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List of Registries/Databases




 
Divisions:    ACSS | Allied Heatlh | Medicine | NCCS | Pathology | Surgery



ACCS

Division  Department  Database Title  PI's Name  Abstract
ACSS  Emergency Medicine Cardiac Arrest and Resuscitation Epidemiology in Singapore phase IV (CARE 4) A/Prof Marcus Ong  -
ACSS  Emergency Medicine Comparing 'IV+IO' as 'IV only' in SCDF EMS Dr Kenneth Tan Boon Kiat  Introduction:
Obtaining intravenous (IV) access in the prehospital setting is a challenging process due to environmental and patient factors. The Singapore Civil Defence Force (SCDF) paramedics have only a 50% success rate of obtaining an IV access. SCDF responds to around 1400 cases yearly and this translates to only 50% of OHCA getting adrenaline in addition to cardiopulmonary resuscitation (CPR). Early administration of adrenaline is thought to improve chances of return of spontaneous circulation (ROSC). Prehospital intraosseous (IO) has also been initiated in some countries with good results.
Aim:
Hence, SCDF has set up an IO protocol for difficult venous access. The purpose of this study is to assess the clinical impact of a protocol including ‘IV+IO’ vs ‘IV alone’ in OHCA. We also aim to see whether there is any difference with the rates of successful vascular access, 1st dose adrenaline administered in both groups and whether there is any difference in ROSC survival outcomes. We also aim to determine the cost benefit of introducing IO access to the Emergency Ambulance Service (EAS) for OHCA.
Methodology:
We propose to conduct a prospective, parallel-group, cluster-randomized, study comparing ‘IV+IO’ and ‘IV alone’ protocols in patients with cardiac arrest (medical or traumatic) managed by SCDF EAS.
The trial will recruit 400 eligible patients over 1 year. Currently, for critical ill patients in whom it is impossible to achieve rapid intravenous access, IO insertion is the accepted standard of care in Singapore General Hospital, Department of Emergency Medicine. Patients will have a proximal tibial insertion if they fulfil the eligibility criteria.
ACSS  Emergency Medicine Pan Asian Resuscitation Outcomes Study (PAROS) A/Prof Marcus Ong

Out of Hospital Cardiac Arrest (OHCA) is a global health concern. Survival rates in Singapore are low (2%) compared to USA or Europe (up to 40%).  Design  a prospective, international, multi-center cohort study of out-of-hospital cardiac arrest in Singapore and across the Asia-Pacific. The cost-effectiveness analysis for this study will be focused on Singapore's Emergency Medical Services (EMS) system. We aim to identify the relative importance of modifiable factors affecting survival from OHCA. We will then derive the most cost-effective strategy to improve survival from OHCA in Singapore. This will be based on a comparison of 5 competing (although not exclusive) strategies targeting major systemic and modifiable factors for OHCA survival.     

The large sample size and international nature of the study provides a unique opportunity for analysis of preventable risk factors for OHCA and systemic predictors of survival. Identifying the relative incremental cost-effectiveness of modifiable factors for OHCA survival will allow prioritization and selection of 5 pre-identified competing interventional strategies (namely: increasing bystander cardio-pulmonary resuscitation (CPR), public access defibrillation, decreasing EMS response times, developing advanced EMS life support, specialized Cardiac Arrest Centers).  

Data will be collected from emergency dispatch records, ambulance patient case notes, Emergency Department (ED) and in-hospital records. All completed data will then be collected and sent to the Study Co-ordination Center (Singapore) for data management using Electronic Data Capture (EDC).    

The required sample size for the study is 13,447 OHCA patients and Singapore will contribute 2,000 cases. The relative effectiveness of the interventions associated with each of the 5 strategies will be determined. A cost analysis for the various strategies will be conducted to determine the incremental cost-effectiveness in Singapore for each strategy.

Eligibility:
All OHCA patients presenting to EMS '995' or Emergency Departments during the study period as confirmed by the absence of pulse, unresponsiveness and apnea.

ACSS  Emergency Medicine Pan Asian Therapeutic Hypothermia Registry (PANTHER) A/Prof Marcus Ong Controlled therapeutic hypothermia is a method of preserving neurological function post-resuscitation. It has been associated with improved functional recovery and reduced histological deficits in animal models of cardiac arrest. Three randomized clinical studies have been reported showing improved neurological outcome and reduced mortality in post-resuscitation patients treated with hypothermia compared to controls.  

Therapeutic hypothermia (TH) after cardiac arrest can possibly help protect patients' neurological function. Therapeutic hypothermia is very new in the Asia Pacific, although it is standard of care in many countries in Europe and North America. We propose to set up a hypothermia registry in Singapore and across the Asia Pacific through the Pan Asian Resuscitation Outcomes Study (PAROS) network. The development of hypothermia registry will allow participating hospitals to collectively enter and manage data. A standardized case record form will be adopted across participating hospitals for more seamless data collection and analyzing of outcomes. Through this registry, we hope to encourage sharing of best practice and build a platform for further research in TH.  For this purpose, we will utilize ePAROS, a web-based, electronic data capture system (EDC) for data collection and managing of data variables. Currently, ePAROS is used as a platform for collecting and entering OHCA data under the PAROS network. An additional hypothermia module will be created in ePAROS to collect variables such as time to reach target temperature, survival outcomes, prehospital and hospital discharge information, and neurological outcomes.

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ALLIED HEALTH

Division  Department  Database Title  PI's Name  Abstract
Allied Health Podiatry Inpatient diabetic foot screening Manfred Mak  A 'modified 60 second diabetic foot screening tool' (DiaFoST) was developed by a multidisciplinary team to enable a quick and simple approach to screening for the high risk diabetic foot.

Inclusion:
Patients with diabetes admitted to DIM, in wards 53,54, 63 and 73.

Exclusion:
Patients without diabetes.  Patients who are non-communicative or are unable to provide informed consent.

Allied Health Pharmacy Anti-fungal resistance diagnosis - moving forward with molecular techniques for point of care therapeutics Dr Andrea Kwa Lay-Hoon  -


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MEDICINE

Division  Department  Database Title  PI's Name  Abstract
Medicine Endocrinology Jade/diamond Dr Goh Su-Yen The Joint Asia Diabetes Evaluation Program (JADE) electronic portal is a framework for data collection, risk stratification and individualization of treatment. SGH is the only Singapore site participating.
Medicine Endocrinology DAFNE Dr Goh Su-Yen DAFNE is a structured patient education program that equips individuals with type 1 diabetes with the knowledge and skills to match insulin to dietary intake and lifestyle. Key points include precise carbohydrate estimation and meal-time insulin-to-carbohydrate ratio calculation, sick day and exercise management. Our centre is the first in Asia to conduct DAFNE training
Medicine Endocrinology Study of weight loss management Dr Tham Kwang Wei  -
Medicine Endocrinology Study of bone and metabolism Dr Tham Kwang Wei  -
Medicine Haematology Chronic Myeloid Leukaemia Dr Charles Chuah  -
Medicine Haematology A Registry for 'OFF LABEL' use of recombination activated factor Vlla (NOVOSEVEN) in Singapore General Hospital Dr Ng. Heng Joo  -
Medicine Haematology A Registry of Patients with Acquired Coagulation Factor Inhibitors Dr Ng. Heng Joo  -
Medicine Respiratory & Critical Care Medicine Prospective database of clinical and demographic data from patients on chronic long-term mechanical ventilation at Singapore General Hospital Dr Ong Thun How  -
Medicine Respiratory & Critical Care Medicine A Prospective Data Base of Clinical and Polysomnographic Features of Patients Undergoing Overnight Polysomnography Dr Ong Thun How During PSG multiple data sets are collected ( electroencephlography, respiratory, electrocardiographic data, sleep staging, oxygenation as measured by pulse oximetry, body positions etc). There is little published data on how the individual data sets of polysomnographic data relate to clinical outcome, especially in an Asian population.
Medicine Rheumatology and Immunology Systemic Sclerosis Database Dr Andrea Low Hsiu Ling  -
Medicine Rheumatology and Immunology Disease characteristics and outcome of patients with systemic sclerosis in Singapore Dr Andrea Low Hsiu Ling Systemic sclerosis (SSc) is an autoimmune disease characterised by skin thickening, microvascular injury and fibrosis, leading to multiple organ damage. Data from multi-ethinic cohorts suggest that non-whites are more likely to have severe disease.
The study involves all patients diagnosed with systemic sclerosis (SSc, diffuse and limited cutaneous forms, and overlap syndromes) under current or previous follow-up by rheumatologist in Singapore General Hospital and Alexandra Hospital. By understanding the determinants of disease, high risk populations can be identified and more effective health interventions can be adminstered. This study aims to identify the clinical and laboratory predictors of adverse outcomes in a predominantly Chinese population so that physicians are able to better manage these patients.
Medicine Rheumatology and Immunology Comparing T-regs with double stranded DNA (dsDNA) and complement levels in predicting flares in SLE (SGH-RHI-CG) Prof Julian Thumboo  -
Medicine Rheumatology and Immunology Prospective study of disease characteristics, progression, prognosis and its determinants in Systemic lupus erythematosus Prof Julian Thumboo  -


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NCCS

Division  Department  Database Title  PI's Name  Abstract
NCCS Surgical Oncology Evaluation of MSI interactions in Stage 2 Colorectal Cancer Dr Melissa Teo The incidence of Colon Cancer is on an uptrend. Out of all new cases of Colon Cancers diagnosed, 30-40% are Stage II. Current NCCN guidelines recommend adjuvant chemotherapy only for select patients with Stage II disease who have high risk of systemic recurrence. There is also data to suggest that patients with microsatelite instabillity (MSI-H) may have a good prognosis and may not benefit from systemic 5 Fluro-Uracil (5 FU) based chemotherapy. These patients may even suffer from the detrimental effects of such therapy. This study thus aims to assess the effects of clinical outcome of 5FU based chemotherapy in MSI-H patients, taking into account the presence and absence of  high risk factors in Stage II Ca Colon (poorly differentiated, bowel obstruction, <12 Lymph Nodes harvest, perineural invasion, localised perforation, close/involved margins).

Inclusion Criteria:

Patients newly diagnosed with Stage II Colon Cancer, treated by surgical resection

Exclusion Criteria:

Patients who present with recurrent disease.


(SGH-NCC-DMO-SGH-Colorectal Cancer)

NCCS Surgical Oncology Studies on the role of the MULE in intestinal homeostasis and colorectal cancer Dr Melissa Teo MULE (aka HUWE1, HECTH9, UREB1, and ARFBP1) was identified several years ago as a potential oncogene, most prominently in colon carcinoma, in Western countries.  Using tumour microarray (TMA) of samples from SGH, we have recently found this to be true for the Singapore population as well.  Strangely, no efforts are published to define the significance of MULE overexpression.  In order to better characterize the nature of MULE overexpression and improve potential outcomes for colon cancer patients in the future, we are proposing an analysis of existing patient tissue to examine how MULE overexpression correlates with demographics and patient outcomes.  Ideally our study could provide another weapon to the current arsenal of pathological assays thus guiding clinicians to prescribe superior therapies.

Target Samples:
300

Inclusion criteria:

1) pathological staging of primary tumors from 1 to 4,
2) no previous treatment at the time of sample collection
3) minimum patient survival of 6 months beyond sampling
4) age 35-70 at the time of sampling

Exclusion criteria:

1) known hereditary cancer-susceptibility mutation
2) patient died of non-CRC related condition within 5 years of sampling
3) known non-compliance or poor compliance with treatment regimen.

 
(SGH-NCC-DMO-SGH-Colorectal Cancer)

NCCS Surgical Oncology Audit of Pelvic Oncology patient outcomes Dr Melissa Teo The primary aim of this project is to create an online database to track outcomes of all pelvic oncology patients and undergo treatment at our institution. We aim to capture the treatment details (i.e. type of treatment, treatment regime and course), operative factors (i.e. duration of surgery and size of tumour), post-operative factors (i.e. length of hospitalisation, blood transfusion), medical treatment (i.e. chemotherapy) and treatment complications, using the capabilities afforded by the new REDCAP (Research Electronic Data Capture) relational database system implemented by the SGH Research Department. With this data, we plan to use the information to analyse the survival and disease free data from our own institution, and the impact of operative and non-operative treatment on patient outcomes. With this knowledge, we will be better able to prognosticate these patients and refine our management plan for pelvic oncology patients

The use of the software in this way creates benefits both in terms of future research as well as practical everyday benefit in terms of expediting the data collection and create an easily retrievable records for future reference. With such a system in place, we can collect data prospectively for any future studies and hence minimise data that might be missing that occurs with retrospective studies.

Inclusion Criteria:
1. All patients referred to the National Cancer Centre and Singapore General Hospital with a diagnosis of pelvic oncological disease
2. Both primary and metastatic pelvic oncology

Exclusion Criteria:

Nil

(SGH-NCC-Audit of pelvic oncology patient outcomes using the REDCap platform)

NCCS Surgical Oncology Audit of Sarcomas Patient Outcomes using the REDCAP platform Dr Melissa Teo The primary aim of this project is to create an online database to track outcomes of all patients who are undergoing sarcoma surgery. We aim to capture the operative factors and post-operative factors and complications, using the capabilities afforded by the new REDCAP (Research Electronic Data Capture) relational database system implemented by the SGH Research Department. With this data, we plan to use the information to analyse the survival and disease free data from our own institution, and the impact of operative and non-operative treatment on patient outcomes. With this knowledge, we will be better able to prognosticate these patients and refine our selection criteria.

Inclusion Criteria:
1. All patients referred to the National Cancer Centre with a diagnosis of sarcoma and will be undergoing surgery.
2. All primary and recurrent sarcomas.

Exclusion Criteria:
 Nil

(SGH-GES-Sarcoma)

NCCS Surgical Oncology Audit of Head and Neck Oncology Patient Outcomes using the REDCAP Platform Dr Gopal Iyer The primary aim of this project is to create an online database to track outcomes of all head and neck oncology patients capturing the various treatment modalities that they receive (surgery, chemotherapy and radiotherapy) substratified by tumour subtype, stage and grade using the capabilities afforded by the new REDCAP (Research Electronic Data Capture) relational database system implemented by the SGH Research Department. The system also allows us to utilize it as a presentation platform for surgical oncology multidisciplinary meetings as well as to enter and record the joint decisions of the committees real-time at the meetings into the database for future research projects and audit purposes. The use of the software in this way creates benefits both in terms of future research as well as practical everyday benefit in terms of expediting the current tumour board system and creating persistent, easily retrievable records for future reference.

Inclusion Criteria:

1. All head and neck cases since 2000.
2. All head and neck cases presented at head and neck tumour board meetings
 
Exclusion Criteria:
Nil


(SGH-HNC-Proj1-Head & Neck Surgery Tumour Board)

NCCS Surgical Oncology Retrospective and Prospective analysis of Quality of Life (QOL) in Sarcoma Patients Dr Melissa Teo

Surgery is the mainstay of treatment for sarcoma and is considered a major surgical procedure with associated morbidities due to the need for adequate clearance and resection of adjacent organs. Currently, there is little local data assessing the quality of life (QOL) in patients diagnosed with sarcoma. With the results from this study, we can have a better understanding of the possible challenges faced by patients during recovery and better tailor the pre/post treatment support.

Inclusion Criteria:
Patients diagnosed with sarcoma.
There will be two groups of participants:
1) For the prospective participants - patients who will be undergoing surgery for sarcoma
2) For the retrospective participants - patients who have undergone surgery for sarcoma in the past 25 years

Exclusion Criteria:

Nil

(SGH-GES-Sarcoma)

NCCS Surgical Oncology Audit of Melanoma patient outcomes Dr Melissa Teo The primary aim of this project is to create an online database to track outcomes of all patients who are diagnosed with melanoma and undergo treatment at our institution. We aim to capture the treatment details (i.e. type of treatment, treatment regime and course), operative factors (i.e. duration of surgery and size of tumour), post-operative factors (i.e. length of hospitalisation, blood transfusion), medical treatment (i.e. chemotherapy) and treatment complications, using the capabilities afforded by the new REDCAP (Research Electronic Data Capture) relational database system implemented by the SGH Research Department. With this data, we plan to use the information to analyse the survival and disease free data from our own institution, and the impact of operative and non-operative treatment on patient outcomes. With this knowledge, we will be better able to prognosticate these patients and refine our management plan for patients with melanoma.

The use of the software in this way creates benefits both in terms of future research as well as practical everyday benefit in terms of expediting the data collection and creates easily retrievable records for future reference. With such a system in place, we can collect data prospectively for any future studies and hence minimise data that might be missing that occurs with retrospective studies.

Inclusion Criteria:
All patients referred to the National Cancer Centre with a diagnosis of melanoma. We will include primary and metastatic melanomas.

Exclusion Criteria:
Nil

(NCC-ONC-Melanoma)

NCCS Surgical Oncology Prospective analysis of Quality of Life (QOL) in Head and Neck Cancer Patients. Dr Gopal Iyer Head and neck cancer is a particularly distressing disease which can profoundly impair daily activities such as swallowing, chewing and speech. Patients require complex, multi-modality treatments including surgery, chemotherapy and radiotherapy.  These treatments are often associated with high morbidity. Medical advances have improved survival but patients still face recovery challenges. Currently, there is little local data assessing the quality of life (QOL) in patients diagnosed with head and neck cancers. This study aims to prospectively collect and analyse QOL data in head and neck cancer patients.

Inclusion Criteria:
1. Patients who are diagnosed with head and neck cancers and thyroid disease requiring thyroidectomy. 
2. Primary and metastatic disease.

Exclusion Criteria:
Nil

(SGH-NCC-DSO-HNQOL-Prospective Analysis of QoL in H&N CA patients)

NCCS Surgical Oncology Prospective analysis of Quality of Life (QOL) in Pelvic Oncology Patients Dr Melissa Teo Cytoreductive surgery, peritonectomy and intra-peritoneal chemotherapy has been shown to improve survival in patients with peritoneal disease in certain cancers such as ovarian and colo-rectal carcinoma. However, there is currently no local data comparing quality of life (QOL) between patients who undergo cytoreductive surgery and palliative chemotherapy.
This study aims to prospectively compare the QOL in patients who underwent peritonectomy and intra-peritoneal chemotherapy vs patients on palliative chemotherapy.

Inclusion Criteria:
All patients with a diagnosis of pelvic oncological disease

Exclusion Criteria:

Nil

(SGH-NCC-Audit of pelvic oncology patient outcomes using the REDCap platform)

NCCS Surgical Oncology Audit of Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) Patient Outcomes using the REDCAP Platform Dr Grace Tan The primary aim of this project is to create an online database to track outcomes of all patients who are undergoing cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for the treatment of peritoneal carcinomatosis. We aim to capture the pre-operative factors (i.e. age at diagnosis, tumour type, previous treatment), the operative factors ( i.e. blood loss, duration of surgery, chemotherapy used), post-operative factors (i.e. length of hospitalisation, blood transfusion), and complications, using the capabilities afforded by the new REDCAP (Research Electronic Data Capture) relational database system implemented by the SGH Research Department. With this data, we plan to analyse the survival and disease free survival data from our own institution, and the impact of pre-operative, operative, post-operative factors and complications on patient outcomes. With this knowledge, we will be able to refine our selection criteria for this procedure, and will be better equipped to counsel patients for CRS and HIPEC.
The use of the software in this way creates benefits both in terms of future research as well as practical everyday benefit in terms of expediting the data collection and creating persistent, easily retrievable records for future reference.


Inclusion Criteria:
All cases considered for CRS and HIPEC

Exclusion Criteria:
Nil

(SGH-GES-Proj1-HIPEC Patient Outcomes (Longitudinal))

NCCS Surgical Oncology A prospective analysis and comparison of Quality of Life (QOL) in patients who underwent peritonectomy and intra-peritoneal chemotherapy vs patients on palliative chemotherapy Dr Melissa Teo

Cytoreductive surgery, peritonectomy and intra-peritoneal chemotherapy has been shown to improve survival in patients with peritoneal disease in certain cancers such as ovarian and colo-rectal carcinoma. However, there is currently no local data comparing quality of life (QOL) between patients who undergo cytoreductive surgery and palliative chemotherapy.
This study aims to prospectively compare the QOL in patients who underwent peritonectomy and intra-peritoneal chemotherapy vs patients on palliative chemotherapy

Inclusion Criteria:
Patients who are diagnosed with peritoneal disease

Exclusion Criteria:
Nil

(SGH-GES-Proj1-HIPEC Patient Outcomes (Longitudinal))

NCCS Surgical Oncology Employment and Work-Related Issues in Head and Neck Cancer Survivors in Singapore Dr Tan Hiang Khoon Background: Head and neck cancer (H&N) patients, post-treatment are at risk for reduction of quality of life, which may influence return to work, and re-employment.

Aim:
1. To assess the effect of H&N cancer treatment on return to work.
2. To determine the factors (clinical, functional and psychological) involved in delaying and potentially preventing the return to work in H&N cancer patients post treatment.
3. To identify additional patient-centered factors associated with return to work plans in H&N cancer patients.
 Methods: Prospective study to survey H&N cancer patients post treatment (surgery/chemotherapy/radiotherapy) with questionnaires or via phone interviews. These patients are selected based on the inclusion and exclusion criteria (please see section on inclusion & exclusion criteria). H&N cancer patients will be purposively recruited according to the number of years post diagnosis (<2 years, 2-5 years and >5 years.) Within each of these three categories, patients will be stratified according to the primary site of cancer (i.e. oropharynx, nasopharynx, larynx, etc).
 A qualitative study will be performed through recorded face-to-face or phone interviews to identify additional patient-centred factors associated with return to work plans in H&N cancer patients that are not covered in the questionnaires. Key phrases or sentences that represent the factors that influence the return to work plans will be picked out from the recorded interviews and presented in a prose.

Primary outcome measures:
Change in employment status before and after treatment, duration of time between treatment and starting employment, factors affecting return to employment.

Secondary outcome measures: Qualitative assessment to have an in-depth understanding of additional patient-centered factors associated with return to work plans in H&N cancer patients.

Inclusion Criteria:

• >=21 years old at the age of diagnosis
• <=65 years old at the age of diagnosis
• clinically recurrence-free
• >=6 months post cancer treatment
• Singaporean/Permanent residents of Singapore
• Patients who are actively working and employed (part-time and full-time) before diagnosis
• Diagnosed with one head and neck malignancy excluding thyroid cancer.


Exclusion Criteria:

• Multiple co-existing malignancies
• Terminally ill patients
• Patients with distant metastasis
• Multiple malignancies
• Patients with on-going treatment
• Patients who have serious conditions (ie within the past 6 months had episodes of AMI or CVA or underwent major surgeries which are none head and neck related afflicting this age group, for eg Total knee replacement)
• <6 months of treatment
• Patients who are not in active employment
• Patients who have experienced other serious health conditions within the past 6 months (e.g. acute myocardial infarction(AMI), cerebrovascular accidents (CVA). major surgeries which are not head and neck related e.g. total knee replacement (TKR)


(SGH-NCC-DSO-Employment and Work-Related Issues in Head and Neck Cancer Survivors in Singapore)

NCCS Surgical Oncology Audit of Lung Cancer patient outcomes using the REDCAP platform Dr Tina Koh The primary aim of this project is to create an online database to track outcomes of all lung cancer patients. We aim to capture the demographics, tumour and treatment details including operative and post-operative factors and complications and chemotherapy and radiotherapy treatment details, using the capabilities afforded by the new REDCAP (Research Electronic Data Capture) relational database system implemented by the SGH Research Department. With this data, we plan to use the information to analyse the survival and disease free data from our own institution, and the impact of operative and post-operative factors and complications on patient outcomes. With this knowledge, we will be better able to prognosticate these patients and refine our selection criteria.

The use of the software in this way creates benefits both in terms of future research as well as practical everyday benefit in terms of expediting the data collection and creating easily retrievable records for future reference. With such a system in place, we can collect data prospectively for any future studies and hence minimise data that might be missing that occurs with retrospective studies.

Inclusion Criteria:
1. All patients referred to the National Cancer Centre Singapore with a diagnosis of lung cancer.
2. Both primary and recurrent lung cancers.

Exclusion Criteria:
Nil

(SGH-NCC-DSO-Audit of Lung Cancer patient outcomes using the REDCAP platform)


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PATHOLOGY

Division  Department  Database Title  PI's Name  Abstract
Pathology Pathology TB Transmission patterns in Singapore using Molecular methods; Finding opportunities for TB Control Transmission Dr Sng Li-Hwei (SGH PI) [Overall PI is Professor Wang Yee Tang Sonny from Tuberculosis Control Unit] Background:
Tuberculosis remains common in Singapore, increasing in incidence since 2008. We attempted to determine the molecular epidemiology of Mycobacterium tuberculosis complex (MTC) isolates locally, identifying major circulating genotypes and obtaining a glimpse of transmission dynamics.

Methodology:
Non-duplicate MTC isolates archived between 2006 and 2012 at the larger clinical tuberculosis laboratory in Singapore were sampled for spoligotyping and MIRU-VNTR typing, with case data obtained from the Singapore Tuberculosis Elimination Program registry database. Isolates between 2008 and 2012 were selected because of either multidrug-resistance or potential epidemiological linkage, whereas earlier isolates were randomly selected. Separate analyses were performed for the early (2006-2007) and later (2008-2012) study phases in view of potential selection bias.

Principal Findings:
A total of 1,612 MTC isolates were typed, constituting 13.1% of all culture-positive tuberculosis cases during this period. Multidrug-resistance was present in 91 (5.6%) isolates – higher than the national prevalence in view of selection bias. The majority of isolates belonged to the Beijing (45.8%) and EAI (22.8%) lineages. There were 347 (30.7%) and 133 (27.5%) cases clustered by combined spoligotyping and MIRU-VNTR typing from the earlier and later phases respectively. Patients within these clusters tended to be of Chinese ethnicity, Singapore resident, and have isolates belonging to the Beijing lineage. A review of prior contact investigation results for all patients with clustered isolates failed to reveal epidemiological links for the majority, suggesting either unknown transmission networks or inadequate specificity of the molecular typing methods in a country with a moderate incidence of tuberculosis.

Conclusion:
Our work demonstrates that Singapore has a large and heterogeneous distribution of MTC strains, and with possible cross-transmission over the past few years based on our molecular typing results. A universal MTC typing program coupled with enhanced contact investigations may be useful in further understanding the transmission dynamics of tuberculosis locally.



SURGERY

Division  Department  Database Title  PI's Name  Abstract
Surgery Colorectal Surgery Singapore Polyposis Registry A/Prof Tang Choong Leong This is a national database capturing polyposis cases and also HNPCC cases. Sporadic colorectal cancer cases are also captured in the database.
Surgery HPB and Transplant Surgery Pancreaticoduodonectomy Database Dr Brian Goh Large database registry of patients diagnosed with pancreatic tumour undergone treatement via Whipple procedure.
Surgery HPB and Transplant Surgery Liver Cancer Database Dr Brian Goh Large database registry of patients, surgically resected, HCC / Liver Cancer
Surgery HPB and Transplant Surgery Distal Pancreatectomy Database Dr Brian Goh Database registry for patients undergone surgical treatment of distal pancreatectomy.
Surgery Orthopaedic Diagnostic Centre Hip Fracture Surgery Outcomes Registry A/Prof Wong Merng Koon Inclusion: All patients with Fracture Neck of Femur, Intertrochanteric Fracture and Subtrochanteric Fracture who are undergoing the following procedures: a. Dynamic Hip Screw (DHS) b. Proximal Femoral Nail Antirotation (PFNA) c. Trochanteric Stabilising Plate (TSP) d. Bipolar Hemiarthroplasty e. Intramedullary (IM Nail) / Interlocking Nail f. Cancellous screw Fixation

Also including: a. Peri-prosthetic fractures and revisions b. Hip fracture cases with other minor fracture c. Patient with co-morbidities

Exclusion: 1. Cases with multiple fractures 2. Hip fracture as a result of major accidents such as Road Traffic Accidents or Fall from Height 3. Pelvic fractures e.g. acetabular fractures
Surgery Orthopaedic Diagnostic Centre Knee Arthroplasty Outcomes Registry A/Prof Yeo Seng Jin Inclusion:
1. Patients with diagnosis of Osteoarthritis or Rheumatoid Arthritis of the knee. 2. Knee Arthroplasty procedures including, Unicompartmental Knee Arthroplasty (UKA), Bicompartmental Knee Arthroplasty, Total Knee Arthroplasty (TKA/TKR), Revision Total Knee Arthroplasty.

Exclusion:
1. Diagnosis such as Bone Metastasis, Fractures 2. Procedures such as High Tibial Osteotomy
Surgery Orthopaedic Diagnostic Centre Hip Arthroplasty Outcomes Registry A/Prof Yeo Seng Jin Inclusion:
1. Patients with diagnosis of Osteoarthritis, Avascular Necrosis or Rheumatoid Arthritis of the hip. 2. Hip Arthroplasty procedures including, Total Hip Arthroplasty (THA/THR), Revision Total Hip Arthroplasty.

Exclusion:
1. Diagnosis such as Hip Fracture 2. Procedures such as Bipolar Hemiarthroplasty of the Hip-
Surgery Orthopaedic Diagnostic Centre Thoracolumbar Spine Surgery Outcomes Registry A/Prof Tan Seang Beng Inclusion:
1. All spine surgery procedures performed between the mid thoracic to the sacral region (T5 to S2).

Exclusion:
1. Procedures for the purpose of biopsy, spinal injections and radiofrequency ablation.
Surgery Orthopaedic Diagnostic Centre Cervical Spine Surgery Outcomes Registry A/Prof Tan Seang Beng Inclusion:
1. All spine surgery procedures performed in the cervical to the mid thoracic region (Occiput to T4).

Exclusion:
1. Procedures for the purpose of biopsy, spinal injections and radiofrequency ablation.
Surgery Orthopaedic Diagnostic Centre Foot and Ankle Surgery Outcomes Registry A/Prof Inderjeet Singh Inclusion:
1. All Foot and Ankle Surgeries, including Calcaneal Fracture Fixation Surgery.

Exclusion:
1. Foot and Ankle Fractures 2. Removal of Ingrown Toenail
Surgery Orthopaedic Diagnostic Centre Shoulder Surgery Outcomes Registry A/Prof Paul Chang All shoulder surgeries including surgeries for fractures of the shoulder joint, manipulation under anaesthesia for frozen shoulder or shoulder capsulitis.
Surgery Orthopaedic Diagnostic Centre Knee Ligament Reconstruction Surgery Outcomes Registry A/Prof Paul Chang Inclusion:
1. Patients with Anterior or Posterior Cruciate Ligament Reconstruction of the knee.
Surgery Otolaryngology Cochlear Implantation as a novel modality of Hearing rehabilitation for single sided deafness due to sudden sensori-neural hearing loss Dr Barrie Tan -
Surgery Otolaryngology The Role of Acupuncture in the Management of Tinnitus Dr Barrie Tan -
Surgery Plastic, Reconstuctive & Aesthetics Surgery Head and neck reconstruction Dr Adrian Ooi  -
Surgery Plastic, Reconstuctive & Aesthetics Surgery SGH free flaps Dr Adrian Ooi  -
Surgery Plastic, Reconstuctive & Aesthetics Surgery Burns Database Dr Chong Si Jack  A systematic and prospective electronic database will facilitate evidence based burns practices in SGH and allow us to improve clinical outcomes in patients. Burns injuries involve multi-disciplinary care. Most modern burns centre have robust database that allows them to track outcomes for evidence-based care. We intend to develop our own database to capture data currently not tracked within existing systems such as CITRIX and OTM. This will allow us to improve evidence based burns practices in SGH.
Surgery Rheumatology and Immunology Disease characteristics and outcome of patients with systemic sclerosis in Singapore Dr Andrea Low Hsiu Ling  Systemic sclerosis (SSc) is an autoimmune disease characterized by skin thickening, microvascular injury and fibrosis, leading to multiple organ damage. Data from multi-ethnic cohorts suggest that non-whites are more likely to have severe disease. It is evident from studies that both ethnicity and the presence of certain antibodies are independent predictors of SSc severity, in particular lung disease, and that ethnicity directly influence the manifestation of SSc. There is limited data on SSc in Asia, with none available in the English literature on Chinese patients.
We therefore aim  
1) To describe disease characteristics of patients with systemic sclerosis (SSc) and overlap syndromes with SSc in Asian patients in Singapore  
2) To study outcome and mortality data in these patients  
3) To collect patients' blood as part of a sera bank for future research projects involving antibody profiling, human leucocyte antigen (HLA) and deoxyribonucleic acid (DNA) studies. The study involves all patients diagnosed with systemic sclerosis (SSc, diffuse and limited cutaneous forms, and overlap syndromes) under current or previous follow-up by rheumatologist in Singapore General Hospital and Alexandra Hospital. Medical records of SSc patients will be reviewed and data extracted using a standardized protocol, which includes data on patient demographics, disease characteristics (both clinical and immunological) and mortality. By understanding the determinants of disease, high risk populations can be identified and more effective health interventions can be administered.
This study aims to identify the clinical and laboratory predictors of adverse outcomes in a predominantly Chinese population so that physicians are able to better manage these patients.
Surgery Surgical Oncology Validation of a Pragmatic management Algorithm for Suspected Appendicitis A/P Ong Hock Soo  -
Surgery Urology LUTS / BPH database Prof Foo Keong Tatt Our aim to analyse the natural history of patients with benign prostatic hyperplasia. This would be done by collecting PSA, IPSS, QOL scores, prostate volume, grade of intravesical prostatic protrusion, uroflowmetry and residual volume of urine over time.

This data would be obtained from the casenotes at first presentation, then at 1 month, 3 month, 6 month, 1 year then early thereafter. Using this information, we would be able to classify patients according to stage of BPH and advise appropriate treatment ie conservative, medical or surgical treatment.

It would enable the study of the effectiveness of the treatment and whether there is improvement in outcome by reassessment of the stage of the disease after intervention. This data collected and analysed would eventually allow prediction of natural history of BPH and its most appropriate treatment at each stage of the disease.

Surgery Urology Urological Cancer Registry Prof Christopher Cheng The urological cancer registry is a systematic data collection of all pathologically and clinically diagnosed cancer cases at Department of Urology, SGH.  Data is stored in the databases of Excel and Access at Department of Urology, SGH with secure features to protect patients' confidentiality and privacy.  It is the critical basis for clinical audits, research initiatives & publications and clinical trials on cancers in the Department of Urology, SGH.  

The registry will take close reference to international standards, such as Commission on Cancer (CoC), Surveillance Epidemiology and End Results (SEER), North American Association of Central Cancer Registries (NAACCR) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule, in its practice of case-finding, data abstracting, data validating and data analysis.  

It is anticipated that the registry will contribute to the improvement of care through clinical audits and quality research.


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