Clinical Databases

Clinical Databases In Action

Clinical databases have been in use extensively over the past years in every industrialized country. This utilization of clinical databases continues to increase as of the moment. In addition, enhancements regarding the quality of clinical databases have been present. Enhancements accompanying clinical databases can be attributed to the understanding of the requirements associated with it. These requirements are scientific rigor as well as technology availability that can be used for process automation like checking for validity.

High quality clinical databases have been receiving recognition for their increasing uses. Some of these applications are managing services, clinical audits and evaluative research. Another use for clinical databases is aiding patients with their respective practitioners in making well-informed decisions regarding their clinical management. This application is one of the less-known uses of clinical databases.

An actual example of this application is the utilization of a database on breast cancer in Finland. Finprog makes use of the data on 2,000 women which have follow-ups for about 10 years. Using this study, a new patient can have an individual survival prediction that can be attained by matching her disease profile against other previous breast cancer patients who have known outcomes. In addition, the practitioner and patient can get a survival curve for the available period of follow-up. They would not just have an estimate for one point in time. This system is applicable to any clinical database assuming it has accurate information about the patients' characteristics that would have an effect on the clinical outcome.

Developments such as this can contribute greatly to the encouragement of patient-centered care. It would also make meaningful shared decision happen for patient and practitioner. Necessity for decision support like this is clearly shown through an inquiry regarding pediatric cardiac surgery in Bristol. The staff failed to give the parents the correct prognostic information because it was not available but not withheld.

Finprog study depicts the possible advantages of this approach but this includes three challenges that should be addressed.

Up-to-date Information Practitioners and their patients would need to have information that is current. This information must also echo clinical services in the locality. At this moment, Finprog study users get information about the outcomes of a group of women who were diagnosed and treated 10 years back. Since clinical care has progressed from that time, databases should be able to offer more current information which replicates up-to-date outcomes of the treatment.

Healthcare Provider Data Another improvement should be the capability of providing data based on the healthcare providers a certain patient is seeing. This will highlight the accomplished outcomes of the said healthcare providers. One drawback is the limit on the statistical confidence regarding the prognosis estimation because of the small amount of patient turning out in one setting.

Health Benefits This approach should not only promote shared decision making of practitioners and patients but it should also highlight the health benefits that could be achieved because of the participation of the patient.

The possibilities for high quality clinical databases uses are escalating quickly. This could be attributed to the increase in clinical databases' availability. In fact, a web based directory about clinical databases has just been developed to promote their usage as well as improve their quality. Presently, this directory is only available in the United Kingdom but other countries can create websites like it.