A country wide adaptation of the European Society of Thoracic Surgeons lung cancer core database: the Hungarian model

Registering details of thoracic surgical activity has a long tradition in Hungary. Implemented first as a procedure based register, characteristics of the treatment, complications and outcomes has been noted for the last three decades. Although the limitations of the used database hindered the scientific analysis in the dataset and restricted the possibility of benchmarking. The European Society of Thoracic Surgeons (ESTS) database is offering a specialty-specific, procedure-specific, web-based electronic database for data contribution enabling international comparisons. Our aim was to accommodate and implement the ESTS database as the new Hungarian national thoracic surgical registry. In 2014, cooperation of the ESTS Database Committee and the Hungarian Society of Thoracic Surgery evolved a new structure for contributing national thoracic surgical data, called the ESTS database "Hungarian model". The European dataset was translated into Hungarian, extended questionnaire and continuous data access helped the completion of the dataset. The "Hungarian model" was incorporated into the common practice of all the thoracic surgical centers in Hungary. In the first year of its implementation the "Hungarian model" of the ESTS dataset became the platform to use for contributing thoracic surgical data in Hungary. All the data included in the dataset were completed and periodically analyzed to form the annual Hungarian report ("the Hungarian Silver Book"). The dataset is permanently accessible for national scientific analysis and serves as a basis for quality improvement intentions. The Hungarian model proved to be able to serve as a national database. The complete dataset of the thoracic activity has become eligible for scientific analysis and international benchmarking, highlighting the most important core messages of the ESTS database project of improving quality and patient safety thoracic surgeons. By creating a framework for a national registry the system is incorporating an alternative for other thoracic surgical societies.