The development of The Society of Thoracic Surgeons voluntary national database system: genesis, issues, growth, and status.

Background: The purpose of this communication is to demonstrate the feasibility of a voluntary national cardiac surgical database.

Methods: The genesis of the Society of Thoracic Surgeons (STS) National Cardiac and General Thoracic Surgery Databases in the interval of 1986 to 1990 is described. The issues facing the Committee in the initial decision making processes are discussed choosing a society-based, in-house activity versus using an outside vendor, private practice needs versus academic ones; open versus closed membership and vendors, risk stratification; data quality; audit; and access to data.

Results: In the 6 years of operation the STS cardiac surgical database has grown from 41,000 to 706,000 patients. The number of practice groups, hospitals, and surgeons has increased from 26 to 624, 32 to 750, and 120 to 1850, respectively. All but one state is represented, as are more than 400 teaching hospitals, including 28 Veterans Administration hospitals and 60 university centers.

Conclusions: The STS database system has become firmly established and is a model for other societies and associations. The data placed yearly in the public domain have become a national standard.