Junger A, Veit C, Klöss T
Abteilung für Anästhesiologie und Operative Intensivmedizin, Justus-Liebig-Universität Giessen.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1998 Jul;33(7):417-24. doi: 10.1055/s-2007-994278.
Since 1992 421,851 anaesthesias were documented by 39 institutes with a standard dataset issued by the German Society of Anaesthesiology and Intensive Care (DGAI). The project was run by the Association for Quality Assurance (EQS) in Hamburg. Some results of the evaluation of this datapool are presented questioning the feasibility of the project to support improvement processes within the participating institutions and which adjustments should be done considering these experiences.
Data from machine-readable protocols and documentation software representing all anaesthesia cases were recorded since 1992 in a pilot project and since 1994 compulsory with a standard dataset issued by the DGAI. Comparing statistics of these data was produced at the EQS project office. In the steering committee and in meetings of the project participants the contents, policy and results of the project office. In the steering committee and in meetings of the project were critically analysed and adjustments initiated whenever necessary. Validity of data and feasibility of the method used was also questioned on the background of comparable studies.
With an incidence of 14.1% of all anaesthesias with special occurrences (AVB) the results are in the same range if compared with most other studies. However, documentation of data is not complete. This is assumed to be due to the large size of the dataset with 112 items and the additional workload associated with it. Nevertheless the participants mostly consider the project to be a very useful support for internal improvement projects.
The project method used so far is not mature yet. The data set must be streamlined and rendered more concise, quality indicators should be defined and tested, and the availability of statistically proven limits of tolerance should be the immediate aims in the further development of the project.
自1992年以来，39家机构使用德国麻醉与重症监护学会（DGAI）发布的标准数据集记录了421,851例麻醉情况。该项目由汉堡的质量保证协会（EQS）负责实施。本文展示了对该数据库评估的一些结果，对该项目支持参与机构内部改进流程的可行性提出了质疑，并根据这些经验探讨了应进行哪些调整。
自1992年起，在一个试点项目中记录了来自代表所有麻醉病例的机器可读协议和文档软件的数据，自1994年起强制使用DGAI发布的标准数据集进行记录。EQS项目办公室对这些数据进行了统计比较。在指导委员会和项目参与者会议上，对项目办公室的内容、政策和结果进行了批判性分析，并在必要时启动了调整。在可比研究的背景下，还对数据的有效性和所使用方法的可行性提出了质疑。
所有麻醉中特殊情况（房室传导阻滞，AVB）的发生率为14.1%，与大多数其他研究相比，结果处于同一范围。然而，数据记录并不完整。这被认为是由于数据集包含112项内容且与之相关的额外工作量所致。尽管如此，参与者大多认为该项目对内部改进项目非常有帮助。
到目前为止所使用的项目方法尚不成熟。必须精简数据集并使其更简洁，应定义并测试质量指标，在项目的进一步发展中，直接目标应是提供经统计验证的公差极限。
