Validation of colorectal cancer surgery data from administrative data sources.
BACKGROUND
Surgery is the primary treatment for colorectal cancer for both curative and palliative intent. Availability of high quality surgery data is essential for assessing many aspects of the quality of colorectal cancer care. The objective of this study was to determine the quality of different administrative data sources in identifying surgery for colorectal cancer with respect to completeness and accuracy.


METHODS
All residents in Alberta, Canada who were diagnosed with invasive colorectal cancer in years 2000-2005 were identified from the Alberta Cancer Registry and included in the study. Surgery data for these patients were obtained from the Cancer Registry (which collects the date of surgery for which the primary tumor was removed) and compared to surgery data obtained from two different administrative data sources: Physician Billing and Hospital Inpatient data. Sensitivity, specificity, positive predictive value, negative predictive value and observed agreement were calculated compared to the Cancer Registry data.


RESULTS
The Physician Billing data alone or combined with Hospital Inpatient data demonstrated equally high sensitivity (97% for both) and observed agreement with the Cancer Registry data (93% for both) for identifying surgeries. The Hospital Inpatient data, however, had the highest specificity (80%). The positive predictive value varied by disease stage and across data sources for stage IV (99% for stages I-III and 83-89% for stage IV), the specificity is better for colon cancer surgeries (72-85%) than for rectal cancer surgeries (60-73%); validation measures did not vary over time.


CONCLUSIONS
Physician Billing data identify the colorectal cancer surgery more completely than Hospital Inpatient data although both sources have a high level of completeness.
Division of Community Oncology, Cancer Care, Alberta Health Services, 1500-10123 99 Street, T5J 3H1, Edmonton, Alberta, Canada.
Xue
X
Li
Charlotte
C
King
Christopher
C
deGara
Jonathon
J
White
Marcy
M
Winget
D000416:Alberta; D015179:Colorectal Neoplasms / Q000145:classification / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D003625:Data Collection / Q000592:standards*; D005260:Female; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data; D038801:International Classification of Diseases; D008297:Male; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data; D060787:Neoplasm Grading / Q000706:statistics & numerical data; D009367:Neoplasm Staging / Q000706:statistics & numerical data; D012042:Registries; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*