Abstract
BackgroundClinical data gathered for administrative purposes often lack sufficient information to separate the records of radiotherapy given for palliation from those given for cure. An absence, incompleteness, or inaccuracy of such information could hinder or bias the study of the utilization and outcome of radiotherapy. This study has three specific purposes: 1) develop a method to determine the therapeutic role of radiotherapy (TRR); 2) assess the accuracy of the method; 3) report the quality of the information on treatment “intent” recorded in the clinical data in Ontario, Canada. A general purpose is to use this study as a prototype to demonstrate and test a method to assess the quality of administrative data.MethodsThis is a population based retrospective study. A random sample was drawn from the treatment records with “intent” assigned in treating hospitals. A decision tree is grown using treatment parameters as predictors and “intent” as outcome variable to classify the treatments into curative or palliative. The tree classifier was applied to the entire dataset, and the classification results were compared with those identified by “intent”. A manual audit was conducted to assess the accuracy of the classification.ResultsThe following parameters predicted the TRR, from the strongest to the weakest: radiation dose per fraction, treated body-region, disease site, and time of treatment. When applied to the records of treatments given between 1990 and 2008 in Ontario, Canada, the classification rules correctly classified 96.1% of the records. The quality of the “intent” variable was as follows: 77.5% correctly classified, 3.7% misclassified, and 18.8% did not have an “intent” assigned.ConclusionsThe classification rules derived in this study can be used to determine the TRR when such information is unavailable, incomplete, or inaccurate in administrative data. The study demonstrates that data mining approach can be used to effectively assess and improve the quality of large administrative datasets.
Highlights
Clinical data gathered for administrative purposes often lack sufficient information to separate the records of radiotherapy given for palliation from those given for cure
Many clinical studies concerning radiotherapy require the knowledge of the therapeutic role of radiotherapy (TRR)
If the goal of the study is to investigate the outcome of the curative radiotherapy, an incorrect classification of the TRR could lead the researcher to observe an outcome poorer than the actual outcome
Summary
Clinical data gathered for administrative purposes often lack sufficient information to separate the records of radiotherapy given for palliation from those given for cure. This study has three specific purposes: 1) develop a method to determine the therapeutic role of radiotherapy (TRR); 2) assess the accuracy of the method; 3) report the quality of the information on treatment “intent” recorded in the clinical data in Ontario, Canada. There has been an increased interest in studying the utilization of palliative radiotherapy at the population level [2,3,4,5,6,7] These studies require the researchers to correctly separate the treatments given for palliation from those given for cure. If the goal of the study is to investigate the outcome of the curative radiotherapy, an incorrect classification of the TRR (for example, many palliative treatments were misclassified as curative treatments) could lead the researcher to observe an outcome poorer than the actual outcome
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