Department of Radiology, Division of Breast Imaging, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Department of Radiology, Imaging Research Division, University of Pittsburgh, Pittsburgh, Pennsylvania.
J Am Coll Radiol. 2019 Jan;16(1):8-14. doi: 10.1016/j.jacr.2018.06.027. Epub 2018 Aug 9.
The National Mammography Database (NMD) contains nearly 20 million examinations from 693 facilities; it is the largest information source for use and effectiveness of breast imaging in the United States. NMD collects demographic, imaging, interpretation, biopsy, and basic pathology results, enabling facility and physician comparison for quality improvement. However, NMD lacks treatment and clinical outcomes data. The network of state cancer registries (CRs) contains detailed pathologic, treatment, and clinical outcomes data. This pilot study assessed electronic linkage of NMD and CR data at a multicenter institution as proof of concept.
We obtained Quality Oversight Committee approval for this retrospective study. Data of patients diagnosed with breast cancer in 2014 and 2015 were retrieved from our NMD-approved radiology information system (RIS) and matched with reportable patients in our CR using social security number (SSN), first name (fname), last name (lname), and date of birth (DOB). Matching was repeated without SSN. Percentage and reasons for mismatch were evaluated.
The RIS query identified 1,316 patients. CR linkage was 99.2% successful (n = 1,305 of 1,316) using SSN, fname, lname, and DOB. Eleven mismatches included four CR case-finding failures, one NMD fname error, five nonreportable in the CR, and one with correct identifiers in both databases. Without SSN, linkage was 97.3% successful (n = 1,281 of 1,316); name errors accounted for 19 and DOB accounted for 5 additional mismatches.
Using common data elements, linkage between the NMD and state CRs may be feasible and could provide critical outcomes information to advance accurate assessment of breast imaging in the United States.
国家乳房 X 光摄影数据库(NMD)包含来自 693 个设施的近 2000 万次检查;它是美国乳房成像使用和效果的最大信息来源。NMD 收集人口统计学、成像、解释、活检和基本病理学结果,使设施和医生能够进行质量改进比较。然而,NMD 缺乏治疗和临床结果数据。州癌症登记处(CR)网络包含详细的病理、治疗和临床结果数据。这项试点研究评估了在一个多中心机构中 NMD 和 CR 数据的电子链接,作为概念验证。
我们获得了质量监督委员会对这项回顾性研究的批准。从我们的 NMD 批准的放射信息系统(RIS)中检索到 2014 年和 2015 年诊断为乳腺癌的患者的数据,并使用社会安全号码(SSN)、名(fname)、姓(lname)和出生日期(DOB)在我们的 CR 中与可报告的患者进行匹配。在没有 SSN 的情况下重复匹配。评估了不匹配的百分比和原因。
RIS 查询确定了 1316 名患者。使用 SSN、fname、lname 和 DOB,CR 链接成功率为 99.2%(n=1305/1316)。11 次不匹配包括 4 次 CR 病例发现失败、1 次 NMD fname 错误、5 次 CR 中不可报告的病例以及 2 次数据库中都有正确标识符的病例。没有 SSN 的情况下,链接成功率为 97.3%(n=1281/1316);名字错误占 19%,出生日期错误占 5%。
使用通用数据元素,NMD 和州 CR 之间的链接可能是可行的,并可以提供关键的结果信息,以促进美国乳房成像的准确评估。