International Circulation: I’m here with Professor Jack Lewin. I’d like to thank you for joining us today， professor. It is a great honor having you here. At first I’d like to ask you the NCDR provides the most comprehensive cardiovascular data registry， representing a very large patient population and millions of records in the US. And this makes significant impact on clinical practice. So could you comment on the recent research projects of NCDR that you think are the most influential perhaps or most important something that we should know about?
Jack Lewin:Well. We are only beginning to reap the benefits of NCDR. We are in 2400 American hospitals. That is more than half of the largest hospitals in the United States. We were virtually in all the hospitals that have major cardiac presents. So， you know if they had cardiac catheterization laboratories， we were there. And now we have this amazing resource， we are beginning to mine it using analytics to start to observe quality of care. So one of the largest studies that has been revolutionary in America is called door to balloon， which we measured the time it takes to treat a person with the heart attack from the emergency room to the final treatment， either surgery or stent or some cases fibrolitic clot buster. We asked the hospitals on a survey before we gave them the data how long they thought it took them to treat a heart attack. They all said in less than one hour. The science says in less than 90 minutes. The data showed the hospitals were taking two and an half hours. Now here is what is amazing. By just giving the hospital their data back， almost every hospital in America now treats the heart attack in less than 90 minutes. So they even improved the system of care. And this is saving millions of lives in America today using this data. Another good example is we tested the difference and morbidity and mortality in patients who had electrocardiogram taken for chest pains while they were still in the ambulance before they got into the hospital emergency room. For the patients that got the electrocardiogram taken and transmitted into emergency room before they arrived， there was 27% reduction in mortality， again， probably one hundred thousand people， whose lives would be saved by this. We are also using it though to test new devices and new drugs in the marketplace and find out about the safety over hundreds of thousands and millions of patients， we recently showed the US FTA that one of the devices on the market was causing excess numbers of bleeding cases. That was very helpful to people. We have demonstrated that the use of our guidelines， the guidelines we developed by translating science into clinical tools actually does save lives and improve mobility and mortality and we are measuring that kind of work. So across the board， there are some amazing studies being done now with this new tool of the NCDR.