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The dataset group of the UK TAVI Steering group updated the UK TAVI dataset in 2013 from version 3.9 to version 4.
The current dataset (version 4) has been designed to be compatible with the Valve Academic Research Consortium definitions. The new version also includes measures of frailty and hopefully better captures important information that fits with our evolving understanding of this technology and its application.
In the comparison with the old version (3.9) there are three types of fields:
1. Unchanged. Previous ‘CCAD sequence’ number unchanged but a zero has been added to the 3rd decimal place (e.g. 1.01 has become 1.010).
2. Unchanged but for modifications to options. Also keep old CCAD sequence number but with extra decimal place.
3. New fields that have been given a new sequence number and can be identified as having a non zero digit in the 3rd decimal place, e.g. 3.041. Some of these new fields are derivable from previous fields, and some are not.
Many old fields have been deleted and so the overall size of the dataset is more or less unchanged. As before, you will find definitions and explanations to the right of the sheet. Range checks and validation rules for appropriate fields are also included.
There has been an amalgamation of complications so there is no longer a split between events occurring in lab and after lab up to discharge.
The plan is for all units to start to collect this dataset from the 1st January 2013. For those using the web based entry system programmed by CCAD / NICOR, this will be updated at that time. For those using in-house or commercial databases to collect data, we urge you to contact your database programmers as quickly as possible so that your data entry systems can be upgraded in time for the start of data collection with the new dataset.
On behalf of the UK TAVI Dataset Group
Early clinical results for the technique of transcatheter aortic valve implantation (TAVI) have been encouraging and many interventional cardiology centres are keen to set up a TAVI programme. Although there are several registries outlining clinical results, randomised controlled trials have either not been performed or are currently enrolling. Such trials are important in establishing the role of the new technology but in their absence, commissioners of healthcare need guidance to ensure equal access to treatment.
The Department of Health Heart Team, in collaboration with the NHS Improvement Programme and the clinical networks in England, held a consensus meeting on December 16th 2008 in London. This was well attended. The presentations are available on the Improvement Programme Website.
At this meeting a joint statement from the Society for Cardiothoracic Surgery in Great Britain and Ireland (SCTS) and the British Cardiovascular Intervention Society (BCIS) was released (BCIS SCTS position statement).
Since that time the national societies have been working with the national commissioning group and have produced guidance for commissioners. This has now been released to all regional commissioning groups in England (Guidance Document).
The various stakeholders have set up a Research Development Group that will be meeting in April 2009 to determine how research and audit relating to this new technology can be organised in the UK.
Mark de Belder
March 23rd 2009
Transcatheter Aortic Valve Implantation (TAVI) Dataset UPDATE 28/9/2009
The transcatheter implantation of prosthetic aortic valves is expanding extremely rapidly across the UK. This is a technology in the early stages of evolution, and for which there are currently few data on medium and long term outcomes. It is a technology with enormous potential, and there seems little doubt that it will play an important part in the treatment of aortic stenosis in frail patients unsuitable for conventional surgical aortic valve replacement.
NICE guidance published in June 2008 (IPG 266) supports appropriate use of TAVI, and suggests all procedures should be recorded in a national database.
Several members of the British Cardiovascular Intervention Society and the Society of Cardiothoracic Surgeons have been working together to try to produce an agreed dataset for TAVI.
It is intended that all units implanting transcatheter aortic valves will complete this dataset for each procedure, and that these data will all be gathered using the mechanisms in place at Central Cardiac Audit Database (CCAD).
A web based user interface is being designed by CCAD, that will allow direct entry of these data into the CCAD servers. If units wish to use their own database software, then the option to upload a csv file via the Lotus Notes user interface will also be available.
It is possible to apply to use the UK TAVI dataset for research. For details please see the data sharing agreements below.