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Common Otology Audit
 
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    • Objectives
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    • Methodology

    Aims of Common Otology Audit Group

    • To provide a focus for clinical practice amongst members
    • To identify common audit data amongst members
    • To provide a way for members to store their otology data
    • To provide a patient base for meaningful statistical analysis
    • To provide standards for future otology audit
    • To create an environment to encourage collaborative studies amongst members

    When?

    Data collection started end of February. However you can register and join in anytime.

    Introduction

    The last national comparative myringoplasty audit was carried out 8 years ago (Clin Oto 1999 24:126-129). This audit will use the same web-based technology as the recent Tonsillectomy Audit, and is a tailored version of the general EarUK Otology Audit available on www.ear-audit.net

    Who?

    All surgeons doing myringoplasty - trainees, SAS, consultants

    Why?

    To:
    1. Enable the participating surgeons to compare their performance with that of two standard deviations of the mean of others entering data
    2. Find the overall incidence of intact tympanic membrane and disease-free ears following myringoplasty, in children and in adults
    3. Identify variables that could influence success rate

    Confidentiality?

    Patient confidentiality will be protected, as all hospital numbers will be stored in the database as encrypted numbers.
    Surgeon confidentiality will be provided by enabling participants to change their password to one only they know.

    Method?

    Data entry will be via the web-based database. This can either be entered directly from the notes in real time, or via a paper form printed from the web-site, completed for each patient, and then transcribed electronically to the database. Data completeness will be ensured by the presence of obligatory fields (an advantage of entering data in real time electronically), and data validation will be carried out by random site visits to participating hospitals by an external inspector/auditor to perform random inspection of patient records.

    MREC has confirmed that formal approval by them or LREC is NOT required. Should local LRECs demand proof of this we can provide a copy of the relevant MREC letter on application.

    Inclusion criteria:
    1. All perforations of the pars tensa
    2. All age groups
    3. Cortical mastoidectomy and myringoplasty for non-cholesteatoma ears

    Exclusion criteria:
    1. Surgery for Cholesteatoma
    2. Cases when concomitant ossiculoplasty is performed

    How to register as a user?

    New users:
    Send email to earauditworld@gmail.com to obtain login user name and password.
    The latter can be changed by you so you alone know it

    Current users of the EarUK web-based audit system:
    After registering, can continue to input the otology data in the usual way but the input for the myringoplasty data will be through the hyperlink in the website.

    Getting Started

    • Register as above and get a user name and password.
    • Access the Common Otology Audit home page either directly (www.ear-audit.net) and click on "UK Myringoplasty Audit", or via the ENT-UK web site (www.entuk.org) and click on "Audits" on left side of the home page, and then on "web-based Common Otology Database" and then on "UK Myringoplasty Audit" as above
    • "UK Myringoplasty Audit" page - Scroll down on "Hospital Name" to find your hospital, and then enter your user name and password. When finished click "submit" to access the "Myringoplasty Menu".
    • "Myringoplasty Menu" page - on first visit personalise your password by clicking on "Change Password". Otherwise "Click on "Create New Case" or "Review/Update" depending if patient is new, or follow-up or if you are entering operative data
    • Data will be entered once preoperatively, preferably when listing the patient for surgery
    • The pre-op audiogram is the one closest to surgery, so will be found on the "Operation" page. Just click on the dB figure for AC or BC and it will automatically appear on the grid. Postoperative data is entered at dated intervals of your own choosing postoperatively.
    • The pre-operative/operative/postoperative forms will be linked by using a case code (combination of patient Number, date of listing and side of operation) to distinguish it from a later, separate, episode involving the other side.
    • Any problems contact Shing Poon, Webmaster, as above

    Data Input

    It is good audit practice to enter preop data before surgery takes place to avoid reporting bias. This practice is required of Level 2 Benchmark users. However, for their own audit purposes Level 1 and Level 2 users can also enter data retrospectively.
    Different data entry forms are available on the website for pre-operative, operative-findings, operative and post-operative data entry. Every field on the data form needs to be completed before the form is accepted, thus ensuring completeness of data entry.

    Separate post-op forms are available for 3, 6, 12, 24, 36, 48 and 60 months after surgery.

    Feedback

    The data from each hospital/surgeon is stored in a SQL Server database and can be distributed to the hospital on a regular basis. Each hospital can only access its own data, but not the data of another hospital. However, a table with the cumulative results of all the participating hospitals will also be provided to each hospital.

    The web master can be contacted via e-mail for surgeons to make enquiries regarding specific comparative audit with other hospitals or surgeons. The identity of the hospitals will be protected unless individual hospitals wish to collaborate in their audit.

    Validation

    Any bias or incorrect entry from one hospital can contaminate the accuracy of the overall database. Validation can be provided by each hospital being visited once a year by an appointed inspector to carry out a random examination of patient records. The results of all Level 2 Benchmark data is externally validated by a peer.If any Level 1 and Level 2 users wish to compare their results with Level 2 Benchmark in a publicaton they can request an external validation provided by the Common Otology Audit group.

    Security

    Each surgeon of a hospital is allocated an access code and a password. The identity of the patients and the surgeons is anonymous. Each hospital is given a Hospital Code Number and each surgeon a Surgeon Code Number. Users give each patient a unique identifier. This identifier is stored in the database in an encrypted form, so it is safe to enter identifiers issued by the hospital administration system. The identifier used is decrypted by the system whenever data is downloaded.

    Join Us?

    To register your interest, please write to the project leader and we shall contact you in due course.

  • Test Drive
  • Practice Session

    • A trial session allows users to get a feel for the way the site works by entering dummy data.
    • Visitors may create their own testing account by entering user name (max 25 characters) and password (max 25 characters) chosen by you. Select the Level you wish to try from the dropdown box.
    • Visitors are made aware Practice Site data can be removed without notice or mixing with other visitors is possible.

    Login (Test Drive)

     
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Announcement

Dear All,

The existing funding raised by Matthew Yung to maintain the Common Otology Audit system has run out. We wish to re-structure the funding source of COA.

Future financing of this web-based database and mobile app will be shared by users. We envisage an annual subscription fee per user to be no more than £200 or USD 260. This re-structuring process requires all users to re-register as users using this link https://ear-audit.net/coa/payment.htm

We understand that some of you may not wish to pay as an user of COA. If that is the case, you can still download your surgical data from COA into your own Excel File before 31 October 2018. After 1 November 2018, your surgical data will be removed from the COA database.

Matthew Yung, Founder COA
Shing Poon, Webmaster COA