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. 2007 May 4;3:149-58.

Development of Query Strategies to Identify a Histologic Lymphoma Subtype in a Large Linked Database System

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Free PMC article

Development of Query Strategies to Identify a Histologic Lymphoma Subtype in a Large Linked Database System

Michael Graiser et al. Cancer Inform. .
Free PMC article

Abstract

Background: Large linked databases (LLDB) represent a novel resource for cancer outcomes research. However, accurate means of identifying a patient population of interest within these LLDBs can be challenging. Our research group developed a fully integrated platform that provides a means of combining independent legacy databases into a single cancer-focused LLDB system. We compared the sensitivity and specificity of several SQL-based query strategies for identifying a histologic lymphoma subtype in this LLDB to determine the most accurate legacy data source for identifying a specific cancer patient population.

Methods: Query strategies were developed to identify patients with follicular lymphoma from a LLDB of cancer registry data, electronic medical records (EMR), laboratory, administrative, pharmacy, and other clinical data. Queries were performed using common diagnostic codes (ICD-9), cancer registry histology codes (ICD-O), and text searches of EMRs. We reviewed medical records and pathology reports to confirm each diagnosis and calculated the sensitivity and specificity for each query strategy.

Results: Together the queries identified 1538 potential cases of follicular lymphoma. Review of pathology and other medical reports confirmed 415 cases of follicular lymphoma, 300 pathology-verified and 115 verified from other medical reports. The query using ICD-O codes was highly specific (96%). Queries using text strings varied in sensitivity (range 7-92%) and specificity (range 86-99%). Queries using ICD-9 codes were both less sensitive (34-44%) and specific (35-87%).

Conclusions: Queries of linked-cancer databases that include cancer registry data should utilize ICD-O codes or employ structured free-text searches to identify patient populations with a precise histologic diagnosis.

Keywords: Large linked database; cancer epidemiology; cancer outcomes research; cancer registry.

Figures

Figure 1.
Figure 1.
System architecture for the GeneSys SI oncology database application
Figure 2.
Figure 2.
Receiver-operator plot of query strategies to identify a pathology-confirmed histologic diagnosis of follicular lymphoma

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