Assurance de qualité pour le cancer rectal – phase 2 ...

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14 PROCARE – phase 2 KCE reports 813 FEASIBILITY STUDY OF QUALITYINDICATOR MEASUREMENT3.1 METHODOLOGY3.1.1 Definition of selected quality indicatorsFor each selected quality indicator, numerator and denominator (and their respectivein- and exclusion criteria) were defined by a small working group (LVE, JV, DDC, FP)and afterwards discussed by the multidisciplinary team.3.1.2 Source databases3.1.2.1 Prospective PROCARE dataThe PROCARE registration form was constructed in consensus by a multidisciplinarygroup based on the data entry for the Dutch TME trial (van de Velde C, personalcommunication) and on data from the literature considered to be relevant for qualityassessment and assurance. The form has undergone two revisions and currently thethird version is being prepared for data collection based on the evidence as presented inthe PROCARE guidelines [1]. Participating centres prospectively submit their data on avoluntary basis to the Belgian Cancer Registry, where they are put into an AccessDatabase. A data manager checks the data on quality and completeness, and purchasescorrect data if necessary.Active input into the database was started in January 2006. Currently (April 2008), dataare available from more than 1400 rectal cancer patients. Sixty-one centres (with 105surgeons) are participating at present. However, for the present study, inclusion wasstopped on December 4 th 2007. At that time, 1071 patients with rectal cancer wereincluded, involving 56 centres and 98 surgeons.3.1.2.2 Coupled administrative dataGeneral description of the used databasesFor the present study, data from the following 3 administrative databases were coupled:1. The Technical Cell (TC) of the RIZIV/INAMI and Ministry of Health, FoodChain Safety and Environment (MOH) yearly composes a database of coupledhospital registration data. These data are based on a) the Minimal Clinical Data(MCD) collected in the hospitals by the MOH for each hospital stay (includingday care), and b) the Minimal Financial Data (MFD) collected by theRIZIV/INAMI in the Sickness Funds. This coupled database contains clinicaldata and facturation data per hospital stay. For the present study these dataare available from July 2001 – December 2004.2. The Belgian Cancer Registry (BCR) has a database containing records onincident rectal cancer. Tumour data consist of the ICD-O-3 and ICD-10code, TNM classification (cStage and pStage), incidence date (i.e. date of firstdiagnosis), received and planned treatment. For each cancer patient, thesedata are registered in a continuous longitudinal way. Moreover, this databaseis coupled with administrative data, making it possible to retrieve the date ofdecease (before December 31 st 2006).Patients are identified based on their unique identification number of socialsecurity (identificatienummer sociale zekerheid, INSZ) and a specific patientpseudonym (Hs), which is obtained by irreversible hashing of the full name,birth date and sex by all data providers of the BCR. For the present studythese data are available from 2000 – 2004 (the year 2004 was only partiallycovered at the moment of data closure).3. The Health Insurance Companies (HIC) possess nomenclature data andindividual facturation data of all their members. They also have data on socialsecurity and date of death (if applicable). All these data can be obtainedthrough the Common Sickness Funds Agency (IMA). For the present study,these data are available from 2000 – 2004.
KCE Reports 81 PROCARE – phase 2 15Selection criteria for data extractionThe patient cohort consists of those patients with a diagnosis of primary rectal cancerfrom January 1 st 2000 until December 31 st 2004. Primary selection is done using the ICD-O-3 topographic codes of the BCR (Figure 3):• C20.9: malignant neoplasm of rectum ,• C19.9: malignant neoplasm of rectosigmoid• C21.1: malignant neoplasm of the anal canal• C21.8: malignant neoplasm of the anorectal junctionFigure 3. Primary selection of the administrative cohort.An attempt was made for a complementary selection to investigate the exhaustivity of theBCR and thus the completeness of the patient cohort (Figure 4). This complementaryselection was done in the MCD-MFD database of the TC using the ICD-9-CM codes154.1 (rectal cancer), 154.0 (rectosigmoidal cancer) and 154.2 (cancer of the anal canal).Patients with primary rectal cancer identified through this complementary step but notthrough the primary selection were added to the final patient cohort if possible.
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35. Etude relative aux coûts poten
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