View source for Data User Portal for the Manitoba Critical Care and Medicine Databases

'''Welcome to the external user's portal for the Manitoba Critical Care and Internal Medicine Ward Databases.'''  Updated {{REVISIONYEAR}}-{{REVISIONMONTH}}-{{REVISIONDAY2}}. 

== Data Elements of this Database ==
*Many, but not all of the conceptual data elements are stored in their own, named data field. Those that do have their own fields are listed in [[Auto Data Dictionary]].
*The others are listed either in: [[Projects]], [[Indicators]], [[Created_Variables_CC 2021_table]] or [[Created_Variables_Common_2021 table]]. Extracting some of these concepts requires taking multiple individual data elements and combining them.
*Also note that while there are many data elements common to the ICU and Medicine databases, there are some elements that are only obtained for ICU patients (e.g. [[TISS]] elements, and some that are only obtained for the IM ward patients (e.g. [[ADL]])  Note that Wiki pages for any data element says explicitly whether it's included in the ICU and/or Medicine ward data.
*Also see [[CCMDB]] and [[Entity Relationship Diagram for the Critical Care and Medicine Database]]

== Legacy Data ==
*Database elements have been modified over time, including: retiring elements, adding elements, modifying elements. This Wiki records such changes. Almost always, retired elements are retained.
*For more information, see [[Legacy Content]]

== What Constitutes a Single Record of Data ==
* The ICU and Medicine Ward databases are organized by what we call a "profile", which could also be called a database "record". The details are slightly different for the Critical Care and Medicine portions of the database. See the following for details. 
** [[Definition of a Critical Care Laptop Admission]]
** [[Definition of a Medicine Laptop Admission]]

== Reconstructing an Episode of Care from Multiple Database Records ==
* A database record is a "bookkeeping" element -- it is relevant mainly for administrative purposes of understanding resource utilization, and for benchmarking. 
* To understand and evaluate overall patient care, it is the '''episode''' of medical care that is most important. [See: Fransoo et al. Constructing Episodes of Inpatient Care: Data Infrastructure for Population-based Research. ''BMC Medical Research Methodology'' 12(1):133, 2012]
**An '''episode of hospital''' care includes everything that occurs from initial hospital admission to final hospital discharge (or death).
**An '''episode of ICU care''' includes everything that occurs from initial ICU admission to final ICU discharge (or death). Thus, an ICU episode may include any number of direct ICU-to-ICU transfers either within or between hospitals. Also, there may be more than one such ICU episode within a hospital episode, and the medical literature on this provides some guidelines for combining seemingly separate ICU episodes if the time interval between them is sufficiently brief (see Fransoo reference). 
**An '''episode of Internal Medicine ward care''' includes everything that occurs from initial ward admission to final ward discharge (or death). Since all portions of Medicine ward admission within a single hospital is counted as a single Medicine ward database record, a ward episode may include any number of direct ward-to-ward transfers between hospitals. 
* One reconstructs episodes from single database records by reference to: database records, timing of starting and ending of the records, responsible medical services, and physical locations. 
**Remember, of course, that our database does not include information on care provided in hospital except for patients admitted to an adult ICU or to an Internal Medicine ward service. Thus, one may encounter gaps in trying to reconstruct entire episodes of care.

== How the Data is Stored ==
*Although once upon a time this was a single "flat table", it is now a relational database including many separate data tables linked together, including 1-to-1 linkages, 1-to-many linkages and the [[Entity–attribute–value model of the L Tmp V2 table]]. The master record identifier for all table linkages is the [[D ID field]].
*The master list of all included tables can be found in: [[CCMDB_Data_Structure]]. Clicking on any of the tables in that Wiki page will take you to it's own page, which includes what data is contained in it.
*Many data elements containing categories of information are coded. Example: for the discharge location (disposition) field [[Dispo]] what is stored is not words (e.g. home, other hospital, death etc) but numbers. The tables holding the translation for such codes are "S-tables", which are listed in the "support tables" item in [[CCMDB_Data_Structure]].
*One of the hardest tables to comprehend is [[L_TmpV2 table]] which we often refer to as the "temp table". 
**While each entry into this table links to a single database record, a single record can have any number of entries in this table, and furthermore, those entries may contain a variety of different types of data. Each entry includes some variables that identify the nature of the data element stored in that entry, and then the element itself. See [[Entity–attribute–value model of the L Tmp V2 table]] for more info on this data model. The types of data included can be found in [[Projects]].

== Using this Wiki ==
*This Wiki is the master source of all information about these databases. These databases have experienced a continuous evolution over time, with numerous changes in what is collected, how it is collected, and how it is stored. Discontinued, "legacy" items are indicated as such in the Wiki.
*Consequently, the Wiki is highly complex.
*We have divided this introductory portal page for external users into 2 segments, which overlap:
**The first segment will help you understand the data contained within the databases
**The second segment addresses the actual structure of how the data is stored

== Requesting Access to Data ==
* [[Database Request Process]]
* [[Contact]]

== Brief History ==
*[[History and Background of the Critical Care and Medicine Database]]
*[[Category:About]]

*Using identical data structure, and stored together, these data include two aspects of inpatient medicine:
**The ICU database (ICUDB) began in 1988, including the Medical ICU and Surgical ICU at Winnipeg Health Sciences Centre. Starting in 1998 it has included all adult ICUs in the Winnipeg Health Region of the province of Manitoba. The number of the number of hospitals containing adult ICUs, the number of adult ICUs, and the number of beds within the ICUs have fluctuated over time. As of October 2021 it includes ICUs in 3 Winnipeg hospitals:  Health Sciences Centre ([[HSC MICU]], [[HSC SICU]] and [[HSC IICU|Intermediate ICU]] [IICU, a chronic ventilator unit]), St. Boniface Hospital ([[STB MICU | MSICU]], [[STB CICU| Cardiac Surgical ICU]], [[STB ACCU|CCU]]), and Grace Hospital ([[GRA_MICU|MSICU]]). See [[Database Anniversary Dates]] for start dates of specific units.
**The Internal Medicine Ward database (IMWDB) began in 2003, including such wards in hospitals within the Winnipeg Health Region. The number of wards included increased over time and starting January 2005 includes all Internal Medicine wards in Winnipeg hospitals. See [[Database Anniversary Dates]] for start dates of specific wards.
*The delineation of ICU versus Medicine ward records is by the [[Program]] field, which is either "CC" or "Med".

== Related articles == 
{{Related Articles}}

[[Category:About]]