The Society of Thoracic Surgeons continues to break new ground in patient safety and quality measurement through a new collaboration with the Duke Clinical Research Institute (DCRI). DCRI will establish a link with STS clinical data and the Centers for Medicare & Medicaid Services (CMS) claims data. This link will enable participants and researchers using data from the STS National Database to track long-term patient outcomes.
"Currently, the STS National Database has clinical data that are all short-term," said STS Research Center Director Fred H. Edwards, MD. "The data include patient outcomes in the hospital and, at most, what happens up to 30 days after discharge. This new collaboration with DCRI will enable STS to track long-term patient outcomes and better understand how patients fare years down the road, which will ultimately lead to improved patient care."
Long-term outcomes include hospital readmission rates, reinterventions (a second procedure), and long-term survival. The benefit of having the long-term picture is the ability to individualize care based on comprehensive data from previous patients with similar symptoms.
"STS will be able to create more accurate and up-to-date risk models and long-term survival calculators for individual procedures," said David M. Shahian, MD, Chair of the STS Workforce on National Databases. "Surgeons would be able to estimate survival probability for patients based on their specific illness severity, co-existing medical conditions, and symptoms. This is particularly important for patients as they research treatment options and work with their physician teams to select the care they feel is best."
Health Care Economics
This new link—a first for any medical specialty society—will also allow researchers to evaluate the overall cost of patient care, which is especially important with the current focus on rising health care costs in the United States.
"Duke has been the primary analysis center for the STS National Database for the past 15 years, and during that time the Database and the field of cardiothoracic surgery have seen tremendous growth," said J. Matthew Brennan, MD, Assistant Professor of Medicine at Duke University Medical Center. "I think we are all hopeful that this collaboration will ultimately help patients by taking the Database to a new level and addressing clinical and economic questions that could not have been addressed previously."
Importance of a Robust Database
As medical research evolves, having a database with comprehensive patient outcome information will allow researchers to quickly and efficiently access data and conduct comparative effectiveness studies.
"Collaborating with CMS and DCRI was a long-time goal for the STS National Database," said Frederick L. Grover, MD, STS Past President and former Chair of the STS Workforce on National Databases. "We have one of the most comprehensive patient databases in the world and adding long-term outcomes and cost information only enhances an already robust dataset."
The STS National Database, established in 1989, represents the largest cardiothoracic surgery outcomes and quality improvement program in the world. The Database has three component databases: the Adult Cardiac Surgery Database (ACSD), the General Thoracic Surgery Database (GTSD), and the Congenital Heart Surgery Database. The new collaboration with DCRI and CMS will affect the ACSD and GTSD because CMS data involve the Medicare population (those aged 65 and older who use Medicare as their primary insurance).
The ACSD currently contains data on more than 5.2 million cardiac surgery procedures, such as coronary artery bypass grafting surgery and aortic valve replacement, and has more than 3,000 participating surgeons. The GTSD contains data on nearly 360,000 procedures, including lobectomy and esophagectomy, and has more than 800 surgeon participants.
The Society of Thoracic Surgeons