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Learn how to utilize SEER-DMS tables to generate monthly ACOS follow-up reports for hospitals. This process involves utilizing SAS software and SQL coding to query and summarize data in a more efficient and accurate manner.
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Utilizing SEER-DMS Tables to Generate Monthly Hospital ACOS Follow-up ReportsGeorge W. Dombi, PhD
MDCSS Responsibilities • Provide cancer data to the National Cancer Institute, (SEER). • Provide data to the State of Michigan. • Provide cancer registry information to selected local hospitals – ACOS reports. • Conduct population-based research. • Support research efforts of outside investigators by file linkage of their data.
Follow-Up • Vital Status is updated from a variety of sources: physicians, hospitals, patients, next-of-kin, other cancer registries and state and federal agencies. • Vital Status is one of the most frequently requested data elements from other investigators.
Why do Follow-Up? • Because…….. It’s the Law. • Allows for survival statistics to be calculation in studies of cancer patients. • SEER has it own guidelines for patient follow-up:
SEER Follow-Up Guidelines • Records of all patients must be at least 95% current. • Under 20 yrs: SEER wants 90%, but will allow anything above 80%. • 20-64 years old, must be at least 90%. • 65+ years old, must be at least 90%. • In-situ cases must be at least 90%.
ACOS Hospitals Follow-Up Reports • American College of Surgeons, ACOS Reports use a 15 month follow-up time window. • Follow-up must be 80% complete for all cases. • Follow-up must be 90% complete for patients diagnosed in last 5 years. • This can be a difficult process, since each month the 15 month time window changes.
Previous Method to Generate Monthly ACOS Reports • Reports generated in 3-step process on old HP server data base. - COGNOS software to query data bases. - SAS to calculate summary values. - EXCEL to present report. • Send report to respective hospitals.
ACOS Report (1) • ACOS 15 month follow-up period • 1-30-2006 to 04-30-2007 April 30, 2007 • Reference dates: Jan. 1, 1972 • Last complete year ended: Dec 31, 2005 • Cases Included: Jan.1, 1972 to present Number • Total cases in registry since reference date 76,655 • 1. less "benign" and "borderline" cases 222 • 2. less carcinoma in situ cervix cases 893 • 3. less cases of in situ and localized basal 1,224 • and squamous cell carcinoma of skin • 4. less foreign residents 1,250 • 5. less nonanalytic 18,402 • Overall Follow-up 54,664
ACOS Report (2) • Overall Follow-up Number % • #analytical cases 54,664 100.0% • #dead 36,547 66.9% • #living 18,117 33.1% • #alive in the last 15 months 14,874 27.2% • total lost to follow-up 3,243 5.9% • Alive Follow-up • #living 18,117 100.0% • #alive in the last 15 months 14,874 82.1% • total lost to follow-up 3,243 17.9% • Follow-up rate for living patients 82.1% • Overall follow-up rates 94.1%
SEER-DMS Method • Reports generated in 2-step process. • SAS software: Oracle password enabled: - to query data bases with SQL. - to calculate summary values. • EXCEL to present report. • Send report to respective hospitals.
Coder’s Corner - SQL in SAS • libname perm "Q:\datarq\2007\07119 ACOS 6040"; • %let Back15Months = 20060130; • proc sql; • connect to oracle (&mydb); • create table perm.acos26 as select * • from connection to oracle • (SELECT ctc.pat_id, fa.ctc_id, p.pat_id, p.display_id, • p.display_id || ctc.tumor_record_number as CanSeq, • far.newdx_flag as NewdxFlag, • ctc.primary_site as PrimeSite, • ctc.survival_time_months as SurvMo, • ctc.date_of_diagnosis_yyyy || LPAD(ctc.date_of_diagnosis_MM, 2, 0) || ctc.date_of_diagnosis_yyyy as YearDx, • ………..
Coder’s Corner - SQL in SAS • decode(trunc(ctc.date_of_diagnosis_yyyy/2001), 0, ctc.behavior_icdo2, ctc.behavior_icdo3) as HistMalig, • FROM facility_admission fa • JOIN facility f ON (fa.fac_id = f.fac_id) • JOIN ctc on (fa.ctc_id = ctc.ctc_id) • JOIN ctc_registry cr on (fa.ctc_id = cr.ctc_id) • JOIN patient p on (ctc.pat_id = p.pat_id) • WHERE (f.display_id IN ('FAC-0026', 'FAC-0129','FAC-0259',FAC-6040')) • AND ctc.date_of_diagnosis_yyyy >= 1972 • ORDER BY canseq ); • disconnect from Oracle; • quit; • * This removes duplicate CSS-num and is equivalent to Subhp3; • data Subhp3; • set perm.acos26; • by display_id; • if last.display_id; • run; ………..
Conclusions • Utilized SEER-DMS in conjunction with SQL coding. • Saved time. • Reduced transcription errors between searching program and analysis program.
Future Goals • Incorporate reporting piece. • Do everything in SAS program. • Searching, analysis and reporting • All in one reusable program.