1. Automated Consolidation of Collaborative Stage Data Items
The Pennsylvania Approach to Enhancing Automation and Implementing Consolidation in the Absence of National Standards
Michelle L. Esterly, RHIA, CTR
Database Manager
Pennsylvania Cancer Registry
NAACCR 2013 Annual Conference
Austin, Texas

2. Collaboration Jennifer E. Seiffert Sanjeev Baral Joseph D. Rogers
CDC/NPCR Contractor
Sanjeev Baral
Joseph D. Rogers
Team Lead, Data Analysis and Support Team, NPCR, CDC
Robin D. Otto
Pennsylvania Cancer Registry Manager

3. Project Overview Background Collaborative Stage Consolidation Process
Evaluation
Future Plans

4. Background Need for Additional Automation
Limited Resources and Staffing
Increase in Reporting Sources
Manual Data Item Consolidation for Collaborative Stage
Known Values Over Unknown
No Standards for Data Item Consolidation

5. Background Data Item-by-Data Item Consolidation Rules
Source Record Comparison
Consolidation Rules
Automated
Manual
Combination

6. Background Manual Review Records Sent to Pending
Text and Visual Review
Customization

7. Collaborative Stage Consolidation
Consolidate Individual CS Data Items
Derived Fields Recalculated
Targeted Higher Volume Sites
Consolidation Rules Created For:
Breast
Colon
Rectum
Lung
Prostate
HemeRetic

8. Collaborative Stage Consolidation
Conditional Consolidation Directives
Programming Logic Added to CRS Plus
Implemented in Production November 2012
Manual Intervention for Complex Decisions

9. Collaborative Stage Consolidation
Template Established
Structure and Pattern

10. Categories Used for CS Consolidation
Known Over Unknown
Ex. Any value over 999
Presence of Tumor Over No Tumor Present
Ex. Eliminate codes equating to No Tumor Present
Specific Over Non-Specific
Ex. Lung CS Extension – Eliminate Code 300 (Localized NOS) if Code 230 (Tumor Confined to Hilus) – Code 230 maps to Localized/more specific

11. Categories Used for CS Consolidation (cont.)
Combination Codes
Ex. Prostate – Clinical Extension
470 ( )
Analytic Over Non-Analytic
As Defined for Central Registries
Same Source As
Ex. CS Reg Nodes Eval
Highest Value (if appropriate)

12. Colon CS Extension Directive
Known over unknown;
Eliminate 950 if any other value = ;
Eliminate 900 if any other value = ;
Eliminate 850 if any other value = ;
Eliminate 560 if any other value = ;
Eliminate 470 if any other value = 400 or ;
Eliminate 300 if any other value = ;
Otherwise if any value = 500 and any other value = , update with 550;
Eliminate 450, 458 or 500 if any value = 550;
Otherwise manual review.

13. Colon CS Extension Directive
Description
Known over unknown
Select known value over unknown
Eliminate 950 if any other value =
Eliminate 950 (No evidence primary tumor) if any other value
Eliminate 900 if any other value =
Eliminate 900 (T4 NOS) if any value in the T4 range
Eliminate 850 if any other value =
Eliminate 850 (Stated as T4b with no other information on extension) if there is a more specific T4b code
Eliminate 560 if any other value =
Eliminate 560 (Stated as T4a with no other information on extension) if there is a more specific T4a code

14. Colon CS Extension Directive cont.
Description
Eliminate 470 if any other value = 400 or
Eliminate 470 (Stated as T3 with no other information on extension) if there is a more specific code equating to T3
Eliminate 300 if any other value =
Eliminate 300 (Localized NOS) if there is a more specific localized code
If any value = 500 and any other value = , update with 550
Combination of , update with the combination code of 550
Eliminate 450, 458 or 500 if any value = 550
Eliminate the codes in the combination if a source reports the combination code
Manual Review
Manually review specific code values using text.

15. Benefits: CS Consolidation
Reduce Number of Records to Pending
Reduce Number of Data Items Requiring Manual Review

16. Evaluation Schema Percent Decrease in Manual Review Prostate 91 Breast75
Rectum 73
Colon 61
Lung 51

17. General Observations
Schema with Fewer Required/Collected SSFs = Less Data Items to Consolidate
Largest Impact – Schema with many SSFs
Data Item Requiring Manual Review Most Often – CS Extension
HemeRetic

18. Manual Review Required with CS
Schema
Percent Requiring Manual Review
Prostate
1.0
Breast
2.8
Rectum
2.1
Colon
2.9
Lung
Above Sites Combined
2.3

19. Summary CS Data Item Consolidation Reduced 30%
Manual Review Required for < 3% of Cases for CS
Pattern Established
Testing

20. Future Plans
Bladder, Kidney Parenchyma, Thyroid, and Melanoma Implemented in PA
Identify Additional Schema by Volume
Modifying Code Ranges – CS Versions

21. Acknowledgements
CDC Registry Plus Development Team

22. Joseph D. Rogers – jrogers@cdc.gov Robin D. Otto – rootto@pa.gov
Thank You!
Michelle L. Esterly -
Jennifer E. Seiffert -
Sanjeev Baral -
Joseph D. Rogers –
Robin D. Otto –