The International Collaboration on Cancer Reporting (ICCR): Development of Evidence Based Core Data Sets for Pathology Cancer Reporting
David W Ellis, James Dvorak, Lynn Hirschowitz, Meagan Judge, Avril Kwiatowski, John Srigley, Kay K Washington, Michael Wells. Royal College of Pathologists of Australasia, Sydney, NSW, Australia; College of American Pathologists, Northfield, IL; Royal College of Pathologists, London, United Kingdom; Canadian Partnership Against Cancer, Toronto, Canada; Canadian Association of Pathology, Toronto, Canada
Background: Cancer pathology data sets (CPDS) are foundational elements for clinical cancer care. Global collaboration and standardization of CPDS is essential for international benchmarking and epidemiological research in cancer and to reduce the burden of dataset production yet this has not been previously attempted.
Design: A quadripartite group, the International Collaboration on Cancer Reporting (ICCR), including Pathology Colleges and Associations of the USA, UK, Canada and Australia and representing a population of approximately 450 million, was established in 2011 to examine the practicability of developing common, internationally agreed and evidence-based CPDS. As a pilot, the ICCR established 4 international review panels (RP) to develop CPDS for prostate, lung, endometrial carcinoma and melanoma, each comprising 9 physicians: an ICCR pathology lead and 2 internationally renowned expert representatives from each country. Existing CPDS from each country were collated and each chair facilitated an evidence-based review and harmonization of the core (required) data elements, permitted responses, non-core (recommended) elements and terminology. Core elements included stage, tumour type and predictive or prognostic data for which there was Level III-2 evidence to support inclusion (BMC Med Res Method 2009, 9:34).
Results: All 4 RPs completed their objectives within the allotted 4 months. Paradoxically, agreement between international experts proved simpler than in institutional or national programs. Through stringent criteria the RPs were able to remove legacy data elements and to rationalize a total of 118 pre-existing core elements to 66 (endometrium 23/17, prostate 38/18, melanoma 38/20 and lung 19/11). Definitions and permitted responses for all data elements were agreed.
Conclusions: This ICCR pilot study demonstrated that internationally standardized and evidence-based CPDS can be produced efficiently with significant improvements in content, including harmonized terminology, definitions and required responses. An operational plan to extend this standardization process to other languages, jurisdictions and cancer types is fundamental to improving cancer reporting globally and thereby international research and comparisons of cancer management.
Category: Quality Assurance
Tuesday, March 5, 2013 9:30 AM
Poster Session III # 270, Tuesday Morning