Evans W K, Crook J, Read D, Morriss J, Logan D M
Ottawa Regional Cancer Centre, Cancer Care Ontario.
Cancer Prev Control. 1998 Dec;2(6):304-9.
This is a retrospective review of an initiative to capture tumour stage information at a regional cancer centre in Ontario.
The minutes of the centre's Health Records and Medical Advisory Committees related to staging were reviewed. Data on stage by tumour type was extracted from the centre's Oncology Patient Information System (OPIS). Three hundred and ninety charts were analysed to assess the accuracy of stage information and identify staging errors. Health Information Services workload statistics were reviewed to determine the types and frequency of projects undertaken using stage-related data.
In January 1994, the Ottawa Regional Cancer Centre introduced policies and procedures to capture stage-related information. Standardized staging forms and a physician reminder system encouraged the centre's physicians to record tumour stage within 3 months of new patient registration. Of all qualifying cases in 1994, 92% were staged. A medical audit in 1998 of 390 charts from the 3 previous years of staging data revealed that 71.5% of the charts reviewed had been staged completely. Of the incompletely staged cases, 19% to 57% had TNM recorded, but the stage grouping was not recorded, or the "stage" was the extent of disease at the time of disease progression rather than at initial diagnosis (35% to 71%). Physician-related staging errors occurred in 2% to 5% of cases; data-entry errors occurred in 3% to 6% of cases.
Stage information has enabled the centre to better describe its patient clientele for accreditation purposes and to assist researchers in estimating the number of patients potentially available for prospective and retrospective studies. It is being used to guide targeted educational initiatives to selected populations in the region's catchment area and assists administrators in estimating resource needs. Resistance to the capture of stage information can be overcome with persistence, the development of procedures that facilitate physician compliance, including a reminder system, the development of institutional policies and procedures and by feedback on the uses and availability of stage information.
这是对安大略省一个地区癌症中心获取肿瘤分期信息举措的回顾性研究。
查阅了该中心健康记录和医学咨询委员会与分期相关的会议记录。从该中心的肿瘤患者信息系统（OPIS）中提取了按肿瘤类型划分的分期数据。分析了390份病历以评估分期信息的准确性并识别分期错误。查阅了健康信息服务工作量统计数据，以确定使用分期相关数据开展的项目类型和频率。
1994年1月，渥太华地区癌症中心出台了获取分期相关信息的政策和程序。标准化的分期表格和医生提醒系统促使该中心的医生在新患者登记后3个月内记录肿瘤分期。1994年所有符合条件的病例中，92%进行了分期。1998年对前三年分期数据中的390份病历进行的医学审核显示，71.5%的审核病历已完整分期。在分期不完整的病例中，19%至57%记录了TNM，但未记录分期分组，或者“分期”是疾病进展时而非初始诊断时的疾病范围（35%至71%）。2%至5%的病例存在与医生相关的分期错误；3%至6%的病例存在数据录入错误。
分期信息使该中心能够为认证目的更好地描述其患者群体，并协助研究人员估计可用于前瞻性和回顾性研究的潜在患者数量。它被用于指导针对该地区服务区域内特定人群的定向教育举措，并协助管理人员估计资源需求。通过坚持不懈、制定便于医生遵守的程序（包括提醒系统）、制定机构政策和程序以及反馈分期信息的用途和可用性，可以克服对获取分期信息的抵触情绪。
