Determining the quality of breast cancer care: do tumor registries measure up?
BACKGROUND
Hospital tumor registries, which provide data that inform health services research and cancer control policies, may be a source of information about quality of cancer care. However, the accuracy of data from such registries is unknown.


OBJECTIVE
To determine the accuracy of tumor registry data by comparing it with data collected from numerous sources for a breast cancer quality improvement project.


METHODS
Retrospective cohort study.


METHODS
Three teaching hospitals with tumor registries in the New York metropolitan area that had participated in the quality improvement project.


METHODS
All women with newly diagnosed primary breast cancer (stage I or stage II) who were surgically treated at the study hospitals between 1 November 1994 and 31 August 1996.


METHODS
Sensitivity and specificity were calculated, and data from the quality improvement project were used as the gold standard.


RESULTS
The tumor registries and the quality improvement project had similar information on tumor stage and surgery type. Sensitivity ranged from 0.91 to 0.96, and specificity ranged from 0.93 to 0.97. When both sources were used to calculate quality measures, the overall rate of radiation therapy after breast-conserving surgery was 80% in the quality improvement project and 48% in the tumor registries (sensitivity, 0.58; specificity, 0.94). For receipt of adjuvant systemic treatment, the rate was 78% in the quality improvement project and 22% in the tumor registries (sensitivity, 0.27; specificity, 0.97).


CONCLUSIONS
Data from tumor registries provide accurate measures for hospital-based surgical treatments but not for outpatient treatments. Unverified tumor registry data should not be used to measure quality of care.
Bickell
N A
NA
Mount Sinai School of Medicine, Department of Health Policy, New York, New York 10029, USA.
Chassin
M R
MR
D000553:Ambulatory Care; D001943:Breast Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D006302:Health Services Research; D006784:Hospitals, Teaching / Q000592:standards*; D006801:Humans; D009518:New York; D011787:Quality of Health Care; D018714:Radiotherapy, Adjuvant; D012042:Registries / Q000592:standards*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity