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Ann Thorac Surg 2004;77:1137-1139
© 2004 The Society of Thoracic Surgeons
a Division of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
b Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
c Outcome Research and Assessment Group, Duke Clinical Research Institute, Durham, North Carolina, USA
d Iowa Foundation for Medical Care, West Des Moines, Iowa, USA
* Address reprint requests to Dr Welke, Division of Cardiothoracic Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Dr, Iowa City, IA 52242, USA.
e-mail: karl-welke@uiowa.edu
Abbreviations: CABG Coronary artery bypass grafting IASTS Iowa Society of Thoracic Surgeons IFMC Iowa Foundation for Medical Care MEDPAR Medicare Provider and Analysis Review NCD National Adult Cardiac Surgery Database STS The Society of Thoracic Surgeons
| The first 300 words of the full text of this article appear below. |
In 1989, The Society of Thoracic Surgeons (STS) created a national voluntary cardiac surgery database as a means of supporting national quality improvement efforts [1]. The database has grown to become the largest clinical database of its kind, and includes 638 hospitals and clinical information from 2,164,079 surgical procedures. This provider-supported database allows participants to benchmark their risk-adjusted results against regional and national standards. In addition, it provides data for research projects that can improve the process of patient care and outcomes. It has also been used to support quality improvement efforts. Each of these uses, however, is dependent on an accurate and complete clinical database. The purpose of this article is to provide the STS membership with a description of the ongoing efforts to assure validity of the National Adult Cardiac Surgery Database (NCD). In particular, we will highlight examples of data quality assurance mechanisms occurring at three levels: internally, regionally, and nationally.
Internal data quality improvement efforts
The site data managers play a crucial role in ensuring the quality of the data being submitted to the NCD. To support these key individuals, the STS has initiated annual site data manager meetings. These well-attended meetings generate in-depth discussions and suggestions about how to best collect the data, the application of clinical data definitions, and other topics related to the overall quality of the database.
In addition, several steps have been added to the data collection process of the NCD with the intent of improving data quality. First, the STS has worked extensively with database vendors to develop point of entry data quality controls. For instance, if a patient is identified as having died during the original hospitalization and the field "date of death" is left blank, the software requires that the expected date of death be entered. These checks assure internal data consistencies
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