Miscoding of Melanoma Thickness in SEER: Research and Clinical Implications.
Miscoding of Melanoma Thickness in SEER: Research and Clinical Implications.
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DOI：
10.1016/j.jid.2016.05.121
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发表时间：
2016-11
期刊：
影响因子：
--
通讯作者：
Guerry D
中科院分区：
文献类型：
--
作者：
Gimotty PA;Shore R;Lozon NL;Whitlock J;He S;Vigneau FD;Dickie L;Elder DE;Xu X;Schwartz AG;Guerry D
黑色素瘤相关死亡和转移患者中的薄(≤1毫米)和超薄(≤0.25毫米)黑色素瘤已报告。这些观察可能反映了不利的生物学和/或管理数据中的错误。在包括监测、流行病学和最终结果(SEER)登记在内的五个队列中，比较了瘦黑色素瘤患者肥胖组的累积黑色素瘤相关死亡率。病理报告中复查了SEER区域的厚度。超薄黑色素瘤患者的5年累积黑色素瘤相关死亡率在SEER(2.8%)高于其他登记(0.6-0.9%)。在16个SEER地区，这一比例为0.25%至8.4%。在SEER，21%的薄型黑色素瘤是超薄的；在其他登记中，它们占5.8-15%。重新检查SEER的一个部位的厚度发现，447个超薄黑色素瘤中有114个有错误；校正后，114个中只有17个保持超薄。大多数错误与小数点位置有关。86例薄黑色素瘤重新分类为>；1.00 mm，包括96%的原始超薄相关死亡和100%的原始阳性淋巴结。SEER中存在着集中在超薄病变中的严重的厚度编码错误，并导致患者预后的错误描述。在使用管理数据时，验证结果可以确定关键数据问题。
Melanoma-related deaths and metastases among patients with thin (≤1 mm) and ultrathin (≤0.25 mm) melanomas have been reported. These observations might reflect adverse biology and/or errors in administrative data. Cumulative melanoma-related death rates for thickness groups of patients with thin melanomas were compared among five cohorts including the Surveillance, Epidemiology, and End Results (SEER) registry. Thickness in one SEER region was reexamined in pathology reports. The 5-year cumulative melanoma-related death rate of patients with ultrathin melanomas was higher in SEER (2.8%) compared with other registries (0.6–0.9%). The rates across the 16 SEER regions were 0.25% to 8.4%. In SEER, 21% of thin melanomas were ultrathin; in other registries, they comprised 5.8–15%. A reexamination of thickness in one SEER site revealed that 114 of 447 ultrathin melanomas had errors; after correction, only 17 of the 114 remained ultrathin. The majority of errors were related to decimal point placement. The 86 thin melanomas reclassified to >1.00 mm included 96% of the original ultrathin-associated deaths and 100% of the original positive lymph nodes. Significant miscoding of thickness that is concentrated in ultrathin lesions is present in SEER and results in mischaracterization of patient outcomes. When using administrative data, validation of results can identify critical data issues.
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