Hospital-activity data inaccurate for determining spread-of-disease at diagnosis for non-small cell lung cancer

Thompson, Bridie, Watson, Melanie, Bowman, Rayleen, Fong, Kwun and Coory, Michael (2012) Hospital-activity data inaccurate for determining spread-of-disease at diagnosis for non-small cell lung cancer. Australian and New Zealand Journal of Public Health, 36 3: 212-217. doi:10.1111/j.1753-6405.2012.00850.x


Author Thompson, Bridie
Watson, Melanie
Bowman, Rayleen
Fong, Kwun
Coory, Michael
Title Hospital-activity data inaccurate for determining spread-of-disease at diagnosis for non-small cell lung cancer
Journal name Australian and New Zealand Journal of Public Health   Check publisher's open access policy
ISSN 1326-0200
1753-6405
Publication date 2012-06
Sub-type Article (original research)
DOI 10.1111/j.1753-6405.2012.00850.x
Volume 36
Issue 3
Start page 212
End page 217
Total pages 6
Place of publication St, Richmond, VIC, Australia
Publisher Wiley-Blackwell Publishing Asia
Collection year 2013
Language eng
Formatted abstract
Objective: Accurate information on spread-of-disease at diagnosis would increase the usefulness of hospital-activity data for cancer research. This study evaluates the accuracy of codes recorded in hospital-activity data to assign spread-of-disease at diagnosis for non-small cell lung cancer (NSCLC).
Methods: The reference (gold) standard was TNM stage as assigned at a multi-disciplinary meeting. To allow comparison with hospital-activity data, TNM stage was mapped to spread-of-disease (local, regional, distant). Sensitivity, specificity and positive-predictive values were stratified by whether the patient had surgery.
Results: Data from the reference standard and hospital-activity database were available for 2,184 patients. According to the reference standard, local disease was present for 57.0% of surgical patients and 12.6% of non-surgical patients at diagnosis. Hospital-activity data over-estimated patients with local disease (surgical: 71.9%, non-surgical: 48.5%). There was a corresponding underestimation of distant spread-of-disease: surgical (reference standard: 4.0%, hospital-activity data: 2.7%); non-surgical (reference standard: 45.9%, hospital-activity data: 36.8%). This meant that hospital-activity data had good sensitivity but poor specificity for local disease; and poor sensitivity, but good specificity for metastatic disease.
Conclusion: Secondary diagnosis codes in hospital activity data do not accurately capture spread-of-disease at diagnosis for patients with non-small cell lung cancer; even when the clinical notes contain TNM clinical stage as documented at a multidisciplinary meeting. Implications: Changes are needed to coding rules, and the ICD codes themselves, to allow for coding of regional and distant spread without specification of the precise site
Keyword Administrative data
Health Services Research
lung neoplasm
Neoplasm staging
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
 
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Created: Wed, 09 Jan 2013, 15:07:36 EST by Geraldine Fitzgerald on behalf of School of Public Health