic Surgery (JATS) for the number of procedures categorized by thoracic disease (Fig. 5)
From June onwards, data identified by the license number of the surgeon registered by the JSS could reflect the surgeon’s performance for board certification at the second level of surgery for chest surgery by the Japanese Board of General Thoracic Surgery

Summary

Introduction

Inclusion and exclusion criteriaClinical databases can be evaluated according to the quantity/quality of data, ‘‘updatability’’ and database size. Two surveys for chest surgery in Japan have been conducted: an annual survey by the Japanese Association for Thoracic Surgery (JATS) [1] and one by the Japanese Joint Committee of Lung-Cancer Registry [2] Both were performed by mail from the flagship CSUs. Both were performed by mail from the flagship CSUs The former is a conventional annual survey collected by JATS since 1986 and linked to the accreditation of educational institutions for chest surgery, and the survey has a highregistration rate. It focused only on the number of surgical procedures and their 30-day mortality and hospital mortality; few data on patient characteristics and perioperative evaluations are available.

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Conclusion