University of Iowa Holden Comprehensive Cancer Center, Iowa City, Iowa.
University of Iowa Department of Epidemiology, Iowa Cancer Registry, Iowa City, Iowa.
J Registry Manag. 2023 Summer;50(2):52-56.
Researchers often rely on hospital tumor registry data to provide comprehensive cancer therapy information. The purpose of this study was to determine the completeness of treatment information found in the abstracted records of patients seen at an academic medical center located in a rural Midwestern state.
The cohort included 846 Iowa residents diagnosed with a single malignant tumor of the female breast, colon/rectum, lung, pancreas, or prostate in 2017-2018 with an abstract recorded by the academic medical center and at least 1 other hospital. Treatment/no treatment agreement between the academic medical center's abstract and the central registry's consolidated abstract was examined for the following summary variables of the North American Association of Central Cancer Registries (NAACCR): surgery of the primary site, chemotherapy, radiation therapy, immunotherapy, and hormone therapy. Treatment summary variables from the academic medical center abstract that agreed with the corresponding variables from the central registry abstract were classified as . The proportion of concordance for each treatment modality was the outcome measure, and 95% confidence intervals were calculated with the Agresti-Coull method. Concordance was also examined at the specific treatment level.
There was high concordance between the treatment information recorded in the academic medical center and the central registry records. The average proportion of treatment/no treatment agreement across all treatment modalities and cancer sites was 0.97 (SD, 0.02). Concordance remained high even when examining specific treatments (average concordance, 0.95; SD, 0.04). The lowest treatment/no treatment concordance proportion was 0.92 (95% CI, 0.86-0.96) for chemotherapeutic treatment of pancreatic cancer. We also found that the academic medical center's summary variables captured most treatments given at other facilities, ranging from 74.4% capture of immunotherapy to 88.2% capture of surgery of the primary site.
These results indicate that NAACCR-formatted, summary variables from the academic medical center's tumor registry are likely to provide comprehensive treatment information for those individuals diagnosed or treated in this setting. Analyses of either the academic medical record registry records or consolidated records from the central registry should yield similar results. Future research should establish whether similar findings are obtained at other medical centers.
研究人员经常依赖医院肿瘤登记数据来提供全面的癌症治疗信息。本研究的目的是确定在位于中西部农村的学术医疗中心就诊的患者的记录中提取的治疗信息的完整性。
该队列包括 846 名 2017 年至 2018 年间在爱荷华州被诊断患有女性乳腺、结肠/直肠、肺、胰腺或前列腺单一恶性肿瘤的居民，该学术医疗中心记录了摘要，并且至少还有另一家医院也记录了摘要。检查学术医疗中心摘要与中央登记处合并摘要之间的以下北美癌症登记协会（NAACCR）总结变量的治疗/无治疗协议：原发部位手术、化疗、放疗、免疫疗法和激素疗法。与中央登记处摘要中相应变量一致的学术医疗中心摘要中的治疗总结变量被分类为. 每种治疗方式的一致性比例是衡量指标，采用阿格里斯特-库利方法计算 95%置信区间。还检查了特定治疗水平的一致性。
学术医疗中心记录的治疗信息与中央登记处记录高度一致。所有治疗部位和癌症部位的治疗/无治疗协议的平均比例为 0.97（SD，0.02）。即使检查特定治疗方法，一致性仍然很高（平均一致性为 0.95；SD，0.04）。胰腺癌化疗的治疗/无治疗一致性比例最低，为 0.92（95%CI，0.86-0.96）。我们还发现，学术医疗中心的总结变量捕获了大多数在其他医疗机构进行的治疗，从免疫治疗的 74.4%捕获率到原发部位手术的 88.2%捕获率不等。
这些结果表明，NAACCR 格式的学术医疗中心肿瘤登记处的汇总变量很可能为在该环境中诊断或治疗的个体提供全面的治疗信息。对学术医疗记录登记处记录或中央登记处的合并记录进行分析，应该会产生类似的结果。未来的研究应确定在其他医疗中心是否获得类似的发现。
