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National Minimum Data Set for Thoracic Surgery and Lung Cancer Surgery
Revised by Tom Treasure 9th April 04
Based on provisionally agreed set following Thoracic Surgical Forum presentation 2003
Pilot run at Guy’s in a Dendrite environment.
Presented to SCTS 2004 with a mandate to continue the project.
Please e-mail questions to
Richard Page, Thoracic Surgery, Liverpool
The Ground Rules and Guiding Principles
The data can be collected
• within a Dendrite environment
• or on Tomcat
• or by any suitable local arrangement
• or onto an Excel spread sheet (as supplied herewith)
• or configured as an Access database locally.
A hospital IT system should enable users to capture case numbers and dates of birth,
admission, procedure and discharge without double entry.
There will be great advantages in using a user-friendly front end such as Dendrite because
the straight listing in the spread sheet is potentially confusing. However any practiced data
handler will find the spread sheet approach easy to deal with once the fields are understood.
The data will have to be returned in a common format.
The “unit of entry” is an operative episode but this may include more than one procedure.
Thus if the patient has any combination of
• bronchoscopy/mediastinoscopy/lung resection
the individual procedures are recorded and can be retrieved but are within the operative
There are two levels of detail
• What we will call “core data” is collected on all cases.
• More detailed information is collected on lung cancer cases. In due course more
detail may be collected on any subsets of interest and these may be chosen locally
Entries will be “1” for the item if applicable. There is no need for “0” or “N”.
If there is date required enter DDMMYYYY.
Core Data (collected on all cases) line 1-76 and 124-132
1. Centre identification. Enter as text or as pre-defined code. This should be an
automatic part of a local system.
2. NHS number. Enter as 10 digit number with no spaces or import from hospital PAS.
This will enable tracking to death certification. Clearly capture from PAS as can be
done with Dendrite or tomcat is the best way.
3. Hospital number. Until we all use NHS numbers this will be needed to track back to
you cases for data verification etc. Enter in local format or import from Hospital PAS.
Clearly this is the best way.
4. Post code This has two purposes. One is that you know where your cases come
from. The other is that any secondary use for research will allow us to link to
5. Date of Birth. Enter as DDMMYYYY (subject to advice) or import from Hospital PAS.
Used to calculate age in years at surgery by subtracting from Date of Operation.
6. Sex. M or F
7. Date of Operation Date on which primary procedure takes place – enter as
DDMMYYYY. This register is built around a surgical procedure.
8. Date of surgical referral - DDMMYYYY
9. Date of first surgical assessment
10. This field no longer required (Consultant’s GMC number)
11. This field no longer required (Operator GMC number)
Select a single choice from
12. Elective – standard booked admission for surgery.
13. Urgent – decision to operate on next available list
14. Emergency – operation arranged outside scheduled list
Reasons for the operation taking place
There may be more than one
15. Diagnostic - to diagnose the condition
16. Staging or assessment – to stage a neoplasm or to assess the progress of the
17. Therapeutic – to cure, alleviate or palliate
More than one is allowed, for example:
• Mediastinoscopy – maybe diagnostic and staging
• VATS pleural biopsy and pleural biopsy – diagnostic and therapeutic
• Thoracotomy, frozen section and proceed - diagnostic and therapeutic
It is the pathological category (based on what used to be called the “surgical sieve”) of the
aetiology of the condition for which surgery is being performed. They include specific
commonly occurring thoracic diagnoses. This is visited twice. At the time of the surgical
procedure and revisited at discharge when it is revised. Multiple answers are allowed. The
box on the spread sheet gives a brief explanation of what is required.
Enter “1” if applicable
20. Primary cancer lung (known or probable)
21. Oesophageal cancer
23. Other primary thoracic malignancy
24. Malignant disease other (secondary, recurrent or metastatic)
26. Benign neoplasms
27. Empyema (include all aetiologies of pleural sepsis)
28. Parenchymal lung disease (as the pathology of interest – not comorbidity)
29. Vascular lesion
31. Pleural effusion
32. Other (write in)
Multiple entries are allowed. You may have to deal with an empyema where the initiating
problem was trauma (stabbing for example). Both are worth retrieving to count trauma and to
count empyema so enter both. The data analyst can recognise that the operative episode
Multiple entries are appropriate if performed in the same session. Select the options that best
describe the operation as a whole – if there was more than one procedure, enter each. The
data analyst can see that they are part of a single operative episode. The purpose of the data
collected here is to indicate service volume and workload.
33. Endoscopy (bronchoscopy/oesophagoscopy +/- biopsy)
34. Endoscopy (bronchoscopy/oesophagoscopy + any other procedure)
35. Drain insertion
36. Other minor procedure (of the scale of node biopsies)
37. Mediastinoscopy and/or mediastinotomy
38. Other intermediate procedure (of the scale of rib resection)
41. Median sternotomy
42. Other major incision
Primary organ/System targeted
Select the main target organ(s) of the operation.
This is an anatomical list
More than one may be entered but coincidental surgery, such as chest wall if that is purely
the route of access, will not be helpful in data analysis.
43. Aorta and/or great vessels
44. Chest wall
53. Trachea and/or main bronchi
Select the procedure(s) performed at this operation. Thus pleural biopsy and pleurodesis can
both be entered. This is not a comprehensive list but is derived from the registry list of
operations performed more than about fifty or so times per annum and/or which are well
defined set piece procedures.
55. Lobectomy (any indication)
56. Lobectomy (complex) with chest wall etc or bilobectomy
57. Pneumonectomy (any indication)
58. Sub lobar lung resection wedge or segmentectomy
60. Pneumothorax surgery (any technique)
61. Lung volume reduction and/or bullectomy
62. Pleurodesis for effusion
63. Pleural biopsy (any technique)
65. Oesophageal resection (any)
66. Hiatus hernia surgery (any)
67. Pectus surgery
69. Thymectomy for myasthenia
70. Thymectomy for thymoma
71. Thyroid surgery
74. Chest drain insertion
75. Other (enter)
Lung cancer data set (76-123)
76. Is this operation for Lung cancer (Core)
If the answer is ‘No’ proceed to Discharge section.
If the answer is ‘Yes’ answer specialised questions for lung cancer surgery. Omit where data
is not available. Do not estimate. If data are too incomplete to analyse it’s better that we
Lung Cancer Surgery Data Set –
Pre-Operative Diagnostic Staging of Primary Lung Cancer
80. Tissue diagnosis preop (includes bronchoscopic, FNA, CT needle and cytology as
long as it is regarded as proof of cancer)
Lung Cancer Surgery Data Set – Histological Diagnosis
Update after surgery if it changes. This is not an audit of the preoperative diagnostic
accuracy. The definitive histology is what we need.
81. Small cell
87. Other or further information (write in)
88. T stage
89. N stage
90. M stage
91. Chemotherapy preop
92. Radiotherapy preop
Lung Cancer Surgery Data Set – Pulmonary Risk Factors
93. Measured FEV1
94. %predicted FEV1 (an algorithm can be included to calculated this1)
95. Measured FVC
96. % Predicted FVC
97. Diffusion capacity by DLCO
98. Never smoked
99. Pack years
Lung Cancer Surgery Data Set – Non Pulmonary Risk Factors
100.Height The patient’s height in centimetres – enter as whole number.
101.Weight The patient’s weight in kilograms – enter to one decimal place.
Dendrite and tomcat automate these calculations to produce BMI or body surface area (BSA).
This list is too long. Factors which are not useful in risk stratification will be eliminated in
future editions of the data base
105.Insulin dependent diabetes
106.Ischaemic Heart Disease
110.Anticoagulation with warfarin or equivalent therapy
112.ASA Grade American Society of Anaesthetists grade
Lung Cancer Surgery Data Set – Surgical Resection performed
Lobes removed. This covers pneumonectomy and any bilobectomy
113.Frozen section taken for diagnosis
114.Frozen section for staging
115.Left upper lobe
116.Left lower lobe
117.Right upper lobe
119.Right lower lobe
120.Sublobar resection (whether wedge or segment)
Lung Cancer Surgery Data Set pTNM staging
125.Reintubation or ITU Admission DDMMYYYY
126.Date of Discharge from ITU DDMMYYYY
128.Air leak >7 days
129.Infection requiring longer hospital stay
130.Further surgery within the same admission
131.Date of Discharge/Death (Core)
132.Death y/n (provide cause on death certificate)
1. Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung
volumes and forced ventilatory flows. Report Working Party Standardization of Lung
Function Tests, European Community for Steel and Coal. Official Statement of the
European Respiratory Society. Eur.Respir.J.Suppl 1993;16:5-40.