Boult Margaret, Cuncins-Hearn Astrid, Tyson Sarah, Kollias Jim, Babidge Wendy, Maddern Guy
Australian Safety and Efficacy Register of New Interventional Procedures - Surgical, Royal Australasian College of Surgeons, Stepney and Department of Surgery, University of Adelaide, Adelaide, South Australia, Australia.
ANZ J Surg. 2005 Oct;75(10):844-7. doi: 10.1111/j.1445-2197.2005.03547.x.
An audit of surgical treatment of early breast cancer was introduced nationally in 1999. In August 2002, the Australian Safety and Efficacy Register of New Interventional Procedures - Surgical, under the auspices of the Royal Australasian College of Surgeons, assumed responsibility for managing this audit. This article provides an update of audit activities, now known formally as the National Breast Cancer Audit (NBCA), including a description of the new governance structure and the development of a secure online surgical audit system.
Major changes have taken place in the design and governance of the NBCA during the last two years. Two committees have been established to oversee the audit. A clinical advisory committee comprises experts from a number of fields including breast surgery, oncology, government, and from peak breast cancer and consumer bodies. A technical advisory committee oversees many of the technical issues that have arisen with the development of an online data entry system. The online system of data entry was developed and launched to surgeons in May 2004.
There are now 28,000 cases of primary breast surgery in the audit. Around 250 surgeons are currently participating, an increase of over 50 surgeons since May 2004. Surgeons can review their data using the online system and compare their own results by generating reports which graph their own results against national aggregate data.
There has been a significant increase in the volume of data received since the launch of the secure online system. The governing committees are working towards creating a clinical audit which will provide an improved data entry system and better reporting for all participating surgeons. The NBCA can also serve as a template on which to base other surgical audits.
1999年在全国范围内开展了早期乳腺癌外科治疗的审计工作。2002年8月，在澳大利亚皇家外科学院的主持下，澳大利亚新介入手术程序安全与有效性登记处——外科，承担了管理该审计工作的职责。本文提供了审计活动的最新情况，该审计活动现正式称为国家乳腺癌审计（NBCA），包括新管理结构的描述以及安全在线外科审计系统的开发情况。
在过去两年中，NBCA的设计和管理发生了重大变化。已设立两个委员会来监督审计工作。临床咨询委员会由来自多个领域的专家组成，包括乳腺外科、肿瘤学、政府以及乳腺癌领域的顶尖机构和消费者团体。技术咨询委员会负责监督在线数据录入系统开发过程中出现的许多技术问题。在线数据录入系统于2004年5月开发完成并向外科医生推出。
目前审计中有28000例原发性乳腺手术病例。目前约有250名外科医生参与其中，自2004年5月以来增加了50多名外科医生。外科医生可以使用在线系统查看自己的数据，并通过生成将自己的结果与全国汇总数据进行对比的报告来比较自己的结果。
自安全在线系统推出以来，收到的数据量显著增加。管理委员会正在努力创建一项临床审计，该审计将提供一个改进的数据录入系统，并为所有参与的外科医生提供更好的报告。NBCA还可以作为其他外科审计的模板。
