Interdisciplinary Interdisciplinary databases in databases in

cardiac surgerycardiac surgery

Örjan Friberg MD, Associate professor

Örebro University Hospital

InterdisciplinaryInterdisciplinary databasesdatabases

• Swedeheart

• CARATH

Why databases in cardiac surgeryWhy databases in cardiac surgery

• Standardized

• Large volumes

• Centralized

• ”Technical”• ”Technical”

– Lots of things to register

• Perfusion/ECC ”ideal” for database use

– Automated recordings of well defined, oftennumeric data

Cardiology

Cardiac surgery

ÖFr 061020

Cardiac surgery

Radiology

CardiacCardiac surgerysurgery::

Preop dataPreop data

ICUICU

Postop Postop

complicationscomplications

SurgerySurgery

PerfusionPerfusion

AnestesiaAnestesia

ICUICU

SWEDEHEART SWEDEHEART –– sincesince 20102010

BoardBoard

RIKSHIARIKSHIA SEPHIASEPHIASCAARSCAARPercutaneousPercutaneousValveValve RegistryRegistry

Swedish Swedish HeartHeartSurgerySurgeryRegistryRegistry

PCISecondaryprevention after AMI

AMITAVI

&Mitraclip

MultidisciplinaryMultidisciplinary cooperationcooperationAimsAims and and AdvantagesAdvantages

In

Preopdata

SurgeryFollow up

•• CollectCollect data from data from

multiplemultiple sourcessources

•• over over timetime

•• acrossacross professionsprofessions

RegistryRegistry

Anestesiaand

perfusion

ICU

Postopcare

•• acrossacross professionsprofessions

•• PossibilityPossibility toto

correlatecorrelate data data acrossacross

medicalmedical disciplinesdisciplines

Clinical Clinical implicationsimplicationsSwedeheartSwedeheart annualannual reportreport 2011 2011

Clinical Clinical implicationsimplicationsM Vidlund, dissertation 2011M Vidlund, dissertation 2011

Before Before buildingbuilding a a databasedatabase

• What data to collect?

What will we need? How to define? Valid data?

• What is the aim of the registry?

• How to design, and who will design the database?

BuildingBuilding a a databasedatabase

database?

• Who will run the registry? Steering committe?

MultidisciplinaryMultidisciplinary databasesdatabases

• Who decides, and designs the database?

• Relations, definitions, • Relations, definitions, time sequencies etc must be crystal clear

• DO NOT UNDERESTIMATE the complexity of medicalprocesses

Design?Design?

Surgeon

Common database

PerfusionistAnestesiologist

Design?Design?

Link or key(Unique ID#, serial# etc)

Surgicaldatabase

Perfusion database

• Too high ambition!

• Data

– Too many variables

– Poorly defined variables

PitfallsPitfalls

– Poorly defined variables

– Poor discipline regarding data entry

=> lost of missing/unvalid data

• Complex design/architecture of the database

SuccessSuccess factorsfactors

• Enthusiastic (but realistic) medical specialists with computer competence

• Strong support from chiefs

• Small scale start, often local database• Small scale start, often local database

AdviceAdvice

• Think before! Preparation takes time!

• Make it simple! If it gets complicated - Kill yourdarlings!!

• Start small, advance one step at a time• Start small, advance one step at a time

• Define who is in charge of the design of the database

• Monitor data quality, feedback to users

• Get support by chiefs

Thank youThank you