Validity of Administrative Databases in Comparison to Medical Charts for Breast Cancer Treatment Data

Table 2

Agreement analysis by receipt of treatment and specific type of treatment, comparing information from administrative databases with medical charts among women with complete radiotherapy, chemotherapy, and surgery data.

Treatment type	Medical; chart; n (%)	Administrative database^1; n (%)	Sensitivity; (%)	Specificity; (%)	PPV; (%)	NPV; (%)	Kappa
Yes	1,970 (82.9)	1,816 (76.5)	92.0	99.3	99.8	71.9	0.793
No	405 (17.1)	559 (23.5)
Breast or chest wall radiation
Yes	1,840 (93.4)	1,735 (88.1)	88.2	n/a	93.5	n/a	n/a
No	130 (6.6)	235 (11.9)
Breast boost
Yes	510 (25.9)	230 (11.7)	43.3	99.4	96.1	83.4	0.520
No	1,460 (74.1)	1,740 (88.3)
Supraclavicular/axilla radiation
Yes	232 (11.8)	223 (11.3)	86.6	98.7	90.1	98.2	0.868
No	1,738 (88.2)	1,747 (88.7)
Yes	840 (36.6)	665 (29.0)	77.7	99.2	98.2	88.5	0.804
No	1,452 (63.4)	1,627 (71.0)
FEC-D
Yes	288 (44.2)	226 (34.7)	71.9	94.8	91.6	81.0	0.682
No	364 (55.8)	426 (65.3)
AC
Yes	109 (16.7)	67 (10.3)	60.6	99.8	98.5	92.6	0.714
No	543 (83.3)	585 (89.7)
ACP/ACT
Yes	95 (14.6)	67 (10.3)	65.3	99.1	92.5	94.4	0.733
No	557 (85.4)	585 (89.7)
TC
Yes	67 (10.3)	47 (7.2)	50.7	97.8	72.3	94.5	0.559
No	585 (89.7)	605 (92.8)
FEC
Yes	48 (7.4)	32 (4.9)	62.5	99.7	93.8	97.1	0.734
No	604 (92.6)	620 (95.1)
Yes	2,396 (99.8)	2,296 (95.7)	95.8	100	100	n/a	n/a
No	4 (0.2)	104 (4.3)
Partial mastectomy
Yes	2,035 (84.9)	1,947 (81.3)	94.2	91.7	98.5	73.7	0.781
No	361 (15.1)	449 (18.7)
Modified radical mastectomy
Yes	277 (11.6)	284 (11.9)	89.5	98.3	87.3	98.6	0.869
No	2,119 (88.4)	2,112 (88.1)
Simple (total) mastectomy
Yes	234 (9.8)	162 (6.8)	60.7	99.1	87.7	95.9	0.693
No	2,162 (90.2)	2,234 (93.2)
Axillary node dissection
Yes	818 (34.1)	244 (10.2)	27.4	98.7	91.8	72.4	0.314
No	1,578 (65.9)	2,152 (89.8)
Sentinel lymph node biopsy
Yes	1,684 (70.3)	1,441 (60.1)	73.7	71.9	86.1	53.6	0.415
No	712 (29.7)	955 (39.9)

Note. Due to small numbers, values marked “n/a” could not be reliably calculated. PPV, positive predictive value; NPV, negative predictive value; FEC-D, Fluorouracil, Epirubicin, Cyclophosphamide, Docetaxel; AC, Adriamycin, Cyclophosphamide; ACP, Adriamycin, Cyclophosphamide, Paclitaxel; ACT, Adriamycin, Cyclophosphamide, Taxol; TC, Taxotere, Cyclophosphamide or Carboplatin; FEC, Fluorouracil, Epirubicin, Cyclophosphamide. ¹The corresponding administrative database is the Activity Level Reporting database (ALR) for radiotherapy and chemotherapy treatment data, and Canadian Institute for Health Information (CIHI) databases for surgical data. ²Including brachytherapy/internal radiation, clinical trials, and unknown and other types of radiotherapy. N = 2,375 for receipt of radiotherapy (women with complete radiotherapy data in medical charts), and N = 1,970 for radiotherapy types (women who received radiotherapy according to medical charts). ³Including clinical trials, unknown, and all chemotherapy protocols. N = 2,292 for receipt of chemotherapy (women with complete chemotherapy data in medical charts), and for chemotherapy protocols (women who received one chemotherapy treatment according to medical charts). ⁴Including partial mastectomies, modified radical mastectomies, simple (total) mastectomies, axillary node dissections, sentinel lymph node biopsies, and other surgeries. N = 2,400 women for receipt of surgery (women with complete surgery data in medical charts) and N = 2,396 for surgery type (women who received surgery according to medical charts).