Division of Community Oncology, Cancer Care, Alberta Health Services, 1500-10123 99 Street, T5J 3H1, Edmonton, Alberta, Canada.
BMC Med Res Methodol. 2012 Jul 11;12:97. doi: 10.1186/1471-2288-12-97.
Surgery is the primary treatment for colorectal cancer for both curative and palliative intent. Availability of high quality surgery data is essential for assessing many aspects of the quality of colorectal cancer care. The objective of this study was to determine the quality of different administrative data sources in identifying surgery for colorectal cancer with respect to completeness and accuracy.
All residents in Alberta, Canada who were diagnosed with invasive colorectal cancer in years 2000-2005 were identified from the Alberta Cancer Registry and included in the study. Surgery data for these patients were obtained from the Cancer Registry (which collects the date of surgery for which the primary tumor was removed) and compared to surgery data obtained from two different administrative data sources: Physician Billing and Hospital Inpatient data. Sensitivity, specificity, positive predictive value, negative predictive value and observed agreement were calculated compared to the Cancer Registry data.
The Physician Billing data alone or combined with Hospital Inpatient data demonstrated equally high sensitivity (97% for both) and observed agreement with the Cancer Registry data (93% for both) for identifying surgeries. The Hospital Inpatient data, however, had the highest specificity (80%). The positive predictive value varied by disease stage and across data sources for stage IV (99% for stages I-III and 83-89% for stage IV), the specificity is better for colon cancer surgeries (72-85%) than for rectal cancer surgeries (60-73%); validation measures did not vary over time.
Physician Billing data identify the colorectal cancer surgery more completely than Hospital Inpatient data although both sources have a high level of completeness.
手术是结直肠癌治疗的主要手段，无论是根治性还是姑息性。获取高质量的手术数据对于评估结直肠癌治疗的多个方面至关重要。本研究旨在确定不同行政数据来源在识别结直肠癌手术方面的完整性和准确性。
从加拿大艾伯塔省癌症登记处确定 2000 年至 2005 年期间被诊断患有浸润性结直肠癌的所有艾伯塔省居民，并将其纳入研究。这些患者的手术数据来自癌症登记处（收集主要肿瘤切除的手术日期），并与来自两个不同行政数据来源的手术数据进行比较：医生计费和医院住院数据。与癌症登记处数据相比，计算了敏感性、特异性、阳性预测值、阴性预测值和观察一致性。
仅使用医生计费数据或与医院住院数据相结合，对于识别手术，其敏感性（两者均为 97%）和与癌症登记处数据的观察一致性（两者均为 93%）均很高。然而，医院住院数据具有最高的特异性（80%）。阳性预测值因疾病分期和数据来源而异，对于 IV 期（I-III 期为 99%，IV 期为 83-89%），特异性对于结肠癌手术（72-85%）优于直肠癌手术（60-73%）；验证措施随时间变化不大。
尽管两种来源都具有较高的完整性，但医生计费数据比医院住院数据更全面地识别结直肠癌手术。
