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Comparison of National Operative Mortality in Gastroenterological Surgery Using Web-based Prospective Data Entry Systems

International collaboration is important in healthcare quality evaluation; however, few international comparisons of general surgery outcomes have been accomplished. Furthermore, predictive model application for risk stratification has not been internationally evaluated. The National Clinical Databa...

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Autores principales: Anazawa, Takayuki, Paruch, Jennifer L., Miyata, Hiroaki, Gotoh, Mitsukazu, Ko, Clifford Y., Cohen, Mark E., Hirahara, Norimichi, Zhou, Lynn, Konno, Hiroyuki, Wakabayashi, Go, Sugihara, Kenichi, Mori, Masaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008495/
https://www.ncbi.nlm.nih.gov/pubmed/26656350
http://dx.doi.org/10.1097/MD.0000000000002194
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author Anazawa, Takayuki
Paruch, Jennifer L.
Miyata, Hiroaki
Gotoh, Mitsukazu
Ko, Clifford Y.
Cohen, Mark E.
Hirahara, Norimichi
Zhou, Lynn
Konno, Hiroyuki
Wakabayashi, Go
Sugihara, Kenichi
Mori, Masaki
author_facet Anazawa, Takayuki
Paruch, Jennifer L.
Miyata, Hiroaki
Gotoh, Mitsukazu
Ko, Clifford Y.
Cohen, Mark E.
Hirahara, Norimichi
Zhou, Lynn
Konno, Hiroyuki
Wakabayashi, Go
Sugihara, Kenichi
Mori, Masaki
author_sort Anazawa, Takayuki
collection PubMed
description International collaboration is important in healthcare quality evaluation; however, few international comparisons of general surgery outcomes have been accomplished. Furthermore, predictive model application for risk stratification has not been internationally evaluated. The National Clinical Database (NCD) in Japan was developed in collaboration with the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), with a goal of creating a standardized surgery database for quality improvement. The study aimed to compare the consistency and impact of risk factors of 3 major gastroenterological surgical procedures in Japan and the United States (US) using web-based prospective data entry systems: right hemicolectomy (RH), low anterior resection (LAR), and pancreaticoduodenectomy (PD). Data from NCD and ACS-NSQIP, collected over 2 years, were examined. Logistic regression models were used for predicting 30-day mortality for both countries. Models were exchanged and evaluated to determine whether the models built for one population were accurate for the other population. We obtained data for 113,980 patients; 50,501 (Japan: 34,638; US: 15,863), 42,770 (Japan: 35,445; US: 7325), and 20,709 (Japan: 15,527; US: 5182) underwent RH, LAR, and, PD, respectively. Thirty-day mortality rates for RH were 0.76% (Japan) and 1.88% (US); rates for LAR were 0.43% versus 1.08%; and rates for PD were 1.35% versus 2.57%. Patient background, comorbidities, and practice style were different between Japan and the US. In the models, the odds ratio for each variable was similar between NCD and ACS-NSQIP. Local risk models could predict mortality using local data, but could not accurately predict mortality using data from other countries. We demonstrated the feasibility and efficacy of the international collaborative research between Japan and the US, but found that local risk models remain essential for quality improvement.
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spelling pubmed-50084952016-09-09 Comparison of National Operative Mortality in Gastroenterological Surgery Using Web-based Prospective Data Entry Systems Anazawa, Takayuki Paruch, Jennifer L. Miyata, Hiroaki Gotoh, Mitsukazu Ko, Clifford Y. Cohen, Mark E. Hirahara, Norimichi Zhou, Lynn Konno, Hiroyuki Wakabayashi, Go Sugihara, Kenichi Mori, Masaki Medicine (Baltimore) 7100 International collaboration is important in healthcare quality evaluation; however, few international comparisons of general surgery outcomes have been accomplished. Furthermore, predictive model application for risk stratification has not been internationally evaluated. The National Clinical Database (NCD) in Japan was developed in collaboration with the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), with a goal of creating a standardized surgery database for quality improvement. The study aimed to compare the consistency and impact of risk factors of 3 major gastroenterological surgical procedures in Japan and the United States (US) using web-based prospective data entry systems: right hemicolectomy (RH), low anterior resection (LAR), and pancreaticoduodenectomy (PD). Data from NCD and ACS-NSQIP, collected over 2 years, were examined. Logistic regression models were used for predicting 30-day mortality for both countries. Models were exchanged and evaluated to determine whether the models built for one population were accurate for the other population. We obtained data for 113,980 patients; 50,501 (Japan: 34,638; US: 15,863), 42,770 (Japan: 35,445; US: 7325), and 20,709 (Japan: 15,527; US: 5182) underwent RH, LAR, and, PD, respectively. Thirty-day mortality rates for RH were 0.76% (Japan) and 1.88% (US); rates for LAR were 0.43% versus 1.08%; and rates for PD were 1.35% versus 2.57%. Patient background, comorbidities, and practice style were different between Japan and the US. In the models, the odds ratio for each variable was similar between NCD and ACS-NSQIP. Local risk models could predict mortality using local data, but could not accurately predict mortality using data from other countries. We demonstrated the feasibility and efficacy of the international collaborative research between Japan and the US, but found that local risk models remain essential for quality improvement. Wolters Kluwer Health 2015-12-11 /pmc/articles/PMC5008495/ /pubmed/26656350 http://dx.doi.org/10.1097/MD.0000000000002194 Text en Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved. http://creativecommons.org/licenses/by-nc-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0
spellingShingle 7100
Anazawa, Takayuki
Paruch, Jennifer L.
Miyata, Hiroaki
Gotoh, Mitsukazu
Ko, Clifford Y.
Cohen, Mark E.
Hirahara, Norimichi
Zhou, Lynn
Konno, Hiroyuki
Wakabayashi, Go
Sugihara, Kenichi
Mori, Masaki
Comparison of National Operative Mortality in Gastroenterological Surgery Using Web-based Prospective Data Entry Systems
title Comparison of National Operative Mortality in Gastroenterological Surgery Using Web-based Prospective Data Entry Systems
title_full Comparison of National Operative Mortality in Gastroenterological Surgery Using Web-based Prospective Data Entry Systems
title_fullStr Comparison of National Operative Mortality in Gastroenterological Surgery Using Web-based Prospective Data Entry Systems
title_full_unstemmed Comparison of National Operative Mortality in Gastroenterological Surgery Using Web-based Prospective Data Entry Systems
title_short Comparison of National Operative Mortality in Gastroenterological Surgery Using Web-based Prospective Data Entry Systems
title_sort comparison of national operative mortality in gastroenterological surgery using web-based prospective data entry systems
topic 7100
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5008495/
https://www.ncbi.nlm.nih.gov/pubmed/26656350
http://dx.doi.org/10.1097/MD.0000000000002194
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