National Obstetric Anaesthetic Database (NOAD)
NOAD was set up in 1998 with an OAA research grant and the support of the Royal Colleges of Anaesthetists, Obstetricians & Gynaecologists, and Midwives. Its aims were to establish a framework for collecting national obstetric anaesthetic data, particularly information considered useful and relevant by obstetric anaesthetists.
NOAD's initial research was to determine what data were already being collected in UK maternity units, and what obstetric anaesthetists would rank as important items. From this evolved three further roles for the NOAD Steering Group. First, this initial project provided useful information that could be fed into the National Maternity Record project. Second, it led to work on the design and content of obstetric anaesthetic records. Third, the multidisciplinary Steering Group became a forum for various groups with an interest in maternity information (e.g. anaesthetists, obstetricians, midwives, public health and lay parties) and attempted to (i) prevent duplication of each other's activities and (ii) coordinate each group's efforts to establish data collection systems.
By 2001, the NOAD research project achieved its original aims. National data had been collected on postpartum headaches in 1999 and in 2000 the scope of high dependency care in obstetrics was investigated. The OAA Committee accepted a change of organisation such that NOAD would become part of the OAA and would be coordinated through its Audit Subcommittee.
In 2003 the NOAD Steering Group reflected on the aims and achievements of the previous 4-5 years. It was felt that too much, too detailed information was being requested making it difficult for units to contribute and difficult for the NOAD committee to analyse, without considerable financial, computer and manpower input which the OAA was unable to facilitate. A much reduced dataset requesting annualised block data from units was produced and ratified by the OAA committee. Since 2004 data has been requested on an annual basis with e-mail and telephone reminders. The response rate for 2004 data was 52% of units. This increased to more than 75% for 2006 data. This is much better national obstetric anaesthetic information than has previously been reported. The full reports are available in the OAA members area.
An outline of NOAD's activities is given below:
Original NOAD Dataset
The NOAD Steering Group produced a dataset with agreed terms and definitions, which was ratified by the OAA and which has contributed to the NHS Information Authority Maternity Care Data Project.
The original dataset comprised 20 "core" items which were considered necessary for national collection, including general (patient's number, age etc), specific obstetric (gestation, mode of delivery etc) and anaesthetic (type of anaesthesia etc) information.
There were also other items more appropriate for local audits and were included to standardise definitions.
The dataset accounted for the fact that different groups already collect different items; thus there should be no need for anaesthetists to collect basic obstetric data since this will routinely be collected by the midwives/obstetricians.
It must be stressed that this dataset was not intended as a bundle of sheets of paper that were to be filled in by hand for every patient, in addition to current paperwork. Rather, it was intended as a guide to what should be the minimum content of any maternity system (usually computerised) planned within a unit. Thus, any supplier of software would have to meet these standards in order to receive OAA approval.
All NOAD reports have only been possible with the support of the OAA membership and we are grateful to all members who have contributed data.
|A list of reports, with links, can be found on the Members' Area of the website|
NOAD-2000 (high-dependency care)
NOAD-2001 (baseline obstetric anaesthetic data)
NOAD-2002 (baseline obstetric anaesthetic data + age and parity with high regional block or difficult intubation)
NOAD-2003 (baseline data + workload data (13% return))
The NOAD 2004 project used the new reduced data set collecting collated information from units. 52% of units responded (the highest response of all previous NOAD projects). The full report may be seen in the members area and in Pencil-point Summer 2006 (No 24).
NOAD 2005 data collection was the same as NOAD 2004. The full report may be seen in the members area.
Some additional fields on epidural administration were added. The collection closed on 8 August 2008 and the full report may be viewed in the members area.
Data fields about parity were omitted and new fields on dural puncture headaches and blood patching were added. 2007 Collection
Fields unchanged. 2008 Collection
Nine additional fields added on obstetric anaesthesia related complications. Data being entered on OAA survey system. 2009 Collection
All suggestions and comments relating to past, current and future projects are very welcome and should be directed to Dr Marc Van de Velde (Chair, Audit subcommittee).