Agreement of Iranian Breast Cancer Data and Relationships
with Measuring Quality of Care in a 5-year Period (2006-2011)
Ali Keshtkaran1, Roxana Sharifian et al.
Abstract
Objectives: To investigate data agreement of cancer registries and medical records as well as the quality of
care and assess their relationship in a 5-year period from 2006 to 2011. Methods: The present cross-sectional,
descriptive-analytical study was conducted on 443 cases summarized through census and using a checklist.
Data agreement of Nemazi hospital-based cancer registry and the breast cancer prevention center was analyzed
according to their corresponding medical records through adjusted and unadjusted Kappa. The process of care
quality was also computed and the relationship with data agreement was investigated through chi-square test.
Results: Agreement of surgery, radiotherapy, and chemotherapy data between Nemazi hospital-based cancer
registry and medical records was 62.9%, 78.5%, and 81%, respectively, while the figures were 93.2%, 87.9%,
and 90.8%, respectively, between breast cancer prevention center and medical records. Moreover, quality of
mastectomy, lumpectomy, radiotherapy, and chemotherapy services assessed in Nemazi hospital-based cancer
registry was 12.6%, 21.2%, 35.2%, and 15.1% different from the corresponding medical records. On the other
hand, 7.4%, 1.4%, 22.5%, and 9.6% differences were observed between the quality of the above-mentioned
services assessed in the breast cancer prevention center and the corresponding medical records. A significant
relationship was found between data agreement and quality assessment. Conclusion: Although the results
showed good data agreement, more agreement regarding the cancer stage data elements and the type of the
received treatment is required to better assess cancer care quality. Therefore, more structured medical records
and stronger cancer registry systems are recommended.
Key Words: Cancer data agreement - care quality measurement - breast cancer care - process of care - Iran
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