Minor Data Request for Quality Improvement

STS National Database participants may use this form for ad hoc queries of Database data for internal quality improvement purposes. Please note: You may submit a data request for the Database component(s) in which you participate. Incomplete forms will not be considered.

(*) Required Field

Requestor's Name:

Email:

Phone:

Organization:

Participant ID Number:

Select Relevant Database:

Please describe your data request.

Example: I am reviewing national results for AVR and need to have cases stratified into isolated AVR; AVR + MVR; AVR + CABG; AVR + MVR +CABG.

How will these data be used?

Surgery Date From (to be included in analysis):

Surgery Date To (to be included in analysis):

Inclusion/exclusion criteria:

Relevant STS variables (Please include shortnames):

Upload table specifications or sample tables (if needed):

One file only.
4 MB limit.
Allowed types: pdf, doc, docx.

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