AATS 2019 大数据的表现

与肺癌有关的大会报告，大数据相关研究约占三分之一。

基于大数据的研究影响巨大！

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AATS的数据质量计划（Quality Program）

President David Adams：

●Quality Program that will harness the power of data to improve both surgical performance and patient outcomes.
●Support the new Quality Program, collaborating to realize the true potential and power of data to improve patient outcomes.

The physician asks: ‘How am I doing?’;

The patient asks: ‘What are my chances?’;

and the profession asks: ‘How can we improve?’”

“Given the enormous strides in communication, the internet, and computer technology on the one hand, and data science with machine learning and artificial intelligence on the other, what would a quality assessment program, squarely focused on those three questions, look like if it were developed from the ground up in the 21st century?”

It would be a single, cloud-hosted solution, said Dr. Blackstone, comprised of core quality datasets, which would be right-sized for adult cardiac, general thoracic, and pediatric and congenital heart disease.

“We are proposing a vision of resources and collaborative discussions focused on how we improve. ...We envision multiple sites connecting themselves as a peer group, with no geographical boundaries, to develop and execute quality initiatives to help us improve,” he added.

“For the patient asking ‘What are my chances?’ we will provide risk assessment across all procedures, providing individualized and site-specific prediction of risk for counseling and informed consent,” said Dr. Blackstone.

Former AATS President Pedro del Nido commented, saying: “The ability of surgeons to collaborate and work in developing better solutions for their patients is a critical part of this program. That’s what we have not had the capability to do up until now. We are trying to develop a system where individual surgeons can share their results in a way that doesn’t make them worried that somehow they are going to be judged by individuals who don’t understand their practice. Because otherwise what you are going to do is inhibit innovation, and you are going to make surgeons risk averse. The willingness to innovate has been the hallmark of our profession,” he concluded.

Jeffrey B. Rich, MD, Past-President of the Society of Thoracic Surgeons, as part of a panel of experts assembled to answer questions stated: “This contemporary quality program is unique. It’s not a brick and mortar database with legacy data, it’s a live, dynamic, interactive technology data platform.” He added that the new platform would be able to codify the up to 60% of patients that fall outside of other databases.

基于常见数据库的研究：

National Cancer Database(NCDB)

42. Lobectomy Does Not Confer Survival Advantage Over Segmentectomy in Patients with Clinical Stage I NSCLC Having Unsuspected Pathological N1/N2: Essential Roles of Adjuvant Chemotherapy

Methods: The National Cancer Database (NCDB) was queried for all patients with clinical T1N0, pathological N1/N2 NSCLC who underwent either lobectomy or segmentectomy.

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