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Original Articles: Adult Cardiac

Invited Commentary

Division of Cardiothoracic Surgery, University of Florida Health Science Center, 653-2 W 8th St, Jacksonville, FL 32209

(Email: fhe{at}comcast.net).

The authors are to be commended for undertaking the development of a national database in cardiac surgery [1]. This is clearly a challenging task, but as pointed out by the authors, it is essential for improving the quality of care.

The purpose of a clinical database is to improve quality. It is surprising that there is little mention of demonstrated quality improvement in the JACVSD registry. Presumably there is a feedback mechanism in place to allow users to gauge their performance against national benchmarks. The feedback mechanism to database participants will likely be the major contributor to quality improvement, and therefore it should be presented both carefully and aggressively.

The authors have developed a cardiac surgery database that may serve as a prototype for contemporary clinical registries. It is particularly important that they have recognized the need for interoperability and interconnectivity, concepts that today are considered essential in the development of modern databases. Their decision to use a web-based system will exploit current technology to achieve maximum flexibility and nimbleness.

They also have chosen to use The Society of Thoracic Surgeons' data definitions, which avoids having to reinvent the wheel and allows direct comparisons between databases.

As more countries recognize the need for data collection and benchmarking, we can anticipate a proliferation of registries in the next few years. The Japanese group has done a lot that is right, and their model may serve as a guide for other countries choosing to develop clinical data registries.

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1. Motomura N, Miyata H, Tsukihara H, Okada M, Takamoto S, the Japan Cardiovascular Surgery Database Organization First report on 30-day and operative mortality in risk model of isolated coronary artery bypass grafting in Japan Ann Thorac Surg 2008;86:1866-1872.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Fred H. Edwards Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Edwards, F. H. Search for Related Content PubMed PubMed Citation Articles by Edwards, F. H. Related Collections Coronary disease Professional affairs Related Article