Current Dataset (5.4.4.)

Version History

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

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

This PCI Database is designed to capture details about percutaneous coronary interventional procedures. Procedure reports and GP letters can be created, the data can be analysed within the database, or exported for analysis. This database collects data that includes version 5.2.3 of the dataset agreed by the British Cardiovascular Intervention Society (BCIS) / Central Cardiac Audit Database (CCAD). It can create the comma separated values (CSV) file required to upload data to the Lotus Notes application for CCAD. Thus the data can be sent encrypted to CCAD in exactly the same way (and using the same gateway) as is done with the Myocardial Infarction National Audit Project (MINAP). I have written the database in Access 2000 / XP (an access 97 version is no longer available).
The latest PCI database version is 12.0 (September 2006). It is also not locked so the code can be explored and modified if necessary (see section – getting inside the database). It should be quite straightforward to get your IT department to set up a link from this database to your local hospital patient administration system, so that patient demographics, NHS numbers etc. do not have to be entered manually. A link to the results server is also very helpful (cholesterols, CK, renal function). In my centre the database is on our main server (and hence automatically backed up each night), and anyone with appropriate permissions (set by the network administrators) can have either read or read write access. Access is designed so that it copes with a number of users simultaneously interacting with the database, so for example it can be running in several cath labs and offices at the same time.
The database is designed so that most of the data is entered during and at the end of a PCI procedure, and a final set of data entered after patient discharge. There is also the option to add later follow up data if required. The data can be analysed using the queries I have written, and in addition the full dataset (excluding sub-tables) can be exported to Microsoft Excel to be analysed elsewhere. In addition if the data if uploaded to the Note Lotus CCAD application, all the Lotus analysis tools are also available. The database is designed to fit on flat screens running at 1024 x 768 resolution without needing scroll bars.
There are several improvements to the database in version 12.0, including the incorporation of risk stratified models. These are detailed in the release notes for version 12.0 below. At present I have not had time to allow create a way for users of Version 11.0 to upgrade to 12.0. I suggest that if you are starting from scratch, use version 12.0, but if you are already using 11.0, then please continue with it for the time being.

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 Dataset5.4.4.

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