October 2014    
LICOR | LICOR Historical Milestones
In early 2003, terms of reference were finalized defining mutual roles and responsibilities of stakeholders. This allowed the development of software specially adapted to the needs of the projected registry. Various versions were debated by the LCS Ad-hoc Committee to reach a final agreement on the extent of data to be collected for the purpose of this registry. As this software was under preparation, several attempts were made to enlarge it to include data on cardiac heart surgery in addition to coronary angiographies and angioplasty. However, despite genuine goodwill on both sides, no practical results were obtained at that time. During spring 2003, a final version of the software was tested it contained individual-based data on cardiovascular risk factors, diagnoses, treatments and outcomes. It enabled hospital other health care units to monitor the results of their own care and treatments and to assess the benefits to the patient provided also an instrument for systematic quality and improvement efforts that previously did not exist. The collected data was also intended to stimulate research.

In all eligible centers, an interventional cardiologist was defined to act as a local focal point in support of the registry. The MOPH Director-General issued a nominal letter to the administrations of those centers inviting their voluntary participation in the Registry. Starting August 2003, LSC staff traveled to all 32 centers, distributed from Halba to Sour and throughout the Bekaa valley to install the software and train in-house technicians to enter data and transfer monthly files to LCS offices in Beirut, The call to participate was met by a spectrum of reactions ranging from outright immediate adhesion to total rejection. As of September 2004, monthly data started to flow back to LCS from about 20 centers, via e-mail or on a diskette. A preliminary analysis in May 2004 of cleaned data from 8 centers from all regions recorded 1614 coronary angiographies and 456 angioplasties. During all that period, personal contacts were made by LCS Chairman and Ad-hoc Committee members to overcome reluctance to participate, and later to ensure regular transfer of collected data. By the end of 2004, the software had been installed in 30 centers in activity in this field. Since its inception in 2003, LICOR has received unrestricted financial support from Sanofi-Aventis. Also, in 2005 Dr. Mohammad Jawad Khalifé, Minister of Public Health issued a memorandum requesting all eligible cardiac catheterization centers to participate in this registry. Despite all efforts, some centers are still refusing to participate in this process, and some others have not made the efforts to become technically ready for using the LICOR software. The use of paper forms in those centers increases the probability for errors and missing data. Major categories of missing data are found in home addresses, body mass index (BMI) and PCI outcomes. We call upon all centers to participate in LICOR, to do so using the electronic form, and to ensure continuity and timeliness of reporting. LSC is happy to provide assistance for the software or any other technical problem.

Data collected in the first year of this registry represented about 30% of all interventional events in Lebanon in 2004. In 2005, LICOR had recorded more than 61% of all coronary- angiographies and more than 56% of angioplasties done in Lebanon. By the end of 2007, the LICOR data base included 45878 coronary procedures collected case per case in real time recording.

In February 2006, the Euro Interventional Journal stated that: “Pilot registries with a real time case per case recording are in progress in a small number of European institutions. The idea is to extend that method of data collection to all invasive centers of the member countries. This will obviate the current reporting delay and guarantee accuracy of numbers. Including reliable hospital outcome data will require a second look data entry at discharge and audits for quality control. A conservative estimate is that the first step can be accomplished within 5 years. The second needing another 5 years…

With LICOR Lebanon has been a leader in this domain in accomplishing the first step in this ambitious project
Lebanon/Denmark session in EUROPCR (Multivessel disease) Thursday 19th May Room 242A 8h30-10h00
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