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D F Pheby

Publications and source records attributed to D F Pheby.

9 recordsLinked to original sources
PubMed2000

Colorectal cancer registration: the central importance of pathology.

BACKGROUND: Changes in cancer care have increased the importance of cancer registries in monitoring trends and outcomes. Registries are increasingly using computerised systems, such as patient administration and histopathology, as data sources. Omissions by registries can cause interpretation errors, but use of multiple data sources can overcome this. METHODS: Registrations of new colorectal cancers in Cornwall were compared with cases identified from primary sources over one year. RESULTS: Two hundred and thirty cases were identified locally, 93% in documentary records, 89.6% via histopathology, and 81.3% in the clinical data capture module of the patient administration system. Two hundred and forty four cases were known to the regional registry, but after eliminating wrongly assigned and unconfirmed cases only 201 remained. Twenty nine cases identified locally, particularly cases of advanced disease, were unknown to the registry. CONCLUSIONS: District registers based on histopathology augmented from other sources would provide more accurate and less biased information than existing regionally based methods.

Colorectal Neoplasms↗
PubMed1996

An ecological study of cancer incidence and radon levels in South West England.

To investigate the relationship of domestic radon levels and cancer, the incidence of 14 major cancers in Devon and Cornwall were examined in relation to the local radon levels. Cancer registrations for 1989-1992 were provided by the South-Western Regional Cancer Registry. The average radon levels for postcode sectors were sorted into ten categories from low (< 40 Bq/m3) to extremely high (> or = 230 Bq/m3) and age-standardised incidence rates were calculated for each radon category. The incidence rates for lung cancer, where radon has been claimed to be a risk factor, were very similar across all domestic radon categories. Only non-melanoma skin cancers, showed a significant increase in incidence in the high-radon postcode sectors (> or = 100 Bq/m3) compared with the low-radon sectors (< 60 Bq/m3) and this effect was observed for both sexes. The remaining 12 cancer sites showed no significant trend in incidence rates with increasing radon concentration. There was no significant difference in corrected survival rates for any cancer site between the low- and high-radon areas. The possible contribution of confounding factors to the results of this study is discussed.

England↗
PubMed1994

The Medical Data Index (MDI) dependency module: a shared database to assist discharge planning and audit.

As part of the development of integrated, patient-based hospital information technology (IT) systems in the South-Western Region of England, a module has been developed which will hold core data pertaining to the functional status and current resources of elderly or disabled patients. Its purpose is to assist early identification of unmet needs and facilitate prompt transfer to community care. The module provides a shared database, which is completed or updated as necessary on admission and is then available to all appropriate users of the hospital system, avoiding duplication of data collection. In addition to details of home circumstances and support, it includes brief, standardized assessment scales for activities of daily living and mental state, which will identify the need for specialist referral. A summary is provided for easy communication with other care agencies.

Activities of Daily Living↗
PubMed1994

Capturing data from distant hospital databases for cancer registration.

The particular logistical problems of collecting cancer registration data in the South-Western region of England are discussed. The Regional Cancer Registry has endeavoured to overcome these through developing electronic links to hospital-based patient-information systems. Some of these involve data transfer on magnetic media, but there are also interrogation facilities which operate on a realtime, interactive basis, and complement these other facilities. A PC-based program (SNODEV5), which can accept data from histopathology computer systems, translate SNOMED codes to ICD-9, and produce files suitable for processing by the registry's Batch Data Entry system is described. Its contribution to the achievement and monitoring of equity in health care provision is discussed.

Data Collection↗
PubMed1994

Improving the comparability of cancer registry treatment data and proposals for a new national minimum dataset.

BACKGROUND: There is no consistent or standardized practice for the collection of treatment data in UK cancer registries. This limits the usefulness and effectiveness of undertaking multiregional or national studies of treatment outcomes and survival. METHODS: A working group was established to examine the practices for recording the type and the amount of treatment data held in the cancer records at different registries. A common set of anonymized case notes for breast and colorectal cancer patients, drawn from each registry, was employed to eliminate any selection bias. Each registry coded these case notes according to their own criteria, and the comparability of such data between registries was determined from their returns. RESULTS: Of the 11 registries in England, seven participated in the full study, with a total of 84 records being submitted by five registries. A flow diagram was constructed to show how specific data items in the cancer record structure could be linked between registries. Errors or inconsistencies in recording treatment details were identified, and the constraints in data comparability were defined from the case note returns. CONCLUSION: Variations in coding practice between registries were such as to vitiate interregional or national comparisons of current data. The working group recommended an extended minimum dataset, which included a date for the start of each treatment modality, that most registries should be able to implement with some system changes.

Data Collection↗
PubMed1982

Changing practice on confidentiality: a cause for concern.

The dissemination of information about patients through computers and multidisciplinary teams involves departures from traditional tenets of confidentiality. This raises ethical problems, exemplified by current practices in child health. In multidisciplinary teams, problems may arise because different professions utilise different types of data. Some team members may not appreciate the extent to which data may be unscientific and judgmental. Children and thier families may be labelled, without justification, preventing objective reappraisal. The ethical and legal implications are considered. Practice may not conform to principles of natural justice, for example when care orders are sought. Obligations to the State may also imperil the confidentiality of the doctor-patient relationship, and of medical records, the legal status of which is confused and requires clarification. Allowing patients access to their records could be a useful safeguard, and the medical profession should devise alternatives should it not be accepted.

Child↗