Introduction of JIPAD | English | JIPAD事業のご紹介 | JIPAD | JIPAD is Japan's largest intensive care database

Publication

Jounal article describing JIPAD
An article describing JIPAD was published in the Journal of Critical Care.
Please find the article via the following links:
J Crit Care.55:86-94,2020
https://www.ncbi.nlm.nih.gov/pubmed/31715536
https://www.sciencedirect.com/science/article/pii/S0883944119307658?via%3Dihub

Participating ICUs

Total number of ICUs/PICUs, n 46
Hospital type, n (%)  
  Public hospital 8 (17)
  Public university hospital 4 (9)
  Municipal hospital 7 (15)
  National university hospital 10 (22)
  National hospital 3 (7)
  Private university hospital 8 (17)
  Private hospital 6 (13)
Number of ICU beds* 10 [6, 14]
Number of annual ICU admissions* 781 [570, 1066]
Number of annual pediatric admissions* 16 [1, 66]
Number of full-time ICU doctors* 3 [2, 4]
Number of board-certified intensivists* 3 [2, 6]
Number of full-time ICU nurses* 32 [25, 44]
ICU/PICUs with certified nurses in intensive care, n (%) 33 (72)
Proportion of ICU/PICUs with certified nurses in emergency nursing, n (%) 7 (16)
Proportion of ICU/PICUs with certified nurse specialists in critical care nursing, n (%) 11 (24)
Proportion of ICU/PICUs with dedicated ICU clinical engineers, n (%) 32 (70)
Proportion of ICU/PICUs with dedicated ICU pharmacists, n (%) 39 (85)

*Median [IQR]
Public hospitals include the Red Cross Hospital, Rosai Hospital, Saiseikai Hospital, Social Insurance Hospital, and Welfare Pension Hospital.

Data quality

Site Visits
Objectives
(1) To determine the status of each ICU/PICU and provide information that may reduce the local workload
(2) To collect defective system reports or requests directly from each ICU/PICU
(3) To become acquainted with site staff and facilitate communication
Specific activities
(1) Participation in morning rounds and conferences
(2) Auditing of the system and its operations
(3) Responses to suggestions or questions regarding JIPAD operations
Achievements
(1) Visited 61 ICUs between March 2015 and December 2019
The Query System
To minimize human error during the data collection process, we developed the following procedure based on interactions between participating ICU/PICUs and administrators (e.g., analysts):
(1) The participating ICU/PICU uploads individual data items in groups of 10.
(2) The administrator verifies the data and replies with comments (e.g., input errors).
(3) The participating ICU/PICU confirms the comments and, if necessary, modifies the dataset and repeats the upload.
(4) The participating ICU/PICU then enters and uploads the next 10 individual data items while considering the previously received comments.
(5) Both the participating ICU/PICU and the administrator continue this process until the uploaded data contain no input errors. The participating ICU/PICU will then be able to upload data freely.
Random Checks
We checked 10 randomly selected the individual data items for each ICU/PICU that had completed the above-described query system procedures and responded with comments regarding typing errors.
This process has enabled us to maintain data accuracy.
Memo
ANZICS and ICNARC also inspect the inputted data. ICNARC aims to inspect all data, assuming that sufficient manpower is available.
In most ICUs/PICUs that adopted the query system, the number of rudimentary errors decreased dramatically after the data had been entered for 50–60 patients. To ensure the continued maintenance of data quality, we repeated the above query system procedure whenever the personnel responsible for data input changed.
Although the query system primarily aimed to increase data accuracy, the system identified both human errors and design errors in the CSV output format adopted by the ICU/PICU.

Activities

Journal article describing JIPAD
An article describing JIPAD was published in the Journal of Critical Care.
Please find the article via the following links:
J Crit Care.55:86-94,2020
https://www.ncbi.nlm.nih.gov/pubmed/31715536
https://www.sciencedirect.com/science/article/pii/S0883944119307658?via%3Dihub
Annual Report
The number of registering ICUs included in the data analysis increased from 32 in 2017 to 46 in the current report.
We estimate that more than 70 registering ICUs/PICUs will be included in the data analysis for the fiscal year 2019.
Start of JIPAD data provision to participating facilities
The institutions that participated in the 2017 annual report will be given access to JIPAD data on these institutions. Please refer to the following JIPAD website for details on the rules for using the data, how to apply for access, and other related matters:
https://www.jipad.org/kiyaku
Collaboration with the Clinical Trial Group (CTG) Committee
We initiated discussions with the CTG committee of the Japanese Society of Intensive Care Medicine regarding our collaborative projects that began last year. We also plan to revise our database, which will enable us to conduct research across multiple domestic ICUs/PICUs. We plan to first make the data available to participating institutions around April 2020.
International Registry Participation
As part of our efforts to build an international registry, we collaborated with Dr. Leo Celi of the Massachusetts Institute of Technology and Dr. David Pilcher of the ANZICS to host the first Datathon in Japan in February 2018. Subsequently, we hosted the second Datathon in Tokyo in March 2019. We are also considering to host the third Datathon in Tokyo in March 2020.
Information about the Datathon can be found at URL: http://datathon-japan.jp/
Collaboration with the Pediatric Intensive Care Committee
Beginning in April 2018, we included the PIM3 and pediatric disease names in the JIPAD to allow calculation of the pSOFA.
Guided by the PICU committee, there are 9 PICUs which are intend to participate JIPAD. We will continue to encourage all Japanese PICUs to register with the JIPAD.
Addition and Revision of Data Collection
In some institutions, permission was not granted to include the date of birth. Therefore, considering personal privacy, JIPAD will not send dates of birth to the server.
A function to mass convert “sent” to “not yet” or “confirmed” will be added.
Transmissions from facilities that do not pass through the query system will be controlled globally (i.e., sending 10 or more cases at once will be prohibited).
Addition of warning conditions:
- Change to warning if the entry route is via an emergency outpatient department and the date of ICU entry is > the date of admission + 2 days.
- Warning if tracheotomy, IABP, PCPS, VV-ECMO, or PMX are marked “yes” when ICU entry was scheduled and the patient is discharged within 24 hours.
Improved ICU patient list screen.
Addition of ExJIPAD CSV output function.
Improved ExJIPAD screen.
Calculation of Predicted Mortality
Both the ANZICS and the Intensive Care National Audit and Research Centre (ICNARC) of the UK have developed their own adult severity scoring systems. Since we have accumulated more than 130,000 patient registrations, we are planning to release a unique mortality prediction scoring system that would account for the current status of healthcare delivery in Japan before presenting our Annual Report for the fiscal year 2019.

Growth

• The graph shown below was generated from the number of registering ICUs/PICUs and registered cases per month, beginning in August 2015.
• As of December 31, 2018, 212 ICUs/PICUs expressed interest in JIPAD participation. Of these, 70 at 65 hospitals began to register data in our system (see Appendix 1).
• The number of registering ICUs/PICUs has increased steadily since 2016, and this upward trend is expected to continue.
• The number of registered cases has also increased steadily to 100,000 in December 2019.

  ICUs/PICUs Registering since
1 ICU, University Hospital, Kyoto Prefectural University of Medicine  March 2015
2 PICU, University Hospital, Kyoto Prefectural University of Medicine  March 2015
3 Emergency and Critical Care Medicine, Tokushima University Hospital March 2015 
4 Department of Intensive Care, The Jikei University Hospital April 2015
5 Department of Emergency and Critical Care Medicine, Nara Medical University April 2015
6 EICU, Kurashiki Central Hospital April 2015
7 ICU, Kumamoto Medical Center May 2015
8 Department of Emergency and Critical Care Medicine, Wakayama Medical University Hospital May 2015
9 ICU, Kurashiki Central Hospital May 2015
10 ICU, Advanced Emergency and Disaster Medical Center, Hirosaki University Hospital June 2015
11 ICU, Department of Emergency and Critical Care Medicine, Keio University Hospital June 2015
12 ICU, Fujita Health University Hospital June 2015
13 Critical Care and Emergency Center, Suwa Red Cross Hospital August 2015
14 ICU, Tokyo Bay Urayasu Ichikawa Medical Center March 2016
15 ICU, The Jikei University Kashiwa Hospital  March 2016
16 Department of Emergency Medicine and ICU, Dokkyo Medical University Hospital April 2016
17 Advanced Critical Care Center, Gifu University Hospital May 2016
18 ICU, Jichi Medical University Saitama Medical Center May 2016
19 Mixed Intensive Care Unit of Surgical & Internal Medicine, Fukuyama City Hospital May 2016
20 ICU, Yokohama City Minato Red Cross Hospital June 2016
21 ICU/CCU Center, Chutoen General Medical Center August 2016
22 ICU, Kobe University Hospital August 2016
23 Department of ICU, Kasugai City Hospital August 2016
24 ICU, Fukuyama City Hospital August 2016
25 E-ICU, St. Mary's Hospital August 2016
26 ICU, St. Mary’s Hospital August 2016
27 Department of Anesthesia, Tokyo Medical Center August 2016
28 ICU, JA Hiroshima General HospitalSeptember 2016 September 2016
29 Kagoshima University Hospital November 2016
30 Central ICU, Kyorin University Hospital November 2016
31 ICU, Juntendo University Hospital December 2016
32 Department of Traumatology and Acute Critical Medicine, Osaka University Hospital December 2016
33 Department of Emergency and Critical Care Medicine, Nara Medical University January 2017
34 Department of Critical Care Medicine, Sakai City Medical Center February 2017
35 ICU, Shin-Yurigaoka General Hospital February 2017
36 Department of ICU, Kenwakai Ōtemachi Hospital February 2017
37 Department of Emergency and Critical Care, Osaka General Medical Center February 2017
38  Emergency and Critical Care Medicine Center, Tottori University Hospital April 2017
39 Emergency and Critical Care Center, Kansai Medical University Hospital April 2017
40 EICU, Kobe City Medical Center General Hospital May 2017
41 GICU, Kobe City Medical Center General Hospital May 2017
42 Department of Emergency Medicine, Jikei University School of Medicine Katsushika Medical Center June 2017
43 Advanced Emergency and Critical Care Center, Hiroshima University Hospital June 2017
44 Department of Emergency and Critical Care Medicine, Kagawa University Hospital June 2017
45 Department of Emergency Medicine, Osaka National Hospital June 2017
46 CCU/ICU, Sendai Kousei Hospital August 2017
47 Department of Emergency Medicine, Okinawa Prefectural Chubu Hospital September 2017
48 Department of Emergency and Critical Care Medicine, Nippon Medical School Chiba Hokusoh Hospital September 2017
49 Department of Emergency Medicine, Gunma University Hospital October 2017
50 Pediatric Intensive Care Unit, Shizuoka Children's Hospital January 2017
51 ICU, Yokosuka General Hospital Uwamachi January 2017
52 Department of Anesthesia, National Hospital Organization Kyoto Medical Center March 2018
53 ICU, Matsudo City General Hospital March 2018
54 ICU, Takamatsu Red Cross Hospital April 2018
55 Intensive Care Center, Shizuoka General Hospital May 2018
56 ICU・CCU, Shiga University of Medical Science Hospital June 2018
57 ICU, Saitama Medical University International Medical Center July 2018
58 Department of Intensive Care Medicine, Tokyo Medical and Dental University Hospital September 2018
59 ICU, Oita University Hospital October 2018
60 ICU, Fujita Health University Hospital December 2018
61 HCU・ICU, Yamagata University Hospital February 2019
62 PICU, Department of Intensive Care, The Jikei University Hospital February 2019
63 PICU・CICU, Hyogo Prefectural Kobe Children's Hospital April 2019
64 Surgical Intensive Care Unit, Nagoya University Hospital April 2019
65 ICU, Chubu Tokushukai Hospital April 2019
66 ICU, Japanese Red Cross Saitama Hospital June 2019
67 ICU, Japanese Red Cross Nagoya Daini Hospital June 2019
68 ICU, St.Marianna University School of Medicine Hospital June 2019
69 ICU, Hamamatsu University Hospital August 2019
70 ICU, Japanese Red Cross Asahikawa Hospital August 2019
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