Dataset Information

Building a Longitudinal National Integrated Cardiovascular Database　- Lessons Learnt From SingCLOUD.

ABSTRACT: Background: Real world data on clinical outcomes and quality of care for patients with coronary artery disease (CAD) are fragmented. We describe the rationale and design of the Singapore Cardiovascular Longitudinal Outcomes Database (SingCLOUD). Methods and Results: We designed a health data grid to integrate clinical, administrative, laboratory, procedural, prescription and financial data from all public-funded hospitals and primary care clinics, which provide 80% of health care in Singapore. Here, we explain our approach to harmonize real-world data from diverse electronic medical and non-medical platforms to develop a robust and longitudinal dataset. We present pilot data on patients with myocardial infarction (MI) treated with percutaneous coronary intervention (PCI) between 2012 and 2014. The initial data set had 53,395 patients. Of these, 35,203 had CAD confirmed on coronary angiography, of whom 21,521 had PCI. Eventually, limiting to 2012-2014, 3,819 patients had MI with PCI, while 5,989 had MI. Compared with the quality improvement registry, Singapore Cardiac Data Bank, which had 189 fields for analysis, the SingCLOUD platform generated an additional 313 additional data fields, and was able to identify an additional 250 heart failure events, 664 major adverse cardiovascular events at 2 years, and low-density lipoprotein levels to 1 year for 3,747 patients. Conclusions: By integrating multiple incongruent data sources, SINGCLOUD enables in-depth analysis of real-world cardiovascular "big data".

SUBMITTER: Yeo KK

PROVIDER: S-EPMC7929705 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Building a Longitudinal National Integrated Cardiovascular Database　- Lessons Learnt From SingCLOUD.

Yeo Khung Keong KK Ong Hean-Yee HY Chua Terrance T Lim Zheng Jie ZJ Yap Jonathan J Ho Hee Hwa HH Jaufeerally Fazlur F Tong Khim-Leng KL Kojodjojo Pipin P Wong Hwee-Bee HB Heng Derrick D Tan Kelvin Bryan KB Richards Arthur Mark AM Teoh Kristine Leok-Kheng KL Sin Kenny K Tan Ngiap Chuan NC Lee Simon Biing Ming SBM Lim Terence T Ta Andy A Liok Edwin E Lau Yee How YH Gao Fei F Liman Christian C Sarkar Joydeep J Sahlén Anders A Koh Tian Hai TH Chan Mark Y MY

Circulation reports 20191207 1

Background: Real world data on clinical outcomes and quality of care for patients with coronary artery disease (CAD) are fragmented. We describe the rationale and design of the Singapore Cardiovascular Longitudinal Outcomes Database (SingCLOUD). Methods and Results: We designed a health data grid to integrate clinical, administrative, laboratory, procedural, prescription and financial data from all public-funded hospitals and primary care clinics, which provide 80% of ...[more]

PMID: 33693172

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Project description:BackgroundThere are discrepancies between evidence-based guidelines for screening and management of cardiovascular disease (CVD) and implementation in Australian general practice. Quality-improvement (QI) initiatives aim to reduce these gaps. This study evaluated a QI program (QPulse) that focussed on CVD assessment and management.MethodsThis mixed-methods study explored the implementation of guidelines and adoption of a QI program with a CVD risk-reduction intervention in 34 general practices. CVD screening and management were measured pre- and post-intervention. Qualitative analyses examined participants' Plan-Do-Study-Act (PDSA) goals and in-depth interviews with practice stakeholders focussed on barriers and enablers to the program and were analysed thematically using Normalisation Process Theory (NPT).ResultsPre- and post-intervention data were available from 15 practices (n = 19,562 and n = 20,249, respectively) and in-depth interviews from seven practices. At baseline, 45.0% of patients had their BMI measured and 15.6% had their waist circumference recorded in the past 2 years and blood pressure, lipids and smoking status were measured in 72.5, 61.5 and 65.3% of patients, respectively. Most high-risk patients (57.5%) were not prescribed risk-reducing medications. After the intervention there were no changes in the documentation and prevalence of risk factors, attainment of BP and lipid targets or prescription of CVD risk-reducing medications. However, there was variation in performance across practices with some showing isolated improvements, such as recording waist circumference (0.7-32.2% pre-intervention to 18.5-69.8% post-intervention), BMI and smoking assessment. Challenges to the program included: lack of time, need for technical support, a perceived lack of value for quality improvement work, difficulty disseminating knowledge across the practice team, tensions between the team and clinical staff and a part-time workforce.ConclusionThe barriers associated with this QI program was considerable in Australian GP practices. Findings highlighted they were not able to effectively operationalise the intervention due to numerous factors, ranging from lack of internal capacity and leadership to competing demands and insufficient external support.Trial registrationAustralian New Zealand Clinical Trials Reference Number ( ACTRN12615000108516 ), registered 06/02/2015.

Dataset Information

Building a Longitudinal National Integrated Cardiovascular Database　- Lessons Learnt From SingCLOUD.

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Building a Longitudinal National Integrated Cardiovascular Database　- Lessons Learnt From SingCLOUD.

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Building a Longitudinal National Integrated Cardiovascular Database - Lessons Learnt From SingCLOUD.

Publications

Building a Longitudinal National Integrated Cardiovascular Database - Lessons Learnt From SingCLOUD.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

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Building a Longitudinal National Integrated Cardiovascular Database　- Lessons Learnt From SingCLOUD.

Building a Longitudinal National Integrated Cardiovascular Database　- Lessons Learnt From SingCLOUD.