From quantity to quality: the central cardiac audit database project

Rickards, Anthony F.; Cunningham, D

doi:10.1136/hrt.82.2008.ii18

Cited by 31 publications

(25 citation statements)

References 8 publications

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“…Details of MINAP and its potential for research have previously been published 13–15. Data for ACS patients are collected prospectively at each acute hospital by a secure electronic system, developed by the Central Cardiac Audit Database (CCAD), electronically encrypted and transferred on-line to a central database 16. CCAD is part of the National Clinical Audit Support Programme,17 which is part of the NHS Information Centre for Health and Social Care 18.…”

Section: Methodsmentioning

confidence: 99%

Impact of missing data on standardised mortality ratios for acute myocardial infarction: evidence from the Myocardial Ischaemia National Audit Project (MINAP) 2004-7

Gale

Cattle

Moore

et al. 2011

Heart

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Section: Methodsmentioning

confidence: 99%

Impact of missing data on standardised mortality ratios for acute myocardial infarction: evidence from the Myocardial Ischaemia National Audit Project (MINAP) 2004-7

Gale

Cattle

Moore

et al. 2011

Heart

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“…The project uses a dataset that allows examination of pre-hospital and in-hospital care of all acute coronary syndromes and is a part of the NHS data dictionary 5. The project is based on the technological platform developed by the Central Cardiac Audit Database Group 6. The primary purpose of the project is to provide hospitals with contemporary online analyses of their individual performance and comparisons with national aggregate data.…”

Section: Methodsmentioning

confidence: 99%

Impact of specialty of admitting physician and type of hospital on care and outcome for myocardial infarction in England and Wales during 2004-5: observational study

Birkhead

Weston

Lowe

2006

BMJ

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Objective To examine process of care and outcome for patients admitted with acute myocardial infarction to hospitals in England and Wales in relation to type of consultant care and type of hospital. Design Observational study of 88 782 patients admitted with myocardial infarction during 2004-5, using records from the national audit of myocardial infarction project (MINAP) database. Outcome measures Use of reperfusion treatment and secondary prevention drugs, use of angiography, and 90 day mortality of patients admitted under the care of cardiologists and non-cardiologists in hospitals with and without facilities for coronary intervention. Findings 36% of patients were admitted under the care of a cardiologist and 20% to a hospital with coronary interventional facilities. Patients admitted under cardiologists had fewer comorbidities than other patients and were more likely to have reperfusion treatment (12 266/14 433 (85%) v 13 682/17 064 (80%)) and appropriate secondary prevention drugs. Overall, 27 431/79 374 (35%) of patients had angiography. Relatively more patients admitted to interventional hospitals (8167/14 661; 56%) than to other hospitals had angiography (19 264/64 713; 30%). The adjusted risk of death by 90 days for patients treated in interventional compared with non-interventional hospitals was 0.93 (95% confidence interval 0.82 to 1.06). The adjusted risk of death at 90 days for patients admitted under cardiologists compared with non-cardiologists was 0.86 (0.81 to 0.91). Conclusions Patients cared for by cardiologists had less comorbidity than other patients. They were more likely to receive proved treatments and angiography, and they had a lower adjusted 90 day mortality. Large differences existed in the use of angiography between interventional and non-interventional hospitals. These findings show wide variations in the management and outcome of patients with myocardial infarction in England and Wales.

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“…MINAP provides a secure electronic data system that uploads encrypted patient information to the central cardiac audit database. 12 The baseline year of 2003 was selected as the first year of complete national coverage of acute care hospitals by MINAP. The returning hospital diagnosed myocardial infarction according to locally agreedon electrocardiographic and biochemical criteria.…”

Section: Patient Groupsmentioning

confidence: 99%

The UK National Health Service

Hawkins

Scholes

Bajekal

et al. 2013

Circ: Cardiovascular Quality and Outcomes

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Background— Social gradients in cardiovascular mortality across the United Kingdom may reflect differences in incidence, disease severity, or treatment. It is unknown whether a universal healthcare system delivers equitable lifesaving medical therapy for coronary heart disease. We therefore examined secular trends in the use of key medical therapies stratified by socioeconomic circumstances across a broad spectrum of coronary disease presentations, including acute coronary syndromes, secondary prevention, and clinical angina. Methods and Results— This was a cross-sectional observational analysis of nationally representative primary and secondary care data from the United Kingdom. Data on treatments for all myocardial infarction patients in 2003 and 2007 were derived from the Myocardial Ischemia National Audit Project (n=51 755). Data on treatments for patients with chronic angina (n=33 211) or requiring secondary prevention (n=32 976) in 1999 and 2007 were extracted from the General Practice Research Database. Socioeconomic circumstances were defined using a weighted composite of 7 area-level deprivation domains. Treatment estimates were age-standardized. Use of all therapies increased in all patient groups, both men and women. Improvements were most marked in primary care, where use of β-blockers, statins, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers for secondary prevention and treatment of angina doubled, from ≈30% to >60%. Small age gradients persisted for some therapies. No consistent socioeconomic gradients or sex differences were observed for myocardial infarction and postrevascularization (hard diagnoses). However, some sex inequality was apparent in the treatment of younger women with angina. Conclusions— Cardiovascular treatment is generally equitable and independent of socioeconomic circumstances. Future strategies should aim to further increase overall treatment levels and to eradicate remaining age and sex inequalities.

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From quantity to quality: the central cardiac audit database project

Cited by 31 publications

References 8 publications

Impact of missing data on standardised mortality ratios for acute myocardial infarction: evidence from the Myocardial Ischaemia National Audit Project (MINAP) 2004-7

Impact of missing data on standardised mortality ratios for acute myocardial infarction: evidence from the Myocardial Ischaemia National Audit Project (MINAP) 2004-7

Impact of specialty of admitting physician and type of hospital on care and outcome for myocardial infarction in England and Wales during 2004-5: observational study

The UK National Health Service

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