Special report
The Society of Thoracic Surgeons and The European Society of Thoracic Surgeons General Thoracic Surgery Databases: Joint Standardization of Variable Definitions and Terminology

https://doi.org/10.1016/j.athoracsur.2014.05.104Get rights and content

The European Society of Thoracic Surgery (ESTS) and the Society of Thoracic Surgeons (STS) general thoracic surgery databases collect thoracic surgical data from Europe and North America, respectively. Their objectives are similar: to measure processes and outcomes so as to improve the quality of thoracic surgical care. Future collaboration between the two databases and their integration could generate significant new knowledge. However, important discrepancies exist in terminology and definitions between the two databases. The objective of this collaboration between the ESTS and STS is to identify important differences between databases and harmonize terminology and definitions to facilitate future endeavors.

Section snippets

Material and Methods

A working group was created including members from the two database committees. The group met for the first time in Fort Lauderdale in 2012 during the STS annual meeting to discuss and collaborate on this subject. The panel identified a set of common variables between the two databases. Many of these variables had common definitions already, but others showed discrepancies (Table 1). This set of variables was circulated among all members of the ESTS and STS database committees to propose

ESTS

The ESTS database was created in 2001 as a joint activity with the sister society, the European Association for Cardio-thoracic Surgery (EACTS). In this first version, data were collected through a computer application (Filemaker Pro). This was password protected, and data were exported from within each unit’s database using encryption, automatically attached to an email, and sent to the central repository. Approximately 3400 cases of lung resection were collected from 2001 to 2003 from 27

ESTS

The principle aim of the ESTS database is data collection for monitoring quality of care in Europe. The wide diversity of educational background and clinical practice across Europe demanded an instrument to closely monitor the performance of GTS units with the ultimate objective of standardizing and improving the outcome. To this purpose, a Composite Performance Score (CPS) was developed, including both risk-adjusted outcomes and processes of care indicators to evaluate in a comprehensive and

ESTS

Participation to the database project is totally free (for members and invited contributors) and voluntary but strongly recommended. It is possible to access the database from the ESTS website homepage or by using the following address: https://ests.dendrite.it/csp/ests/intellect/login.csp. To join the database a personal login account is needed. It can be requested by downloading and completing an application form from the ESTS homepage (http://www.ests.org).

STS

Participation in the GTSD is

ESTS

Data are anonymously reported, independently accessed, and encrypted. The data of a given unit can be downloaded at the local level and used for internal quality analyses or institutional research purposes. In other words, end users have the possibility to export their data (Microsoft Excel format) in their computers for their own purposes. It runs currently on a Dendrite platform, which ensures appropriate level of software, hardware, extensive data security, and frequent backups. The

ESTS

The ESTS database is a specialty-specific, procedure-specific, prospectively maintained, periodically audited, and web-based electronic database designed for quality control and performance monitoring. It includes many risk factors, processes of care, and outcomes, which are specially designed for quality control and performance audit. The ESTS database is managed by a database committee, which is responsible for its periodical revisions and updates. An annual report (the Silver Book), is

ESTS

A first analysis from the ESTS was published in 2005, based on approximately 3,500 patients undergoing pulmonary resection [19]. The objective was to develop and validate a risk-adjusted in-hospital mortality model for risk stratification and quality of care investigations. The analysis yielded a parsimonious model composed of two variables: age and predicted postoperative forced expiratory volume in 1 second (ppoFEV1), named the European Society Objective Score (ESOS). This score was

How and Why the Two Databases Differ in Data Fields and Approaches

The GTSD and the ESTS-database have a large amount of common and consistent data. Most differences that can be identified are related to the peculiarity of the healthcare systems from which the databases are derived. However, the two registries are very similar in terms of data collection regarding the patients’ baseline characteristics and the preoperative comorbidities. In fact, for these sections, it is possible to isolate more than 20 common variables between the two databases.

Regarding the

ESTS

The ESTS Database Committee is devoted to promoting a high-quality culture in the European thoracic community by continuously upgrading the database structure and providing educational opportunities. The ESTS database will continue to provide evidence that measurement of outcomes with benchmark tools is effective in improving surgical safety and patient care. Therefore, a major goal will be to achieve a progressive evolution from morbidity and mortality to total quality management. In other

References (23)

Cited by (0)

View full text