Lai Sue-Min, Keighley John, Garimella Sarma
J Registry Manag. 2014 Fall;41(3):139-45.
The role of physicians in outpatient setting in reporting of hematopoietic malignancies is not well known.
This study described the approaches that Kansas Cancer Registry (KCR) used to ascertain completeness of hematopoietic malignancies reporting at the state level. Our study also examined the role of hematologists, oncologists and primary care physicians (PCP) in outpatient setting in reporting of hematopoietic malignancies.
KCR engaged all outpatient hematologists, oncologists, and a sample of PCPs who cared for patients in geographic areas where there was limited access to hematologists/oncologists. Cases that met reportable eligibility were identified using the ICD- 9-CM codes from the medical record disease index files and confirmed by reviewing patient medical records. Confirmed cases were then abstracted and sent to the registry. The study focused on 2010 diagnosed Kansan cases.
Of the total 2010 diagnosed cases, 18.7 percent were reported solely by outpatient physicians (17.0 percent reported by outpatient hematologists/ oncologists and 1.7 percent reported by outpatient PCPs only). Fifty-eight percent of polycythemia vera was diagnosed and treated by outpatient hematologists, oncologists, and some PCPs. Using reportable ICD-9-CM codes only for hematopoietic malignancies causes an overestimation of the true reportable hematopoietic malignancies cases.
Outpatient physicians are critical in the scheme of care for hematologic malignancies. Therefore collection of cancer data from these outpatient providers by a well operated statewide registry provides a far more accurate picture of what is really going on with hematopoietic malignancies.
门诊医生在报告造血系统恶性肿瘤方面所起的作用尚不为人所知。
本研究描述了堪萨斯癌症登记处(KCR)用于确定该州造血系统恶性肿瘤报告完整性的方法。我们的研究还考察了血液科医生、肿瘤内科医生和初级保健医生(PCP)在门诊环境中报告造血系统恶性肿瘤方面的作用。
KCR联系了所有门诊血液科医生、肿瘤内科医生,以及在血液科医生/肿瘤内科医生就诊机会有限的地理区域照顾患者的一部分初级保健医生。使用病历疾病索引文件中的ICD - 9 - CM编码识别符合报告资格的病例,并通过查阅患者病历进行确认。然后提取确诊病例并发送至登记处。该研究聚焦于2010年确诊的堪萨斯州病例。
在2010年确诊的所有病例中,18.7%仅由门诊医生报告(17.0%由门诊血液科医生/肿瘤内科医生报告,1.7%仅由门诊初级保健医生报告)。58%的真性红细胞增多症由门诊血液科医生、肿瘤内科医生以及一些初级保健医生诊断和治疗。仅使用可报告的ICD - 9 - CM编码来统计造血系统恶性肿瘤会导致对实际可报告的造血系统恶性肿瘤病例的高估。
门诊医生在血液系统恶性肿瘤的治疗方案中至关重要。因此,通过运作良好的全州登记处从这些门诊医疗服务提供者处收集癌症数据,能更准确地反映造血系统恶性肿瘤的实际情况。