Sherer Eric A, Fisher Deborah A, Barnd Jeffrey, Jackson George L, Provenzale Dawn, Haggstrom David A
Department of Chemical Engineering, Louisiana Tech University, Ruston, LA, USA.
Center for Health Information and Communication, Richard L. Roudebush Veterans Affairs Medical Center, Indianapolis, IN, USA.
BMC Health Serv Res. 2016 Feb 11;16:50. doi: 10.1186/s12913-016-1294-9.
The National Comprehensive Cancer Network and the American Society of Clinical Oncology have established guidelines for the treatment and surveillance of colorectal cancer (CRC), respectively. Considering these guidelines, an accurate and efficient method is needed to measure receipt of care.
The accuracy and completeness of Veterans Health Administration (VA) administrative data were assessed by comparing them with data manually abstracted during the Colorectal Cancer Care Collaborative (C4) quality improvement initiative for 618 patients with stage I-III CRC.
The VA administrative data contained gender, marital, and birth information for all patients but race information was missing for 62.1% of patients. The percent agreement for demographic variables ranged from 98.1-100%. The kappa statistic for receipt of treatments ranged from 0.21 to 0.60 and there was a 96.9% agreement for the date of surgical resection. The percentage of post-diagnosis surveillance events in C4 also in VA administrative data were 76.0% for colonoscopy, 84.6% for physician visit, and 26.3% for carcinoembryonic antigen (CEA) test.
VA administrative data are accurate and complete for non-race demographic variables, receipt of CRC treatment, colonoscopy, and physician visits; but alternative data sources may be necessary to capture patient race and receipt of CEA tests.
美国国立综合癌症网络和美国临床肿瘤学会分别制定了结直肠癌（CRC）的治疗和监测指南。考虑到这些指南，需要一种准确且高效的方法来衡量医疗服务的接受情况。
通过将退伍军人健康管理局（VA）的行政数据与在结直肠癌护理协作（C4）质量改进计划中为618例I - III期CRC患者手动提取的数据进行比较，评估了VA行政数据的准确性和完整性。
VA行政数据包含了所有患者的性别、婚姻状况和出生信息，但62.1%的患者缺少种族信息。人口统计学变量的一致性百分比范围为98.1% - 100%。接受治疗的kappa统计量范围为0.21至0.60，手术切除日期的一致性为96.9%。C4中诊断后监测事件在VA行政数据中的百分比，结肠镜检查为76.0%，医生就诊为84.6%，癌胚抗原（CEA）检测为26.3%。
VA行政数据在非种族人口统计学变量、CRC治疗的接受情况、结肠镜检查和医生就诊方面准确且完整；但可能需要其他数据来源来获取患者种族和CEA检测的接受情况。
