Current Dataset (5.4.5.)

Version History

The current version of the Database Programme and instructions to use are available on our Current Database Page

November 2009

Re: Latest BCIS audit, dataset clarifications and reminders
I am pleased to say that the latest audit of PCI activity in the UK is now available for download at our website: http://www.bcis.org.uk/resources/audit
I would like to clarify a few issues in the dataset that relate to:
1. Emergency CABG
2. Date time fields
3. Definition of ‘balloon’ time
4. Definition of a PCI
5. The recording of IVUS only, and FFR only studies
6. Automated cumulative funnel plots

Read this document

Dataset version 5.4.4 to 5.4.5

This is to let you know that we are adding new items to four of the volatile fields in the BCIS-CCAD dataset. This is simply a library update and does not involve a change in the structure of the dataset.

I have also altered the drug eluting stent descriptors, as they had become illogical and unwieldy. CCAD will accept both the old and new descriptors.

Description of changes

What should I do?
1. The commercial vendors of databases are all being informed of this modification, and I am sure will be able to add these items, or instruct you as to how to do it yourselves.
2. The Lotus Notes database will be updated to include these shortly.
3. If you are using my database, then you can make the change yourself by clicking the button on the front page menu ‘default menus and drop down lists’, and then selecting the appropriate volatile fields and typing in the changes. The items will then appear in the database drop down menus

Peter Ludman
BCIS audit lead
peter.ludman@uhb.nhs.uk

December 2008

The risk adjusted outcome cummulative funnel plot generator for PCI is now ready to be used. The report works in the same way as the generation of aggregate data reports, and the time delays reports generator. Via the Lotus Notes program in BCIS section, look under the list of reports on the left of the page. Click on ' Funnel Plot'
Work your way through the steps, which represent a series of choices regarding the variables and parameters you would like to use to analyse your data .

The report will generate an analysis in the form of a password protected excel spreadsheet. The predicted and observed MACCE are listed for each PCI procedure using your reported CCAD data and the NQWIP model. A cummulative funnel plot is generated with 2 and 3 sigma lines. You will find an explanation of this plot in the last few slides (number 156 to 177) of my BCIS audit presentation of 2007 data at http://www.bcis.org.uk/resources/audit/audit2007.

The latest version of the delays report generator for PCI is now ready to be used. The report works in the same way as the generation of aggregate data reports. Via the Lotus Notes program in BCIS section, look under the list of reports on the left of the page. Click on 'Delay reports v.6' This will bring up the following dialogue (please see attachment for dialogue).
Work your way through the 7 steps, which represent a series of choices regarding the variables and parameters you would like to use to analyse your data.
The report will generate an analysis in the form of a password protected excel spreadsheet. The worksheets include a measure of your data completeness for the key fields, and explanation of how each field is calculated, and overall analysis of various time intervals in the treatment of patients being treated for acute coronary syndromes. The report will aslo create statistical process control charts allowing you to see (for example) each individual door to balloon time delay for each patient treated for STEMI. These charts can be split to look at night versus day time delays.
I hope you find this is helpful. If you spot any errors in our programming please do not hesitate to contact me.

Best wishes

Peter Ludman
Audit secretary for BCIS

August 2008

This is to let you know that we are adding three new items to one of the volatile fields in the BCIS-CCAD dataset. This is simply a library update and does not involve a change in the structure of the dataset.

Three items are being added to the ‘Drug(s) eluted by stent(s)’ menu (which perhaps would now be more accurately described as ‘drug based stents’ menu).

The list should now be as follows:

Short Code/Text for long code
0 None
1 Paclitaxel (Taxus)
2 Rapamycin (Cypher)
3 Paclitaxel (Achieve)
4 Dexamethasone (Dexamet)
5 ABT-578 / Cobalt chrome (Endeavor by Medtronic)
6 Paclitaxel / Cobalt chrome (CoStar by Conor)
7 Tacrolimus / Carbofilm (Janus by Sorin)
8 Everolimus / Cobalt chrome (Xience V by Guidant J&J)
9 no drug / Magnesium Absorbable Metal (Lekton Magic by Biotronik)
10 Everolimus / Cobalt chrome (Promus by Boston Scientific)
11 Paclitaxel / polymer and steel (Coroflex Please by Braun)
12 EPC capture / steel (Genous stent by Orbus Neich)
99 Unlisted

This brings the current dataset version to 5.4.4

What should I do?
1. The commercial vendors of databases are all being informed of this modification, and I am sure will be able to add these items, or instruct you as to how to do it yourselves.
2. .The Lotus Notes database will be updated to include these shortly.
3. If you are using my database, then you can make the change yourself by clicking the button on the front page menu ‘default menus and drop down lists’, and then selecting ‘drug eluted from stent list’, and when this list opens, type in the three extra options so that the list looks like the one above. These will then appear in the database in the scroll box for drug eluting stents.

Peter Ludman
BCIS audit secretary
peter.ludman@uhb.nhs.uk

Current Database:
The current version of the database programme together with instructions is available on the Current Database Page

There needs to be a further minor change to the current BCIS-CCAD dataset version 5.3.3, which will update it to version 5.4.3. Two further fields are needed:

Additional field 1.
The Healthcare Commission require that Trusts provide a single performance indicator for the treatment of patients with ST elevation MI by PCI. This will be ‘Call to Balloon’ time, interpreted to mean ‘call to first device time’, whether that device be a balloon, or for example an extraction or aspiration device. The principle is that they wish to capture the entire patient’s experience from seeking help to getting treatment. This is analogous to the ‘Call to Needle’ time for thrombolysis.

In order to deliver this, we need to add a single additional date/time field to the BCIS minimum dataset – that is ‘Call time’

Additional field 2.
In addition, in order to help track the patient journey between 2 centres, to cross-link with the MINAP dataset, we need to add the referring hospital to the dataset.

Thus the csv export file will be increased from 104 fields to 106. The extra Date/time field is only required for patients being admitted for emergency treatment for ST elevation MI by PCI.

To summarise:

• Dataset Version 5.4.3
• Additional field 1: 5.27 Date/time of first call for help (STEMI only)
• Additional field 2: 5.28 Referring Hospital
• csv export file length:106

When will the change occur?
I would propose that the change is implemented within the next 6 months if at all possible. As of now, CCAD is able to accept both export csv file lengths (representing datasets 5.3.3 and 5.4.3). From 1st Jan 2009, only the new dataset 5.4.3 (file length 106) will be accepted.

What do I need to do?

You have one of four options:

1. If you use commercial software to collect and export your PCI data, you will need to ask them to upgrade your data collection tool to make it compatible with the new dataset – version 5.4.3. This letter is being sent to my contact list so everyone should be aware of the planned update.

2. If you use the Lotus Notes front end, then this has already been updated, and you need do nothing other than make sure that the additional field is filled in.

3. If you use your own in house software, then see attached files for details of the new dataset and the csv file specification.

4. If you use the database that I have written, then you will need to update it. Instructions for updating both versions 11.0 and 12.0a are available from this web site. You will need to download the following files:

For version 11.0
1. PCI_db_v_15.11_Carrier.mdb
2. Instructions for updating PCI database version 11 to version 15.11.pdf

For Version 12.0a
1. PCI_db_v_15.12_Carrier.mdb
2. Instructions for updating PCI database version 12.0a to version 15.12.pdf

For new users
Download PCI_db_v_15.0 which is the latest version of my PCI database

(all these files are compressed into a zip file and need unzipping before use).

Additional information for download:
1. BCIS v 5.4.3.xls
2. csv file specification 5.4.3.pdf
3. History of all dataset version changes
4. All centre IDs

If you have any questions about any of this, please don’t hesitate to contact me.

Peter Ludman
Audit Officer BCIS

There are a variety of issues that relate to the way data gets from a percutaneous coronary intervention (PCI) centre’s database into the servers of the Central Cardiac Audit Database (CCAD). The BCIS-CCAD minimum dataset is being used by England and Wales, and hopefully soon by Northern Ireland.

I felt it important to document the mechanism of data import from the English and Welsh centres to help those who are interested understand the process, and make clear how any apparent anomalies might occur

Upload Rules Document

Peter Ludman
BCIS Audit Secretary

I am writing to let you know that there will be a minor change to the current BCIS-CCAD dataset (version 5.2.3). As you know I have resisted changing the dataset for as long as possible to allow units to get up to speed with collecting the data, without having to chase moving goalposts. However the problem is that this dataset does not allow us to measure time delays involved in moving patients between hospitals (particularly from non-PCI centres to PCI centres).
The dataset (latest version 5.2.3) was set up with only one admission date/time field: field 2.08 ‘Date/Time arrival at hospital (ACS only)’. This is defined as 'Date/Time of admission to first hospital (potentially of a series of hospitals) where cardiological treatment initiated. This is not necessarily the hospital where PCI is performed'.
There is no field for the Date/Time of arrival at the centre where PCI was performed (unless this happens to be the first hospital the patient gets to). The proposed change to the dataset involves the addition of this new Date/Time field, and a clarification of the field prompt for the existing date/time field. There are no other changes. Thus the CSV export file will be increased from 103 fields to 104, with the last field being this extra Date/time field.

This means that:

1. The existing date/time field for admission needs to be clearly labelled on the data collection software as the date/time of admission to first hospital (potentially of a series of hospitals) where cardiological treatment initiated. This is not necessarily the hospital where PCI is performed.

2. A new field needs to be added and clearly labelled to differentiate it from the existing field, to collect the date/time of arrival at the centre where PCI was performed.

Thus if a patient’s first hospital is the PCI centre then the data in both fields will be the same. Where the patient is admitted first to a non-PCI centre and then is transferred for a PCI, the original field 2.08 will contain the date/time of first admission, and the new field 5.26 will contain the date/time of arrival at PCI centre.These fields are only required for patients being admitted with an acute coronary syndrome.

When will the change occur?
I would propose that the change is implemented within the next 6 months if at all possible. As of now, CCAD is able to accept both export csv file lengths (representing datasets 5.2.3 and 5.3.3). From 1st June 2008, only the new dataset 5.3.3 (file length 104) will be accepted.

What do I need to do?
If you use commercial software to collect and export your PCI data, you will need to ask them to upgrade your data collection tool to make it compatible with the new dataset – version 5.3.3. I have contacted them to explain what changes will be necessary. A copy of that letter is available to Download.

If you use the Lotus Notes front end, then this will be updated, and you need do nothing other than make sure that the additional field is filled in. If you use your own in house software, then see attached files for details of the new dataset and the csv file specification. If you use the database that I have written, then data regarding both date/time points are already being collected, and all you need is an updated export query.

To do this please download the following files:
1. Update Carcass (533)
2. Instructions for updating PCI database (v12)

Additional information for download:
1. BCIS Dataset (v5.3.3)
2. CSV file specification

If you have any questions about any of this, please don’t hesitate to contact me.

Peter Ludman
Audit Officer BCIS

I have discovered that Database 12.0 has a bug that means it fails to accurately export the vessel types treated to the csv file for CCAD export. In version 12.0a this has been fixed. If you have not started using version 12.0, then just use version 12.0a instead. If you are using version 10.0 or version 11.0, this is fine as this problem is not present in these versions. Only if you are already using version 12.0 do you need to do anything. Please read the following Bug-Fix PDF first, which will explain the changes that need to be made. If you are starting from scratch, without an existing database, copy the Database version 12.0a file, if you need to update version 12.0 to version 12.0a, then download the version 12.0 to 12.0a Update file:

Bug-Fix
Database version 12.0a
Database version 12.0 to 12.0a Update

It is unlikely that there are many centres using version 12.0a; if I can offer any help, please let me know.

Peter Ludman
BCIS Audit Secretary

If planning to use version 12.0, then download:

PCI database version 12.0
Release notes for version12.0 (short list of upgraded features)
Release notes for dB version 11.0 (detailed explanation of dB functioning for 11 and 12)
Mousehook for dB (for version 11.0 and 12.0 – see release notes for v11 for explanation)

The following files are available to View/Download:

Database Version 12.0:
Database version 12.0
Release Notes for dB version 12.0

Database Version 11.0:
Database version 11.0
Release Notes for dB version 11.0
Mousehook for dB version 11.0 (see Release Notes for explanation)

To Update from PCI database version 10.0 to version 11.0:
Carcass of database version 11.0

Datasets:
Explanatory Text (Dataset Evolution History)
Previous (February 2003) BCIS Dataset v5.1.2
Previous (October 2004) BCIS Dataset v5.1. 3
Previous Dataset (March 2005) BCIS Dataset v5.2.3 (Corrected)
Previous Dataset (June 2008) v. 5.4.3
Current Dataset 5.4.4.

I cannot provide sites with formal support for the BCIS dB, but I will help in any way I can.