Summary
of the ESSCA meeting on December, 14
th,
2000 in Amsterdam (VU)
Participants:
R. Arnold (IVDK, Göttingen), W. Kamphof (VU/Dermatology, Amsterdam), B.
Knudsen (Gentofte Hospital, Copenhagen), F. Lessmann (VU/IT Dept., Amsterdam),
M. Meinardi (Acad. Med. Centr., Amsterdam), Th. Rustemeijer (VU/Dermatology,
Amsterdam), C. Scholten (AZH/Dermatology, Groningen), W. Uter (IVDK,
Osnabrück)
Thanks
to the staff of the VU dermatology department for hosting this meeting!
- Together
with the German ESSCA partners, the three Dutch partners and B. Knudsen from
Copenhagen are the first to install and use the WinAlldat/ESSCA software.
- Funding
for ESSCA will be sought for from manufacturers and industrial associations;
additionally, A. Schnuch and W. Uter are preparing a EU proposal under the 5
FP, area ”Environment & Health”.
- In
the VU department, the program runs under Windows 2000 and MS Office/Access
2000, respectively. While this is not actually supported by the program
developers, it seems to be possible without stability problems.
- It
is possible to work in a network with WinAlldat (as several German partners
do), but it is recommended not to use more than five clients simultaneously.
- Personal
data, including hospital or national patient ID-numbers, are not transferred
with the set of data exported for ”central pooling”. The export
files contain plain ASCII; they are automatically compressed to one zip-file.
- In
the unlikely case of the whole database having to be transferred to the data
centre / support in Göttingen (instead of applying a set of transactions
locally to the database, e.g., for future extensions and amendments) the
patient data will be encrypted locally, so that they are not readable
elsewhere, and decrypted only on return of the updated database. R. Arnold will
supply ESSCA partners with such a tool; e.g., via the Göttingen
FTP-server. For additional security, the database would be treated on a PC not
connected to the Internet in Göttingen.
Catalogues
- Occupations:
The
full list of occupations is considered too long to be practicable. However, if
only a very concise version, including only the most common job titles is used,
with the instruction to consult the full list if the actual job title of a
patient cannot be found, the latter may not be done, resulting in too gross or
mis-classification. As a compromise, to make the European standard ISCO-88COM
applicable for ESSCA, W. Uter will present a carefully shortened list.
- Current
diagnoses:
All
Dutch ESSCA partners require the recording of more diagnoses than the ones
included in the ”minimal dataset” (ACD, ICD, endogenous eczema,
”Other” diagnosis [to be specified]). As a compromise combining
this apparent need with ESSCA ”minimal dataset” requirements, W.
Uter suggested to include 4 diagnoses (with identical pick lists, containing
the three above mentioned diagnoses and any additional terms) together with an
additional qualifier for each of these 4 diagnoses (i.e.,
”exclusively”, ”predominantly”,
”contributing”).
- Substances:
The
names of the allergens can be edited (=changed, e.g., translated) via MS
Access, as long as the full meaning is preserved and the key number is not
altered. Occasional duplicates may occur despite utmost care when introducing
new allergen names. If they have not yet been used in a test series, they may
be invalidated by typing ”XXX...” in the ”name” data
field. If they are used, the same can be done, but the substance-ID has to be
changed into the ID belonging to the remaining term in the table
”tblTestsubst” via MS Access
(this
table links the allergens names with concentration etc.; the
”testsubstid” is quoted in the table ”tblBlocksubst”
which is then linked to ”tblBlock”, containing the name of the
series etc.)
Test
series containing special substances currently under investigation which should
not be transferred to the data centre for pooling can be given the test method
attribute ”epicutaneous in loco” (or, actually, any other –
possibly newly created – attribute than ”epicutaneous”): only
results with substances contained in test series marked
”epicutaneous” (ID=A) are selected for transfer. In future, an
additional attribute of the test series will serve as a respective flag.
- Sites:
Altogether
six sites are considered necessary; as with additional diagnoses, the present
possibility to include these as ”additional questions” is
considered too clumsy (question: diagnosis-related, i.e., six sites for each
diagnosis? To be clarified)
- Screen
and other designs:
Several
improvements have been suggested concerning screen design, which can help to
ease the use of the program:
- Moving
the left ”final diagnosis” button upwards
- Using
the free space for a header ”printouts”, referring to the 4 buttons
at the bottom of the main dialogue
- Use
the same terms on buttons and on the entries in the pull-down menu lists
- Narrower
page margins for printout, especially test protocols, to enable longer test
series to fit under the first-page header.
- Reports
The
reports presently included are partly rudimentary. They are derived from
statistics included in the old IVDK software. As further development of this
essential function (data entry would not be worthwhile if data cannot be
analysed locally also) R. Arnold and W. Uter propose the creation of a second
database, containing a transformed copy of the original database (which is
optimised for minimum storage and maximum update flexibility) in a much more
aggregated fashion, largely identical to the data structure of centrally pooled
data. This would mean that the same queries can be used locally and centrally
(=synergistic effect); additionally, queries developed locally by experienced
MS Access users (as C. Scholten) can be distributed (e.g., via the data centre
/ FTP-server) to other ESSCA partners, because most of the statistics will be
of interest for others, too. However, in this case, the purpose and logic of
such a report must be carefully documented and explained, so that it can be
fully understood by those applying it.
- This
and that:
- Instead
of travelling to the ”OK-button” with the mouse pointer, the
”Pos-1” key can be activated for ”save” and the
”End” key for ”cancel” (pull-down menu
”Extras” à ”Options” à
”Keyboard”)
- The
paper ”history form” (a Winword 97 document which may be edited,
e.g. translated locally) will be distributed together with installation files
- Data
fields containing unstructured text should either be visible (e.g.,
”unformatted text” in the main dialogue, as ”relevance
description” is visible in the relevance dialogue and – at least
partly – at the bottom window of the main dialogue) or some marking
should be displayed showing that text has been entered (e.g., comments to the
reading of a test series at a certain reading time).
- During
the meeting of ESSCA after the ESCD meeting in May, 2000, already it was
suggested (and will be implemented in the next program version) that the user
should be able to pick single standardised test-substances and compile these to
an individualised test series (as with materials brought in by the patient)
without loosing the possibility to include these in analyses concerning these
standardised allergens (as yet, patient materials from individual test series
are stored and analysed differently).
At
the moment the only possibility is to choose a test series containing the
desired allergen(s) and mark all other allergens with ”NT” for not
tested.
Wolfgang
Uter, Osnabrück, Dec., 17
th,
2000