Registries that include extent of surgical procedure may frequently inaccurately code total thyroidectomy as thyroid lobectomy, according to a retrospective analysis of the Tennessee Cancer Registry presented during the plenary session of the Society for Surgical Oncology’s Annual Cancer Symposium.
Facilities accredited by the Commission on Cancer accounted for most of the inaccurately coded cases, results showed.
Analyses that have evaluated data from the National Cancer Data Base have shown that approximately 20% of patients with thyroid cancer who underwent thyroid lobectomy received radioiodine, which is not standard treatment.
Colleen M. Kiernan, MD, MPH, a resident in the division of surgical oncology and endocrine surgery at Vanderbilt University Medical Center, and colleagues surmised that many thyroid cancer registry abstracts inaccurately coded the extent of the surgical procedure.
To assess their hypothesis, researchers conducted a retrospective review of thyroid cancer cases recorded in the Tennessee Cancer Registry, which receives case information from statewide providers and health care facilities that diagnose and treat patients with cancer.
Certified registrars at the registry reviewed abstracts and/or telephoned reporting facility staff to confirm whether thyroid lobectomy was the performed procedure.
There were 918 thyroid cancer cases in which the definitive surgical procedure was coded as thyroid lobectomy between 2004 and 2011.
Of these cases, 40.2% (n = 369) were incorrectly coded, most of which the researchers changed to total thyroidectomy (65.6%; n = 242).
When researchers classified hospitals in the registry as Commission-on-Cancer–accredited or non-accredited, they found 85% of the 242 cases changed from thyroid lobectomy to total thyroidectomy were reported from Commission-on-Cancer–accredited facilities.
The researchers then performed a subgroup analysis of 184 (20%) records originally coded as thyroid lobectomy with postoperative radioiodine receipt. Of these, 62.5% (n = 115) were inaccurately coded.
Overall, only 7.5% of patients who underwent thyroid lobectomy actually received postoperative radioiodine, which represented a significant difference compared with the recorded 20% in the registry (P < .01 for comparison).
“These Commission on Cancer facilities contribute case information to other large national cancer databases, such as the National Cancer Data Base,” Kiernan and colleagues wrote. “Using text-to-code reabstraction audits and facility contact where needed, these discrepancies can be corrected to improve data quality.” – by Cameron Kelsall
Kiernan CM, et al. Abstract 5. Presented at: Society for Surgical Oncology Annual Cancer Symposium; March 2-5, 2016; Boston.
Disclosure: HemOnc Today could not confirm the researchers’ relevant financial disclosures at the time of reporting.