Ten Years of Data Verification: The Society of Thoracic Surgeons Congenital Heart Surgery Database Audits.

BACKGROUND: The completeness and accuracy of data contained within clinical databases and registries is critical to the reliability of reports emanating from these platforms. Therefore, vigorous data verification processes are a core competency of any mature database or registry. The Society of Thoracic Surgeons Congenital Heart Surgery Database (STS CHSD) has conducted audits of participant data for just over ten years. This report documents the validity of data elements within the STS CHSD. METHODS: We review the various elements of a robust audit process, detail the STS CHSD audit methodology, and report completeness and agreement rates for all adjudicated fields in the most recently completed audit. RESULTS: The rate of completeness for general data elements was 97.6% and the rate of agreement was 97.4%. The rate of completeness for variables in the mortality review was 100% and the rate of agreement was 99.3%. CONCLUSIONS: The STS CHSD audit is a highly structured and reproducible process. The most recently completed audit documents a very high level of completeness and accuracy of data variables, particularly those most germane to outcomes measurement.

Regional chest wall motion dysfunction in patients with pectus excavatum demonstrated via optoelectronic plethysmography.

BACKGROUND: Paradoxical chest wall motion is recognized clinically in pectus excavatum (PE). We report chest wall volume and motion differences between PE patients and unaffected individuals. METHODS: A prospective, institutional review board-approved study compared nonoperated PE patients with normal controls (C). Subjects had deep breathing maneuvers captured by infrared cameras. Chest wall volume and excursion were calculated using optoelectronic plethysmography marker reconstruction combined with proprietary software (BTS Bioengineering, Milan, Italy). RESULTS: One hundred nineteen patients underwent optoelectronic plethysmography analysis (PE: 64, C: 5). Total chest wall volume at rest was similar in both groups (PE: 13.6 L, C: 14.1 L, P = .55). During maximal inspiration, PE patients had a significant increase in the volume within the abdominal rib cage compartment (PE: 0.77 L, C: 0.6 L, P < .01). Patients with PE had 51% less midline marker excursion at the angle of Louis (P < .01), a 46% decrease at the level of the nipples (P < .01), and 28% less excursion at the xiphoid process (P = .02). At the level of the umbilicus, PE patients had 147% increase in midline marker excursion compared with controls (P < .01). CONCLUSIONS: Optoelectronic plethysmography kinematic analysis allows for quantification of focal chest wall motion dysfunction. Patients with PE demonstrate significantly decreased chest wall motion at the area of the pectus defect and increased abdominal contributions to respiration compared with controls. This finding may help to explain exertional symptoms of easy fatigability or shortness of breath in PE.