Abstract Plus Abstract Plus Overview for Pacific Regional Central Cancer Registry Honolulu, Hawaii March 7, 2009 Software for Abstracting and Coding Cancer Cases

Overall Learning Objectives Identify Abstract Plus purpose and benefits Logging into Abstract Plus Identify the components of Abstract Plus Understand how Abstract Plus is set up and configured Create and modify abstracts; resolve edit errors Export abstracts Run the available reports

Used to abstract and code cancer cases using standard data items and codes Supports abstraction of all data items in national standard data sets, including all text fields and state- specific data items Entered abstracts are validated by customizable edits, allowing for interactive error correction while abstracting Customized by central registries for distribution to and use by hospitals and other reporting sources Also used for special projects and start-up registries Abstract Plus

Abstract Plus Purpose Summarize the medical record into an electronic report of cancer diagnosis and treatment by abstractors and other individuals or groups who work with cancer data CDC provides support and consultation to state central registries for their state-specific customization and distribution of the Registry Plus software

Abstract Plus Features Output: electronic abstract in the format of the North American Association of Central Cancer Registries (NAACCR) data exchange layout State-specific needs in data collection can be accommodated Edits are tightly integrated into Abstract Plus, allowing for interactive editing and error correction Abstract Plus includes Registry Plus Online Help

Abstract Plus Features Can be distributed free of charge to cancer reporting facilities in a state Suitable for reporting from non-registry hospitals, clinics, laboratories, and other sources for cancer incident reports Can be configured for special studies

Abstract Plus Users Facility Abstractors: –Add, edit, delete, and export abstracts (cannot perform administrative functions) Administrators: Perform all the functions of Facility Abstractors, plus: –Edit display types and fields –Change user IDs or passwords –Administrator password is required

Abstract Plus Basics Log in as a guest Create your own user ID and password Log in using your own user ID and password Navigate the Abstract Plus main menu

Launching Abstract Plus Start--->All Programs--->Abstract Plus---> Absplus

Logging in as the Guest User guest

Creating a New User ID AP1

Creating a New User ID LAST, FIRST INITIALS PASSWORD PRESS ENTER

Confirm Password and Log In as Newly-Created User 2. CLICK CHANGE CURRENT USER 1. CONFIRM PASSWORD AND PRESS ENTER CLOSE

Abstract Plus Main Window YOU ARE LOGGED ON

Abstract Plus File Menu Items

New Abstract

Display Fields Area Field Entry/Code Selection Information Tabs – Text/Edits/ Projects Abstract Section Display Type Abstract Reference ID Number

Enter a Few Fields

Save Your Work!

Assign a Project to the Abstract

Close the Abstract

Open/Find the Abstract Double-click Patient Name to Open

Copy the Abstract

Copied to New Abstract Abstract Reference ID Number 2

Save New Abstract

Run Edits on the Abstract

Abstract Plus Edits Tab Selected Error Total Number of Errors Edit Set Name Failed Edit Name Fields Included in Edit

Data Editing - Overview Edits consist of data validation routines: Single field edits –Verify that only acceptable values are used for codes –Example: check validity of primary site code Interfield edits –Enforce relationships among values in related data items –Example: check validity of primary site code for a specific sex code

Standard Setters and Edits Development Standard Setters –SEER –COC –NPCR –NAACCR Edits Development –Establish specifications –Write edits

Users of Data Edits NAACCR SEER NPCR COC/NCDB State cancer registries Hospital cancer registries Cancer registry software providers

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

Edit Differences by Agency SEER Edits Strict application of rules by diagnosis year – Example: Treatment edits Many edits include Sequence Number – Central CoC Edits Assume data conversion rather than strict application of rules by diagnosis year –Example: Treatment edits Many edits include Sequence Number - Hosp

The Data Cleaning Cycle Using EDITS Repeat Steps 1 and 2 until clean!

Edit Name* Agency Edit Sets Fields* Error Messages* Description* Administrative Notes Edit Logic *Note: Sections marked with an asterisk are commonly referenced when resolving errors, and are included in your PRCCR edits dictionary Edits Documentation Report Sections

Date of Last Contact, Date of Diag. (NAACCR IF19) FIELDS: Date of Diagnosis Date of Last Contact ERROR MESSAGES: Date of Diagnosis and Date of Last Contact conflict DESCRIPTION: Date of Last Contact must not precede Date of Diagnosis. If either year is unknown (9999), the edit is skipped. If either month is unknown (99), then only the years are compared. If either day is unknown (99), then only the years and months are compared. ADMINISTRATIVE NOTES: Edit Name List of fields checked by edit Error message: What’s wrong or needs to be reviewed Description: The coding “rules”; may include tips or additional coding rules to help resolve error Administrative Notes: Additional information; how edit differs from another edit of same name

5 Easy Steps to Cleaner Cancer Data: 1.Review error message/edit description 2.Note the fields to be reviewed 3.Review the codes 4.Verify the codes through review of Text 5.Resolve the error Resolving Listed Errors

Resolving Listed Errors Setting Over-rides Should not be set unless the case has been reviewed and documentation is found to confirm that the case is rare or unusual and was originally correctly coded Majority of errant cases corrected, not over- ridden Enter a ‘1’ (2 or 3) to indicate that the case has been reviewed, and is correct-as-is Will prevent the case from generating an error when it is re-run through the edits

Impact of Edits “Standardized transportable data edits and easy-to-use software for creating and applying them have enhanced the accuracy and comparability of data from reporting facilities and central registries across North America.” 1 1 Menck, HR, Deapen, D, Phillips, JL, and Tucker, TC. (Eds.). (2007). Central Cancer Registries: Design, Management and Use, page 151.

Export Abstract In general, only complete cases (no edit errors) are exported, for reporting to the CCR

Export Abstract

Abstract Plus Administrator Menu

Abstract Plus Utilities Menu Items

Abstract Plus Utilities Menu Batch Completion Re-check

Abstract Plus Utilities Menu Doctor Query System

Abstract Plus Reports Menu Items

Abstract Plus Reports Accession Register

Abstract Plus Reports Patient Index

Abstract Plus Reports Selected Cases

Abstract Plus Reports Status Report (Count)

Abstract Plus Reports Status Report

Abstract Plus Reports Completion Status by Month

Abstract Plus Help Menu Items

Abstract Plus Help Contents

Integrated, user-friendly, Windows-based Help system Facilitates abstraction of cancer cases by incorporating standard abstracting and coding manuals into one accessible, easy-to-use resource Contains text of major cancer registry coding references, hyper-linked and cross-indexed for online viewing –NAACCR Data Dictionary, COC FORDS, Collaborative Staging, SEER Manuals (Coding Manual/Old EOD), ICD-O-3, Edits Integrated into Registry Plus products, when applicable Registry Plus Online Help RPOH

RPOH Contents Contains text of major cancer registry coding references –NAACCR Data Dictionary –COC FORDS –Collaborative Staging –SEER Manuals (Coding Manual/Old EOD) –ICD-O-3 –Edits information –Abstract Plus Users Guide

Registry Plus Online Help Navigation PaneDisplay Pane

Standard Windows help functions Four Tabs –Contents: Find a book and topic when you know what you are looking for and where –Index: Find a pre-indexed topic, for example, by NAACCR data item name –Search: Full text search. Find a topic not pre- indexed, e.g., “gestational trophoblastic” –Favorites: Save your most frequently accessed topics for even faster look-up Registry Plus Online Help

Click on the “+” sign to the left of a purple book to open it Click on the “+” sign to the left of a sub-book to open it Click on a topic to view information in the display pane Contents Tab

Abstract Plus Help Search for Help On

Favorites Tab In Contents Tab, select Topic that you wish to add to your Favorites

RPOH—How to Use Browse buttons —”page” through a book Internal hyperlinks to other parts of the same book Cross references between books

RPOH—Browse Buttons

RPOH—Internal Hyperlinks

RPOH—Cross References

Abstract Plus Help About (Version Info)

Registry Plus Abstracting Exercises Mock Case A as a Group Mock Case B Independently