Correspondence
Anaesthesia 2014, 69, 511–526
other incidents. Their investigations have all shown that the damage to each valve was very similar to the Bath incident, but that the actual cause has still not been identified. F. E. Kelly R. Hardy Royal United Hospital Bath, UK Email: fi[email protected] P. Henrys BOC Ltd Guildford, UK No external funding and no competing interests declared. Previously posted on the Anaesthesia correspondence website: www.anaesthesia correspondence.com.
References 1. Kelly FE, Hardy R, Hall EA, et al. Fire on an intensive care unit caused by an oxygen cylinder. Anaesthesia 2013; 68: 102–4. 2. Tremelling L. Coroner decides terrifying RUH fire contributed to death of OAP. http://www.bathchronicle.co.uk/Coronerdecides-terrifying-RUH-contributed-death/ story-19509150-detail/story.html (accessed 07/03/14). 3. Safe Anaesthesia Liason Group: promoting fire safety on intensive care and in theatre. https://www.rcoa.ac.uk/system/ files/SALG-FIRE-SAFETY_0.pdf (accessed 07/03/2014). doi:10.1111/anae.12698
Anaesthetists and accurate database recording We read with interest the article by White et al. [1] on outcome by mode of anaesthesia for hip fracture surgery and would like to discuss our experience from the recent Anaesthesia Sprint Audit Project (ASAP).
During ASAP, additional consultant anaesthetist-entered data about type of anaesthesia were uploaded to the National Hip Fracture Database (NHFD), in addition to the standard NHFD dataset, entered by an orthopaedic research co-ordinator, within which the type of anaesthesia was also recorded, therefore allowing us to compare data accuracy by both method. During the ASAP period, we uploaded full data for 100% of eligible cases, but found a discrepancy rate between the ASAP and NHFD data for type of anaesthesia involving 4/101 (4%) patients. Two patients were recorded as having had general anaesthesia when they received spinal anaesthesia, one (who died within 30 days postoperatively) was recorded as having had spinal anaesthesia despite having received general anaesthesia, and one was recorded as having had general + spinal anaesthesia when they received general anaesthesia with nerve block. We agree with the authors, therefore, that it is not possible to rule out inaccurate data collection as one of the causes for failure to demonstrate important differences between various anaesthetic techniques. Our experience reiterates the concerns of others [2–4] who have stressed the importance of active involvement of anaesthetists in order to reduce inaccuracies in the data collection and entry process. However, data collection and entry for just the three months of the ASAP collection period involved a considerable amount of consultant anaesthetic time, such as is probably unfeasible in the longer term.
© 2014 The Association of Anaesthetists of Great Britain and Ireland
The aim of ASAP is to strengthen the evidence base for hip fracture anaesthesia, but the conclusions and future recommendations will rely heavily upon the accuracy of the data entered. D. B. Jumani Warrington & Halton Hospitals NHS Foundation Trust Warrington, UK Email: [email protected] S. H. McClelland Aintree University Hospital NHS Trust Liverpool, UK No external funding and no competing interests declared. Previously posted on the Anaesthesia correspondence website: www.anaesthesia correspondence.com.
References 1. White SM, Moppett K, Griffiths R. Outcome by mode of anaesthesia for hip fracture surgery. An observational audit of 65 535 patients in a national dataset. Anaesthesia 2014; 69: 224–30. 2. Howes BW, Clarke PA, Cook TM. The National Joint Registry may fail to collect accurate, validated anaesthetic data. Anaesthesia 2009; 64: 694–5. 3. Cook T. Anaesthetists engagement in National Joint Registry data collection. Anaesthesia 2014; 69: 180. 4. Sessler DI. Big Data – and its contributions to peri-operative medicine. Anaesthesia 2014; 69: 100–5. doi:10.1111/anae.12673
Big Data – of the people, for the people, by the people We share Dr Sessler’s enthusiasm for Big Data [1], and welcome such
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Anaesthesia 2014, 69, 511–526
other incidents. Their investigations have all shown that the damage to each valve was very similar to the Bath incident, but that the actual cause has still not been identified. F. E. Kelly R. Hardy Royal United Hospital Bath, UK Email: fi[email protected] P. Henrys BOC Ltd Guildford, UK No external funding and no competing interests declared. Previously posted on the Anaesthesia correspondence website: www.anaesthesia correspondence.com.
References 1. Kelly FE, Hardy R, Hall EA, et al. Fire on an intensive care unit caused by an oxygen cylinder. Anaesthesia 2013; 68: 102–4. 2. Tremelling L. Coroner decides terrifying RUH fire contributed to death of OAP. http://www.bathchronicle.co.uk/Coronerdecides-terrifying-RUH-contributed-death/ story-19509150-detail/story.html (accessed 07/03/14). 3. Safe Anaesthesia Liason Group: promoting fire safety on intensive care and in theatre. https://www.rcoa.ac.uk/system/ files/SALG-FIRE-SAFETY_0.pdf (accessed 07/03/2014). doi:10.1111/anae.12698
Anaesthetists and accurate database recording We read with interest the article by White et al. [1] on outcome by mode of anaesthesia for hip fracture surgery and would like to discuss our experience from the recent Anaesthesia Sprint Audit Project (ASAP).
During ASAP, additional consultant anaesthetist-entered data about type of anaesthesia were uploaded to the National Hip Fracture Database (NHFD), in addition to the standard NHFD dataset, entered by an orthopaedic research co-ordinator, within which the type of anaesthesia was also recorded, therefore allowing us to compare data accuracy by both method. During the ASAP period, we uploaded full data for 100% of eligible cases, but found a discrepancy rate between the ASAP and NHFD data for type of anaesthesia involving 4/101 (4%) patients. Two patients were recorded as having had general anaesthesia when they received spinal anaesthesia, one (who died within 30 days postoperatively) was recorded as having had spinal anaesthesia despite having received general anaesthesia, and one was recorded as having had general + spinal anaesthesia when they received general anaesthesia with nerve block. We agree with the authors, therefore, that it is not possible to rule out inaccurate data collection as one of the causes for failure to demonstrate important differences between various anaesthetic techniques. Our experience reiterates the concerns of others [2–4] who have stressed the importance of active involvement of anaesthetists in order to reduce inaccuracies in the data collection and entry process. However, data collection and entry for just the three months of the ASAP collection period involved a considerable amount of consultant anaesthetic time, such as is probably unfeasible in the longer term.
© 2014 The Association of Anaesthetists of Great Britain and Ireland
The aim of ASAP is to strengthen the evidence base for hip fracture anaesthesia, but the conclusions and future recommendations will rely heavily upon the accuracy of the data entered. D. B. Jumani Warrington & Halton Hospitals NHS Foundation Trust Warrington, UK Email: [email protected] S. H. McClelland Aintree University Hospital NHS Trust Liverpool, UK No external funding and no competing interests declared. Previously posted on the Anaesthesia correspondence website: www.anaesthesia correspondence.com.
References 1. White SM, Moppett K, Griffiths R. Outcome by mode of anaesthesia for hip fracture surgery. An observational audit of 65 535 patients in a national dataset. Anaesthesia 2014; 69: 224–30. 2. Howes BW, Clarke PA, Cook TM. The National Joint Registry may fail to collect accurate, validated anaesthetic data. Anaesthesia 2009; 64: 694–5. 3. Cook T. Anaesthetists engagement in National Joint Registry data collection. Anaesthesia 2014; 69: 180. 4. Sessler DI. Big Data – and its contributions to peri-operative medicine. Anaesthesia 2014; 69: 100–5. doi:10.1111/anae.12673
Big Data – of the people, for the people, by the people We share Dr Sessler’s enthusiasm for Big Data [1], and welcome such
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