The Commission on Cancer established the National Cancer Data Base in 1989 in order to gather and disseminate information that could help physicians improve treatment for their cancer patients. A data warehouse such as the NCDB is a repository of data, usually stored on multiple servers, allowing an organization to conduct detailed analysis and to collate selected data for reporting. NCDB data provides a view of trends in cancer incidence and morbidity, while also helping physicians assess treatment effectiveness for specific cancer types.
Types of Data Tracked
Every record within the NCDB includes patient identification and the ICD-O codes for their cancer. These codes describe the sites at which cancerous tissue is located and the behavior of the cancer, indicating whether it's benign or metastasizing to further sites. The NCDB also hosts demographic information, describing how incidence of specific types of cancer occur within different population groups, and includes statistics on treatment effectiveness and morbidity.
Enforcing Quality Control
Each case record goes through three different editing and quality assessment processes before the software writes the data to the NCDB. The first process looks for invalid information in fields where bad data results in automatic rejection of the record, such as a patient's birthdate, their zip code at the time of diagnosis and the data on which their physician diagnosed them with cancer. The second process assigns a numerical score to each case record, assessing information accuracy in the remaining fields. The editing software assigns a zero to error-free data, with scores increasing in value with the number of errors detected. The system then rejects any records with a score of 200 or greater. NCDB's editing software generates an edit report during the third process, identifying deficiencies in data quality and publishing the scores earned by each participating health care provider.
The NCDB incorporates a number of safeguards to comply with the Health Insurance Portability and Accountability Act of 1996's rules for maintaining security of electronic health records. The American College of Surgeons maintains the NCDB's servers, and after HIPAA's passage, added a server dedicated firewall hosting to provide additional protection to the server acting as the central data repository. ACoS also has all staff assigned to the NCDB undergo technical training to ensure they understand the technical underpinnings of the database's security.
NCDB Benefits to Health Care Providers
All participating health care providers can access the NCDB to compare treatment effectiveness and note which practices are particularly effective in bringing about partial or complete remission. The CoC also generates benchmarks on treatment quality and patients' quality of life from the NCDB's data, measuring the performance of their participating institutions. If a particular provider falls into the lower 10 or 25 percentile of a specific benchmark, the CoC works with the provider to develop a plan for improvement.
- A Foundation for Evidence-Driven Practice: A Rapid Learning System for Cancer Care: Workshop Summary; Sharon Murphy, et. al.
- Cancer Disparities: Causes and Evidence-Based Solutions; Ronit Elk and Hope Landrine
- Cancer Registry Management Principles and Practices; National Cancer Registrars Association
- Cancer Clinical Trials: Proactive Strategies; Stanley P. L. Leong
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