癌症登记与临床护理团队病历摘要在识别癌症复发方面的准确性对比

Elsa A. Sutton MD , Benjamin C. Kamdem Talom BA , Daniel K. Ebner MD, MPH , Taylor M. Weiskittel MS , William G. Breen MD , Roman O. Kowalchuk MD , Heather J. Gunn PhD , Courtney N. Day MS , Eric J. Moore MD , Sara J. Holton CTR, BS Health/Health Care Administration/Management , Kathryn M. Van Abel MD , Chadi N. Abdel-Halim MD , David M. Routman MD , Mark R. Waddle MD
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引用次数: 0

摘要

患者和方法肿瘤放射科和耳鼻喉科研究人员收集了复发信息。这与一家三级癌症中心连续接受头颈癌放射治疗的患者的机构癌症登记资料进行了比较。以人工复查作为金标准,计算了机构癌症登记数据的敏感性和特异性。将假阴性复发与真阳性复发进行比较,以评估患者特征的差异。结果 共有1338名从2010年1月1日至2017年12月31日接受治疗的患者被纳入癌症登记册并接受审查。其中,375人(30%)已确诊癌症复发,45人(3%)有复发可能,但未得到放射学或病理学证实,31人(2%)病情持续存在。大多数确诊复发为远处复发(37%)或远处加局部复发(29%),而仅为局部复发(11%)、局部复发(9%)或局部复发(14%)的复发率则很低。癌症登记准确率为 89.4%,灵敏度为 61%,特异性为 99%。复发时间与登记准确率有关。真阳性患者的复发时间中位数为 414 天,而假阴性患者的复发时间中位数为 1007 天。对癌症状态进行更长时间的随访可能会提高灵敏度。没有发现患者的差异会导致灵敏度的不同。需要新的、最好是自动化的数据抽取工具来提高癌症复发的检测率,并最大限度地减少人工病历审查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Accuracy of a Cancer Registry Versus Clinical Care Team Chart Abstraction in Identifying Cancer Recurrence

Objective

To evaluate the completeness and reliability of recurrence data from an institutional cancer registry for patients with head and neck cancer.

Patients and Methods

Recurrence information was collected by radiation oncology and otolaryngology researchers. This was compared with the institutional cancer registry for continuous patients treated with radiation therapy for head and neck cancer at a tertiary cancer center. The sensitivity and specificity of institutional cancer registry data was calculated using manual review as the gold standard. False negative recurrences were compared to true positive recurrences to assess for differences in patient characteristics.

Results

A total of 1338 patients who were treated from January 1, 2010, through December 31, 2017, were included in a cancer registry and underwent review. Of them, 375 (30%) had confirmed cancer recurrences, 45 (3%) had concern for recurrence without radiologic or pathologic confirmation, and 31 (2%) had persistent disease. Most confirmed recurrences were distant (37%) or distant plus locoregional (29%), whereas few were local (11%), regional (9%), or locoregional (14%) alone. The cancer registry accuracy was 89.4%, sensitivity 61%, and specificity 99%. Time to recurrence was associated with registry accuracy. True positives had recurrences at a median of 414 days vs 1007 days for false negatives.

Conclusion

Currently, institutional cancer registry recurrence data lacks the required accuracy for implementation into studies without manual confirmation. Longer follow-up of cancer status will likely improve sensitivity. No identified differences in patients accounted for differences in sensitivity. New, ideally automated, data abstraction tools are needed to improve detection of cancer recurrences and minimize manual chart review.

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来源期刊
Mayo Clinic proceedings. Innovations, quality & outcomes
Mayo Clinic proceedings. Innovations, quality & outcomes Surgery, Critical Care and Intensive Care Medicine, Public Health and Health Policy
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