CARDIOVASCULAR JOURNAL OF AFRICA • Vol 21, No 3, May/June 2010
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for example be structured to print a patient summary for report
back to a referring colleague, or alternatively create print outs for
a monthly or annual clinical audit.
Security and anonymity
Registered users gain access to their own data by password. Data
can either be stored on their PC, or a server can be accessed via
an internet connection. Data are stored in an encrypted form on a
central server with industry standard backup and firewall protec-
tion. Data protection is an ethical priority in database manage-
ment and a university ethics board (UFS Ethics Committee
ETOV S46/08) has approved the protocols used. Access to any
data other than the users’ ‘own’ for research purposes is subject
to authorisation on application to the working group committee
of the South African Heart Association. Anonymity of doctors
and patients will be protected in any extract of data.
Conclusion
This is a powerful tool for clinical development and advocacy
that has the potential to serve as a repository of a wide range of
patient data, which can be selectively exported for investigation
of specific clinical research problems.
The SND was established in 1989 and has since become the
gold standard of national databases. Participation in the USA had
grown to over 1 500 surgeons in 706 hospitals within five years
of its inception.
6,8
Since then it has undergone many improve-
ments and now includes general thoracic surgery. The South
African National Cardiothoracic Surgery database is based on
the SND because of a need for an already proven database that
could be easily adapted to South African requirements and that
would facilitate a common ground for international communica-
tion regarding the data collected and the definitions applied to
it.
It is hoped that the cardiothoracic surgery community in
South Africa will participate enthusiastically, as the long-term
benefits to South African cardiothoracic surgery and the public
are significant. Surgeons wishing to obtain access to the data-
base can contact Mrs Elizabeth Schaafsma on e-mail elizabeth@
vodamail.co.za.
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