Cancer Epidemiology Research Unit, Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia.
BMC Health Serv Res. 2011 Oct 6;11:253. doi: 10.1186/1472-6963-11-253.
Population-based patterns of care studies are important for monitoring cancer care but conducting them is expensive and resource-intensive. Linkage of routinely collected administrative health data may provide an efficient alternative. Our aim was to determine the accuracy of linked routinely collected administrative data for monitoring prostate cancer care in New South Wales (NSW), Australia.
The NSW Prostate Cancer Care and Outcomes Study (PCOS), a population-based survey of patterns of care for men aged less than 70 years diagnosed with prostate cancer in NSW, was linked to the NSW Cancer Registry, electronic hospital discharge records and Medicare and Pharmaceutical claims data from Medicare Australia. The main outcome measures were treatment with radical prostatectomy, any radiotherapy, external beam radiotherapy, brachytherapy or androgen deprivation therapy, and cancer staging. PCOS data were considered to represent the true treatment status. The sensitivity and specificity of the administrative data were estimated and relevant patient characteristics were compared using chi-squared tests.
The validation data set comprised 1857 PCOS patients with treatment information linked to Cancer Registry records. Hospital and Medicare claims data combined described treatment more accurately than either one alone. The combined data accurately recorded radical prostatectomy (96% sensitivity) and brachytherapy (93% sensitivity), but not androgen deprivation therapy (76% sensitivity). External beam radiotherapy was rarely captured (5% sensitivity), but this was improved by including Medicare claims for radiation field setting or dosimetry (86% sensitivity). False positive rates were near 0%. Disease stage comparisons were limited by one-third of cases having unknown stage in the Cancer Registry. Administrative data recorded treatment more accurately for cases in urban areas.
Cancer Registry and hospital inpatient data accurately captured radical prostatectomy and brachytherapy treatment, but not external beam radiotherapy or disease stage. Medicare claims data substantially improved the accuracy with which all major treatments were recorded. These administrative data combined are valid for population-based studies of some aspects of prostate cancer care.
基于人群的护理模式研究对于监测癌症护理至关重要，但开展此类研究既昂贵又需要大量资源。常规收集的行政健康数据的链接可能提供一种有效的替代方法。我们的目的是确定链接常规收集的行政数据监测澳大利亚新南威尔士州（新南威尔士州）前列腺癌护理的准确性。
新南威尔士州前列腺癌护理和结果研究（PCOS）是一项针对新南威尔士州 70 岁以下男性前列腺癌患者护理模式的基于人群的调查，与新南威尔士州癌症登记处、电子住院记录以及澳大利亚医疗保险局的医疗保险和药物索赔数据进行了链接。主要结果测量指标是接受根治性前列腺切除术、任何放射治疗、外照射放射治疗、近距离放射治疗或雄激素剥夺治疗以及癌症分期。PCOS 数据被认为代表真实的治疗状态。使用卡方检验比较了相关患者特征，估计了行政数据的敏感性和特异性。
验证数据集包括 1857 名具有与癌症登记处记录相关治疗信息的 PCOS 患者。医院和医疗保险索赔数据的组合比单独使用任何一种数据更准确地描述了治疗情况。组合数据准确记录了根治性前列腺切除术（96%的敏感性）和近距离放射治疗（93%的敏感性），但雄激素剥夺治疗（76%的敏感性）记录不准确。外照射放疗很少被捕获（5%的敏感性），但通过包括医疗保险索赔的放射野设置或剂量学，可以提高敏感性（86%的敏感性）。假阳性率接近 0%。由于癌症登记处中三分之一的病例疾病阶段未知，疾病阶段的比较受到限制。行政数据记录的治疗方法更准确的病例位于城市地区。
癌症登记处和住院患者数据准确地捕捉了根治性前列腺切除术和近距离放射治疗，但未捕捉到外照射放疗或疾病阶段。医疗保险索赔数据大大提高了记录所有主要治疗方法的准确性。这些行政数据的结合对于前列腺癌护理某些方面的基于人群的研究是有效的。
