• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.2107-2111
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• 2013

Objectives: To investigate data agreement of cancer registries and medical records as well as the quality of care and assess their relationship in a 5-year period from 2006 to 2011. Methods: The present cross-sectional, descriptive-analytical study was conducted on 443 cases summarized through census and using a checklist. Data agreement of Nemazi hospital-based cancer registry and the breast cancer prevention center was analyzed according to their corresponding medical records through adjusted and unadjusted Kappa. The process of care quality was also computed and the relationship with data agreement was investigated through chi-square test. Results: Agreement of surgery, radiotherapy, and chemotherapy data between Nemazi hospital-based cancer registry and medical records was 62.9%, 78.5%, and 81%, respectively, while the figures were 93.2%, 87.9%, and 90.8%, respectively, between breast cancer prevention center and medical records. Moreover, quality of mastectomy, lumpectomy, radiotherapy, and chemotherapy services assessed in Nemazi hospital-based cancer registry was 12.6%, 21.2%, 35.2%, and 15.1% different from the corresponding medical records. On the other hand, 7.4%, 1.4%, 22.5%, and 9.6% differences were observed between the quality of the above-mentioned services assessed in the breast cancer prevention center and the corresponding medical records. A significant relationship was found between data agreement and quality assessment. Conclusion: Although the results showed good data agreement, more agreement regarding the cancer stage data elements and the type of the received treatment is required to better assess cancer care quality. Therefore, more structured medical records and stronger cancer registry systems are recommended.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7731-7736
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• 2013

Aim: To compare the agreement of screening breast mammography plus ultrasound and reviewed mammography alone in asymptomatic women. Materials and Methods: All breast imaging data were obtained for women who presented for routine medical checkup at National Cancer Institute (NCI), Thailand from January 2010 to June 2013. A radiologist performed masked interpretations of selected mammographic images retrieved from the computer imaging database. Previous mammography, ultrasound reports and clinical data were blinded before film re-interpretation. Kappa values were calculated to assess the agreement between BIRADS assessment category and BIRADS classification of density obtained from the mammography with ultrasound in imaging database and reviewed mammography alone. Results: Regarding BIRADS assessment category, concordance between the two interpretations were good. Observed agreement was 96.1%. There was moderate agreement in which the Kappa value was 0.58% (95%CI; 0.45, 0.87). The agreement of BI-RADS classification of density was substantial, with a Kappa value of 0.60 (95%CI; 0.54, 0.66). Different results were obtained when a subgroup of patients aged ${\geq}60$ years were analyzed. In women in this group, observed agreement was 97.6%. There was also substantial agreement in which the Kappa value was 0.74% (95%CI; 0.49, 0.98). Conclusions: The present study revealed that concordance between mammography plus ultrasound and reviewed mammography alone in asymptomatic women is good. However, there is just moderate agreement which can be enhanced if age-targeted breast imaging is performed. Substantial agreement can be achieved in women aged ${\geq}60$. Adjunctive breast ultrasound is less important in women in this group.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.4901-4903
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• 2012

To assess the awareness of cervical cancer among couples, data were collected from two urban slums community in Mumbai. A total of 1958 married women aged from 18 to 49 and their husbands were selected using simple random sampling. Women (37.7%) were significantly more aware of cervical cancer than husbands (8.7%). A slight agreement (kappa statistics=0.16) was observed between husbands and wives on awareness of cervical cancer. Significantly higher percentages of wives were aware of pap smear test than husbands. Overall, awareness of cervical cancer and pap smear test among couples is low. There is need to educate and motivate both of them to participate in cervical cancer screening program.

• Tuberculosis and Respiratory Diseases
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• v.62 no.1
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• pp.27-32
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• 2007

Background: This study evaluated the accuracy of smoking habit from the data obtained from the medical records of lung cancer patients against the data obtained form face-to-face interview questionnaires Methods: The smoking habits of 225 lung cancer patients were categorized into never smoked, ex-smoker and current smoker in face-to-face interview questionnaire and medical record taken at the time of admission for a diagnosis. The overall agreement between two sources was evaluated. The factors affecting the disagreement between two sources and the level of data omission of the smoking habits in medical records were analyzed suing multiple logistic regression. Results: The smoking habit between two sources showed moderate overall agreement(Kappa $({\kappa})=0.60$). The lowest agreement was observed in the ex-smokers(${\kappa}=0.49$). Multivariate analysis revealed an age of 65 or older to be a statistically significant factor associated with the increasing disagreement risk compared with those 64 or younger (OR 3.02; 95% CI 1.58-5.80). The omission rate of smoking habits in the medical records was 18.2%. Adenocarcinoma was shown to be a statistically significant factor of associated with an increasing omission rate compared with squamous cell carcinoma (OR 3.00; 95% CI 1.19-7.59). Conclusion: The smoking habits obtained from medical record moderately reflect their true behavior. However, the smoking habit data from medical record should be used with caution when being used in a clinical study or cohort study of lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.259-263
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• 2015

Background: In the field of cancer, the ICD-10 coding convention is based on the site of a neoplasm in the body and usually ignores the morphology, thus the same code may be assigned to tumors of different morphologic types in an organ. Nowadays, all general (provincial) and center hospitals in Thailand are equipped with the hospital information system (HIS) database. Objective: This study aimed to find the characteristics and magnitude of agreement represented by the positive predictive value (PPV) of provisional cancer diagnoses in the HIS database in Pattani Hospital in Thailand in comparison with the final cancer diagnosis of the ICD-10 codes generated from a well established cancer registry in Songklanagarind Hospital, the medical school hospital of Prince of Songkla University. Materials and Methods: Data on cancer patients residing in Pattani province who visited Pattani Hospital from January 2007 to May 2011 were obtained from the HIS database. The ICD-10 codes of the HIS computer database of Pattani Hospital were compared against the ICD-10 codes of the same person recorded in the hospital-based cancer registry of Songklanagarind Hospital. The degree of agreement or positive predictive value (PPV) was calculated for each sex and for both sexes combined. Results: A total of 313 cases (15.9%) could be matched in the two databases. Some 222 cases, 109 males and 113 females, fulfilled the criteria of referral from Pattani to Songklanagarind Hospitals. Of 109 male cancer cases, 76 had the same ICD-10 codes in both hospitals, thus, the PPV was 69.7% (95%CI: 60.2-78.2%). Agreement in 76 out of 113 females gave a PPV of 67.3% (95%CI: 57.8-75.8%). The two percentages were found non-significant with Fisher's exact p-value of 0.773. The PPV for combined cases of both sexes was 68.5% (95%CI: 61.9-74.5%). Conclusions: Changes in final diagnosis in the referral system are common, thus the summary statistics of a hospital without full investigation facilities must be used with care, as the statistics are biased towards simple diseases able to be investigated by available facilities. A systematic feedback of patient information from a tertiary to a referring hospital should be considered to increase the accuracy of statistics and to improve the comprehensive care of cancer patients.

• The Journal of Korean Medicine
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• v.42 no.1
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• pp.1-11
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• 2021

Objectives: This pilot study aimed to evaluate the agreement between traditional face-to-face Korean medicine (KM) pattern identification and non-face-to-face KM pattern identification using the data from related questionnaires, tongue image, and pulse features in patients with cancer. Methods: From January to June 2020, 16 participants with a cancer diagnosis were recruited at the one Korean medicine hospital. Three experienced Korean medicine doctors independently diagnosed the participants whether they belong to the cold pattern or not, heat pattern or not, deficiency pattern or not, and excess pattern or not. Another researcher collected KM pattern related data using questionnaires including Cold-Heat Pattern Identification (CHPI), tongue image analysis system, and pulse analyzer. Collected KM pattern related data without participants' identifier was provided for the three Korean medicine doctors in random order, and non-face-to-face KM pattern identification was carried out. The kappa value between face-to-face and non-face-to-face pattern identification was calculated. Results: From the face-to-face pattern identification, there were 13/3 cold/non-cold pattern, 4/12 heat/non-heat pattern, 14/2 deficiency/non-deficiency pattern, and 0/16 excess/non-excess pattern participants. In cold/non-cold pattern, kappa value was 0.455 (sensitivity: 0.85, specificity: 0.67, accuracy: 0.81). In heat/non-heat pattern, the kappa value was 0.429 (sensitivity: 0.75, specificity: 0.72, accuracy: 0.75). The kappa value of deficiency/non-deficiency and excess/non-excess pattern was not calculated because of the few participants of non-deficiency, and excess pattern. Conclusions: The agreement between traditional face-to-face pattern identification and non-face-to-face pattern identification seems to be moderate. The non-face-to-face pattern identification using questionnaires, tongue, and pulse features may feasible for the large clinical study.

• Nutrition Research and Practice
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• v.16 no.6
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• pp.789-800
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• 2022

BACKGROUND/OBJECTIVES: The aim of this study was to examine the validity and reproducibility of a food frequency questionnaire (FFQ) developed in Korea for breast cancer survivors. SUBJECTS/METHODS: Ninety-nine breast cancer survivors who completed an FFQ twice and three 3-day dietary records (DRs) between 2016-2017 were included. Energy and 14 nutrient intakes were calculated from FFQs and DRs. To determine the validity of the FFQ, energy-adjusted de-attenuated Pearson correlations between two FFQ assessments and the average of the three 3-day DRs were calculated, and to determine reproducibility, energy-adjusted Pearson correlations and degrees of agreement were calculated between the first and second FFQ assessments. RESULTS: Correlation coefficients of validity ranged from 0.29 (protein) to 0.47 (fat) (median value = 0.36) for the FFQ assessment and from 0.20 (riboflavin) to 0.53 (calcium) (median value = 0.37) for the second. Correlation coefficients of reproducibility ranged from 0.22 (sodium) to 0.62 (carbohydrate) (median value = 0.36). Regarding FFQ reproducibilities, percentage classifications of exact agreements for energy-adjusted nutrients ranged from 27.3% (sodium) and 45.5% (fat). A median 76.8% of participants were classified into the same or adjacent quartiles, while a median of 5.6% of participants were classified in extreme quartiles. Bland-Atman plots for the majority of data points of three macronutrients, calcium and vitamins A and C fell within limits of agreement. CONCLUSIONS: These results indicated that the newly developed FFQ for Korean breast cancer survivors has acceptable validity and reproducibility as compared with three 3-day DRs collected over a one-year period.

• Journal of Preventive Medicine and Public Health
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• v.42 no.2
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• pp.117-122
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• 2009

Objectives : We tried to evaluate the agreement of the Charlson comorbidity index values(CCI) obtained from different sources(medical records and National Health Insurance claims data) for gastric cancer patients. We also attempted to assess the prognostic value of these data for predicting 1-year mortality and length of the hospital stay(length of stay). Methods : Medical records of 284 gastric cancer patients were reviewed, and their National Health Insurance claims data and death certificates were also investigated. To evaluate agreement, the kappa coefficient was tested. Multiple logistic regression analysis and multiple linear regression analysis were performed to evaluate and compare the prognostic power for predicting 1 year mortality and length of stay. Results : The CCI values for each comorbid condition obtained from 2 different data sources appeared to poorly agree(kappa: 0.00-0.59). It was appeared that the CCI values based on both sources were not valid prognostic indicators of 1-year mortality. Only medical record-based CCI was a valid prognostic indicator of length of stay, even after adjustment of covariables($\beta$ = 0.112, 95% CI = [0.017-1.267]). Conclusions : There was a discrepancy between the data sources with regard to the value of CCI both for the prognostic power and its direction. Therefore, assuming that medical records are the gold standard for the source for CCI measurement, claims data is not an appropriate source for determining the CCI, at least for gastric cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2547-2556
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• 2012

Objectives: Smoking among university students represents a formidable and global public health challenge. We assessed the associations between socio-demographic, health and wellbeing variables as independent variables, with daily smoking, attempts to quit smoking, and agreement with smoking ban as dependent variables. Methods: A sample of 3258 undergraduate students from eleven faculties at Assiut University, Assiut, Egypt, completed a general health questionnaire. Results: Overall daily or occasional smoking in last three months prior to the survey was about 9% (8% occasional and 1% daily smokers), and smoking was generally more prevalent among males (male=17%, female=0.6%, P < 0.001). After adjustment for confounders, not having normal BMI and having a mother who completed at least bachelor's degree education was positively associated with daily smoking, and conversely, no history of illicit drug use was a protective factor. About 76% of smokers had attempted to quit smoking within the last 12 months prior to the survey. Although a large proportion of students agreed/strongly agreed with the banning of smoking at university altogether (87%), such agreement was less likely among smokers. Conclusion: There is need for implementation of non-smoking policies on university premises, as well as regular up-to-date information on, and the periodic/yearly monitoring of tobacco use by university students employing standardised data collection instruments and reference periods. In addition, it would be valuable to develop campus-based educational/ awareness campaigns designed to counteract tobacco advertisement directed towards young people in Middle East countries. Otherwise, the danger could be that the current relatively low smoking prevalence among university students may escalate in the future.

• Health Policy and Management
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• v.28 no.4
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• pp.360-368
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• 2018

Background: The proportion of pharmaceutical expenditure out of total health-care expenditure in South Korea is high. In 2016, 25.7% of national health insurance (NHI) spending was for pharmaceuticals. Given the increasing demands for the access to newly introduced medicines and following increase in pharmaceutical spending, the management of NHI pharmaceutical expenditure is becoming more difficult. Methods: This study analyzed the data claimed to NHI for pharmaceutical reimbursement from 2010 to 2016. Results: The policy implications with respect to the trends and problems in spending by drug groups were elicited. First, the proportion of off-patent drugs spending which were treated to chronic disease was much higher than anti-cancer drug spending. Second, the spending to the newly introduced high-costed medicine increased, however, current price-reduction mechanism was not sufficient to manage their expenditure efficiently. Conclusion: Our system seems to need several revisions to improve the efficiency of pharmaceutical expenditure and to cope with high-costed medicines. This study suggested that the prices of off-patent drugs need to be regularly readjusted and the Price-Volume Agreement System should be operated more flexibly as well.