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dimensions of QOL are significantly influenced by an intestinal stoma.
and screening. Methods: Our methods include a multi-step test development
Qualitative comments provided insight into the meanings and live experiences
process, beginning with iterative team reviews of the dimensions to be
related to the spirituality items. Persons with ostomies report less inner
considered in test development, a literature review and member interviews to
peace, feeling less hopeful, not having a reason to be alive, as well as fewer
identify potentially confusing terms and concepts, and collection of sample
spiritual and religious activities for coping. An understanding of
messages from the media and simulated physician–patient encounters to
these factors will facilitate integration of holistic care and treatment in
provide a basis for the actual test items. Results: Our process identified 13
this population.
dimensions to be considered in selecting and scripting the cancer prevention
and screening messages that will be included in the assessment. Four of these
Abstract C-B1-03
dimensions are (1) the purpose of the message (instructional, informational/
The Trustworthiness of Administrative Health Plan Data in
didactic, or query), (2) message style (narrative, statistical, or factual), (3)
Chemotherapy Research
setting/context (messages available to the public, including those delivered
via radio, television, or internet; messages delivered to the individual
Erin J. Aiello Bowles, MPH, Group Health Center for Health Studies; Leah
including messages delivered in physician-patient encounters, or in person or
Tuzzio, MPH, Group Health Center for Health Studies; Tyler Ross, MA,
telephone encounters with other healthcare providers), and (4) content (e.g.,
Group Health Center for Health Studies; Andrew E. Williams, PhD, Kaiser
cancer causes, screening, risk, epidemiology). The presentation will include
Permanente Hawaii; Andrea Altschuler, PhD, Kaiser Permanente Northern
full descriptions of all 13 dimensions with illustrative examples, the results
California; Debra P. Ritzwoller, PhD, Kaiser Permanente Colorado; Larissa
of the iterative test specification process and sample items. Conclusions: We
Nekhlyudov, MD, MPH, Harvard Pilgrim Health Care
have successfully completed the first steps in developing a test to assess
comprehension of health literacy oral in the context of cancer prevention and
Background: Collecting chemotherapy administrations is important to any
screening. The next steps include soliciting feedback on our methods and
study of cancer treatment. However, abstracting data from medical records
results to date, and suggestions for pilot testing and refining our materials.
can be time consuming while chemotherapy data from tumor registries may
be lacking sufficient detail. The goal of this study was to describe the
Analytic Methods
accuracy of automated chemotherapy data from administrative health plan
databases compared with data from tumor registries. Methods: From eight
Abstract C-B3-01
Cancer Research Network (CRN) tumor registries, we identified 1218
Data Quality Assessment of the Vaccine Safety Datalink Dynamic
women diagnosed with primary ovarian cancer between January 2004 and
Data Files
June 2006. Using the Virtual Data Warehouse (VDW), we linked cases to all
known automated chemotherapy administrations through June 2006 by
Allison L. Naleway, PhD, Kaiser Permanente Center for Health Research;
pooling administrative health plan data from procedure, pharmacy, and
Lois Drew, Kaiser Permanente Center for Health Research; Brad Crane, MS,
diagnosis automated databases. We then calculated the sensitivity of these
Kaiser Permanente Center for Health Research; James Baggs, PhD, Centers
three data sources for capturing any chemotherapy administrations compared
for Disease Control and Prevention; Eric Weintraub, Centers for Disease
to chemotherapy as coded by tumor registries at each site. Results: The
Control and Prevention; John P. Mullooly, PhD, Kaiser Permanente Center
health plan data contained records of at least one chemotherapy administration
for Health Research
in 51.3% of cases (range across sites 4.3%-80.0%) while the tumor registry
data contained such records in 68.8% of cases (range
To enhance our ability to rapidly detect adverse events following immunization,
57.3%-95.2%). The overall sensitivity of administrative data compared to
the Vaccine Safety Datalink (VSD) developed dynamic data files (DDF). The
tumor registry data was 69.3% (range 2.9%-95.2%) and varied by
DDF are created through weekly extracts of selected electronic medical
administrative data source: 52.8% (range 0.0%-90.3%) using procedures,
records data at participating VSD HMOs. However, the timeliness and
46.5% (range 0%-80.7%) using pharmacy records, and 29.1% (range
completeness of these files depend largely on the data storage capacity and
0.0%-65.9%) using diagnosis codes. Sensitivity decreased over time from
infrastructure at each of the HMOs. VSD Data Managers produce a series of
81.4% among cases diagnosed January-June 2004, to 47.7% among
weekly, monthly, and annual reports to identify patterns that might signal a
diagnoses between January-June 2006. Conclusions: Tumor registries
data quality problem in the DDF. All sites collect multiple weeks of event
appeared to capture the chemotherapy administrations more often than
data during the weekly data extracts. To assess data quality, we can examine
automated health plan administrative data. We noted wide variability in the
summaries of any particular week of event data repeated over multiple
sensitivity of administrative data by site. Capture of administrative data may
extracts. One data quality report summarizes the number of observations in a
be enhanced through site-specific coding of chemotherapy administration
dataset for a given event week across multiple extracts, and calculates the
and additional understanding at each site of clinical and billing coding
percent change in observations across extracts. We used this report to
practices.
estimate the number of weeks (or ‘lag time’) until the diagnosis and
vaccination data at each HMO become relatively stable in the DDF. For each
Abstract C-B1-05
event week, we estimated the lag time until stability for outpatient diagnoses,
Development of an Instrument to Assess Comprehension of Spoken
inpatient diagnoses, and vaccinations in the DDF. Stability was defined as
Cancer Prevention Messages
four consecutive extracts with less than 1% change (positive or negative)
from the previous week. We created a set of criteria to define anomalous
Kathleen Mazor, EdD, Meyers Primary Care Institute; Laura Saccoccio, BS,
extract weeks and then imputed the percent change for these anomalous
Meyers Primary Care Institute; Douglas Roblin, PhD, Kaiser Permanente
weeks in our estimation of lag time. Anomalous weeks included extracts in
Georgia; Josephine Calvi, MPH, Kaiser Permanente Georgia; Melissa
which datasets were not updated (i.e., the percent change across event weeks
Finucane, PhD, Kaiser Permanente Hawaii; Rebecca Cowan, MA, Kaiser
was 0%) and extracts in which the percent change across all event weeks was
Permanente Hawaii; Terry Field, ScD, Meyers Primary Care Institute;
equal to 5%. The average lag time for outpatient diagnoses ranged from 3 to
Elizabeth Dugan, PhD, Meyers Primary Care Institute; Sarah Greene, MPH,
19 weeks, and the average lag time for inpatient diagnoses ranged from 3 to
Group Health; Paul Han, MD, MA, MPH, National Cancer Institute; Mary
25 weeks across HMOs. The average lag time for vaccinations ranged from
Costanza, MD, University of Massachusetts Medical School
2 to 26 weeks. Our findings suggest that the timeliness of diagnosis and
vaccination data varies across the HMOs. In spite of this limitation, the DDF
Background: The ability to understand orally communicated health-related
have proven to be a useful tool for rapid vaccine adverse event detection.
messages is a critical component of health literacy. Recent attention has
Continuous data quality assessment of the DDF enables problems to be
focused primarily on the prevalence and impact of inadequate health literacy
identified rapidly and either corrected or properly documented.
with regard to written communication, largely ignoring that the majority of
health information is communicated orally. Most Americans rely on
physicians or television for health information, but there is an alarming lack
of information on how well people comprehend orally presented health
information. We will report on our efforts to develop and validate a
computer-based assessment of health literacy–oral around cancer prevention
CM&R 2008 : 3/4 (December)
HMORN 2008 – Oral Presentations
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