title: Using administrative health data to describe colorectal and lung cancer care in New South Wales, Australia: a validation study.
abstract: BACKGROUND
  Monitoring treatment patterns is crucial to improving cancer patient care. Our aim was to determine the accuracy of linked routinely collected administrative health data for monitoring colorectal and lung cancer care in New South Wales (NSW), Australia.
  
  
  METHODS
  Colorectal and lung cancer cases diagnosed in NSW between 2000 and 2002 were identified from the NSW Central Cancer Registry (CCR) and linked to their hospital discharge records in the NSW Admitted Patient Data Collection (APDC). These records were then linked to data from two relevant population-based patterns of care surveys. The main outcome measures were the sensitivity and specificity of data from the CCR and APDC for disease staging, investigative procedures, curative surgery, chemotherapy, radiotherapy, and selected comorbidities.
  
  
  RESULTS
  Data for 2917 colorectal and 1580 lung cancer cases were analysed. Unknown disease stage was more common for lung cancer in the administrative data (18%) than in the survey (2%). Colonoscopies were captured reasonably accurately in the administrative data compared with the surveys (82% and 79% respectively; 91% sensitivity, 53% specificity) but all other colorectal or lung cancer diagnostic procedures were under-enumerated. Ninety-one percent of colorectal cancer cases had potentially curative surgery recorded in the administrative data compared to 95% in the survey (96% sensitivity, 92% specificity), with similar accuracy for lung cancer (16% and 17%; 92% sensitivity, 99% specificity). Chemotherapy (~40% sensitivity) and radiotherapy (sensitivity≤30%) were vastly under-enumerated in the administrative data. The only comorbidity that was recorded reasonably accurately in the administrative data was diabetes.
  
  
  CONCLUSIONS
  Linked routinely collected administrative health data provided reasonably accurate information on potentially curative surgical treatment, colonoscopies and comorbidities such as diabetes. Other diagnostic procedures, comorbidities, chemotherapy and radiotherapy were not well enumerated in the administrative data. Other sources of data will be required to comprehensively monitor the primary management of cancer patients.
authors.affiliation: Cancer Research Division, Cancer Council NSW, PO Box 572, Kings Cross, NSW 1340, Australia. davidg@nswcc.org.au
authors.forename: David E
authors.initials: DE
authors.lastname: Goldsbury
authors.forename: Katie
authors.initials: K
authors.lastname: Armstrong
authors.forename: Leonardo
authors.initials: L
authors.lastname: Simonella
authors.forename: Bruce K
authors.initials: BK
authors.lastname: Armstrong
authors.forename: Dianne L
authors.initials: DL
authors.lastname: O'Connell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology*; D015179:Colorectal Neoplasms / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D003625:Data Collection / Q000592:standards; D005260:Female; D006297:Health Services Accessibility / Q000592:standards; D006801:Humans; D008297:Male; D008498:Medical Record Linkage / Q000379:methods*; D008875:Middle Aged; D009367:Neoplasm Staging; D009517:New South Wales / Q000453:epidemiology; D010343:Patient Admission / Q000706:statistics & numerical data; D011159:Population Surveillance / Q000379:methods*; D012042:Registries; D015203:Reproducibility of Results; D017678:Sex Distribution