SCTS Conference News 2022 newspaper now available online

SCTS Conference News 2022 newspaper now available online

SCTS 2022Dendrite Clinical Systems and the Society for Cardiothoracic Surgery in the UK are pleased to announce the SCTS Conference News 2022 newspaper is now available to view/download. The newspaper reports a multitude of presentations from the meeting including the latest and the best information on new technologies and techniques in cardio-thoracic surgery.

This year’s meeting in Belfast included presentations of the highest quality from surgical and masterclass presentations to the latest clinical updates and technical innovations. The newspaper will be of interest to surgeons, anaesthetists, nurses, surgical care practitioners, physiotherapists, child governance leads, database managers and allied health professionals.

Please click here to read SCTS Conference News 2022.

MiECS randomised controlled trial to assess MiECC vs. cCPB

MiECS randomised controlled trial to assess MiECC vs. cCPB

MiECSResearchers led by the Clinical Research Unit at the Special Unit for Biomedical Research and Education (SUBRE), Aristotle University of Thessaloniki School of Medicine, Greece, have initiated a randomised control trial (RCT) that will compare minimally invasive extracorporeal circulation (MiECC) with conventional cardiopulmonary bypass (cCPB).

According to the researchers, the ‘Minimally invasive extracorporeal circulation versus conventional cardiopulmonary bypass in patients undergoing cardiac surgery (MiECS)’ trial will be one of the largest multicentre RCTs on extracorporeal circulation. The study will be conducted under the auspices of Minimal Invasive Extracorporeal Technologies International Society (MiECTiS).

“This study is ultimately designed to address the emerging effectiveness of MiECC systems in the light of modern perfusion practice worldwide,” explained Professor Polychronis Antonitsis, Associate Professor of Cardiac Surgery, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Greece, and co-investigator of the trial. “The primary hypothesis is that MiECC, as compared to cCPB, reduces the proportion of patients experiencing serious perfusion-related postoperative morbidity after cardiac surgery.”

According to the researchers, the MiECS study will overcome most limitations of previous trials of MiECC as it will focus on specific perfusion-related clinical outcomes after cardiac surgery that could be potentially affected by MiECC, and should also target for higher-risk patients undergoing complex procedures that are more likely to develop complications and, thus, benefit from the advanced technology.

The study will be conducted in ten to 15 cardiac surgery centres worldwide (Germany, Greece, Italy, United Kingdom, Switzerland, Turkey and Canada) and any surgeon with an experience of more than 50 patients operated on MiECC is eligible to take part. Patients will be recruited if they are having coronary artery bypass surgery, aortic valve replacement or both. The research objectives will be addressed by randomising participants (1:1 ratio) to have surgery using MiECC system or cCPB.

The trial will be powered by Dendrite Clinical Systems’ Intellect Web software that will collect patient demographic, procedural, complication/s and outcomes data. In addition, the innovate software features automatic patient randomisation - once the inclusion and exclusion criteria are completed, a random number generator automatically randomises the patient to a treatment group.

"This intuitive system is incredibly easy to use whether it is a cardiac surgeon, perfusionist or nurse entering the data. In addition, investigators can monitor each patient record as the trial continues. With a paper-based system, one has no idea who is enrolling patients, who has put in incomplete data etc without directly monitoring them," explained Dr Peter Walton, Managing Director of Dendrite Clinical Systems. “Our system allows researchers to keep a track on patient randomisation and importantly, ensure centres are adhering to protocol etc. “A web-based platform for data collection offers unprecedented access by investigators across multiple sites, allowing real-time supervision of patient enrolment. Our web-based system can be adapted for national and international clinical registries and trials in any clinical setting.”

A total of 1,300 participants will be randomised in two arms over a period of 36 months. The composite primary outcome consists of death, myocardial infarction, stroke, acute kidney injury, reintubation, tracheostomy, mechanical ventilation for more than 48 hours, or reoperation up to 30 days after surgery.

“If MiECC is shown to be effective in such a trial, the technology is available and could be rapidly implemented in clinical practice providing a significant healthcare benefit,” Professor Antonitsis concluded.

Dendrite's cardiac dashboards facilitate on-line, real-time benchmarking at the touch of a button

Dendrite's cardiac dashboards facilitate on-line, real-time benchmarking at the touch of a button

Mr Uday TrivediDendrite Clinical Systems, working in close cooperation with the SCTS and several cardiac centres, has developed a series of ‘Dashboards’ that allow users to access to their unit’s surgical outcomes and compare them to national results in real-time. By uploading their data to the central Dendrite National Cardiac Surgical Registry, individual units or centres can instantly benchmark their results via an on-line database for internal consumption to assist units with their own clinical governance and for auditing purposes.

“There are several organisations in the United Kingdom that already examine surgical data and report a variety of clinical and organisational outcomes such as the National Cardiac Benchmarking Collaborative (NCBC). For several years the SCTS, working with the National Institute for Cardiovascular Outcomes Research (NICOR) as part of the National Cardiac Audit Programme, has been seeking to gather data on outcomes other than mortality,” explained Mr Uday Trivedi, Consultant Cardiothoracic Surgeon, from the Royal Sussex County Hospital, Brighton and Hove, and SCTS Adult Cardiac Surgery Audit Lead. “As the overall mortality from cardiac surgery is now so low, we really require data on additional outcomes such as complications like renal failure, stroke and bleeding, as well as length of hospital stay, patient surgical group demographics etc, to try and assess how we improve the quality of care for our patients. The Dashboards now give individual centres the ability to compare these complications at a national level. This is important data - not just for the multi-disciplinary surgical teams - but also for hospital managers and administrators.”

The Dashboards are exclusively for adult cardiac procedures and therefore excludes all congenital and thoracic procedures, as well as transplantation. During the development phase of the Dashboards, it was decided they would include the volume and type of procedures expected to be carried out by most surgeons or centres. As a result, the Dashboards report data on coronary surgery, aortic valve procedures and mitral valve procedures.

In addition to coronary and aortic and mitral valve procedures, a separate area for major aortic procedures is currently under development to try and ascertain how much major aortic work is performed in an emergency and/or elective setting. Specifically, this will help determine how many dissections are performed, by which units and reveal the outcomes from these procedures.

“One of the first things we had to decide was how to work around the information governance issues and GDPR requirements,” added Mr Trivedi. “Using only anonymised data, the process for data collection and analysis was mostly concerned with establishing suitable definitions, applying caveats to risk-modelling and risk-adjusted analyses.”

The desire for surgeons to benchmark themselves against national standards has always been a goal for the speciality. However, the ability to do this is dependent on several factors including how often data are submitted, it what form the data are submitted, how often and to what extent the data are analysed. By using the central Dendrite National Cardiac Surgical Registry, the ability to benchmark your data against national standards is realised with the push of a few buttons. Initially, the pilot Dashboards were rolled out to five centres and an additional 15 centres have expressed an interest in using them.

The Dashboards are not exclusive to units that only use Dendrite’s ‘Intellect Web’ software and are available for all units and centres across the develop nations. For example, units in Scotland can benchmark themselves against UK standards. Moreover, the intuitive Dashboards also allow users to take a more in-depth look at patients demographics and groups without the need for any additional coding or SQL queries on the part of users.

It is important to note that cardiac units can only look at their own data and benchmark their data to the national standard. The Dashboards cannot be used to compare one unit to another unit, and units cannot look at another unit’s data.

One key advantages of the Dashboards is the speed at which units can analyse their data, whether units unload their data monthly or quarterly, comparisons can be made in an instant. The data is presented in useful graphs and tables with the additional functionality of a data export facility to allow the data to be presented at governance and management meetings.

“We know that within centres, surgeons have different degrees of experience and seniority etc. This can lead to a skewed patient population for individuals. The SCTS has agreed with many national NHS bodies that the cardiac outcome data should be done on a unit level only and to move away from individual reporting. One of the tenets of this approach is for units to look for any negative variation in their outcomes on a quarterly basis. The Dashboards provide units with the tools to look for this variation,” Mr Uday concluded. “Clinical outcomes are the result of care provided by many clinical teams throughout the department or unit, not just one single surgeon or operation. By making the outcomes unit based, it provides both individual and collective responsibility for outcomes, creating awareness and therefore, driving quality improvement processes.”

“At the push of a single button and in just four or five seconds, surgeons can generate 37 comprehensive graphs and tables that illustrate surgical activity and outcomes at their hospital benchmarked against nationally collected data,” said Dr Peter Walton, Managing Director of Dendrite. “Dendrite is very pleased to be able to provide this added-value service to the UK community of adult cardiac surgeons.”

New Zealand researchers publish first national breast cancer register report

New Zealand researchers publish first national breast cancer register report

NZBCFDendrite Clinical Systems is delighted to announce the first ever report from New Zealand’s Te Rēhita Mate Ūtaetae - Breast Cancer Foundation National Register. The ground-breaking report, titled, “30,000 voices: Informing a better future for breast cancer in New Zealand,” covers 30,000 patients diagnosed from 2003 to 2019.

The register has been collecting breast cancer case data since 2000 for use in research and audit to help improve diagnosis and treatment. It began as four regional registers funded by Breast Cancer Foundation NZ. In 2015, Breast Cancer Foundation NZ set the goal for the Register to achieve 100% coverage of New Zealand breast cancer patients to ensure a robust, equitable dataset. The Ministry of Health, recognising the value of a national breast cancer register, provided funding to consolidate the four existing registers. In 2016, Dendrite was subsequently chosen to develop, implement and host the new consolidated register, Te Rēhita Mate Ūtaetae - Breast Cancer Foundation National Register, was launched on 1 January 2018.

“The development of the Breast Cancer Foundation National Register was particularly challenging and necessitated our developers to create bespoke code to ensure the database could not only collect but also deliver data useful for clinical analysis,” explained Dr Peter Walton, Managing Director, Dendrite Clinical Systems. “The findings from this landmark report demonstrate the importance of recording and assessing clinical data to not only improve survival rates but aid future research and our understanding of life-threatening conditions. I would like to congratulate everyone involved in the truly ground-breaking publication.”

Some of the key findings highlighted in the report include:

  • The five-year risk of dying of breast cancer has halved since 2003, but 10-year rates expose the drastic differences that exist for the most vulnerable groups and those with high-risk cancers;
  • Pacific women were 52% more likely to die of breast cancer within 10 years than Pākehā. They had the highest rate of stage 3 and 4 breast cancers and of HER2+ cancers, and more grade 3 tumours than all other ethnicities
  • Younger women (under 45) had much lower 10-year survival than the 45-69 age group - 82% compared to 89%
  • Delays to surgery worsened: over 60% of women did not getting their first surgery within 31 days of diagnosis
  • Too many women had a mastectomy when breast conserving surgery with radiation treatment has better survival: a third of women who had a mastectomy probably did not need this more invasive option.

“This report shows New Zealand’s five-year survival rate is comparable with other countries, but it does not tell us the full story,” commented Dr Reena Ramsaroop, chair of Breast Cancer Foundation NZ’s medical advisory committee. “To fulfil our vision, it’s now time to focus on ten-year survival. This will show us where we have to prioritise earlier diagnosis, timelier treatment and rigorous follow-up in order to protect those most at risk of dying from breast cancer.”

To download a copy of the report, please visit: www.breastcancerregister.org.nz

About Dendrite Clinical Systems

For nearly 30 years, Dendrite Clinical Systems’ specialist clinical databases have enabled the international healthcare community to gather important clinical data to improve patient outcomes and professional practice. The company has developed more than 200 national & international registries across six continents that have collected data on patients, disease groups, procedures, medical devices, pharmaceuticals & therapeutics. The company’s flexible “Intellect-Web” software can be adapted to any clinical scenario and incorporates very powerful data analysis and real-time reporting tools. Privately held and headquartered in Reading, UK, with a technical support office in New Malden, south-west London. UK. For more information, please visit www.e-dendrite.com

About Breast Cancer Foundation NZ (BCFNZ)

BCFNZ is a not-for-profit, non-government funded organisation that depends on donations and fundraising for its work in breast cancer education and awareness, medical research and training grants, advocacy, and supporting Kiwis with breast cancer. BCFNZ’s programmes are evidence-based and overseen by its medical advisory committee. For more information, please visit  www.breastcancerfoundation.org.nz/

ESOT signs agreement with Dendrite Clinical Systems for a web-based registries platform

ESOT signs agreement with Dendrite Clinical Systems for a web-based registries platform

ESOT_logoThe European Society for Organ Transplantation (ESOT) has signed an agreement to develop a series of web-based registries on organ transplantation with Dendrite Clinical Systems Ltd. The Council of the European Society for Organ Transplantation took the decision to partner with Dendrite after a rigorous, competitive tender process. Under the agreement, Dendrite will work closely with ESOT to design, develop and implement a modular platform to integrate user-friendly registries that will facilitate clinical and patient reported outcome data collection, analysis, reporting and research covering all transplant domains.

“We are delighted to see this project take shape,” commented Professor Gabriel Oniscu, ESOT President Elect. “The partnership with Dendrite Clinical is a major step towards establishing a multi-registry platform in Europe that will promote clinical and scientific exchanges and collaborations and for the first time, collect patient reported outcomes. This will be a unique resource for all transplant stakeholders.”

ESOT is dedicated to the pursuit of clinical and research excellence and improving patient outcomes. Its core mission is to promote the sharing of scientific information and building of evidence-based international practice, policies and guidelines. To fulfil these aims, ESOT will establish a professional platform to host pan-European registries on transplant recipients and living donors. The registries will be available to competent authorities and transplant centres willing to join ESOT in this pan-European effort.

The ESOT registries platform will initially host four registries and will be designed to easily integrate additional registries. In the second phase of the project, a Patient Portal will be developed to facilitate the collection of patient reported outcomes. The first registries are:

  • The European Liver Transplant Registry (ELTR)
  • The European Pancreas and Islets Transplant Registry (EPITR)
  • The European Kidney Recipient Registry (EKRR)
  • The European Living Donor Registry (ELDR)

“We are very proud to have been selected to partner with ESOT to create a platform to host a series of registries. Our unique, flexible ‘Intellect-Web’ registry software is the ideal platform for the implementation of such complex registries, as it allows multi-registries within the same system, such as transplant candidates, transplant recipients and living donors,” explained Dr Peter Walton, Managing Director of Dendrite Clinical Systems. “By collecting and recording data on organ transplantation across Europe, we believe researchers will be able examine the treatment of every patient and, where appropriate, recommended changes to improve clinical outcomes. We look forward to working with ESOT on this very exciting project.”

This project is supported by the European Commission.

For more information about the ESOT registry project, please contact Dr Daniele Roppolo (daniele.roppolo@esot.org) or Chiara Parisotto (chiara.parisotto@esot.org)

About the European Society for Organ Transplantation

The European Society for Organ Transplantation (ESOT) was founded nearly 40 years ago and is dedicated to the pursuit of excellence in organ transplantation. Facilitating a wealth of international clinical trials and research collaborations over the years, ESOT remains committed to its primary aim of improving patient outcomes in transplantation. With a community of over 8,000 members from around the world, ESOT is an influential international organisation and the facilitator of the biennial congress which hosts approximately 3,500 experts who come together to meet, explore and discuss the latest scientific research. ESOT attracts the foremost transplantation experts to work in its committees and sections, and has an impressive track record in supporting research, professional education, and promoting changes in European policy, to improve outcomes for patients requiring and undergoing organ transplantation.

Further information: www.esot.org

About Dendrite Clinical Systems

For nearly 30 years, Dendrite Clinical Systems’ specialist clinical databases have enabled the international healthcare community to gather important clinical data to improve patient outcomes and professional practice. The company has developed more than 200 national & international registries that have collected data on patients, disease groups, procedures, medical devices, pharmaceuticals & therapeutics, and the company’s flexible “Intellect-Web” software can be adapted to any clinical scenario.

Further information: www.e-dendrite.com

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