Research Methdology in Cardiovascular Surgery
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Transcript of Research Methdology in Cardiovascular Surgery
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Clinical Research and Paper in CVS
Robert Chen
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Outlines
•Data Source(s)
•Journals and Paper Submission
•Examples of Submitted Papers
•Topics Welcome
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Motivation
•How well are we doing? Benchmark.
•How is the operation risk from experience?
•Papers
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Database Example
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Data Variables(Computer)
•Text
•Number
•Date
•Administrative data
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Data Variables(Epidemiology)
•X1, X2, ..., Xn -> Y
•Predictor: Xi
•Outcome: Y
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Data Variables(Statistics)
•Scale: Continuous. eg. body weight
•Ordinal: Grading. eg. severity
•Nominal: Category. eg. location
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Data Variables(Surgery)
•Demographics
•Baseline
•Preop
•Op
•Postop
•Outcome
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Variable Content
•Yes / No
•Timing
•Category
•Measurement
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Paperwork
•Question
•Grant (optional, if big research)
•Data collection
•Analysis
•Paper writing
•Submission and revision
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Data Source
•FEMH CVS Database
•National Health Insurance Database
•FEMH Hospital Database
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CVS Database•Basic data
•Risk factors
•Preop Intervention
•Symptoms/Signs
•Preop Cardiac Condition
•Hemodynamics
•Preop Meds
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CVS Database
•Mechanical Circulatory Support
•Preop Assessment
•CPB (perfusionist)
•Operation Intro (OR)
•Op CABG
•Op Valve
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CVS Database
•Op MICS
•Op Others Cardiac
•Op Others Non-cardiac
•Postop Conditions
•Complications
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CVS Database
•Death
•Discharge
•Re-admission
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Process
•13 F, Database specialist 林孟葦
•Time range
•Diagnosis or procedures
•Variables (from questions)
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Process
•Excel data spreadsheet
•Statistics analysis
•Paper writing and submission
•Revision
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http://w3.nhri.org.tw/nhird
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ICD-9 Codes and Diagnoses DM=250.* COPD=490-492.* or 496 PAOD=443.*-444.* CVA 434.91 or 434.11 or 997.02 Acute renal failure=584.* Chronic renal failure=586.*-588.* Critical=785.51 or “shock” or “IABP” or “ECMO” UA=413.* or “angina” LV dysfunction = 428.* or “critical” or “CHF” or “ICMP”
AMI=410.* or “AMI” or “infarction” PHT=416.* or “pulmonary hypertension” IE=424.*
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Nat’l Health Insurance CodeOperations Postop Course
CABG*1= 68023 CABG+LIMA=
68023X1/2 CABG*2=68024 CABG*3=68025
MVA/TVA=68015 AVR/MVR/TVR=68016 DVR=68017 AVR+MVR+TVR=6801
8 Redo=68003
Ventilator=57001 IABP=33079 HD=58001 CVVH=58014
“Text data-mining”
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Hospital Information
System (HIS)•Help from IT
•Variable definitions
•SQL (Structured Query Language)
•SELECT [X1], [X2] FROM [DB] WHERE [X3] ? [X4]
•Xi? DB?
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Data Collection from HIS
•Diagnosis: ICD9
•Operation: NHI
•Procedures: NHI
•IABP, MV, HD,...
•Drugs: ?
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Data Analysis: Statistics
•Descriptive (敘述性 ): Tables, Graphs
•Inferential (推論性 ): p-values
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Inferential Statistics
•Different or not?
•Related or not?
•Predictor or not?
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Different?
•Groups
•Variables to compare
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Related?
•Correlation
•Variable-1
•Variable-2
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Predictors?
•Predictor variables X1, X2,...Xn
•Outcome variable Y
•Scale
•Event (Y/N)
•Time-event
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Journals•JCR 2011 Ranking
•Impact Factors
•Different journals, different rules
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EndNote X5
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Submitted•Pigtail delivery of cardioplegia for minimally
invasive mitral valve surgery
•Parasternal minimally invasive cardiac surgery
•Comparative Study of Serum Amyloid A and C-Reactive Protein in Patients undergoing Off-pump Coronary Artery Bypass Surgery
•Comparing the endothelial integrity of the saphenous vein grafts harvested by the endoscopic and open techniques
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Potential Topics•MICS vs. conventional for outcomes
and complications
•Limiting factors of MICS
•NHID valve mechanical vs. bio for outcomes and complications
•Aortic bifurcation angle and cross-over tech success rate
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Welcome Ideas•Interesting topics
•Questions
•Then we can go on to papers
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DEMO
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