Breast Cancer

We established the surgeon-led Emergency General Surgical service at The Royal Melbourne Hospital in 2011 and set up a clinical database, which was autopopulated from the admission episode system (iPM) from our institution. The database has been built to be flexible to capture morbidity and mortality in real-time and to validate admission diagnoses, operations and complications. Projects include outcomes after Emergency General Surgery comparing a new model of care to an older established care of surgical patients was the largest study at the time evaluating over 7000 patients and showed a 47% reduction in mortality and 56% decrease in mortality. Other completed studies evaluated the impact on the management of acute biliary disease, liver trauma, trauma in pregnancy.

Administrative data is routinely collected on all patients who are admitted to a hospital in Australia. Patient demographics, diagnosis, length of stay, procedures and complications are all captured in this fashion. Built for the purpose of billing, it also offers a unique opportunity to be used for the purpose of clinical outcomes research. The strength of administrative data as a research tool is its extremely large numbers, low cost and completeness. We have used various platforms for data linkage and have enabled comparative projects such as international variation in management and morbidity and mortality after acute diverticultis and colorectal cancer resection and using administrative data to act as surrogates for cancer databases.