newsletter #17 march 2019 - monash university
TRANSCRIPT
Newsletter #17 March 2019
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Greetings! As the New Year began, staff at the Registry were busily entering data to ensure that the Semi-Annual Report contained all the information submitted over the holiday period. Highlights of the Semi-Annual Report are posted in this newsletter.
Audit of Surgical Devices The Bariatric Surgery Registry is conducting an important audit of the device preferences of all surgeons who have contributed to the Registry to date. This audit will validate the device data which has been captured for the operations in the Registry. All contributing surgeons have been emailed a request to complete the audit either online using the Survey Monkey link provided or by completing the Audit form. Surgeons who have not yet submitted their device preferences are asked to do so as soon as possible so that the audit can be finalized and data verified. If you have any questions about the audit or would like a form to complete, please contact Jenifer Cottrell by email: [email protected] or phone: +61 03 9903 0721. ______________________________________________
New Sites Last year the Registry submitted an ethics application to add a number of new sites to the Registry under the National Mutual Application (NMA) scheme. This Scheme allows for the streamlining of ethics review by having one lead ethics committee with oversight for the project. Until now, the Registry had been hamstrung
by the number of different ethics committees whose approval was required each time an amendment to the protocol was needed. As the number of committees grew to nearly 40, action needed to be taken. The short-term pain for making an NMA application called for the project to be reviewed as a ‘new’ study. Hence the protocol would need considered review to ensure that it adhered to the revised National Statement on Ethical Conduct in Human Research 2007 (updated 2018). The Registry successfully received approval from The Alfred Hospital Human Research Ethics Committee on the 5th of March 2019. Site Assessment applications have begun for all new sites and must be completed before data may be submitted. However, not all Registry sites are eligible for the NMA scheme. These sites are those with review by the following ethics committees: Mater Misericordiae Limited HREC, Mater North Queensland HREC, the Calvary Care HRECs, St John of God HREC and the Tasmanian Health and Medical Ethics Committee. Protocol amendment applications will now be required to be submitted to these committees. These amendment submissions have commenced, ensuring that all Australian sites are following the revised protocol and related documentation. An amendment to New Zealand’s Health and Disability Ethics Committee will also be submitted by the end of April 2019, which covers the relative differences to meet their local requirements. ________________________________________________ Revised Study Protocol All contributing surgeons and gastroenterologists are considered to be investigators in the study. As such it is vitally important that everyone participating adheres to the study protocol and does not deviate from it. If you are participating in the Registry, please ensure that you are familiar with the new study Protocol version 5.0 which can be found on the Registry’s website here: https://www.monash.edu/medicine/sphpm/registries/bariatric/policies-procedures _______________________________________________
Registry Snapshot as of the 7th of March:
Over 61,000 participants enrolled with an opt out rate of 3.35%!
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BARIATRIC SURGERY REGISTRY NEWSLETTER #17 MARCH 2019
Certificates of Outstanding Merit are awarded to:
Milly England (Mr Michael Hii) Kelly Sanguinetti (Mr Ahmad Aly) Rebecca Wade (Mr Ahmad Aly) Shelley Lisle (Mr Ahmad Aly)
Under 18’s in the Registry One of the significant changes made to the Protocol is that patients under 18 years old must go through informed consent in order to participate in the Bariatric Surgery Registry. If your practice is planning a bariatric procedure on a patient under 18 years old, please contact the Registry for an Informed Consent form and for Registry staff to explain what is involved to you or your staff. Bariatric surgery is increasing amongst the younger population. The Registry aims to capture information about procedures performed on young persons in order to reliably report the appropriateness, safety and effectiveness of bariatric surgery in this age group. ___________________________________________
Linkage with LapBase Available The Registry can directly link with LapBase to collect annual follow-up data for those surgeons who have subscriptions to the software. [NOTE: Surgeons are still required to provide operation and perioperative follow-up data.] All enquiries about this linkage must go to LapBase directly. For further information contact Wayne at [email protected] ___________________________________________ Welcome to the Registry’s New Team Members Several staff have recently left the Registry at Monash University as they have completed their tertiary or graduate studies. Whilst they will be sorely missed, the Registry is pleased to welcome the following new staff: Angus Campbell, Rebecca Tourogianis, Declan Wain, Jared Cox and Hayley Cottrell. Marlene Jacobs was also given a fond farewell as she and her husband moved to Mackay. Simone Wilkins has replaced Marlene in the Administration Officer role and will be the new main point of contact for the Registry in Melbourne. Please join the Registry’s warm welcome to them all! ___________________________________________
Recognising Star Staff Mr Michael Hii and Mr Ahmad Aly have nominated their staff for their outstanding dedication and hard work in collecting [our] BSR data.” Mr Hii contacted the Registry first thing in the New Year to nominate Milly England for her dedication and to ensure that she is recognized for Outstanding Merit. Mr Aly nominated the following staff of Darebin Weight Loss Surgery with comments about each of them: Kelly Sanguinetti “Kelly works as our Administrate Manager as well as being the primary Receptionist. Her role is demanding in both volume and breadth of tasks and her dedication is something I am extremely grateful for. She monitors and audits our BSR lists, assists with data extraction and patient recall schedules on top of her already overloaded work program. Kelly deserves rich and formal recognition and a certificate of outstanding merit could not be better placed.” Rebecca Wade “Rebecca has volunteered in the practice for 12 months and has been meticulous in gathering follow up data as well as auditing and correcting where required submitted data. She has instituted several novel processes to aid patient recall and monitoring and has been instrumental in ensuring our high quality data submission to the Registry.” Shelley Lisle “Shelley is our Clinical Nurse Consultant who co-ordinates all the care of patients and without whom we could not provide the care we do. She has been innovative in creating a closed patient face book page which now has 600 members and is a terrific instrument in encouraging patients to re attend follow up and participate in the registry data collection process. She is the glue that holds the practice processes in place.”
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BARIATRIC SURGERY REGISTRY NEWSLETTER #17 MARCH 2019
Contact the Registry to nominate your staff who are the “glue” for your practice! Nominees can also include your hospital data collectors. Upon receiving staff nominations, the Registry reviews the recent efforts made on behalf of the practice and confers a Certificate for Outstanding Merit to deserving nominees. Nominations made prior to the next newsletter will be mentioned and all nominees for that period will go into a draw for a $100 VISA gift card. The winner of the $100 Card for this period is: Kelly Sanguinetti!! Congratulations to each staff member who has received a Certificate of Outstanding Merit to date. _________________________________________
Stakeholder Engagement Seminar The first Bariatric Surgery Registry Stakeholder seminar was held in Melbourne on March 15th. Guests came from across Australia and New Zealand to attend this inaugural event.
Featured speakers included: Professor Jeff Hamdorf, The University of Western Australia; Ms. Mary Warner, Medicare Benefits Scheme, Commonwealth Government Department of Health; Mrs. Kaye McMillian, LaTrobe Health Services; Ms. Sandra Marjanovic, Medical Technology Association of Australia; Ms. Nicola Ware, Ramsay Hospital Research Foundation; and Ms. Lyn Keppler, Bariatric Patient.
Dr Nick Williams and Dr Nic Kormas chaired the afternoon session which captivated the audience. All speakers spoke about the relevance of having a bariatric surgery from their unique perspective as well as the importance of a registry. Perhaps most importantly, Ms. Keppler told how those considering bariatric surgery seek out “real-world information.” Her presentation made a profound impact on everyone, and encouraged surgeons to think about the way in which they talked to patients in regards to their procedures.
The Registry would like to extend its sincere appreciation to all who travelled from near and far to take part in the seminar.
Photo
Above photo from the Seminar: Prof Paul O’Brien leading the panel discussion after the first session.
____________________________________
The Bariatric Surgery Registry is funded in Australia by the Department of Health.
These sponsors are acknowledged for their generous support providing additional funding of this important health initiative (including the New Zealand arm of the Registry.)
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BARIATRIC SURGERY REGISTRY NEWSLETTER #17 MARCH 2019
Leading and Valued Contributors of 2018 Bariatric Surgery Registry has the enormous pleasure of naming the significant contributors of data for 2018. To be considered as a Leading or Valued Contributor, a follow-up completion rate of 75% must have been achieved. Leading Contributors must have at least 100 operations in the Registry and an ongoing contribution of at least 30 operations per calendar year. Valued Contributors need to submit at least 30 operations in a calendar year.
The Registry would like to particularly mention Dr David Schroeder as the first New Zealand surgeon to be included as a Valued Contributor. Dr Schroeder and his team are congratulated and commended for the commitment they have shown to the Registry.
2018 Valued Contributors
Douraid Abbas Janine Arnold James Askew Ingrid Bringmann Paul Caska Anthony Cheng John Copp Mark Hehir Matthew Henderson Andrew Packiyanathan Aravinthan Saravanamuttu David Schroeder
2018 Leading Contributors Reza Adib Ahmad Aly Jon Armstrong Samuel Baker Andrew Barbour Johannes Basson Ian Baxter Justin Bessell Peter Bovey Blair Bowden Roy Brancatisano William Braun Wendy Brown Paul Burton Salim Chaloob Harsha Chandraratna James Chau Richard Chen Yuan Cheng Jacob Chisholm Adam Cichowitz Stephen Clifforth Anthony Clough Leon Cohen Gary Crosthwaite Mark Daoud Michael Devadas Arun Dhir Giuseppe D'Onofrio Continued on next page...
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BARIATRIC SURGERY REGISTRY NEWSLETTER #17 MARCH 2019
Geoffrey Draper Zdenek Dubrava Stuart Eaton Robert Finch Harry Frydenberg Siva Gounder Jeffrey Hamdorf Richard Harrison Michael Hatzifotis Chris Hensman Michael Hii George Hopkins Carolyn Jameson Jacobus (Jorrie) Jordaan John Jorgensen David Joseph Costa Karihaloo Fadil Khaleal David Koong Lilian Kow Govind Krishna Vytauras Kuzinkovas Steven Leibman Paul Leong Victor Liew Kiat Lim Philip Lockie Damien Loh Ken Loi Raymond McHenry Garth McLeod David Martin Ian Martin Patrick Moore Paul Moroz William Munro Peter Nottle Paul O'Brien Girish Kumar Pande Nigel Peck George Petrou Andrew Ramsay
Andrew Russell Brendan Ryan
David Scott Jon Shenfine Candice Silverman Adam Skidmore Stewart Skinner Andrew Smith Garett Smith Michael Talbot
Susan Taylor Alan Thomas Chek Heng Tog John Treacy Salena Ward Senarath Werapitiya Stephen Wilkinson Nicholas Williams Jason Winnett
Kenneth Wong Timothy Wright
Gary Yee David Yong
Ali Zarrouk
If your practice has more than one surgeon and all sugeons are Leading Contributors, the practice can get a “Bariatric Surgery Registry 2018 Leading Contributors” certificate with the practice name on the certificate. Please contact the Registry if you would like this for your practice.
Important Notice for 2019 Contribution Levels! For 2019, the follow-up rate needed in order to meet the requirements of the Valued or Leader Status will be at 80%, based on the funding agreement with the Commonwealth Government, ensuring that the Registry maintains an 80% follow-up completion rate.
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BARIATRIC SURGERY REGISTRY NEWSLETTER #17 MARCH 2019
Current Hospital Participation Report for Australian and New Zealand Hospitals where Bariatric Surgery is Provided
As at 11 March 2019
State
Approved Sites Sites in Progress
Ethics/Locality Total
Not Contributing
Contributing
Approvals Yet to Commence
NSW/ACT 4 29 21 2 56 QLD 7 20 3 - 30
SA/NT - 9 4 - 13 TAS - 5 - - 5 VIC 9 31 5 - 45 WA 2 9 4 - 15
AUS Total 22 103 37 2 164 NZ Total 5 6 10 1 22
Approved Sites Sites in Progress
Sites To Do
Not Contributing
Contributing AUS Private 15 80 21 2
AUS Public 7 23 14 -
NZ Private 3 5 3 1
NZ Public 2 1 7 -
Total 27 109 45 3
Hospital Participation in Australia
Previous Report March 2019
Hospitals known to do bariatric surgery
162 162
Hospitals with ethics approval 124 125
Contributing 103 105
Hospital Participation in New Zealand March 2019
2018 Hospitals known to do bariatric surgery
22 Hospitals with ethics approval 11
Contributing 6
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BARIATRIC SURGERY REGISTRY NEWSLETTER #17 MARCH 2019
Current Report of Surgeon Participation As at 11 March 2019
At Sites with Ethics Approval Enlisted Not Enlisted Not Contributing Contributing but not at
site with ethics
approval
At site with ethics
approval
At site yet to get ethics
approval
Total
NSW/ACT 4 40 6 5 2 58 QLD 4 28 2 6 1 41 SA/NT - 19 1 - - 20 TAS 1 4 - - - 5 VIC 7 59 1 1 - 68 WA 1 26 1 2 - 30 AUS Total 17 176 11 14 3 221 NZ 8 10 0 - 6 24 Total
30 182 14 14 18 245
Surgeon Participation in Australia March 2019
Percent of Total # of Bariatric Surgeons at a Site with Ethics
Approval
Surgeons known to do bariatric surgery 221 (100%) All surgeons at sites with ethics approval 207 93.6% Enlisted 204 92.3% Enlisted and at sites with ethics approval 193 87.3% Contributing 176 79.6%
Surgeon Participation in New Zealand March 2019
Percent of Total # of Bariatric Surgeons at a Site with Ethics
Approval Surgeons known to do bariatric surgery 24 (100%) All surgeons at sites with ethics approval 18 75% Enlisted 18 75% Enlisted and at sites with ethics approval 18 75 % Contributing 10 41.6 %
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BARIATRIC SURGERY REGISTRY Newsletter #17 March 2019
Australian Hospitals with
Ethics Approval
Albury-Wodonga Private Hospital
Ashford Private Hospital
Austin Hospital
Baringa Private Hospital
Belmont District Hospital
Bethesda Hospital
Box Hill Hospital
Brisbane Waters Private Hospital
Cabrini Hospital Brighton
Cabrini Hospital Malvern
Cairns Private Hospital
Calvary Central District Hospital
Calvary North Adelaide Hospital
Calvary Riverina Hospital
Calvary St Vincent's Hospital
Calvary Wakefield Hospital
Campbelltown Private Hospital
Concord Repatriation General Hospital
Darwin Private Hospital
Epworth Eastern Hospital
Epworth Freemasons Hospital
Epworth Geelong Hospital
Epworth Richmond Hospital
Essendon Private Hospital
Fiona Stanley Hospital
Flinders Medical Centre
Flinders Private Hospital
Footscray Hospital
Geelong Private Hospital
Glen Iris Private
Glengarry Private Hospital
Gold Coast Private Hospital
Gosford Private Hospital
Gosford Public Hospital
Greenslopes Private Hospital
Hamilton Hospital
Heidelberg Repatriation Hospital
Hobart Private Hospital
Hollywood Private Hospital
Holy Spirit Northside Hospital
Hospital for Specialist Surgery
Hurstville Private Hospital
Ipswich General Hospital
Jessie McPherson Private Hospital
John Fawkner Private Hospital
John Flynn Private Hospital
John Hunter Hospital
Joondalup Health Campus
Kareena Private Hospital
Kawana Private Hospital
Knox Private Hospital
Lake Macquarie Private Hospital
Latrobe Regional Hospital
Launceston General Hospital
Linacre Private Hospital
Lingard Private Hospital
Maryvale Private Hospital
Mater Hospital (Brisbane)
Mater Private Hospital (Brisbane)
Mater Private Hospital (Bundaberg)
Mater Private Hospital Mackay
Mater Private Hospital (North Sydney)
Mater Private Hospital Pimlico
Mater Private Hospital (Redland)
Mater Private Hospital Rockhampton
Mater Private Hospital (Springfield)
Mildura Base Hospital
Mildura Private Hospital
Mitcham Private Hospital
Monash Medical Centre
Mount Hospital
Mulgrave Private Hospital
Nambour Selangor Private Hospital
National Capital Private Hospital
Nepean Private Hospital
Newcastle Private Hospital
Noosa Private Hospital
North Shore Private Hospital
North West Private Hospital (Brisbane)
North West Private Hospital (Burnie)
Northpark Private Hospital
Norwest Private Hospital
Nowra Private Hospital
Peninsula Private Hospital
Pindara Private Hospital
Port Macquarie Private Hospital
Prince of Wales Private Hospital
Princess Alexandra Hospital
Queen Elizabeth Hospital
Queen Elizabeth II Jubilee Hospital
Repatriation General Hospital
Royal Adelaide Hospital
Royal Brisbane and Women's Hospital
Royal Hobart Hospital
Royal North Shore Hospital
Royal Prince Alfred Hospital
Shepparton Private Hospital
Southern Highlands Private Hospital
St Andrew's War Memorial Hospital
St Andrew's-Ipswich Private Hospital
St George Private Hospital
St John of God Hospital Ballarat
St John of God Hospital Bendigo
St John of God Hospital Berwick
St John of God Hospital Bunbury
St John of God Hospital Geelong
St John of God Hospital Geraldton
St John of God Hospital Mt Lawley
St John of God Hospital Murdoch
St John of God Hospital Subiaco
St John of God Hospital Warrnambool
St Vincent's Hospital Melbourne
St Vincent's Private Hospital (Fitzroy)
Strathfield Private Hospital
Sunnybank Private Hospital
Sunshine Coast Private Hospital
Sunshine Coast University Private Hospital
Sunshine Hospital
Sydney Adventist Hospital
Sydney Southwest Private Hospital
The Alfred Hospital
The Avenue Private Hospital
The Wesley Hospital
Wagga Wagga Rural Referral Hospital
Waikiki Private Hospital
Wangaratta Private Hospital
Warringal Private Hospital
Waverley Private Hospital
Western Private Hospital
Westmead Private Hospital
Williamstown Hospital
New Zealand Hospitals with
Ethics Approval
Auckland City Hospital
Chelsea Hospital Gisborne
Gisborne Hospital
Grace Hospital Tauranga
Middlemore Hospital
Ormiston Hospital
St George’s Hospital
Southern Cross Hospital Christchurch
Southern Cross Hospital Hamilton
Southern Cross Hospital North Harbour
Southern Cross Hospital Wellington
CONTACT INFORMATION
Bariatric Surgery Registry
AUSTRALIA
T: 03 9903 0725
F: 03 9907 0717
Email:[email protected]
Bariatric Surgery Registry
NEW ZEALAND T: 0800 636 276
F: 9 273 1710
Email: [email protected] ________________________________
2019 Steering Committee
Meeting Dates
Friday 22 June
Friday 20 September
Friday 22 November g Co
The Bariatric Surgery Registry aims to monitor the safety and standards of bariatric surgeryperformed at public and private hospitals in Australia and New Zealand. As a clinical qualityregistry, it can lead to improved patient care and outcomes. This initiative has the supportof the Australia & New Zealand Metabolic and Obesity Surgery Society (ANZMOSS) andthe Royal Australasian College of Surgeons (RACS), with funding primarily from theCommonwealth Government of Australia and the medical technology industry.
59,036 Participants
Registry Data as at 31 December 2018
112 Hospitalshavecontributed
19.2% LegacyProcedures
Procedure Mix (n = 19,757)
6.4% Public Hospitals
One Revision Procedures Two Revision Procedures
Three Revision Procedures Four (or more) Rev. Procedures
967
180
40 18
47,523 Primary Participants having a total of:
93.6%PrivateHospitals
78.6% PrimaryProcedures
http://www.med.monash.edu/medicine/sphpm/registries/bariatric/
21% Male
79% Female
Calendar Year: 1 Jan 2018 - 31 Dec 2018
3.47% Opt out
% MBS Procedures Captured (n=24,479)Jan 2018 - Oct 2018 only (Aus only)
2.2% Revision on BSR Primary Patients
Includes Sleeve, Band, SAGB, RYGB & Reversal only
70%Sleeve
4% Band7% Reversal
3% Other
16% RYGB
& OAGB
190 Surgeonshavecontributed
Total Procedures Recorded:
40,270
23,051
63,657
31 Dec2016
31 Dec2018
Australia: (61) 3 9903 0725
New Zealand: (64) 9 373 7599 [email protected]
31 Dec2017
Unplanned Return to Theatre Unplanned Admission to ICU
Unplanned Re-admit to Hospital
258
23
239
Peri-operative Defined Adverse Events(Completed peri-operative follow-up, n = 13,731)
68.3%
AdverseEvent in aPrimaryProcedure
27.1%
AdverseEvent in aRevisionProcedure
2.1%
Excess WeightLoss after 12 months
Thanks to our Supporters:
(n=2,986)
(n=18,789)
Total WeightLoss after 12 months
7.2%
Weight Outcomes
Diabetes Outcomes
Safety Outcomes in 2018
(n=10,745)
14.5%
PrimaryParticipantsidentifed ashavingdiabetesbefore surgery
(n=19,057)
Diabetes Treatment Before and After Surgery (n=3,277)
(n=47,523)
% Weight Loss of Participants Who Have Reached3 Year Follow Up (n = 2,433)
Excess Weight Loss Total Weight Loss
0 1 2 30
10
20
30
40
50
60
Years After Surgery
% W
eigh
t Los
s