Abstract
BackgroundThe National Comprehensive Cancer Network and the American Society of Clinical Oncology have established guidelines for the treatment and surveillance of colorectal cancer (CRC), respectively. Considering these guidelines, an accurate and efficient method is needed to measure receipt of care.MethodsThe accuracy and completeness of Veterans Health Administration (VA) administrative data were assessed by comparing them with data manually abstracted during the Colorectal Cancer Care Collaborative (C4) quality improvement initiative for 618 patients with stage I-III CRC.ResultsThe VA administrative data contained gender, marital, and birth information for all patients but race information was missing for 62.1 % of patients. The percent agreement for demographic variables ranged from 98.1–100 %. The kappa statistic for receipt of treatments ranged from 0.21 to 0.60 and there was a 96.9 % agreement for the date of surgical resection. The percentage of post-diagnosis surveillance events in C4 also in VA administrative data were 76.0 % for colonoscopy, 84.6 % for physician visit, and 26.3 % for carcinoembryonic antigen (CEA) test.ConclusionsVA administrative data are accurate and complete for non-race demographic variables, receipt of CRC treatment, colonoscopy, and physician visits; but alternative data sources may be necessary to capture patient race and receipt of CEA tests.
Highlights
The National Comprehensive Cancer Network and the American Society of Clinical Oncology have established guidelines for the treatment and surveillance of colorectal cancer (CRC), respectively
Sherer et al BMC Health Services Research (2016) 16:50 in terms of access to large samples across multiple sites and low incremental costs. In this methodologic study, our objective was to compare the receipt of CRC-related care in Veterans Health Administration (VA) according to administrative data compared with data from a manual chart abstraction of the electronic health record performed during a quality improvement collaborative (EHR/QI) called the Colorectal Cancer Care Collaborative (C4)
The EHR/QI project completed chart abstraction for 624 patients with American Joint Committee on Cancer (AJCC) collaborative stage I, II, or III CRC; as shown in Table 3, the demographic characteristics of the EHR/QI cohort are similar to those of all patients diagnosed with AJCC collaborative stage I-III CRC in the VA Central Cancer Registry (VACCR) during the study period
Summary
The National Comprehensive Cancer Network and the American Society of Clinical Oncology have established guidelines for the treatment and surveillance of colorectal cancer (CRC), respectively. Considering these guidelines, an accurate and efficient method is needed to measure receipt of care. 3,400 colorectal cancers (CRC) are diagnosed in the Veterans Health Administration (VA) each year [1]. Potential data sources include surveys [10], health record review [11], and health claims (billing) data [10, 12,13,14,15,16,17].
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