Morales David L S, McClellan Andrew J, Jacobs Jeffrey P
Division of Congenital Heart Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
Cardiol Young. 2008 Dec;18 Suppl 2:188-95. doi: 10.1017/S1047951108002916.
The interest of professional medical societies in research about outcomes, mixed with the recent accessibility to management of data on the internet, has moved many societies to create national databases or registries for their specialty. In societies with procedure-based specialties such as surgery, these databases will help with the care of patients by predicting prognosis, defining risk-factors, and aiding with the selection of patients who are the best candidates for these procedures. These databases eventually will also help to establish standards of care. The latter is rapidly growing in importance as governments attempt to create "pay-for-performance" programs in many of the surgical specialties. It is essential to create a database from which a specialty can provide accurate data and standards to its members, its patients, and third parties, such as regulatory bodies and agencies of re-numeration. Unfortunately, surgeons often only care for their patients in the short-term peri-operative period, typically lasting weeks to months; and therefore, the ability of surgeons to create databases with long-term follow-up has been limited. The introduction of "personal health information" into a surgical database, with the intention of linking with other societies or national databases that have long-term follow-up, can remedy this weakness. This article describes the investigation by one surgical society into the available national registries of death and examines their accuracy, accessibility, cost, and their suitability in respect to the goals of that society. The information gathered, the comparisons outlined, and the processes used to determine the best combination of indices of death for this society should be translatable and hopefully useful for other societies and registries who wish to empower their databases with long-term national data about mortality.
专业医学协会对结果研究的兴趣，再加上近期互联网上数据管理的便利性，促使许多协会为其专业领域创建国家数据库或登记处。在外科等基于手术的专业协会中，这些数据库将通过预测预后、确定风险因素以及辅助选择最适合这些手术的患者，来帮助患者护理。这些数据库最终还将有助于确立护理标准。随着政府试图在许多外科专业领域创建“按绩效付费”项目，护理标准的重要性正在迅速提升。创建一个能为其成员、患者以及第三方（如监管机构和薪酬机构）提供准确数据和标准的数据库至关重要。不幸的是，外科医生通常只在短期围手术期（通常持续数周或数月）护理患者；因此，外科医生创建具有长期随访功能数据库的能力有限。将“个人健康信息”引入外科数据库，旨在与其他具有长期随访功能的协会或国家数据库建立链接，可弥补这一不足。本文描述了一个外科协会对现有国家死亡登记处的调查，并考察了它们的准确性、可及性、成本以及与该协会目标的契合度。所收集的信息、所概述的比较以及用于确定该协会最佳死亡指数组合的过程应具有可转移性，有望对其他希望利用长期国家死亡率数据增强其数据库功能的协会和登记处有所帮助。
