Real-world outcomes in spinal cord stimulation: predictors of reported effect and explantation using a comprehensive registry-based approach.

Introduction: Despite advancements in implanted hardware and development of novel stimulation paradigms in Spinal Cord Stimulation (SCS), real world evidence suggests a large variation in patient reported outcomes and a proportion of patients are later explanted due to loss of analgesia. Possible predictors for outcome have been explored in smaller short-term evaluations, but few clinically applicable robust measures for long term outcome have emerged. Methods: We performed a comprehensive retrospective study based on an assembled patient-level aggregated database from multiple local and national registries in Sweden. Variables associated with risk of explantation (due to insufficient analgesia) and analgesic effect was analyzed using a Cox regression analysis and an ordered logit regression model, respectively. Results: We found the accumulated risk of explantation due to loss of analgesia to be 10% and 21% at two and ten years follow up, respectively. The use of 10 kHz spinal cord stimulation (compared with Tonic waveform; p = 0.003), and being 60 years or older (reference 18-40 years; p = 0.003) were associated with an increased risk of explantation.At a mean follow up at 1 year, 48% of patients reported a pain intensity reduction from baseline of at least 30%. Secondary (p = 0.030) and post-secondary (p = 0.001) education (compared with primary education) was associated with an increased probability of successful patient reported outcomes. Conclusion: This study suggests that a higher educational level and being employed are associated with successful treatment outcome in patients with chronic pain treated with SCS in Sweden.

Completeness and correctness of acute myocardial infarction diagnoses in a medical quality register and an administrative health register.

Aims: Health registers are used for administrative purposes, disease surveillance, quality assessment, and research. The value of the registers is entirely dependent on the quality of their data. The aim of this study was to investigate and compare the completeness and correctness of the acute myocardial infarction (AMI) diagnosis in the Norwegian Myocardial Infarction Register and in the Norwegian Patient Register. Methods: All Norwegian patients admitted directly to St Olavs hospital, Trondheim University Hospital, Trondheim University Hospital from 1 July to 31 December 2012 and who had plasma levels of cardiac troponin T measured during their hospitalization (n=4835 unique individuals, n=5882 hospitalizations) were identified in the hospital biochemical database. A gold standard for AMI was established by evaluation of maximum troponin T levels and by review of the information in the medical records. Cases of AMI in the registers were classified as true positive, false positive, true negative, and false negative according to the gold standard. We calculated sensitivity, positive predictive value (PPV), specificity, and negative predictive value (NPV). Results: The Norwegian Myocardial Infarction Register had a sensitivity of 86.0% (95% confidence interval (CI) 82.8-89.3%), PPV of 97.9% (96.4-99.3%), and specificity of 99.9% and NPV of 98.9% (98.6-99.2%) (99.8-100%). The corresponding figures for the Norwegian Patient Register were 85.8% (95% CI 82.5-89.1%), 95.1% (92.9-97.2%), and 99.7% (99.5-99.8%) and 98.9% (98.6-99.2%), respectively. Both registers had a sensitivity higher than 95% when compared to hospital discharge diagnoses. The results were similar for men and women and for cases below and above 80 years of age. Conclusions: The Norwegian Myocardial Infarction Register and the Norwegian Patient Register are adequately complete and correct for administrative purposes, disease surveillance, quality assessment, and research.

Registros de la criminalidad en Colombia y actividad operativa de la Policía Nacional durante el año 2015 / Criminality records in Colombia and National Police operative activity during year 2015 / Registros da criminalidade na Colômbia e a atividade operacional da Polícia Nacional durante o ano 2015

La criminalidad que ocurre en Colombia suele conocerse en todo el territorio nacional, en primera instancia, por la Policía Nacional; por tanto, los registros administrativos para conocer la criminalidad del país se organizan en el Sistema de Información Estadístico Delincuencial, Contravencional y Operativo (SIEDCO), y desde allí se realizan los análisis criminológicos y reportes estadísticos que sirven de insumo para interpretar los cambios del crimen en los ámbitos temporal y territorial. Este artículo presenta la descripción de los delitos por títulos penales y agrupaciones criminológicas en el período comprendido entre el 1 de enero y el 31 de diciembre del año 2015, comparando los datos con el año anterior. Asimismo, describe los resultados operativos de la Policía Nacional en la lucha contra la criminalidad y las contravenciones aplicadas a los ciudadanos de acuerdo con el Código de Policía vigente para el país. Adicionalmente, se presenta un análisis del delito de homicidio, por considerarse como una de las más importantes manifestaciones de la violencia en una sociedad. Entre las principales conclusiones se identifican: el cambio en las dinámicas del delito, las variaciones hacia los delitos que afectan la seguridad ciudadana y la disminución de la violencia homicida.

Crimes occurring in Colombia are usually known in the first place by the National Police throughout the country's territory. Therefore, administrative records serving to get information concerning criminality in the country are organized into the Statistical Criminal Contraventional and Operating Information System (SIEDCO) and, from there, criminological analyses and statistical reports used as an input to construe crime changes in the temporal and territorial environment are prepared. This article exposes the description of offenses by titles and criminological groupings within the period between 1st of January and 31st December 2015, and data are compared with those of the previous year. Likewise, National Police operational outcomes in their fight against criminality are described as well as the contraventions applied to citizens in accordance with the Police Code in force for the country. In addition, it includes an analysis of the crime of homicide since it is seen as one of the most serious manifestations of violence in any given society. Among the most important conclusions, the following findings have been identified: the change taking place in crime dynamics, variances towards offenses affecting citizen safety and security, and a decline in homicidal violence.

A criminalidade que acontece na Colômbia é conhecida geralmente em todo o território nacional, em primeira instância, pela Polícias Nacional; portanto, os registros administrativos para conhecer a criminalidade do país são organizados no Sistema de Informação Estatístico Delinquencial, Contravencional e Operacional (SIEDCO), e a partir daí, as análises criminológicas e os relatórios estatísticos que servem como insumo para interpretar as mudanças do crime nos espaços temporais e territoriais são realizadas. Este artigo apresenta a descrição dos crimes por títulos penais e agrupamentos criminológicos no período entre 1 de janeiro e 31 de dezembro de 2015, e os dados são comparados com o ano precedente. Também, os resultados operacionais da Polícia Nacional na luta contra a criminalidade e as contravenções aplicadas aos cidadãos são descritos de acordo com o Código da Polícia válido para o país. Adicionalmente, uma análise do crime do homicídio é apresentado, por se considerar como uma das manifestações as mais importantes da violência em uma sociedade. Entre as conclusões principais são identificados: a mudança nas dinâmicas do crime, as variações para os crimes que afetam a segurança do cidadão e a redução da violência homicida.

Registros administrativos de policía para la consolidación de cifras de criminalidad en Colombia / Administrative registers and records for the consolidation of criminality figures in Colombia / Registros administrativos da polícia para a consolidação das cifras de criminalidade na Colômbia

La Policía Nacional de Colombia desarrolla la operación estadística "Conductas y servicios de policía", para tener insumos que permitan la formulación de políticas públicas en seguridad y seguimiento permanente del impacto del servicio de policía; esta operación usa como herramienta tecnológica el Sistema de Información Estadístico, Delincuencial, Contravencional y Operativo - SIEDCO. La metodología para la recolección, registro, consolidación y difusión de los registros administrativos, con propósitos estadísticos, permite obtener las cifras de criminalidad de acuerdo con los tipos penales del Código Penal colombiano, delitos de mayor impacto y actividad operativa, con la posibilidad de ubicarlos por jurisdicción política o policial. De otra parte, las herramientas tecnológicas de software actuales, para extracción de información, ofrecen diferentes maneras de analizar y estudiar los datos en un menor período de tiempo en cada una de las unidades policiales.

The National Police of Colombia is developing its statistic "Police conducts and services" operation in order to have inputs allowing for the formulation of public policies dealing with security and permanent follow-up of the police service impact. This operation uses as a technological tool the statistics, criminal, contravention and operative information system known as the "Sistema de Informacion Estadistico, Delincuencial, Contravencional y Operativo - Siedco. The methodology for the collection, filing, register, consolidation and dissemination of administrative records for statistical purposes helps obtain criminal figures according to the criminal types of the Colombian Criminal Code, crimes of greater impact and operative activity, with the possibility of locating them by political or police jurisdiction. On the other hand, current technological software tools for the gathering of information offer different ways to analyze and study data at each police unit, in a shorter period of time.

A Polícia Nacional da Colômbia desenvolve a operação estatística "Condutas e serviços da polícia", para ter os insumos que permitem a formulação de políticas públicas na segurança e no seguimento permanente do impacto do serviço da polícia; esta operação usa como ferramenta tecnológica o Sistema de Informação Estatístico, Delinquencial, de Contravenções e Operativo - Siedco. A metodologia para a colheita, o registro, a consolidação e a difusão dos registros administrativos, com propósitos estatísticos, permite obter as cifras de criminalidade de acordo com os tipos penais do Código Penal Colombiano, crimes de um maior impacto e atividade operativa, com a possibilidade de localizá-los pela jurisdição política ou policial. De outra parte, as ferramentas tecnológicas do software atuais, para a extração da informação, oferecem maneiras diferentes de analisar e estudar os dados em um menor período de tempo em cada uma das unidades policiais.