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Version 2.41 Training Manual GENERAL THORACIC SURGERY DATABASE TRAINING MANUAL VERSION 2.41 General Thoracic Surgery Database V2.41 Training Manual November 15, 2018 Table of Contents Case Examples ............................................................................................................................................................3 Definitions ..................................................................................................................................................................4 Demographics .............................................................................................................................................................4 Admission ................................................................................................................................................................ 13 Pre-Operative Evaluation ........................................................................................................................................ 19 Diagnosis (Category of Disease) .............................................................................................................................. 54 Operative ................................................................................................................................................................. 76 Lung Cancer ............................................................................................................................................................ 113 Esophageal Cancer .................................................................................................................................................. 135 Thymus/Mediastinal Mass Resection ....................................................................................................................... 148 Tracheal Resection .................................................................................................................................................. 160 Hiatal Hernia / GERD ............................................................................................................................................... 173 Disposition .............................................................................................................................................................. 194 Post – Operative Events .......................................................................................................................................... 196 Discharge ................................................................................................................................................................ 228 Follow Up................................................................................................................................................................ 234 Quality Measures .................................................................................................................................................... 235 Resources .............................................................................................................................................................. 239 2 | P a g e General Thoracic Surgery Database V2.41 Training Manual November 15, 2018 Case Examples Case #1: Patient has nodule on CT and is also worked up with a PET. Surgeon thinks it could be cancer so lung resection is completed and path comes back as lung cancer. Enter as lung cancer case and record clinical and path staging. Case #2: Same as above but path comes back as hamartoma. This would be a diagnostic wedge and is not captured in the database. Enter as lung cancer case, but select “No cancer found, benign tumor” for seq# 1910. Clinical staging gets recorded but no path staging. Case #3 Patient worked up for presumed lung cancer. Taken to OR for wedge followed by lobectomy if frozen section shows cancer. Frozen section comes back as granuloma. Surgery ends there. This would be a diagnostic wedge and is not captured in the database. Enter as suspected lung cancer, select “No cancer found, benign tumor” for Seq. 1910. Clinical staging gets recorded. Case #4 Patient presents to hospital with pneumonia. CT shows necrotic fluid suspicious for lung abscess in LLL. Patient taken to OR to drain effusion, wedge resection of abscess is done and then completion lobectomy because the lung was not salvageable. Never suspected cancer. Does not fall into any of the other analyzable categories (Thymus, GERD/Hernia, Tracheal resection, etc.). Do not need to enter case. If collected case will not be analyzed. Case #5 Patient presents with primary pneumothorax. Patient taken to OR for excision of bullae. Do not need to enter case. If collected case will not be analyzed. Case #6 Patient with history of breast cancer and previous met to lung, removed via wedge. Presenting with new nodule and surgeon assumes it’s another met. Taken to OR for therapeutic wedge resection, but final path comes back as early stage primary lung cancer. This was not a resection for “known or presumed lung cancer”. This case should be entered as a lung cancer case. This scenario is not uncommon. In this situation it is worth discussing with the surgeon. If the surgeon never suspected lung cancer then it would not be entered. However, if the surgeon documented possible primary lung cancer or benign etiology this case would be coded. Case #7 Patient presents with empyema and undergoes decortication. Do not need to enter case 3 | P a g e General Thoracic Surgery Database V2.41 Training Manual November 15, 2018 Definitions “No” versus “Unknown” (using Pulmonary HTN as an example) “No” should be indicated if there is documentation that the patient does not have Pulmonary Hypertension. “Unknown” should be indicated if it is not known if the patient has Pulmonary Hypertension or if testing has not been performed. Demographics SeqNo: 10 Long Name: Operations Table Record Identifier Short Name: RecordID Definition: An arbitrary, unique value generated by the software that permanently identifies each record in the participant's database (note that unlike the PatID value, this does not identify the individual patient). The value of the identifier is a combination of a code assigned to the software developer by the STS, and a value generated by the software to create a unique value. Once assigned to a record, this value can never be changed or reused. The data warehouse will use this value to communicate issues about individual records with the participant. It may also be used by the data warehouse to link this record to other clinical data. Intent/Clarification: A record should be initiated for inpatient and outpatient thoracic procedures on every visit to the operating room (includes Endoscopy Suite or Outpatient Surgical Center) whether planned or unplanned. SeqNo: 20 Long Name: Procedures Table Record Identifier Short Name: RecordID Definition: This field is the foreign key that links this record with the associated records in the "Operations" table. SeqNo: 30 Long Name: Software Vendor's Identification Short Name: VendorID Definition: Software vendor's identification assigned by the STS. SeqNo: 40 Long Name: Vendor's Software Version Number Short Name: SoftVrsn Definition: Vendor's software product version number identifying the software which created this record. Vendor controls the value in this field. Version passing certification/harvest testing will be noted at the data warehouse. 4 | P a g e General Thoracic Surgery Database V2.41 Training Manual November 15, 2018 SeqNo: 50 Long Name: Version Of STS Data Specification Short Name: DataVrsn Definition: Version number of the STS Data Specifications/Dictionary, to which the record conforms. The value will identify which fields should have data, and what are the valid data values for those fields. It must be the version implemented in the software at the time the record was created. The value must be entered into the record automatically by the software. SeqNo: 60 Long Name: Participant ID Short Name: ParticID Definition: Participant ID is a unique number assigned to each database Participant by the STS. A database Participant is defined as one entity that signs a Participation Agreement with the STS, submits one data file to the harvest, and gets back one report on their data. The ParticipantID must be entered into each record. Intent/Clarification: Each participant’s data, if submitted to the data warehouse, must be in one data file. If one participant keeps data in more than one file (e.g. at two sites), the participant must combine them back into one file for data submission. If two or more participants share single purchased software and enter cases into one database, the data must be extracted into two different files, one for each participant ID, with each record having the correct participant ID number. SeqNo: 70 Long Name: Demographics Table Data Version Short Name: DemogDataVrsn Definition: Version number of the STS Data Specifications/Dictionary, to which the Demographics record conforms. The value will identify which fields should have data, and what are the valid data for those fields. It must be the version implemented in the software at the time the record was created. The value must be entered into the record automatically by the software. Note that the data version of the demographics record does not necessarily need to match the data version of all of the associated operation records for that patient. This is because new data
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