Mukherjee A K, Leck I, Langley F A, Ashcroft C
Department of Public Health and Epidemiology, University of Manchester.
Public Health. 1991 Jan;105(1):69-78. doi: 10.1016/s0033-3506(05)80319-1.
The completeness and accuracy of Hospital Activity Analysis (HAA) and Regional Cancer Registry (RCR) records were investigated in a series of 868 histologically reviewed cases in which primary ovarian neoplasms had been diagnosed according to one or more of seven data sources including HAA and RCR. All the women concerned were residents of Manchester and Salford who had presented in 1979-83 aged 15 years or more. The histological review confirmed the diagnosis of ovarian neoplasia in 829 of these women and excluded it in 39. Among the 829 confirmed cases, 333 were malignant or of borderline malignancy and therefore eligible for registration with the RCR, and 496 were benign. Only 611 (74%) of the 829 cases were listed as ovarian neoplasms or cysts in HAA records of hospital admissions from the study area during the study period, and the HAA diagnosis was incorrect in 40% of the 611 listed cases. Among the 333 borderline or malignant cases, only 241 (72%) appeared among the RCR's registrations of ovarian neoplasms for the study period and area. The RCR record of histological diagnosis was inaccurate in over 20% of these 241 registered cases, although most of the inaccuracies did not affect whether the neoplasm was classified as borderline or malignant. Five per cent of the cases listed as ovarian neoplasms in the HAA file and 15% of those listed as registrable ovarian neoplasms by the RCR should not have been so listed. The findings highlight the limitations of these routine health information systems, both as sources of cases for research and as National Health Service management tools.
在一系列868例经组织学检查的病例中，对医院活动分析（HAA）和区域癌症登记处（RCR）记录的完整性和准确性进行了调查。这些病例根据包括HAA和RCR在内的七个数据源中的一个或多个，诊断为原发性卵巢肿瘤。所有相关女性均为曼彻斯特和索尔福德的居民，于1979年至1983年就诊，年龄在15岁及以上。组织学检查证实其中829名女性患有卵巢肿瘤，39名排除。在829例确诊病例中，333例为恶性或交界性恶性，因此有资格在RCR登记，496例为良性。在研究期间，研究区域医院入院的HAA记录中，829例病例中只有611例（74%）被列为卵巢肿瘤或囊肿，在611例列出的病例中，40%的HAA诊断不正确。在333例交界性或恶性病例中，在研究期间和区域的RCR卵巢肿瘤登记中，只有241例（72%）出现。在这241例登记病例中，超过20%的RCR组织学诊断记录不准确，尽管大多数不准确并不影响肿瘤是否被分类为交界性或恶性。HAA文件中列为卵巢肿瘤的病例中有5%以及RCR列为可登记卵巢肿瘤的病例中有15%不应如此列出。这些发现凸显了这些常规健康信息系统作为研究病例来源和国家医疗服务管理工具的局限性。
