CTR, CTR Exam Prep (CRM P&P), CTR Exam Blue Book, CTR Organizations, CTR seer educate, CTR EXAM, Cancer Registry general info, Registry Organization and Operations, Questions from Cancer Management Book, CRM P&P Study Guide

Sit codes always start with ____

"C"

edit overrides/conversion history/system administration

(NAACCR) code systems used to record and transmit data, edit overrides, record processing trail, historic codes

record identification

(NAACCR) items used to identify the layout and content of the record being transmitted

state/requestor items

(NAACCR) registry specific or other special use items, not in the standard NAACCR data dictionary but maintained by the receiving registry.

List the four steps in the logic model for combining information from these four data sources.

(a) Demographic characteristics (poverty and literacy) contribute to (b) risk behaviors (smoking or not being screened), which contribute to (c) the incidence of cancer and/or stage at diagnosis, which contributes to (d) mortality from the disease.

Name the current coding books used in the United States for (a) coding mortality and (b) coding neoplasms for cancer registries.

(a) International Classification of Diseases, tenth revision (ICD-10). Another name for coding "mortality" is coding death certificates. (b) International Classification of Diseases for Oncology, third edition (ICD-O-3)

Calculate percent change

(final- initial)/ initial

3 methods of rapid case ascertainment rapid case data requires institutional review board (IRB) approval.

**Some central cancer registries require basic information for every cancer case within six weeks of diagnosis followed by a full abstract within the usual six-month time frame. This method is conducive to population-based studies of all cancer sites. **Other central registries may have a "Rapid Case Ascertainment" (RCA) unit. The RCA cancer registrars visit facilities to identify cases needed for special studies. This method is ideal for collecting additional patient information not usually part of the registry case report. RCA staff helps research by identifying cases within days of diagnosis and can be a great resource for study planning and grant writing. *** Another method utilized for rapid case reporting is the electronic pathology reporting that some central cancer registries have in place. The electronic pathology system has the ability to scan all pathology reports searching for key terms to determine reportability. As technology advances, more central registries can be expected to increase the computerization of all reporting processes. Where electronic pathology reporting is not in place, central registries rely upon the hospital registrars within the study areas to fax pathology reports that meet study criteria to the central cancer registry.

Death certificate rate

- # of DCO/ number of incident cases - A high DCO rate indicated The registry may be missing cases

Becoming an Accredited Facility

- 3- year cycle - Multidisciplinary discussion of tx options discussed at cancer conference - evaluating and improving patient care through completion of studies of quality and implementation of corrective actions or new programs - cancer committee miniues - Granted by CoC - 80% of standards must be in compliance

Calculate the # of cases that need to be presented based on the annual # of cases

- 400 cases per year * 15%

Follow up Percentages

- 80% all - 90% past 5 years

Name five standard setters for central cancer registries.

- ACoS/CoC - AJCC - SEER - NPCR - NCRA - NAACCR - WHO

List the three parts of the NCDB data cycle.

- Annual Call for Data - Data processing that includes edit checks and writing case records to the CoC's data warehouse - Data analysis and evaluation

Name three annual statistical reports where SEER data are combined with data from other national surveillance partners.

- Annual Report to the Nation on the Status of Cancer - Cancer in North America - U.S. Cancer Statistics.

Quality control

- Begins at the time of abstracting by following data standards - visual review for completeness - edit check ran by computer - physician review of abstracting data

Patient left your facility after DX, who do you contact for follow up?

- Can send patient letter or next of kin

Who has access to SAR?

- Cancer committee identifies one team member to be the key contact - Large facilities: cancer program administrator

Name three types of scientific studies that can be based on central registry data.

- Cancer mapping - GIS - Ecologic or Correlation - Case-Control - Cohort - Genetic - Patterns of Care - Survival Surveillance - Cancer Control

Name three purposes for central registries to perform record linkages:

- Casefinding - Duplicate detection - Passive Follow-up - Linking patients with other cohorts or risk exposure records

bar charts

- Compare size or amount of a variable (category) - width of bars should be the same, bars should be separated by spaces

Historical Data Review

- Compare the current year incidence rate to prior years - If there is a decrease with no valid reason, there may be missing cases

Case finding methods for non-hospital facilities

- Cost, quality of date, # of new incidence, impact on future data

Six Sigma

- Define, Measure, Analyze, Improve, Control - Use data to determine how to improve

Follow up date: letter sent to pt on 9/30, pt returned but didn't sign/date, do you use date sent, date postmarked from pt, or date you received response?

- Depends on the type of contact/audience - Date is the date that the cancer registry will use to update their follow-up info with the patient as the last known date alive, not the date the letter was sent and not received - Left blank: date stamped on envelope in the DOLC

What are the two types of record linkage?

- Deterministic - Probabilistic

Line Graph

- Display survival - are most effective of showing trend changes over time - x-axis: horizontal: describes categories- independent variable - y-axis: vertical: shows amount or frequency- dependent variable

Quality: Accuracy

- Edit checks, re-coding audits, re-abstracting - computerized edit checks (allowed values) - visual edits ( text vs code) - recoding audits (recode based on text in abstract)

Cancer Conference: What? Why? Where? registry?

- Enhance patient care - look at prospective cases - establish accurate staging, treatments and management plans - adjuvant tx, or tx plans for recurrence

For more than two decades, NCI has utilized this flexible mechanism of Rapid Response Surveillance Studies to conduct studies by individual and collaborative groups of SEER investigators. What are the six categories of studies?

- Evaluating methodologic issues - Evaluating cancer treatment and outcomes - Monitoring screening practices - Monitoring health behaviors and risk factors - Linking databases - Improving technical aspects of registry operations

Through its Web site, SEER makes available public-use data which include SEER incidence and population data associated by age, sex, race, year of diagnosis, and geographic areas (including SEER registry and county). The data file is free, but a signed data agreement is required. Beyond the data /software package SEER*Stat, what is available on the Web site for statistical inquiries?

- Fast*Stats - Statistical Fact Sheets - Cancer Query System (CANQUES)

Diagnosis Date

- First/ earliest date physician states cancer

Central Registry notices that you have a 79% rate of unknown race documented in 2014 and 57% in 2015, what would you do?

- Fix the problem - Educate staff on importance of coding all info collected in a chart

Non- reportable cases

- Foreign countries - patients over 100 years and no contact for 12 months - CoC 00 Dx after 1/1/06

What are some of the Web-based self-instructional training modules available on the SEER Web site?

- Hematopoietic & Lymphoid Neoplasms online training: educational recording of presentations for the hematopoietic and lymphoid neoplasms project - Multiple Primary and Histology (MP/H) Coding Rules training: recordings of the online MP/H Coding Rules training sessions - SEER's Training Web site: Web-based training modules for cancer registration and surveillance

The primary quality-control concerns of central registries involve which two straighforward questions?

- How complete is case ascertainment? - How complete and accurate are the data that are collected?

Quality: Timeliness

- Lag- time report (time between dx and reporting date) - Monitor monthly reporting/ submission

Validation of data quality in SEER registries is a coordinated process involving audits of completeness and accuracy of coding and abstracting. The audit scores are combined with two other aspects of a registry's performance -- the NAACCR certification standards and analysis of the public use data file -- to produce a Data Quality Profile (DQP). What are the data quality goals used for the DQP for death certificate only cases, completeness, and follow-up for vital status?

- Less than 1.5% death certificate only cases - Greater than 98% estimated completeness - More than 90% follow-up of patients (95% for those 65 years old or older)

Data Linkage 2. Tumor Matching

- Matching same patient and the same tumor based on the MPH rule

Data Linkage 1. Patient Matching

- Matching same patient based on demographics

Identify five types of personnel, or staff, found in a central registry.

- Medical or Scientific Director/Epidemiologist - Registry/Project Manager - Office/Accounts Manager - Abstractors (CTR skill staff) - Quality Control/Management - Data processing (IT Perssonel) - Statistician - Coding/processing - Research analyst - Data entry - Secretarial/clerical

Deterministic Linkage

- Must have exact match on certain key fields, cannot make a match if data is missing

Timeliness

- NACCRR: 95% of cases reported within 23 months - SEER: complete new cases for the calendar within 22 months, - CDC: 90% reporting within 12 months, 95% within 24 -CoC: 90% cases be abstracted within 6 months of DOFC - Changes in timeliness: error, missed deadline, ICD09 codes, failure to include all programs

Name three evaluation activities conducted by the National Program of Cancer Registries.

- NPCR-CSS Data Evaluation Reports - NPCR Program Evaluation Instrument - NPCR Data Completeness and Quality Audits

List six categories of information that the collected data in the NCDB include.

- Patient characteristics - Tumor staging - Histology characteristics - Type of first-course treatment administered - Disease recurrence - Survival information

Name some reports and publications based on NCDB data:

- Public benchmark reports - Hospital Comparison Benchmark Reports - NCDB Survival Reports - Cancer Program Practice Profile Reports (CP3R)

A National Program of Cancer Registries goal is to provide data to ____________, so that the ____________ can be monitored and that ____________ can be planned.

- Public health planners - Burden of disease - Cancer prevention and control programs

Who has control over reportable list?

- SEER: population based registries - ACoS, CoC: Hospital based registries -NAACCR: published consensus standards adopted by CDC

Histograms

- Shows frequency distributions - no space between the bars, used for continuous variables o The x-axis is a number line and shows the measured value, usually in equal ranges. The ranges cannot overlap each other. y-axis shows the number of times (the count or frequency) that the measure occurs in the sample.

Automated consolidation

- Software chooses the best value, rules are applied uniformly

Who is required to be at cancer conference?

- Surgery, medical oncology, radiation oncology, diagnostic radiology and pathology - Physician is voluntary

What are some advantages to research in comparing cancer rates across countries?

- Understanding cancer causes - Dissemination of cancer control and treatment - Comparison of risk factors

Pie Chart

- Used of stage - no more than 6 slices

Passive

- Used to determine vital status - obituaries, hospital records of death, reports from rt and oncology clinics, DMV, performing death clearance

casefinding audits

- a type of audit that involves independently identifying all cases diagnosed and/or treated at a facility that are eligible for reporting to the central registry, usually for a sample time period - casefinding procedures are reviewed to ensure that all areas where a patient may be identified are included in the process - after reconciliation efforts, the number of tumors that matched expressed as a percentage of all tumors identified at audit provides an estimate of case completeness for the audited facility

Suspense list purpose

- ambiguous terms - End results of case finding process - cases remain on list for the facility until an abstract is received or until documentation is provided on case

Total quality managment

- assign responsibility, define scope, identify important aspects, identify indicators, establish triggers, collect data, evaluate data, take action to improve, assess actions, communicate results

reabstraction audits

- audits that identify specific problem areas in need of improvement/accuracy and is done by comparing the original source document to the coded data submitted to the CCR - include independently reabstracting a sample of case records reported by the facility from the actual source patient medical records and comparing the reabstracted data with the data already in the registry - its goal is to describe the level of agreement between the data reabstracted from the source records and the data in the central registry

recoding audits

- audits that involve independently recoding particular data items from abstracted text that was submitted to the central registry by the reporting facility, rather than reviewing actual source documents - the goal is to describe the level of agreement between the data recoded from the submitted text and the data in the central registry

when do you edit the data?

- before submitting to the state or national registries - hospitals submit to the state central registry and to NCDB - central registries submit to SEER and NPCR - many edits are built into the database so they are run every time to a record is processed

three types of audits

- casefinding audits - reabstraction audits - recoding audits

Rapid case ascertainment

- central registry - earlier access for research - consideration when specific case types are needed for epidemiological protocols and for cancer conference presentations and clinical trials

Record consolidation rules

- chose the value that is: > most frequent (dob) > highest value (surgery code) > Hierarchy ( dxconf) > time submitted ( closest to dx date) > known over unkown - Or find the most accurate source and use all of their data

Probabilistic linkage

- computer program creates a score or weight for how similar key fields are - the closer the match probability, the higher score - undetermined matched are close but need manual review

The CoC requires the following in hospitals:

- criteria - timetable - methods - activities to be evaluated - the scope of the evaluation - min benchmarks - documentation

Central Registry identifies several cases with meningioma cases coded to Brain, NOS

- educate staff on layers of the brain

you find that pituitary adenomas are not being reported by registry, what would you do?

- educated staff on reportable list

Acceptance sampling

- evaluate the quality of all cases with computer software (edit checks), the use manual review of samples for specific groups of cases

Benchmarking

- focuses on how to improve any process by using best practice rather than simply measuring best performance - improving performance by continually identifying, understanding and adapting process

What to code in the follow up date and DOLC?

- follow up info on the initial abstract includes the DOLC or death date - status of cancer

non-hospital registry sources

- hospitals without a cancer registry - clinics - physician offices - pathology laboratories - nursing homes - vital records

Metafile

- is a set of edit instructions, - includes: the data dictionary, record layout, the edits and error messages - portable because it can be used over and over for several tasks

death clearance process in CCRs

- linking all death records from the state's vital stats office to registry records to identify patients in the registry who have died - review of positive matches, possible matches and nonmatches

nonreportable cases

- malignant neoplasms - epithelial carcinomas of the skin - papillary and squamous cell carcinomas of the skin - basal cell carcinomas of any site except the genital sites

Process Control

- monitor the quality of cases, provide feedback to the facility to improve - re- review rejection cases to see why they are being rejected

Cancer Status

- never disease free, unk, disease free - recurrence: has to completely cancer free

Data completeness

- no missing data - low percentage of unknown values - good follow up - text documentation: allows visual editing by central registry to make corrections - Monitor unknown values through edit checks and queries

basic data items for CCRs

- patient identification and demographics - cancer identification - hospital-specific data - stage and prognostic factors - treatment: first course and subsequent - follow-up - death - edit overrides - system administration - patient, hospital and physician - narrative text

Manual consolidation

- person choose the best values, different people can make different choices on the same data

record consolidation

- process of combining data from 2 or more sources for the same patient and tumor to produce a single best or consolidated record - An accurate count of the primary tumors (incidence) - Most registries use a combo of automated and manual consolidation

You are requesting CME's for physicians, attending tumor board, what should you work on?

- request CME for attendance at cancer conference to provide an additional boost to overall physician attendance

Casefinding audits

- review certain months of disease indices, path reports, radiation oncology logs to find cases that were not reported

Reportable list

- set by SEER, ACoS, NAACCR, CDC - Behavior code 2, 3, or 0, 1 intracranial tumors

3 Major Cancer Staging Systems

- the TNM stage groupings of the AJCC - the Extent of Disease (EOD) system of the SEER program - the SEER summary stage system

Quality of conformance

- the data is reproduced accurately (the product adheres to the design)

Quality of performace

- the end product is useful and reliable

Quality of design

- the intent of the data is correct- clear definitions and tolerances

Death Clearnance

- using deal certificate as a case-finding source - SEER no more than 1.5% of case identifies by DC - DC provides the CR a yearly opportunity to assess the effectiveness of its case-find

Class of case

-10 -22 needs to be reported - non-analytic cases: > Received first course treatment > second opinion another facility > Patient with history but who is being seen at different facility for another condition

Reliability study

-All abstractors code the same cases, and then the results are compared to see where there are different in coding

For which of the following assignments is the Cancer Registry Quality Coordinator responsible? Response : -Cancer Registry Policy and Procedure eligibility requirements -Implementing two cancer care improvements each calendar year -Studies of quality focused on measuring the quality of care and outcomes for the patient -None of the above

-Cancer Registry Policy and Procedure eligibility requirements Rationale: During a term, an INDIVIDUAL CANNOT SERVE IN MORE THAN 1 coordinator ROLE. The Cancer Registry Quality Coordinator is responsible for OVERSEEING THE FACILITY'S COMPLIANCE with the: Cancer registry policy and procedure eligibility requirements (ER5) Cancer registry quality control plan (Standard 1.6)

Hospital based registry

-Collects info from dx and tx in a hospital. - focus on clinical management and follow up. -Report to central registry

Data Standards

-Fields, codes, definitions and instructions for a data set -set by ACOS CoC, SEER -NAACCR uniform data standards committee was formed to develop uniform standards among all agencies -CDC (NPCR) developed edits software to make it possible to check incoming data validity against the standards

Active

-Sending letters to physicians for follow up, about recurrence, tx, vital status

Accession Number and Sequence

-Variations such as dx in two different facilities - 2 malignant and one benign - 9 digits, first 4 are the year the patient is dx - the rest is a sequential order in which the patient was identified by registry

Time Motion Study

-Work flow and work load determine staff productivity levels -Evaluating the results at regular intervals, provides updated info regarding shifting or growing staff needs

HIPPA (Health Insurance Portability and Accountability Act)

-a federal law that sets standards for protecting the privacy of patients' health information -the original intent was to reduce the cost of healthcare

nonphysician membership on the cancer committee must include what?

-administration -nursing -social services -cancer registry -quality assurance

offsite backups

-backup on alternative server in a remote location -implementation of a reliable data backup and retrieval system

Doctor wants to do a study of 5 major sites.

-cancer registries fall under the operations of HIPPA -sign a confidentiality pledge -can release to instate facilities for follow up purposes -Allows hospitals and physicians to disclose PHI to registry

Interoperability

-data can be incorporated from one database into another -data standards: there are now widespread acceptance of the NAACR data exchange same length, allowable cose, instructions for coding

Data management system (DMS) features:

-data import and entry -record consolidation (internal) -record linkage (external) -quality assurance (edit checks) -reporting and analysis -data exchange and export -security (passwords) -Tracking (audit trails and productivity)

Inter-field errors

-disagreement between data in different fields, -behavior of 3 and SEER stage 0 -females cannot have prostate cancer

Inter- record errors

-disagreement between data on different records -incorrect sequence numbers

Policy and procedure

-employees trained for security and confidential info -establish internal procedures as part of their operational management system -organizational control: who has access, to whom can disclose data, record keeping of disclosure, ability of patient to review and correct data

Purpose of the CR

-establish and maintain a cancer incidence reporting system -be a data resource fro physicians, researchers, and staff -provide data to assist PH officials and agencies in planning and evaluation of cancer prevention control programs

what are the four major components of an approved cancer program include?

-multidisciplinary cancer committee -multidisciplinary cancer confrences -quality outcome and improvement -cancer registry

commercial databases

-oracle -sybase -Microsoft SQL server

for the cancer committee: it is expected that _____ from the ____ major sites of cancer seen at the institution will be included

-physician representatives -5 major sites of cancer

what would you do if you needed more staff?

-prepare a report showing increase in work load over past 1-2 years examples: -2500 cases per year/ hours = 1.5 registrars -abstracter takes about 1 hours with approx 15 min per case -other items escape the algorithm

Staffing

-sets staff once registry's responsibility is realized -Mission of your facility, small vs large, services and community needs -easily accessible: medical records paper copy, track down, emr with help of software

News reporters wanting data

-they are not under the umbrella of operations -be referred to an administrator or another staff member who has authority to respond

Independent case ascertainment assesses completeness using estimations from an independent survey of cases.

...

IF GOAL THEN 1 Describe the observed mortality patterns in the cohort of patients 2 Measure the excess mortality associated with a cancer diagnosis 3 Have reliable cause of death information (e.g., clinical trials) 4 Unreliable information on cause of death but has accurate expected other cause mortality from general population for the cohort

1 Describe the observed mortality patterns in the cohort of patients Overall survival 2 Measure the excess mortality associated with a cancer diagnosis Net survival 3 Have reliable cause of death information (e.g., clinical trials) Cause-specific survival 4 Unreliable information on cause of death but has accurate expected other cause mortality from general population for the cohort Relative survival

BCR-ABL fusion gene

1. Chronic myeloid leukemia analyze blood and bone marrow

rapid case ascertainment

1. cancer conference presentations 2. clinical trials 3. concurrent abstracting

Epidemiological reasoning

1. describe the disease frequency 2. develop a hypothesis for what causes increase risk 3. develop a study to test hypothesis 4. develop preventative measures based on the study results

How much of IT staff time should be devoted to the registry?

100%

Contingencies must be resolved within how long of the survey

12 months

Phase I Clinical Trial

15 to 30 participants Determine safe dosage Decide how the drug should be administered Observe the effects of the drug on the body

When and where was the meeting that jump-started the expansion of internatioaln data collection on cancer rates?

1946 - in Copenhagen

When and where was the meeting that jump-started the expansion of international data collection on cancer rates?

1946 in Copenhagen

When were the first coding rules and guidelines established?

1950s

The SEER program of the CDI was started in what year?

1973

The SEER Program of the NCI was started in

1973.

The NCDB was established in what year?

1989

The legislation enabling the NPCR was passed in what year?

1992

The legislation enabling the NPCR was passed in

1992.

Continuing education for CTR

20 hours every 2 years

A patient is admitted to the reporting facility for the first time on 05/03/2010 having been recently diagnosed in the physician's office with prostate cancer. The patient received treatment for the prostate cancer during this admission. This is the only malignant primary cancer this patient has had in his lifetime. This will be the 279th case entered into the database for 2010. The complete accession number that will be assigned for the prostate primary will be

201000279. The accession number is a nine-digit number. The first four digits of the number indicate the year in which the patient was first seen for cancer in the reporting institution (2010 in this scenario). The remaining five digits of the number are the sequential order in which the patient was identified by the registry or abstracted into the database (00279 in this scenario).

The NCDB contains information on almost ____________ million cases of reported cancer diagnoses for the period 1985 through 2007.

25

At what age are pediatric patients excluded from follow up?

26

At what age are pediatric patients excluded from follow-up calculations? Response : 18 21 25 26

26 Rationale: According to Standard 5.4, while PEDS PT(s) are EXCLUDED FROM F/U calculations AT AGE 26, REGISTRARS SHOULD CONTINUE to INCLUDE THEM in F/U ACTIVITIES because LONG-TERM F/U CONTINUES to be IMPORTANT in ASSESSING OUTCOMES of CA CARE.

Seer covers what percent of the US population

28 percent

How many stages in Meaningful use program

3

Major changes to registry data changes by standard setters are instituted every ______ year(s).

3

Which CoC standard is defined as complete data for all analytic cases submitted to the NCDB in accordance with the annual call for data?

3.6

Clinical trial percentage for pediatric cancer programs

30%

calculate a ratio

3:2 3/1 (3x2) (1x2) = 6X 2

How many member organizations are involved with the Commission on Cancer?

48

How many stage groups exist in Summary Stage

5

Cancer is a reportable disease ,under state law,in how many states?

50, all states

Cancer is a reportable disease, under state law, in how many states?

50, all states

According to the American College of Surgeons Commission on Cancer Program Standards, abstracts must be completed within ______ months of date of first contact.

6

NCDB collects what percentage of newly diagnosed cases in US?

70%

The NCDB captures what percentage of all newly diagnosed malignant cancer cases in the United States annually?

70%

What percentage of newly diagnosed cancer patients are accessioned annually into the National Cancer Data Base?

70%

Institute of Medicine

8 core capabilities of an EHR to promote greater safety, quality and efficiency In healthcare delivery

follow up lifetime required since your reference date is

80 percent

The minimum percentage of prospective cases presented annually at cancer conference is Response : 85% 80% 75% 70%

80% Eligibility requirement ER3 states that annually the percentage of prospective case presentations is 80%.

The required follow-up rate for all eligible analytic cases since the registry's reference date is Response : 80% 85% 90% 95%

80% Rationale: Standard 5.3 requires that ALL ELIGIBLE ANALYTIC CASES have an 80% F/U RATE from the CA REGISTRY REFERENCE DATE.

last 5 year follow up required is

90 percent

The required follow-up rate for eligible analytic cases diagnosed within the last five years is Response : 95% 90% 85% 80%

90% Rationale: Standard 5.4 requires a 90% follow-up rate for eligible analytic cases diagnosed within the last five years.

What percent of cancer cases are histologically confirmed

95

Percent of cancer cases histologically confirmed

95%

What minimum percentage of eligible pathology reports with a cancer diagnosis are required to adhere to the CAP synoptic reporting format? Response : -95% -90% -85% -80%

95% Rationale: EACH CALENDAR YEAR, at least 95% of the ELIGIBLE PATH REPORTS W/ a REPORTABLE CA DX are REQUIRED to be generated using the College of American Pathologists (CAP) Protocol and Synoptic Reporting format per Standard 2.1.

The pathologist must use CAP protocols to report the required data items on what percentage of eligible pathology reports? Response : 75% 80% 90% 95%

95% Standard 2.1 states that the CAP protocol must be used to report required data items on 95% of eligible pathology reports.

For reporting and analysis of data, the NCDB organizes much of its data by: A. Disease Site B. Histology C. AJCC stage of disease.

A

Match one of the registries in the column with it's purpose: A. AFIP DNA Registry B. Nun study C. National Marrow Donor Program D. Trauma Registry E. Advance Directive Registry. Purpose: Identifying combat casualties

A

Of the registries listed, which goes with: Analyze environmental exposure effects. A. Tremolite Asbestos Registry B. Birth Defects Registry C. Intestinal Transplant Registry D. Breast Health Registry E. GIST Registry.

A

The NCDB does not contain information that can be used to identify: A. The patient's name B. The reporting facility C. The case abstractor D. All of the above

A

Which sentence(s) is (are) true? a. Computer monitors should be placed with the top line at or below eye level. b. Monitors should be directly in front of or facing windows. c. Monitors should be placed more than two arm lengths away. d. All of the above e. None of the above

A

Who oversees the activities of the North American Association of Central Cancer Registries (NAACCR)?

A Board of Directors

surges and outages

A UPS (uninterruptable power supply) is used to protect computers from power

uninterruptible power supply (UPS)

A battery power source that provides electric current during a power outage.

Purchase of major equipment

A capital budget is prepared for:

Accuracy

A characteristic of data quality is:

prospective

A cohort study where members are identified before the outcome occurs is known as a ____________________ study.

verifies data accuracy

A computer data edit:

digitize and store, data editing

A computerized registry will _____ data and automate _____.

counting, sorting and preparing

A computerized registry will eliminate tedious aspects of _____.

follow up record keeping, lists and reports

A computerized registry will facilitate _____ and provide _____.

patient data, monitor patient care

A computerized registry will facilitate collecting ____ to ____.

easier and more flexible adaptation, data coding standards

A computerized registry will offer _____ as _____ change.

more efficient casefinding

A computerized registry will offer opportunities for _____.

Commission on Cancer

A consortium of professional organizations dedicated to improving survival and quality of life for cancer patients through standard setting, prevention, research, education, and the monitoring of comprehensive quality care.

newly diagnosed first course of treatment analytic: non-analytic method used to denote the diagnostic confirmation

A decision on the timing of the cancer diagnoses must also be considered. All central cancer registries require that newly diagnosed cancer cases be reported. This means the patient has just received their initial diagnosis and their first course of treatment plan for treating the cancer. In addition, most require all cancer cases with active disease (no matter how long ago they were diagnosed), which would include patients undergoing a recurrence or progression of their disease. The term that denotes "newly diagnosed" is analytic, and the term for those who were "previously diagnosed or treated elsewhere" is non- analytic. The CoC requires that only analytic cases be abstracted and reported because the focus is on the care delivered at the time of initial diagnosis and treatment. However, most central cancer registries require that both analytic and non-analytic cases be abstracted and reported. Remember that the central registry is trying to identify all cases of cancer within a defined population. While the role of facility is important, for case ascertainment purposes there is less focus on why the patient was seen at the reporting facility and more on ensuring that all patients with a diagnosis of cancer are included. Requiring non-analytic cases allows an opportunity for cases that may have been missed by the facility that initially diagnosed the patient to be identified. The terms analytic and non-analytic are used primarily by hospital registries and will be discussed in detail in the next course. However, they are also pertinent in the central registry for determining what cases are required to be reported and for deciding what type of statistical analysis may be done on patients in each category. For instance, a central registry would not include non-analytic cases in a quality of care study because the non-analytic cases may not have received their initial treatment in that state, or the standard of care may have changed based upon further knowledge or technological advances after the patient was treated. To compare these patients with the newly diagnosed cases (or analytic cases) would not result in meaningful information on the quality of care in that particular state. The method used to denote the diagnostic confirmation is also important in determining what cases should be reported. In other words, determining what method was used to confirm the diagnosis of cancer. Were there microscopic examination of respected tissue (pathology), or was the only confirmation of the cancer based on radiological exams (clinical)? These rules should include required diagnostic methods such as pathology, cytology, clinical, and so forth. Explicit rules must be established to guide facilities in determining which of the out of the ordinary cases should be reported, for example those seen for transient care, those seen for consultation only, those who are diagnosed at autopsy, and the like.

a way to make sure that computerized registry data is backed up every night and is easily recoverable.

A disaster recovery plan is:

Reabstracting study

A formal procedure to check data accuracy against source documents

Waldeyers ring

A lymphoma would most likely arise in

Provide standards for coding and editing Certify registries that meet national data quality standards Train and educate registry staff

A major activity of NAACCR is:

Continuity of Data

A mapping can be done between the historic data and the new data items

variance

A measure of spread within a distribution, away from the mean

How often must the Cancer Liaison Physician (CLP) report to the cancer committee? Response : Monthly Annually A minimum of twice a year A minimum of four times a year

A minimum of four times a year Rationale: Standard 4.3 requires that the Cancer Liaison Physician (CLP) reports to the cancer committee a minimum of four times each calendar year.

The National Cancer Data Base is what type of database? Response : A population-based incidence database A nationwide outcomes database Both (A) and (B) Neither (A) nor (B)

A nationwide outcomes database Rationale: Standard 5.5 states that the NCDB is an OUTCOME DATABASE. As an outcomes database, it is used as a CLINICAL SURVEILLANCE TOOL to MONITOR CHG(s) and VARIATIONS in PATTERNS OF CA CARE. It is also USED to PROVIDE BENCHMARKS for PT CARE and QUALITY OF CARE.

Health Level Seven (HL7)

A non-profit organization involved in the development of international healthcare informatics interoperability standards which provide a framework (and related standards) for the exchange, integration, sharing, and retrieval of electronic health information.

15 months

A patient is considered delinquent/lost to follow up if no contact is made withing _____ of date of last contact.

can be disclosed to state/central cancer regsitries without the consent of the patient

A patient's medical record information

Etiology of cancer

A primary objective of conducting epidemologic cancer surveys is to develop clues about the:

Agenda for Change

A program of the Joint Commission that emphasized continuous quality improvement of all facets of healthcare services. The A.f.C shifted the focus from examining an institution's capabilities to capabilities to deliver quality care to monitoring their performance in healthcare delivery and evaluating the actual improvement achieved in their results.

Training needs

A recoding audit will assess

training needs

A recoding audit will assess

How do reliability and reabstracting studies differ?

A reliability study uses a set of standardized medical charts by a sample of data collectors. This study is reviewing the range of answers and checking on consistency of those answers. A reabstracting study assesses the quality of the collected data by having a staff member reabstract a sample of abstracts from the medical records. This study is assessing discrepancies identified by the reabstractor.

Death Certificate Only (DCO)

A reportable case for which the only information available to the central registry is a death certificate

true

A sequence number is added to the end of the number to indicate the number of primary cancers that the patient has had true or false

What does the terminology "meaningful use" have to do with the EHR environment?

A specific EHR must have "meaningful use" features and benefits to qualify for certain government funding.

Casefinding

A systemic method of locating all eligible cases

Law that covers wrongful acts that result in harm to another person, such as invasion of privacy, is called ____________________ and can result in compensation to the injured party.

A tort

Cohort study

A type of epidemiologic study where a group of exposed individuals (individuals who have been exposed to the potential risk factor) and a group of non-exposed individuals are followed over time to determine the incidence of disease

Case control study

A type of epidemiologic study where a group of individuals with the diseases, referred to as cases, are compared to individuals without the disease, referred to as controls Always retrospective

A disaster recovery plan is

A way to make sure that computerized registry data is backed up every night and is easily recoverable

Examples of possible duality of interest are: (more than one answer may apply) a. outside consultation services. b. holding of two separate certifications. c. committee appointments. d. business enterprises interests.

A, C and D

Match the registries in the column with main supporting agencies. (May be more that one) A. Early Rheumatoid Arthritis Treatment Evaluation Registry B. National Exposure Registry C. Alzheimer's Disease Registry D. United Stated Eye Injury Registry E. Environmental Polymorphism Registry F. Lupus Registry G. Special Needs Emergency Registry H. Temporomandibular Joint Replacement Registry I. Cystic Fibrosis Registry J. Lamotrigine Pregnancy Registry Supporting Agency: Academic center

A, E, H

What type of HIPAA security safeguard is being adhered to when a covered entity adopts a written set of privacy procedures that address access authorization, establishment, modification, and termination; and when covered entities out-source some of their business processes to a third party, they require that their vendors also have a framework in place to comply with their HIPAA requirements? Response : A. Administrative B. Physical C. Technical D. None of the above

A. Administrative

Hospital and population-based cancer registries collect cancer data to Response: A. Be aggregated by a Federal agency. B. Be sent to the National Cancer Data Base (NCDB). C. Meet standards of the Commission on Cancer (CoC). D. Be sent to the State cancer registry.

A. Be aggregated by a Federal agency.

Hospital and population-based cancer registries collect cancer data to Response : A. Be aggregated by a Federal agency. B. Be sent to the National Cancer Data Base (NCDB). C. Meet standards of the Commission on Cancer (CoC). D. Be sent to the State cancer registry.

A. Be aggregated by a Federal agency. Data are collected by hospital and population-based cancer registries (central registries) to be aggregated by a Federal agency. Central registries do not send data to NCDB nor do they meet standards of the CoC. Central registries may send data to a state cancer registry if there are regional cancer registries in the state, but that is true for only a few states. Not all hospital registries are CoC approved hospitals, so they do not send data to NCDB nor do they meet the standards of CoC.

Computerized edits programs were developed to promote Response : A. Data standardization. B. Interoperability. C. Both (a) and (b) D. Neither (a) nor (b)

A. Data standardization COMPUTERIZED DATA EDITS were DEVELOPED to PROMOTE DATA STANDARDIZATION. Data edits test the data against the coding rules. Through the leadership of North American Association of Central Cancer Registries (NAACCR), edit standards have been compiled for data elements within and across standard data sets. Using edits promotes data quality by encouraging standardization of the data collection processes in order to provide clear data for analysis. Interoperability refers to the ability of software and hardware on different machines from different vendors to share data without manipulation.

Match the registries in the column with main supporting agencies below. There may be more than one type of registry for each supporting agency. A. Early Rheumatoid Arthritis Treatment Evaluation Registry B. National Exposure Registry C. Alzheimer's Disease Registry D. United States Eye Injury Registry E. Environmental Polymorphism Registry F. Lupus Registry G. Special Needs Emergency Registry H. Temporomandibular Joint Replacement Registry I. Cystic Fibrosis Registry J. Lamotrigine Pregnancy Registry ______ Federal government ______ State government ______ Academic center ______ Not-for-Profit organization ______ Commercial enterprise

A. Early Rheumatoid Arthritis Treatment Evaluation Registry B. National Exposure Registry C. Alzheimer's Disease Registry D. United States Eye Injury Registry E. Environmental Polymorphism Registry F. Lupus Registry G. Special Needs Emergency Registry H. Temporomandibular Joint Replacement Registry I. Cystic Fibrosis Registry J. Lamotrigine Pregnancy Registry _ B, F_____ Federal government _C, G_____ State government _A, E, H_____ Academic center __D, I____ Not-for-Profit organization __J____ Commercial enterprise

Security management planning involves Response : A. Evaluating the flow of data throughout the organization. B. Delegating responsibility to implement and maintain the security system. C. Establishing appropriate controls over the handling and control of confidential data. D. Verifying the identity and authority of employees before granting access to confidential information.

A. Evaluating the flow of data throughout the organization. Security management planning involves evaluating the flow of data throughout the organization and identifying all unreasonable security weaknesses. It is management's responsibility to identify who has the authority and responsibility to implement and maintain the security system. Developing information handling procedures refers to establishing procedures to ensure control over how confidential data is maintained. Implementing access controls refers to employees that should have access to various types of confidential data.

What rule requires covered entities and business associates to provide notification following a breach of unsecured protected health information? Response : A. HIPAA Breach Notification Rule B. HIPAA Patient Safety Rule C. HIPAA Security Rule D. None of the above

A. HIPAA Breach Notification Rule The HIPAA Breach Notification Rule REQUIRES COVERED ENTITIES and BUSINESS ASSOCIATES to PROVIDE NOTIFICATION following a BREACH of UNSECURED protected health information (PHI).

Which statement(s) is true regarding the National Provider Identifier (NPI)? Response : A. HIPAA covered entities must use only the National Provider Identifier (NPI) to identify covered health care providers in standard transactions. B. The NPI replaces all other identifiers used by health plans, Medicare, Medicaid, and other government programs, including state license number and tax identification number. C. Both (a) and (b) D. Neither (a) nor (b)

A. HIPAA covered entities must use only the National Provider Identifier (NPI) to identify covered health care providers in standard transactions HIPAA covered entities (e.g., providers completing electronic transactions, healthcare clearinghouses, and large health plans) must use only the National Provider Identifier (NPI) to identify covered health care providers in standard transactions. All covered entities using electronic communications (e.g., physicians, hospitals, health insurance companies) must use a single NPI that replaces all other identifiers used by health plans, Medicare, Medicaid, and other government programs. The NPI does not replace a provider's DEA number, state license number, or tax identification number. The NPI is 10 digits (may be alphanumeric), with the last digit being a checksum. The NPI cannot contain any embedded intelligence; in other words, the NPI is simply a number that does not itself have any additional meaning. The NPI is unique and national, never re-used, and except for institutions, a provider usually can have only one. An institution may obtain multiple NPIs for different "subparts" such as a free-standing cancer center or rehab facility.

Which program addresses the privacy and security challenges presented by electronic health information exchange involving multiple states? Response : A. Health Information Security and Privacy Collaboration (HISPC) B. Cancer Bioinformatics Grid (caBIG) C. Certification Commission for Health Information Technology (CCHIT) D. None of the above Correct Answer :

A. Health Information Security and Privacy Collaboration (HISPC)

Which piece of legislation was intended to assure the workforce is properly trained and equipped to be meaningful users of certified Electronic Health Records (EHRs)? Response : A. Health Information Technology for Economic and Clinical Health Act B. Patient Safety and Quality Improvement Act C. Health Insurance Portability and Accountability Act D. None of the above

A. Health Information Technology for Economic and Clinical Health Act Rationale: Health Information Technology (HITECH) for Economic and Clinical Health Act was enacted under Title XIII of the AMERICAN RECOVERY and REINVESTMENT ACT of 2009. Under the HITECH Act, the United States Department of Health and Human Services (HHS) INVESTED billions TO PROMOTE AND EXPAND the ADOPTION OF HEALTH INFORMATION TECHNOLOGY in order TO IMPROVE AMERICAN HEALTHCARE DELIVERY AND PATIENT CARE. The provisions of the HITECH Act are specifically DESIGNED TO WORK TOGETHER to PROVIDE NECESSARY ASSISTANCE and TECH SUPPORT to PROVIDERS, enable COORDINATION and ALIGNMENT WITHIN and AMONG STATES, ESTABLISH CONNECTIVITY to the PUBLIC HEALTH COMMUNITY IN CASE OF EMERGENCIES, and ASSURE WORKFORCE IS PROPERLY TRAINED AND EQUIPPED TO be MEANINGFUL USERSof certified Electronic Health Records (EHRs).

Which piece of legislation protects health insurance coverage for workers and their families when they change or lose their jobs? Response : A. Health Insurance Portability and Accountability Act B. Patient Safety and Quality Improvement Act C. Health Information Technology for Economic and Clinical Health Act D. None of the above

A. Health Insurance Portability and Accountability Act The Health Insurance Portability and Accountability Act (HIPAA) of 1996 was enacted by the United States Congress. Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs. Title II of HIPAA requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. Provisions also address the security and privacy of health data. The standards are meant to improve the efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in the U.S. health care system.

Which non-profit organization is involved in the development of international healthcare informatics interoperability standards which provide a framework (and related standards) for the exchange, integration, sharing, and retrieval of electronic health information? Response : A. Health Level Seven B. American National Standards Institute C. National Cancer Informatics Program D. eHealth Exchange

A. Health Level Seven

Which procedure(s) occurs as part of the EHR Incentive Program? Response : A. Incentive payments are given to healthcare providers to use EHR technologies in ways that positively impact patient care. B. Reimbursement for purchasing or replacing an EHR system. C. Both (a) and (b) D. Neither (a) nor (b)

A. Incentive payments are given to healthcare providers to use EHR technologies in ways that positively impact patient care. The EHR Incentive Program PROVIDES INCENTIVE PAYEMENTS for CERTAIN HEALTHCARE PROVIDERS TO USE electronic health record (EHR) technology in WAYS that can POS IMPACT PT CARE. While EHR technology allows healthcare providers to record patient information electronically instead of using paper records, EHRs are often capable of doing much more than just recording information. The EHR Incentive Program ASKS PROVIDERS TO USE the CAPABILITIES of their EHRs TO ACHIEVE BENCHMARKS that can LEAD TO IMPROVED PT CARE. Providers must meet all of the objectives established by Centers for Medicare and Medicaid Services (CMS) for these programs. If providers are able to demonstrate MEANINGFUL USE of their EHRs, they will receive incentive payments. The EHR Incentive Program is NOT a REIMBURSEMENT PROGRAM for purchasing or replacing an EHR.

The caBIG was sponsored by the Response: A. National Cancer Institute (NCI). B. Commission on Cancer (CoC). C. National Program of Cancer Registries (NPCR). D. International Association of Cancer Registries (IACCR).

A. National Cancer Institute (NCI)

The caBIG was sponsored by the A. National Cancer Institute (NCI). B. Commission on Cancer (CoC). C. National Program of Cancer Registries (NPCR). D. International Association of Cancer Registries (IACCR).

A. National Cancer Institute (NCI). caBIG (the Cancer Biomedical Informatics Grid) was sponsored by the National Cancer Institute Center for Bioinformatics to develop a network of tools, data, and researchers to support the discovery of new approaches for the detection, diagnosis, treatment, and prevention of cancer, ultimately improving cancer care for patients.

The ultimate goal of analyzing cancer data is to Response : A. Prevent and control cancer. B. Develop educational programs for health care providers, patients and the general public. C. Both (a) and (b) D. Neither (a) nor (b)

A. Prevent and control cancer. The goal of analyzing cancer data is to prevent and control cancer and to improve patient care. To that end, analyzing data makes it possible to perform the following types of activities: Allocate financial and personnel resources at the health care facility level and regional level. Analyze referral patterns. Calculate survival rates by various data items. Develop educational programs for health care providers, patients and the general public. Evaluate effectiveness of treatment modalities. Provide follow-up information for cancer surveillance. Provide information for cancer program activities. Report cancer incidence as required under state law.

The three major initiatives for the Agenda for Change include: A. Redesign of TJC's Standards to stress the entire organization's effectiveness in patient services B. Patient outcomes are influenced by all of the activities of a healthcare organization C. Continuous improvement in the quality of care should be a priority of healthcare orga- nizations D. Redesign of the survey process to provide more interactive consultative services E. Development of a national performance measurement system, commonly known as the Indicator Measurement System F. TJC should focus on these activities of healthcare organizations that are most impor- tant to the quality of care G. Traditional assessments of compliance with standards should be complemented by the accredited organization's collection, analysis, and feedback of data that reflect their actual performance in undertaking key activities

A. Redesign of TJC's Standards to stress the entire organization's effectiveness in patient services D. Redesign of the survey process to provide more interactive consultative services E. Development of a national performance measurement system, commonly known as the Indicator Measurement System

The role of American National Standards Institute (ANSI) in the development of healthcare information standards in the United States is to Response : A. Safeguard the integrity of assessment systems. B. Set standards for assessment systems that must be followed. C. Develop and distribute mandatory assessment systems to standard setters. D. Develop standards used by all U.S. registries.

A. Safeguard the integrity of assessment systems. The American National Standards Institute (ANSI) SAFEGUARDS THE INTEGRITY OF ASSESSMENT SYSTEMS. The PARTICIPATION in ANSI is VOLUNTARY and the STANDARDS and ASSESSMENT SYSTEMS that are DEVELOPED ARE NOT MANDATORY. The MISSION of ANSI is TO ENHANCE both the GLOBAL COMPETITIVENESS of U.S. BUSINESS (INCLUDING THE HEALTH CARE INDUSTRY) and the U.S. QUALITY OF LIFE by PROMOTING and FACILITATING VOLUNTARY NATIONAL CONSENSUS STANDARDS and CONFORMITY ASSESSMENT SYSTEMS, and SAFEGUARDING their INTEGRITY. ANSI FACILITATES the DEVELOPMENT of American National Standards (ANS) by accrediting the procedures of standards developing organizations. These GROUP WORKS COOPERATIVELY To develop voluntary national consensus standards. Accreditation by ANSI signifies that the procedures used by the standards body, in connection with the development of ANS, meet the Institute's essential requirements for openness, balance, consensus and due process.

Which term refers to the "network of networks"? Response : A. eHealth Exchange B. National Cancer Informatics Program C. Health Level Seven D. American National Standards Institute

A. eHealth Exchange Rationale: The eHealth Exchange, formerly known as the NATIONWIDE HEALTH INFORMATION Network (often abbreviated as the NHIN or NwHIN), is an initiative for the EXCHANGE OF HEALTHCARE INFORMATION. The exchange is a web-services based series of specifications designed to securely exchange healthcare related data. The Office of the National Coordinator for Health Information Technology has been facilitating development of the NwHIN, which will TIE TOGETHER HEALTH INFORMATION EXCHANGES, integrated delivery networks, pharmacies, government, labs, providers, payers and other stakeholders into a "network of networks."

an organization of comprehensive hospitals and cancer centers with an interest in community activities. Members are concerned about the how and why of cancer program development, the impact of perspective payment, capitation, and competition, and the establishment and maintenance of high-standards of quality patient care (national)

AACR American association of Cancer research

a professional medical association to improve the quality of care for surgical patients by elevating the standards of surgical education and practice

ACOS AMERICAN COLLEGE OF SURGEONS (NATIONAL)

NCDB meeting the established standards before submitting data

ACOS approved facilities report annually directly to NCDB captures about 70% of incident cases nationwide. Use FORDS for coding Data transmission specified by NAACCR standards Confidential data must be protected under HIPAA All cases 2003 and later. Class of case 00 through 22 only (analytic cases) Use NCDB metafile to edit cases. Clinical checks - cases that do not pass clinical checks are flagged for review. The checks compare the cases to recognized standards of care.

The first code manual used in cancer registries was published by:

ACS

private cancer research organization, which supports, through grants, investigator initiated projects in established medical and other scientific institutions across the country

ACS AMERICAN CANCER SOCIETY (NATIONAL)

The activities of the NCDB are funded by:

ACS and ACoS

Which organization does not participate in the annual report to the nation on status of cancer

ACoS

Collaborative stage is sponsored by

AJCC

Organized in 1959 for the purpose of clinical staging, decided to use the TNM system of the UICC to develop its own system of clinical and pathologic staging.

AJCC AMERICAN JOINT COMMITTEE ON CANCER (NATIONAL)

Edit Over-rides flags

ALLOWS the REGISTRY STAFF to INDICATE that QUESTIONABLE DATA is ACTUALLY CORRECT. Setting over-ride flags on cases can ELIMINATE THE NEED to REVIEW the SAME CASE MULT TIMES FOR the SAME ISSUE that would CONTINUE TO FAIL ONE or MORE EDITS, should such a flag not exist. If a case has an OVERRIDE FLAG SET INVOLVING SELECTED FIELDS, the CASE SHOULD NOT HAVE TO BE MANUALLY REVIEWED AGAIN UNLESS there is a CHANGE in the CODING VALUES INVOLVING the FIELDS THAT TRIGGERED the EDIT FAILURE INITIALLY.

Founded in 1918 as a nonprofit, voluntary collaboration for standardization activities

ANSI (American National Standards Institute)

Cancer Committee must have

AUTHORITY documented and established by the FACILITY

Hospital Associate Cancer Program

Accession 100 or fewer cases annually

Community CancerProgram

Accession more than 100 but fewer than 500 cases annually

Comprehensive Community Cancer Program

Accession more than 500 cases annually

ignore the microscopic foci and use the "Single Tumor" module

According the the MP/H rules, when a tumor has separate microscopic foci

According to the CoC, what are accredited programs to follow when treating cancer patients? Response : Accountability measures indicated in the Cancer Program Practice Profile Reports ASCO's Guide to Cancer Treatment ACR's Practice Parameters and Technical Standards None of the above

Accountability measures indicated in the Cancer Program Practice Profile Reports Rationale: According to Standard 4.4, Cancer Program Practice Profile Reports (CP3R) REFLECT NATIONALLY ACCEPTED ACCOUTABILITY MEASURES required by the CoC to be used by accredited cancer programs. Documentation of a program's Estimated Performance Rates (EPR) associated with each accountability measure, any CORRECTIVE ACTION should the REQUIRED EXPECTATION NOT BE MET and ANY F/U NECESSARY TO MEET the EPRs are included in the cancer committee minutes.

What is the most important concern in coding neoplasms?

Accuracy

Which file format is recommended to publish documents to the Web because it is widely used by standard-setting organizations and has a free reader?

Acrobat (.pdf)

Process of improvement

Action taken to meet new goal and objective

Define the following two terms: active follow-up and passive follow-up.

Active follow-up refers to someone initiating direct contact with patients. From a central registry perspective, active follow-up may also include contacts made by hospital registrars with physician's offices. Passive follow-up refers to methods that do not require registry contact with hospitals, physicians, or individual cancer patients. These methods usually involve computerized searches of existing nonregistry files that may contain the cancer patient's name, and follow-up status can be inferred.

Death clearance and casefinding audits

Activities unique to central cancer registries

A Web URL is entered into the____________ __________ of the Web browser.

Address bar

What is a primary goal(s) of a population-based registry?

Address epidemiologic and public health issues

kidney histology

Adenocarcinoma, Wilms tumor

Secondary prevention

After disease has occurred, but before patient notices anything wrong

Non Confidential Data

Aggregate Data (does not contain patient identifiers)

Cross Sectional study

Aim to provide data on entire population

Which of the following requirements indicates a standard eligible for commendation if the cancer program also fulfills all additional compliance criteria for that same standard? Response : 90 percent of all pathology reports follow the synoptic format defined by the CAP Each calendar year, 10% of oncology nurses employed by the facility hold an oncology nursing certification All CTRs attend a national or regional cancer-related meeting once during the three-year survey cycle At the time of accreditation, the program participates in RQRS and submits all eligible cases for valid performance measures

All CTRs attend a national or regional cancer-related meeting once during the three-year survey cycle Rationale: Currently, there are 7 STANDARDS that INCLUDE COMMENDATION RATINGS OF PERFORMANCE if the cancer program COMPLETES the REQUIREMENTS LISTED BELOW and also FULFILLS the ADDTIONAL COMPLIANCE CRITERIA outlined for that same standard in the 2016 Edition of the Cancer Program Standards. These include the following: Standard 1.11: All CTRs attend a national or regional cancer-related meeting once during the three-year survey cycle. Standard 1.9: The required commendation percentage of patients, as indicated for each cancer program category, is accrued to a cancer-related clinical trial each calendar year. Standard 1.12: The cancer committee develops and distributes a report of patient or program outcomes to the public each calendar year. Standard 2.1: 95% of cancer pathology reports follow the synoptic format defined by the College of American Pathologists (CAP) and 95% of the reports include the required data items as stated in the CAP protocol. Standard 2.2: 25% of oncology nurses employed by the facility (both full-time and part-time) hold a current applicable oncology nursing certificate during each calendar year. Standard 5.2: The program must participate in RQRS and submit all eligible cases for all valid performance measures from initial enrollment and throughout the accreditation period. Standard 5.6: Cases submitted to the NCDB annually that were diagnosed on 1/1/03 or later meet the established quality criteria for the annual Call for Data on initial submission.

july 1

All abstracted cases for a calendar year are due to ISCR by _____ of the following year.

What data is submitted to the NCDB after a new program completes its initial survey request and accreditation is awarded? Response : The last five years of eligible analytic cases The eligible analytic cases from the most recent complete abstracting year All analytic cases for any diagnosis dates beginning with its reference date (for all applicable years currently accepted by the NCDB) None of the above

All analytic cases for any diagnosis dates beginning with its reference date (for all applicable years currently accepted by the NCDB) Rationale: Standard 5.5 states that AFTER A NEW PRAGRAM has COMPLETED INITIAL SURVEY REQUEST and ACCREDITATION IS REWARDED, the PROGRAM SUBMITS CASES for ALL APPLICABLE YEARS CURRENTLY ACCEPTED by the NCDB. A NEW PROGRAM SUBMITS ALL ANALYTIC CASES for any DX YR BEGINNING W/ its REFERENCE DATE, which REFERS TO the START DATE ESTABLISHED for CoC ACCREDITED REGISTRIES. The REFERENCE DATE is SET BY the CA COMMITTEE PRIOR TO its INITIAL SURVEYand should be set as of January 1 of a given year.

Prevalance rate

All cases in pop / people at risk in pop

Observed survival

All cause; Not a hypothetical probability;

Question : Cancer registry data that must be submitted to NCDB are Response : All cases for the year specified in the Call for Data All completed analytic cases specified in the Call for Data All analytic cases for the last complete diagnosis year None of the above

All completed analytic cases specified in the Call for Data Rationale: Standard 5.5 states that all COMPLETED ANALYTIC CASES SPECIFIED IN THE CALL FOR DATA are to be SUBMITTED to NCDB EACH YEAR. The CALL FOR DATA DOCUMENTATION will SPECIFY THE YEARS ASSOCIATED W/ the COMPLETED ANALYTIC CASES to be SUBMITTED.

It is required that the registry perform follow-up on these cases Response : Reportable-by-agreement cases All eligible analytic cases Both (A) and (B) Neither (A) nor (B)

All eligible analytic cases Rationale: Standard 5.3 states that F/U MUST BE DONE on ALL ELIGIBLE ANALYTIC CASES in the DATABASE.

Which hospitals are required to submit data to the state cancer registry?

All hospitals are required to submit data to the state cancer registry if cancer reporting is mandatory per state regulation.

Patient eligibility

All inpatients and outpatients diagnoses (clinically or histologically) are eligible for inclusion Includes: Patients diagnosed and treated at the hospital Patients who were diagnosed elsewhere and receiving their first course of treatment Patients diagnosed but receiving treatment elsewhere Patients diagnosed at autopsy

either the state registry or the central registry in their region

All states and the District of Columbia have laws, regulations or statutes requiring healthcare facilities and providers to report cancer data to

ACS

American Cancer Society

ACoS (standard setter)

American College of surgeons

AJCC

American Joint Committee on Cancer

Standard setters for central registries include the following:

American Joint Committee on Cancer (AJCC) Commission on Cancer (CoC) National Cancer Registrars Association (NCRA) National Program of Cancer Registries (NPCR) North American Association of Central Cancer Registries (NAACCR) Surveillance, Epidemiology, and End Results Program (SEER) World Health Organization (WHO)

AJCC

American Joint Committee on Cancer (stage cancer and the TNM system)

ANIS

American National Standards Institute; safeguards the integrity of assessment systems for health information standard

Replace a hard copy log Have a summary of all requests Provide a clean solution for tracking & sorting information

An electronic request log is used to:

Observed (all-cause) survival

An estimate of the probability of survival for all causes of death

observed (all-cause) survival

An estimate of the probability of survival of all causes of death

The outcome being measured; it may be death due to any cause or death related to a specific cause of interest such as the cancer under study.

An event of interest

histology-specific cancer conference

An example of a cancer conference format that includes a discussion of rhabdomyosarcoma is referred to as a

Identifies a treatment date coded prior to the diagnosis date

An example of an inter-field (or multi-field) edit is one that

compares the sequence numbers for a patient

An example of an inter-record (or multi-record) edit is one that

What activity contributed to development of clinical practice guidelines

An extensive literature review

coverage of disparate populations within the United States

An important aspect of the Surveillance, Epidemiology, and End Results (SEER) Program database is its

The collection and maintenance of data on data quality

An important element of a quality control program is:

three years

An organization is awarded accreditation every _____.

database

An organized collection of information.

The psychosocial services coordinator is required to report to the cancer committee Response : Annually Twice a year Quarterly At each meeting

Annually Rationale: Standard 3.2 states that the psychosocial services coordinator must REPORT EACH CALENDAR YEAR to the CA COMMITTEE summarizing information related to: # of patients SCREENED # of patients REFERRED for DISTRESS RESOURCES Whether CARE was provided ON-SITE or by REFERRAL to an off-site location

The cancer committee is required to do a community-based cancer prevention program Response : Two times a year Annually Every two years Every three years

Annually Rationale: Standard 4.1 requires a COMMUNITY-BASED CA PREVENTION PROGRAM TO be implemented EACH CALENDAR YEAR that FOCUSES ON DECR the # OF PT'S DX with a SPECIFIC FORM of CA and it TARGETS a PREVENTION NEED of the COMMUNITY BEING SERVED.

Metastatic prostate cancer

Antiandrogens are primarily used to treat

71

Approximately _____ percent of all newly diagnosed cancer patients are treated in CoC accredited cancer programs.

Cancer program goals Response : -Are established by the cancer committee -Are either clinically or pathologically oriented -Can be developed from Quality Improvements used to meet CoC Standard 4.8 -None of the above

Are established by the cancer committee Rationale: Standard 1.5 states that the CA PROGRAM GOALS are ESTABLISH BY the CA COMMITTEE. At least ONE NEW CLINICAL and ONE NEW PROGRAMMATIC GOAL must be ESTABLISHED ANNUALLY at the BEGINNING of the CALENDAR YEAR. Cancer programs are to use the goal-setting tool known as SMART (Specific, Measurable, Achievable, Realistic and Timely). Cancer program goals cannot be a restatement of either a CoC standard or an Eligibility Requirement because compliance with such a standard or eligibility requirement is necessary. Goals must be evaluated and monitored at least twice annually during two subsequent cancer committee meetings, mid-year and at the end of the same calendar year. Cancer committee minutes should reflect what the goals are and must include documentation related to monitoring the program's progress toward meeting those goals.

Screening programs

Are focused on DECR the # of PTS who PRESENT W/ LATE STAGE DZ. Establishing a COLONOSCOPY SCREENING program is an example of this type of program

CoC patient studies

Are performed by a voluntary network and merged with NCDB when it was established

Tables in a report should have

As much white space as possible surrounding the rows and cells

If patient requests record change then the state registry must

At least document the request

How often should time-motion studies be performed?

At predetermined intervals or when a new or change of responsibility occurs

A Survivorship Care Plan (SCP) must be given to the patient Response : At the completion of treatment At the time of diagnosis Both (A) and (B) Neither (A) nor (B)

At the completion of treatment Rationale: Standard 3.3 states the Survivorship Care Plan (SCP) must be given to the patient AFTER he/she COMPLETES CA TX The documentation INCLUDES A SUMMARY OF THE TX provided and a F/U PLAN. The SCP is to be PROVIDED within 1 YEAR of DX and NO LATER THAN 6 MOS FOLLOWING the COMPLETION OF ADJ THERAPY (other than long-term hormonal therapy). For patients RECEIVING LONG-TERM HORMONE THERAPY, the SCP DELIVERY TIME FRAME is EXT TO 18 MONTHS. The SCP is REQUIRED to be DISCUSSED W/ the PT to MEET this STANDARD. MAILING, ELECTRONICALLY SENDING or POSTING the DOCUMENT through a PT PORTAL DOES NOT MEET THIS STANDARD.

Prevention or screening/early detection programs must be monitored and those activities are reported to the cancer committee Response : -Twice each calendar year -At the end of each calendar year -Every two years -Every three years

At the end of each calendar year Rationale: Standard 1.8 states that community outreach programs (PREVENTION OR SCREENING/EARLY DETECTION) must be monitored and reported to the cancer committee at the END OF EACH CALENDAR YEAR..

Real time reporting

Automatic identification of case information through electronic transmission to the central registry as it is entered/digitzed in the originating facility.

NCRA

Award CTR

All cancer patients are seen in hospitals. Nonhospital sources of patients are unlikely. a. True b. False

B

Match one of the registries in the column with it's purpose: A. AFIP DNA Registry B. Nun study C. National Marrow Donor Program D. Trauma Registry E. Advance Directive Registry. Purpose: Tracking course of Alzheimer's disease

B

Of the registries listed, which goes with: Provide information about services. A. Tremolite Asbestos Registry B. Birth Defects Registry C. Intestinal Transplant Registry D. Breast Health Registry E. GIST Registry.

B

The history of U.S. cancer registration began in the: A. 1890s B. 1920s C. 1940s D. 1960s

B

Match the actions with the appropriate guidelines. A. Producing complete, accurate, and timely information B. Truthfully and accurately representing Credentials, education and experience C. Revocation of the CTR credential D. Providing lists of patients for marketing purposes ______ Professionalism ______ Discharge of entrusted professional duties and responsibilities ______ Confidentiality and privacy ______ Breach of ethical conduct sanction

B A D C

Select the term that matches the statements below. A. Lead time error B. Administrative data items C. Relevance of a data item ______ Can be used to identify the coding scheme in use when a case was originally coded ______ Can change over time as medical knowledge changes ______ Can occur when medical technology advances and some cancers are diagnosed earlier in their progression than in the past

B C A

Select the term that matches the statements below. A. Data set B. Standard data item C. Data dictionary D. Interoperability ______ Data item whose codes, definitions, and coding instructions are shared among registry organizations ______ Consistency with which varied organizations and software systems handle the transmission of similar information ______ The collection of data items maintained by a registry ______ Provides coding instructions, code definitions, and the code options

B D A C

CoC accredited cancer programs are required to resolve which of the following types of cases that failed an edit? (Check all that apply) A. Cases with a data quality score of zero B. Cases that accumulate a data quality score between 1 and 199 C. Cases that accumulate a data quality score of 200 or greater D. Cases that received "rejection edits"

B, C, D

Match the registries in the column with main supporting agencies. (May be more that one) A. Early Rheumatoid Arthritis Treatment Evaluation Registry B. National Exposure Registry C. Alzheimer's Disease Registry D. United Stated Eye Injury Registry E. Environmental Polymorphism Registry F. Lupus Registry G. Special Needs Emergency Registry H. Temporomandibular Joint Replacement Registry I. Cystic Fibrosis Registry J. Lamotrigine Pregnancy Registry Supporting Agency: Federal Government

B, F

It is illegal to Response : A. Abstract data from a medical record of a family member. B. Access medical records of family, friends, or celebrities to read the information. C. Both (a) and (b) D. Neither (a) nor (b)

B. Access medical records of family, friends, or celebrities to read the information.

Which program was replaced by the National Cancer Informatics Program (NCIP) in May 2012 following a 2011 report which raised significant questions about effectiveness and oversight of its program? Response : A. Health Information Security and Privacy Collaboration (HISPC) B. Cancer Bioinformatics Grid (caBIG) C. Certification Commission for Health Information Technology (CCHIT) D. None of the above Correct Answer :

B. Cancer Bioinformatics Grid (caBIG) In 2011 a report on caBIG RAISED SIGNIFICANT QUESTIONS ABOUT EFFECTIVENESS and OVERSIGHT, and ITS BUDGET AND SCOPE were SIGNIFICANTLY TRIMMED. In May 2012, the National Cancer Informatics Program (NCIP) was CREATED as caBIG's SUCCESSOR PROGRAM. Cancer Bioinformatics Grid (caBIG) was a U.S. government program described as a voluntary virtual informatics infrastructure that connected data, research tools, scientists, and organizations. The goal of the program was to develop an open source, open access information network using technology known as grid computing for secure data exchange of cancer research. The initiative was developed by the National Institutes of Health's National Cancer Institute. In addition to caGrid, the underlying infrastructure for data sharing among organizations, caBIG developed software tools, data sharing policies, and common standards.

With the continuing development of electronic medical records (EMRs), the registrar must proactively Response : A. Check with their vendors to see whether information from the EMR can be imported into the cancer registry abstract. B. Ensure the registry participates in the design of the EMR. C. Attend any educational meetings on how to use the EMR when it has been implemented. D. None of the above

B. Ensure the registry participates in the design of the EMR. Cancer registrars must work proactively within their organizations to ensure the registry participates in and benefits from the design and/or implementation of new Electronic Health Record (EHR) systems. Proactive actions include notifying registry management and cancer committee members of the need for the REGISTRY TO BE CONSIDERED A STAKEHOLDER in the EHR needs assessment process. There should be a BUSINESS ANALYST or SYSTEM ANALYST ASSIGNED TO THE REGISTRY to help ensure that the registry's workflow and data requirements are communicated to the appropriate people. The registry must respond to all inquiries in a timely fashion because the implementation team has many deadlines to meet. The implementation team is most likely unaware of the registry's existence and the registry's large reliance on access to data. Retroactive actions are any actions taken AFTER THE DESIGN and IMPLEMENTATION DECISIONS have BEEN MADE. This INCLUDES registry staff ATTENDING EDUCATION MEETINGS on HOW TO USE THE SYSTEM after it has already been implemented and asking your hospital registry software vendor if there is the capability to receive data from the EHR system. WAITING UNTIL the EHR is DEVELOPED, then LEARNING HOW TO USE IT, MEANS REGISTRY HAS LOST their WINDOW OF OPPORTUNITY TO HELP DESIGN the EHR to ensure functionality exists that is necessary to meet the needs of the registry staff. Checking with the implementation team (or the business analyst assigned to the registry) and the hospital registry software vendor to see whether information from the EHR can be imported to the cancer registry abstract should be done as soon as possible.

Which rule provides federal protections for individually identifiable health information held by covered entities and their business associates and gives patients rights with respect to that information? Response : A. HIPAA Patient Safety Rule B. HIPAA Privacy Rule C. HIPAA Security Rule D. None of the above

B. HIPAA Privacy Rule

Which types of cancer registries can receive CoC approval for their cancer programs?

B. Hospital-based registries

Which types of cancer registries can receive CoC approval for their cancer programs? Response: A. Population-based central registries B. Hospital-based registries C. Both (a) and (b) D. Neither (a) nor (b)

B. Hospital-based registries

To assist in edit resolution, the registry should Response : A. Teach staff to change codes for fields listed in the error message so the case passes edits. B. Identify common coding errors and provide education for staff. C. Both (a) and (b) D. Neither (a) nor (b)

B. Identify common coding errors and provide education for staff. One of the actions that will assist in edit resolution is identifying common errors made by the staff and providing education to them to prevent those errors from occurring again in the future. Once there is an understanding of coding principles that apply to cases, it is important to teach staff how to properly correct the fields with potential errors. Staff should never override error messages without having data reviewed for accuracy, nor should they simply change the codes in one or more fields to eliminate the error message and have the case pass the edits because that could result in unreliable data being introduced into the database. Edit errors are potential errors in coding that require a manual review to determine how best to resolve the case: Change the coding in one or more fields. Set an over-ride flag if available to indicate that the coding was not changed because it is correct. Inform the standard setter, vendor or funding agency that there is a problem with the edit logic because the case is correctly coded and no override flag is available to set to indicate the unusual coding combination is accurate.

What term describes the networking capability for a group of computers in close proximity to each other such as in an office building? Response : A. Firewall B. LAN C. Server D. VPN

B. LAN Rationale: A local area network (LAN) supplies NETWORKING CAPABILITY TO A GROUP of COMPUTERS IN CLOSE PROXIMITY TO EACH OTHER such as in an OFFICE BUILDING. A LAN is useful for SHARING RESOURCES LIKE FILES, PRINTERS or OTHER APPLICATIONS. A LAN in turn often CONNECTS TO OTHER LANs, and to the INTERNET or OTHER WIDE AREA NETWORK (WAN).

What are the four underlying concepts for the Agenda for Change? A. Redesign of TJC's Standards to stress the entire organization's effectiveness in patient services B. Patient outcomes are influenced by all of the activities of a healthcare organization C. Continuous improvement in the quality of care should be a priority of healthcare organizations D. Redesign of the survey process to provide more interactive consultative services E. Development of a national performance measurement system, commonly known as the Indicator Measurement System F. TJC should focus on these activities of healthcare organizations that are most important to the quality of care G. Traditional assessments of compliance with standards should be complemented by the accredited organization's collection, analysis, and feedback of data that reflect their actual performance in undertaking key activities

B. Patient outcomes are influenced by all of the activities of a healthcare organization C. Continuous improvement in the quality of care should be a priority of healthcare organizations F. TJC should focus on these activities of healthcare organizations that are most important to the quality of care G. Traditional assessments of compliance with standards should be complemented by the accredited organization's collection, analysis, and feedback of data that reflect their actual performance in undertaking key activities

What type of HIPAA security safeguard is being adhered to when the procedures involve access to hardware and software being limited to properly authorized individuals, workstations not being located in high traffic areas and monitor screens not being in direct view of the public? Response : A. Administrative B. Physical C. Technical D. None of the above

B. Physical Rationale: Physical safeguards involve controlling of physical access to protect against inappropriate access to protected data. They involve the following types of procedures: Access to hardware and software is limited to properly authorized individuals and is carefully controlled and monitored. Workstations are not located in high traffic areas and monitor screens are not in direct view of the public. Controls govern the introduction and removal of hardware and software from the network. (When equipment is retired, it must be disposed of properly to ensure that PHI is not compromised.) Required access controls consist of facility security plans, maintenance records, and visitor sign-in and escorts. If the covered entities utilize contractors or agents, they too must be fully trained on their physical access responsibilities.

Which term refers a systematic, computer-processable collection of medical terms that allows a consistent way to index, store, retrieve, and aggregate medical data across specialties and sites of care? Response : A. CAP B. SNOMED C. LOINC D. None of the above

B. SNOMED

The cancer registry must keep a record of disclosure, (an accounting of what, where, when, to whom and for what purpose information was distributed) for what period of time? Response : A. Five years B. Six years C. Seven years D. Ten years

B. Six years An important provision of HIPAA is the patient's right to know to whom PHI has been released without his or her consent. A record, referred to as an "accounting of disclosures" must be kept for the most recent six years. This includes data submissions to central and state registries that are legally mandated to receive this information as well as researchers conducting institutional review board (IRB) approved studies.

What do you call a government agency or court writ that has authority to compel the production of evidence? Response: A. Subpoena ad testificandum B. Subpoena duces tecum C. Both (a) and (b) D. Neither (a) nor (b)

B. Subpoena duces tecum

What do you call a government agency or court writ that has authority to compel the production of evidence? Response : A. Subpoena ad testificandum B. Subpoena duces tecum C. Both (a) and (b) D. Neither (a) nor (b)

B. Subpoena duces tecum A subpoena is a WRIT by a GOV AGENCY or COURT that has AUTHORITY to COMPEL TESTIMONY by a WITNESS PRODUCTION of evidence. FAILURE TO COMPLY with a subpoena can result in a PENALTY BY THE government agency or court. Subpoena ad testificandum orders a person to testify before the ordering authority or face punishment. The subpoena can also request the testimony to be given by phone or in person.

What type of budget requires that every line item of a new budget be justified, even if those items were approved in a previous year's budget? Response : A. Top-down budget B. Zero-based budget C. Bottom-up budget D. None of the above

B. Zero-based budget A zero-based budget requires that EVERY LINE ITEM of the BUDGET BE APPROVED, RATHER THAN ONLY CHANGES to the BUDGET FROM ONE YEAR to the NEXT. Zero-based BUDGETING REQUIRES THE BUDGET REQUEST be RE-EVALUATED THOROUGHLY, STARTING FROM SCRATCH. This type of budgeting process does not take into account whether the total budget or specific line items costs are increasing or decreasing.

Tumor Marker for cutaneous melanoma and colorectal

BRAF

Hospital and population-based cancer registries collect cancer data to

Be aggregated by a Federal agency.

Hospital and Pop based cancer reg collect cancer data to

Be aggregated by federal agencies; combined NPCR and SEER data is the official source of federal government cancer statistics

The application that allows the public and hospitals to design customized reports based on selected data items is called:

Benchmark reports

Interferons are coded as

Biological response modifiers

The annual call for data specifies that specific years of historic data be resubmitted to NCDB. What requirement(s) must these historic cases meet? Response : -Established data quality -Resubmission deadline -Both (A) and (B) -Neither (A) nor (B)

Both (A) and (B) Standard 5.6 states that RESUBMITTED data from January 1, 2003 forward MUST MEET the ESTABLISHED QUALITY CRITERIA and RESUBMISSION DEADLINES SPECIFIED IN THE CALL TO DATA

What type of cases can be used by a physician as part of a thorough analysis intended to monitor the cancer program's compliance with evidence-based national treatment guidelines? Response : -Uncommon cases -Review of a single treatment regimen for a specific site -Both (A) and (B) -Neither (A) nor (B)

Both (A) and (B) Rationale: According to Standard 4.6, a PHYSICIAN CAN USE ANY of the following SAMPLE SELECTIONS for a thorough ANALYSIS TO MONITOR the CA'S PROGRAM COMPLIANCE with evidence-based national treatment guidelines: Cancer site-specific sample: All cases from the selected site, to a maximum of 300 cases; or Based on an identified issue with the selected site; or Involves UNCOMMON CA Review of a single treatment regimen for a specific cancer site: All cases who received that treatment regimen, to a MAX of 300 cases; or Based on an identified issue with the specific treatment regimen

Cancer conference prospective cases include Response : -Patients who were previously presented at a cancer conference if there is a need to discuss systemic treatment for disease progression following the completion of first course of treatment -Patients who were previously diagnosed if there is a need to discuss palliative care options. -Both (A) and (B) -Neither (A) nor (B)

Both (A) and (B) Rationale: Eligibility requirement ER3 states that the following are some of the patients included as prospective cases for cancer conference: Patients previously presented at cancer conference who completed initial therapy but now need adjuvant treatment or treatment for recurrence or progression of disease, as well as those who require supportive or palliative care.

There must be a policy and procedure for all systemic therapy that is Response : -Administered in a staff physician's office -Administered at locations that contracted with the facility -Both (A) and (B) -Neither (A) nor (B)

Both (A) and (B) Rationale: Eligibility requirement ER8 states there must be a policy and procedure for systemic therapy administered in the following: On-site Locations owned by the facility Locations that contracted with the facility Locations supervised by members of the facility medical staff, including physician offices

Which type(s) of program is exempt from RQRS participation? Response : Programs undergoing initial survey for accreditation Pediatric programs Both (A) and (B) Neither (A) nor (B)

Both (A) and (B) Rationale: Rapid Quality Reporting System (RQRS) is a reporting and quality-improvement tool of the National Cancer Data Base (NCDB) that PROMOTES USE OF EVIDENCE-BASED CANCER CARE at the facility level. It is a WEB-BASED APPLICATION that requires systematic DATA COLLECTION in order for ITS USERS TO HAVE ACCURATE ALERTS related to anticipated care typically offered to patients presenting with a particular type and stage of cancer. According to CoC standard 5.2, RQRS participation is MOT REQUIRED FOR PROGRAMS undergoing INITIAL SURVEY for ACCREDIATION and PEDS PROGRAM.

The sources for patient care improvements include Response : Actions to address undesirable performance Changes to improve acceptable performance Both (A) and (B) Neither (A) nor (B)

Both (A) and (B) Rationale: STANDARD 4.8 includes BOTH ACTIONS to ADDRESS UNDESIREABLE PERFORMANCE and CHG(s) TO IMPROVE ACCEPTABLE PERFORMANCE as SOURCES FOR PT CARE IMPROVEMENTS.

A palliative care team may include Response : Nurses Spiritual counselors Both (A) and (B) Neither (A) nor (B)

Both (A) and (B) Rationale: Standard 2.4 REQUIRES PALLIATIVE CARE SERVICES be AVAILABLE to the PT(s). Services may be offered either on-site or by referral. The multidisciplinary PALLIATIVE CARE TEAM INCLUDES PHYSICIANS and NON-PHYSICIANS. A member of the facility's palliative care team is REQUIRED TO BE A CANCER COMMITTEE MEMBER. Depending on the scope of the program, the on-site palliative care services might be offered by physicians, nurses, social workers, mental health professionals, and spiritual counselors. If needed services are not offered on-site at the facility, a formal referral to either another facility or agency is required.

Palliative care services include Response : -Psychosocial support for families -Bereavement support for provider team members who cared for the deceased person -Both (A) and (B) -Neither (A) nor (B)

Both (A) and (B) Rationale: Standard 2.4 states palliative care services BEGIN AT THE TIME of DX and are CONTINUOUSLY AVAILABLE THOUGHOUT TX, F/U and BEREAVEMENT. These services are INTENDED TO OPTIMIZE the QOL by providing support for the patient, family and provider team. These services include psychosocial and bereavement support for all these individuals. In addition to the services mentioned above, palliative care also includes the following types of services: Team-based care planning Communication among provider team members, patients and families Continuity of care Pain and symptom management Spiritual counseling Hospice care

When a community needs assessment is completed, it Response : Identifies gaps and barriers to providing needed services Identifies health care disparities Both (A) and (B) Neither (A) nor (B)

Both (A) and (B) Rationale: Standard 3.1 states the CNA must IDENTIFY BARRIERS that PREVENT TIMELY ASSESS to DIAGNOSTIC and TX SERVICES and IDENTIFY HEALTH DISPARITIES and ANY SHORTFALLS in RESOURCES AVAILABLE to ADDRESS ISSUES. Barriers to providing needed services may be related to the patient, provider or the heath system. FACTORS ASSOCIATED W/ UNDERSERVED pops, race, ethnicity, gender, and socioeconomic status CAN IMPACT the HEALTH DISPARITIES (differences) that EXIST IN THE COMMUNITY. Patient navigation OFFERS SPECIALIZED HELP TO PTS, FAMILIES and their CAREGIVERS to OVERCOME any EXISTING BARRIERS and GAPS IN SERVICES (or access to services) so the PT RECEIVES QUALITY CARE.

Which of the following is an example(s) of a "pivotal" medical visit requiring at least one psychosocial screening? Response : -After chemotherapy ends but before radiation therapy begins -After all therapy ends -Both (A) and (B) -Neither (A) nor (B)

Both (A) and (B) Rationale: Standard 3.2 describes a few examples of PIVOTAL MEDICAL VISITS requiring at least 1 PSYCHO SOCIAL SCREENING as being: -TIME OF DIAGNOSIS -PRIOR to the INITIATION of TX (e.g., radiation, chemo) -TRANSITIONS DURING TX (e.g., AFTER RT ENDS but BEFORE CHEMO BEGINS) -TRANSITIONS OFF TX

Who can discuss the Survivorship Care Plans (SCP) with the patient? Response : Physicians Advanced Practice Nurses Both (A) and (B) Neither (A) nor (B)

Both (A) and (B) Rationale: Standard 3.3 requires that the Survivorship Care Plan (SCP) include INPUT from the PHYSICIAN and ONC CARE TEAM MEMBERS who COORDINATE THE TREATMENT for the patient. RELEVANT TX INFO provided BY OUTSIDE PROVIDERS SHOULD ALSO BE INCLUDED. The SCP can be DISCUSSED AND PROVIDED to the PT by ANY ONE of the FOLLOWING PROVIDERS from the PT'S CARE TEAM including: Physicians Registered Nurses Advanced Practice Nurses Nurse Practitioners Physician Assistants Credentialed clinical navigators (which does NOT INCLUDE LAY NAVIGATORS)

The patient care improvements are required to be Response : Sent to all of the medical staff Sent to administration Both (A) and (B) Neither (A) nor (B)

Both (A) and (B) Rationale: Standard 4.8 requires that the PT CARE IMPROVEMENTS BE REPORTED in the cancer committee minutes and shared with all of the medical staff and administration.

Methods to obtain follow-up information include Response : Contacting other facilities/hospitals Using internet sources to locate people Both (A) and (B) Neither (A) nor (B)

Both (A) and (B) Rationale: Standard 5.3 lists CONTACTING OTHER FACILITIES involved in the care of the patient and using internet services (e.g., death index, voter registration files, obituary listings) as two potential sources of follow-up information for required analytic patients who were diagnosed and received all or part of first course treatment at your facility. Other examples of active or passive follow-up sources used to verify the patient's vital status include contacting the patient's health care providers, obtaining dates of service associated with inpatient or outpatient services offered at your facility, contacting the patient or family members directly by phone or mail, pathology reports, and death certificates.

The purpose of follow-up is Response : To evaluate cancer care outcomes To compare cancer program data with other sources Both (A) and (B) Neither (A) nor (B)

Both (A) and (B) Rationale: Standard 5.3 states that LONG-TERM F/U is ESSENTIAL TO EVALUATE CA CARE OUTCOMES and that ACCURATE F/U INFORMATION ALLOWS THE CA PROGRAM to COMPARE ITS OUTCOMES W/ REGIONAL, STATE, AND NATIONAL STATISTICS.

The NCDB data can be used for Response : Monitoring changes and variations in patient care Benchmarks for a quality improvement project Both (A) and (B) Neither (A) nor (B)

Both (A) and (B) Rationale: Standard 5.5 states that the NCDB MAY BE USED to MONITOR CHG(S) and VARIATIONS OF PATTERNS of CARE and for CONTINUOUS QUALITY IMPROVEMENT (QI) for cancer programs.

Special studies are designed to Response : Provide feedback to improve patient care Set performance benchmarks Both (A) and (B) Neither (A) nor (B)

Both (A) and (B) Rationale: Standard 5.7 states that HYPOTHESIS BASED special studies are designed to EVALUATE PT CARE, SET BENCHMARKS, and PROVIDE FEEDBACK TO USE IN QUALITY IMPROVEMENT PROJECTS.

The following are NCDB reporting tools available through the CoC Datalinks Portal Response : NCDB Hospital Comparison Benchmark and Survival Reports CP3R and RQRS Both (A) and (B) Neither (A) nor (B)

Both (A) and (B) Rationale: The NCDB Reporting Tools AVAILABLE THROUGH the CoC Datalinks Portal include the NCDB Hospital Comparison Benchmark Reports, NCDB Survival Reports, Cancer Program Practice Profile Reports (CP3R) and the Rapid Quality Reporting System (RQRS).

Which hospitals are required to submit data to the state cancer registry? A.Hospitals with CoC approved cancer programs B. Hospitals without CoC approved cancer programs C. Both (a) and (b) D. Neither (a) nor (b)

Both (a) and (b)

Benign Brain Tumor Cancer Reg Amendment

Brain, meninges, spinal cord, cause equine, cranial nerve, pituitary gland, pineal gland, and craniopharyngeal duct

Tort

Breach of confidentiality (by CTR)

Right skew

Bulk of data on left

Left Skew

Bulk of data on right

5. How can a Commission on Cancer (CoC)-trained consultant assist a program?

By guiding the cancer committee to understand their role

documenting policies and procedures for routine usage and dissemination of confidential data

By law and regulation, each organization should protect confidential data by

Case definition includes: A. A list of collected data items B. Follow-up policy C. Identification of population covered D. Security control provisions.

C

Match one of the registries in the column with it's purpose: A. AFIP DNA Registry B. Nun study C. National Marrow Donor Program D. Trauma Registry E. Advance Directive Registry. Purpose: Finding transplant matches

C

Of the registries listed, which goes with: Monitor surgical procedure. A. Tremolite Asbestos Registry B. Birth Defects Registry C. Intestinal Transplant Registry D. Breast Health Registry E. GIST Registry.

C

Which is not a current trend in registry software development? A. Writing programs to perform specific registry functions. B. Writing programs that facilitate transmission of data between registries C. Writing programs that open registry databases to general public inquiries D. Writing programs that link registry data with case management functions.

C

Which of the following types of cases that failed an edit would not be written to the NCDB data warehouse? (Check all that apply) A. Cases with a data quality score of zero B. Cases that accumulate a data quality score between 1 and 199 C. Cases that accumulate a data quality score of 200 or greater D. Cases that received "rejection edits"

C, D

Match the registries in the column with main supporting agencies. (May be more that one) A. Early Rheumatoid Arthritis Treatment Evaluation Registry B. National Exposure Registry C. Alzheimer's Disease Registry D. United Stated Eye Injury Registry E. Environmental Polymorphism Registry F. Lupus Registry G. Special Needs Emergency Registry H. Temporomandibular Joint Replacement Registry I. Cystic Fibrosis Registry J. Lamotrigine Pregnancy Registry Supporting Agency: State government

C, G

Which hospitals are required to submit data to the state cancer registry? Response: A. Hospitals with CoC approved cancer programs B. Hospitals without CoC approved cancer programs C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b)

A patient may recover damages from a healthcare institution when Response : A. Confidential data was unintentionally released. B. The institution did not use reasonable procedures to protect confidential data. C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) A patient may recover damages from a healthcare institution when confidential data was unintentionally released and also when the institution did not use reasonable procedures to protect that confidential data.

Cancer registries in the United States have the reputation of being the most complete and highest quality public health surveillance systems because of A. The training and certification of Certified Cancer Registrars (CTRs). B. Comprehensive case identification. C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Cancer registries in the United States have the reputation of being the most complete and highest quality public health surveillance systems because of standardized case definitions and data elements, comprehensive case identification, and the rigorous training and certification procedures for cancer registrars.

Which goal(s) is hoped to be achieved through Meaningful Use compliance? Response : A. More robust research data on health systems B. Empowered individuals C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Meaningful use requires implementing certified electronic health record (EHR) technology to: Improve quality, safety, efficiency, and reduce health disparities Engage patients and family Improve care coordination, and population and public health Maintain privacy and security of patient health information Ultimately, it is hoped that the meaningful use compliance will result in: Better clinical outcomes Improved population health outcomes Increased transparency and efficiency Empowered individuals More robust research data on health systems

Information technology security risks are inherent in Response : A. Emails. B. Internet usage. C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) SECURITY RISKS are INHERENT in EMAIL AND INTERNET, with DIRECT INGRESS and EGRESS from the OUTSIDE WORLD INTO AND OUT of AN ORGANIZATION'S NETWORK.

Without administrative permission, data may not be transmitted to A. The central registry. B. NCDB. C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) Unless there is administrative permission, data may not be transmitted by phone, paper, or electronically to the central cancer registry or any other entity. Administrative permission is required even though state law requires transmission to central registries.

The hospital cancer registry data set should include A. Data items required by the State registry. B. Data items required by the hospital. C. Both (a) and (b) D. Neither (a) nor (b)

C. Both (a) and (b) The DECISION about WHAT ITEMS to INCLUDE in the HOSP REGISTRY DATA SET is BASED ON the GOALS of the REGISTRY and the PLANNED USES of the DATA COLLECTED. CRITICAL to this decision is EVALUATING the NEEDS and REPORTING REQUIREMENTS of the following: FUNDING SOURCES such as the HOSPITAL, SEER or NPCR STATE HEALTH DEPARTMENT SPECIAL INTEREST GROUPS REGISTRY (items to support and monitor internal activities) The collection of some data items may be limited to certain primary sites or for a defined period of time.

What term refers to a unique numeric identifier assigned to machines on the Internet or an intranet? Response: A. URL B. Web address C. IP address D. None of the above

C. IP address

What term refers to a unique numeric identifier assigned to machines on the Internet or an intranet? Response : A. URL B. Web address C. IP address D. None of the above

C. IP address The IP address is a unique numeric identifier assigned to machines on the Internet or an intranet. This 32-bit numerical address is used so machines can identify and locate each other for the purpose of sending and receiving data. The URL and the web address are terms with the same meaning. They both represent address strings containing the access protocol, domain name, and file or resource path which is normally used to specify the address of a web page, image, or other document on the Internet.

findings necessary to provide quality patient care? Response : A. LOINC B. CAP C. SNOMED D. None of the above

CAP

develops protocols and checklists used in pathology reports

CAP (college of american pathologists)

What CoC program does ACS award funding to on annual basis

CLP

representing 28 national provincial organizations, the commission seats multi-disciplinary cooperation and cancer management. It establishes standards for approval of cancer programs, simulates cancer programs and institutions and committees, develops nationwide patient care evaluation studies of specific organ sites and types of malignancy as well as symposia and postgraduate courses on cancer for physicians

COC COMMISSION ON CANCER OF THE AMERICAN COLLEGE OF SURGEONS (NATIONAL)

Inter-record Edits

COMPARE DATA on MORE THAN ONE RECORD. These types of edits are RUN ACROSS RECORDS for PATIENTS that have MULT PRIMARIES. These EDITS COMPARE CODES RECORDED IN the SAME DATA ITEM BETWEEN EACH of the TUMOR RECORDS FOR the PATIENT. For example, SEX and BIRTHPLACE would EXPECT to be CODED THE SAME FOR ALL PRIMARIES.

Inter-field Edits

COMPARE the CODES RECORDED for ONE DATA ITEM WITH CODES RECORDED for RELATED DATA ITEMS to ACCESS CORRECTIVENESS in coding ALL involved FIELDS. For example, an inter-field edit would IDENTIFIES a MALE (SEX= 1) CODED as having an OVARIAN PRIMARY (C569). At least one of these fields is incorrect because males cannot have ovarian primaries. It is possible for these types of edits to confirm upon review that both fields were INCORRECTLY CODED. For example, the actual case may involve a FEMALE (Sex = 2) W/ a RENAL PELVIS PRIMARY (C659).

server

COMPUTER OR DEVICE on a network that MANAGES NETWORK RESOURCES.

HIPAA Patient Safety Rule

CONFIDENTIALITY provisions PROTECT IDENTIFIABLE INFORMATION being used to ANALYZE PATIENT SAFETY EVENTS and IMPROVE PATIENT SAFETY

The application that allows CoC-accredited cancer programs to compare patterns of care and assess their own trends of care for breast and colorectal cancer is called:

CP3R

Computer-Based Patient Record Institute

CPRI

Blends your findings with physician findings to help create less error

CSv2 (collaborative staging version 2)

2007, 2010 and later

CSv2 began in _____ and is used for patients diagnosed in _____.

T-Test

Calculates whether statistical difference between means used

Statistics

Can be used to describe the characteristics of a sample in order to infer the characteristics of the population sample is subset of total population

The Cancer Liaison Physician (CLP) Response : Can serve an unlimited number of 3-year terms Can be an Ambulatory Care Staff physician Both (A) and (B) Neither (A) nor (B)

Can serve an unlimited number of 3-year terms Rationale: Standard 4.3 requires that the Cancer Liaison Physician (CLP) serves a leadership role within the cancer program, is a member of the cancer committee and REPORTS to the cancer committee at least 4xs EACH CALENDAR YEAR. This individual monitors, interprets and updates reports of the cancer program's performance using National Cancer Data Base (NCDB) data, which helps evaluate and improve the quality of care. The standard also states that the CLP SERVES A 3 YEAR TERM and MAY SERVE AN UNLIMITED # OF TERMS AS LONG AS his/her PERFORMANCE IS ACCEPTABLE to the CoC and the CA COMMITTEE. The CLP must be an ACTIVE STAFF MEMBER and DOES NOT SPECIFY WHETHER the PHYSICIAN has to be a PARTICULAR SPECIALIST (e.g., oncologist, hematology specialist, or surgeon). However, the physician CANNOT BE AMBULATORY CA, CONSULTING or COVERAGE STAFF PHYSICIAN.

caBIG

Cancer Biomedical Informatics Grid that is sponsored by NCI; network that allows constituents in cancer industry to share data and knowledge

Rejected NCDB cases are monitored by

Cancer Committee

Annually, the American Cancer Society (ACS) publishes

Cancer Facts and Figures

The Commission on Cancer's ________________ ________________ ___________________ ________________ ___________________ provides feedback to the CoC-accredited cancer programs on their performance to cancer quality measures.

Cancer Program Practice Profile Reports (CP3R)

The National Program of Cancer Registries' objectives are outlined in the:

Cancer Registries Amendment Act

The National Program of Cancer Registries' objectives are outlined in the ____________________.

Cancer Registries Amendment Act.

Observed survival

Cancer cases expected to die from all causes

Relative Survival

Cancer cases expected to die from cancer

Follow up letter are approved by

Cancer committee, hospital admin, or governing agency

What roles can CTR hold?

Cancer conference coordinator, cancer registry quality coordinator

"The use of evidence-based prevention, early detection, diagnosis, treatment, and continuing care intervention strategies to reduce cancer incidence, morbidity, and mortality in defined populations."

Cancer control.

The rate at which the general population dies of cancer in a certain time period.

Cancer mortality rate

Death Certificate Only

Cancer on death certificate but can't track patient back to a hospital; should be less than 2%

The NCDB contains data submitted by:

Cancer programs accredited by the CoC

Conflict of Interest/Duality of Interest

Cancer reg exploits the relationship between their hospital and an outside consulting company

malignant, benign brain and spinal tumors, basal cell, squamous cell, cervical

Cancer registries collect data only on ______ cancers and _____. They do not collect data on ____, ____, and ____ cancers.

Define the term confidential health information and provide examples of confidential health in- formation that is processed by cancer registries.

Cancer registry personnel routinely collect, evaluate and interpret, and disclose patient identification information and detailed medical histories referred to as confidential health information. You may have named any of the following examples: Names Addresses Dates Telephone and fax numbers E-mail addresses ID numbers such as medical record numbers Health plan beneficiary information Account, certificate, license numbers Text fields

NCRA represents

Cancer registry professionals and CTRs; liaison between partner organizations involved in cancer registry profession

Net Survival

Cancer specific; hypothetical probability; relative survival or cause specific survival

Four section of budget

Capital expenditures, salaries, supplies, fixed costs

Surveillance Informatics

Capturing and transferring data through comp programs

Surveillance informatics refers to

Capturing and transferring data through computer programs

planned use of the data

Casefinding timeliness in a central registry is determined by

Planned use of the data and the agency(ies) to which the central registry reports

Casefinding timeliness in a central registry is determined by the

"lost" to follow-up

Cases are considered ______ if no patient contact has been made within the previous15 months

analytic cases

Cases diagnosed elsewhere but not treated prior to coming to your hospital

analytic cases

Cases originally diagnosed in your hospital

Reporting cases to the central registry

Cases should pass NAACCR standard edit before being submitted to the central registry

non-analytic cases

Cases treated elsewhere are

CDC

Center for disease Control

on an ongoing basis

Central registry monitoring of facility case completeness should be performed:

program management

Chapter 1 of the CoC standards is _____.

15 to 30 participants Determine safe dosage Decide how the drug should be administered Observe the effects of the drug on the body

Clinical Trail Phase I

detect cases with potentially incorrect or absent treatment information

Clinical edit checks developed for breast and colorectal cancer cases that are submitted to the National Cancer Data Base (NCDB) were created to _____________________________.

Rapid Quality Reporting System (RQRS)

CoC quality tool maintains a prospective alert system to indicate the anticipated care for breast and colorectal cancer patients in order to help support the coordination services offered to each patient

80, 90

CoC requires that cancer registries follow up on _____ percent of patients from reference date and _____ percent of patients diagnosed within the last 5 years.

ACoS

CoC, NCDB, AJCC

ACos components include what 3 organizations

Coc (standards), NCDB (database), AJCC (staging)

Coc publishes

Coc Standards and the Store Manuel

Which hospitals are required to submit data to the state cancer registry?

Coc approved and non coc approved programs

Virus

Code loaded onto a comp without ur knowledge

Population-based registry

Collect all cases for a defined population

3rd highest incidence and mortality rate in men and women

Colon/ rectum

What is the only leading cancer site group ranked the same for both new cancer cases and deaths for both men and women based on 2009 estimates.

Colorectal cancer is ranked #3 for both men and women and for both new cases and deaths.

CoC (under the umbrella of ACoS)

Commision on Cancer

CoC

Commission on Cancer

cancer registry, their manual, FORDS

Commission on Cancer approved programs maintain a _____ and follow _____ entitled ____.

What organization compiles the National Cancer Data Base and heads the Approvals Program for hospitals in the United States?

Commission on Cancer of the American College of Surgeons

What organization compiles the National Cancer Data Base and heads the Approvals Program for hospitals in the United States?

Commission on Cancer of the American College of Surgeons

Specialty cancer registries include

Commission on Cancer's National Cancer Data Base (NCDB). Registries that collect information on familial or hereditary cancers, such as the Gilda Radner Familial Ovarian Cander Registries Registries that collect information on specific cancer sites, such as the Central Brain Tumor Registry of the United States (CBTRUS)

Who implements cancer control programs

Community organizations

Inter-field edits

Compare code for one data item with codes recorded for other data items

Inter-record Edit

Compare data on more than one record

Clinical Trial phase III

Compare new treatment with the standard treatment

QC benchmarking

Compares processes and performances to best practices; CP3R

Visual Editing

Compares text in abstract to coded data items

Benchmarking

Comparing your registry's practice and performance to other registries

Represents the proportion of people alive on a certain day who previously had a diagnosis or the disease, regardless of how long ago the diagnosis was, or if the patient is still under treatment or is considered cured (http://srab.cancer.gov/prevalence/).

Complete prevalence

Quality control

Completeness, accuracy, and timeliness Perhaps the three most time-consuming and knowledge-intensive activities for registry staff is resolving edits and reconciling duplicates and death clearance Some central cancer registries have 20% of their annual caseload linked as duplicate records. Cancer registrars at the central registry also conduct re- abstracting and case completeness audits on a random basis at reporting facilities. At the end of the audit, the central cancer registry is able to provide a percent of accuracy. A common benchmark for this is around 96% accuracy. Most of the cancer registrar's time at the central cancer registry is spent in the office resolving edits, reconciling duplicates and completing death clearance activities. However, conducting audits can be quite time-consuming as well because doing so requires traveling to the reporting facility, spending several days onsite, and then taking time afterwards to complete the reports.

Random Access Memory (RAM)

Computer location where instructions and data are stored on a temporary basis. This memory is volatile.

data standardization

Computerized edits programs were developed to promote

replace registrar, untrained staff, registrars work load

Computerized registry does not allow hospital to _____ with _____ or reduce _____.

track down doctors, tracking down of hard to follow patients

Computerized registry does not prevent need to _____ or make ______ easier.

abstracting

Computerized registry does not save time in _____.

Completing an abstract as information becomes available is called ____________ abstracting.

Concurrent

The best way to determine how much time to allocate reg staff is

Conduct a step assessment and time motion study

Confidentiality

Confidential data must be reported to the state and then the central registry is responsible for keeping the individual identity confidential The central registry may disclose aggregate data, to the public

Cancer registry policy and procedure manual must cover

Confidentiality and release of information

Where was the first cancer registry in the U.S. ?

Connecticut

The first truly population based registry in the US was

Connecticut Cancer Registry

The first course of treatment

Consists of all cancer-directed treatment regardless of where it takes place

data set

Consists of five components: -incidence -cancer types -extent of disease -treatment -survival

Active Follow Up

Contacting physicians or patients directly

a mapping can be done between the historic data items and the new data item

Continuity of data over time means that

HIPPA Technical safegaurds

Control access to computer systems

HIPPA Physical Safegaurd

Controlling physical access

What do you do if cases are rejected?

Correct and re-submit to the state registry

What Management report would a central registry create for distribution

Corrections performed on cases submitted be reporting facility Registrar

frequency distribution category data

Count the number of times an observation fits into a category the number of males and the number of females

____________________ _____________________are descriptions of key elements in the process of care that should be accomplished to achieve maximum quality and maximum cost.

Critical pathways

Match one of the registries in the column with it's purpose: A. AFIP DNA Registry B. Nun study C. National Marrow Donor Program D. Trauma Registry E. Advance Directive Registry. Purpose: Preventing accidents

D

Of the registries listed, which goes with: Integrate treatment management. . A. Tremolite Asbestos Registry B. Birth Defects Registry C. Intestinal Transplant Registry D. Breast Health Registry E. GIST Registry.

D

The NCDB uses ____________ to identify duplicate cases. A. The patient's name B. The patient's Social Security Number C. The patient's primary site and histology D. A contextual code based on scientific data item code values from the record.

D

The National Cancer Data Base (NCDB) provides the means for all of the following except: A. Comparative Analysis to examine patterns of care. B. Active monitoring of cancer care in the United States C. Important information to those interested in the care of cancer patients D. Population-based statistics

D

The primary method of evaluating the quality of data during submission to the NCDB is the use of: A. Reabstracting Audits B. Visual Review C. Special Reports and Studies D. Edits

D

Match the registries in the column with main supporting agencies. (May be more that one) A. Early Rheumatoid Arthritis Treatment Evaluation Registry B. National Exposure Registry C. Alzheimer's Disease Registry D. United Stated Eye Injury Registry E. Environmental Polymorphism Registry F. Lupus Registry G. Special Needs Emergency Registry H. Temporomandibular Joint Replacement Registry I. Cystic Fibrosis Registry J. Lamotrigine Pregnancy Registry Supporting Agency: Not-for-Profit organization

D, I

A necessary element for a real-time reporting system is Response: A. Adequate cancer registry staff. B. Efficient transmission of data from the hospital to the central registry. C. Cooperation between the hospital and central registry. D. Data source streams from key departments of the facility

D. Data source streams from key departments of the facility

A necessary element for a real-time reporting system is Response : A. Adequate cancer registry staff. B. Efficient transmission of data from the hospital to the central registry. C. Cooperation between the hospital and central registry. D. Data source streams from key departments of the facility.

D. Data source streams from key departments of the facility. A necessary element for real-time reporting is the AVALIBILITY OF DATA source streams from the key departments within the facility (e.g., +admissions, +radiology, +oncology, +pathology). These DATA STREAMS must be BROUGHT TOGETHER in a SINGLE STRUCTURED, ╝standardized database╝ or a ╝data stream╝ that can be transmitted to the hospital or central registry. WITHOUT this capability, REAL-TIME reporting would be VERY DIFFICULT and TIME-CONSUMING to implement.

Professional development Response : A. Occurs once a year when attending annual meetings. B. Is accomplished through volunteerism. C. Is accomplished through networking. D. Is self-motivated and self-directed.

D. Is self-motivated and self-directed. Professional development is continual and requires a registrar to be both self-motivated and self-directed. Professional development does not occur once a year; it is an ongoing process. While volunteerism and networking play significant roles in professional development, they do not describe what the entire process entails to be successful.

All states and the District of Columbia have laws, regulations or statutes requiring healthcare facilities and providers to report cancer data to Response : A. The Surveillance, Epidemiology, and End Results (SEER) program. B. National Program of Cancer Registries (NPCR). C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) All states and the District of Columbia have laws, regulations or statutes requiring healthcare facilities and providers to report cancer data to either the state registry or the central registry in their region.

Registry staffing needs can be assessed by Response : A. Caseload divided by staff. B. Comparison with like facilities. C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) Determining staffing levels by simply dividing the caseload by the number of staff fails to take into consideration that there are a number of other activities involved in registry operations that involve time such as Casefinding Follow-up Chart location logistics Cancer committee meetings and preparation Cancer conferences Audits Patient care studies Data requests Other administrative duties A comparison with like facilities may also not be accurate because the goals and mission of individual facilities may be different which will impact the staffing level at each facility. Registry staffing needs are better determined when the following is considered: Understand the facility type to help determine the registrar's role in achieving its mission. Calculate the ease of access to and use of the facility's health records. Determine the training, hardware/software and maintenance costs associated with using a registry specific software application to collect cancer data. Conduct time and motion studies to identify all tasks performed by the registry and associated times for those tasks (e.g., casefinding, abstracting, follow-up, ease of moving around in the electronic medical record (vs chart location logistics), cancer committee meetings and preparation, cancer conferences, audits, patient care studies, data requests, and other administrative duties. Determine the type of staff (e.g., CTRs, clerical support, contractors) needed to perform the various activities identified.

Disciplinary actions for breaches of confidentiality are Response : A. Up to the manager's discretion. B. Do not apply to upper management. C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) Disciplinary actions for breaches of confidentiality are defined in the policies and procedures and are not up to the manager's discretion. Disciplinary action must apply to all levels of the organization, which includes upper management.

What expression(s) is used to describe the capability of different registries being able to read, write and exchange data via a common set of exchange formats? Response : A. Standard data item B. Data submittals C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) Interoperability is the term used to describe the capability of different registries being able to read, write and exchange data via a common set of exchange formats. Maintaining interoperability is dependent upon the use of the same coding instructions, code values and code options to avoid any special effort on the part of registry organizations to use one another's files. A standard data item refers to a data item whose coding instructions, code values and definitions are shared among the registry organizations. Data submittals refer to the process of extracting data from the registry database system for submission to another entity (e.g., funding agency).

HIPAA provides individuals with the right to review their records. State registries may Response : A. Refer the individual to the original point of care (physician's office, hospital, etc.) to obtain this information. B. Honor the request to view records immediately if the only record of care is at the state registry. C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) State cancer registries must review applicable state law related to the access of information to an individual's own records to determine which requirements apply to them. If applicable, the state registry should define the following: Acceptable means for providing the contents of the applicable medical records Procedures for filing the requests for information Timelines for supplying the information (within regulatory requirements) Format used to supply the information Cost to be charged to provide the information

Specialty cancer registries may collect data A. From specific facilities. B. On familial cancers. C. Both (a) and (b) D. Neither (a) nor (b)

D. Neither (a) nor (b) Specialty cancer registries can collect and maintain data from: Specific facilities, as NCDB does from only ACoS approved facilities Specific cancer sites, such as the Central Brain Tumor Registry of the United States (CBTRUS) Specific familial cancers, such as the Gilda Radner Familial Ovarian Cancer Registries

What term refers to an element in a document on the web that links to a whole document or to a specific element within a document? A. Collaborative software B. Encryption C. File extension D. None of the above

D. None of the above Hyperlink is an element in an electronic document on the web that links to a whole document or to a specific element within a document. Hypertext is text with hyperlinks. In hypertext, a hyperlink is reference to another web page, document, or other file type. Clicking on a link will usually take you to said page, document, or file. Collaborative software is application software designed to help people involved in a common task achieve goals by incorporating knowledge management into business processes so employees can share information and solve business problems more efficiently. Using this type of software (e.g., Microsoft Sharepoint, Google Apps, WebEx) a group of individuals are allowed the use of shared calendars, surveys, document libraries and shared task lists.

What type of edits checks one data field at a time? Response : A. Inter-field edits B. Inter-record edits C. Over-ride edits D. None of the above

D. None of the above Rationale: Single Field Edits (also known as Item Edits) are those that verify and validate the field values for ONLY ONE DATA ITEM AT A TIME. For example, a single field edit for the item "BIRTHPLACE" would verify that ONLY VALID CODES for BIRTHPLACE are USED IN THE FIELD. Keep in mind that single field edits are SIMPLY RANGE CHECKS (i.e., these edits INDICATE A VALID CODE was USED); they CANNOT IDENTIFY whether the FIELDS WERE ACTUALLY CODED CORRECTLY. In this example, a case WILL PASS the birthplace single field EDIT IF a CODER USES the CODE for the STATE of OREGON for a PATIENT who SHOULD HAVE HAD CALIFORNIA CODED as the BIRTHPLACE. While a valid code was used, the correct code was not.

Which statement regarding web applications is not true? Response : A. The latest release of the application is generally the only version of the application available to users on a given browser. B. Web applications can be accessed by devices with a web browser including desktops, laptops, tablets, and smart phones. C. Either the internet or network connection is required to use/access a web application. D. None of the above

D. None of the above The latest release of the application is generally the only version of the APPLICABLE available to users on a given browser. Web applications update themselves automatically resulting in the latest version appearing with all the newest features and improvements included. Occasionally, web applications maintain slightly different versions of the product if there are browser incompatibility issues that have yet to be resolved prior to the release of latest version of the product. All electronic devices with a browser including desktops (PC or MAC), laptops, tablets and smart phones can access the same web application because the web is an open platform. However, tablets and/or smart phones may not be able to provide the user with sufficient screen display or navigational means to use some or all of the functionality of the web application. Web applications are dependent on a server to deliver the application to your web browser. Without an internet or network connection, the browser will not be able to load the web application.

Typically, the largest line items in the registry budget are Response : A. Use of space in the facility which includes maintenance, electricity, heat, etc. B. Computers, desks, paper, fax machines, and telephones. C. Software programs and IT support. D. Salaries and benefits.

D. Salaries and benefits.

The laws that take precedence over all other laws are Response : A. Federal laws. B. State laws. C. City or municipal laws. D. State laws that are more stringent than Federal laws.

D. State laws that are more stringent than Federal laws. There is a hierarchical structure of legal precedence in this country. Generally, federal laws have precedence over state laws and state laws have precedence over city/municipal laws. However, if a state or city/municipal law is stricter than a federal law, it can take precedence.

Congress granted regulatory powers to the following agencies Response: A. The Surveillance, Epidemiology, and End Results program (SEER) and the North American Association of Central Cancer Registries (NAACCR). B. The National Program of Cancer Registries (NPCR) and the North American Association of Central Cancer Registries (NAACCR). C. The National Program of Cancer Registries (NPCR) and the Commission on Cancer (CoC). D. The Surveillance, Epidemiology, and End Results program (SEER) and the National Program of Cancer Registries (NPCR).

D. The Surveillance, Epidemiology, and End Results program (SEER) and the National Program of Cancer Registries (NPCR).

Congress granted regulatory powers to the following agencies Response : A. The Surveillance, Epidemiology, and End Results program (SEER) and the North American Association of Central Cancer Registries (NAACCR). B. The National Program of Cancer Registries (NPCR) and the North American Association of Central Cancer Registries (NAACCR). C. The National Program of Cancer Registries (NPCR) and the Commission on Cancer (CoC). D. The Surveillance, Epidemiology, and End Results program (SEER) and the National Program of Cancer Registries (NPCR).

D. The Surveillance, Epidemiology, and End Results program (SEER) and the National Program of Cancer Registries (NPCR). The National Cancer Institute's (NCI) SEER program and the Centers for Disease Control and Prevention's (CDC) NPCR program BOTH HAVE CONGRESSIONAL REGULATORY POWERS THAT IMPACT CA WORK. Congress has empowered these two federal administrative agencies to make laws by passing "enabling legislation." When these agencies, which are both part of the U.S. Department of Health and Human Services, make such laws they are referred to as regulations. The NCI oversees the SEER program which is a national system of population-based registries established in 1971 when Congress passed the National Cancer Act. SEER data collection began in 1973 with a limited amount of registries and continues to expand to include even more areas and demographics today. Currently the following areas are covered by the SEER program: Alaska Native Tumor Registry Arizona Indians Cherokee Nation Connecticut Detroit Georgia Center for Cancer Statistics Atlanta Greater Georgia Rural Georgia) Greater Bay Area Cancer Registry San Francisco-Oakland San Jose-Monterey) Greater California Hawaii Iowa Kentucky Los Angeles Louisiana New Jersey New Mexico Seattle-Puget Sound Utah CDC oversees the NPCR program which was developed when Congress enacted the Cancer Registries Amendment Act in October 1992. Today, NPCR supports central cancer registries in 45 states, District of Columbia, Puerto Rico, and the U.S. Pacific Island Jurisdictions. NPCR covers approximately 96 percent of the U.S. population.

CAP protocols are required for resected specimens of Response : -In situ bladder cancer -In situ ductal carcinoma -Both (A) and (B) -Neither (A) nor (B)

DCIS

CAP protocol for in situ specimens

DCIS only

Name the five key components of a metafile.

Data Dictionary Record Layouts Edit Sets Standard Setting Agencies User Lookup Tables

Spatial analysis that involves reducing a small variation in an image to reveal trend

Data aggregation, spatial smoothing, cluster analysis

Metadata includes

Data dictionary, record layouts, edit sets, user look up tables, location, time and date of creation, purpose of data

DATA EDITS

Data edits test the data against the coding rules

Aggregate data

Data extracted from individual health records and combined to form de-identified information about groups of patients that can be compared and analyzed

Semantic interoperability is defined as

Data having a common meaning.

Semantic Interoperability

Data having common meaning

Central reg matches it data with data from DMV to determine date last alive for patients, this is

Data linkage

Behavior Risk Factor Surveillance System

Data on items such as obesity, exercise, smoking

Cancer registrars are:

Data specialists who collect cancer data from a variety of sources and report their results to various healthcare agencies

Edit programs promote

Data standardization

Computerized data edits were developed to promote

Data standardization.

CoC approved programs

Data submission to the National Cancer Database is required of ____.

death clearance follow back DCO death certificate only (<3% goal) path data computerized

Death clearance is both a data quality and a casefinding process. The CCR will obtain an electronic file of death records from vital records and link (or match) it with the registry database. The previously registered cancer cases are checked with the information on the death certificates to record cause of death and to verify place of birth and other patient identification. If the case has not been previously registered, steps are taken to gather complete information for inclusion into the central cancer registry. These steps are known as "follow back." Follow back is conducted with the last known health provider or health facility where the patient expired. A health provider is sent a letter that asks for more information on the patient's cancer. If the patient died in a health facility, a letter is sent to the facility asking that this patient's health information be abstracted and sent to the central cancer registry. Of course, there is always the possibility that the case was not "missed" by the facility but was not reported because after review, it was determined that it was not a reportable case. An example would be a patient who was diagnosed or treated before the central cancer registry's reference or start date. If all attempts to gather more complete data fail, the case is retained in the central registry as a death-certificate-only case (DCO). Registries strive to have less than 3% of their caseload as DCO cases. It is not beneficial to users of the data if the cases are not being identified until after the patient has died—often when details about the initial diagnosis and treatment are difficult to obtain. It is optimal to be identifying patients at the time they are being diagnosed and treated so that the information about the diagnosis and treatment are more accessible and reliable. Reporting pathology data is becoming an increasingly computerized process. A software system is able to select reports with a diagnosis of cancer from all pathology and cytology reports processed by the pathology laboratory. This information is matched against the central cancer registry to see whether the patient and this particular cancer had been reported. The pathology report does not contain all of the information necessary for a complete abstract. Therefore, the central registry must follow back to the managing physician or facility to obtain the complete information. If they are a reporting source for the central registry, the facility will be required to abstract the case and submit with their next transmission of data. If not, then the central registry will have to abstract and enter the case into the central registry database so that this cancer is counted. From a quality perspective, identifying cases through these other means allows the central registry and the reporting sources to identify problems in the casefinding and reporting procedures. Perhaps a particular type of case is inadvertently being omitted from casefinding reports, or the facility may not be applying the eligibility rules correctly and incorrectly determining that a particular type of case is not reportable. The goal is to communicate with reporting sources about cases being identified elsewhere that should have been reported by that facility. The facility can then review and hopefully improve their processes so that the identification of cases is taking place where it should be—at the facility that diagnosed or treated the patient.

FIREWALL

Defined as a system designed to prevent unauthorized access to or from a private network. Firewalls can be implemented in both hardware and software, or a combination of both.

Disciplinary actions for breaches of confidentiality are

Defined in policies and procedures

Non population based central registry includes

Department of Defense (ie military)

Non pop based central registries

Dept of defense (ACTUR); Dept of veterans affairs, NCDB

Peau d'orange

Dermal lymphatic invasion by breast cancer

content requirements of the annual report

Description of the goals, achievements, and activities of the cancer program Report of the cancer registry activities Statistical summary of cancer data In-dept statistical report on at least one major site, complete with survival analysis and narrative critique State, regional and national data comparison Findings of patient care evaluations and subsequent actions taken

A prevention program is Response : -Designed to reduce the incidence of a specific form of cancer -Designed to decrease the number of patients who initially present with late-stage disease. -Both (A) and (B) -Neither (A) nor (B)

Designed to reduce the incidence of a specific form of cancer Rationale: Standard 4.1 requires that prevention programs be BASED ON COMMUNITY NEEDS and be designed to reduce the incidence of a specific form of cancer. Screening programs are focused on decreasing the number of patients who present with late-stage disease.

Software companies contribute to registry infrastructure by:

Designing and providing electronic programs through which registry data are collected and transmitted.

Clinical trial phase II

Determine safety and efficacy of the treatment

Which matching method follows this rule: "A match cannot be made if one data file is missing a critical data field"?

Deterministic

Apparently

Diagnosis

Comparable with, compatible with, consistent with

Diagnosis

Favors

Diagnosis

Malignant appearing or most likely

Diagnosis

Presumed

Diagnosis

Probable

Diagnosis

Suspected

Diagnosis

Suspicious for

Diagnosis

Typical of

Diagnosis

Name three challenges to standardizing data edits.

Differing computer language in registry systems Standard specifications may be programmed differently Incomplete editing of data during data entry

Automating much of the casefinding

Digitized pathology records that are sent electronically provide the most benefit for the hospital registry byfp

A listing of patients seen in a hospital, both inpatient and outpatient, with ICD-9-CM diagnosis codes.

Disease Index

Name facility sources used to identify cases.

Disease indices, pathology and laboratory reports, patient logs, and other similar resources

Name facility sources used to identify cases

Disease indices; pathology and laboratory reports; patient logs and other similar resources

If cytology is identified only with an ambiguous term...

Do not interpret it as a diagnosis of cancer; abstract only if positive biopsy or physician clinical impression of cancer

After the Patient Navigation Process is established, the cancer committee is required to Response : Document activities and related outcomes associated with the patient navigation process Identify gaps and barriers to providing needed services Identify health care disparities Evaluate and report on the PNP at least once every three years

Document activities and related outcomes associated with the patient navigation process Rationale: Standard 3.1 states the cancer committee needs to DOCUMENT ACTIVITIES and RELATED OUTCOMES ASSOCIATED W/ the PT NAVIGATION PROCESS in the committee minutes EVERY CALENDAR YEAR. IDENTIFYING HEALTH DISPARITIES as well as GAPS AND BARRIERS to PROVIDING NEEDED SERVICES is part of the CNA that is analyzed prior to the development of the patient navigation process.

passive follow-up

Does not require direct contact with hospital or patients

Death clearance

Done every year

Stage system based on resection of tumor and measures depth of invasion through mucosa and bowel wall

Dukes

Neoplasm or Tumor

Dx only for brain/cns

Match one of the registries in the column with it's purpose: A. AFIP DNA Registry B. Nun study C. National Marrow Donor Program D. Trauma Registry E. Advance Directive Registry. Purpose: Making living wills accessible

E

Of the registries listed, which goes with: Measure efficacy of treatment drugs. A. Tremolite Asbestos Registry B. Birth Defects Registry C. Intestinal Transplant Registry D. Breast Health Registry E. GIST Registry.

E

Potential benefits of a diabetes registry include: A. Automated notification of clinic visits. B. Automated identification of uncontrolled blood sugar values C. Analysis of treatment regimen outcomes D. None of the above E. All of the above

E

Which of the following is not a Basic Data Item for central registries? A. Patient identification and demographics B. Cancer identification C. Hospital-specific (admission dates, class, and analytic status) data D. Stage and prognostic factors E. Optimum patient vitamin doses F. Treatment: first course and subsequent G. Follow-up H. Death I. Edit overrides J. System administration (case completed, changed) K. Patient, hospital, and physician L. Narrative text

E

Tamoxifen or Aromatase inhibitors are standard treatment for breast cancer patients who are

ER +

2

Each year, the cancer committee shall participate in at least ______ formal evaluations of the quality measures relevant to its improvement priorities

NAACCR administrative items

Edit Over rides

What is the name of the Edits feature that allows a user to note that the data are unusual, but correct?

Edit Over-ride

Single Field Edits (also known as Item Edits)

Edits that verify and validate the field values for only one data item at a time.

3. Name two purposes of the survey?

Education Evaluation

NCRA

Education and certification

To receive commendation, the cancer committee must develop and distribute a report on Response : Patient outcomes Program outcomes Either (A) or (B) Neither (A) nor (B)

Either (A) or (B) To receive commendation, Standard 1.12 requires that the CA COMMITTEE DEVELOP and DISTRIBUTE A REPORT on eitherPT OUTCOMES or on PROGRAM OUTCOMES each calendar year

All of the state cancer registries in the United States are required to submit their data to

Either CDC/NPCR or NCI/SEER

Disease Index

Electronically processed is a cross check on the pathology case finding

What is the primary role of the program coordinators?

Ensure that the activity for a specified program area fulfills the requirements

HIPPA Breach notification rule

Entities and business associates must provide Notification after breach

Descriptive stats

Enumerate, organize and graph

Rapid case ascertainment supports

Epidemiological research, clinical research and concurrent abstracting

Melanoma is most likely to develop in the

Epidermis

Selection bias

Error in choosing individuals or groups for study

NAACCR

Est consensus on standards, promote use of data, aggregate data (us and Canada), train cancer reg professionals

Cancer prevention programs may include Response : Establishing smoking/chewing tobacco cessation program Establishing a colonoscopy screening program Both (A) and (B) Neither (A) nor (B)

Establishing smoking/chewing tobacco cessation program Rationale: Cancer prevention programs can involve the use of drugs, vitamins, or other agents as well as the initiation or the cessation of activities that try to reduce the risk of, or delay the development or recurrence of, cancer. These programs also include activities that raise public awareness of cancer risks associated with specific forms of cancer. Standard 4.1 describes just a few examples of some cancer prevention programs including: Establishing smoking/chewing tobacco cessation programs to reduce the risk of developing lung and other smoking related cancers Educating the public on the dangers of UV ray exposure and tanning bed usage in developing skin cancer Educating the public about nutrition and physical activity changes and implementing weight loss programs that can reduce one's risk of developing cancer

Observed survival

Estimate of probability of survival for all cancer deaths

Nuremberg Code (1947)

Ethical principles governing clinical research

A primary objective for conducting epidemiological cancer surveys is to develop clues about

Etiology of cancer

Two large international studies focused on cancer survival are

Eurocare and Concord

The European Network of Cancer Registries (ENCR) was established in 1989 to improve the quality, comparability, and availability of cancer incidence data, and develop a basis for monitoring cancer rates in the ____________ ____________.

European Union

Casefinding audit

Evaluate a registries case completeness

Security management planning involves

Evaluating the flow of data through the organization

How often should a registry plan to replace desktop computers?

Every 3 to 5 years

NPRC requires central registries to do hospital audits on each hospital

Every 5 years

Medicaid

Every state runs its own program

How often does the cancer committee conduct a community needs assessment? Response : -Annually -Every two years -Every three years -Every four years

Every three years Rationale: Standard 3.1 states that the CANCER COMMITTEE or their DESIGNEE CONDUCTS a CNA EVERY 3 YEARS (ONCE DURING the 3-year SURVEY CYCLE). The CNA must IDENTIFY HEALTH DISPARITIES, BARRIERS that PREVENT TIMELY ACCESS to DIAGNOSTIC and TX SERVICES, and any SHORTFALL IN RESOURCES AVAILABLE TO ADDRESS these ISSUES. The PT NAVIGATION PROCESS is then ESTABLISHED to help patients, families and their caregivers OVERCOME EXISTING BARRIERS and GAPS IN SERVICES (or access to services) so the PT RECEIVES QUALITY CARE.

What does the metafile contain?

Everything necessary to edit the data, except the data

descriptive epidemiology

Examines the distribution of disease in a population

Autopsy only cases

Examples of nonanlytic cases for a typical hospital registry include

What is an objective of the American Cancer Society/Commission on Cancer partnership?

Expanding cancer awareness/information availability, as well as American Cancer Society (ACS) services delivery at the community level, increasing utilization of ACS services and programs at Commission on Cancer (CoC)-accredited cancer programs, engaging the Cancer Liaison Physicians in the CoC-accredited cancer programs to support implementation of local prevention and early detection programs and state cancer plans, and promotng CoC-accredited cancer programs and the quality of care provided at these facilities

Correlation Coefficient

Extent to which 2 variables are associated

Quality control encompasses: A. Data Definitions B. Personnel Training C. Data Edits D. Data submission tracking E. None of the above F. All of the above

F

What resource is used by COC programs as the basis for data collection

FORDS

Facility Oncology Registry Data Standards

FORDS stands for

CoC

Facility Oncology Registry Standards is published by ________________

All central registries have similar staffs, despite their objectives, caseload, and catchment area. a. True b. False

False

Assessing edits on a regular basis increases the time to review cases before submission

False

If the occupation code sometimes represents the patient's dominant lifetime occupation, sometimes the current occupation, and sometimes the most recent occupation, reliability can be improved by changing the codes applied.

False

Include Cancer Registry on mailing envelopes as the return address true or false

False

NAACCR has no role in managing the generation of new registry data items.

False

Rejected cases meet the specified data quality criteria in CoC Standard 3.7

False

Submission of Class of Case 6 is required

False

True or False: All National Program of Cancer Registries training materials are available with an annual subscription

False

True or False: Data evaluation results are only used to determine inclusion in publications.

False

True or False: Data standards are nice but not required for efficient registry operations.

False

True or False: E-path reporting refers to the capability of computers to find the shortest electronic path through the Internet's routers and servers, thereby saving money. a. True

False

True or False: For casefinding purposes, the Reportable List refers to Allowable drug compounds that are approved for treatment.

False

True or False: If an abstract is prepared by a hospital-based CTR, no quality control is necessary by the central registry.

False

True or False: It is better for each central registry to use its own coding systems to enhance security and confidentiality.

False

True or False: Passive follow-up methods are preferred, but they are more expensive.

False

True or False: Recent events, including computerization, and lessening the need for security and confidentiality of central registry data.

False

True or False: Registries are designed to collect every bit of available information about patients included in their databases.

False

True or False: Registry software just replaces paper-based ways of collecting and storing data

False

True or False: The abbreviation IRB stands for Internal Revenue Bureau.

False

True or False: The central registry is not obligated to use their data in any way.

False

True or False: The central registry need not be concerned with patients who live within their catchment area but are diagnosed or treated outside their catchment area.

False

True or False: The goals and objectives and characteristics of central registries and hospital registries are so similar they may be considered identical.

False

True or False: Well-documented cancer clusters, or hot spots, have been identified in more than 40 states.

False

The National Program of Cancer Registries (NPCR) Cancer Surveillance System (CSS) was authorized by National Cancer Act in 1971.

False The CDC-funded NPCR is a population-based system of cancer registries established in 1992 by the Cancer Registries Amendment Act (Public Law 102-515).

Specialty registries

Familia and site specific

Data Transmission should be faxed True or False

Fase

HIPPA Privacy Rule

Federal protection for PHI

annual sequential listing

First case in 2009 is 2009-0001; second is 2009-0002 etc

date of last contact, recurrence, subsequent treatments, vital, cancer, performance

Follow up information generally includes ______, _____ information, ______, and ____, _____, and ____ status.

treating facilities, physicians, patients, contacts, nursing homes, hospice agencies, SSA, state tax agencies, obituaries

Follow up may be obtained from _____ and _____, ______ and their ______, _____, _____, _____, _____, and _____.

the registry is electronic

Follow-up can be automated if?

a tickler file

Follow-up can be done manually using ?

Budget Fiscal year

For any 12 months

patient authorization

For follow up, patient PHI can be provided without ______.

cancer program administrator, oncology nurse, social worker, CTR, performance improvement professional, palliative care team member

For the cancer committee, the required non physician members include (6):

diagnostic radiologist, pathologist, general surgeon, medical oncologist, radiation oncologist, chair and liaison physician

For the cancer committee, the required physician members include (6):

6, 20, 2, 4

For university programs, ____ percent have to be on cancer-related clinical trials. For NCI cancer centers, _____ percent, VA programs, ______ percent, and Comphrehensive Community Hospitals _____.

eHealth Exchange

Formerly known as the Nationwide Health Information Network (often abbreviated as the NHIN or NwHIN), is an initiative for the exchange of healthcare information. The exchange is a web-services based series of specifications designed to securely exchange healthcare related data. The Office of the National Coordinator for Health Information Technology has been facilitating development of the NwHIN, which will tie together health information exchanges, integrated delivery networks, pharmacies, government, labs, provides, payers and other stakeholders in a "network of networks."

Serosa (peritoneum)

Front of ascending colon, front of descending colon and entire transverse colon

Peristalsis

Function of muscularis propria of intestines

_____________ presents incidence, prevalence, and mortality estimates from 27 cancers for all countries in the world

GLOBOCAN

Individuals contribute to registry infrastructure by:

Gathering and entering data into registry databases.

In addition to running the NCDB metafile, what other practice is beneficial to perform before NCDB file submission?

GenEdits Plus

Nominal data

Gender or race pie chart bar chart

Deterministic linkage application

Generates link based on the number of individual identifiers that match amount data sets; simple

Per an existing CoC standard, who is required to provide genetics counseling ? Response : -Attending physician -Genetics professional -Oncologist or hematologist -Surgeon

Genetics professional Rationale: Standard 2.3 requires that a GENETICS PROFESSIONAL provide GENETICS COUNSELING, cancer risk assessment and testing services. These services can be provided either ON-SITE or by REFERRAL to an off-site genetics professional.

Three-Year with Commendation

Given to new and established programs that comply with all standards and receive a commendation rating for one or more standards

Three-Year Accreditation

Given to new and established programs that comply with all standards but do not receive a commendation rating

Three-Year Accreditation with Contingency

Given when 1 to 7 standards are rated deficient for an established program or 1-2 deficiencies for new programs at the time of survey.

HITECH

Grants and funds for health organizations that successfully demonstrate meaningful use

LAN

Group of comp in close proximity

What are the four components of the Determinates of Quality?

Guidelines , performance measures, outcomes, and research and training

The gathering of healthcare information electronically across organizations within a region or community

HIE (Healthcare Information Exchange)

Which statement(s) is true regarding the National Provider Identifier (NPI)?

HIPAA covered entities must use only the National Provider Identifier (NPI) to identify covered health care providers in standard transactions.

1996

HIPAA was enacted in ____________.

A patient's right to personal privacy and confidential handling of medical records is covered under what important federal law concerned with health insurance portability?

HIPPA (Health Insurance Portability and Accountability Act of 1996) is United States legislation that provides data privacy and security provisions for safeguarding medical information.

American Recovery and Reinvestment act 2009

HITECH, promote adoption and meaningful use of health information technology

Produce standards/protocol for transmission of clinical and administrative data

HL7 Health Level 7 (a set of international standards for transfer of clinical and administrative data between software applications used by various healthcare providers. These standards focus on the application layer, which is "layer 7" in the OSI model.)

Where was the first known cancer registry?

Hamburg

Nurses who care for cancer patients must Response : Be certified to provide oncology care Have specialized knowledge and skills in oncology nursing Both (A) and (B) Neither (A) nor (B)

Have specialized knowledge and skills in oncology nursing Standard 2.2 requires that oncology nursing care be provided by nurses with specialized knowledge and skills. Oncology nurse certification, while NOT REQUIRED, IS STRONGLY ENCOURAGED.

Canada's provinces and territories administer publically funded health insurance programs by assigning a unique, lifetime identifier referred to as the _____________________.

Health Card Number

HIM

Health Information Management

Which program addresses the privacy and security challenges presented by electronic health information exchange involving multiple states?

Health Information Security and Privacy Collaboration (HISPC)

HISPC

Health Information Security and Privacy; privacy and security challenges with electronic health exchange; multistate

HIPAA stands for

Health Insurance Portability and Accountability Act

What does HL7 stand for and what is it?

Health Level Seven is a widely used data exchange standard in the healthcare industry.

HL7

Healthcare informatics Interoperability standards

Leading Cause of Death in US

Heart Disease

Radio frequency ablation uses

Heat Energy

The Goal of Cancer Registry (4)

Help prevent and control cancer; improve future pt care; assist in dx; aid in descion making and respond to local needs

Why would you want data outside of your catchment area? (from other states)

Help with Death Clearance, to have more complete data, reporting on residents diagnosed out of state

Trojan horse

Hides as benign application; do not replicate themselves

Continuous data is best represented by

Histogram

Incidence completeness

Historical data reviews are typically performed to asess __________________________. The procedure involves comparing the total number of cases expected with the number of cases actually observed over a period of time. Should the volume observed be lower than expected, checking the number of cases by primary site may help identify the cause for under-reporting (e.g., loss of service or physician specialty at the facility).

Surveillance, Epidemiology, and End Results (SEER) Program

Historically, the national reportability standards for central registries were established by the

Reed sternburg cells

Hodgkin lymphoma

Diethylstilbesterol

Hormonal Agent

Reporting cases to the American College of Surgeons National Cancer Database (NCDB).

Hospital cancer registry data management systems (DMS) support _________________

Types of Hospital based registries

Hospital, Network, Free Standing, military

Hospital Based registries

Hospital, network, free standing, military, veterans administration

Implement process controls

How can a registrar quickly identify whether unknown or ill-defined codes are used too frequently?

implement process controls and utilize computerized edits

How can a registrar quickly identify whether unknown or ill-defined codes are used too frequently?

Reviewing lag-time reports

How can registry timeliness be evaluated?

Data Set Reliabilty

How likely diff people will use the same code for a data item when reviewing the same source documents

12 months

How long does an established cancer program have to resolve a Commission on Cancer (CoC) deficiency if it received a "Three-Year Accreditation with Contingency" award following a survey?

34

How many CoC Standards are there?

160

How many hours of professional experience does a registrar need to be certified?

There are five main categories in the Summary Staging classification system: 1. In situ: Abnormal cells are present only in the layer of cells in which they developed. 2. Localized: Malignancy is limited to the organ in which it began, without evidence of spread. 3. Regional: Malignancy has spread beyond the primary site to nearby lymph nodes and/or adjacent tissues. 4. Distant: Malignancy has spread from the primary site to distant organs or lymph nodes. 5. Unknown: There is not enough information to determine the stage at diagnosis.

How many main stage groups exist in the Summary Staging classification system?

10% or 300 cases annually

How much of the annual analytic caseload must the cancer registry quality control plan outline?

HTTP stands for

HyperText Transfer Protocol.

What two organizations took over production of C15 with the third volume?

IARC and IACR

site, morphology, behavior, grading

ICD O 3 codes are a multi-axial classification of what four things related to neoplasms?

International Classification of Diseases for Oncology

ICD O stands for _____.

Coding classification for cancer sites and morphologies

ICD-O-3

Deterministic patient matching

Identical identifiers

Pre abstracting activities

Identify potentially reportable case, gather source documents, determine whether new or separate primary

non accredited

If an organization has 8 or more deficiencies, an organization will be _______.

Who is ultimately responsible for the developing of a cancer conference plan in a CoC-approved facility?

If the facility is approved by the CoC, the Cancer Committee is responsible. If the facility is not CoC approved, the facility should assign the responsibility to the individuals.

1. Determine whether the request can be altered using data routinely collected by the registry 2. If time and funding permit, perform a special study to collect the information requested. 3. Deny the request if the data cannot be obtained because of financial or legal constraints.

If the registry receives a request for information that it does not routinely collect, do the following:

Tumor Marker for multiple myeloma

Immunoglobulin

Herceptin

Immunotherapy

The purpose of the Cancer Regisrty Amendment Act

Improve exsisting cancer registries; plan and implement registries where they do not exsist; develop model legislation and regulations; set standards for data completeness, timeliness/ quality; procide training; hlp establish a reporting and data processing system

Primary goal of Clinical Practice guidelines

Improve quality of patient care by incorporating new research findings into clinical practice

Surveillance, Epidemiology and End Results

In 1973, the National Cancer Institute established the SEER program. SEER is an acronym for:

NPCR was established

In 1992 due to need for national cancer incidence rates

HIPAA

In 1996 the U.S. Congress passed a law requiring, among other things, uniform privacy protections for individually identifiable health information. This law is:

Province/Territory level

In Canada, funding for cancer registries is primarily a responsibility at the ___________________

CTR

In CoC approved hospital, abstracting is performed/reviewed by _____.

true

In abstracting it is important to determine whether the patient has been treated in another hospital true or false

What are some unique features of the SEER database?

In addition to the capturing data on the anatomic origin of each cancer or primary site, there is information on more than 300 anatomic subsites and 500 histologic subtypes. The SEER Program is the only comprehensive source of population-based data in the United States that includes stage of cancer at the time of diagnosis and survival rates by stage. It is the population-based national source with the longest record of incidence and survival data with a 35-year history in most of its registries. Other unique features of the SEER database include depth of the database available for research, accessibility, and usability of public-use data and software; leadership in defining data elements and setting data standards; innovation in data collection, such as linkages and electronic data capture; and development of analytical methods for use with population-based data.

Blanket permission

In registry terms, what phrase is used to describe the general approval by a facility's medical staff for the registry to contact patients directly to obtain current follow-up information?

There are two steps in the model for cancer control that require the use of central registry data: Step 1: Identifying the problem. (Done using central registry data). Step 4: Evaluate the impact of the intervention. (Done using central registry data.)

In the four steps that comprise the cancer control model, which step(s) involves the use of central registry data?

administrative planning and marketing, financial analysis, clinical care, cancer control, cancer research, professional education, community uses, public education

In what eight areas is cancer registry data used?

Phase III clinical trail

In which phase of a clinical trial does the principal investigator evaluate the new drug against the current drugs used to treat the disease?

declining, 0.5, 1.5

Incidence and mortality of cancer is _____. New diagnoses in U.S. decreased approximately _____ percent per year from 1999 to 2010. Cancer deaths decreased ____ percent per year from 2001-2010.

Historical data reviews are performed to asses

Incidence completeness

Population-based registry

Includes information from more than one facility in a particular geopolitical area, such as a state or region.

Real time reporting

Increase reg ability to capture, diagnosis, treatment and survival data

____________________ ___________ _______________ assessed completeness using estimations from an independent survey of cases.

Independent case ascertainment

Beginning in 2003, NCI funded SEER registries to link their data to what database, aimed at addressing racial misclassification in the cancer registries, and although not perfect, it is a logical step in the process of identifying addition cancer cases among American Indian and Alaska Native populations?

Indian Health Service (IHS) patient registration database

Beginning in 2003, NCI funded SEER registries to link their data to what database, aimed at addressing racial misclassification in the cancer registries, and although not perfect, it is a logical step in the process of identifying addition cancer cases among American Indian and Alaska Native populations?

Indian Health Service (IHS) patient registration database

The commitment to professional development and growth is a/an ____________________ commitment.

Individual

KP Rule

Inexpensive forms of review should be done on all cases, expensive form of review should be done on specific groups only

casefinding, abstracting, follow up

Information in the cancer registry database is entered through which three major activities?

Pop based central registries can give hospital registries

Information on Follow up, death clearance and tx received at another fac

IRB

Institutional Review Board

What information is included in an organization's Call for Data?

Instructions for case submission transmission file specifications and Data format requirements

Performance measurement system

Inter- related set of outcomes measures, process measures, or both, that supports internal comparisons of organizations performances over time and external comparisons of performance among organizations at comparable times

An abstract has an edit error that states the Surgery Summary of Scope of Regional Lymph Nodes (SurgSumScopeRegLN) field conflicts with the number of lymph nodes examined and number of lymph nodes positive. What kind of edit check is this?

Interitem edit

IARC

International Agency for Research on Cancer

IACR

International Association of Cancer Reg; published cancer incidence in 5 continents

IACR

International Association of Cancer Registries

Name the primary role of the Cancer Liaison Physician.

Interpret and monitor their facility's National Cancer Data Base (NCDB) data and the facility's plan to use the information to evaluate and improve quality of care, report NCDB data to the cancer committee on a quarterly basis, report on Commission on Cancer activities to the cancer committee, and serve as liaison for their cancer program with the American Cancer Society and facilitate development of a collaboration plan.

Frozen Section

Intraoperative microscopic consultation

voluntary

Is participation in the American College of Surgeons Commission on Cancer required or voluntary?

What countries currently belong to the MECC?

Israel Egypt Turkey Cyprus Jordan Palestinian Authority

include reportable-by-agreement cases in the registry

It is optional for an American College of Surgeons (ACoS) approved cancer program to

Single Field Edits also known as

Item Edits

Match the registries in the column with main supporting agencies. (May be more that one) A. Early Rheumatoid Arthritis Treatment Evaluation Registry B. National Exposure Registry C. Alzheimer's Disease Registry D. United Stated Eye Injury Registry E. Environmental Polymorphism Registry F. Lupus Registry G. Special Needs Emergency Registry H. Temporomandibular Joint Replacement Registry I. Cystic Fibrosis Registry J. Lamotrigine Pregnancy Registry Supporting Agency: Commercial enterprise

J

Accuracy standards for cases submitted to NCDB must be met for cases diagnosed Response : January 1, 2000 and later January 1, 2001 and later January 1, 2002 and later January 1, 2003 and later

January 1, 2003 and later Rationale: Standard 5.6 states that CASES DX JAN 1, 2003 and LATER MUST MEET the ESTABLISHED QUALITY CRITERIA.

What analytic software program is used to test trends in cancer statistics for statistical significance? .

Joinpoint (http://srab.cancer.gov/joinpoint/) and Average Annual Percent Change (AAPC; http://srab.cancer.gov/joinpoint/aapc.html)

Facility accreditation should be thru

Joint Commission

In what publication would you find an abstract/article about developing a trauma registry?

Journal of Registry Management (JRM)

What is the open source language for managing and displaying geographic data on the internet?

KML

Tumor Marker Colorectal

KRAS,

Probabilistic patient matching

Key fields are given a weight and comp algorithm determines if they match

Terminology database facilitates the exchange of clinical results, such as blood hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research

LOINC (Logical Observation Identifiers Names and Codes)

How can registry timeliness be evaluated

Lag time reports

How to do QC on Timliness?

Lag time reports-date of 1st contact to date of input of patient into registry

NCDB

Large diverse Hospital based reg

Phase II clinical trial

Less than 100 participants Assess the impact of the drug on the cancer

Represents the proportion of people alive on a certain day who had a diagnosis of the disease within the past x years.

Limited-duration prevalence

Passive follow up methods for central registries includes

Linkage w/ state death certificate, linkage w/ state health files and linkage w/hospital discharge summaries

Record Linkage

Linking info from external data sources, such as death certificates, with existing records

Record Consolidation

Linking multiple records for same primary cancer

AFP (alpha fetoprotein)

Liver tumor Marker

Physical security

Locked offices and cabinets,entry limited to authorized personnel

Carina

Lower edge of junction between the right and left main stem bronchi

Ann Arbor Staging System

Lymphoma

distant metastasis

M component

National Cancer Informatics Program (NCIP) was created

MAY 2012 The program supports the National Cancer Institute's (NCI) research initiatives through SUSTAINING A MULTIDISCIPLINARY COMMUNITY of BIOMEDICAL RESEARCH, INFORMATICISTS, and DEVELOPERS DEDICATED TO IMPROVING informatics PRACTICES in the STUDY OF CANCER and the TRANSLATION of that knowledge INTO IMPROVED CLINICAL INTERVENTIONS.

Virtual private network (VPN)

METHOD IMPLORING ENCRYPTION to PROVIDE SECURE ACCESS to a REMOTE COMPUTER OVER the INTERNET.

Hilum

Main bronchus, pulmonary arteries and veins, nerves and lymph vessels enter and leave through

Capital expense

Major equipment and long term investments

Inferential stats

Make conclusions about pop using info from specific sample

Match the registries in the column with purpose below. A. Tremolite Asbestos Registry B. Birth Defects Registry C. Intestinal Transplant Registry D. Breast Health Registry E. GIST Registry ______ Measure efficacy of treatment drugs ______ Monitor surgical procedure ______ Provide information about services ______ Analyze environmental exposure effects ______ Integrate treatment management

Match the registries in the column with purpose below. A. Tremolite Asbestos Registry B. Birth Defects Registry C. Intestinal Transplant Registry D. Breast Health Registry E. GIST Registry ____E_ Measure efficacy of treatment drugs ___C__ Monitor surgical procedure ___B___ Provide information about services __A____ Analyze environmental exposure effects ___D___ Integrate treatment management

Alternate Hypothesis

Meaningful difference between groups

Prevalence

Measures how many living people have the disease Number of cases alive/ number of people in populations

Incidence

Measures new cases of disease in population Number of new cases/ number of population

What statement is true regarding CoC quality improvement measures? Response : Validation of the measures was performed using cancer registry data reported to SEER. Measures were developed by the CoC with the expectation that cancer registries would be used to collect the data. Measures are designed to assess individual physician performance. All of the above

Measures were developed by the CoC with the expectation that cancer registries would be used to collect the data. Rationale: CA REGISTRY DATA elements are NATIONALLY STANDARDIZED. EACH of the CoC QUALITY IMPROVEMENT was prepared by the CoC with the expectation that CA REGISTRIES would be USED TO COLLECT the REQUIRED DATA TO ASSESS and MONITOR CA PROGRAM'S ABILITY TO COMPLY W/ THESE MEASURES. An extensive assessment and validation of the measures was performed using cancer registry data reported to the National Cancer Data Base (NCDB). All quality improvement measures are DESIGNED TO ASSESS THE HOSPITAL or SYSTEM-LEVEL PERFORMANCE and are NOT INTENDED TO EVALUATE an INDIVIDUAL PHYSICIAN PERFORMANCE.

The great vessels are located in

Mediastinum

Investigators have examined the use of cancer tests and procedures and the costs of cancer treatment through a collaborative effort linking SEER data to what other database?

Medicare claims data

C-Change

Members from federal and state governments, the motion picture industry, private businesses and non profit groups; elimination of cancer as a major healthcare problem

Sarcoma arises in

Mesodermal tissue

Name the three edit components.

Metafile Edit Set Individual Edits

Antiabdrogens

Metastatic prostate cancer

Mediun

Middle number

What does SEER use to determine current cancer trends and timliness

Modeling reporting data

Address Standardization

Modifying an address to conform to conventions of format as defined by postal service

Compliance with the CoC quality improvement measures includes which task(s)? Response : -Monitoring the program's EPR against the Cancer Program Practice Profile Reports -Implementing an action plan to improve at least one quality measure that falls below the expected EPR -Calculating expected EPR using data from randomized clinical trials and experimental studies -All of the above

Monitoring the program's EPR against the Cancer Program Practice Profile Reports Rationale: Standard 4.5 states the cancer committee monitors the cancer program's expected Estimated Performance Rates (EPR) for EACH QUALITY IMPROVEMENT measure defined by the CoC using the Cancer Program Practice Profile Reports (CP3R). If the program DOES NOT MEET or EXCEED THE EXPECTED EPR for EACH QUALITY MEASURE for EVERY YEAR SINCE the program's LAST SURVEY, an ACTION PLAN MUST BE IMPLEMENTED that REVIEWS AND ADDRESSES EVERY LOW PERFORMANCE. This monitoring activity must be recorded in the cancer committee minutes each calendar year. The function of a quality improvement measure is to IDENTIFY ANY NEED for QUALITY IMPROVEMENT or CHG(s) to the treatment the cancer program is currently providing its patients. While evaluating data from experimental studies can be used for analysis, the data from randomized trials cannot.

Meaningful Use

More robust research and empowered individuals

How many Commission on Cancer-accredited cancer programs are there in the United States and Puerto Rico?

More than 1,500

Bone

Most common metastatic site for prostate

Open source programming

Mozilla firefox; source code is available to public

Inter-field Edits, also known as

Multi-field edits

Inter-record Edits also known as

Multi-record Edits

Which of the following are open-source database applications? Select all that apply. a. Microsoft Access b. Microsoft SQL Server c. MySQL d. Oracle e. Postgres

MySQL Postgres

regional lymph node involvement

N component

What organization compiles data for Cancer in North America?

NAACCR

Who Certifies Central Cancer Registries

NAACCR

Based on the estimated annual caseload of the registry

NAACCR Guidelines state that staffing needs for state/central registries should be:

A professional society whose members are from population based registries for the most part, interested in the development and application of cancer registration and morbidity survey techniques to studies of define population groups into the conduct of cancer control programs

NAACCR NORTH AMERICAN ASSOCIATION OF CENTRAL CANCER REGISTRIES (NATIONAL)

Danielle Data Manager is preparing to submit data from the hospital cancer registry to the state central registry. What is used to facilitate the data exchange?

NAACCR data exchange record layout

Organizations involved in developing uniform data standards for hospital and pop based registries

NAACCR, COC, ACS, IARC, NCRA, NPCR, SEER

Most utilized clinical practice guidelines

NCCN

The registrar does not know the standard of care for treating melanoma. Where can that info be found?

NCCN

Analytic case goes to what organization

NCDB

What is the nationwide oncology outcomes database for accredited cancer programs in the United States?

NCDB

What does the Cancer Liaison Physician (CLP) use to evaluate and interpret the program's performance? Response : CoC guidelines for performance Evidence-based guidelines NCDB data Results of quality improvement projects

NCDB data Rationale: Standard 4.3 states that the Cancer Liaison Physician (CLP) is REQUIRED to REPORT on the CA PROGRAM'S PERFORMANCE using NCDB DATA to evaluate and improve the quality of care for the patient.

Seer is part of what umbrella program

NCI National CAncer institute

One of the national institutes of health in the US. Department of health and human services. Established as a center for cancer research. assumed a leading role in acquired immune deficiency syndrome research (Federal)

NCI National cancer institute

Specify two substantial funding sources/organizations for population-based central registries

NCI/SEER CDC/NPCR

United States Cancer Statistics (USCS) contains data from:

NPCR & SEER.

To which agency do central registry report their data to

NPCR AND SEER

National registries include

NPCR and SEER

Central registries

NPCR and SEER programs are considered ____________________

CDC programs

NPCR, IARC (international agency for research on cancer), IACR (international association of cancer registrars)

Population Based Registries

NPCR, SEER, state central reg

NCDB

National Cancer Data Base

NCDB (part of the Coc)

National Cancer Data Base

Every CoC approved hospital must submit data on an annual basis to the Response : Cancer Program Standards department of the Commission on Cancer National Cancer Data Base Both (A) and (B) Neither (A) nor (B)

National Cancer Data Base Rationale: Standard 5.5 SPECIFIES THAT DATA are SUBMITTED to the NCDB on an ANNUAL BASIS. The Commission on Cancer (CoC) is a branch of the American College of Surgeons; NCDB is a PART OF THAT BRANCH.

The Certified Tumor Registrar (CTR) credential is awarded by the

National Cancer Registrars Association (NCRA).

NPI

National Provider Identifier; must use only NPI to identify covered providers in standard transaction

What type of database is NCDB

Nationwide outcomes database

For each quality improvement study, the Quality Improvement Coordinator and the cancer committee are responsible for Response : Comparing the data to national benchmarks Establishing follow-up steps to monitor activities recommended in the action plan developed as a result of analyzing and evaluating the study results Both (A) and (B) Neither (A) nor (B)

Neither (A) nor (B) Rationale: Per Standard 4.7, the STUDIES OF QUALITY topics chosen MUST BE BASED ON A PROBLEMATIC QUALITY-RELATED ISSUE that is SIGNIFICANT to both the CA PROGRAM and the LOCAL CA POPULATION. The intention of this activity is to IDENTIFY a potential ISSUE and UNDERSTAND WHY the PROBLEM is OCCURRING. The following activities will not fulfill this standard: Completing quality studies that DUPLICATE TOPICS from year to year CONTINUING ONGOING activities FOLLOWING a COMPLETED QUALITY STUDY PERFORMING SURVIVAL STUDIES and ANALYSIS used to MONITOR COMPLIANCE with evidence-based guidelines (as required by STANDARD 4.6) REVIEWING DATA PRESENTED in the NCDB DATA REPORT orTOOLS.

A survey extension would be granted for Response : Unexpected staff absences or resignations Software conversions Both (A) and (B) Neither (A) nor (B)

Neither (A) nor (B) Rationale: SURVEY EXT ARE GRANTED for NATURAL DISASTERS (e.g., flood, hurricane) or other disasters (e.g. fire). EXTs are NOT GRANTED for ISSUES related to REGISTRY OPERATIONS such as DELAYED ABSTRACTING, DEFICIENCIES IN STANDARDS, SOFTWARE CONVERSION, or the RESIGNATION OF STAFF.

The cancer committee is required to present one clinical educational meeting each calendar year. This meeting must focus on Response : -Prospective case presentation -Discussion of treatment options -Both (A) and (B) -Neither (A) nor (B)

Neither (A) nor (B) Rationale: Standard 1.10 states clinical educational meetings PRESENTED EACH YEAR must FOCUS on a PARTICULAR CA TX including EVIDENCE BASED GUIDELINES currently USED IN TX PLANNING. This meeting CAN also ADDRESS the use of AJCC or OTHER APPROPRIATE STAGING in the CLINICAL SETTING.

The Quality Improvement Coordinator Response : -Is usually the cancer registrar -Reports findings to the cancer liaison physician -Both (A) and (B) -Neither (A) nor (B)

Neither (A) nor (B) Rationale: Standard 1.2 states the Quality Improvement Coordinator REPORTS FINDINGS EACH CALENDAR YEAR to the CA COMMITTEE. The standard also indicates a CANCER REGISTRAR CANNOT be SELECTED TO FULFILL this COORDINATOR ROLE.

How many goals involving the diagnosis, treatment, services and care of the cancer program's cancer patients are required to be established each calendar year? Response : -It depends on the number of cases accessioned annually -It depends on the hospital category -Both (A) and (B) -Neither (A) nor (B)

Neither (A) nor (B) Rationale: Standard 1.5 states the cancer committee must establish, implement, and monitor at least ONE clinical goal related to cancer care EACH CALENDAR YEAR. Clinical goals are related to the diagnosis, treatment, services and care of the cancer program's cancer patients. This standard also requires that the cancer committee establish at least ONE programmatic goal EACH CALENDAR YEAR. Programmatic goals are related to the scope, coordination, practices and processes of the program's cancer care.

The cancer registry quality control plan is established by Response : -The quality control coordinator -The cancer registry supervisor -Both (A) and (B) -Neither (A) nor (B)

Neither (A) nor (B) Rationale: Standard 1.6 requires that the CANCER COMMITTEE establish and IMPLEMENT A PLAN EACH CALENDAR YEAR to EVALUATE the CANCER REGISTRY DATA.

It is required that the patient have access to on-site Response : -Risk assessment and genetic counseling -Genetic testing services -Both (A) and (B) -Neither (A) nor (B)

Neither (A) nor (B) Rationale: Standard 2.3 states that PT(s) must have ACCESS TO CA RISK ASSESSMENT, genetic counseling, and genetic testing either ON-SITE OR BY REFFERAL

An 80% follow-up rate is required for eligible Response : Analytic and non-analytic cases since the registry reference date Analytic cases diagnosed within the last five years Both (A) and (B) Neither (A) nor (B)

Neither (A) nor (B) Rationale: Standard 5.3 requires an 80% follow-up rate for all eligible analytic cases since the registry reference date. Standard 5.4 requires a 90% follow-up rate for eligible analytic cases diagnosed within the last 5 years. There is no NO REQURED F.U RATE FOR NON-ANALYTIC CASES.

Follow-up is required for Response : Patients age 100+ with no follow-up information for more than one year Class of Case 00 diagnosed on or after January 1, 2006 Both (A) and (B) Neither (A) nor (B)

Neither (A) nor (B) Rationale: Standard 5.3 states F/U IS NOT REQUIRED for any of the following patients: PT(s) OVER 100 years old with the LAST CONTACT DATE of MORE THAN 12 months PT(S) W/ CLASS OF CASE CODED to 00 DX on or after January 1, 2006 Case types that are REPORTABLE BY AGREEMENT RESIDENTS OF FOREIGN COUNTRIES

A hospital program submits data to NCDB in Response : January of each year July of each year Both (A) and (B) Neither (A) nor (B)

Neither (A) nor (B) Rationale: Standard 5.5 states that DATA ARE SUBMITTED in RESPONSE to NCDB's CALL FOR DATA. The TIMING of that submission will be SPECIFIED in the CALL FOR DATA.

Submissions to NCDB include Response : All analytic cases Analytic cases for the last complete data year Both (A) and (B) Neither (A) nor (B)

Neither (A) nor (B) Rationale: Standard 5.5 states that cases submitted to NCDB will be specified in the Call for Data.

Which cancer program category requires participation in training of resident physicians? Response : NCI-designated Comprehensive Cancer Center Program Integrated Network Cancer Program Both (A) and (B) Neither (A) nor (B)

Neither (A) nor (B) Rationale: The participation in TRAINING RESIDENT PHYSICIANS is OPTIONAL for NCI-designated Comprehensive Cancer Center Programs (NCIP) and Integrated Network Cancer Programs (INCP).

Which of the following is an example(s) of an educational activity that the cancer registry staff can use to satisfy the Cancer Registry Education standard? Response : Cancer conference Tumor board Both (a) and (b) Neither (a) nor (b)

Neither (a) nor (b) Standard 1.11 states that all CA REGISTRY STAFF MUST ATTEND ONE CA-RELATED EDUCATIONAL ACTIVITY APPLICABLE to THEIR POSITION EVERY CALENDAR YEAR. However, attendance at any format of patient management cancer conferences and/or tumor boards DOES NOT MEET REQUIREMENTS for this standard. All members of the cancer registry staff are required to participate in cancer-related education applicable to their position CONDUCTED AT THE LOCAL, STATE, REGIONAL OR NATIONAL LEVEL EACH CALENDAR YEAR.

Professional development

Networking, volunteerism, mentoring, professionalism

Incidence rate

New cases / people in pop

Clinical Practice Guidelines

New treatment recommendations and procedures

Are all Central Registries population based?

No

Cannot be ruled out

No Dx

Equivocal

No Dx

Possible

No Dx

Potentially Malignant

No Dx

Questionable

No Dx

Suggests

No Dx

Worrisome

No Dx

Null hypothesis

No difference between groups

Are IACR and IARC the same organization?

No, IACR is the International Association of Cancer Registries, which is an association of cancer registries from around the world, and IARC is the International Agency for Research on Cancer, which is a WHO agency whose mission in cancer research for cancer prevention.

Are notes of cancer conference discussion always discoverable during legal proceedings?

No, it depends on the state's laws.

Will commercial support change the format for cancer conferences?

No, the format should include the "disclosures" and "transparency" documents if CE's are provided.

CD20

Non Hodgkin lymphoma tumor Marker

NCDB is what type of registry

Non Population based Central Registry

Multi hospital organization using the same reporting software is what type of registry

Non Population based central registry

Aggregate data

Non confidential

Automated central tumor registry (ACTUR) is what type of central cancer registry

Non population based.

Registrars required to attend a cancer-related educational program other than cancer conference, include Response : -Non-CTRs -Contract CTR staff working for at least two consecutive months -Both (A) and (B) -Neither (A) nor (B)

Non-CTRs Rationale: According to Standard 1.11, all registry staff, CTRs and non-credentialed staff are required to attend a cancer-related educational program. The standard also specifies that CONTRACT CTR STAFF WORKING for at LEAST 3 consecutive MONTHS must attend AT LEAST 1 EDUCATIONAL PROGRAM.

What is the minimum number of patients all hospitals are required to enroll in clinical trials? Response : 5% 10% 20% None of the above

None of the above Standard 1.9 states that the required % of PTS ACCRUED to CA-RELATED CLINICAL TRIALS each calendar year is DETERMINED by the FACILITIES CA PROGRAM CATEGORY.

The cancer registrar is required to Response : -Implement a procedure to follow-up on positive findings from screening programs -Evaluate the effectiveness of access and referral processes associated with screening and early detection activities -Create a community outreach activity summary report that summarizes the activities provided, the results of outreach programs and follow-up -None of the above

None of the above Rationale: According to Standard 1.8, it is the Community Outreach Coordinator who is responsible to perform the following: Implement a procedure to follow-up on positive findings from screening programs Evaluate the effectiveness of access and referral processes associated with screening and early detection activities Create a community outreach activity summary report that summarizes the activities provided, the results of outreach programs and follow-up Ensure that the available prevention and screening programs reflect the needs of the community and the cancer experience at the facility's cancer program Ensure that prevention and screening activities adhere to nationally accepted, evidence-based guidelines and interventions The position of the COMMUNITY OUTREACH COORDINATOR CANNOT BE HELD BY THE CA REGISTRAR.

Which of the following coordinator roles can be filled by a cancer registrar? Response : Quality Improvement Coordinator Clinical Research Coordinator Community Outreach Coordinator None of the above

None of the above Rationale: All six coordinator positions are required members of the cancer committee. An INDIVIDUAL CANNOT SERVE IN MORE THAN ONE COORDINATOR ROLE during a 1 YEAR CALENDAR TERM. According to Standard 1.2, a cancer registrar can fill the following coordinator roles, which are appointed by the cancer committee: Cancer Conference Coordinator Cancer Registry Quality Coordinator A CANCER REGISTRAR CANNOT FILL the following coordinator roles, which are also appointed by the cancer committee: Quality Improvement Coordinator Community Outreach Coordinator Clinical Research Coordinator Psychosocial Services Coordinator

The Quality Improvement Program activities are monitored by the Response : Cancer Committee Cancer Registrar Cancer Registry Quality Coordinator None of the above

None of the above Rationale: Per Standard 4.7, the cancer committee, under the guidance of the Quality Improvement Coordinator, initiates, evaluates and documents the required number of studies that measure the quality of care and outcomes for cancer patients. It is the QUALITY IMPROVEMENT COORDINATOR who MONITORS QUALITY IMPROVEMENT PROGRAM ACTIVITIES and REPORTS FINDINGS EVERY CALENDAR YEAR to the cancer committee.

CAP protocols must be followed to report the required data elements for Response : -Cytology specimens -Diagnostic biopsy specimens -Special studies -None of the above

None of the above Rationale: Standard 2.1 indicates special studies, diagnostic biopsy specimens, cytology specimens and reports of in situ tumors (except for DCIS) are EXCLUDED from the College of American Pathologists (CAP) Protocol and Synoptic Reporting requirement.

NAACCR stands for

North American Association of Central Cancer REgistries

The American Lung Association

Not a member of the Commission on Cancer

administer cancer treatments, care for cancer patients

Nursing education focuses on the knowledge base needed to _______ and ______.

Health Level Seven (HL7)

ON-PROFIT ORGANIZATION INVOLVED IN the DEVELOPMENT of INTERNATIONAL HEALTHCARE INFORMATICS INTEROPERABILITY STANDARDS. "HL7" also refers to some of the specific STANDARDS CREATED BY THE ORGANIZATION. HL7 and its members PROVIDE A FRAMEWORK (and related standards) for the EXCHANGE, INTEGRATION, SHARING, and RETRIEVAL OF EHI. HL7 is ONE of SEVERAL American National Standards Institute (ANSI) accredited Standards Developing Organizations (SDOs) operating in the healthcare arena. Most of these SDOs produce standards (sometimes called specifications or protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance (claims processing) transactions. Health Level Seven's domain is clinical and administrative data.

____________________ was the name of the TJC's initiative to integrate performance processes into the accreditation process.

ORYX®

Cohort Study

Observe group of disease free individuals over time to determine if they develop disease; retrospective or prospective; only one exposure examined but multiple outcomes can be studied

Confounding bias

Observed association is due to the effects of differences between the study groups that could affect the risk of developing the outcome being studied

Cancer cases exected to die from all causes

Observed survival rate

Clinical trial phase IV

Obtain additional information about product being tested

Updating case finding programs should be annually during which month?

Oct

The abbreviations ONCHIT and ONC refer to ________________________________________ and ________________________________________, respectively.

Office of the National Coordinator for Health Information and Office of National Coordinator,

NAACCR Standards Implementation task force determined major changes to database will happen

On a 3 year cycle

public benchmark reports

On the Commission on Cancer website, what type of data/reports can the public obtain from the NCDB?

Single field edit

One data field at a time

The Privacy Act of 1974

One of the first Federal laws to protect privacy was:

The largest provincial/territorial registry in Canada is operated by the province of _______________________ and covers approximately 38% of the total Canadian population.

Ontario

Subpoena duces tecum

Orders a person or organization to BRING PHYSICAL EVIDENCE BEFORE the ORDERING AUTHORITY or FACE PUNISHMENT. This is often used for requests to mail copies of documents to the requesting party or directly to court.

SEER

Organization which publishes Multiple Primary & Histology Rules and Hematopoietic & lymphoid Neoplasm Case Reportability

Total Quality Management

Organization wide effort to improve products and services; JCAHO

Record Layout

Organizes fields from data dictionary into a particular file format

researchers, physicians, clinical standards, quality of care

Outcomes and end results data are important for ____, ____, and assessment of _____ and _____.

How many members in NCRA

Over 5,500

American National Standards Institute

Oversees the development of voluntary consensus standards for products, services, processes, systems and personnel in US

Name three current technologies that have evolved to create dynamic websites?

PHP, CSS, and Javascript

Technical safeguards

PROCEDURE that CONTROL ACCESS to COMPUTER SYSTEMS and ENABLE COVERED ENTITIES to PROTECT COMMUNICATIONS containing PHI transmitted electronically over OPEN NETWORKS from BEING INTERCEPTED by ANYONE OTHER THAN the INTENDED RECIPIENT.

The HIPAA Privacy Rule

PROVIDES FEDERAL PROTECTIONS for individually IDENTIFIABLE HEALTH INFORMATION held by covered entities and their business associates and gives patients rights with respect to that information.

t-test

Parametric test: compares the means of two samples to determine if they are significantly different

Follow up preferences and cost

Passive follow up is more typically performed and is less expensive than active follow up

checking the hospital database for readmission of patients in the registry database

Passive follow-up means:

Linkage with state death certificate files Linkage to state health files Linkage with hospital discharge summaries

Passive follow-up methods performed by central registries include:

What are the two most important casefinding sources for central reg?

Pathology reports and disease indicies

Confidential Data

Patient Specific Data (contains patient identifiers)

Died from another cause of cancer, lost to follow up, and those alive past time follow up is being conducted

Patients who are censored

At cancer conference, prospective case presentations include Response : -Patients who were previously presented at a cancer conference -Patients who completed initial treatment after diagnosis who now need some form of palliative care -Both (A) and (B) -Neither (A) nor (B)

Patients who completed initial TREATMENT AFTER DZ who now need some form of palliative care Rationale: Eligibility requirement ER3 states that the following are considered prospective cases: those who are either newly or previously diagnosed and those who have yet to begin or have completed some forms of treatment that now need additional care issues discussed. This includes care management discussions related to potential initial, adjuvant, recurrent, supportive or palliative care and/or treatment options required for the patient.

location, size, number, lymph node involvement, metastasis

Per the AJCC website, what are the 5 common elements of staging systems?

Passive Casefinding

Performed by other healthcare professionals who the registry relies on; self reporting

Active case finding

Performed by registry personnel

The CoC does special studies Response : Every calendar year Every two years Periodically When requested by a member of the American College of Surgeons

Periodically Rationale: Standard 5.7 states that the CoC PERIODICALLY DESIGNS and CONDUCTS HYPOTHESIS-BASED SPECIAL STUDIES to EVALUATE PT CARE, SET PERFORMANCE BENCHMARKS, and PROVIDE FEEDBACK to IMPROVE CA PT care.

The community outreach coordinator must be a Response : -CTR -Person who is affiliated with or employed by the program -Member of the outreach department -Physician

Person who is affiliated with or employed by the program Rationale: Standard 1.8 indicates the community outreach coordinator MAY BE a PHYSICIAN or NON-PHYSICIAN. The individual MAY BE the DIRECTOR or STAFF MEMBER of the OUTREACH PROGRAM. But whoever is appointed MUST be a PERSON WHO is AFFILIATED W/ or EMPLOYED by the PROGRAM.

What does PHR stand for?

Personal Health Record

occur after the new treatment has been approved for standard use. Less common than phase I-III trials.

Phase IV clinical trials

established to prevent unreasonable threats to an organization's buildings, equipment, and media. They take into consideration physical threats, such as di- saster, physical or electronic break-in, theft, and careless or intentional physical access to confidential information, and are intended to protect against both external and internal threats. They can include locks, physical barriers, monitoring, visitor control, as well as the control of media and equipment, for example, automatic log outs of soft- ware applications after idle period.

Physical Safeguards

Ways to obtain follow-up information

Physician follow-up letters Patient letter Third-party letter Hospital records (readmissions) Department of vital statistics (death lists) Department of motor vehicles Employers Obituaries CMS Religious organizations Phone books Schools Support groups Labor unions

The joint commission survey team includes

Physician, nurse, administrator

Casefinding timeliness is determined by

Planned use of data and agency to which central reg reports

Case finding timeliness in central Registry is determined by

Planned use of the data

SEER is what type of registry

Population based Central Cancer Registry

Contains all cases in a defined geographic region

Population based central cancer registrary data...............

contains all cases in a defined geographic region

Population based central cancer registry data ___________________________________

CONCORD

Population based comparison of survival rates amount cancer in US and Europe

What type of research is explained as "The conduct of basic and applied research in the behavioral, social, and population sciences to create or enhance interventions that, independently or in combination with bio-medical approaches, reduce cancer risk, incidence, morbidity and mortality."

Population-based cancer control research.

Follow-up, death clearance, and treatment received at another facility

Population-based central cancer registries may give hospitals in their area information about

From where can a registrar obtain incidence rates?

Population-based central registries

Hospitals and independent pathology labs

Population-based registries receive cancer data from:

Cancer Control PLANET

Potential partners, information regarding cancer/risk factors within a state

It is required that the patient receive genetic counseling and cancer risk assessment Response : -Pre- and post-genetic testing -If there is a strong family history of cancer -After the genetic testing is done -After a treatment plan is established

Pre- and post-genetic testing Rationale: Standard 2.3 REQUIRES that the PT RECEIVE GENETICS COUNSELING and CA RISK ASSESSMENT both BEFORE AND AFTER GENETIC TESTING.

Chi squared

Predict if variance is due to chance or some other factor

Reportable dx made in utero

Pregnancy results in live birth, and dx confirmed prior to birth and the disease is not evident due to regression

Identify the audience How will they use the data?

Presented a conference? annual report?

1971

President Nixon declared "War on Cancer" when he signed the National Cancer Act of __________

Cross Section study determines

Prevalence

The ultimate goal of analyzing cancer data is to

Prevent and control cancer.

Primary prevention

Prevent disease form occuring

Tertiary prevention

Preventing pain, slowing disease progression, preventing complications, etc.

When is the patient navigation process implemented? Response : Prior to a diagnosis of cancer After a diagnosis of cancer After the patient has received first course of treatment When the patient is referred for palliative care

Prior to a diagnosis of cancer Rationale: Standard 3.1 states the PT NAVIGATION PROCESS STARTS PRIOR to the DX OF CA and CONTINUES through ALL STAGES of the CA experience. In CANCER CARE, PT NAVIGATION refers to the SPECIALIZED HELP PROVIDED TO THE PT(s), FAMILIES and their CAREGIVERS to OVERCOME EXISTING BARRIERS and GAPS in SERVICES(or access to services) so the PT receives QUALITY CARE.

When is patient navigation process implemented

Prior to diagnosis of cancer

Defines the permissible means of access, use, and disclosure of the applicable patient information,

Privacy

Net (cancer- specific) (cause specific) survival

Probability of surviving cancer in the absence of other causes of death, cases dying from other causes of death are removed from the study

P value

Probability that a difference as large as the observed would occur by chance alone

P-Test

Probability that the difference between 2 means in T test are similar

Running computerized edit checks and processing the results Visual editing of the abstracts to compare text with the codes submitted Recoding audit, which involves a review of the originally abstracted text on a sample of cases and recoding the data items Reabstracting study, which involves both reabstracting and recoding a sample of previously submitted cases

Procedures used to assess data accuracy

Historial data reviews Casefinding audits Independent case ascertainment Death clearance

Procedures used to assess incidence completeness

Visual review

Process of identifying incomplete or inaccurate information for individual abstracts

Which type of program is exempt from RQRS

Programs undergoing initial survey and pediatric programs

Hospital Quality Alliance

Promotes public access to hospital performance data

Survival measures are often expressed as the ______________________ of patients alive at some point subsequent to the diagnosis of their cancer, or represented as the _________________ of a group of patients "surviving" a specified amount of time (e.g., 3, 5, or 20 years).

Proportion, probability

Give some examples of differences between prospective and retrospective case presentations.

Prospective cases are presented for discussion at the time of initial diagnosis with an emphasis on establishing accurate staging (clinical or pathologic), treatment options based on national treatment guidelines, and expected patient management plans. Prospective conferences may also include discussion of adjuvant therapy after the initial surgical treatment or treatment plans for a recurrence. The prospective approach is in essence a look forward, as opposed to the retrospective approach. Retrospective cases are discussed after the completion of all treatment, primarily for the purpose of education, and are not intended to influence the management of patient care.

Most common cancer in men and 2nd most deadly

Prostate

The primary purpose of cancer registry standards is to

Protect the integrity of the data.

HIPPA Patient Safety Rule

Protection of PHI being used to analyze patient safety events and improve patient safety

What is a critical requirement(s) of every IT disaster recovery plan?

Provide a reliable backup and recovery system.

What is an essential element of proper disaster recovery planning?

Providing a reliable backup and recovery system

Registries support public health surveillance by:

Providing disease-specific incidence information and survival data, and by revealing trends in severity, treatment, and delivery services over times and geographic areas.

Canadian funding for registries is by

Province/Territory

The central advisory panel that guides ad asses in the prioritization of the work conducted by the NCDB staff is the:

Quality Integration Committee

Generating registry management reports Performing edit checks on new and existing case reports Performing case-finding and reabstracting audits Generating random samples for QA activities

Quality assurance (QA) activities include:

Content for educational programs is identified through:

Quality assurance activities

What is the difference between quality control and quality assurance?

Quality control is a planned set of activities. Quality assurance is monitoring the processes and methods used to ensure quality.

Cancer Registrar can not fulfill which role?

Quality improvement coordinator, Community outreach coordinator, clinical research coordinator, or psychosocial services coordinator

Healthcare stakeholders within a defined geographic area that govern a health information exchange according to nationally recognized standards

RHIO A Regional Health Information Organization is a group of organizations within a specific area that share healthcare-related information electronically according to accepted healthcare information technology (HIT) standards.

To assess compliance with the standard that requires data items be reported using CAP protocols, a quality control activity is to be completed each year that consists of a Response : -Random 10% of eligible pathology reports -Random 15% of eligible pathology reports -Maximum of 200 cases -Minimum of 200 cases

Random 10% of eligible pathology reports Rationale: Standard 2.1 states that a RANDOM SAMPLES of 10% of eligible PATH reports or a MAX of 300 CASES must be reviewed EACH YEAR to ensure that the College of American Pathologists (CAP) Protocol and Synoptic Reporting is being used to report the required data elements.

____________________ is the process of identifying cases quickly for epidemiologic protocols.

Rapid Case Ascertainment

Re abstracting study

Re abstract from source documents and compare to original abstract

Estimate rates of agreement between registry data and the information in the source documents Identify programs in the interpretation and coding of specific data Develop standard guidelines and rules for abstracting ambiguous situation.

Reabstracting is performed to:

What method of a designed study would be used to monitor data completeness?

Reabstracting study

National Program of Cancer Registries (NPCR)

Realizing the need for national cancer incidence rates, the U.S. Congress in 1992 established the

Recurrence:

Reappearance of disease that was though to be cured OR a new occurrence of cancer not related to earlier cancer

What level of protection is needed for confidential health information within an organization

Reasonable protection

________________audit provides verification that coding guidelines and rules are correct as applied by the data collectors.

Recoding

Source Record

Record received at the central registry from a reporting facility

Recoding Audit

Record sample of abstracts using text provided

HIPPA was enacted to

Reduce healthcare cost and standardize coding/transmission of healthcare data

Refers to the effective date on or after which all reportable cases should be registered in a registry database.

Reference date

ACS standards for casefinding, abstracting and quality control measures to ensure the accuracy of data collected

Reference date Case eligibility Patient eligibility Patient index Casefinding Accession register Abstracting Coding Staging Quality control

Define Passive follow-up.

Refers to methods that do not require registry contact with hospitals, physician, or individual cancer patients. These methods usually involve computerized searches of existing nonregistry files that may contain the cancer patient's name, and follow-up status can be inferred.

Define Active follow-up.

Refers to someone initiating direct contact with patients. From a central registry perspective, active follow-up may also include contacts made by hospital registrars with physician's offices

where are Abstracting guidelines are provided ?

Registry Operations and Data Standards (ROADS) publication of the Commission on Cancer

What is the most popular structure of a central registry database model?

Relational

What activity measures data consistency?

Reliability study

How to do QC on Consistency

Reliability study- standardized source documents abstracted by a sample of data collectors; useful when new data fields added

Hospital Cancer reg Data Management Systems support

Reporting cases to ACoS NCDB

Clinical Research Coordinator

Reports to the Cancer Committee the required percentage of patients referred to a clinical trial as appropriate to the cancer program category

How is registry data used?

Research, quality management, facility planning and marketing

All population based registries are required to identify cancer patients who

Reside in their catchment area at time of diagnosis who were dx or tx either inside or outside their catchment area

Cases that do not need follow up

Residents of foreign countries, reportable by agreement, 100 years old or older w/o contact for 12 months, class 00 diagnosed after 1/1/2006

Privacy

Restricting access, use, and disclosure of confidential info

The quality improvement coordinator is required to do one patient care improvement based on Response : NCCN evidence-based performance guidelines Results of a completed study that measures both the quality of patient care and outcomes Both (A) and (B) Neither (A) nor (B)

Results of a completed study that measures both the quality of patient care and outcomes Rationale: Standard 4.8 REQUIRES that AT LEAST ONE of the TWO PT CARE IMPROVEMENTS be BASED on RESULTS of a COMPLETE STUDY that MEASURES BOTH the QUALITY OF PT CARE and OUTCOMES as discussed in Standard 4.7 (Studies of Quality).

case control study

Retrospective study; based on presence or absence of disease; casefinding important

HIPAA and other regulations give patients the right to:

Review their own medical records kept by the organization

NCRA Program Recognition Committee

Reviews and determines activity that meets CTR continuing education activities

100

Routine and automated edit checks should be applied to ______% of a registry's cases.

most frequent rule hierarchy rule highest value rule time submitted rule known over unknown rule

Rules used during record consolidation

NPCR-EDITS metafile is maintained by

SEER

The first national cancer registry program was established by:

SEER

Which organization established the first cancer reg?

SEER

NCI programs

SEER (28% of pop)

What coding system formed the basis for the Collaborative Staging (CS) System imple- mented in 2004 as part of the effort to simplify and standardize the rules and guidelines for collecting cancer data in the United States?

SEER Extent of Disease coding system

What coding system formed the basis for the Collaborative Stage (CS) System implemented in 2004 as part of the effort to simplify and standardize the rule and guidelines for collecting cancer data in the United States?

SEER Extent of Disease coding sytem.

collect incidents and follow up data in nine areas in the United States for the purpose of identifying and monitoring trends and cancer incidencs and survival (Federal)

SEER Surveillance, epitomeology, and end results

Congress granted regulatory powers to

SEER and NPCR

22

SEER central registries are required to provide complete counts of new cases for a calendar year within ________ months of the end of that calendar year.

national cancer institute, national cancer act

SEER is a program of the ____ and was established by _____.

surveillance, epidemiology, and end results program

SEER stands for ____.

What advantages did the Data Management System (SEER*DMS) bring to central cancer registry operations?

SEER*DMS provides support for all core cancer registry functions—case finding, importing data, editing, linkage, consolidation, data submission, and reporting. SEER*DMS improves cost efficiency and reduces duplication of effort in terms of system maintenance and ad- ministration. Furthermore, the centralized system design and development improves data quality and consistency, increases efficiency, and increases the sharing of knowledge and experience among registries.

HIPAA Security Rule

SPECIFIES a SERIES of administrative, physical, and technical SAFEGUARDS for COVERED ENTITIES and their BUSINESS ASSOCIATES to use to assure the confidentiality, integrity, and availability of electronic protected health information.

What computer language is often used to create, update, and delete data from a database?

SQL

Closed source programming

SQL; source code not available to public

The Systematized Nomenclature of Medicine (SNOMED)

SYSTEMATIC, COMPUTER-PROCESSABLE COLLECTION OF MEDICAL TERMS that COVERS anatomy, diseases, findings, procedures, microorganisms, substances, etc. It ALLOWS CONSISTENT WAY TO INDEX, STORE, RETRIEVE, and AGGREGATE MED DATA ACROSS SPECIALITIES and SITES OF CARE. Although now international, SNOMED was STARTED in the U.S. by the College of American Pathologists.

HIPPA Security Rule

Safegaurds to ensure confidentiality

The role of American National Standards Institute (ANSI) in the development of healthcare information standards in the United States is to

Safeguard the integrity of assessment systems.

Operating expenses

Salaries, benefits, supplies, fixed cost

Largest cost in registry

Salaries; registry is a non profit producing department

frequency polygon

Same as a histogram but with lines instead of bars

Syntactic Interoperability

Same coding system across organizations

Governs the operational and technical mechanisms necessary to protect personal information.

Security

Professional Development is

Self-motivated and self-directed

SEER is being linked to the National Longitudinal Mortality Study (NLMS; http://surveillance. cancer.gov/disparities/nlms/) to add socioeconomic data at the individual level that cannot be obtained from the SEER database itself. What data elements are available in the NLMS?

Self-reported race/ethnicity, marital status, education, income, occupation and industry, residence, nativity/immigrant status, smoking status, health status, and availability of health insurance

SEER is being linked to the national Longitudinal Mortality Study to add socioeconomic data at the individual level that cannot be obtained from the SEER database itself. What data elements are available in the NLMS

Self-reported race/ethnicity, marital status, education, income, occupation and industry, residence, nativity/immigrant status, smoking status, health status, and availability of health insurance

Quality assurance

Set of activities designed to ensure process is adequate; preventing mistakes and no feedback loop

Quality Control

Set of activities designed to evaluate registry data; feedback loop and involves finding mistakes

Pie chart

Show stage used most often for nominal and ordinal data

Patient Index

Similar to the MPI The following data should be collected: Patient name Sex Primary site of cancer Histology Date of diagnosis Accession number Sequence number Date of birth and death (if necessary) Medical record number

Name the three types of edits.

Single-Field Edits Inter-field Edits Inter-record Edits

Cancer registry must keep a record of disclosure for

Six years

SEER Staging

Size of the tumor Extension Lymph nodes

rhabdomyosarcoma primary site

Skeletal muscle

What sources does SEER use for follow up information

Social security admin, National death index, motor vehicle reg, state vital records dept

Cases may be abstracted by Response : Some non-credentialed registry staff under the supervision of a CTR Contract workers who are not credentialed CTR eligible staff Only credentialed staff (CTR)

Some non-credentialed registry staff under the supervision of a CTR Rationale: Standard 5.1 states that case abstracting is performed by a Certified Tumor Registrar (CTR). In addition, non-credentialed registry staff working under the supervision of a CTR can abstract cases for up to three years. In the latter situation, a supervision plan must be in place and include the scope of supervision, an outline of the quality control plan to review the abstracts completed, and education/training activities for the non-credentialed registry staff. If the non-CTR abstractor fails to pass the CTR examination within three years of the date of hire at a CoC-accredited program, then he/she may not perform abstracting in any CoC-accredited program until passing the exam. In other words, a NON-CREDENTIALED ABSTRACTOR CANNOT MOVE from one CoC-accredited program to another and CONTINUE TO ABSTRACT to AVOID SITTING for and PASSING THE CTR exam. There is only one three-year grace period if working in CoC-accredited programs. Because there is a provision for non-CTRs to temporarily abstract, this makes answer D incorrect.

Specific facilities, as NCDB does from only ACoS approved facilities Specific cancer sites, such as the Central Brain Tumor Registry of the United States (CBTRUS) Specific familial cancers, such as the Gilda Radner Familial Ovarian Cancer Registries

Specialty cancer registries can collect and maintain data from:

Commission on Cancer's National Cancer Data Base (NCDB) and registries that collect information on familial or hereditary cancers

Specialty cancer registries include

Specialty Cancer Registry can collect data on

Specific Facilities on a particular type of cancer site

Submissions to the NCDB will be

Specified in the call for data

Cancer Registry Policy and Procedure Manual

Specified that current CoC data definitions and coding instructions are used to describe all reportable cases

A performance measure is used to

Specify how to measure quality output

AJCC staging

Staging basis is an important descriptor in which staging system

board certified, general specialty

Standard 1.1. (Program Management - Physician Credentials) states that diagnostic and treatment services are provided by or referred to physicians who are currently ______ in their _____.

cancer related educational activity

Standard 1.10 (Program Management - Clinical Education Activity) states that the cancer committee offers at least one _______ to physicians, nurses, and allied health professionals.

cancer related educational activity

Standard 1.11 (Program Management - Cancer Registrar Education) states that each year, all members of the cancer registry staff participate in one _____.

patient or program outcomes

Standard 1.12 (Program Management - Public Reporting of Outcomes) states that the cancer committee develops and disseminates a report of _____ to the public.

physicians, diagnostic, treatment specialties, non physicians, administrative, support services

Standard 1.2 (Program Management - Cancer Committee Membership) states that the membership of the cancer committee is _______ representing physicians from _____ and ______ as well as _____ from ______ and _____.

50

Standard 1.3 (Program Management - Cancer Committee Attendance) states that each required member attends at least _____ percent of the cancer committee meetings during the year.

once, quarter

Standard 1.4 (Program Management - Cancer Committee Meetings) states that each year the cancer committee meets at least _____ each calendar ____.

clinical goal, programmatic goal

Standard 1.5 (Program Management - Cancer Program Goals) states that each year, the cancer committee establishes, implements and monitors at least one _____ and one _____ for the endeavors related to cancer care.

quality of cancer registry data and activity

Standard 1.6 (Program Management - Cancer Registry Quality Control Plan) states that the cancer committee establishes and implements a plan to annually evaluate _______.

cancer conference coordinator

Standard 1.7 & 1.8 (Program Management - Monitoring Conference Activity & Community Outreach) states that the ________ monitors and evaluates the cancer conference and community outreach activities and reports findings to cancer committee annually.

percentage of patients

Standard 1.9 (Program Management - Clinical Trial Accrual)The required _____ is accrued to cancer related clinical trials each year.

90, cancer pathology reports

Standard 2.1 (Clinical Services - College of American Pathologists) states that CAP protocols are followed to report required data elements in ____ percent of eligible ______ each year.

specialized knowledge and skills, competency

Standard 2.2 (Clinical Services - Nursing Care) states that oncology nursing care is provided by nurses with _______, and ____ is evaluated annually.

cancer risk assessment, genetic counseling, testing services, genetics professional

Standard 2.3 (Clinical Services - Risk Assessment and Genetic Counseling) states that _____, _____, and ______ are provided to patients either on-site or by referral, by a qualified ______.

palliative care services

Standard 2.4 (Clinical Services - Palliative Care Services) states that _____ are available to patients either on site or by referral.

health care disparities, barriers, community needs assessment

Standard 3.1 (Continuum of Care Services - Patient Navigation Process) states that the process is established to address _______ and _____ for patients and is driven by a _____.

psychosocial distress screening, psychosocial care

Standard 3.2 (Continuum of Care Services - Psychosocial Distress Screening) states that the cancer committee develops and implements a process to integrate and monitor on site _____ and referral for provision of ______.

comprehensive care summary, follow up plan

Standard 3.3 (Continuum of Care Services - Survivorship Care Plan) states that the cancer committee develops and implements a process to disseminate a _____ and _____ to patients with cancer who are completing cancer treatment.

Data submission to the NCDB is a requirement specified in which standard of the CoC's Cancer Programs Standards?

Standard 3.6

Data submission to the NCDB is a requirement specified in which standard of the CoC's Cancer Programs Standards?

Standard 3.6

cancer prevention, community, specific cancer type, evidence based

Standard 4.1 (Patient Outcomes - Prevention Programs) states that, each year, the cancer committee provides at least one _______ program that is targeted to meet the needs of the ______ and should be designed to reduce the incidence of _____. The prevention program is consistent with ______ guidelines.

cancer screening program, late stage disease, community needs, evidence based

Standard 4.2 (Patient Outcomes - Screening Programs) states that, each year, the cancer committee provides at least one _____ program that is targeted to decreasing the number of patients with _____. The screening program is based on _____ and is consistent with ______ guidelines and interventions.

leadership role, performance, National Cancer Database data

Standard 4.3 (Patient Outcomes - Cancer Liaison Physician Responsibilities) states that a cancer liaison physician serves in a _____ within the cancer program and is responsible for evaluating, interpreting, and reporting that program's _____ using _____.

performance levels, accountability measures

Standard 4.4 (Patient Outcomes - Accountability Measures) states that annually, _____ are met for each of the specified ______ as defined by CoC.

performance levels, quality improvement measures

Standard 4.5 (Patient Outcomes - Quality Improvement Measures) states that annually, ______ are met for each of the specified _______ as defined by the CoC.

patients within the program, evidence based national treatment

Standard 4.6 (Patient Outcomes - Monitoring Compliance with Evidence-Based Guidelines) state that, each year, a physician member of the cancer committee performs a study to assess whether _____ are evaluated and treated according to _______ guidelines.

quality improvement coordinator, quality of care, outcomes, patients with cancer

Standard 4.7 (Patient Outcomes - Studies of Quality) states that, each year, based on category, the _____, under the direction of the cancer committee, develops, analyzes, and documents the required studies that measure _______ and ____ for ______.

quality improvement coordinator, patient care improvements, results of a completed study, quality of care, outcomes, another source, completed study

Standard 4.8 (Patient Outcomes - Quality Improvements) states that annually, the ______, under the direction of the cancer committee, implements two _____. One is based on _______ that measures cancer patient ________ and _____. One can be identified from ____ or from a _____.

certified tumor registrar

Standard 5.1 (Data Quality - Cancer Registrar Credentials) states that case abstracting is performed by _____.

RQRS, eligible cases, performance measures, RQRS terms, conditions

Standard 5.2 (Data Quality - Rapid Quality Reporting System Participation) states that from initial enrollment and throughout the 3 year accreditation period, the program participates in _____, submits all _____ for all valid ______, and adheres to ____ and ____.

80

Standard 5.3 (Data Quality - Follow up of all patients) states that, for all eligible analytic cases, _____ percent follow up rate is maintained from the cancer registry reference.

90, 5 years

Standard 5.4 (Data Quality - Follow Up of Recent Patients) states that a _____ percent follow up rate is maintained for all eligible analytic cases diagnosed within the last _____ or from the cancer registry reference date, whichever is shorter.

National Cancer Data Base

Standard 5.5 (Data Quality - Data Submission) states that, each year, complete data for all requested analytic cases are submitted to ______ in accordance with the annual Call for Data.

quality criteria, resubmission deadline

Standard 5.6 (Data Quality - Accuracy of Data) states that, annually, cases submitted to the NCDB that were diagnosed on January 1, 2003 or later meet the established _____ and ______ specified in the annual Call for data.

special studies, Commission on Cancer

Standard 5.7 (Data Quality - Commission on Cancer Special Studies) states that the program participates in ______ as selected by ______.

North American Association of Central Cancer Registries (NAACCR)

Standard setting organization that guides central registries

What was the main reason data edits were developed?

Standardization of data collection

The single most important quality assurance tool

Standardized Edits

Describe one method of creating complex logic for a report.

Start with a simpler version of the request that can be easily verified and add complexity.

Statutes are passed by

State and Federal

population-based providers of incidence data multi-purpose

State central registries are usually:

Population Based central registries

State or National; NPCR and SEER; catchment area

First step of an investigation

State your hypothesis: statistical tests can be used to determine if there is significant difference between populations Null hypothesis: there is no difference between groups a statistical test may show that there is a low prob that the null hypothesis is correct, so we can reject the null hypothesis and assume there is a difference between groups

Canadian census every 5 years is conducted by

Statistic Canada

Misclassification bias

Subjects incorrectly classified

What is most important to achieving interoperability with other data systems?

Supporting and adopting widely used data standards

Organizations contribute to registry infrastructure by:

Supporting and funding registries, defining and monitoring data standards, collecting, reporting, and transmitting data.

Registries support hospital facilities by:

Supporting quality improvement activities through monitoring of therapies and outcomes.

SEER

Surveillance, Epidemiology and End Results

SEER

Surveillance, Epidemiology and End Results (SEER) Program

Less than 1.5% and greater than 0.0%

Surveillance, Epidemiology, and End Results (SEER) Program produces an annual Data Quality Profile (DQP) for each of its member registries. What is the DQP data quality goal related to the allowable percentage of death certificate only cases that should be reflected in the database by year of diagnosis?

1. What is SAR?

Survey application record

The Surveillance, Epidemiology, and End Results (SEER) Program is the only comprehensive source of population-based data in the United States that includes the _____________

Survival rates by stage.

Potentially reportable cases that have been identified and are waiting to be abstracted are stored in what is called the:

Suspense System.

A case is included on a ____________________ during the casefinding process until the appropriate hospital or physician officially reports the case.

Suspense list

size/depth of primary tumor

T component

Method of staging including information on location and size of tumor

TMN (tumor, metastasis, nodes)

Probabilistic linkage application

Takes into account a wide range of potential identifiers to link data sets in a statistically justifiable way; most often used by central reg

Clinical trial phase I

Test toxicity

analytic epidemiology

Tests a hypothesis about the cause of disease

cancer prevention, access to care, research and training, other standard setters

The American Cancer Society supports ______, ____, and _____, and works closely with _____.

American Cancer Society (ACS) National Cancer Institute (NCI) Centers for Disease Control and Prevention (CDC) North American Association of Central Cancer Registries (NAACCR)

The Annual Report to the Nation on the Status of Cancer provides an update of cancer incidence, mortality, and trends in the United States. The following organizations have collaborated since 1998 to create the report:

What committee determines the process and development of the Distinguished Member Award?

The Awards Committee

Which document mandated the establishment of Institutional Review Boards (IRB)?

The Belmont Report

Which document mandated the establishment of the IRB

The Belmont report

What must be included in hospital reportable list?

The COC reportable list, reportable by agreement list and state reportability list

Name the two organizations responsible for the development of Edits software?

The Centers for Disease Control and Prevention (CDC) The National Program of Cancer Registries (NPCR)

data, cancer care quality, treatment

The CoC collects _____ and measures and monitors _______ and ______.

standards, surveys, compliance

The CoC establishes ________ and conducts _____ for _____.

cancer control, clinical surveillance activities, educational interventions

The CoC supports _____, monitor ______ and develops _______.

Software that calculates complete prevalence based on limited-duration prevalence statistics (http://srab.cancer.gov/comprev/).

The ComPrev

70%

The Commission on Cancer (CoC) National Cancer Data Base (NCDB) currently captures approximately what percentage of newly diagnosed cases in the United States from approved cancer programs?

6 months in abstracting from the date of initial diagnosis

The Commission on Cancer allows a maximum delay of?

CAnswer

The Commission on Cancer provides registrars with online system for questions known as _____.

AJCC staging

The Commission on Cancer requires physicians to assign ______ when applicable.

molecular markers

The Latest TNM Manual includes prognostic indicators based on _____.

23

The NAACCR standard for reporting expected cases of reportable cancer occurring in residents during that year should be reported within __________ months of the close of the diagnosis year.

List the two agencies to which facilities accredited by the American College of Surgeons Commission on Cancer will report their data.

The NCDB and the state/territory's central cancer registry

CTR certification and maintenance, training and communication between registrars

The NCRA provides _____, and _____

What law led to the establishment of the SEER Program?

The National Cancer Act of 1971

A non-population-based central registry

The National Cancer Data Base is an example of:

American Cancer Society, American College of Surgeons

The National Cancer Database is a joint effort between _____ and _____.

Centers for Disease Control and Prevention (CDC)

The National Program of Cancer Registries (NPCR) is a function of:

on a three-year cycle

The North American Association of Central Cancer Registries (NAACCR) committee, Standards Implementation Task Force, has determined that major changes to the database will be implemented

Make sure changes are implemented at the same time

The North American Association of Central Cancer Registries (NAACCR) formed a committee, Standards Implementation Task Force, to

how far a cancer has spread from point of origin

The SEER Summary Staging Manual categorizes cancer according to _____.

All patients diagnosed with a reportable disease who are residents of the geographic areas covered by a SEER registry at the time of diagnosis

The Surveillance, Epidemiology and End Results Program (SEER) requires reporting of

28%

The Surveillance, Epidemiology, and End Results (SEER) Program registries cover approximately what percentage of the United States population?

United Nations

The World Health Organization is the authority for health within which system?

Annual control plan

The ___________________________________ required by the CoC for hospital cancer registries is an example of quality control.

The parietal peritoneum lines

The abdominal and pelvic walls

Record linkage

The ability of a central registry to combine information from several sources. refers to the process of finding records in a data set that refer to the same entity across different data sources i.e., identifies and matches patient data. occurs before record consolidation.

November 1 of the next cancer data year

The annual report must be published by when?

Cancer registry informatics

The application of information science to cancer registration

Reference date

The beginning date of data collection It is usually January 1 of a given year The reference date can not be changed

the patient's primary physician

The best source for the follow-up is considered to be:

in each 12 month period

The cancer committee must document at least two cancer patient care enhancements or improvements when

Case selection for the cancer conferences Review of the CoC requirements for the cancer conferences Provide recommendations to improve cancer conferences

The cancer conference coordinator performs these tasks:

Six years

The cancer registry must keep a record of disclosure, (an accounting of what, where, when, to whom and for what purpose information was distributed) for what period of time?

Without administrative permission, data may not be transmitted to

The central registry. and NCDB

What procedure(s) must occur before a clinical trial involving cancer patients can be initiated in a hospital?

The clinical trial must be approved by the institutional review board (IRB)

Cases rejected by NCDB for not meeting quality standards must be corrected and resubmitted by Response : January of the following year December of the current year The time of the next year's data submission The deadline specified in the Call for Data

The deadline specified in the Call for Data Rationale: Standard 5.6 states that REJECTED CASES MUST be CORRECTED and RESUBMITTED by the DEADLINE SPECIFIED in the NCDB CALL FOR DATA.

The patient's age and ethnicity

The demographic section of the cancer patient's record contains

cross sectional study

The exposure and outcome for each subject is determined at the same time

Record Identification

The field that reflects the coding standard used for the stage fields in a NAACCR exchange record layout is an example of what type of data item in a cancer registry?

For what reason(s) might a National Cancer Data Base (NCDB) data submission file be rejected?

The file was prepared using an incorrect record layout and or The file included confidential information.

Connecticut Cancer Registry

The first truly population-based registry in the US was the:

the cancer registry

The fourth required element of the Commission on Cancer's cancer program

Net survival

The hypothetical probability of surviving cancer in absence of all other causes of cancer

be compliant with reporting timelines and meet national accreditation standards.

The information collected in a cancer registry database is required to

CPU (Central Processing Unit)

The internal operating unit or "brain" of a computer.

casefinding, abstracting, follow up

The main functions of cancer registries include _____, ____, and ____.

Volunteers from within the organization's membership

The mission of the North American Association of Central Cancer Registries (NAACCR) is primarily carried out by

Intravenously

The most common route of chemotherapeutic administration

The most critical area needing physical barriers to protect confidential information is

The network administration control room

For these questions, consider the following scenario: You are working with a researcher investigating whether taller men are at greater risk for prostate cancer than shorter men. To address this hypothesis, the researcher selected a sample of men from her state cancer registry who lived in a certain neighborhood and were diagnosed with prostate cancer in 2009. She then randomly selected men from the same neighborhood as the cases who had never been diagnosed with prostate cancer (the controls). She collected information on the age at diagnosis(or an assigned reference date for the controls), race, and height at age 18 for the cases and controls (shown in Table 24-1). State the null and alternative hypotheses being tested.

The null hypothesis being tested is that there is no difference in prostate cancer risk be- tween taller and shorter men. The alternative hypothesis is that there is a difference in pros- tate cancer risk between taller and shorter men, or more specifically, that taller men are at greater risk for prostate cancer than shorter men.

North American Association of Central Cancer Registries (NAACCR)

The organization responsible for maintaining standards for data transmissions.

true

The patient retains the original accession number even if he returns with a new cancer - the sequence number indicates the new cancer true or false

The best source for follow up is considered to be

The patients primary care physician

continued medical surveillance, health status of patients

The primary purpose of follow up is to ensure ______ and monitor ______.

One of the first federal laws to protect privacy was

The privacy act of 1974

What requirement determines the percentage of patients enrolled in clinical trials each calendar year? Response : The size of the hospital The number of cancer patients accessioned The program category The availability of clinical trials

The program category Rationale: Standard 1.9 states that the required % of PTS ACCRUED to CA-RELATED CLINICAL TRIALS each calendar year is DETERMINED by the FACILITIES CA PROGRAM CATEGORY.

rapid case ascertainment ***3 methods: see next entry

The purpose of rapid case ascertainment is to identify eligible study cases shortly after diagnosis in order to provide researchers with immediate patient access. This is especially important for those cases under special study with high morbidity or mortality rates. The goal is to reach the patient for firsthand interviews and perhaps tissue or blood samples while any lifestyle changes are still fresh in their minds. Genetic studies surrounding issues of early detection have increased the demand for rapid access to eligible study cases.

measured evaluated improved

The quality of cancer patient care is

Recurrence

The reappearance of disease that was thought to be cured or inactive or a new occurrence of cancer arising from cells that have nothing to do with the earlier (first) cancer.

Cancer Control

The reduction of cancer incidence, mortality and morbidity through an orderly sequence from research on interventions and their impact in defined populations to the broad systematic application of the research results

Define the relative survival rate.

The relative survival rate is the ratio of the observed survival rate in the study population to the expected survival rate in the subset of the general population with the same character-istics as the study population. That is, the relative survival rate is the observed survival rate, adjusted because some of the subjects can be expected to die of causes of death other than that under study.

Define the relative survival rate.

The relative survival rate is the ratio of the observed survival rate in the study population to the expected survival rate in the subset of the general population with the same characteristics as the study population. That is, the relative survival rate is the observed survival rate, adjusted because some of the subjects can be expected to die of causes of death other than that under study.

Case eligibility

The reportable list Use of ICD-0 to develop list

safeguard the integrity of assessment systems

The role of American National Standards Institute (ANSI) in the development of healthcare information standards in the United States is to

Data dictionary

The set of information that includes the contents, format, and structure of a database and the relationship between its elements, used to control access to and manipulation of the database

the Certified Tumor Registrar (CTR) credential offered by the National Cancer Registrars Association

The staff is encouraged to gain and maintain ?

true

The stage at the time of the initial diagnosis is documented true or false

state of the art, cancer program administrator, cancer conferences, quality improvement, cancer registry and database

The success of a CoC program is dependent upon _______ treatment and evaluation, ______ leads the program, ________, ______ program, and _______.

Pathology reports and disease indices.

The two most important casefinding sources for both hospital and central registries

observed (all-cause) survial and net (cancer-specific) survival

The two standard measures of survival are:

relative survival and cause-specific survival

The two types of net (cancer-specific) survival are:

Mode

The value that occurs most frequently in a given data set.

frequency distribution

The way values for a variable are distributed

1500, 30

There are currently over _____ CoC accredited cancer programs in the US which represents about ____ percent of all hospitals.

1. Timeliness (Registry procedures occur on schedule) 2. Consistency (Similar interpretation of medical information resulting in little coding variance among registry staff) 3. Accuracy (Validity and reproducibility of data) 4. Case incidence completeness (All required cases to be reported have been reported) 5. Data completeness (Avoiding omissions in data collection and maintaining high rates of known rather than unknown values in data fields)

There are five characteristics of registry data quality which include:

A registry must enter into a data use agreement when

There is access to a file with known disclosure risks

Which of the following is a true statement regarding cancer screening programs? Response : They are designed to decrease the number of patients presenting with late-stage disease. They are designed to reduce the incidence of a specific cancer type. They involve the use of strategies to modify attitudes and behavior to reduce the chance of developing cancers. None of the above

They are designed to decrease the number of patients presenting with late-stage disease.

Why is it important for laptop computers to be configured with disk encryption?

They may be lost or stolen.

the Commission on Cancer

This coding scheme is recommended by?

National Cancer Database

This entity collects, tracks and analyzes data on all types of cancer. These data are used to explore trends in cancer care, to create regional and state benchmarks for participating hospitals, and to serve as the basis for quality improvement.

casefinding

This involves capturing all patients diagnosed and/or treated at the facility.

follow up

This involves monitoring patients annually throughout their lifetime.

abstracting

This involves obtaining data about patients' diagnosis and treatment as well as coding and entering these in database.

Zero based budget

This method calls for each department or sub-department to look at all expenses and justify them at each budgeting cycle.

Collaborative Staging version 2

This was developed to reduce duplicate data produced by TNM and SEER Summary Staging and to produce more clinically relevant data that's reproducible over time.

Record Identification

Those fields used to recognize layout and content of the record being transmitted (ex: patient ID number, tumor record number, coding standards)

When the CoC designs a special study, the following must participate Response : Those programs specified by CoC All approved programs All approved programs and those programs that have applied for an initial survey Programs that have not completed their quality improvement studies for that year

Those programs specified by CoC Rationale: Standard 5.7 states the CoC WILL SELECT PROGRAMS to PARTICIPATE in their hypothesis-based special studies. SELECTION for PARTICIPATION IS BASED on the STUDY CRITERIA DEVELOPED.

Uncensored patients

Those that reach the end point of interest (death, recurrence)

Which Rule is used in record consolidation?

Time submitted rule and known over unknown rule

reason for follow up

To catch a recurrence early For better palliation Patients are prone to have a second primary (about 25% of patients will develop a second independent primary) Assurance of the patient To make sure that the cancer patient has been rehabilitated so that he can live as normal a life as possible

What major role(s) involves the 52 organizational members of the Commission on Cancer (CoC)?

To develop standards for cancer data collection and develop standards for cancer care delivery.

The purpose of follow up is

To evaluate cancer care outcomes and to compare cancer program data with other sources

What is the purpose of an Edit Set?

To group individual edits

What were the two reasons given for the development of Edits software?

To improve the quality of data To standardize the way data items are checked for validity

casefinding audits

To monitor case completeness of reporting facilities, central registries may perform:

The primary role of the institutional review board (IRB) is

To protect the rights of human subjects participating in research, To guarantee that patient consent to participate in the trial is appropriately obtaine, To identify the risks and benefits that might potentially be involved in the experiments.

1-8, above and beyond

To receive accreditation with commendation, ____ standards go _____ requirement.

1-7, 12 months

To receive accreditation with contingency, an organization will have _____ deficiencies which must be resolved within _____.

Why are standard data edits created?

To test data against coding rules

As soon as a path report is signed, it can be sent

To the state, hospital and central registry

Three industrial quality-control methodologies are

Total Quality Management Benchmarking Six Sigma.

Registries support the pharmaceutical industry by:

Tracking complications and outcomes for patients taking specified drugs.

A recording audit will asses

Training needs

Worm

Travels comp to comp

An Advisory Committee to a central registry can provide outreach to the local community and state, and provide helpful support when needed. a. True b. False

True

Another area covered by HIPAA's provisions includes the accuracy of record keeping.

True

Cancer registry information should not be released to individual patients True or False

True

Case finding is a system utilized to identify all eligible reporting cases

True

Honorable discharge of the Association's responsibilities is one of the guidelines addressed in the NCRA Professional Practice Code of Ethics.

True

In situ bladder cancer cases are included in the National Program of Cancer Registries Cancer Surveillance System analytic file. True or False

True

New standard data items for cancer registries are implemented at the beginning of a diagnosis year.

True

Pure HTML code is static, not dynamic

True

Some central registries like the National Cancer Data Base (NCDB) are not population based. a. True b. False

True

Step assessments are a necessary part of time-motion studies.

True

True or False: Computers have become and important part of many processes within the central registry.

True

True or False: Death clearance ensures that all persons with cancer on their death certificate are correctly ascertained by the central registry.

True

True or False: In comparing incidence rates between groups, use of age-specific incidence rates controls for difference in the age composition of the groups.

True

True or False: In situ bladder cancer cases are included in the National Program of Cancer Registries Cancer Surveillance System analytic file.

True

True or False: Many different types of scientific studies can be performed on the population-based data of central registries.

True

True or False: Population-based central registries provide for calculation of incidence rates.

True

True or False: Registry purpose determines registry design.

True

True or False: The Cyber Cancer Registry provides new cancer registrars an opportunity to gain hand-on practice in cancer registry operations.

True

True or False: Using the data can provide important quality feedback.

True

Web address is a synonym of URL (Uniform Resource Locator).

True

Specificity

True negative rate

Sensitivity

True positive rate

HIPPA allows patient information to be shared for

Tumor Board and Follow up from other facilities

Beta-hCG

Tumor Marker for choriosarcoma and testicular

KRAS mutation analysis

Tumor marker used to determine whether treatment with a particular type of targeted therapy is appropriate for colorectal cancer and non-small cell lung cancer

BRAF mutation V600E

Tumor marker used to predict response to therapy for cutaneous melanoma and colorectal cancer.

AJCC - uses the following data to stage the tumor

Tumor size (T) Lymph node involvement (N) Metastases (M)

How often is a clinical goal established per Standard 1.5 required to be monitored and evaluated by the cancer committee? Response : -At every cancer committee meeting -Twice in the same calendar year -Four times in the same calendar year -At the end of each calendar year

Twice in the same calendar year Rationale: Standard 1.5 requires that at least one clinical and one programmatic goal be established each calendar year by the cancer committee. These goals must be evaluated and monitored at least twice in the same calendar year during two subsequent cancer committee meetings, mid-year and at the end of the year. Cancer committee minutes should reflect what the goals are and must include documentation related to monitoring the program's progress toward meeting those goals.

What number of quality improvements must the Quality Improvement Coordinator implement each calendar year? Response : One Two Three Four

Two Rationale: Per Standard 4.8, the CA COMMITTEE, under the GUIDANCE of the QUALITY IMPROVEMENT COORDINATOR, requires that 2 CA CARE IMPROVEMENTS be initiated EACH CALENDAR YEAR. ONE IMPROVEMENT can be BASED ON THE RESULTS of STANDARD 4.7 study that IDENTIFIED PROBLEMATIC QUALITY-RELATED ISSUE that was SIGNIFICANT TO BOTH the CA PROGRAM and the LOCAL CA POPULATION to understand why the problem was occurring. The OTHER IMPROVEMENT can be based on ANY STUDY or PERTINENT DATA SOURCE (e.g., activities to address substandard patient care, enhancements to patient care that are currently evaluated to be merely acceptable).

Population-based and multi-hospital or non-population based

Two main types of central cancer registries

In addition to tracking the date of last contact, the cancer committee is interested in monitoring the use of unknown values in the following field(s) to ensure complete follow-up reporting Response : Primary site Type of first recurrence Both (A) and (B) Neither (A) nor (B)

Type of first recurrence Rationale: Standard 5.3 states that in addition to registries meeting the various benchmarks for required follow-up rates, the CANCER COMMITTEE MONITORS the USE OF UNK VALUES in the DATE and TYPE OF FIRST RECURRENCE FIELDS as well as the CA STATUS FIELD to ENSURE COMPLETE REPORTING F/U INFORMATION.

Work flow

Type of systems and process are at your facility

Phase III Clinical Trial

Typically from 100 to thousands of participants Evaluate the new drug against the current drugs used to treat the form of cancer

Phase IV Clinical Trial

Typically several hundred to several thousand participants Further evaluate the long term effect and safety of the new drug

What was the first organization to produce *Cancer Incidence in Five Continents (CI5)* ?

UICC

Logical Observation Identifiers Names and Codes (LOINC)

UNIVERSAL CODE SYSTEM for IDENTIFYING LAB and CLINICAL OBSERVATIONS from SERUM LEVELS of HEP B SURFACE ANTIGEN to DIASTOLIC BP. LOINC has STANDARDIZED TERMS for ALL KINDS OF OBSERVATIONS and MEASUREMENTS THAT ENABLE EXCHANGE AND AGGREGATION of ELECTRONIC HEALTH DATA from many independent systems

Income and literacy information is obtained by

US Census Bureau

Which organization provides guidelines used by central reg to determin residence at dx?

US Census Bureau

NCRA Ethics committee

Unethical behavior

UDSC

Uniform Data Standards Committee

What group has members from all standard-setting organizations and whose goal is data standardization?

Uniform Data Standards Committee (UDSC) of the American Association of Central Cancer Registries (AACCR)

What is the title of the publication of official annual federal cancer statistics?

United States Cancer Statistics

Urothelial carcinoma

Ureters, renal pelvis and urethra

Coding instructions

Use guidelines and standard according to state rules and national standard setters

NCRA

Use of the Cyber Cancer Registry can serve to satisfy part of the clinical practicum for formal education programs approved by what organization?

Ancillary drugs

Used to enhance effects of cancer directed tx but do not affect the cance r

During the on-site visit, what documentation is provided to support compliance with the standard that relates to the qualifications of those performing abstracting for the registry? Response : Verification of the date of hire to perform abstracting The plan for supervision of credentialed staff who perform abstracting for the registry Both (A) and (B) Neither (A) nor (B)

Verification of the date of hire to perform abstracting Rationale: Standard 5.1 states the program needs to PROVIDE VERIFICATION of the DATE OF HIRE to PERFORM ABSTRACTING DURING SITE VISIT. In addition, the program needs to PROVIDE CONFIRMATION of valid CTR credential for all certified staff, and a PLAN THAT INDICATES NON-CREDENTIALED STAFF are not only supervised, but SUPERVISED BY a CTR.

Patient Safety and Quality Improvement Act

Voluntary reporting system to enhance the data available to asses and resolve patient safety and health care quality assurance e

Revised European and American Lymphoma classification

WHO hem/lymph is based on

Hospital Comparison Benchmark Reports (HCBR)

What CoC quality tool includes all cancer case types diagnosed and submitted to NCDB since 2000 which can be generated to show your facility data alone or in comparison to other facilities or regions?

Cancer Liaison Program (CLP) National Cancer Data Base (NCDB)

What Commission on Cancer's (CoC) program(s) does the American Cancer Society (ACS) award funding to annually?

CDC, Veterans Administration, C/Net Solutions, ONCO, Electronic Registry Systems, Rocky Mountain Cancer Data Systems, Elekta

What are seven vendors of cancer registry databases?

physical exams, imaging tests, laboratory tests, pathology reports, surgical reports

What are the 5 basic methods used to determine cancer stage as stated on the AJCC website?

Accuracy, timeliness, and completness

What are the data quality characteristics of a cancer registry?

Step 1: Identifying the problem. (Done using central registry data). Step 2: Select the target population and develop an intervention strategy. (Done by health care providers.) Step 3: Implement the intervention plan. (Done by health care providers.) Step 4: Evaluate the impact of the intervention. (Done using central registry data.)

What are the four steps that comprise the cancer control model?

Clinical care and hospital administration

What are the major goals of a hospital registry?

Epidemiology and public health

What are the major goals of a population-based registry?

commendation, accreditation, contingency

What are the three types of accreditation?

Incidence and mortality rates

What can only be done in a population-based registry

CNext Software

What cancer registry database did C/Net develop?

oncolog

What cancer registry database did ONCO develop?

Oncotrax

What cancer registry database did Veterans Administration develop?

Registry Plus, WebPlus

What cancer registry databases did CDC develop?

Metafile

What component of NPCR-EDITS contains all of the logic, tables, constants, and messages needed to test data items, one at a time or in groups, and report their agreement or disagreement with the established standard?

ICD 10

What forms the basis for ICD O?

ICD-10 and SNOMED

What is ICD-O-3 based on?

SEER Summary Staging Manual

What is SEER's manual's name?

1) Identify potentially reportable cases 2) Gather source documents 3) Determine whether the case is a new or separate primary

What is the correct order in which pre-abstracting activities are performed?

casefinding

What is the first module available in the Cyber Cancer Registry?

To improve survival and quality of life for cancer patients through standard setting, prevention, research, education, and the monitoring of comprehensive quality care

What is the goal of the Commission on Cancer

Associates degree of equivalent (60 college level credits)

What is the minimum level of education required to be a cancer registrar?

Receipt of pathology reports will improve outpatient case ascertainment activities.

What is the primary reason central registries should pursue receipt of pathology reports from all laboratories when state reporting rules support this activity?

to promote and market NCRA approved formal education programs and to recruit new programs

What is the purpose(s) of the NCRA Formal Education Committee?

to evaluate activities for cancer registry continuing education value, assign appropriate continuing education hours and the publication of the approved educational activities

What is the purpose(s) of the NCRA Program Recognition Committee?

75%

What is the required percentage of meetings that each required member of the cancer committee has to attend each year?

80%

What is the required success rate for analytic cases entered in the database since the reference date?

Reviews and determines whether an activity meets the criteria to quality a CTR for continuing education credits

What is the role(s) of the NCRA's Program Recognition Committee?

Sponsoring members' contributions

What is the source(s) of substantial financial support received by North American Association of Central Cancer Registries (NAACCR)?

version 02.04.40

What is the version number of Collaborative Stage currently in use by cancer registries?

ICD O

What is the worldwide standard cancer diagnosis system?

The CoC reportable list, reportable-by-agreement cases, and the state reportability requirements

What must be included in a hospital reportable list?

Communication and Feedback

What needs to be provided to data collectors as part of registry quality control program to ensure that change is affected?

Modeling Reporting Delay

What process is used by the Surveillance, Epidemiology, and End Results (SEER) Program to more precisely determine current cancer trends and monitor the timeliness of reporting?

Define the purpose

What question are you trying to answer?

The Facility Oncology Registry Data Standards (FORDS) manual

What resource is used by CoC accredited hospital registries as the basis of the data colection effort at their facility?

Corrections performed on cases submitted by reporting facility registrar

What sort of management report would a central cancer registry create for distribution?

Most childhood cancers are staged using either the staging criteria of the Children's Oncology Group (COG), which conducts pediatric clinical trials, or the TNM system (e.g., retinoblastoma)

What stage classification system(s) are used for most pediatric malignancies?

There are two steps in the cancer control model that involve the health care providers: Step 2: Select the target population and develop an intervention strategy. (Done by health care providers.) Step 3: Implement the intervention plan. (Done by health care providers.)

What step(s) in the cancer control model involves the health care providers?

prevalence

What term is used to describe new and preexisting cancer cases alive as of a certain date?

Logical Observation Identifiers Names and Codes (LOINC)

What term refers to a universal code system to identify laboratory and clinical observations?

Full Member

What type of membership status does a population-based central registry have in the North American Association of Central Cancer Registries (NAACCR) organization

Probabilistic record linkage

What type(s) of linkage application is used in a central registry to link datasets in a stastically justifiable way?

The request and the registry's response should be sent to the patient's attending physician. The registry can release information directly to an individual patient if the registrar's state law allows for such disclosure.

When a patient requests their confidential data

Type 1 error hypothesis testing

When null hypothesis is mistakenly rejected

Cases submitted to NCDB will be specified in the Call for Data Response : In July of each year In January of each year When the registry has completed all cases for the year required When requested by NCDB

When requested by NCDB Rationale: Standard 5.5 states that data submission will be in accordance with the annual Call for Data sent by National Cancer Data Base. The timing of that submission will be specified in the Call for Data.

When is a placebo used in clinical trial

When there is currently no standard treatment given for disease in study

hospitals, diagnostic and treatment facilities, research centers, laboratories

Which 4 settings might have cancer registries?

Canadian Institute for Health Information (CIHI)

Which Canadian organization helps policy makers assess the changes in policies, practices and processes and helps assess their impact within the health care system?

The Uniform Data Standards (UDS) Work Group

Which North American Association of Central Cancer Registries (NAACCR) committee provides a formal mechanism to review and recommend proposed changes in data codes and/or the addition of new items submitted by NAACCR members?

Statistics Canada

Which agency is responsible for conducting the Canadian census every 5 years?

The NCRA Ethics Committee

Which body reviews charges of unethical behavior against a cancer registrar?

Edit overrides

Which category of data items does NAACCR consider administrative items?

Cancer Registries Amendment Act of 1992

Which entity established a computerized registry system?

american cancer society

Which group often has reps as members of hospital Cancer committees?

Canadian Partnership Against Cancer (CPAC)

Which independent Canadian agency founded in 2007 has goals that include expansion of core surveillance data collection, improving analytic capacity and increasing access to and use of registry data?

Commission on Cancer

Which organization administers the National Accreditation Program for Breast Cancers?

SEER

Which organization developed Summary Staging - Basic Staging?

Commission on Cancer

Which organization develops standards for approved cancer programs?

American Joint Committee on Cancer

Which organization develops the TNM Manual for prognostic staging of cancers?

WHO

Which organization is responsible for publishing disease codes?

American Joint Committee on Cancer (AJCC)

Which organization is the administrative sponsor for the Collaborative Stage Data Collection System?

The National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program

Which organization maintains the NPCR-EDITS metafile written for the Suveillance, Epidemiology and End Results (SEER) Program participants to use to test their data against SEER cancer registry standards?

AJCC

Which organization maintains the overall management of the Collaborative Staging System?

College of American Pathologists

Which organization provides guidelines for definitive cancer reporting with regard to size, grade, location, extension, and TNM staging?

U.S. Census Bureau

Which organization provides the guidelines used by central registries to determine the residence of the patient at the time of diagnosis?

SEER

Which organization published Multiple Primary & Histology Rules and Hematopoietic & Lymphoid Neoplasm Case Reportability?

Commission on Cancer

Which organization requires physicians to assign AJCC staging when applicable?

Commission on Cancer

Which organization surveys cancer programs to ensure standards are being met?

Every state runs its own program

Which organization(s) runs the Medicaid EHR Incentive Program?

every state runs its own program

Which organization(s) runs the Medicaid EHR Incentive Program?

American Joint Committee on Cancer (AJCC) Commission on Cancer (CoC) National Cancer Registrars Association (NCRA) National Program of Cancer Registries (NPCR) North American Association of Central Cancer Registries (NAACCR) Surveillance, Epidemiology, and End Results Program (SEER) World Health Organization (WHO)

Which organizations are standard setters for population-based central registries?

Hospital Quality Alliance (HQA)

Which partnership program(s) promotes public access to hospital performance data?

Patient Safety and Quality Improvement Act

Which piece of legislation establishes a voluntary reporting system designed to enhance the data available to assess and resolve patiient safety and health care quality issues?

Health Information Technology (HITECH) for Economic and Clinical Health Act

Which piece of legislation was intended to assure the workforce is properly trained and equipped to be meaningful users of certified Electronic Health Records (EHRs)?

American National Standards Institute (ANSI)

Which private non-profit organization oversees the development of voluntary consensus standards for products, services, processes, systems, and personnel in the United States?

Certification Commission for Health Information Technology (CCHIT)

Which program established the first comprehensive definition of the capabilities needed to achieve widespread adoption of health information technology in order to promote improvements in quality, safety, efficiency and access?

National Cancer Informatics Program (NCIP)

Which program supports the National Cancer Institute's (NCI) research initiative through sustaining a multidisciplinary community of biomedical researchers, informaticists, and developers dedicated to improving informatics practices in the study of cancer and the translation of that knowledge into improved clinical intervention?

Cancer Bioinformatics Grid (caBIG)

Which program was replaced by the National Cancer Informatics Program (NCIP) in May 2012 following a 2011 report which raised significant questions about effectiveness and oversight of its program?

AJCC Cancer Staging Manual

Which publication is used for prognostic staging of cancers?

TNM Manual

Which publication is used for prognostic staging of cancers?

Manual of Tumor Nomenclature and Coding

Which publication led to ICD O 3?

WebPlus

Which software collects cancer data securely over the public Internet and is ideal for use by central cancer registries for all electronic reporting needs? Its abstracting capability is also ideal for reporting from physicians' offices and other low-volume reporting sources.

hospitals, freestanding treatment facilities, health care networks

Which three organizations are eligible for CoC accreditation?

Beta-hCG

Which tumor marker is commonly used to assess stage, prognosis and response to treatment for choriocarcinoma and testicular cancer?

CD20

Which tumor marker is used to determine whether treatment with a targeted therapy is appropriate for non-Hodgkin lymphoma?

Immunoglobulins

Which tumor marker is used to help diagnose multiple myeloma

Which types of cancer registries can receive CoC approval for their cancer programs?

While all hospitals do not choose to seek CoC approval for their cancer programs, they are the types of facilities that receive CoC approval for their cancerprograms

A board of directors which includes elected representatives from the membership and the executive director of the organization

Who oversees the activities of the North American Association of Central Cancer Registries (NAACCR)?

Commission on Cancer

Who publishes FORDS?

The Commission on Cancer (CoC) of the American College of Surgeons (ACoS) and the American Cancer Society (ACS)

Who runs the National Cancer Data Base (NCDB)

To be able to share information received with the residents' population-based registry, facilitate death clearance processing, and allow preparation of complete and accurate reports to individual facilities regarding patients diagnosed and/or treated at their facility

Why does the North American Association of Central Cancer Registries (NAACCR) recommend that population-based central registries include in their database case reports of non-residents received from facilities in their geographic catchment area?

What is the "why, when, where and how" of edits? Why: When: Where: How:

Why: to identify incorrect data When: state or SEER submissions, NCDB Call for Data (Hospital Registries), NAACCR or NPCR Call for Data (Central Registries) Where: hospital or Central Registry How: Flag blank fields Indicate single-field edit errors Specify disagreement between multiple data fields Indicate potential errors that require manual review

Thematic maps

With Geographic Information Systems (GIS) technology, what type(s) of map might a central registry use to display cancer incidence or mortality rates for its region?

When programs receive a three-year accreditation with contingencies, they must resolve the deficiencies Response : Within six months Within twelve months Within two years Within three years, prior to the next survey

Within twelve months Rationale: Per the guidelines, established programs awarded a Three-Year ACCREDITATION W/ CONTINGENCY had 1-7 STANDARDS that were RATED DEFICIENT at the TIME OF SURVEY; new programs had 1-2 deficiencies at the time of survey. All deficiencies must be RESOLVED IN 12 MONTHS.

Time motion study

Work flow charts and daily productivity sheets

WHO

World Health Organization (responsible for publishing disease codes)

GLOBOCAN

Worldwide incidence rates and mortality

Merkel cell carcinoma

Worst prognosis skin cancer

HIPPA Administrative Safegaurds

Written set of policies

How often must the competency of oncology nurses be evaluated? Response : Six months Year Two years Three years prior to the survey process

Year Rationale: Standard 2.2 requires that the competency of oncology nurses be evaluated each calendar year.

13. Can two different data standards be syntactically interoperable but not semantically interoperable?

Yes

During the George W. Bush administration (2001-2009), attention was paid to, and support was given, to the emerging EHR environment

Yes

Is using national treatment guidelines required by the Commission on Cancer for a cancer conference in an approved facility?

Yes

Should review of the cases seen within your facility by primary site be completed when selecting cases for presentation at cancer conferences?

Yes, if the facility is CoC approved, case presentations are required based on the major sites within the facility.

List three agencies to which state/territory central cancer registries may report their data.

You may have listed any three of the following: a. NAACCR b. NPCR c. SEER d. Canadian Cancer Registry

Name three reports and publications based on NCDB data.

You may have named any of the following: a. Public benchmark reports b. Hospital Comparison Benchmark Reports c. NCDB Survival Reports d. Cancer Program Practice Profile Reports (CP3R)

Name at least three important types of software applications important to registry operations.

You may have named any of the following: a. Record linkage b. Statistical analysis c. Geospatial analysis d. Edit checking e. Electronic pathology transmissions f. Collaborative Stage Data Collection System

What choices exist if the data requested are not routinely collected by the registry?

You may have named any of the following: a. Restructure the request to use routine data. b. Deny the request if data cannot be obtained for legal or practical reasons. c. Perform a special study to collect the desired information.

Name three types of scientific studies that can be based on central registry data.

You may have named any of the following: a. cancer mapping b. GIS c. ecologic or correlation d. case-control e. cohort f. genetic g. patterns of care h. survival surveillance i. cancer control

Name three purposes for central registries to perform record linkages:

You may have named any of the following: a. casefinding b. duplicate detection c. passive follow-up d. linking patients with other cohorts or risk exposure records

Name one National Cancer Data Base Web-based tool.

You may have named any one of the following: a. Benchmark Hospital Comparison Reports b. NCDB Survival Reports c. Cancer Program Practice Profile Reports d. Rapid Quality Reporting System e. NCDB Public Benchmark Reports

Name three of the most common methods of quality control of cancer data.

You may have named any three of the following most common methods: a. Visual review b. Computerized data edit checks c. Physician review of abstracted data d. Reabstracting audits e. Targeting specific areas of review through the generation of reports from the cancer registry database

Name three services that a cancer conference coordinator provides?

You may have named any three of the following: a. Case selection b. Facilitating cancer conference discussions c. Reviewing CoC requirements d. Providing recommendations for improvement of cancer conference

Identify three sources for use in selecting cases for presentation at cancer conferences.

You may have named any three of the following: a. Physician presenters will personally select the cases for discussion b. Evaluation of current in-house admissions with a diagnosis of cancer c. Evaluation of weekly pathology cases with a cancer-related diagnosis d. Cancer Registry involvement through disease index listings or other casefinding mechanisms.

Name three of the determining factors for setting the frequency and format of a cancer conference?

You may have named any three of the following: a. Program category b. Number of annual analytic accessions c. Types of cases seen by the facility d. Need for consultative services e. Need for educational activities (Requirements for the frequency and format of cancer conference are detailed in CoC Standard 2.6 [revised, 2009].)

Describe at least two differences between ICD and ICD-O.

You may have named any two of the following: a. Code structure (ICD-9 is numeric, ICD-O is alphanumeric) b. Code length (ICD-9 is 5 digits, ICD-O is 10 digits) c. Single axis (ICD-9) versus dual axis (ICD-O) d. Codes all diseases (ICD-9) versus codes neoplasms only (ICD-O) e. ICD-O is only a subset of ICD

What are two benefits of creating a presenter format for case presentation at a cancer conference?

You may have named any two of the following: a. Facilitate the discussions b. Adhere to the requirements of the CoC c. Provide useful information for registrar use

Name two ways the National Cancer Data Base data are used.

You may have named any two of the following: a. Measure treatment patterns and outcomes. b. Evaluate hospital provider performance. c. Conduct research and develop focused studies to meet the demand for an ongoing assessment of the quality of cancer care. d. Assess and validate nationally accepted quality measures for cancer care. e. Develop effective resources and tools to improve outcomes at the national, regional, and local levels.

Match the following types of cancer registry with the goals below: A. Hospital-based cancer registry B. Population-based cancer registry C. Specialty cancer registry ______ Advancing clinical, epidemiological, and health services research on cancer ______ Evaluating clinical care and hospital administration ______ Providing advocacy and educational opportunities to cancer patients ______ Exploration of trends in cancer care ______ Creation of regional and state benchmarks for hospitals ______ Gathering and disseminating epidemiologic data on a specific type of cancer ______ Determination of cancer patterns among various populations or sub-populations, ______ Monitoring cancer trends over time ______ Guiding planning and evaluation of cancer control efforts to help prioritize healthresource allocations. ______ Improving patient care programs. ______ Research into the cause

__B, C_____ Advancing clinical, epidemiological, and health services research on cancer __A____ Evaluating clinical care and hospital administration ___A, C___ Providing advocacy and educational opportunities to cancer patients ___B___ Exploration of trends in cancer care ___B___ Creation of regional and state benchmarks for hospitals ___C___ Gathering and disseminating epidemiologic data on a specific type of cancer ___B______Determination of cancer patterns among various populations or sub-populations, resource allocations. _B_____Monitoring cancer trends over time __B____ Guiding planning and evaluation of cancer control efforts to help prioritize health resource allocations. _A, B_____ Improving patient care programs. _B, C_____ Research into the cause

Match the following words to the appropriate definition. A. Class of case B. Analytic C. Accession number D. Sequence number E. Date of diagnosis F. Visual review G. Edits H. Text ______ A computer program that compares the coded data with the rules for abstracting ______ The facility participated in either initially diagnosing and/or delivering all or part of the first course of treatment ______ Individual abstracts are reviewed to identify incomplete or inaccurate codes and information ______ Unique number assigned to a patient that can be used as a numerical control to identify the patient ______ Defines the role of the reporting facility in the management of the patient's cancer ______ The first time a medical practitioner confirms the presence of cancer ______ Validates the codes assigned in the abstract ______ Indicates the number of primaries a patient has had in his or her lifetime

__G___ A computer program that compares the coded data with the rules for abstracting __B____ The facility participated in either initially diagnosing and/or delivering all or part of the first course of treatment ___F___ Individual abstracts are reviewed to identify incomplete or inaccurate codes and information ___C___ Unique number assigned to a patient that can be used as a numerical control to identify the patient ___A___ Defines the role of the reporting facility in the management of the patient's cancer __E____ The first time a medical practitioner confirms the presence of cancer __H____ Validates the codes assigned in the abstract __D____ Indicates the number of primaries a patient has had in his or her lifetime

Match the following types of cancer registry with the appropriate cancer data sources. A. Hospital-based cancer registry B. Population-based cancer registry C. Specialty cancer registry Sources: ______ Death certificate information from the vital statistics registration system ______ Patients diagnosed in Independent pathology laboratories ______ Active follow-up information on registered patients ______ Patients diagnosed and/or treated for cancer at a particular facility or facilities ______ Patients who voluntarily self-enroll ______ Only patients with certain familial cancers ______ Patients treated in independent cancer centers ______ Patients from private clinics and hospices ______ Only patients with a particular type of cancer ______ Patients enrolled by physicians

___B___ Death certificate information from the vital statistics registration system ___B___ Patients diagnosed in Independent pathology laboratories __A,B____ Active follow-up information on registered patients __A,B____ Patients diagnosed and/or treated for cancer at a particular facility or facilities __C__ Patients who voluntarily self-enroll _C_____ Only patients with certain familial cancers __B____ Patients treated in independent cancer centers ___B___ Patients from private clinics and hospices __C____ Only patients with a particular type of cancer __C____ Patients enrolled by physicians

Match the registries in the column with its purpose below. A. AFIP DNA registry B. Nun Study C. National Marrow Donor Program D. Trauma Registry E. Advance Directive Registry ______ Making living wills accessible ______ Finding transplant matches ______ Identifying combat casualties ______ Tracking course of Alzheimer's disease ______ Preventing accidents

___E___ Making living wills accessible __C____ Finding transplant matches ___A___ Identifying combat casualties __B____ Tracking course of Alzheimer's disease ___D___ Preventing accidents

lead time

____ ____ errors occurs when there is a passage of time between the time the cancer was actually diagnosed and the time it would have been diagnosed using the older techniques

data dictionary

____ __________defines the data items in a registry data set, including coding instructions, code definitions, and the code options

data set

____ ___the collection of items maintained by a registry

95

____% of eligible pathology reports containing a cancer diagnosis must contain scientifically validated elements per College of American Pathologists

Match the items in the column to the categories below. A. Patient's last name B. Date of first registry case C. Confidentiality statement D. ICD-9 Manual ______ Case definition ______ Policy manual ______ Data item list ______ Coding standard

____B__ Case definition ____C__ Policy manual ____A__ Data item list ___D___ Coding standard

Number the abstracting activities listed below in the order in which they are performed.

_____ Prepare the abstract. _____ Disseminate data for reports and studies. _____ Determine whether the case is a new or separate primary. _____ Conduct quality control on the data. _____ Gather source documents. _____ Identify potentially reportable cases.

Indicate which section of the abstract each of the following data items would be grouped. Use the corresponding letter for the section of the abstract. P - Patient Identification C - Cancer Identification S - Stage of Disease at Diagnosis F - First Course of Treatment O - Outcomes ______ Laterality ______ Collaborative Stage Tumor Extension ______ Date of initial diagnosis ______ Vital status ______ Accession number ______ Hormone therapy ______ Behavior code ______ Summary Stage ______ Histology ______ Sequence number ______ Diagnostic confirmation ______ Radiation therapy ______ Social Security number ______ Date of last contact ______ Race ______ AJCC TNM ______ Date of birth ______ Collaborative Stage lymph nodes ______ Class of case ______ Surgical procedure of the primary site ______ Primary site ______ Cancer status ______ Grade/differentiation ______ Collaborative Stage metastasis at diagnosis ______ Chemotherapy

_____C_ Laterality _____S_ Collaborative Stage Tumor Extension ___C___ Date of initial diagnosis ___O___ Vital status ___P___ Accession number ____F__ Hormone therapy ___C___ Behavior code ____S__ Summary Stage ____C__ Histology ____P__ Sequence number ___c___ Diagnostic confirmation ____F__ Radiation therapy ____P__ Social Security number ____O__ Date of last contact ___P___ Race ___S___ AJCC TNM ____P__ Date of birth ____S__ Collaborative Stage lymph nodes ____C__ Class of case ___F___ Surgical procedure of the primary site ___C___ Primary site ___o___ Cancer status ____C__ Grade/differentiation ___S___ Collaborative Stage metastasis at diagnosis ___F___ Chemotherapy

standard data item

________ ____ ____is a data item whose codes, definitions, and coding instructions are shared among registry organizations

standard data set

________ ____ ___is the collection of standard data items defined as the minimal data set required by an applicable standard setting organization

case consolidation

a combination of automated functions that the cancer registry software can perform and manual functions that can only be done by the cancer registrar; patient records from multiple sourced are matched, abstracts are filled out and duplicates are removed

EDITWriter

a component of EDITS that allows standard setters to create rules in an executable form. used to define data items, maintain reference tables, specify algorithms, logic, and documentation; and create record layouts.

class of case

a data item and concept used by hospital-based registries to denote whether the case was diagnosed and/or treated at the reference hospital, or has received treatment previously elsewhere

Cancer cluster

a descriptive analysis to evaluate cancer occurrences in a certain location or during a certain time period

Privileged use

a documented system of procedures and polices that provide for all routine privileged use and disclosure of confidential info

edit set

a group of edits used to edit a data file

Network

a group of facilities that work together and are integrated within that organization

suspense system

a list of cases that have been identified but not yet abstracted

reportable list

a list that should include all diagnoses that are to be reported and that specify which diagnoses are not reportable

Thematic Map

a map that shows a particular theme, or topic

Canadian Cancer Society (CCS)

a national, community-based organization of volunteers whose mission is to eradicate cancer and enhance the quality of life of people living with cancer.

FCCP

a nonhospital-based program and offers at least 1 cancer-related treatment modality; full range of diagnostic and treatment services is available by referral; no minimum caseload requirement

administration

a part of ahealth care facility that deals with day-to-day operations of the facility rather than direct patient care

analytic case

a patient who was diagnosed with cancer at your facility and has all of their first course of treatment planned and administered at your facility

Accession Register

a permanent log of all the cases entered into the database

edit check

a programmed instruction or subroutine designed to check input data by performing a computerized comparison of data fields for resonableness, validity, limit and completeness

SEER Cancer Statistics Review (CSR), 1975-2006

a publication by SEER that includes tables showing cancer statistics by race, sex, age, and year of diagnosis for the major cancer sites and for all cancers combined; an annual report published online that contains the most recent incidence, mortality, prevalence, lifetime risk and survival statistics

Cancer Stat Fact Sheets

a publication by SEER that is a collection of statistical summaries for a number of common cancer types

State Cancer Profiles

a publication by SEER that is a comprehensive system of dynamic maps and graphs enabling the investigation of cancer trends at the national, state, and county level

Fast Stats

a publication by SEER that links to tables, charts, and graphs of cancer statistics for all major cancer sites by age, sex, race, time period. The statistics include incidence, mortality, survival and stage, prevalence, and the probability of developing or dying from cancer

Annual Report to the Nation

a publication by SEER that provides an annual update on cancer occurrence and trends in the US

Cancer Query Systems

a publication by SEER that provides more flexibility and a larger set of cancer statistics than Fast Stats with ability to customize the format of the output into tables, graphs, and delimited format

Cancer Mortality Maps and Graphs

a publication by SEER that that shows geographic patterns and time trends of cancer death rates for the time period 1950-1994 for more than 40 cancers

Quality assurance

a set of activities designed to ensure that the development and/or maintenance process is adequate to ensure a system will meet its objectives. Help make sure you are doing the right things, the right way. methodology and standards development are examples

Quality control

a set of activities designed to evaluate the registry's data (i.e., its work product). Makes sure that the results produced were what you expected. Focused on finding defects in deliverables. Testing and evaluating data or procedures in a registry is an example

GenEDITS Plus

a software program that allows a user to run sets of edits against a data file of cancer records and produce an error report. The edits and edit sets are typically created by the standard setters. The data file of cancer records is an extract of records from a registry's database written out into a text file using the NAACCR data exchange record layout for abstracts.

abstract

a summary, abridgement, or abbreviated record that identified pertinent cancer information about the patient, the disease, the cancer-directed treatment, and the disease process from the time of diagnosis until the patient's death. -The basis for all the registry's function

bias

a systemic error in epidemiological study

e-path reporting

a term that was first used to connote the concept of automation of cancer casefinding from independent pathology laboratories

adjuvant therapy

a treatment modality given in conjunction with another treatment modality, such as chemotherapy given after surgery or radiation for localized disease, with the intent to destroy micrometastases

astrocytoma

a tumor of the brain or spinal cord

Radiofrequency ablation

a type of treatment that uses heat energy

accession number

a unique number assigned to the patient by the registrar, indicating the year in which the patient was first seen at the reporting institution and the sequential order in which the patient was identified by the registry or abstracted into the database. -Used for all additional primaries the patient mat develop, regardless of the year in which subsequent, reportable tumor occur

Name three annual statistical reports where SEER data are combined with data from other national surveillance partners.

a. "Annual Report to the Nation on the Status of Cancer" b. Cancer in North America c. U.S. Cancer Statistics

Name five standard setters for central cancer registries. You may have named any of the following:

a. ACoS/CoC b. AJCC c. SEER d. NPCR e. NCRA f. NAACCR g. WHO

List the three parts of the NCDB data cycle.

a. Annual Call for Data b. Data processing that includes edit checks and writing case records to the CoC's data warehouse c. Data analysis and evaluation

The acronym ACTUR stands for: a. Automated Central Tumor Registry. b. Actual Registry. c. Automated Cancer and Tumor Registry. d. Actual Tumor Reporting System.

a. Automated Central Tumor Registry.

What are the four cornerstones of cancer program accreditation?

a. Cancer committee b. Cancer conferences c. Cancer registry d. Quality improvement program

4. Which of the following is not a use for the SAR? a. Design a cancer center b. Track program activities c. Customize the survey d. Report and analyze program activities across the country

a. Design a cancer center

List two methods of matching.

a. Deterministic b. Probabilistic

For more than two decades, NCI has utilized this flexible mechanism of Rapid Response Surveillance Studies (http://seer.cancer.gov/rapidresponse/) to conduct studies by individ- ual and collaborative groups of SEER investigators. What are the six categories of studies?

a. Evaluating methodologic issues b. Evaluating cancer treatment and outcomes c. Monitoring screening practices d. Monitoring health behaviors and risk factors e. Linking databases f. Improving technical aspects of registry operations

_____________________is an example of a Web 2.0 site. You may have named any of the following:

a. Facebook.com b. Wikipedia.com c. Linkedin.com d. Myspace.com e. Youtube.com

2. Which profession is not represented on the surveyor team? a. Facility administrators b. Surgeons c. Certified Cancer Registrars d. Medical Oncologists

a. Facility administrators

Name four sources of electronic data files.

a. Facility electronic health record b. Pathology laboratory c. Physician office/clinic including outpatient oncology d. Central registry

Through its Web site (http://seer.cancer.gov/), SEER makes available public-use data, which include SEER incidence and population data associated by age, sex, race, year of diagnosis, and geographic areas (including SEER registry and county). The data file is free, but a signed data agreement is required. Beyond the data/software package SEER*Stat, what is available on the Web site for statistical inquiries?

a. Fast*Stats b. Statistical Fact Sheets c. Cancer Query System (CANQUES)

What committee is represented by the Professional Development Board Director? a. Formal Education Program Review Committee b. Education Committee c. CTR Exam Prep Committee d. Alternative Methods Committee

a. Formal Education Program Review Committee

Name current drivers and standards of privacy and security protection.

a. HIPAA b. Industry standards c. Duty of care d. Patient interests

The primary quality-control concerns of central registries involve which two straightforward questions?

a. How complete is case ascertainment? b. How complete and accurate are the data that are collected?

List the four steps in the model for cancer control.

a. Identify the burden of cancer in geographic areas and by characteristics of person (measure). b. Share this information with community organizations so they can target the areas and populations most in need and plan appropriate intervention strategies (plan). c. Implement the intervention plan (act). d. Measure whether the desired changes occurred (measure).

Determining the number of primary tumors is: a. Important if registry data are to be comparable b. Is the same in the United States and worldwide c. Neither a nor b d. Both a and b

a. Important if registry data are to be comparable

Which quality method is most costly? a. Independent case ascertainment b. Reliability study c. Reabstracting study d. CoC survey review

a. Independent case ascertainment

Why should a probabilistic record linkage application be used to link records in a central registry? a. It makes it feasible and efficient to link data sets in a statistically justifiable manner. b. It increases the probability that two records can be matched. c. It allows weighted match probabilities to be ignored. d. It is faster than comparing two spreadsheets. e. It reduces the rate of typographical errors often found in registry data.

a. It makes it feasible and efficient to link data sets in a statistically justifiable manner.

List the three major types of cancer for which evidence-based cancer control intervention strategies are currently available.

a. Lung cancer b. Colorectal cancer c. Breast cancer

What is the backbone of the NCDB metafile? a. NAACCR standard edits b. FORDS standard edits c. SEER standard edits d. None of the above

a. NAACCR standard edits

NAACCR's first standards volume published in 1994 represented the status of agreed-on data items and codes. The groups agreeing to these standards were: a. NAACCR, American College of Surgeons, National Cancer Institute, Centers for Disease Control and Prevention, National Cancer Registrars Association. b. NAACCR, American Joint Commission on Cancer, American Cancer Society, National Cancer Institute. c. NAACCR, National Cancer Data Base, National Cancer Institute, National Cancer Regstrars Association. d. none of the above

a. NAACCR, American College of Surgeons, National Cancer Institute, Centers for Disease Control and Prevention, National Cancer Registrars Association.

Specify two substantial funding sources/organizations for population-based central registries.

a. NCI/SEER b. CDC/NPCR

Name three evaluation activities conducted by the National Program of Cancer Registries.

a. NPCR-CSS Data Evaluation Reports b. NPCR Program Evaluation Instrument c. NPCR Data Completeness and Quality Audits

List the six categories of information that the collected data in the NCDB include.

a. Patient characteristics b. Tumor staging c. Histology characteristics d. Type of first-course treatment administered e. Disease recurrence f. Survival information

The SEER registries routinely collect data on what types of information on the patients and their cancers?

a. Patient demographics b. Primary tumor site c. Tumor morphology and stage at diagnosis d. Initial course of cancer treatment e. Follow-up for vital status

What are the six common sections of a cancer registry abstract?

a. Patient identification b. Cancer identification c. Stage of disease at diagnosis d. First course of treatment e. Outcomes f. Case administration

List the four categories of cancer control research that use central cancer registry data.

a. Primary prevention and chemoprevention research b. Biomarkers, screening and early detection studies c. Patterns of care research d. Survivorship research

What are the goals and objectives for education and professional development in NCRA? a. Provide comprehensive educational opportunities that are accessible, cost appropri- ate and forward thinking. b. Develop a comprehensive education plan to meet the changing demands of the pro- fession and the CTR-credentialed individual. c. Deliver basic and advanced (post-CTR) education opportunities. d. Expand and enhance formal education opportunities. e. Monitor and encourage informatics role in cancer registry profession.

a. Provide comprehensive educational opportunities that are accessible, cost appropri- ate and forward thinking. b. Develop a comprehensive education plan to meet the changing demands of the pro- fession and the CTR-credentialed individual. c. Deliver basic and advanced (post-CTR) education opportunities. d. Expand and enhance formal education opportunities. e. Monitor and encourage informatics role in cancer registry profession.

List three benefits of cancer program accreditation. You may have named any three of the following:

a. Provides a framework for cancer program structure and process b. Includes access to cancer program and data standards c. Provides for external and internal assessments of the quality of care being provided to cancer patients d. Allows access to the National Cancer Data Base to assess and improve care e. Provides educational tools, resources, and best practices to enhance cancer program performance f. Results in promotion and recognition by the public, payers, and government agencies

What changes will technologic advances likely bring to cancer registries? Select all that apply. a. Registry data will be available closer to real time. b. Interoperability will no longer be necessary. c. The registry data set will become more simplified. d. Cancer registration will become completely automated, eliminating the need for cancer registrars. e. Registry data will become even more clinically relevant and important.

a. Registry data will be available closer to real time. e. Registry data will become even more clinically relevant and important.

What is secondary prevention? a. Slowing disease progression, preventing complications, and limiting disability b. Preventing a second cancer from occurring c. Requiring a second intervention to prevent the disease d. All of the above

a. Slowing disease progression, preventing complications, and limiting disability

What are the three key roles for cancer registry technical staff? a. Software development b. Systems administration c. Registry operations technical support

a. Software development b. Systems administration c. Registry operations technical support

What is not a principle of an Abstracting Methods course? a. Statistics and epidemiology b. Identification of cases that are eligible for cancer registry database inclusion c. Methods of documenting clinical information into data fields d. Independent practice on cancer registry data elements

a. Statistics and epidemiology

Which of the following is a method for protecting confidential data? a. Suppression of table cells that have low counts b. Sending password-protected data files using a secure method with the password c. Accurate statistical analysis of registry data d. Avoiding electronic distribution of data

a. Suppression of table cells that have low counts

CS resolved which issue between the other staging systems? a. Timing rules b. Depth of invasion c. Tumor size d. Distant lymph nodes

a. Timing rules

The complete ICD-O code for a neoplasm contains 10 characters. What are the principal parts of the code and what do they represent?

a. Topography (primary site): 4 characters b. Morphology (cell type): 4 digits c. Behavior: 1 digit d. Grade or differentiation: 1 digit

A probabilistic matching algorithm creates a match score based on the mathematical likelihood that identical or similar field values indicate a match. a. True b. False

a. True

An effective data quality management program is dependent on timely, complete, and high-quality data. a. True b. False

a. True

Both text and images can be hyperlinks in Web pages. a. True b. False

a. True

CPG are effective in translating research into clinical practice. a. True b. False

a. True

Collaborative Staging was originally developed to provide a translation between the TNM staging system of the AJCC and the SEER Summary Staging System. a. True b. False

a. True

Death clearance ensures that all persons with cancer on their death certificate are cor- rectly ascertained by the central registry. a. True b. False

a. True

Deterministic matching requires that records must have an exact match on key fields to be considered the same patient. a. True b. False

a. True

Employees of central cancer registries in North America are considered NAACCR members. a. True b. False

a. True

Hospital standardization was one of the first activities of the newly formed American Col- lege of Surgeons (ACoS). a. True b. False

a. True

In comparing incidence rates between groups, use of age-specific incidence rates controls for difference in the age composition of the groups. a. True b. False

a. True

Linking data is the process of matching data from different sources based on identical or similar items from each source. a. True b. False

a. True

NAACCR standard metafiles are crucial to central registry reporting. a. True b. False

a. True

NCRA is a founding and Sponsoring Member of NAACCR. a. True b. False

a. True

National Cancer Institute (NCI) has set a priority of quality of cancer care by identifying, developing, applying, and evaluating quality-of-care measures. a. True b. False

a. True

No facility-specific patient information can be released unless authorized under law. a. True b. False

a. True

Phase IV trials are used to further evaluate the long-term safety and effectiveness of a treatment. a. True b. False

a. True

Population-based central registries provide for calculation of incidence rates. a. True b. False

a. True

Quality of performance is the degree to which the final product/service will meet the needs of the consumer. a. True b. False

a. True

Record consolidation is the process of combining data from two or more records for the same patient and same tumor? a. True b. False

a. True

Some central registries like the National Cancer Data Base (NCDB) are not population based. a. True b. False

a. True

The Belmont Report, published in 1978, mandated the establishment of institutional review boards (IRBs), outlined protocol design criteria, and required that written informed consent be provided to all research subjects. a. True b. False

a. True

The Cyber Cancer Registry provides new cancer registrars an opportunity to gain hands-on practice in cancer registry operations. a. True b. False

a. True

The National Cancer Act of 1971 promoted the development of oncology training pro- grams, facilities, and public education services. a. True b. False

a. True

The Nuremberg Code of 1947 serves as the foundation for ethical principles governing clinical research today. a. True b. False

a. True

The conception of TJC began with Dr. Ernest Codman. a. True b. False

a. True

The Pareto diagram helps identify areas that need attention by ranking them. a. True b. False

a. True When analyzing data about the frequency of problems or causes in a process. When there are many problems or causes and you want to focus on the most significant.

List the four data sources that are generally available in each U.S. state and can be used for defining the burden of cancer.

a. U.S. Census data b. Behavioral Risk Factor Surveillance System (BRFSS) data c. Central cancer registry data d. Vital records mortality data

When can confidential patient data be transmitted over the Web or Internet? Select all that apply. a. When using encrypted Web connections b. Only when the recipient is expecting the data and can quickly retrieve it from e-mail c. By attaching data to e-mail in an encrypted file d. When data are contained on a CD mailed using nondescript packaging e. When data are encrypted on physical media

a. When using encrypted Web connections c. By attaching data to e-mail in an encrypted file e. When data are encrypted on physical media

Name three organizations that have helped to develop the topography and morphology codes used to code neoplasms.

a. World Health Organization b. College of American Pathologists c. American Cancer Society

NAACCR is governed by: a. a Board of Directors. b. NCRA. c. NCI. d. CDC.

a. a Board of Directors.

If a patient has multiple primary cancers: a. all records will be updated with the date of last contact, but the cancer status will need to entered separately. b. all records are updated with the date of last contact, but record cancer status only if the patient still has evidence of disease. c. all records are updated with the date of last contact. The cancer status is not updated when performing patient follow-up. d. none of the above.

a. all records will be updated with the date of last contact, but the cancer status will need to entered separately.

The application that allows the public and hospitals to design customized reports based on selected data items is called: a. benchmark reports. b. NCDB Survival Reports. c. CP3R.

a. benchmark reports.

The NCDB contains data submitted by: a. cancer programs accredited by the CoC. b. state central cancer registries. c. all facilities that diagnose or treat cancer. d. hospital-based cancer registries only.

a. cancer programs accredited by the CoC.

The term multimodality refers to: a. combined forms of cancer-directed treatment. b. more than one cause of mortality. c. use of various imaging techniques for cancer case presentations. d. more than one type of radiation therapy given to the same patient.

a. combined forms of cancer-directed treatment.

What are the three eligibility requirements that must be met before a cancer program can be considered for survey? Before the initial survey, the institution must:

a. demonstrate 1 year of compliance with the standards. b. have accrued 2 years of data with 1 year of successful follow-up. c. have met the requirements for consideration for accreditation as outlined in the Cancer Program Standards manual.

For reporting and analysis of data, the NCDB organizes much of its data by: a. disease site. b. histology. c. AJCC stage of disease.

a. disease site.

The survey focuses on which of the following activities except: a. how the budget is spent. b. how clinical care is provided. c. assurance of the accuracy of data collection. d. how quality of care and patient outcomes are evaluated and improved.

a. how the budget is spent.

All of the following are true of the Accredited Cancer Program Performance Report except that it: a. identifies the program as an Outstanding Achievement Award recipient. b. provides a summary of the program deficiencies. c. identifies the facility, surveyor, and date of the survey. d. provides the Accreditation Award.

a. identifies the program as an Outstanding

AJCC clinical classification is defined as: a. information before initiation of treatment or within 4 months of diagnosis, whichever is shorter. b. information before initiation of treatment or within 4 months of diagnosis, whichever is longer. c. information before neoadjuvant therapy only. d. information before surgical resection only.

a. information before initiation of treatment or within 4 months of diagnosis, whichever is shorter.

All of the following are responsibilities of the key contact for survey except: a. leads the tour of the facility. b. ensures the accuracy of data recorded in the SAR. c. works with the surveyor and cancer committee to identify the best date for the survey. d. works with the surveyor to develop the survey agenda.

a. leads the tour of the facility.

Cancer Registries can provide measurement data to assess how CPG's are being followed or to monitor other aspects of care by: a. real-time reporting. b. reporting cases in 3 to 6 months after diagnosis. c. none of the above.

a. real-time reporting.

Brachytherapy is: a. sealed radioactive sources placed in or near tumors. b. the use of heat to treat tumors. c. the use of intraperitoneal chemotherapeutic agents. d. all of the above.

a. sealed radioactive sources placed in or near tumors.

All of the following are true of the surveyor team except that: a. surveyors are employees of the CoC. b. Certified Tumor Registrars are CoC surveyors. c. physicians from multiple specialties are CoC surveyors. d. the surveyor team has more than 40 members.

a. surveyors are employees of the CoC.

The NCDB does not contain information that can be used to identify: a. the patient's name. b. the reporting facility. c. the case abstractor. d. all of the above.

a. the patient's name

NAACCR work is done primarily by: a. various committees, work groups, task forces, and ad hoc groups composed of volunteers. b. independent contractors and coders. c. staff from comprehensive cancer centers. d. researchers.

a. various committees, work groups, task forces, and ad hoc groups composed of volunteers.

An appeal of an Accreditation Award is appropriate: a. when the program had complied with the standard at the time of survey. b. any time after the survey has been completed. c. after the issues have been addressed by the program. d. when new documentation of program activity has been created.

a. when the program had complied with the standard at the time of survey.

handwritten typed or computerized

abstract may be?

circuit riders

abstractors who are employed by the central registry to visit reporting facilities and perform casefinding and abstracting of data in the field

Statistical quality-control principles include

acceptance sampling, process control, and designed studies.

CCCP

accessions 500 or more newly diagnosed cancer cases each year; provides a full range of diagnostic and treatment services either on-site or by referral; participation in cancer-related clinical research is required

CCP

accessions more than 100 but fewer than 500 newly diagnosed cancer cases each year and provides a full range of diagnostic and treatment services, but referral for a portion of diagnosis or treatment may occur

What is The Joint Commission (TJC) accreditation survey cycle?

accreditation survey cycle is every three years for healthcare organizations and every two years for laboratories.

Ancillary drugs

agents that enhance the effects of cancer-directed treatment but do not directly affect the cancer (e.g., Leucovorin and Mesna)

Observed survival is an estimate of the probability of surviving all

all causes of death

Data Set

all items collected by a registry

bias Selection

all of the subjects in population do not have the same opportunity to be selected

Edit Over-rides flags

allow the registry staff to indicate that questionable data is actually correct.

Rapid Quality Reporting System (RQRS)

allows for the collection of a minimum number of data items necessary for the selected primary sites in order to support ongoing quality assurance programs and to compare and evaluate any variations in care among CoC accredited cancer programs

Inter-field Edits

also known as Multi-field Edits) compare the codes recorded for one data item with codes recorded for related data items to assess correctness in coding all involved fields.

Inter-record Edits

also known as Multi-record Edits) compare data on more than one record.

Rapid reporting/case ascertainment

an abbreviated cancer report sent as soon as possible after diagnosis and is critical to some patient studies; this is especially important for those cases under special study with high morbidity or mortality rates; The goal is to reach the patient for firsthand interviews and perhaps tissue or blood samples while any lifestyle changes are still fresh in their minds

accession register

an annual, sequential listing of all reportable cancers and reportable-by-agreement cases included in the registry

Process improvement

an aspect of organizational development in which actions are taken within an organization to identify, analyze and improve existing procedures to meet new goals and objectives

case-control study

an epidemiologic study (retrospective) design in which enrollment into the study is based on presence ("case") or absence ("control") of the disease under study. Characteristics, such as previous exposure, are then compared between cases and controls. Performing casefinding activities to identify both the eligible cases from a defined population from which sampling for controls can be performed is especially important.

Cancer registry

an information system designed for the collection, storage, management, and anlysis of data on persons with cancer, usually covering a hospital or group of hospitals

disease registry

an organized system for the collection, storage, analysis, and interpretation of data on persons with the particular disease of concern

The codes for the Class of Case data item are divided into two broad categories:

analytic and nonanalytic.

The Commission on Cancer patient care studies

are done by a voluntary network of contributors. When NCDB was established, the patient care studies were merged with NCDB.

Single Field Edits

are those that verify and validate the field values for only one data item at a time

the medical staff bylaws must identify the cancer committee as what?

as a multidisciplinary standing committee

Audit hospital case findings activities and/or re-abstract audits

at least once every 5 years

mean

average

The history of U.S. cancer registration began in the: a. 1890s. b. 1920s. c. 1940s. d. 1960s.

b. 1920s.

Population-based cancer registration started at the provincial/territorial level in Canada in what year? a. 1930 b. 1932 c. 1935 d. 1937

b. 1932

How long is the term of office for someone elected to the position of Treasurer Junior? a. 1 year b. 2 years c. 3 years d. 4 years

b. 2 years

In what year was Version 1 of the Collaborative Staging System released? a. 2001 b. 2004 c. 2005 d. 2009

b. 2004

The NCDB captures what percentage of all newly diagnosed malignant cancer cases in the United States annually? a. 60% b. 70% c. 80% d. 90%

b. 70%

What is the required rate (percentage) for follow-up in programs approved by the Commission on Cancer of the American College of Surgeons for all eligible analytic patients diagnosed within the last 5 years or from the cancer registry reference date, whichever is shorter? a. 80% b. 90% c. 100% d. There is no percentage requirement

b. 90%

What is the NCDB? a. A statewide facility-based oncology data set b. A nationwide, facility-based oncology data set c. A regional facility based oncology data set d. None of the above

b. A nationwide, facility-based oncology data set

Which organization is the administrative sponsor for the Collaborative Stage Data Collection System? a. American College of Surgeons b. AJCC c. College of American Pathologists d. SEER

b. AJCC

Which types of cancer are evaluated by the clinical checks? a. Genitourinary system cancer b. Breast and colorectal cancer c. Lymphoid neoplasms and hematopoietic diseases d. Colorectal and malignant and benign brain tumors

b. Breast and colorectal cancer

CoC-accredited cancer programs are required to resolve which of the following types of cases that failed an edit? Check all that apply. a. Cases with a data quality score of zero b. Cases that accumulate a data quality score between 1 and 199 c. Cases that accumulate a data quality score of 200 or greater d. Cases that received "rejection edits"

b. Cases that accumulate a data quality score between 1 and 199 c. Cases that accumulate a data quality score of 200 or greater d. Cases that received "rejection edits"

If reliable cause of death information is available, then we can use which of the following survival measures? a. Observed all cause b. Cause-specific survival c. Relative survival

b. Cause-specific survival

What does the acronym CAM stand for? a. Chemotherapy and medical treatment b. Complementary and alternative medicine c. Cobalt and alternative medicine d. Chemotherapy and alternative medicine

b. Complementary and alternative medicine

What software function(s) are unique to hospital registries? Select all that apply. a. Data linkage with Social Security Administration files b. Conducting active patient follow-up c. Generating data for clinicians d. Submitting data to the American College of Surgeons' National Cancer Database e. Submitting data to the Centers for Disease Control and Prevention

b. Conducting active patient follow-up d. Submitting data to the American College of Surgeons' National Cancer Database

Which of these is a step that must be taken to define the data used in a report? a. Define the types of statistics to be shown. b. Confirm the specific codes used to define variables such as site, morphology, and stage. c. Determine the method of distribution. d. Obtain approval for data usage.

b. Confirm the specific codes used to define variables such as site, morphology, and stage

All National Program of Cancer Registries training materials are available with an annual subscription. a. True b. False

b. False

American Society of Clinical Oncology's (ASCO's) Quality Oncology Practice Initiative (QOPI®) includes use of Cancer Registry Data for hematology/oncology practices. a. True b. False

b. False

Assessing edits on a regular basis increases the time to review cases before submission. a. True b. False

b. False

Cancer is a reportable disease (by law) in all Canadian provinces and territories. a. True b. False

b. False

Clinical trials are the first step in the research process of moving scientific research from the laboratory to treatments for people. a. True b. False

b. False

Deterministic scores are usually divided into ranges indicating a match, a nonmatch, or an undetermined match. a. True b. False

b. False

E-path reporting refers to the capability of computers to find the shortest electronic path through the Internet's routers and servers, thereby saving money. a. True b. False

b. False

Ethnicity data are a standard data element in the Canadian Cancer Registry. a. True b. False

b. False

If red shading on a map corresponds to above-average rates, and most of a state's area is red, this means that the state as a whole has above-average rates. a. True b. False

b. False

Issues with program activity should be addressed after the survey. a. True b. False

b. False

Membership in the AJCC is restricted to organization representatives only. a. True b. False

b. False

NAACCR set criteria for the certification of central cancer registries that are out of reach for most cancer registries. a. True b. False

b. False

Nonanatomic factors were first added to the classifications that modified stage groups beginning with the sixth edition of the AJCC Cancer Staging Manual. a. True b. False

b. False

Registry staff can call the patient or his/her next of kin to discuss the patient's current cancer status. a. True b. False

b. False

Submission of Class of Case 6 is required. a. True b. False

b. False

The Canadian Council of Cancer Registries offers a certification program for cancer registrars. a. True b. False

b. False

The central registry need not be concerned with patients who live within their catchment area but are diagnosed or treated outside their catchment area. a. True b. False

b. False

The goals and objectives and characteristics of central registries and hospital registries are so similar, they may be considered identical. a. True b. False

b. False

The minimum requirements for cancer program accreditation were first published in 1933. a. True b. False

b. False

The survey process is the same for every facility. a. True b. False

b. False

Well-documented cancer clusters, or hot spots, have been identified in more than 40 states. a. True b. False

b. False

A hospital with an ACoS-approved cancer program is not required to maintain a cancer registry. a. True b. False .

b. False A cancer registry is mandatory for an ACoS-approved cancer program.

Hospital-based cancer registries obtain death certificates from vital statistics government agencies in search for potentially missed cases. a. True b. False

b. False Death clearance is performed only by central cancer registries.

The disease index is the primary casefinding source used by central registries to identify incident cases. a. True b. False

b. False Pathology reports are considered the primary casefinding source because 95% of all reportable cases are histologically confirmed. The disease index is used as a cross-check on the completeness of reporting of pathology cases at hospitals, as well as an effective method to identify clinically diagnosed cases.

The AJCC was founded by two organizations, the American College of Surgeons and the America Cancer Society. a. True b. False

b. False The multidisciplinary AJCC is administered by American College of Surgeons Cancer Programs.

Hospitals are responsible to identify the list of ICD-9-CM codes that are mandatory to include on the disease index file to meet state reporting requirements. a. True b. False

b. False Central registries are responsible for providing to hospitals a list of the mandatory and optional ICD-9-CM codes that should be included for casefinding purposes per the reporting rules of the state or region.

Inter-record edit checks examine data items within a particular patient's abstract. a. True b. False

b. False Inter-record checks examine data items between related records. A patient may have more than one primary, and so on.

The p value for the odds ratio is p 5 0.61; therefore, there is a statistical association be- tween height and prostate cancer risk. a. True

b. False The p value is greater than 0.05, so there was not a statistical association between height and prostate cancer risk in this data set. Therefore, we cannot reject the null hypothesis.

Computerized edit checks are one of the least cost-effective methods for assessing quality. a. True b. False

b. False They are the most cost-effective

The principles of the minimum standard were considered necessary to ensure the proper care of patients in any hospital and were the beginning of the accreditation process as we know it today. How many standards were there in the minimum standard? a. Four b. Five c. Six d. Eight

b. Five

What does not count as an approved activity for Continuing Education (CE)? a. Active participation in professional organizations b. Formal presentation of non-original work to cancer registry field or audience c. Attending cancer conferences d. Taking journal quizzes and/or completing

b. Formal presentation of non-original work to cancer registry field or audience

Which cancer vaccine is in most common use? a. Gleevec b. Gardasil c. Garda toxin d. MGV vaccine

b. Gardasil

What is the difference between IMRT and IGRT? a. IMRT is radiation given in beamlets, and IGRT is image-guided treatment planning. b. IMRT is radiation given in beamlets, and IGRT is image-guided radiation therapy using images taken each day before treatment. c. IMRT is radiation given in beamlets, and IGRT is image-given radiation. d. IMRT is radiation given in multiple rads, and IGRT is image-guided treatment planning.

b. IMRT is radiation given in beamlets, and IGRT is image-guided radiation therapy using images taken each day before treatment.

The most comprehensive, most frequently updated and used guidelines available in any area of medicine are: a. ACOS guidelines. The American College of Surgeons Cancer Programs benefit an array of health care professionals, patients, and facilities through standard-setting, accreditation, and educational activities b. NCCN guidelines. c. ASCO guidelines American Society of Clinical Oncology seeks to provide the highest-quality resources in education, policy, the pioneering of clinical research

b. NCCN guidelines. National Comprehensive Cancer Network a not-for-profit alliance of leading cancer centers devoted to patient care, research, and education

Which organizations have established guidelines and standards for cancer reporting? a. CBS, NPCR, BOA, NCI b. NCI, SEER, NPCR, NAACCR, ACoS c. GMAC, ABC, ACS d. None of the above e. All of the above

b. NCI, SEER, NPCR, NAACCR, ACoS

What is the definition of an asynchronous learning environment? a. In-person learning environment that involves "real-time" live interaction b. Online learning environment that does not involve a coordinated live interaction c. In-person learning environment in which the lesson is pre-recorded d. None of the above

b. Online learning environment that does not involve a coordinated live interaction

What is the Education Committee responsible for? a. Accrediting formal education programs for cancer registrars b. Overseeing the development and delivery of basic and advanced educational opportunities c. Reviewing educational activities in which cancer registrars participate d. Developing educational opportunities that can be accomplished by an individual

b. Overseeing the development and delivery of basic and advanced educational opportunities

In what phase of clinical trial is the safety of a new agent tested against a specific type of cancer using the dosage determined in the Phase I clinical trial? a. Phase I b. Phase II c. Phase III d. Phase IV

b. Phase II

What type of follow-up letter is necessary? a. Patient b. Physician c. Facility d. None of the above

b. Physician

What are the two most commonly used adrenocorticoids? a. Progesterone and prednisone b. Prednisone and Decadron c. Decadron and Symbicort d. All of the above

b. Prednisone and Decadron

The following are examples of active follow-up except: a. physician letters. b. Social Security Death Index. c. patient letters. d. all are examples of active follow-up.

b. Social Security Death Index.

The National Program of Cancer Registries uses which CS-derived stage? a. AJCC b. Summary Stage c. AJCC elements but not the stage group d. None of the above

b. Summary Stage

What are the three main categories of cancer treatment? a. Biopsy, surgery, systemic therapy b. Surgery, chemotherapy, radiation therapy c. Surgery, hormones, radiation therapy d. Cryosurgery, chemotherapy, brachytherapy

b. Surgery, chemotherapy, radiation therapy

What is the screening effect? a. The risk of being harmed by the screening procedure b. The fact that when you screen for disease you find new previously unidentified cases of cancer causing the incidence rate to increase c. The effectiveness of the screening procedure to correctly identify people who actually have the disease d. The effectiveness of the screening procedure to correctly identify people who do not actually have the disease

b. The fact that when you screen for disease you find new previously unidentified cases of cancer causing the incidence rate to increase

Who is responsible to the clinical trials group for conducting research? a. The clinical trials research nurse (CTRN) b. The principal investigator (PI) c. The intergroup (IG) d. The institutional review board (IRB)

b. The principal investigator (PI)

What is the main function of an institutional review board (IRB)? a. To determine which arm of a clinical trial a patient should be placed b. To protect the rights of human subjects participating in research c. To interview potential candidates for clinical research trials d. To gain additional information about the drug being tested

b. To protect the rights of human subjects participating in research

A metafile is: a. a big file. b. a set of instructions. c. a container.

b. a set of instructions.

Monoclonal antibodies work by: a. acting on the DNA phase of a cancer cell. b. binding to specific antigens on cancer cells inducing an immunologic response. c. blocking the supply of blood to the tumor. d. all of the above.

b. binding to specific antigens on cancer cells inducing an immunologic response.

Flexible aggregation refers to the ability to: a. reduce noise in a map. b. combine cases into any geographic unit for analysis. c. identify areas of unusually high or low cancer risk. d. assign latitude and longitude coordinates to patient addresses.

b. combine cases into any geographic unit for analysis.

An example of acceptance sampling is: a. reabstracting study. b. computer edit checks. c. edit rejection rates. d. lag time in reporting.

b. computer edit checks.

Guidelines addressed in the NCRA Professional Practice Code of Ethics are: Guidelines addressed in the NCRA Professional Practice Code of Ethics are: a. submission of continuing education hours. b. cooperation with other professions and organizations. c. HIPPA Privacy Rule. d. civil versus criminal law.

b. cooperation with other professions and organizations.

Radiofrequency ablation (RFA) involves the use of: a. cold. b. heat. c. lasers. d. microwaves.

b. heat.

case finding, abstracting, follow-up, data analysis

basic functions of a cancer registry

Incidence in females

breast lung and colon

diagnosis year

by agreement of major registry standard setters, new codes are implemented to begin in a specified _________ ____

Which of the following are types of cancer registries? 1. Population-based registries 2. State cancer registries 3. Specialty cancer registries 4. Hospital-based cancer registries a. 1, 2, and 3 b. 2, 3, and 4 c. 1, 3, and 4 d. All of the above

c. 1, 3, and 4

In what year was the first edition of the Cancer Staging Manual published? a. 1959 b. 1941 c. 1977 d. 1983

c. 1977

How long is the term of office for someone who is voted in as President-Elect/Secretary of the NCRA? a. 1 year b. 2 years c. 3 years

c. 3 years

Which CoC Standard is defined as complete data for all analytic cases submitted to the NCDB in accordance with the annual Call for Data? a. 2.8 b. 7.1 c. 3.6 d. 4.1

c. 3.6

Cancer in North America (CINA) includes data on more than ______ million cancer cases. a. 2 b. 4 c. 6 d. 8

c. 6

How many CS data items are there, excluding the site-specific factors? a. 10 b. 6 c. 9 d. 7

c. 9

Approximately what percentage of cancer cases is histologically confirmed? a. 50 b. 80 c. 95 d. 100

c. 95

The activities of the NCDB are funded by: a. ACoS and CoC. b. ACS and WHO. c. ACS and ACoS. d. CoC and NAACCR.

c. ACS and ACoS.

When is total body irradiation (TBI) used? a. Before laparoscopy for lymphomas b. Before kidney transplantation c. Before stem-cell transplant d. For patients with mycoses fungoides

c. Before stem-cell transplant

The Commission on Cancer of the American College of Surgeons requires accredited cancer programs to meet which follow-up standard? a. Maintain an 80% follow-up rate for all eligible analytic patients from the cancer registry reference date b. 90% follow-up rate must be maintained for all eligible analytic patients diagnosed within the last 5 years, or from the cancer registry reference date, whichever is shorter c. Both a and b d. None of the above

c. Both a and b

Which data format(s) are recommended by NAACCR to laboratories for reporting pathology report text information electronically to central registries? a. HL7 b. Pipe-delimited c. Both a and b d. Neither a nor b

c. Both a and b

An example of accuracy and specificity in coding primary site for upper lobe of lung is: a. C34.9 b. C34.3 c. C34.1 d. C34.0

c. C34.1

The application that allows CoC-accredited cancer programs to compare patterns of care and assess their own trends of care for breast and colorectal cancers is called: a. benchmark reports. b. NCDB Survival Reports. c. CP3R.

c. CP3R.

If you wanted to learn about the approved methods in providing comparable data analysis, which core class would you take? a. Cancer Registry Structure and Management b. Oncology Treatment and Coding c. Cancer Registry Operations d. Cancer Disease Coding and Staging

c. Cancer Registry Operations

Which of the following types of cases that failed an edit would not be written to the NCDB data warehouse? Check all that apply. a. Cases with a data quality score of zero b. Cases that accumulate a data quality score between 1 and 199 c. Cases that accumulate a data quality score of 200 or greater d. Cases that received "rejection edits"

c. Cases that accumulate a data quality score of 200 or greater d. Cases that received "rejection edits"

The American College of Surgeons (ACoS) was founded by ____________________ with other physicians in 1910. a. Dr. Green and Dr. Martin b. Dr. Codman and Dr. Green c. Dr. Martin and Dr. Codman d. all of the above

c. Dr. Martin and Dr. Codman

What are the two most common types of antiandrogens used for prostate cancer? a. Estrogen and progesterone b. Prednisone and progesterone c. Flutamide and Casodex d. 5-Fluorouracil and prednisone

c. Flutamide and Casodex

Which of the following meets the eligibility requirements for the Council on Certification? a. Previously a State Association President b. Is a committee member of the Formal Education Committee c. Has been a CTR for 5 years d. Has served two consecutive terms as a representative for the Council on Certification

c. Has been a CTR for 5 years

What is the definition of a synchronous learning environment? a. Online learning environment that does not involve a coordinated live interaction b. In-person learning environment in which the lesson is pre-recorded c. In-person learning environment that involves "real-time" interaction d. None of the above

c. In-person learning environment that involves "real-time" interaction

What are two advantages of increasing interoperability of registry data? a. It reduces the need for federal funding of central registries. b. It protects registry data from unauthorized use. c. It enhances the central registry's ability to automatically incorporate data from other sources. d. It ensures researchers learn complex registry data coding standards. e. It makes it easier for researchers and others to utilize registry data.

c. It enhances the central registry's ability to automatically incorporate data from other sources e. It makes it easier for researchers and others to utilize registry data.

Radiation therapy is useful in preventing what type of recurrence? a. Distant b. Regional c. Local d. Systemic

c. Local

A select group of breast cancer patients have been able to receive radiation directed to their tumor. What is the process that has been in use since 2002? a. IMRT b. IGRT c. MammoSite d. Mammographic port planning for radiation therapy

c. MammoSite

The acronym NOTES stands for: a. Needed Opening Transluminal Endoscopic Surveillance. b. Natural Opening Transluminal Endoscopic Surgery. c. Natural Orifice Transluminal Endoscopic Surgery. d. Natural Orifice Transluminal Excisional Surgery.

c. Natural Orifice Transluminal Endoscopic Surgery.

Updates to the ICD-9-CM codes are effective annually in which month? a. January b. April c. October d. December

c. October

What phase of clinical trials focuses on learning how a new treatment compares with standard, or the most widely accepted, treatment? a. Phase I b. Phase II c. Phase III d. Phase IV

c. Phase III

The central advisory panel that guides and assists in the prioritization of the work conducted by the NCDB staff is the: a. Committee on Accreditation. b. Committee on Cancer Liaison. c. Quality Integration Committee.

c. Quality Integration Committee.

Which survival measure requires expected rate from general population matched on age, sex, race, and so on? a. Observed all cause b. Cause-specific survival c. Relative survival

c. Relative survival

What is the Program Recognition Committee's role in developing education? a. Reviews educational activities for knowledge and expertise assurance b. Facilitates communication and outreach to Accredited Formal Education programs c. Reviews and determines program's criteria for Continuing Education credits d. Develops educational opportunities that can be accomplished as an individual

c. Reviews and determines program's criteria for Continuing Education credits

When a follow-up letter is returned, what date do you use to update your database as the date of last contact? a. The date your registry mailed out the follow-up letter b. The date you received the letter back from the patient c. The date patient or representative signed and completed the letter d. None of the above

c. The date patient or representative signed and completed the letter

The NAACCR committee that evaluates new data items and codes is: a. Data Evaluation and Certification Committee. b. Data Use and Research Committee. c. Uniform Data Standards Committee. d. Information Technology Committee.

c. Uniform Data Standards Committee.

What is the title of the publication of official annual federal cancer statistics? a. Cancer in North America b. Annual Report to the Nation c. United States Cancer Statistics d. CDC WONDER

c. United States Cancer Statistics

When is it appropriate to show data in a table rather than a graph? a. When showing trends in data over time b. When comparing percentages of three or four values c. When comparing exact values among several variables

c. When comparing exact values among several variables

ASCO guidelines are focused on: a. several questions around many topics. b. Cancer Registry data. c. a single question or group of questions around an important topic in specific areas of cancer.

c. a single question or group of questions around an important topic in specific areas of cancer.

The goal of palliative treatment for cancer patients is to: a. test treatments on patients with terminal disease. b. qualify for hospice care. c. alleviate symptoms to improve the quality of life symptoms. d. both b and c.

c. alleviate symptoms to improve the quality of life symptoms.

Google Chrome is: a. an operating system (OS). b. a Web browser. c. an operating system (OS) and a Web browser.

c. an operating system (OS) and a Web browser.

The three types of bone marrow transplants are: a. autologous, allogeneic, and synthetic. b. autologous, allergic, and syngeneic. c. autologous, allogeneic, and syngeneic. d. none of the above.

c. autologous, allogeneic, and syngeneic. The stem cells for an autologous transplant are taken from a patient's own blood. The word "allogeneic" is derived from the Greek roots "allo-," meaning "other" and "-gen," meaning "born." Allogeneic transplants involve donor stem cells. A syngeneic transplant, in which the identical twin serves as a donor, can be the optimal situation for individuals with multiple myeloma.

Historical data review involves: a. CoC survey review through acceptance sampling. b. physician review of abstracts through quality-control plan. c. comparison of number of cases expected with those observed. d. all of the above.

c. comparison of number of cases expected with those observed.

Cryosurgery is the use of: a. freezing targeted cancer tissues with the use of a cold probe. b. freezing targeted cancer tissues with the use of liquid nitrogen. c. freezing targeted cancer tissues with the use of argon gas. d. both a and b. e. both b and c.

c. freezing targeted cancer tissues with the use of argon gas.

Case definition includes: a. a list of collected data items. b. follow-up policy. c. identification of population covered. d. security control provisions.

c. identification of population covered.

When a file is "checked out" from SharePoint: a. only members of the site can edit it and check the file back in. b. any Internet user who knows the location of the file can download the file. c. only the user who checked out the file can edit the file before checking it back in. d. the file is locked and nobody can edit it.

c. only the user who checked out the file can edit the file before checking it back in.

The mission of NAACCR is to: a. collect all cancer cases in North America and aggregate them into a single database. b. certify cancer registries. c. promote uniform data standards, provide education and training, aggregate and publish data, certify registries, and promote data use. d. produce cancer maps for North America.

c. promote uniform data standards, provide education and training, aggregate and publish data, certify registries, and promote data use.

An example of quality control of data accuracy is: a. an historical data review. b. monitoring DCO rate. c. recoding audit. d. benchmarking.

c. recoding audit.

Relative survival rate

calculated by dividing the observed all caused survival rate by the survival observed in a similar population

kaplan- meyer survival analysis

calculates the survival every time a case dies from cancer

Central cancer registry

can be a population-based cancer registry or non population based

relative survival rate

cancer cases expected to die from cancer

The rejected cases resolution (correction) and resubmission to the NCDB is monitored by the Response : Cancer committee Cancer registrar NCDB Approvals department of the Commission on Cancer

cancer committee Rationale: Standard 1.6 states that the CANCER COMMITTEE MUST MONITOR the CORRECTION AND RESUBMISSION of REJECTED CASES.

January 1

cancer registry reference date

Work load

case load, cancer committees, conferences, audits and reviews

Non-analytic cases

cases who were diagnosed and received all of first course therapy elsewhere prior to the date of referral to the facility. These cases include patients treated for recurrence or progression of disease only, patients for whom the facility provided only a treatment plan or a second opinion regarding the diagnosis and/or treatment options available, as well as patients diagnosed at autopsy, per death certificate, or who only had pathology slides read at the facility

Hyperlink

causes the browser to open another web page

calendar year

changes to data standards are implemented at the beginning of a ________ ____

single field edit

checks only 1 data field at a time. ex. race codes must have only the allowable values

The date of diagnosis is often confirmed _______________ before a biopsy or surgical resection is performed.

clinically (such as on physical examination, radiology, laboratory test)

A geographic area of unusually high or low occurrences of cancer is known as a ____________________.

cluster.

8000/39 malignant neoplasm, NOS

code for patient who refused further work up

ICD-O

coding manual for oncology; published by WHO

Standard data set

collection of standard data items

Specialty registry

collects info on specific site

inter/multi record

compare data on more than one like record ex. multiple primaries

chi - square test

compares data that is non-continuous between categories

inter/multi field edit

compares related data item codes for correctness ex. females can not have prostate cancer

clinical studies

comparison of different treatments to evaluate effectivness

10

complete code is _____ digits

tumor

complete set of information on a single primary cancer or reportable neoplasm, compiled from one or more source records and for a central registry, from one or more facilities

HIPAA Patient Safety Rule

confidentiality provisions protect identifiable information being used to analyze patient safety events and improve patient safety.

Consolidation

consolidating multiple records

error message

contained in the metafile to explain the edit

data dictionary

contains all the data elements or fields to be edited by the metafile

USCS

contains cancer statistics from NPCR and SEER

metafile

contains everything necessary to edit the data. it is created with the EDIT Write program from CDC

accuracy

correctness; in registry terms, a true representation on the abstract of the facts in the source document. See also, consistency, reliability, validity

The NCDB was established in: a. 1913. b. 1922. c. 1985. d. 1989.

d. 1989.

The NCDB contains information on almost _______ million cases of reported cancer diagnoses for the period 1985 through 2007. a. 10 b. 15 c. 20 d. 25

d. 25

How many provincial/territorial cancer registries cover less than a 1 million population? a. 3 b. 5 c. 7 d. 8

d. 8

Currently in the United States, which governing agencies set reporting standards for hospital and population-based registries? a. American College of Surgeons (ACoS) Commission on Cancer (CoC) b. National Program of Cancer Registrars (NPCR) c. Surveillance, Epidemiology, and End Results (SEER) d. All of the above

d. All of the above

Laser ablation is utilized for what types of malignancy? a. Superficial skin cancer b. Non-small-cell lung cancer c. Penile cancers d. All of the above e. None of the above

d. All of the above

Record consolidation rules include: a. Hierarchy rules b. Most frequent c. Known over unknown d. All of the above

d. All of the above

What is a function of a central registry? a. To perform as a data repository for a state b. Monitor cancer incidence trends and mortality c. Evaluate cancer-control initiatives d. All of the above

d. All of the above

What primary purpose does the cancer registrar database serve? a. Research b. Quality management c. Marketing d. All of the above

d. All of the above

Which of the following are considered "passive" follow-up linkage sources? a. Motor vehicle/driver license files b. Centers for Medicare and Medicaid Services c. Stage voter registration files d. All of the above e. None of the above

d. All of the above

Why should central registries be concerned with registry data management systems used by their reporting hospitals? a. The majority of central registry data is first collected by the hospital data management system. b. Edit checks and coding rules may or may not be consistently implemented by hospital registry vendors. c. It may be important when coordinating transitions to new coding standards. d. All of the above e. None of the above

d. All of the above

Which of the following is true about virtual servers? a. Several may exist on the same server hardware. b. They may be easily scaled depending on the applications requirements. c. Amazon Web Services is a major provider of virtual servers. d. All of the above.

d. All of the above. A virtual server is a server that shares hardware and software resources with other operating systems (OS), versus dedicated servers. Because they are cost-effective and provide faster resource control, virtual servers are popular in Web hosting environments.

Which organization is the administrative sponsor of the AJCC? a. International Union Against Cancer b. Commission on Cancer c. National Cancer Database d. American College of Surgeons

d. American College of Surgeons

Which of the following is a benefit to automation of the record consolidation process? a. Consistency in data collection b. Saves both money and time c. Does not allow one to monitor the effects of rule changes d. Both a and b

d. Both a and b

What are the two types of monoclonal antibodies? a. Rituximab and trastuzumab b. Velcade and Rituxan c. Herceptin and Rituxan d. Both a and c e. None of the above

d. Both a and c

A 44-year-old woman was recently diagnosed with infiltrating duct carcinoma, poorly differentiated, tumor size 2.1 cm with 3 of 15 positive axillary nodes. Her estrogen receptor was negative, as was her progesterone receptor; the Her-2/neu was 31 positive by FISH. After surgery, what type of treatment would she be expected to receive? a. Chemotherapy, radiation therapy followed by tamoxifen b. Chemotherapy, radiation therapy followed by Arimidex c. Chemotherapy and radiation therapy d. Chemotherapy, Herceptin, and radiation therapy

d. Chemotherapy, Herceptin, and radiation therapy

Many community hospitals across the country participate in clinical trials as part of which NCI Program? a. American College of Surgeons Oncology Group (ACOSOG) b. Cancer and Leukemia Group B (CALGB) c. National Surgical Adjuvant Breast and Bowel Project (NSABP) d. Community Clinical Oncology Program

d. Community Clinical Oncology Program

Of the report-writing tasks listed below, which step should be taken first? a. Identify the patients and data items on which the report will be based. b. Define the type of information that will be included in the report. c. Decide whether to use tables or graphs. d. Determine how the recipient will use the report and their level of expertise.

d. Determine how the recipient will use the report and their level of expertise

A 76-year-old male patient with a history of metastatic prostate cancer treated with hormones has become hormone refractory. What is the next treatment he can be expected to receive? a. Colony-stimulating factors b. Alpha-Interferon c. Monoclonal antibodies d. Endocrine surgery

d. Endocrine surgery In medicine, describes a disease or condition that does not respond to treatment with hormones. Also called hormone-resistant.

Which committee is not represented by the Board Director of Education? a. Alternative Methods Committee b. Continuing Education Committee c. Education Committee d. Formal Education Committee

d. Formal Education Committee

What is the name of the small molecule inhibitors used for gastrointestinal stromal tumors and chronic myelogenous leukemia? a. Glycogen b. Gardasil c. Glucosamine d. Gleevec

d. Gleevec

What is the most common radioisotope used, and what type of cancer is it used for? a. IMRT for thyroid b. IGRT for prostate c. I-131 for prostate d. I-131 for thyroid

d. I-131 for thyroid

"Residency at diagnosis" refers to the usual residence of the patient at the time of diagnosis of a reportable cancer. Which entity provides the rules and guidelines used by central registries to determine residency at diagnosis? a. U.S. Federal Bureau of Investigation b. U.S. Social Security Administration c. U.S. Postal Service d. U.S. Census Bureau

d. U.S. Census Bureau

A performance measure: a. is a set of technical specifics that define how to calculate a rate for a specific indicator of quality. b. uses the measures to determine whatever rate it is and how it compares. c. gathers and provides treatment information for consumers and healthcare professionals. d. a and b

d. a and b

Define CyberKnife radiation therapy. a. CyberKnife is treatment given using a miniaturized photon linear accelerator. b. CyberKnife is treatment given using cobalt energy. c. CyberKnife is a type of specialized scalpel used during brain surgery. d. a and b

d. a and b

The NCDB uses _____________________ to identify duplicate cases. a. the patient's name b. the patient's Social Security number c. the patient's primary site and histology d. a contextual code based on specific data item code values from the record

d. a contextual code based on specific data item code values from the record

An emphasis on cancer surveillance may include which of the following? a. Evaluation of efficacy of treatment b. Analyzing referral patterns c. Compliance with treatment guidelines d. a, b, and c e. b and c

d. a, b, and c

A recoding audit will assess (indicate all that are correct): a. training needs. b. inadequate text documentation. c. application of coding d. all of the above.

d. all of the above.

Data research products produced by NAACCR include: a. CINA. b. CINA1 Online. c. CINA Deluxe. d. all of the above.

d. all of the above.

Unknown values: a. are monitored through process controls. b. can be legitimately utilized. c. should have stable rates over time. d. all of the above.

d. all of the above.

What is necessary for CTRs to maintain their certification? a. Complete 12 hours of CE credits b. Complete the required CE credits every 2 years c. Complete 20 hours of CE credits d. b and c e. a and b

d. b and c

Radiofrequency ablation (RFA) is most frequently used for the treatment of: a. liver cancers, both primary and metastatic. b. lung cancer. c. brain tumors. d. both a and b. e. both a and c.

d. both a and b.

The four types of CAM commonly used by cancer patients are: a. massage therapy, acupuncture, laetrile, and krebiozen. b. massage therapy, acupuncture, hyperbaric oxygen, chemotherapy with shark cartilage. c. massage therapy, acupuncture, hyperbaric oxygen, chemotherapy with mistletoe extract. d. both b and c. e. none of the above.

d. both b and c.

Summary stage can be categorized as: a. forward flexibility and clinical utility. b. only useful with large groups of cases. c. capturing data at different points in time. d. broad categories with longitudinal stability.

d. broad categories with longitudinal stability.

Death clearance only is an example of: a. accuracy. b. data consistency. c. data completeness. d. case incidence completeness.

d. case incidence completeness.

The most widely used type of radiation therapy is: a. orthovoltage. b. brachytherapy. c. seed implantation. d. external beam.

d. external beam.

AJCC staging system can be categorized as: a. broad with longitudinal stability. b. only capturing data at one point in time. c. categories that rarely change. d. forward flexibility and clinical utility.

d. forward flexibility and clinical utility.

AJCC pathologic classification is defined as: a. information after radiation therapy only. b. information after systemic therapy only. c. information through completion of definitive surgery or within 4 months of diagnosis, whichever is shorter. d. information through completion of definitive surgery or within 4 months of diagnosis, whichever is longer.

d. information through completion of definitive surgery or within 4 months of diagnosis, whichever is longer.

Timeliness is critical to a registry quality-control process. The methods for evaluating timeliness are (indicate all that are correct): a. visual review. b. reabstraction study. c. casefinding audit. d. lag-time report.

d. lag-time report.

record linkage

data from many hospitals summarized in a larger database

continuous data

data is not divided into categories usually a variable that can be measured with a number age, weight, bp, temp

United States census

data source used by researchers to obtain income and literacy information that can be used to help define and address the cancer burden in the region

cancer registry

database of information about cancer patients; specifically their diagnosis, their staging, their treatment, and their outcomes

successful followup

defined as documented contact with the patient through his physician, readmission to the hospital, clinic visit, response to follow-up letter by patient or relative, or through another registry

catchment area

defined geographical area in which a registry collections their data

Data Dictionary

defines the data items in a set

Standardization

definitions, codes, conversions and required items all the same to allow comparison - NAACCR

what must the bylaws do for the cancer committee?

delineate the committees duties and responsibilities

The three categories of quality are

design, conformance, and performance.

inter-record (or multi-record) edits

designed to compare data recorded across more than one record and are applied across tumor records for a patient that has more than one primary

tumor linkage

determines if there is a new primary or if this is an existing primary

There are two types of record linkage:

deterministic and probabilistic.

electronic medical record (EMR)

digital version of the paper chart in the physician office. Contains the medical and treatment history of the patient in a single practice. Use of such a system allows the physician to track data (disease condition, vital signs, vaccinations) over time, identify when patient is due for screenings, and monitor the overall quality of care within the practice. Even though the information is held in an electronic forma, it doesn't easily travel in that format outside the practice.

active follow-up

direct contact with hospitals and patients

frequency distribution Continuous data

divide the measurements into groups and count the number in each group the frequency distribution is most often displayed in a chart

Why is a relational database structure better for storing registry data than a NAACCR data exchange record? a. Registry data are logically grouped into records such as patient demographics and cases. b. The NAACCR record is designed for data exchange, not storage. c. Some NAACCR data exchange fields simply do not make sense to store in a registry database. d. The NAACCR data exchange record can accommodate only a fixed number of therapy records. e. All of the above

e. All of the above

Which of the following survival measures is called the "hypothetical probability" of survival of cancer in the absence of other causes of death? a. Observed all cause-survival b. Relative survival c. Cause-specific survival d. All of the above e. b and c only

e. b and c

Which term refers to the "network of networks"?

eHealth Exchange

SEER, NCDB, NAACCR or NPCR

edits are applied on state or ____, ____, ______ or ____

blank

edits flag _____ fields

incorrect

edits help identify _________ data

single field

edits indicate ______ _____ edit errors

manual

edits indicate potential errors that require _____ review

multiple data

edits specify disagreement between ________ ____ fields

Inter-record (or multi-record) edits

edits that are designed to compare data recorded across more than one record and are applied across tumor records for a patient that has more than one primary (example - compares how sex is coded on each tumor record. If the sex field is not coded exactly the same for each record, the edit will fail).

Inter-field (or multi-field) edits

edits that compare the codes recorded for one data item with codes recorded for related data items (example - identifies when the treatment date is coded prior to the diagnosis date for a primary)

NAACCR data exchange record layout

essential in data exchange and what you use to report

CoC

established in 1922; the first US organization to establish standards to ensure quality, multidisciplinary, and comprehensive cancer care delivery in healthcare settings; publishes "Patient Care Evaluation Studies"; a branch off the ACoS; it represents hospital cancer registries

NAACCR

establishes concensus on standards

Visual review

evaluating every 10th abstract from each batch of abstracts submitted to them by reporting hospitals

Survival can be measured in various ways. The choice of measurement depends on the research question or _____________ ___ _________________

event of interest.

How often are programs surveyed

every 3 years

Computerized edit rejection rates Percentage of death certificate-only cases Percentage of unknown code by field Lag time between diagnosis and case reporting

examples of process control methods used in cancer registries include monitoring the:

linakge

external data sources such as DC, national death index, social security admin, medicare and medicaid and dmv

CoC

first added cancer registry operations as an approval requirement for hospital cancer programs in 1956 and published a recommended data set in 1981

The NCDB requires that as many as 5 specified years of data be submitted during the annual call for data to facilitate obtaining the most recent data available, as well as ____________ and _____________ data for previously reported patients

follow-up recurrence and survival

The NCDB requires that as many as 5 specified years of data be submitted during the annual Call for Data to facilitate obtaining the most recent data available, as well as _____________________ and _____________________ data for previously reported patients.

follow-up recurrence and survival data

every 3 years

frequency of surveys

The process of assigning geographic information to a cancer patient record based on the place of usual residence is known as

geocoding.

to ensure patients with cancer receive the highest quality care close to home

goal of American College of Surgeons Commission on Cancer

twice

goals are evaluated _____ annually

Identify the audience What format will be most effective?

graph, tables, charts or written text, combination

American Joint Committee on Cancer

group that developed the TNM staging system

advisory board

group that provides direction for cancer surveillance programs or central cancer registries. It includes representatives from the major stakeholders in the registry catchment area, helps to reinforce program goals, and solicits support.

record layout

grouping and organization of fields from the data dictionary into a particular file format

edit sets

groups of individual edits, combined for a purpose

The Standardization and Registry Development Steering Committee

helps the organization prepare central registries to adapt rapidly and successfully to changing developments in cancer surveillance

The Department of Defense (DoD) includes information on patients' participation in military campaigns and exposure to toxic agents for

historical and epidemiologic purposes

Correlation

how closely do the variables vary with each other

Reliability refers to:

how consistently different people will code the same circumstances the same way.

reliability

how likely different people are to arrive at the same data code, given the same information

3

how many type of edits are there

Probabilistic record linkage

i.e., fuzzy matching) takes into account a wide range of potential identifiers to link datasets in a statistically justifiable way

Purpose of central registry

identify and register all reportable cases

Primary focus of hospital-based cancer registries

improve patient care by evaluating treatment outcomes.

noninvasive, noninfiltrating, intraepithelial

in situ

Patient identification fields

include accession number, sequence number, social security number, race, sex, date of birth, geographic location, physicians and institutions involved in the care of the patient

Stage/Prognostic Factors

include all fields associated with coding stage, tumor markers and secondary diagnoses but they do not include the field associated with the coding standard applied.

demographic data

include fields used to categorize patients for analysis (e.g. age, sex, race and ethnicity, residential location, and occupation)

State/Requestor data items

include optional registry specific or special use fields that are not in the standard NAACCR data dictionary but are maintained by the receiving registry when a data exchange is performed using the NAACCR record layout. For example, a facility might opt to capture exposure to potentially cancer causing agents or events. While these data items are not part of the standard NAACCR layout, they can be transmitted to another registry in this section of the NAACCR record.

data set standards

include specifications for data items, codes, and storage format; comparable data must be consistent or "standard" to provide useful information for research and new technologies to diagnose and treat patients

Administrative safeguards

include the PRACTICE BY A COVERED ENTITY to ADOPT A WRITTEN SET of PRIVACY PROCEDURES.

Record identification items

include those fields used to recognize the layout and ccontent of the record being transmitted (e.g., record type, patient ID number, tumor record number, coding standards used for particular fields).

Net (cancer-specific) survival calculation

includes only those patients who died from cancer. Patients who died of causes other than cancer, those who are alive, and those who are lost to follow-up are excluded from this calculation.

Observed (all-cause) survival calculation

includes patients who died from cancer and patients who died from a cause other than cancer. Patients who are alive and those who are lost to follow-up are excluded from this calculation

Cancer Identification data

includes such items as the primary site, histology, tumor sequence and screening information

Cancer identification data

includes such items as the primary site, histology, tumor sequence, and screening information

Confidential data

includes the physician's name and the patient's name, social security number and address at diagnosis. Any data item used to track a specific patient, health care provider, or facility.

edit over-ride flags

indicates that case was reviewed by physician or cancer committee and the unusual data in question was determined to be correct

edits

individual data checks that contain the logic needed to edit each field

patient or case

individual person with one or more primary cancers or reportable neoplasms

aggregate data

information about a group of patients without personal identifiers

Recoding audit

intended to verify that coding rules and guidelines are correctly applied by abstractors. This type of audit can assess the following: Registry training needs Accuracy of the application of the coding rules Inadequate text documentation that results in coding ambiguity

In 2010, the way registries transmit dates was changed to improve:

intraoperability of date transmission.

active follow-up

involve contacting the patient's physician to track the patient's outcome

Security management

involves evaluating the flow of data throughout the organization and identifying all unreasonable security weaknesses.

Record consolidation

involves the process of combining data from two or more records for the same patient and tumor in order to evaluate the best value for each data field.

A server

is a computer or device on a network that manages network resources.

a trojan horse

is a destructive program that masquerades as a benign application

The College of American Pathologists (CAP)

is a medical society serving more than 18,000 physician members and the laboratory community throughout the world.

Virtual Private Network (VPN)

is a method employing encryption to provide secure access to a remote computer over the Internet.

record layout

is a named group and organization of fields from the data dictionary into a particular file format, such as the NAACCR data exchange record.

Health Level Seven (HL7)

is a non-profit organization involved in the development of international healthcare informatics interoperability standards.

American National Standards Institute (ANSI)

is a private non-profit organization that oversees the development of voluntary consensus standards for products, services, processes, systems, and personnel in the United States

a worm

is a program or algorithm that replicates itself over a computer network and usually performs malicious actions

a virus

is a program or piece of code that is loaded onto your computer without your knowledge and runs against your wishes.

Edit check

is a programmed instruction or subroutine designed to check input data by performing a computerized comparison of data fields for reasonableness, validity, limit and completeness.

Logical Observation Identifiers Names and Codes (LOINC)

is a universal code system for identifying laboratory and clinical observations from serum levels of hepatitis B surface antigen to diastolic blood pressure

reportable-by-agreement

is added to the cancer registry reportable list of conditions at the discretion of the cancer committee

Hyperlink

is an element in an electronic document on the web that links to a whole document or to a specific element within a document.

A firewall

is defined as a system designed to prevent unauthorized access to or from a private network.

passive follow-up

is more typically performed by central registries and it is less expensive than active follow-up

Record linkage

is simply the bringing together of information from two or more records that is believed to relate to the same patient.

symantic

is the meaning

security

is the methodology by which privacy or confidentiality is maintained

Syntactic

is the structure

standard data item

item refers to a DATA ITEM whose CODING INSTRUCTIONS, CODE VALUES and DEFINITIONS are SHARED AMONG the REGISTRY organizations.

Record Identification

items include those fields used to recognize the layout and content of the record being transmitted (e.g., record type, patient ID number, tumor record number, coding standards used for particular fields).

One of the biggest challenges to cancer registrars will continue to be:

keeping up with changes in data collection, coding, and reporting standards.

clinical services, cancer committee, cancer conferences, quality outcomes/improvements, cancer registry

key elements of a commission-approved cancer program

record linkage

linking all patients from a certain small area with the same type of cancer

Edits contain the __________ to edit each field.

logic

mortality females

lung, breast colon

mortality males

lung, prostate, colon

NAACCR

maintains responsibility for data set standards in the United States

3, annually

major changes will now be implemented on a _ year cycle. minor edits implemented ________

capital expenses

major equipment expenses, things that are long term investments like computers, chairs etc

patient linkage

match that patient against all other patients to determine if they have been already submitted as to not double count

passive follow-up

may involve linking cancer patients with other databases such as vital records, motor vehicles or voter registration and many others; methods that do not require registry contact with hospitals, physicians, or individual cancer patients; used primarily to determine the patient's vital status and current date last seen alive or date of death

2009-0002/02

means the patient has had two primary cancers

2009-0001/00

means the patient has one primary cancer

cancer committee: a physician is designated to provide what for the cancer program?

medical direction...this individual may be the cancer committee chairman

accreditation

meeting specific standards for the quality of a cancer program and passing a survey by the CoC of the ACoS. Categories of accreditation are based on the facility's caseload, staff qualifications, available services, and other factors.

2

morphology code for well to moderately well differentiated

Commission on Cancer

most active organization in the U.S. for the establishment and approval of hospital cancer programs

who is on the cancer committee?

must be composed of at least one board certified physician representative from -surgery -medical oncology -radiation oncology -diagnostic radiology -pathology also include the cancer liason physician

demographics include:

name DOB age SSN gender race address phone#

HIPPA protects individually identifiable health information such as

name, address, social, phon number

Which is an example of a domain name? a. .com b. www.ncra-usa.org c. ncra-usa.org d. www

ncra-usa.org

confidential data transmission

need authorization, non by fax, electronic encryption, paper shredding

Do canadian registrars have a seperate ctr process?

no

Outside Consultants

no salary but hourly cost is higher

Identify the audience What method of distribution is appropriate?

non confidential and confidential

benign

non malignant non invasive

wilcoxon mann

non parametric t-test

ANOVA

non-parametric regression

Parametric

normal curve

non-parametric

not normal curve

four

number on months within initial diagnosis that SEER summary staging is performed within

Hospital registry data are used for?

o Management reports o Statistics o Evaluation of hospital patient survival rates o Evaluation of patient care compared to guidelines

Central registry data are used for?

o Population-based research o Primary prevention - reduce exposure o Biomarkers, screening, early detection o Patterns of care o Survivorship

cancer control: reduction of cancer incidence, mortality and morbidity

o Primary prevention o Screening o Early diagnosis o Treatment o Palliative care

Central registry data are used to identify problems

o This information is used to plan cancer control strategies. o Once these programs are implemented, the central registry data is again used to measure how effective these programs are.

What are two standard measures of survival

observed survival net survival

When an old item is no longer relevant:

one or more new response categories may be added to the older item or the old item may be dropped, and no longer coded.

ordinal data

ordered or ranked categories stage Pie chart Bar chart

Subpoena ad testificandum

orders a person to TESTIFY BEFORE the ORDERING AUTHORITY or FACE PUNISHMENT. The subpoena can also request the testimony to be given by phone or in person.

Name three of the formats used for cancer conferences. You may have named any three of the following: a. Departmental b. Facility wide c. Network wide d. Site focused e. Academic/teaching f. Community wide

ou may have named any three of the following: a. Departmental b. Facility wide c. Network wide d. Site focused e. Academic/teaching f. Community wide

regression

parametric: compares the means of more than 2 groups to see if they are different

Computer security

passwords, data backups, control access to programs or servers, activity logging, audit trails

non-analytic case

patient who was diagnosed and had all of their first course of therapy elsewhere comes to your facility for subsequent treatment due to recurrence or progression of disease

Prospective cases

patients who are presented at the time of initial diagnosis for the purposes of determining accurate staging, treatment options and patient management plans

Retrospective cases

patients who have completed all their treatment. Such cases are discussed primarily for educational purposes. Discussions are not designed to influence patient management care.

analytic cases

patients who were diagnosed and/or received all or part of the first course of therapy at the facility. includes patients who were provided only palliative care in lieu of first course treatment or as part of first course treatment at this facility

Quality Assurance Programs transformed into ____________________ __________________Programs.

performance improvement

TJC defines a core measure set as a "unique grouping of ____________________ ___________________carefully selected to provide, when viewed together, a robust picture of the care provided in a given area."

performance measures

Casefinding audits

performed by central registries to monitor case completeness of reporting facilities

A common performance improvement model used in many hospitals is the ____________________, ____________________, ____________________, and ____________________ model.

plan, do, check and act

Multiple myeloma is a cancer of

plasma cells.

zero based budget

prepared as if being done for the first time and each item is justified

bottom up budget

prepared by registry manager

top down budget

prepared by top management

abstract

prepared for every case that is eligible for inclusion in the database The information is obtained from the patient's health record

prevention

primary: before the onset of the disease ( preventative regulations) secondary: after exposure but before symptoms ( screening) tertiary: after diagnosis (treatment)

The basic premise of the _______________ system is that the higher the score, the closer the match probability.

probabilistic

Which method is used, if a birth date is different by one day in a patient record in an incoming data file, the match to the patient record in the database can still be made.

probabilistic

Observed all cause survival rate

probability of surviving all causes of death

Rapid Case Ascertainment (RCA) and the Commission on Cancer's (CoC) Rapid Quality Reporting System (RQRS)

procedures in which selected information is reported to interested parties shortly after initial contact, which is usually before the standard abstracting timeframe for the facility

consolidation

process of combining data from 2 or more records for the same patient and tumor to produce a single best value for each patient or tumor data fields

address standardization

process of modifying an address so it conforms to conventions for format, abbreviation, and address components as defined by the US Postal Service

Time Motion Studies

productivity sheet at the end of each day listing tasks completed that day.

NCCN

program developed as a comprehensive set of diagnostic, treatment, and supportive care guidelines. Guidelines cover 97% of the tumors seen by oncology practices. Best treatment at the time they were deprived, with constant updating.

Edit writer

program that is used to create edits in a metafile

incidence males

prostate, lung, colon

Vital records

provide cancer mortality data

CP3R

provide feedback to CoC accredited facilities on their performance to the breast and colorectal cancer quality measures. These measures are directed toward comparing clinical performance at your hospital vs other CoC approved facilities. Help guide committee efforts in their assessment and examination of data accuracy and completeness

The EDITS Workgroup

provides a formal mechanism to review and make additions/changes to edits and the NAACCR EDITS metafile.

CONCORD

provides a population-based comparison of survival rates among patients with selected cancers in Europe and the United States

CONCORD does what

provides a population-based comparison of survival rates among patients with selected cancers in Europe and the United States.

what does the cancer committee do?

provides cancer program leadership

VACP

provides care to military veterans and offers the full range of diagnostic and treatment services either on-site or by referral, preferably to CoC-accredited cancer programs

Central registry

provides data on incidence, stage and treatments

Behavioral Risk Factor Surveillance System (BRFSS)

provides data on items such as obesity, exercise, smoking and not being screened

HIPAA Privacy Rule

provides federal protections for individually identifiable health information held by covered entities and their business associates and gives patients rights with respect to that information.

annual report

provides the hospital with a forum in which to highlight the goals and accomplishments of the cancer program

reference date

provides the start date of data collection; is always January 1 of any given year

A National Program of Cancer Registries goal is to provide data to ____________________ so that the ____________________ can be monitored and that _______________________________________ can be planned.

public health planners burden of disease cancer prevention and control programs can be planned.

ACS

published the first code manual used in cancer registries, "Cancer Facts and Figures"

Hospital Based Cancer Registry

purpose is to collect information on patients diagnosed and or treated for cancer at their facility.

Content for educational programs is identified through ____________________.

quality assurance activities.

Finish this sentence: Edits are the

quality-control gatekeepers.

Performance measures

quantitative measure of an aspect of patient care that can be used as a guide to monitor and evaluate the quality and appropriateness of healthcare delivery

how often does the cancer committee meet?

quarterly

each abstract u enter is a record

record

automated, manual

record consolidation can either be _________ or _____

A central registry has the ability to combine information from several sources. This ability is called:

record linkage

The Pathological Grade

records the highest grade of the primary tumor that has been surgically resected without neoadjuvant therapy.

Process controls

refer to statistical methods used to evaluate any procedure that results in a trigger indicating a review of the procedure is necessary because staff is not meeting performance expectations

Data submittals

refer to the process of EXTRACTING DATA from the REGISTRY DATABASE SYSTEM for SUBMISSION to ANOTHER ENTITY (e.g., funding agency).

user lookup tables

reference tables within the metafile for performing look-ups

Metadata

refers to a set of data that describes and gives information about other data. Provides information about one or more aspects of the data such as: purpose of the data time and date of creation creator or author of the data (standard setting agencies) data dictionary location on a computer network where the data were created user look-up tables edit sets record layouts

interoperability

refers to the ability of software and hardware on different machines from different vendors to share data without manipulation

GLOBOCAN

refers to the database that collects data pertaining to worldwide incidence rates and mortality.

Date of first contact

refers to the date of admission for diagnosis or for treatment of a reportable disease process.

Reference date

refers to the effective date to accession cases into the registry for a specified at-risk population (e.g., central registry) or for a specific facility (e.g. hospital)

Date of last contact or death

refers to the last date on which the patient was known to be alive or the date of death.

Date of diagnosis

refers to the month, day and year a reportable disease process was first diagnosed, clinically or microscopically, by a recognized medical practitioner.

record linkage

refers to the process of finding records in a data set that refer to the same entity across different data sources i.e., identifies and matches patient data.

Visual review (or visual editing)

refers to the process of having individual abstracts reviewed to identify incomplete or inaccurate codes and information.

Contracted CTR

registry behind on abstracts and need to hire an employee for a special report

Measures of Excess Risk RR

relative risk incidence in the exposed/ incidence in the unexposed

biopsy

remove a part of the tissue of the tumor for examination

censored

removed from the study because they cannot be contacted or they died from a cause that is not of interest

Casefinding

reporting facilities must identify all reportable cases under the facility license

Prevalence

represents the proportion of alive people found to have a condition (e.g., lung cancer) in the population.

Identify the audience Do they have a right to request data?

require written permission

HIPAA Breach Notification Rule

requires covered entities and business associates to provide notification following a breach of unsecured protected health information (PHI).

cancer committee

responsible for establishing the quality improvement priorities of the institution's cancer program and monitoring the effectiveness of quality management activities

NAACCR Uniform Data Standards Committee (UDSC)

responsible for reviewing the proposed changes to data items, codes and definitions

most frequent rule

rule applied when there are multiple incomplete records for the same patient that states if there is a discrepancy among records, then the most frequent value will be used. For instance, if the birthplace in one record is 093 (Washington) but is 097 California) in three records, then 097 is the consolidated code value for this field.

deterministic record linkage

rules based linkage- generates links based on a number of individual identifiers that match

Redundant Array of Independent Disks (RAID)

set of strategies for using more than one drive in a system

frequency distribution

shows how often the values of a variable occur in a sample or population

Reference Map

shows the location of the geographic areas for which census data are tabulated and disseminated

Purpose of sharing info with neighboring registries

simplifies death clearance processing, and allows preparation of individual hospital reports that include all of the hospital cases

A map in which rates are averaged across multiple geographic areas to reduce noise is known as a ____________________ map.

smoothed map.

A form of data analysis that incorporates information about the geographic location of events is known as

spatial analysis.

HIPAA Security Rule

specifies a series of administrative, physical, and technical safeguards for covered entities and their business associates to use to assure the confidentiality, integrity, and availability of electronic protected health information.

reportable list

specifies which neoplasms will be included in the registry database

The registry

staff by knowledgeable personnel

GenEdits Plus

standalone edit program

coding rules

standard data edits are created to test data against ______ _____

Measures of Excess Risk SIR

standardized incidence ratio number of observed cases/ numbers of expected cases

Reporting guidelines does a hospital registry use

state

etiology

study of the cause of disease

Reabstracting study

study that assesses data quality and completeness by having a staff member abstract a sample of medical records to identify discrepancies between the reabstracted document and the original abstract submitted to the registry

Reliability study

study that involves a sample of data collectors abstracting the same set of charts in order to review the range and consistency of the coding submitted

Misclassification

subjects are assigned to the wrong group

Rapid Case Ascertainment (RCA)

supports population-based epidemiology research as well as cancer prevention and control research that requires early contact with nearly diagnosed patients

physician reps from which fields participate in the cancer conferences?

surgery medical oncology radiation oncology radiology pathology

neoadjuvant therapy

systemic treatment administered before cancer direct surgery

Systematized Nomenclature of Medicine (SNOMED)

term refers a systematic, computer-processable collection of medical terms that allows a consistent way to index, store, retrieve, and aggregate medical data across specialties and sites of care?

overlapping tumor

term that describes a single tumor that involves adjacent sites (next to each other) and the tumor is contiguous

Exchangeable-edits, Data-dictionary, and Information Translation Standard known as EDITS

term that refers to a collection of software tools that allows the different standard setters (CoC, SEER, NPCR and NAACCR) the ability to create rules to test and improve data quality

record layout

term that refers to the organization of fields from the data dictionary into a particular file format, such as the NAACCR data exchange record

Sufficient carcinogen

term used to describe a carcinogen that can produce carcinogenesis without the interaction of other agents

Censored

term used to describe a patient who is withdrawn from survival analysis because their survival time is unknown (e.g., patient is lost to follow-up, patient is still alive at the end of the interval of observation)

Interoperability

term used to describe the CAPABILITY of DIFFERENT REGISTRIES being ABLE TO READ, WRITE and EXCHANGE DATA via a COMMON SET of EXCHANGE FORMATS. Maintaining interoperability is dependent upon the use of the SAME CODING INSTRUCTIONS, CODE VALUES and CODE OPTIONS TO AVOID ANY SPECIAL EFFORTS on the PART OF REGISTRY ORGANIZATION to USE ONE ANOTHER'S FLIES.

true

the Commission on Cancer places accountability for quality control of registry data with the cancer committee because it has overall supervision of the cancer registry true or false

The International Agency for Research on Cancer (IARC)

the World Health Organization's interdisciplinary agency whose mission is cancer research for cancer prevention.

most frequent

the ____ ________ rule applies when there are multiple incoming records for the same patient ex. record 1 1/1/1940 record 2 1/1/1941 record 3 1/1/1940 value would be 1/1/1940

Specificity

the ability of a test to give a negative finding when the person tested does not have the condition

Casefinding

the ability to identify every reportable case of cancer Pathology department HIM department Radiology department Outpatient departments

followup active and passive

the active follow-up methods requires someone to initiate a contact with the patient's treatment facility, physician, or possibly the actual patient •the passive follow-up methods do not require registry contact with hospitals, physicians, or patients. Passive methods include a computerized search of databases for the patient's vital status and current date last seen alive or date of death All states have laws that require the reporting of cancer cases and, as already mentioned in this course, most of the data comes from hospitals, so it is very important for the central registry to have a good working relationship with the hospital registries. In addition to offering educational opportunities, the central registry can provide other services to the hospitals. There is a very helpful listing of the services that central registries can provide in the textbook on page 394, Table 36-10.

Triad - 3 basic elements

the agent ( cause of disease) Host ( person) environment ( the place where host and agent meet)

/2, /3, /6, /9

the behavior codes in a morphologic diagnosis that indicate a malignancy

pathology reports

the best source of casefinding

at least annually

the cancer committee shall assess the effectiveness of quality management activities in achieving its priorities for improvement

annually

the cancer committee shall identify at least two important evaluation interests related to cancer patient care when

Standard data item

the code, definition, and instructions for a data items are shared by registries

HACP

the facility accessions 100 or fewer newly diagnosed cancer cases each year and has a limited range of diagnostic and treatment services available on-site

PCP

the facility only provides care to children, or the pediatric oncology program is a component within a larger CoC-accredited facility; offers the full range of diagnostic and treatment services either on-site or through referral; required to participate in cancer-related clinical research focused on pediatric patients

ACAD

the facility provides postgraduate medical education in at least 4 program areas; accessions more than 500 newly diagnosed cancer cases each year; required to participate in cancer-related clinical research either by enrolling patients in cancer-related clinical trials or by referring patients for enrollment at another facility or through a physician's office

1996

the first NAACCR standard edits were available to the public in ____

Catchment area

the geographic area from which the population source of the central registry is drawn

net (cancer-specific) survival

the hypothetical probability of surviving cancer in the absence of other causes of death

acceptance sampling

the inspection or subsequent approval (acceptance) or rejection of a product; for example, computerized *edit checks* for registry data

follow up

the most important single function of the cancer registry

American College of Surgeons

the national organization which surveys and approves cancer programs

interval

the numbers have an arbitrary starting point temperature

abstracting

the process of collecting and recording pertinent cancer data from a health record.

Record consolidation

the process of combining data from 2 or more records for the same patient and tumor to produce a single best value for each patient and tumor variable

GenEdits

the programs that acts as an engine or driver that runs the edits against the database to find any data that may be incorrect - using the instructions of the metafile

incidence

the rate at which a certain event occurs (e.g., the number of new cases of specific disease occurring during a certain period of time)

relative survival

the ratio of the proportion of the observed survivors in a cohort of cancer patients to the proportion of expected survivors in a comparable set of patients without cancer

Standard deviation

the square root of the variance Normal distribution: 685 of the values are within one standard deviation from the mean. 95% of the values are within 2 standard deviations

pathology reports and disease indices

the two most important casefinding sources for central registries

Death clearance

the use of mortality (death certificate) files to update death and other missing information on cases that exist in the registry database and to increase incidence reporting completeness by using these files as a casefinding source

confounding

there is a factor that is associated with the exposure and the outcome that interferes with the study

Ratio

there is a true 0 tumor size, height

Identify the audience What is there level of knowledge?

this determines the level of detail, format and use of medical terminology

staging

this is the extent of the spread of the disease which is determined for each case and entered into the abstract

current coding system

this version of the coding system describes the coding system currently used to code a specific data item

original coding system

this version of the coding system describes the response categories available to the coder when the data item was originally abstracted and coded

non-analytic cases

those cases that were diagnosed and received their entire first course of treatment before admission to the reporting hospital

The goals for abstracting are to have ________________. __________________ and ____________________ cancer data.

timely, accurate, and complete

purpose of the accession register

to assess caseload and to provide each patient with a registry identification number

accession

to enter a case into a registry and assign it a number

multidisciplinary cancer confrences are conducted to provide what?

to provide consultative services to cancer patients

Majority of registries use what kind of budget?

top down budget; A top-down budget is prepared by top management, passed down to primary departments and then sub departments

The use of standard data item definitions facilitates: a. training procedures for coders. b. common editing procedures. c. comparability of data.

training procedures for coders. common editing procedures. comparability of data.

Mixed chimerism transplant

transplanted cells come from either a related or unrelated donor. The transplant takes place after the recipient has a moderate dose of chemotherapy and radiation to set up a mixed immune system. This type is also called a mini-transplant or nonmyeloablative transplant. (This is a type of allogeneic transplant).

Cord blood

transplanted cells come from the umbilical cord and placenta after a baby is born. This blood is rich in blood-forming cells. (This is a type of allogeneic transplant).

Administrative safeguard

type of HIPAA security safeguard being adhered to when a covered entity adopts a written set of privacy procedures that address access authorization, establishment, modification, and termination; and when covered entities out-source some of their business processes to a third party, they require that their vendors also have a framework in place to comply with their HIPAA requirements

computerized edits

typically check for completion of all required fields, allowable range, allowable values, and interfield consistency (such as primary site consistent with sex); they can test for invalid entries, such as an unusual site-histology combination, or flag unusual entries for review

NAACCR Committee that recommends changes in data codes or new items

uniform data standards work group

Benchmark

used as tools by which to evaluate and compare the cancer care delivered to patients dx and or treated at their facility vs. state and national levels

pathologic

used to assess survival

clinical

used to determine a treatment plan

Reference date

usually January 1st, from which coverage begins

data edits

verify data accuracy through the use of a computer software algorithm

CDC, NPCR, to improve quality of data & to standardize the way data items are check for validity

what 2 entities began the task of developing EDITS software and with what 2 purposes in mind

metafile, edit set, edits

what are the 3 components of the edit

standard setting agencies, data dictionary, record layout, edits, edit sets, error messages, user lookup table

what are the 7 key components of a metafile

90%

what follow-up rate is required by the Commission on Cancer

to collect data on every patient with cancer, to maintain the data in an organized way, and to make the data available for use by the medical staff and others interested in the morbidity and mortality of cancer patients

what is the goal of the hospital cancer registry

interoperability

what refers to the consistency in which varied organizations and software systems handle the transmission of similar information

data standardization

what was the key to developing edits

death-certificate only (DCO)

when all attempts to gather more complete data fails, the case is retained in the central registry as one of these

SEER or NPCR

when choosing data item selection, the data set should include items required by funding sources such as ____ or ____

standards implementation task force

who is charged (formed by NAACCR) with the yearly review of the timing of data changes