Population-based data from the Swedish Colon Cancer Registry

Kodeda, Karl; Nathanaelsson, Lena; Jung, B.; Olsson, Håkan; Jestin, Pia; Sjövall, Annika; Glimelius, Bengt; Påhlman, Lars; Syk, Ingvar

doi:10.1002/bjs.9166

Cited by 91 publications

(86 citation statements)

References 18 publications

(21 reference statements)

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“…Due to the few cases of CRC, a simplified model was used to calculate losses of QALYs due to CRC. We made an approximation of stage-specific survival rates based on data from the Swedish Colorectal Cancer Registry (SCRCR) 2007-2011 [19]: Stages I and II -100% survival; Stage III -50% deceased on year five after one year of terminal care; and Stage IV -100% deceased after one year of palliative care. Stage distribution at CRC diagnosis was also based on data from the SCRCR.…”

Section: Calculation Of Qalysmentioning

confidence: 99%

Colonoscopic surveillance – a cost-effective method to prevent hereditary and familial colorectal cancer

Sjöström

Lindholm

Melin

2017

Scandinavian Journal of Gastroenterology

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Objective: Approximately 20-30% of all colorectal cancer (CRC) cases may have a familial contribution. The family history of CRC can be prominent (e.g., hereditary colorectal cancer (HCRC)) or more moderate (e.g., familial colorectal cancer (FCRC)). For family members at risk, colonoscopic surveillance is a wellestablished method to prevent both HCRC and FCRC, although the evidence for the exact procedures of the surveillance is limited. Surveillance can come at a high price if individuals are frequently examined, as this may result in unnecessary colonoscopies in relation to actual risk for CRC. This study analyses the cost-effectiveness of a surveillance programme implemented in the Northern Sweden Health Care Region. Methods: The study includes 259 individuals prospectively recorded in the colonoscopic surveillance programme registry at the Cancer Prevention Clinic, Umeå University Hospital. We performed a cost-utility analysis with a contrafactual design: we compared observed costs and loss of quality-adjusted life years (QALYs) due to CRC with the surveillance programme to an expected outcome without surveillance. The main measure was the incremental cost-effectiveness ratio (ICER) between surveillance and non-surveillance. Scenario analysis was used to explore uncertainty. Results: The ICER between surveillance and non-surveillance in the base model was 3596e/QALY. The ICER varied from À4620e in the best-case scenario to 33,779e in the worst-case scenario. Conclusion: Colonoscopic surveillance is a very cost-effective method to prevent HCRC and FCRC compared to current thresholds for cost-effectiveness and other cancer preventive interventions. ARTICLE HISTORY

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Section: Calculation Of Qalysmentioning

confidence: 99%

Colonoscopic surveillance – a cost-effective method to prevent hereditary and familial colorectal cancer

Sjöström

Lindholm

Melin

2017

Scandinavian Journal of Gastroenterology

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“…A further problem can be accurate identification and timing of the primary diagnosis, leading to incorrect times to future health outcome events (such as treatment, readmission or death) 43 . The process by which individuals are identified for inclusion in the database can also result in subtle biases (such as lead-time bias as a consequence of a screening programme) 2 . Procedure codes, at least as far as is necessary for clinical management or reimbursement purposes, may be more accurately recorded than diagnostic coding in administrative databases, although they tend to lack detail 15 .…”

Section: Data Qualitymentioning

confidence: 99%

“…Additionally, the main challenges associated with using these data sources for research purposes are considered. Clinical databases come in two main forms ( Table 1) 2,12,13 : administrative databases (for example, HES in England 14 or insurance claims data in the USA, such as Medicare 15 ), set up to collect management and/or reimbursement data; and clinical registries focusing on a disease (Swedish Colon Cancer Registry 2 ), or device/procedure-based registries (UK Transcatheter Aortic Valve Implantation (TAVI) registry 16 ) that tend to focus primarily on quality improvement and enable research as a secondary process. The main advantages of using such data sources are: their comprehensive nature (some provide complete coverage for an entire population 2 ); the relatively large number of patients, allowing subgroups and rare events to be investigated; and the ability to compare healthcare providers, at both the institution and individual healthcare-professional level.…”

Section: Introductionmentioning

confidence: 99%

The rise of big clinical databases

Cook

Collins

2015

British Journal of Surgery

126

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Background:The routine collection of large amounts of clinical data, 'big data', is becoming more common, as are research studies that make use of these data source. The aim of this paper is to provide an overview of the uses of data from large multi-institution clinical databases for research.Methods: This article considers the potential benefits, the types of data source, and the use to which the data is put. Additionally, the main challenges associated with using these data sources for research purposes are considered.Results: Common uses of the data include: providing population characteristics; identifying risk factors and developing prediction (diagnostic or prognostic) models; observational studies comparing different interventions; exploring variation between healthcare providers; and as a supplementary source of data for another study. The main advantages of using such big data sources are their comprehensive nature, the relatively large number of patients they comprise, and the ability to compare healthcare providers. The main challenges are demonstrating data quality and confidently applying a causal interpretation to the study findings. Conclusion:Large clinical database research studies are becoming ubiquitous and offer a number of potential benefits. However, the limitations of such data sources must not be overlooked; each research study needs to be considered carefully in its own right, together with the justification for using the data for that specific purpose.

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“…Results are similarly improved in rectal cancer, potentially also challenging routines developed based upon studies performed in the past. More intensive staging at diagnosis, better surgery, more careful pathological examinations and discussions at multidisciplinary team meetings all contribute to improved outcomes overall and in the separate stages, so called stage migration [56][57][58].…”

Section: Modifying the Time Interval To Surgerymentioning

confidence: 99%