Miscoding of Melanoma Thickness in SEER: Research and Clinical Implications.

Autor:	Gimotty PA; Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA. Electronic address: pgimotty@mail.med.upenn.edu., Shore R; Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA., Lozon NL; Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA., Whitlock J; Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA., He S; Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA., Vigneau FD; Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA., Dickie L; Division of Cancer Control and Population Science, National Cancer Institute, Rockville, Maryland, USA., Elder DE; Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA., Xu X; Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA., Schwartz AG; Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA., Guerry D; Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Jazyk:	angličtina
Zdroj:	The Journal of investigative dermatology [J Invest Dermatol] 2016 Nov; Vol. 136 (11), pp. 2168-2172. Date of Electronic Publication: 2016 Jun 25.
DOI:	10.1016/j.jid.2016.05.121
Abstrakt:	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. (Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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