ABC | Volume 114, Nº3, March 2020

Original Article Vaz et al. RIAM – registry of acute myocardial infarction Arq Bras Cardiol. 2020; 114(3):446-455 Figure 3 – National Distribution - Centers of the multicenter Registry of Acute Myocardial Infarction. Via Google Drawings - https://docs.google.com/drawings Instituto de Cardiologia do Distrito Federal (IC-DF), Brasilia, Distrito Federal COORDINATING CENTER Instituto de Cardiologia - Fundação Universitário de Cardiologia (IC-FUC), Porto Alegre – RS Hospital e Maternidade Marieta Konder Bornhausen (HMMKB), Itajaí – SC Hospital Geral de Caxias do Sul (HGCS), Caxias do Sul – RS Hospital UNIMED, Caxias do Sul – RS Hospital da Cidade de Passo Fundo (HCPF), Passo Fundo – RS Hospital Universitário de Santa Maria (HUSM), Santa Maria – RS ICOR - Laboratório de Cardiologia e Hemodinâmica Ltda., Santa Maria – RS The training focused on the goal of the registry, clarifying the process of collecting and entering data into REDCap. The SOP for data collection ensures standardized and consistent data collection and contains a description of all data elements, including their definitions and procedures to be used while entering data (Figure 4). In addition, online and face-to-face training was provided to researchers to clarify possible questions about the data collection process. Data entry activities were monitored online. Data quality reports by REDCap software For the generation of automated quality control reports and to prevent incomplete data, the main variables were included as required data, and the limits were defined as minimum and maximum ranges for numerical variables ( ranges ). Missing data reports ( missing ) were sporadically generated for internal checking of the required variable ( records ). Field validation reports for checking incorrect data were also generated, as well as numeric field reports for checking non-standard, invalid, or unfilled variables. (Figure 5). Discussion In this study, we described the process of implementing a STEMI database in a reference hospital and its application to other centers across the national territory through the use of a web-based platform. We also detailed the processes for standardization of variables, implementation of institutional REDCap software, development of case report forms (CRF), expansion of the registry to other reference centers using the REDCap software, and training of staff and participating centers using an SOP (Standard Operating Procedure). Randomized controlled trials (RCTs) are the gold standard for demonstrating the effectiveness of a given intervention and form the theoretical basis for formulating guidelines. Observational data such as those obtained from clinical records complement scientific evidence of RCTs by demonstrating effectiveness in clinical practice. 24 The assessment of clinical practice in Brazil requires access to national records representing the STEMI patient population to provide the analysis of clinical and therapeutic characteristics in addition to its outcomes. Besides that, it allows to measure compliance to guidelines, develop risk stratification tools and inform public policies to improve the treatment of this pathology in our country. 4,25,26 The evaluation of outcomes requires the standardization of variables using standard terminology, thus allowing comparison with results from other studies such as international registries and RCTs. It also promotes collaboration from information exchange across STEMI patient care centers. During the process of improvement and standardization of variables in our registry, the NCDR STEMI registry coordinated by the ACCF was used as a reference, and the same variable profile was found both in RIAM and NCDR databases. 16,17 Any registry seeking national representativeness and coverage should include the largest number of consecutive patients and an association of quality and efficiency in data collection. In addition to that, it is important to keep minimal interference in clinical practice. 11 REDCap, developed by Vanderbilt University, has the necessary features to serve as a tool for data collection and storage. Software features include 451