Development of an annually updated Japanese national clinical database for chest surgery in 2014

doi:10.1007/s11748-016-0697-1

Review

. 2016 Oct;64(10):569-76.

doi: 10.1007/s11748-016-0697-1. Epub 2016 Aug 8.

Development of an annually updated Japanese national clinical database for chest surgery in 2014

Shunsuke Endo^{1

2}, Norihiko Ikeda^{3

4}, Takashi Kondo^{3

5}, Jun Nakajima^{3

6}, Haruhiko Kondo^{3

7}, Kohei Yokoi^{3

8}, Masayuki Chida^{3

9}, Masami Sato^{3

10}, Shinichi Toyooka^{3

11}, Koichi Yoshida^{3

4}, Yoshinori Okada^{3

12}, Yukio Sato^{3

13}, Meinoshin Okumura^{14

15}, Munetaka Masuda^{14

16}, Koji Chihara^{17

18

19}, Hiroaki Miyata^{20

21}

Affiliations

¹ Committee for NCD, The Japanese Association for Chest Surgery, 3F Chiyoda Seimei Kyoto Oike Building 200 Takamiya-cho, Takakura-Oike-dori, Nakagyo-ku, Kyoto, 604-0835, Japan. tcvshun@jichi.ac.jp.
² Department of Thoracic Surgery, Jichi Medical University, Tochigi, Japan. tcvshun@jichi.ac.jp.
³ Committee for NCD, The Japanese Association for Chest Surgery, 3F Chiyoda Seimei Kyoto Oike Building 200 Takamiya-cho, Takakura-Oike-dori, Nakagyo-ku, Kyoto, 604-0835, Japan.
⁴ Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
⁵ Department of Thoracic Surgery, Tohoku Pharmaceutical University Hospital, Miyagi, Japan.
⁶ Department of Thoracic Surgery, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
⁷ Department of General Thoracic Surgery, Kyorin University Hospital, Tokyo, Japan.
⁸ Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Aichi, Japan.
⁹ Department of General Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan.
¹⁰ Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
¹¹ Department of Thoracic, Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
¹² Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Miyagi, Japan.
¹³ Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
¹⁴ Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery, 1F Teral Kohraku Building, 2-3-27 Kohraku, Bunkyo-ku, Tokyo, 112-0004, Japan.
¹⁵ Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
¹⁶ Department of Surgery, Yokohama City University, Kanagawa, Japan.
¹⁷ The Japanese Board of General Thoracic Surgery Tokyo, 1F Teral Kohraku Building, 2-3-27 Kohraku, Bunkyo-ku, Tokyo, 112-0004, Japan.
¹⁸ The Japanese Board of General Thoracic Surgery Kyoto, 3F Chiyoda Seimei Kyoto Oike Building 200 Takamiya-cho, Takakura-Oike-dori, Nakagyo-ku, Kyoto, 604-0835, Japan.
¹⁹ Division of Thoracic Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan.
²⁰ National Clinical Database, 1-8-3 Marunouchi, Chiyoda-ku, Tokyo, Japan.
²¹ Department of Health Policy and Management School of Medicine, Keio University, Tokyo, Japan.

PMID: 27501695
PMCID: PMC5035318
DOI: 10.1007/s11748-016-0697-1

Review

Development of an annually updated Japanese national clinical database for chest surgery in 2014

Shunsuke Endo et al. Gen Thorac Cardiovasc Surg. 2016 Oct.

. 2016 Oct;64(10):569-76.

doi: 10.1007/s11748-016-0697-1. Epub 2016 Aug 8.

Authors

Affiliations

¹ Committee for NCD, The Japanese Association for Chest Surgery, 3F Chiyoda Seimei Kyoto Oike Building 200 Takamiya-cho, Takakura-Oike-dori, Nakagyo-ku, Kyoto, 604-0835, Japan. tcvshun@jichi.ac.jp.
² Department of Thoracic Surgery, Jichi Medical University, Tochigi, Japan. tcvshun@jichi.ac.jp.
³ Committee for NCD, The Japanese Association for Chest Surgery, 3F Chiyoda Seimei Kyoto Oike Building 200 Takamiya-cho, Takakura-Oike-dori, Nakagyo-ku, Kyoto, 604-0835, Japan.
⁴ Department of Thoracic Surgery, Tokyo Medical University Hospital, Tokyo, Japan.
⁵ Department of Thoracic Surgery, Tohoku Pharmaceutical University Hospital, Miyagi, Japan.
⁶ Department of Thoracic Surgery, University of Tokyo Graduate School of Medicine, Tokyo, Japan.
⁷ Department of General Thoracic Surgery, Kyorin University Hospital, Tokyo, Japan.
⁸ Department of Thoracic Surgery, Nagoya University Graduate School of Medicine, Aichi, Japan.
⁹ Department of General Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan.
¹⁰ Department of General Thoracic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
¹¹ Department of Thoracic, Breast and Endocrinological Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
¹² Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, Miyagi, Japan.
¹³ Department of Thoracic Surgery, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
¹⁴ Committee for Scientific Affairs, The Japanese Association for Thoracic Surgery, 1F Teral Kohraku Building, 2-3-27 Kohraku, Bunkyo-ku, Tokyo, 112-0004, Japan.
¹⁵ Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
¹⁶ Department of Surgery, Yokohama City University, Kanagawa, Japan.
¹⁷ The Japanese Board of General Thoracic Surgery Tokyo, 1F Teral Kohraku Building, 2-3-27 Kohraku, Bunkyo-ku, Tokyo, 112-0004, Japan.
¹⁸ The Japanese Board of General Thoracic Surgery Kyoto, 3F Chiyoda Seimei Kyoto Oike Building 200 Takamiya-cho, Takakura-Oike-dori, Nakagyo-ku, Kyoto, 604-0835, Japan.
¹⁹ Division of Thoracic Surgery, Shizuoka City Shizuoka Hospital, Shizuoka, Japan.
²⁰ National Clinical Database, 1-8-3 Marunouchi, Chiyoda-ku, Tokyo, Japan.
²¹ Department of Health Policy and Management School of Medicine, Keio University, Tokyo, Japan.

PMID: 27501695
PMCID: PMC5035318
DOI: 10.1007/s11748-016-0697-1

Abstract

Objectives: A national clinical database (NCD) adopted an "Internet-based collection" in 2011. An NCD specializing in chest surgery was launched based on the NCD system in 2014. The system was linked to the board certification as the second level in the hierarchy of the specialty of chest surgery and accreditation of educational institutions for chest surgery. Here, we report the status of the NCD for chest surgery in 2014 and clarified its registration rate and its accuracy.

Methods: Chest surgeries undertaken in Japan since January 1st, 2014 until the end of the same year were registered through an Internet-based system until April 8th, 2015. The registration rate was compared with the annual survey conducted by the Japanese Association for Thoracic Surgery (JATS) from 2011 to 2014. The rate of accurate inputting was measured by an Internet-based audit in reference to 563 anonymous operative notes of patients presented by 106 chest surgeons at the time of renewal for board certification for chest surgery.

Results: A total of 88,112 chest-surgical procedures were registered from 1000 chest surgery units (CSUs). Distribution of procedures by thoracic disease was almost identical to that of the annual survey conducted by JATS. However, the NCD had 4260 more registered procedures compared with the annual survey. The Internet-based audit showed that inter-rater agreement between Internet-based data and operative notes in any item was >94 %.

Conclusions: The NCD system can sustainably provide important and up-to-date information relating to preoperative status, oncology, and best practice for chest surgery in Japan.

Keywords: Board certification; Chest surgery; Database; Internet; Nationwide survey.

PubMed Disclaimer

Conflict of interest statement

Compliance with ethical standards Funding This work was supported in part by Health Labour Sciences Research Grant No. 201313055C. Conflict of interest Shunsuke Endo and other co-authors have no conflict of interest.

Figures

**Fig. 1**
First step of NCD registration. The essential items required for the first step of NCD registration. The postal code of the patient must be inputted. Surgeons and assistants can be identified by the license number registered by the Japanese Surgical Society

**Fig. 2**
Chart of input items for perioperative information. In the first step of the registry process for chest surgery, the operation is categorized as a surgical thoracic disease. All input items, which are displayed according to the thoracic disease, must be filled out. Perioperative evaluations include common items and unique items according to the categorized disease. Finally, discharge information is inputted. These clinical data in relation to chest surgery were inputted until the completion of data registration without alerts showing inputting mistakes

**Fig. 3**
Internet-based audit system. An Internet-based audit system was developed to maintain the data quality of the NCD for chest surgery. Surgeons had to provide anonymous operative notes of patients selected randomly by the NCD and given to the JACS at the time of application for board certification for chest surgery. A committee authorized by the NCD and JACS could check the inter-rater reliability between these samples and Internet-based data from the NCD

**Fig. 4**
Number of patients registered for chest surgery and for other fields of surgery of the NCD 2014 for each surgical procedure. Malignant neoplasm included lung cancer and metastatic lung tumor. Bulla-related procedures included bullectomy and volume reduction surgery

**Fig. 5**
Comparison between the annual report by JATS and NCD 2014 shows the number of registrations to be almost identical for the selected thoracic diseases

**Fig. 6**
Ratio of inter-rater agreement of operative data based on 563 operative notes. Agreement was >94 % which is acceptable, but will improve with better education and database management

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References

1. Masuda M, Kuwano H, Okumura M, Arai H, Endo S, Doki Y, et al. Thoracic and cardiovascular surgery in Japan during 2013: annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2015;63:670–701. doi: 10.1007/s11748-015-0590-3. - DOI - PMC - PubMed
1. Sawabata N, Miyaoka E, Asamura H, Nakanishi Y, Eguchi K, Mori M, et al. Japanese lung cancer registry study of 11,663 surgical cases in 2004: demographic and prognosis changes over decade. J Thorac Oncol. 2011;6:1229–1235. doi: 10.1097/JTO.0b013e318219aae2. - DOI - PubMed
1. Miyata H, Gotoh M, Hashimoto H, Motomura N, Murakami A, Tomotaki A, et al. Challenges and prospects of a clinical database linked to the board certification system. Surg Today. 2014;44:1991–1999. doi: 10.1007/s00595-013-0802-3. - DOI - PubMed
1. Gotoh M, Miyata H, Hashimoto H, Wakabayashi G, Konno H, Miyakawa S, et al. National Clinical Database feedback implementation for quality improvement of cancer treatment in Japan: from good to great through transparency. Surg Today. 2016;46:38–47. doi: 10.1007/s00595-015-1146-y. - DOI - PMC - PubMed
1. Shiloach M, Frencher SK, Jr, Steeger JE, Rowell KS, Bartzokis K, Tomeh MG, et al. Toward robust information: data quality and inter-rater reliability in the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg. 2010;210:6–16. doi: 10.1016/j.jamcollsurg.2009.09.031. - DOI - PubMed

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[1] Masuda M, Kuwano H, Okumura M, Arai H, Endo S, Doki Y, et al. Thoracic and cardiovascular surgery in Japan during 2013: annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2015;63:670–701. doi: 10.1007/s11748-015-0590-3. - DOI - PMC - PubMed

[2] Masuda M, Kuwano H, Okumura M, Arai H, Endo S, Doki Y, et al. Thoracic and cardiovascular surgery in Japan during 2013: annual report by The Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2015;63:670–701. doi: 10.1007/s11748-015-0590-3. - DOI - PMC - PubMed

[3] Sawabata N, Miyaoka E, Asamura H, Nakanishi Y, Eguchi K, Mori M, et al. Japanese lung cancer registry study of 11,663 surgical cases in 2004: demographic and prognosis changes over decade. J Thorac Oncol. 2011;6:1229–1235. doi: 10.1097/JTO.0b013e318219aae2. - DOI - PubMed

[4] Sawabata N, Miyaoka E, Asamura H, Nakanishi Y, Eguchi K, Mori M, et al. Japanese lung cancer registry study of 11,663 surgical cases in 2004: demographic and prognosis changes over decade. J Thorac Oncol. 2011;6:1229–1235. doi: 10.1097/JTO.0b013e318219aae2. - DOI - PubMed

[5] Miyata H, Gotoh M, Hashimoto H, Motomura N, Murakami A, Tomotaki A, et al. Challenges and prospects of a clinical database linked to the board certification system. Surg Today. 2014;44:1991–1999. doi: 10.1007/s00595-013-0802-3. - DOI - PubMed

[6] Miyata H, Gotoh M, Hashimoto H, Motomura N, Murakami A, Tomotaki A, et al. Challenges and prospects of a clinical database linked to the board certification system. Surg Today. 2014;44:1991–1999. doi: 10.1007/s00595-013-0802-3. - DOI - PubMed

[7] Gotoh M, Miyata H, Hashimoto H, Wakabayashi G, Konno H, Miyakawa S, et al. National Clinical Database feedback implementation for quality improvement of cancer treatment in Japan: from good to great through transparency. Surg Today. 2016;46:38–47. doi: 10.1007/s00595-015-1146-y. - DOI - PMC - PubMed

[8] Gotoh M, Miyata H, Hashimoto H, Wakabayashi G, Konno H, Miyakawa S, et al. National Clinical Database feedback implementation for quality improvement of cancer treatment in Japan: from good to great through transparency. Surg Today. 2016;46:38–47. doi: 10.1007/s00595-015-1146-y. - DOI - PMC - PubMed

[9] Shiloach M, Frencher SK, Jr, Steeger JE, Rowell KS, Bartzokis K, Tomeh MG, et al. Toward robust information: data quality and inter-rater reliability in the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg. 2010;210:6–16. doi: 10.1016/j.jamcollsurg.2009.09.031. - DOI - PubMed

[10] Shiloach M, Frencher SK, Jr, Steeger JE, Rowell KS, Bartzokis K, Tomeh MG, et al. Toward robust information: data quality and inter-rater reliability in the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg. 2010;210:6–16. doi: 10.1016/j.jamcollsurg.2009.09.031. - DOI - PubMed

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Development of an annually updated Japanese national clinical database for chest surgery in 2014

Affiliations

Development of an annually updated Japanese national clinical database for chest surgery in 2014

Authors

Affiliations

Abstract

Conflict of interest statement

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References

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