Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Cancer Centre, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City, Taiwan.
Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taipei, Taiwan.
J Formos Med Assoc. 2018 Dec;117(12):1093-1100. doi: 10.1016/j.jfma.2017.12.012. Epub 2018 Jan 10.
Although cancer treatment information has been collected through the Cancer Registry system in Taiwan for more than 10 years, the accuracy of such data has never been evaluated. This study examined the accuracy rate between registrar experience and on-site chart review for the first course of cancer treatment.
In this retrospective chart review study, 392 randomly selected medical records from 14 hospitals were re-abstracted by experienced abstractors. The kappa coefficients of accuracy for the abstracting data were calculated against the gold standard. Correlations between registrar background and workload were then identified through regression analysis.
Regarding surgery type, low accuracy rates were noted for gastric cancer (84.0%), oral cavity cancer (84.6%), and bladder cancer (88.9%). For chemotherapy, low accuracy rates were observed for hematopoietic diseases (81.3%) and esophageal cancer (88.0%). For radiotherapy, low accuracy rates were noted for esophageal cancer (80.0%), cervical cancer (81.8%), and lymphoma (85.7%). When stratifying by surgery type after adjustment for hospital caseload, a high accuracy rate was found for cancer registrars who had progressed from basic to advanced licenses within 5 years of graduating.
The accuracy rate for the first course of cancer treatment was affected by the cancer type and the experience of cancer registrars, but it was not affected by the workload of cancer registrars. We recommend that cancer registrars with basic licenses upgrade to advanced licenses as soon as possible. Medical record collaboration should establish documentation for checklist of radiotherapy and surgical operation records.
尽管台湾的癌症登记系统已经收集癌症治疗信息超过 10 年,但这些数据的准确性从未得到过评估。本研究旨在检验癌症登记员经验与现场病历审查在癌症治疗初始阶段的准确性。
本回顾性病历审查研究中,从 14 家医院中随机抽取了 392 份病历,由经验丰富的摘要员重新进行摘要。使用kappa 系数计算了摘要数据与金标准的准确性。然后,通过回归分析确定了登记员背景与工作量之间的相关性。
在手术类型方面,胃癌(84.0%)、口腔癌(84.6%)和膀胱癌(88.9%)的准确性较低。在化疗方面,血液疾病(81.3%)和食管癌(88.0%)的准确性较低。在放疗方面,食管癌(80.0%)、宫颈癌(81.8%)和淋巴瘤(85.7%)的准确性较低。在校正医院工作量后按手术类型分层,在毕业 5 年内从基础执照升级为高级执照的癌症登记员的准确性较高。
癌症治疗初始阶段的准确性受到癌症类型和癌症登记员经验的影响,但不受癌症登记员工作量的影响。我们建议癌症登记员尽快从基础执照升级为高级执照。医疗记录协作应建立放疗和手术操作记录的检查表文档。