82 SPECIFICATION AND VALIDATION OF PROSTATE CANCER QUALITY OF CARE E-MEASURES IN THE VETERANS HEALTH ADMINISTRATION (2013)

You have accessJournal of UrologyGeneral & Epidemiological Trends & Socioeconomics: Evidence-Based Medicine & Outcomes (II)1 Apr 201382 SPECIFICATION AND VALIDATION OF PROSTATE CANCER QUALITY OF CARE E-MEASURES IN THE VETERANS HEALTH ADMINISTRATION Jeremy Shelton, Ted Skolarus, Jennifer Malin, Anna Liza Antonio, and Christopher Saigal Jeremy SheltonJeremy Shelton Los Angeles, CA More articles by this author , Ted SkolarusTed Skolarus Ann Arbor, MI More articles by this author , Jennifer MalinJennifer Malin Los Angeles, CA More articles by this author , Anna Liza AntonioAnna Liza Antonio Los Angeles, CA More articles by this author , and Christopher SaigalChristopher Saigal Los Angeles, CA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1460AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Quality measures based on chart abstraction are the “gold-standard,” but the costs of measurement limit widespread adoption. Electronically specified measures (e-measures) promise a way forward, however the fidelity of electronic abstraction compared to chart abstraction is unknown. We sought to validate e-measure versions of VHA-developed prostate cancer quality of care measures. METHODS Quality measures were chart abstracted from the medical records of 11,263 men in the VHA with incident prostate cancer in 2008. We identified and linked VHA cancer registry and administrative data for the same cohort. E-measures were specified iteratively and validated by comparing the sensitivity, specificity and accuracy of measure denominators and numerators, and the overall pass rates to chart abstracted results. RESULTS 2 of 6 quality measures were successfully specified and validated while a third measure was specified, but validation was limited by a high pass rate (Table 1). CONCLUSIONS The VHA's information technology infrastructure is sufficiently advanced to support valid e-measurement that is equivalent to that performed by chart abstraction, however data availability at this time limits the breadth of e-measurement as compared to chart abstraction. Sensitivity (sens), specificity (spec), accuracy and pass rate of prostate cancer quality e-measures vs. chart abstraction Quality Measures Denominator sens/spec (%) Denominator accuracy (%) Numerator sens/spec Numerator accuracy (%) Chart abstraction pass rate (%) E-Measure pass rate (%) No bone scan in low risk disease 80/95 94 90/71 86 82 84 Use of 3D radiotherapy 74/90 87 92/21 90 94 93 Androgen deprivation with EBRT 67/98 96 84/94 85 85 65 ≥ 10 cores from prostate biopsy Not feasible - - - - - Doses of at least 75 Gy for EBRT Not feasible - - - - - Docetaxel-based therapy Not feasible - - - - - © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e34 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jeremy Shelton Los Angeles, CA More articles by this author Ted Skolarus Ann Arbor, MI More articles by this author Jennifer Malin Los Angeles, CA More articles by this author Anna Liza Antonio Los Angeles, CA More articles by this author Christopher Saigal Los Angeles, CA More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...