Introduction
The Myocardial Infarction Audit Project (MINAP) began in late 1998 when a broadly based steering group developed a dataset for acute myocardial infarction (AMI). This allowed clinicians to examine the management of myocardial infarction within their hospitals against targets specified by the National Service Framework for Coronary Heart Disease (NSF).
Background
The project uses a highly secure electronic system of data entry, transmission and analysis developed by the Central Cardiac Audit Database (CCAD). The system uses encryption of patient identifiers to allow secure transfer of data between hospitals and central servers and allows linkage with the Office of National Statistics for mortality tracking. Initially the project focussed on the hospital management of ST elevation AMI but the dataset has been expanded to cover other acute coronary syndromes (ACS), the introduction of pre-hospital thrombolysis and primary angioplasty. MINAP has recently changed its name from the Myocardial Infarction Audit Project to the Myocardial Ischaemia National Audit Project to reflect the inclusion of all acute coronary syndromes. All hospitals in England and Wales that admit patients with ACS contribute data and in April 2008 the database contained over 596,000 records.
Continuous online analyses in comparison to aggregate data are available to hospitals. Quarterly reports are available for hospitals, Strategic Health Authorities, and the Department of Health. MINAP provides thrombolysis data to the Healthcare Commission for their Annual Health Check. MINAP provides data to ambulance services to help monitor patient outcomes and support improvements in training and care delivery. MINAP also provides data to cardiac networks to support service improvement. MINAP is the first national audit to release annual reports showing hospital performance against NSF targets in the public domain which are available below. Sustained improvement of performance against NSF targets for thrombolysis and use of secondary prevention medication has been demonstrated since the end of 2000.
MINAP has now relocated from the RCP to the National Institute for Clinical Outcomes Research based at the Heart Hospital. It has established a MINAP Academic Group to develop the research potential of the database.
MINAP Academic Group
Work Programme 2008-9
- Maintain support for hospitals to ensure continuity of data collection and robust data quality
- Development of the MINAP web portal
- Development of graphical output tools
- Perform annual data validation study
- Publish the annual Public Report for England and Wales
- Provide data for Healthcare Commission Annual Health Check
- Revise the dataset and data application
Downloads and Links
Data Collection Application Notes version 6.0 (477kb PDF- opens in new window)
Data Entry for Non-Clinicians (444kb, Opens in new window)
Data Collection Form version 6.0 (63k MS-Excel Spreadsheet - opens in new window)
MINAP Core Data Set version 8.1 (130k MS Excel Spreadsheet - opens in new window)
Changes to v7 dataset Feb09 (52k MS Excel Spreadsheet - opens in new window)
Powerpoint Presentations
Analysis of MINAP database (455k Powerpoint - opens in new window)
Impact of specialty of admitting physician and type of hospital on care and outcome for myocardial infarction in England and Wales during 2004-5: observational study (Powerpoint, 168k - opens in new window)
Gender Issues (Powerpoint, 150k - opens in new window)
Links to other sites
MINAP Steering Group Membership
Minap Steering Group Membership Feb 09 (52k Word document - opens in new window)
Publications and Reports
How the NHS manages heart attacks (June 2009)
Management of acute coronary syndromes in England and Wales: a survey of facilities in 2006 (PDF, 499k - opens in new window)
Commentary on the 2006 Survey of Facilities for Acute Coronary Syndrome Patients (PDF, 43k - opens in new window)
How the NHS manages heart attacks (June 2008)
How the NHS Manages Heart Attacks (July 2007)
How the NHS Manages Heart Attacks (June 2006)
How the NHS Manages Heart Attacks (June 2005)
How the NHS Manages Heart Attacks (June 2004)
How Hospitals Manage Heart Attacks (June 2003)
How Hospitals Manage Heart Attacks (November 2002) (PDF, 320k - opens in new window)
A Baseline Survey of Facilities for the Management of Acute Myocardial Infarction in England 2000 (PDF, 179k - opens in new window)
Appendix C: survey form (PDF, 71k - opens in new window)
Measurement of clinical performance: Practical approaches in acute myocardial infarction. Edited by Robert West & Robin Norris
Data Quality Study Report December 2005 (PDF, 65k - opens in new window)
Data Quality Study Report December 2004 (PDF, 60k - opens in new window)
Data Quality Study Report December 2003 (PDF, 52k - opens in new window)
Data Quality Study Report December 2001 (PDF, 526k - opens in new window)
MINAP Trial Study Report (PDF, 240k - opens in new window)
Publications
MINAP Publications Feb 09 (42k - Word document - opens in new window)
The National Audit of Myocardial Infarction: a new development in the audit process
Birkhead J, Pearson M et al.
Journal of Clinical Excellence (2002) 4: 379 - 85. |
|
Where are we today? Early results from MINAP, the national audit of myocardial infarction project
Birkhead JS.
Heart 2003; 89 (Suppl II): ii13 - ii15 |
|
Can successful treatment of cardiac arrest be a performance indicator for hospitals?
Norris RM, Lowe D and Birkhead JS.
Resuscitation 60 (2004) 263 – 269. |
|
Improving care for patients with acute coronary syndromes: initial results from the National Audit of Myocardial Infarction Project (MINAP).
Birkhead JS, Walker L, Pearson M, Weston C, Cunningham AD and Rickards AF.
Heart 2004; 90: 1004 – 1009. |
|
Redefining the coronary care unit: an observational study of patients admitted to hospital in England and Wales in 2003-2005.
Quinn T, Weston C, Birkhead JS, Walker L, Norris R, on behalf of MINAP Steering Group.
Quarterly Journal of Medicine 2005; 98 (11):797-802. |
|
Impact of specialty of admitting physician and type of hospital on care and outcome for myocardial infarction in England and Wales during 2004-5: observational study
Birkhead JS, Weston C, Lowe D, on behalf of the National Audit of Myocardial Infarction Project. |
|
BMJ 2006;332:1306-1311. |
Early impact of insulin treatment on mortality for hyperglycaemic patients without known diabetes who present with an acute coronary syndrome
Weston C, Walker L and J Birkhead JS.
Heart 2007;93 1542-1546 |
|
The impact of pre-hospital thrombolytic treatment on re-infarction rates: analysis of the Myocardial Infarction National Audit Project (MINAP).
Horne S, Weston C, Quinn T, Hicks A, Walker L, Chen R, and Birkhead JS.
Heart, Oct 2007; doi:10.1136/hrt.2007.126821 |
Contacts:
MINAP
National Institute for Clinical Outcomes Research
University College London
Suite 501
The Heart Hospital
Westmoreland Street
London W1G 8PH
Tel: 020 7504 8958
email: minap@uclh.nhs.uk
Clinical Director: Dr John Birkhead
Associate Director: Dr Clive Weston
Programme Manager: Lynne Walker
Project Co-ordinator: Ronald van Leeven