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| Australian and New Zealand Cardiac and Thoracic Surgery Database | |
|---|---|
| Name | Australian and New Zealand Cardiac and Thoracic Surgery Database |
| Type | Clinical registry |
| Headquarters | Sydney, Sydney |
| Region served | Australia, New Zealand |
Australian and New Zealand Cardiac and Thoracic Surgery Database is a clinical registry that aggregates perioperative and outcome data for cardiac and thoracic surgical procedures across hospitals in Australia and New Zealand. The registry supports benchmarking, quality improvement, and research by capturing standardized datasets from participating centres, collaborating with professional bodies and health services. It interfaces with national health agencies, academic institutions, and specialty colleges to inform practice and policy.
The registry originated from initiatives by the Cardiac Society of Australia and New Zealand, Royal Australasian College of Surgeons, and leading academic units such as the University of Sydney and the University of Auckland to create a regional database comparable to registries like the Society of Thoracic Surgeons and the National Surgical Quality Improvement Program. Early pilots involved tertiary hospitals in Melbourne, Auckland, and Wellington, with methodology adapted from international models including the European Society of Cardiology registries and the American College of Cardiology. Over time the database expanded through agreements with state health departments in New South Wales, Victoria, and Queensland and major centres including Royal Prince Alfred Hospital and Auckland City Hospital.
The registry covers adult and paediatric cardiac procedures such as coronary artery bypass grafting, valve repair and replacement, and congenital cardiac surgery, as well as thoracic operations including lung resection and pleural disease management. Objectives include risk-adjusted outcome measurement, surgical audit for institutions like Canberra Hospital and Christchurch Hospital, support for guideline development by bodies such as Thoracic Society of Australia and New Zealand, and provision of data for clinical trials at centres like John Hunter Hospital and Royal Hobart Hospital.
Data elements include preoperative risk factors, intraoperative details, and postoperative outcomes captured through electronic systems deployed at hospitals and integrated with health information platforms used by Australasian College of Surgeons members. Coding aligns with standards from the World Health Organization and uses classification schemes comparable to those developed by the International Consortium for Health Outcomes Measurement and the Australian Institute of Health and Welfare. Participating sites submit de-identified data from local databases at institutions including St Vincent's Hospital and Middlemore Hospital to a central repository hosted by academic partners such as the Monash University clinical informatics group.
Governance structures involve a steering committee with representatives from the Cardiac Society of Australia and New Zealand, the Royal Australasian College of Surgeons, patient advocacy groups, and university academics from the University of Queensland and University of Otago. Ethical oversight follows frameworks set by national human research ethics committees similar to those at University of Melbourne and regional institutional review boards at hospitals like Royal Adelaide Hospital. Data sharing agreements reflect privacy laws in Australia and New Zealand and principles endorsed by organisations such as the National Health and Medical Research Council and the Health Research Council (New Zealand).
Clinicians and researchers from centres including Flinders Medical Centre, Fiona Stanley Hospital, and Christchurch Hospital use registry outputs for risk prediction models, comparative effectiveness studies, and quality improvement programs. The database has supported multicentre analyses analogous to studies by the New England Journal of Medicine and collaborative projects with academic partners like University of Western Australia and Auckland Bioengineering Institute. Outputs inform training curricula of the Royal Australasian College of Surgeons and guideline updates by specialist societies such as the Cardiac Society of Australia and New Zealand.
The registry has enabled risk-adjusted benchmarking that influenced clinical pathways at leading centres including Austin Hospital and Middlemore Hospital, contributed to reduced complication rates reported in institutional audits, and supported policy recommendations to health authorities in Canberra and Wellington. Published analyses from registry data have appeared in journals comparable to those of the Lancet and have been presented at meetings of the European Association for Cardio-Thoracic Surgery and the American Association for Thoracic Surgery.
Challenges include variable data completeness across hospitals such as smaller regional centres in Tasmania and the South Island, interoperability issues with diverse electronic health record vendors used by institutions like Darlinghurst Hospital and funding constraints similar to those faced by other registries. Risk adjustment for complex procedures remains limited by sample size for rare conditions treated at specialist centres including Royal Children's Hospital (Melbourne) and by lag times in data submission from busy units.
Category:Medical registries in Australia Category:Medical registries in New Zealand