Durham VA Health Care System, Durham, North Carolina.
Duke University School of Medicine, Durham, North Carolina.
J Registry Manag. 2024 Spring;51(1):21-28.
The Veterans Health Administration (VHA) is a leader in generating transformational research across the cancer care continuum. Given the extensive body of cancer-related literature utilizing VHA data, our objectives are to: (1) describe the VHA data sources available for conducting cancer-related research, and (2) discuss examples of published cancer research using each data source.
We identified commonly used data sources within the VHA and reviewed previously published cancer-related research that utilized these data sources. In addition, we reviewed VHA clinical and health services research web pages and consulted with a multidisciplinary group of cancer researchers that included hematologist/oncologists, health services researchers, and epidemiologists.
Commonly used VHA cancer data sources include the Veterans Affairs (VA) Cancer Registry System, the VA Central Cancer Registry (VACCR), the Corporate Data Warehouse (CDW)-Oncology Raw Domain (subset of data within the CDW), and the VA Cancer Care Cube (Cube). While no reference standard exists for cancer case ascertainment, the VACCR provides a systematic approach to ensure the complete capture of clinical history, cancer diagnosis, and treatment. Like many population-based cancer registries, a significant time lag exists due to constrained resources, which may make it best suited for historical epidemiologic studies. The CDW-Oncology Raw Domain and the Cube contain national information on incident cancers which may be useful for case ascertainment and prospective recruitment; however, additional resources may be needed for data cleaning.
The VHA has a wealth of data sources available for cancer-related research. It is imperative that researchers recognize the advantages and disadvantages of each data source to ensure their research questions are addressed appropriately.
退伍军人健康管理局(VHA)在癌症护理连续体方面引领变革性研究。鉴于大量利用 VHA 数据的癌症相关文献,我们的目标是:(1)描述可用于进行癌症相关研究的 VHA 数据源,(2)讨论使用每个数据源发表的癌症研究示例。
我们确定了 VHA 中常用的数据源,并回顾了利用这些数据源进行的先前发表的癌症相关研究。此外,我们审查了 VHA 临床和卫生服务研究网页,并咨询了包括血液学家/肿瘤学家、卫生服务研究人员和流行病学家在内的多学科癌症研究人员小组。
常用的 VHA 癌症数据源包括退伍军人事务部(VA)癌症登记系统、VA 中央癌症登记处(VACCR)、公司数据仓库(CDW)-肿瘤原始域(CDW 中的数据子集)和 VA 癌症护理多维数据集(Cube)。虽然癌症病例确定没有参考标准,但 VACCR 提供了一种系统方法,可确保完整捕获临床病史、癌症诊断和治疗。与许多基于人群的癌症登记处一样,由于资源有限,存在很大的时间滞后,这可能使其最适合进行历史流行病学研究。CDW-肿瘤原始域和多维数据集包含关于新发癌症的全国信息,这可能有助于病例确定和前瞻性招募;但是,可能需要额外的资源来清理数据。
VHA 拥有丰富的癌症相关研究数据源。研究人员必须认识到每个数据源的优缺点,以确保他们的研究问题得到妥善解决。