Abstract:The AHSQC has been established as a quality improvement initiative utilizing concepts of CQI. This ongoing effort will continually refine its scope and goals based on stakeholder input to improve care delivered to hernia patients.
“…Two registries were launched in 2012: EuraHS [8], and the Spanish Registro Español de Eventraciones (EVEREG) [11]. The Americas Hernia Society Collaboration (AHSQC) Registry followed in 2013 [12]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…The aim of the registry was to report on the operative techniques used and to analyze outcome measures in order to stimulate quality improvement [6]. A number of national and international registries have since been added [6–12]. …”
IntroductionThe aim of the international CORE project was to explore the databases of the existing hernia registries and compare them in content and outcome variables.MethodsThe CORE project was initiated with representatives from all established hernia registries (Danish Hernia Database, Swedish Hernia Registry, Herniamed, EuraHS, Club Hernie, EVEREG, AHSQC) in March 2015 in Berlin. The following categories were used to compare the registries: initiation and funding, data collection and use for certification of hernia centers, patient data and data protection, operative data, registration of complications and follow-up data.ResultsThe Danish Hernia Database is the only one to qualify as a genuine national registry where participation is compulsory for entry of all procedures by all surgeons performing a hernia operation. All other registries have to be considered as voluntary and completeness of data depends upon the participating hospitals and surgeons. Only the Danish Hernia Database and the Swedish Hernia Registry are publicly funded. All other registries are reliant on financial support from the medical technology industry. As an incentive for voluntary participation in a hernia registry, hospitals or surgeons are issued a certificate confirming that they are taking part in a quality assurance study for hernia surgery. Due to data protection and privacy regulations, most registries are obliged or have chosen to enter their patient data anonymously or coded. The Danish Hernia Database and Swedish Hernia Registry utilize a national personal patient code. In the Herniamed Registry, patient data are saved in a coded and anonymous format after obtaining the patient’s informed consent.ConclusionDespite the differences in the way data are collected for each of the listed hernia registries, the data are indispensable in clinical research.
“…Two registries were launched in 2012: EuraHS [8], and the Spanish Registro Español de Eventraciones (EVEREG) [11]. The Americas Hernia Society Collaboration (AHSQC) Registry followed in 2013 [12]. Fig.…”
Section: Resultsmentioning
confidence: 99%
“…The aim of the registry was to report on the operative techniques used and to analyze outcome measures in order to stimulate quality improvement [6]. A number of national and international registries have since been added [6–12]. …”
IntroductionThe aim of the international CORE project was to explore the databases of the existing hernia registries and compare them in content and outcome variables.MethodsThe CORE project was initiated with representatives from all established hernia registries (Danish Hernia Database, Swedish Hernia Registry, Herniamed, EuraHS, Club Hernie, EVEREG, AHSQC) in March 2015 in Berlin. The following categories were used to compare the registries: initiation and funding, data collection and use for certification of hernia centers, patient data and data protection, operative data, registration of complications and follow-up data.ResultsThe Danish Hernia Database is the only one to qualify as a genuine national registry where participation is compulsory for entry of all procedures by all surgeons performing a hernia operation. All other registries have to be considered as voluntary and completeness of data depends upon the participating hospitals and surgeons. Only the Danish Hernia Database and the Swedish Hernia Registry are publicly funded. All other registries are reliant on financial support from the medical technology industry. As an incentive for voluntary participation in a hernia registry, hospitals or surgeons are issued a certificate confirming that they are taking part in a quality assurance study for hernia surgery. Due to data protection and privacy regulations, most registries are obliged or have chosen to enter their patient data anonymously or coded. The Danish Hernia Database and Swedish Hernia Registry utilize a national personal patient code. In the Herniamed Registry, patient data are saved in a coded and anonymous format after obtaining the patient’s informed consent.ConclusionDespite the differences in the way data are collected for each of the listed hernia registries, the data are indispensable in clinical research.
“…When constructing a VH perioperative variable and postoperative outcome dataset for randomised control trials, workers should also consult the VH databases currently being used in America [71], Europe [69], Denmark [72] and Spain [73]. These databases collect data prospectively from large cohorts of patients and will generate sizeable observational studies.…”
VH RCTs report peri- and post-operative variables inconsistently, and with poor definitions. A standardised minimum dataset, including definitions of recurrence, is required.
“…Study population/data source The Americas Hernia Society Quality Collaborative (AHSQC) was established in 2013 in an effort to improve the value of hernia care by using real-time continuous quality improvement principles. 8 The AHSQC includes surgeons that practice in academic, community, and academic-affiliated institutions. As such, it is thought to be more representative of current hernia practice compared with single-institution experiences.…”
Section: Methodsmentioning
confidence: 99%
“…In addition, it contains hernia-specific variables, including hernia size and location of mesh placement, that have been shown to be associated with hernia repair outcomes and are not available in larger national databases. 8 For these reasons, we sought to develop and validate a ventral hernia patient engagement tool using the AHSQC. At the time of this study, the AHSQC had data available from 237 surgeons.…”
BACKGROUND: Patient engagement is an increasingly important component of surgical decision making.Given the many factors associated with successful ventral hernia repair (VHR), we developed and validated the Outcomes Reporting App for Clinical and Patient Engagement (ORACLE) tool to help facilitate preoperative surgeon-patient discussions about VHR.
METHODS:All patients undergoing elective, VHR with 30-day follow-up data available within the Americas Hernia Society Quality Collaborative were eligible for study inclusion. Using bootstrapping and bias-corrected calibration, predictive models were generated and validated for 5 quality measures after VHR, including postoperative wound events, estimated length of hospital stay, unplanned 30-day readmission to the hospital, and risk of hernia recurrence at 1 year postoperatively.
RESULTS:A total of 10,690 patients met inclusion criteria. Based on comparison of the theoretical best to the observed calibration curves, the models for each of the 5 outcomes of interest have strong predictive strength as reflected in the Brier score for surgical site infection, surgical site occurrence requiring procedural intervention, and 30-day hospital readmission, the c-index for 1year hernia recurrence and the R 2 value for the model for predicted hospital length of stay. CONCLUSIONS: Using a national data set for development, ORACLE can be used to facilitate patient engagement, with the goal of tailoring interventions for VHR given each patient's unique factors.With ongoing data input into the Americas Hernia Society Quality Collaborative and a continuous re-evaluation of these risk models, it is our intention that this tool will serve as an up-todate resource for hernia surgeons and ventral hernia patients. (J Am Coll Surg 2019;229: 259e266. Ó
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