The quality of cholecystectomy in Denmark has improved over 6-year period.

PURPOSE: The Danish Cholecystectomy Database (DCD) was a nationwide quality database that existed from 2006 to 2011. The main goal (indicators) for the database was to increase the quality of cholecystectomy in Denmark by (1) reducing the number of primary open cholecystectomies, (2) increasing the proportion of outpatient surgery, (3) reducing the number of postoperative readmissions, and (4) reducing the number of bile duct injuries and other postoperative complications. The purpose of this study was to evaluate whether the DCD met these goals. METHODS: Data from the DCD were used to identify all patients treated with cholecystectomy in the period from 2006 to 2011. The indicators were analyzed over time as a measure of quality of cholecystectomy and analyzed using chi-square statistics. RESULTS: A total of 37,317 patients were included in the study. The registration rate in the DCD was around 90 %, except in 2011 where it was 70.7 %. The proportion of open cholecystectomies decreased from 2.6 % in 2006 to 0.9 % in 2011 (p < 0.0005). Likewise, in 2011, 80 % of patients undergoing cholecystectomy were discharged within 24 h, an increase compared to 2006 (p < 0.0005). The proportion of readmissions remained steady in the area of 10 % (p = 0.6). Bile duct injuries were low (0.3 %) and unchanged during the study period. CONCLUSION: During the observed 6-year period, a significant increase of laparoscopic procedures was observed with more operations being performed as outpatient procedures. The proportion of readmissions and complications did not increase during this time period.

Cumulative incidence and registry validation of groin hernia repair in a 34-year nationwide cohort.

INTRODUCTION: The purpose of this study was to present a nationwide cumulative incidence and an age-specific incidence rate of groin hernia repair as well as to evaluate the validity of inguinal and femoral hernia operation codes in the Danish National Patient Registry (DNPR). METHODS: All persons born in Denmark from 1977 to 2010 were investigated for groin hernia operations registered in the DNPR with respect to date of admission, operation, discharge and specific operation codes. To validate the predictive values of registrations, we randomly extracted data on elective and emergency groin hernia operations from the DNPR from 2005 to 2010 and examined the medical records. RESULTS: The study population (n = 2,109,417) from 1977 to 2010 was followed from the primary groin hernia operation (n = 53,262) to 2010, yielding a total of 33.4 million person-years of follow-up. The probability of being operated for a groin hernia prior to the age of 34 years was 5.70% (95% confidence interval (CI): 5.62-5.78) for males and 1.26% (95% CI: 1.20-1.32) for females. The highest incidence rate was seen among males aged 0-1 years (10.19 (95% CI: 10.00-10.38)). The positive predictive value of patients registered with inguinal hernia operations in the DNPR who had been operated for an inguinal hernia was 100% (95% CI: 96-100%) and 91.3% (95% CI: 83-96%) for femoral hernia operations. CONCLUSIONS: The incidence rate of groin hernia operations peaked at the 0-1 year age group in males and at the 3-4-year age group in females. Furthermore, the validation of the DNPR showed very high positive predictive values for both inguinal hernia operations and femoral hernia operations. FUNDING: none. TRIAL REGISTRATION: not relevant.

For 481 biomedical open access journals, articles are not searchable in the Directory of Open Access Journals nor in conventional biomedical databases.

Background. Open access (OA) journals allows access to research papers free of charge to the reader. Traditionally, biomedical researchers use databases like MEDLINE and EMBASE to discover new advances. However, biomedical OA journals might not fulfill such databases' criteria, hindering dissemination. The Directory of Open Access Journals (DOAJ) is a database exclusively listing OA journals. The aim of this study was to investigate DOAJ's coverage of biomedical OA journals compared with the conventional biomedical databases. Methods. Information on all journals listed in four conventional biomedical databases (MEDLINE, PubMed Central, EMBASE and SCOPUS) and DOAJ were gathered. Journals were included if they were (1) actively publishing, (2) full OA, (3) prospectively indexed in one or more database, and (4) of biomedical subject. Impact factor and journal language were also collected. DOAJ was compared with conventional databases regarding the proportion of journals covered, along with their impact factor and publishing language. The proportion of journals with articles indexed by DOAJ was determined. Results. In total, 3,236 biomedical OA journals were included in the study. Of the included journals, 86.7% were listed in DOAJ. Combined, the conventional biomedical databases listed 75.0% of the journals; 18.7% in MEDLINE; 36.5% in PubMed Central; 51.5% in SCOPUS and 50.6% in EMBASE. Of the journals in DOAJ, 88.7% published in English and 20.6% had received impact factor for 2012 compared with 93.5% and 26.0%, respectively, for journals in the conventional biomedical databases. A subset of 51.1% and 48.5% of the journals in DOAJ had articles indexed from 2012 and 2013, respectively. Of journals exclusively listed in DOAJ, one journal had received an impact factor for 2012, and 59.6% of the journals had no content from 2013 indexed in DOAJ. Conclusions. DOAJ is the most complete registry of biomedical OA journals compared with five conventional biomedical databases. However, DOAJ only indexes articles for half of the biomedical journals listed, making it an incomplete source for biomedical research papers in general.

[Diagnostic imaging and acute abdominal pain]. / Billeddannende undersøgelser ved akut opståedemavesmerter

Acute abdominal pain is a common clinical condition. Clinical signs and symptoms can be difficult to interpret, and diagnostic imaging may help to identify intra-abdominal disease. Conventional X-ray, ultrasound (US) and computed tomography (CT) of the abdomen vary in usability between common surgical causes of acute abdominal pain. Overall, conventional X-ray cannot confidently diagnose or rule out disease. US and CT are equally trustworthy for most diseases. US with subsequent CT may enhance diagnostic precision. Magnetic resonance seems promising for future use in acute abdominal imaging.