Prevalence of Missing Data in the National Cancer Database and Association With Overall Survival

Yang, Daniel; Khera, Rohan; Miccio, Joseph A.; Jairam, Vikram; Chang, Enoch; Yu, James B.; Park, Henry S.; Krumholz, Harlan M.; Aneja, Sanjay

doi:10.1001/jamanetworkopen.2021.1793

Cited by 85 publications

(66 citation statements)

References 54 publications

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“…Completion of healthcare records is low. The evidence indicates that medical records have a high prevalence of unknown data; as such, in cancer registry data, it was seen that variables of clinical interest had between 39.7% and 71% unknown data [ 53 ]. Some nursing professionals perceive the implementation of registries as a task of little use that takes time away from patient care [ 54 ].…”

Section: Discussionmentioning

confidence: 99%

Influenza and Pertussis Maternal Vaccination Coverage and Influencing Factors in Spain: A Study Based on Primary Care Records Registry

Fernández-Cano

Marañón

Reyes-Lacalle

et al. 2022

IJERPH

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The purpose was to determine the coverage of maternal vaccination against influenza and pertussis, and the characteristics associated with being vaccinated, in a health area of Catalonia, Spain. Some 36,032 anonymized and computerized clinical records registries of pregnant women from Primary Care Centres (e-CAP database) were analysed, from between 2015 and 2018. Vaccination coverage and the association with sociodemographic variables and clinical conditions were estimated using a Poisson regression model. Maternal vaccination coverage against influenza ranged between 11.9% in 2015 and 6.8% in 2018, following a decreasing trend (p < 0.001). Coverage with the tetanus toxoid, diphtheria toxoid, and acellular pertussis vaccine varied between 49.8% in 2016 and 79.4% in 2018, following an increasing trend (p < 0.001). Having living children and suffering from obesity were factors associated with not being vaccinated against both infections. The predictive variables of vaccination against influenza were diabetes (IRR: 2.17, 95% CI: 1.42–3.30) and asthma (IRR: 2.05, 95% CI: 1.76–2.38); and for pertussis, it was asthma (IRR: 1.10, 95% CI: 1.03–1.17). Different socio-demographic factors and chronic conditions in pregnant women were associated with maternal vaccination, and which will have to be taken into account in clinical practice when implementing strategies to improve the coverage of the programme.

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Section: Discussionmentioning

confidence: 99%

Influenza and Pertussis Maternal Vaccination Coverage and Influencing Factors in Spain: A Study Based on Primary Care Records Registry

Fernández-Cano

Marañón

Reyes-Lacalle

et al. 2022

IJERPH

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“…Additionally, a sizable proportion of patients was excluded from the study due to the missing stage. The direction and degree of bias resulting from missing data is not fully known; evidence suggests that survival outcomes are overestimated and that minority patients are underrepresented 43 . This limitation cannot be easily overcome with data imputation, which would also introduce error.…”

Section: Discussionmentioning

confidence: 99%

“…The direction and degree of bias resulting from missing data is not fully known; evidence suggests that survival outcomes are overestimated and that minority patients are underrepresented. 43 This limitation cannot be easily overcome with data imputation, which would also introduce error. Finally, although preference for one treatment modality for another should be informed by the ultimate outcome of survival benefit, survival analyses using cancer registry data such as the NCDB must be viewed cautiously due to the lack of detailed information on clinically relevant factors including types and doses of chemotherapy received.…”

Section: Sensitivity Analysismentioning

confidence: 99%

Differences in receipt of multimodality therapy by race, insurance status, and socioeconomic disadvantage in patients with resected pancreatic cancer

Hao

Mitsakos

Irish

et al. 2022

Journal of Surgical Oncology

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Background and Methods: Racial and socioeconomic disparities in receipt of adjuvant chemotherapy affect patients with pancreatic cancer. However, differences in receipt of neoadjuvant chemotherapy among patients undergoing resection are not well-understood. A retrospective cross-sectional cohort of patients with resected AJCC Stage I/II pancreatic ductal adenocarcinoma was identified from the National Cancer Database (2014)(2015)(2016)(2017). Outcomes included receipt of neoadjuvant versus adjuvant chemotherapy, or receipt of either, defined as multimodality therapy and were assessed by univariate and multivariate analysis.Results: Of 19 588 patients, 5098 (26%) received neoadjuvant chemotherapy, 9624 (49.1%) received adjuvant chemotherapy only, and 4757 (24.3%) received no chemotherapy. On multivariable analysis, Black patients had lower odds of neoadjuvant chemotherapy compared to White patients (OR: 0.80, 95% CI: 0.67-0.97) but no differences in receipt of multimodality therapy (OR: 0.89, 95% CI: 0.77-1.03). Patients with Medicaid or no insurance, low educational attainment, or low median income had significantly lower odds of receiving neoadjuvant chemotherapy or multimodality therapy.Conclusions: Racial and socioeconomic disparities persist in receipt of neoadjuvant and multimodality therapy in patients with resected pancreatic adenocarcinoma.Discussion: Policy and interventional implementations are needed to bridge the continued socioeconomic and racial disparity gap in pancreatic cancer care.

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“…In our analysis, we have selected a number of covariates based on studies conducted from the National Cancer Database (NCDB) ( 10 , 11 ). There are a number of studies documenting limitations of using the NCDB, namely, selection bias, lack of clinically relevant endpoints, and prevalence of missing data among hospital-based cancer patients ( 17 , 18 ). Despite this, we believe that the results of our analysis may have been negative as nearly half of our patients who experienced delays were due to technical issues, which would be independent of sociodemographic factors.…”

Section: Discussionmentioning

confidence: 99%

Treatment Interruptions During Stereotactic Body Radiotherapy for Prostate Cancer

et al. 2022

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BackgroundDuring the course of radiation treatment for prostate cancer, patients may have unintentional interruptions in their treatment course due to a wide variety of factors. Stereotactic body radiation therapy (SBRT) decreases the number of treatments compared to conventionally fractionated radiation; hence, it has the potential to decrease treatment delays and non-completion. This study sought to determine the incidence of treatment delay and characterize the etiology and length in a large cohort of men treated with SBRT for their prostate cancer.MethodsOne thousand three hundred and thirty-six patients treated with SBRT from 2008 to 2021 at the Georgetown University Hospital for prostate cancer were included in this retrospective study. A treatment delay was defined as a patient requiring longer than 14 days to complete 5 fractions of SBRT. Non-completion was defined as patients treated with less than 5 fractions. In the patients who experienced delays, chart review was performed to characterize the length and etiology of each delay. Multivariate analysis was performed via binary logistic regression modeling on PSPP.ResultsAll individuals in the cohort eventually completed the planned 5-fraction regimen. Thirty-three patients experienced a treatment delay. Median length of time to complete treatment was 11 days (range 5–155 days). In patients who experienced a delay, nearly half (45.5%) experienced only a one-day delay. The most common reason for a delay was a technical issue (48.5%), including the machine maintenance, fiducial misalignment, or inadequate pretreatment bowel preparation. Other reasons included unplanned breaks due to acute side effects (21.2%), logistical issues (18.2%), non-treatment related health issues (9.1%), and inclement weather (3.0%). There were no significant sociodemographic, oncologic, or treatment variables that predicted treatment interruption on multivariate analysis.ConclusionsThe incidence of treatment interruptions in patients undergoing SBRT for their prostate cancer was low. Most treatment delays were short.

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Prevalence of Missing Data in the National Cancer Database and Association With Overall Survival

Cited by 85 publications

References 54 publications

Influenza and Pertussis Maternal Vaccination Coverage and Influencing Factors in Spain: A Study Based on Primary Care Records Registry

Influenza and Pertussis Maternal Vaccination Coverage and Influencing Factors in Spain: A Study Based on Primary Care Records Registry

Differences in receipt of multimodality therapy by race, insurance status, and socioeconomic disadvantage in patients with resected pancreatic cancer

Treatment Interruptions During Stereotactic Body Radiotherapy for Prostate Cancer

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