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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
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dc.contributor.advisor | 賴美淑(Mei-Shu Lai) | |
dc.contributor.author | Chin-Ying Cheng | en |
dc.contributor.author | 鄭金英 | zh_TW |
dc.date.accessioned | 2021-06-17T04:43:26Z | - |
dc.date.available | 2021-08-30 | |
dc.date.copyright | 2018-08-30 | |
dc.date.issued | 2018 | |
dc.date.submitted | 2018-08-03 | |
dc.identifier.citation | 參考文獻
1. Wild BWSaCP. World Cancer Report 2014: International Agency for Research on Cancer, 2014. 2. DOH. Cancer registry annual report,2009. In: Yuan E, ed. Republic of China: Department of Health, 2012:2-5. 3. Storm HH. The Danish Cancer Registry, a self-reporting national cancer registration system with elements of active data collection. IARC Sci Publ 1991:220-36. 4. ACoS. Facility Oncology Registry Data Standards: Commission on Cancer, 2007. 5. Surgeons ACo. Registry Operations and Data Standards. Volume 2016, 1989. 6. DOH. Cancer registry annual report,2013. In: Yuan E, ed. Republic of China: Department of Health, 2016. 7. Brewster DH, Stockton D, Harvey J, et al. Reliability of cancer registration data in Scotland, 1997. European Journal of Cancer (Eur J Cancer) 2002;38:414-7. 8. Polissar L, Feigl P, Lane WW, et al. Accuracy of basic cancer patient data: results from an extensive recoding survey. J Natl Cancer Inst 1984;72:1007-14. 9. Gulliford MC, Bell J, Bourne HM, et al. The reliability of Cancer Registry records. British Journal of Cancer 1993;67:819-821. 10. Liu WL, Kasl S, Flannery JT, et al. The accuracy of prostate cancer staging in a population-based tumor registry and its impact on the black-white stage difference (Connecticut, United States). Cancer Causes Control 1995;6:425-30. 11. Schouten LJ, Langendijk JA, Jager JJ, et al. Validity of the stage of lung cancer in records of the Maastricht cancer registry, The Netherlands. Lung Cancer 1997;17:115-22. 12. Du XL, Key CR, Dickie L, et al. Information on chemotherapy and hormone therapy from tumor registry had moderate agreement with chart reviews. Journal of clinical epidemiology 2006;59:53-60. 13. Harvei S, Tretli S, Langmark F. Quality of prostate cancer data in the cancer registry of Norway. Eur J Cancer 1996;32A:104-10. 14. Kahn LH, Blustein J, Arons RR, et al. The validity of hospital administrative data in monitoring variations in breast cancer surgery. American Journal of Public Health 1996;86:243-245. 15. Jensen AR, Overgaard J, Storm HH. Validity of breast cancer in the Danish Cancer Registry. A study based on clinical records from one county in Denmark. Eur J Cancer Prev 2002;11:359-64. 16. Green E, Benjamin C. Impact of the medical record credential on data quality, 1986. 17. Schouten LJ, Jager JJ, van den Brandt PA. Quality of cancer registry data: a comparison of data provided by clinicians with those of registration personnel. British Journal of Cancer 1993;68:974-977. 18. Malin JL, Kahn KL, Adams J, et al. Validity of Cancer Registry Data for Measuring the Quality of Breast Cancer Care. Journal of the National Cancer Institute 2002;94:835-844. 19. Elbasmi AA, Fayaz MS, Al-Mohanadi S, et al. Reliability of the Kuwait Cancer Registry: a comparison between breast cancer data collected by clinical oncologists and registry staff. Asian Pac J Cancer Prev 2010;11:735-8. 20. Hennessy DA, Quan H, Faris PD, et al. Do coder characteristics influence validity of ICD-10 hospital discharge data? BMC Health Serv Res 2010;10:99. 21. Mariotto A, Feuer EJ, Harlan LC, et al. Trends in use of adjuvant multi-agent chemotherapy and tamoxifen for breast cancer in the United States: 1975-1999. J Natl Cancer Inst 2002;94:1626-34. 22. Bickell NA, Chassin MR. Determining the quality of breast cancer care: do tumor registries measure up? Ann Intern Med 2000;132:705-10. 23. You R-H. Quality assessment of cancer registry in Taiwan area. Taiwan, 1992. 24. Wu MF. Quality of Colorectal Cancer Registry in Relation to Prognosis : Empirical Results from One Medical Center. Volume Master. Taiwan: National Taiwan University, 2003. 25. Faber KD, Carlos MC, Cortessis VK, et al. Validation of Surveillance, Epidemiology, and End Results TNM staging for testicular germ cell tumor. Urol Oncol 2014;32:1341-6. 26. Kiernan CM, Whiteside MA, Solorzano CC. Cancer Registries: Can We Improve the Quality of Thyroid Cancer Data? Ann Surg Oncol 2017;24:1202-1207. 27. Du X, Freeman JL, Goodwin JS. Information on radiation treatment in patients with breast cancer: the advantages of the linked medicare and SEER data. Surveillance, Epidemiology and End Results. J Clin Epidemiol 1999;52:463-70. 28. Santos S, Murphy G, Baxter K, et al. Organisational factors affecting the quality of hospital clinical coding. Health Inf Manag 2008;37:25-37. 29. Lai HT. Study on the Quality and Its Related Factors of International Classification of Disease Coding System in National Health Insurance. Volume Master. Taiwan: National Taiwan University, 1996. 30. Levin SG, Levin SL, Meisel JB. A Dynamic Analysis of the Adoption of a New Technology: The Case of Optical Scanners. The Review of Economics and Statistics 1987;69:12-17. 31. Li X, King C, deGara C, et al. Validation of colorectal cancer surgery data from administrative data sources. BMC Medical Research Methodology 2012;12:1-7. 32. Du X, Freeman JL, Warren JL, et al. Accuracy and completeness of Medicare claims data for surgical treatment of breast cancer. Med Care 2000;38:719-27. 33. TWIAP. pathology report checklist, 2015:Taiwan society of pathology. 34. RSROC. radiology report checklist, 2015:The radiological society republic of China. 35. Shimizu K, Ito K, Matsunaga N, et al. Diagnosis of gastric cancer with MDCT using the water-filling method and multiplanar reconstruction: CT-histologic correlation. AJR Am J Roentgenol 2005;185:1152-8. 36. Filippone A, Ambrosini R, Fuschi M, et al. Preoperative T and N staging of colorectal cancer: accuracy of contrast-enhanced multi-detector row CT colonography--initial experience. Radiology 2004;231:83-90. 37. Burke DE, Wang BB, Wan TT, et al. Exploring hospitals' adoption of information technology. J Med Syst 2002;26:349-55. 38. TCOG. Cancer Practice Guideline. Taiwan, 2015:Taiwan Cooperative Oncology Group. 39. Chang C-Y. The relationship between high-tech medical equipment and health service volume. Volume Master's thesis. Taipei, Taiwan: National Sun Yat-sen University, 2007. 40. DOH. Taiwan Cancer Registry Coding Manual Long Form Revision. In: Yuan E, ed. Republic of China: Department of Health, 2011. | |
dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/70910 | - |
dc.description.abstract | 背景
儘管台灣癌症登記資料庫(Taiwan Cancer Registry,TCR)蒐集癌症期別與治療的資料已長達十年以上,但就癌症期別及治療方式的摘錄正確性尚未有相關的評估研究,研究目的為實地再閱醫院病歷以評估癌症期別及癌症治療方式的摘錄正確性,並進一步檢定醫療服務機構及專業癌症登記摘錄者經驗對癌症期別及治療方式摘錄品質的影響。 方法 此為回溯性實地再閱病歷的研究,共選取14家醫院,隨機抽樣392位癌症病人,比較由資深癌症登記摘錄者至醫院實地再閱原始病歷與台灣癌症資料庫申報資料的摘錄正確性,並依據醫院當年度的癌症病人數分成高低服務量二組及專業癌症登記摘錄者考取基礎級證照至進階級證照之間隔分為5年內及超過5年(含)二組,採用kappa統計量測量一致性,進一步採用多變項回歸分析醫療服務機構及專業癌症摘錄者經驗對癌症期別及治療方式等對癌症登記摘錄正確性的影響。 結果 癌症別以咽癌、食道癌、直腸癌、乳癌以及攝護腺癌在臨床與病理期別的摘錄正確性都很高,而卵巢癌的摘錄正確性偏低,大腸直腸癌、肺癌及卵巢癌在手術治療方式、化學藥物治療處方及放射線治療範圍的摘錄正確性都很高,而淋巴癌在手術治療方式、化學藥物治療處方及放射線治療範圍的摘錄正確性都偏低。控制了專業癌症登記摘錄者經驗後,發現低癌症申報量醫院在臨床期別的摘錄正確性偏低,控制了醫院癌症病人數量的高低後,發現專業癌症登記摘錄者「考取基礎級證照後超過五年才考取進階級證照者」,在「癌症期別」及「手術治療方式」的摘錄正確性偏低。 結論 癌症登記資料庫在癌症期別及治療方式的摘錄品質,除了癌症別間特性有差異外,也受到醫院癌症病人數量的影響,進一步檢定發現專業癌症登記摘錄者經驗影響更甚,尤其在「臨床期別」及「手術治療方式」的摘錄正確性偏低,建議加速考取進階級的癌症登記資格,以及投入更多專科化的癌症期別教育訓練,政府也應該更積極推動醫院與醫學會落實手術記錄及放射線治療摘要等結構化的條列式記錄方式。 | zh_TW |
dc.description.abstract | Background:
Although staging and treatment information has been collected through the cancer registry system in Taiwan for more than 10 years, but its quality of coding in cancer staging and treatment data has not been discussed. This study assessed the accuracy rate for staging and the first course of treatment by site visit at medical institutes and the influence of the nature of medical institute and the experience of cancer registrars on staging and treatment data accuracy. Methods: In this retrospective chart review study, 392 randomly selected medical records from 14 hospitals were re-abstracted by experienced abstractors; the senior cancer registrar reviewers had compared each original chart with data from the TCR to assess accuracy rate for staging and treatment. The hospitals were classified into two groups on the basis of the number of cancer patients. Furthermore, qualified cancer registrars who had progressed from basic to advanced licenses were classified as (≧5 years) and (<5 years). The kappa (κ) statistic method and multiple regression analysis were used to compare among the medical institutes and qualified cancer registrars. Results: The accuracy rate was high in pharynx, esophageal, rectal, breast, and prostate cancers, and low in ovarian and other cancers for clinical and pathological staging. For the first course of its treatment, the accuracy rate was high (≥96%) for colorectal cancer, lung cancer, and ovarian cancer but low (<85%) for any type of lymphoma. After adjustment for the experience of the qualified cancer registrar, low-caseload hospitals had a significantly lower clinical staging accuracy rate than that of high-caseload hospitals. When stratifying by staging and surgery type after adjustment for hospital caseload, a high accuracy rate was found for cancer registrars who had progressed from basic to advanced licenses within 5 years of graduating. A high workload for a registrar nonsignificantly reduced the accuracy rates for chemotherapy and radiotherapy. Conclusions: The reliability of staging data in the TCR is affected not only by the cancer type but also by the number of patients treated in hospital. Moreover, the experience of cancer registrar strongly influences accuracy rate, especially in clinical staging and surgery type. We recommend that cancer registrars with basic licenses upgrade to advanced licenses as soon as possible. Furthermore, continuous education regarding cancer site specific abstracting skills and rules should be emphasized. Medical record collaboration should establish documentation for the checklist of radiation oncology and surgical operation records in hospitals. | en |
dc.description.provenance | Made available in DSpace on 2021-06-17T04:43:26Z (GMT). No. of bitstreams: 1 ntu-107-D97846001-1.pdf: 3004936 bytes, checksum: 74ce9814fa8e60326b14cab5bcabefa5 (MD5) Previous issue date: 2018 | en |
dc.description.tableofcontents | 目錄
頁數 口試委員會審定書I 序言………………………………………………..………………………………………….I 中文摘要……………………………………………………………..…………….……...…II 英文摘要……………………………………………………….……………………………IV 目錄…………………………………………………………………….……………………VI 圖目錄…………………………………………………………………………….…….…VIII 表目錄………………………………………………………………………………….….…IX 英文縮寫對照表………………………………………………………………………..…XII 第一章研究背景………………………………………………………………….….…1 第二章文獻回顧……………………………………………………….………….……3 第一節癌症登記腫瘤期別國內外之演進……………………………………..…3 第二節癌症資料庫品質之研究…………………………………………………………3 第三節癌症資料庫品質之影響因素的相關性研究………………………………6 第四節文獻回顧的總結……………………………………………………..……7 第三章研究目的、研究架構與研究假說……………………………………….. 16 第一節研究目的、架構與內容…………………………………………….….………16 第二節研究假說……………………………………………………………...……16 第四章材料與方法…………………………………………...………………………………19 第一節研究設計………………………………….………………………………19 第二節實地再閱資料庫………………………………………………………19 第三節研究變項與操作型定義………………………………………………………22 第四節一致性定義……………………………………………………………………25 第五節統計方法……………………………………………………………………26 第五章研究結果…………………………………………………..……………………27 第一節整體癌症摘錄正確性之分析…………………………………………..……27 第二節癌症別摘錄正確性之分析……………………………………………..…… 30 第三節影響癌症登記摘錄正確性的相關分析……………………………..…… 31 第四節非結構資料「癌症登記(長表)摘錄檢核表」中的「檢核紀錄」之分析結果……35 第六章討論與建議………………………………………………………..……………. 38 第七章研究限制…………………………………………………..…………….… 43 第八章未來研究之建議………………………………………….………....…………….… 44 參考文獻…………………………………………………………………………….…..45 附錄…………………………………………………………………………….….…47 與此研究有關之已發表著作…………………………………………………….….103 | |
dc.language.iso | zh-TW | |
dc.title | 影響台灣癌症登記資料庫的正確性及相關因素 | zh_TW |
dc.title | A study on factors affecting accuracy of National Cancer Registry in Taiwan | en |
dc.type | Thesis | |
dc.date.schoolyear | 106-2 | |
dc.description.degree | 博士 | |
dc.contributor.oralexamcommittee | 孔憲蘭(Shin-Lan Koong),郭年真(Nien-Chen Kuo),季瑋珠(Wei-Chu Chie),李文宗(Wen-Chung Lee),高偉堯(Woei-Yau Kao) | |
dc.subject.keyword | 正確性,癌症登記資料,癌症登記摘錄者,病歷再閱,資料品質, | zh_TW |
dc.subject.keyword | accuracy,cancer registry data,cancer registrar,chart review,data quality, | en |
dc.relation.page | 103 | |
dc.identifier.doi | 10.6342/NTU201800721 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2018-08-03 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 流行病學與預防醫學研究所 | zh_TW |
顯示於系所單位: | 流行病學與預防醫學研究所 |
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