Medtech Insight: EU I.Q., European Healthcare Data

The European Surgical Diagnostic Procedures (ESDP) Database 2007-2010 Release provides 2007 procedure volumes and three-year forecasts for inpatient and outpatient surgical diagnostic procedures performed in public and private hospitals in Spain, France, Germany, the United Kingdom, and Italy. This includes both primary and secondary procedure volumes for a wide range of biopsies and endoscopic procedures (e.g. colonoscopy, hysteroscopy, laparoscopy). Procedures performed in private practices outside the hospitals are not included. The 2007-2010 ESDP also includes the number of needles used and samples taken per needle for applicable biopsy procedures.

The data were standardized using the ICD-9-CM system for comparison and then validated with national organizations and or via interviews with physician experts and opinion leaders in the appropriate specialty per country. ESDP data are derived from the most recently available data in each country. The following outlines the methodology used to include and validate procedures in the database:

PROCEDURES INCLUDED
	ESDP 2007-2010 release (2007 data plus three forecast) now includes both primary and secondary procedures. In Europe, a diagnostic procedure is not coded or reimbursed as secondary procedure if it is performed in conjunction with a therapeutic intervention. Since only primary procedures are officially coded and reported by the national databanks in each country, intensive primary research was performed to obtain the secondary procedure volumes. This required massive field work, including interviews with surgeons and hospital departments at more than 20 hospitals in each country to determine the total number of diagnostic procedures performed. The procedures chosen for inclusion in the database were those identified as the most frequently performed during surgeon interviews. ICD-9 codes were used for data definitions and to standardize data between countries.
As a result the new ESDP 2007-2010 Release represents:	1) A solid diagnostic database which will be expanded with new procedures in future updates 2) The EU Big 5: Spain has been added. (ESDP 2006 Release contains only four countries: France, Germany, Italy & the United Kingdom) 3) The addition of 3 year-forecasts for each procedure by country 4) The estimated number of needles used per biopsy (when applicable) 5) The estimated number of samples taken per needle (when applicable)
GENERAL
The European Diagnostic Surgical Procedures Database includes all primary and secondary procedures performed in public, private and university hospitals in France, Germany, Italy, Spain and UK. The procedures performed outside the hospitals in private practices are not included in this database
METHODOLOGY
For each country data was derived from national databases, hospital statistical departments, ward records and face-to-face interviews with physician experts and professional organizations. As each country uses different coding systems, the data was standardized using the ICD-9 system for comparison and also validated via interviews with physician experts and opinion leaders in each specialty (ENT, Cardiology, Orthopedics, etc.) in all countries.
To make sure we handle the same definitions in each European country, procedures are defined by identifying the correct ICD-9 code. The definition of this code is then used to find the country-specific codes.
Data-identification	When there is a clear code translation from the ICD-9 coding to the country-coding, the numbers are identified in the country-databases.
	Some ICD-9 procedures are in other coding systems part of more general code. To filter out the defined procedure, we contact National Organisations and/or Opinion Leaders and/or Experts.
Following quality checks are taken into account:	The procedures/population ratio is calculated for each country and compared to all other countries.
	When the procedures/population ratio in a country is significantly different from the other countries, the database figures are checked with National organisations and/or Opinion leaders
Change in process	As the different country-databases in Europe evolve, there can be a change in data identification from one year to the next for a specific procedure. This can mean new and more detailed codes are added or a new database is launched.
Needles & samples	The number of needles used and samples taken, reflect the common usage in the countries obtained from primary research including face-to-face and telephone interviews.
SOURCES
National databanks
Face-to-Face interviews with physician experts in each specialty (ENT, Cardiology, Gastroenterology, etc.)
Hospital Departments
National organizations
Desk Research
Literature Research