The Garden of Edits Alan R. Houser, MA, MPH Research Scientist II C/NET Solutions NCRA Educational Conference May 8, 2006

Importance of Data Quality Cancer registry data is used to Determine disease origins Determine disease origins Look for demographic or geographic patterns Look for demographic or geographic patterns Determine course of treatment Determine course of treatment Evaluate new treatment regimes Evaluate new treatment regimes In all cases, good data gives good insights

History of Edits Pre-computer era: Paper abstracts Paper abstracts Visual editing Visual editing Manual files Manual files Manual reports Manual reports

History of Edits Early computer era: Mainframes, Mini-computers Mainframes, Mini-computers Key entry from paper abstracts Key entry from paper abstracts Data storage limitations Data storage limitations Batch edits - custom programs written Batch edits - custom programs written Reports easier Reports easier

History of Edits Modern computer era: Desktop computers Desktop computers Interactive edits Interactive edits Still custom programmed Still custom programmed

History of Edits Concept of portable edits developed in mid-1980s Allows for standardization of edits Allows for standardization of edits Platform-independent Platform-independent Same edits can be applied at all levels Same edits can be applied at all levels

Use edits for: Evaluation of data quality prior to submission to CCR or SS Correcting edit errors on report from CCR Abstracting (interactive data validation w/in software) Run edits on CCR and Reporting hospital submissions to: Enforce national data standards Assess data quality and completeness Provide feedback to CCRs and Reporting Hospitals Vendors Reporting Facilities Central Cancer Registries (CCR) Standard Setters (SS) Incorporate edits in Reporting Facility and CCR cancer abstraction and reporting software (interactive data validation & batch mode) Support CCR and Facility- specific edit needs Run Call For Data edits prior to submission to SS Run edits on incoming data submissions to assess for accuracy and completeness, and to identify training needs NPCR, SEER, & NAACCR COC COC- Approved EDITS Used at ALL LEVELS of Cancer Reporting Slide courtesy of Susan Capron

CDC Edits Support EditWriter EditWriter developed to create data dictionary, record layouts, edits, and edit sets and integrate edits with lookup tables; produces compiled Runtime MetaFile (RMF)developed to create data dictionary, record layouts, edits, and edit sets and integrate edits with lookup tables; produces compiled Runtime MetaFile (RMF)

CDC Edits Support EditWriter EditWriter developed to create data dictionary, record layouts, edits, and edit sets and integrate edits with lookup tables; produces compiled Runtime MetaFile (RMF)developed to create data dictionary, record layouts, edits, and edit sets and integrate edits with lookup tables; produces compiled Runtime MetaFile (RMF) Edit Engine – Edit Engine – developed to apply edits within a MetaFile to a data streamdeveloped to apply edits within a MetaFile to a data stream

CDC Edits Support EditWriter EditWriter developed to create data dictionary, record layouts, edits, and edit sets and integrate edits with lookup tables; produces compiled Runtime MetaFile (RMF)developed to create data dictionary, record layouts, edits, and edit sets and integrate edits with lookup tables; produces compiled Runtime MetaFile (RMF) Edit Engine – Edit Engine – developed to apply edits within a MetaFile to a data streamdeveloped to apply edits within a MetaFile to a data stream Released to Cancer Registry Community in the mid-1990s Released to Cancer Registry Community in the mid-1990s

CDC Edits Support GenEdits GenEdits DOS program for batch processing of submission filesDOS program for batch processing of submission files GenEdits Lite GenEdits Lite Windows program for batch processing of submission filesWindows program for batch processing of submission files

Sources of Edits National Standards Agencies: National Standards Agencies: SEER Program (National Cancer Institute)SEER Program (National Cancer Institute) NCDB (Commission on Cancer)NCDB (Commission on Cancer) NPCR (CDC)NPCR (CDC) NAACCRNAACCR

Sources of Edits National Standards Agencies: National Standards Agencies: SEER Program (National Cancer Institute)SEER Program (National Cancer Institute) NCDB (Commission on Cancer)NCDB (Commission on Cancer) NPCR (CDC)NPCR (CDC) NAACCRNAACCR State Registries State Registries

Sources of Edits National Standards Agencies: National Standards Agencies: SEER Program (National Cancer Institute)SEER Program (National Cancer Institute) NCDB (Commission on Cancer)NCDB (Commission on Cancer) NPCR (CDC)NPCR (CDC) NAACCRNAACCR State Registries State Registries Cancer Committees Cancer Committees

Sources of Edits National Standards Agencies: National Standards Agencies: SEER Program (National Cancer Institute)SEER Program (National Cancer Institute) NCDB (Commission on Cancer)NCDB (Commission on Cancer) NPCR (CDC)NPCR (CDC) NAACCRNAACCR State Registries State Registries Cancer Committees Cancer Committees Vendors Vendors

What is this Garden? Good data doesnt just happen Good data doesnt just happen

What is this Garden? Good data doesnt just happen Good data doesnt just happen Soil – Data StandardsSoil – Data Standards

What is this Garden? Good data doesnt just happen Good data doesnt just happen Soil – Data StandardsSoil – Data Standards Weeds – Bad DataWeeds – Bad Data

What is this Garden? Good data doesnt just happen Good data doesnt just happen Soil – Data StandardsSoil – Data Standards Weeds – Bad DataWeeds – Bad Data Gardener – RegistrarGardener – Registrar

What is this Garden? Good data doesnt just happen Good data doesnt just happen Soil – Data StandardsSoil – Data Standards Weeds – Bad DataWeeds – Bad Data Gardener – RegistrarGardener – Registrar Tools – EditsTools – Edits

What is this Garden? Good data doesnt just happen Good data doesnt just happen Soil – Data StandardsSoil – Data Standards Weeds – Bad DataWeeds – Bad Data Gardener – RegistrarGardener – Registrar Tools – EditsTools – Edits Flowers – Clean DataFlowers – Clean Data

How an Edit is Created 1.Look at sources

How an Edit is Created 2.Find an interaction between two or more fields

How an Edit is Created Establish logical relationships Establish logical relationships If Surg Prim Site is 00 or 98, Date Most Definitive Surgery must be If Surg Prim Site is 00 or 98, Date Most Definitive Surgery must be If Surg Prim Site is 99, Date Most Definitive Surgery must be If Surg Prim Site is 99, Date Most Definitive Surgery must be

How an Edit is Created Write the edit logic Write the edit logic

How an Edit is Created Write the edit logic Write the edit logic Write the edit help (more later) Write the edit help (more later)

How an Edit is Created Write the edit logic Write the edit logic Write the edit help (more later) Write the edit help (more later) Write the edit error message Write the edit error message

Application of Edits Batch Processing on Transmit Files Batch Processing on Transmit Files GenEditsGenEdits GenEdits LiteGenEdits Lite Interactive Processing in Database Interactive Processing in Database Abstract PlusAbstract Plus CNExTCNExT

The Error Message Multi-line edit messages (e.g., GenEdits) Multi-line edit messages (e.g., GenEdits) Not constrained by line length, so all data fields examined in the edit are listed with current valuesNot constrained by line length, so all data fields examined in the edit are listed with current values

The Error Message Multi-line edit messages (e.g., GenEdits) Multi-line edit messages (e.g., GenEdits) Not constrained by line length, so all data fields examined in the edit are listed with current valuesNot constrained by line length, so all data fields examined in the edit are listed with current values Relies on message to describe interactions between data fields that may trigger editRelies on message to describe interactions between data fields that may trigger edit

The Error Message Multi-line edit messages (e.g., GenEdits) Multi-line edit messages (e.g., GenEdits) Not constrained by line length, so all data fields examined in the edit are listed with current valuesNot constrained by line length, so all data fields examined in the edit are listed with current values Relies on message to describe interactions between data fields that may trigger editRelies on message to describe interactions between data fields that may trigger edit Lists edit name, including owner of edit (Standard Setter)Lists edit name, including owner of edit (Standard Setter)

The Error Message Multi-line edit messages (e.g., GenEdits) Multi-line edit messages (e.g., GenEdits)

The Error Message Multi-line edit messages (e.g., GenEdits) Multi-line edit messages (e.g., GenEdits) Not constrained by line length, so all data fields examined in the edit are listed with current valuesNot constrained by line length, so all data fields examined in the edit are listed with current values

The Error Message Multi-line edit messages (e.g., GenEdits) Multi-line edit messages (e.g., GenEdits) Not constrained by line length, so all data fields examined in the edit are listed with current valuesNot constrained by line length, so all data fields examined in the edit are listed with current values Relies on message to describe interactions between data fields that may trigger editRelies on message to describe interactions between data fields that may trigger edit

The Error Message Multi-line edit messages (e.g., GenEdits) Multi-line edit messages (e.g., GenEdits) Not constrained by line length, so all data fields examined in the edit are listed with current valuesNot constrained by line length, so all data fields examined in the edit are listed with current values Relies on message to describe interactions between data fields that may trigger editRelies on message to describe interactions between data fields that may trigger edit Lists edit name, including owner of edit (Standard Setter)Lists edit name, including owner of edit (Standard Setter)

The Error Message Multi-line edit messages (e.g., GenEdits) Multi-line edit messages (e.g., GenEdits) Not constrained by line length, so all data fields examined in the edit are listed with current valuesNot constrained by line length, so all data fields examined in the edit are listed with current values Relies on message to describe interactions between data fields that may trigger editRelies on message to describe interactions between data fields that may trigger edit Lists edit name, including owner of edit (Standard Setter)Lists edit name, including owner of edit (Standard Setter) Report can get quite large quicklyReport can get quite large quickly

The Error Message Single-line edit messages Single-line edit messages

The Error Message Single-line edit messages Single-line edit messages More compact (shorter printouts)More compact (shorter printouts)

The Error Message Single-line edit messages Single-line edit messages More compact (shorter printouts)More compact (shorter printouts) Not all fields in edit may be listedNot all fields in edit may be listed

The Error Message Single-line edit messages Single-line edit messages More compact (shorter printouts)More compact (shorter printouts) Not all fields in edit may be listedNot all fields in edit may be listed Values of fields in edit may not be listedValues of fields in edit may not be listed

The Error Message Single-line edit messages Single-line edit messages More compact (shorter printouts)More compact (shorter printouts) Not all fields in edit may be listedNot all fields in edit may be listed Values of fields in edit may not be listedValues of fields in edit may not be listed Message may offer clues to resolutionMessage may offer clues to resolution

The Error Message Single-line edit messages Single-line edit messages More compact (shorter printouts)More compact (shorter printouts) Not all fields in edit may be listedNot all fields in edit may be listed Values of fields in edit may not be listedValues of fields in edit may not be listed Message may offer clues to resolutionMessage may offer clues to resolution Doesnt include owner of editDoesnt include owner of edit

The Error Message Single-line edit messages Single-line edit messages More compact (shorter printouts)More compact (shorter printouts) Not all fields in edit may be listedNot all fields in edit may be listed Values of fields in edit may not be listedValues of fields in edit may not be listed Message may offer clues to resolutionMessage may offer clues to resolution Doesnt include owner of editDoesnt include owner of edit Requires better help systemRequires better help system

Edit Help Not readily accessible Not readily accessible Some third party solutionsSome third party solutions What information can be gleaned from the error message? What information can be gleaned from the error message? Conflict between A and BConflict between A and B What are the values of A and B?What are the values of A and B? Why do they conflict?Why do they conflict?

Edit Help Not readily accessible Not readily accessible Some third party solutionsSome third party solutions

Edit Help Edit message listings Edit message listings

Edit Help NCDB Edits Help NCDB Edits Help

Edit Help NCDB Edits Help (interactive) NCDB Edits Help (interactive)

Edit Help Abstract Plus Abstract Plus

Edit Help CNExT SmartHelp CNExT SmartHelp

Resolving Edit Errors General Steps General Steps 1.Review error message/edit help 2.Note fields to be reviewed 3.Review codes 4.Verify codes by reviewing text 5.Resolve error Slide adapted from Kathleen Thoburn

The Error Message Hybrid solutions Hybrid solutions Combine edit error with resolution toolsCombine edit error with resolution tools

The Error Message Hybrid solutions: Abstract Plus Hybrid solutions: Abstract Plus Jump to field from listJump to field from list

The Error Message Hybrid solutions: CNExT Hybrid solutions: CNExT Build edit resolution screen dynamicallyBuild edit resolution screen dynamically

The Data Cleaning Cycle Using Edits Repeat Steps 1 and 2 until clean! 1. Run Edits 2. Clean Errors Slide courtesy of Susan Capron

Checking the Standards Whose edit is it? Whose edit is it? Different Standard Setters may have different rules for a particular situationDifferent Standard Setters may have different rules for a particular situation Knowing whose rules applies tells you whose manual to reach for firstKnowing whose rules applies tells you whose manual to reach for first BUT, many edits have been adopted by multiple Standard Setters when they agree on how the edit should be appliedBUT, many edits have been adopted by multiple Standard Setters when they agree on how the edit should be applied

New Tools on the Horizon GenEdits Plus GenEdits Plus Edit Help Edit Help