Message to Patients
Regarding NCD Database Project Linked to Japan’s board certification system in surgery/physicians
Our healthcare system is facing challenges such as uneven distribution of board-certified surgeons/physicians and declining hospitalcare. Many groups are working on solutions, but without knowing where and what kind of care is provided, we cannot design asystem that delivers the best medical care for patients. To address this, many clinical societies have joined forces to establish the"National Clinical Database" (NCD) in 2010. This initiative aims to understand the current state of healthcare in our country bycomprehensively registering various types of care, including surgical and interventional procedures. Through this initiative, we can
not only assess and plan for the proper placement of specialist surgeons and physicians to provide optimal medical care to patients,
but also bolster the efforts of each facility in delivering the best possible medical care.
We want to keep you informed of our ongoing work to improve the state of healthcare in our country. We greatly appreciate yourunderstanding and cooperation in this initiative.

Representative Director, National Clinical Database (General Incorporated Association)
Norihiko Ikeda
1．Your participation in this project
Whether to participate in this project or not will be left to the discretion of each patient. If you do not desire to participate, you
may refuse registration of your data. Refusal for data registration will not place you at any disadvantage when receiving routine
clinical care or the like.

2．Objectives of data registration
In providing better healthcare for patients, it is important to research and understand the current state of medical care. The NCD
will continue discussions and efforts towards improving the quality of medical care on the basis of systematically registeredinformation. The characteristics and open issues at individual institutions affiliated to the NCD will be assessed in comparison to
the nationwide standard data in Japan, to begin their own efforts towards improvement. According to many past examples inJapan and overseas, support for such efforts at the initiative of clinical sectors have yielded remarkable achievements in terms ofimprovement of the quality of clinical care. In addition, at the initiative of each field (professional societies and so on), thecollected data will be utilized for facilitating research towards improvement in the quality of medical care.

3．Details of the information registered
The information that will be registered includes the diagnoses triggering tests and treatments during routine clinical practice, thevarious types of treatment provided (e.g., surgery) and their methods, the short- and long-term outcomes, information on billingunder the national health insurance scheme, etc. Even though with such information alone, it is not possible to identify individual
patients easily, this does constitute critical information related to individual patients and will therefore be managed strictly.
Handling and safety management of information will comply with the relevant statutes and rules (e.g.: Act on the Protection of
Personal Information, Ethical Guidelines for Medical and Biological Research Involving Human Subjects, Guidance for Appropriate
Handling of Personal Information by Medical and Care-Related Business Operators, Guidelines for Safety Management of Medical
Information Systems). The NCD has also been implementing robust information management as a privacy mark-granted
business operator. If you desire to obtain information about your own registered data, please contact the medical departmentthat you visited.

4．Ways of utilization of the registered information
The information registered will be provided as feedback to the institutions affiliated to the NCD and to each clinical field so that it
may be utilized for improving the outcome of treatment at individual institutions and for facilitating better health of thepopulation. In addition, it will also be utilized for academic research aimed at improving the quality of medical care at theinitiative of each clinical field. The information utilized for such activities assumes only the form of processed and analyzed
statistical information. Thus, the NCD will never make public the data in forms that would allow identification of individualpatients. For appropriate evaluation of the treatment outcomes, research may be conducted by uniting the case data derived
from multiple departments and/or institutions. Before the registered information is made public for such purposes, sufficientarguments will be made at the relevant committees within the NCD and individual clinical fields, and only the information

approved will be made public.
If case of any questions, please contact the department that you visited or the NCD Secretariat.
National Clinical Database Secretariat
URL: https://www.ncd.or.jp/（Please use the inquiry form provided in the Homepage）