Accuracy of Screening Tools for Pap Smears in General Practice

Catherine Harding, Alexa Seal, Louis Pilotto, Ken Mackey, Geraldine Duncan, Ronald Huynh, Robert McWilliam, Stephanie Blake

Abstract


Background Data extraction tools (DETs) are increasingly being used for research and audit of general practice, despite their limitations.

Objective This study explores the accuracy of Pap smear rates obtained with a DET compared to that of the Pap smear rate obtained with a manual file audit.

Method A widely available DET was used to establish the rate of Pap smears in a large multi-general practice (multi-GP) in regional New South Wales followed by a manual audit of patient files. The main outcome measure was identification of possible discrepancies between the rates established.

Results The DET used significantly underestimated the level of cervical screening compared to the manual audit. In some instances, the patient file contained phone/specialist record of Pap smear conducted elsewhere, which accounted for the failure of the DET to detect some smears. Those patients who had Pap smears whose pathology codes differed between time intervals, i.e. from different pathology providers or from within the same provider but using a different code, were less likely to have had their most recent Pap smear detected by the DET (p < 0.001).

Conclusion Data obtained from DETs should be used with caution as they may not accurately reflect the rate of Pap smears from electronic medical records.

How this fits in DETs are increasingly being used for research and audit of general practice. This study explores the accuracy of Pap smear rates obtained with a DET compared to that of the Pap smear rate obtained with a manual file audit The DET tested significantly underestimated the level of cervical screening compared to manual screening. Data obtained from DETs should be used with caution as they may not accurately reflect the rate of Pap smears from electronic medical records


Keywords


cervical smear; data extraction tools; electronic medical records; pap smear

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References


References

Pearce C and Shearer MEA. A division’s worth of data Australian Family Physician 2011;40:167–70. PMid:21597524.

Liaw ST and Tomlins R. Developments in information systems. In: General Practice in Australia, edition 1. Canberra: Australian government Department of Health and Ageing, 2004:544–86.

Bourke A and Dattani HEA. Feasibility study and methodology to create a quality-evaluated database of primary care data. Informatics in Primary Care 2004;12:171–7. http://dx.doi.org/10.14236/jhi.v12i3.124.

Morrell S, Perez DA, Hardy M, Cotter T and Bishop JF. Outcomes from a mass media campaign to promote cervical screening in NSW, Australia. J Epidemiol Community Health 2010;64(9):777–83. http://dx.doi.org/10.1136/jech.2008.084657. PMid:19822553.

Department Of Health And Ageing and Australian Institute of Health and Welfare. Cervical Screening in Australia 2005-2006. Canberra: AIHW, 2008.

Hancock L and Sanson-Fisher REA. Cervical cancer screening in rural New South Wales Health Insurance Commission data compared to self report. Australian and New Zealand Journal of Public Health 1998; 22:307–12. http://dx.doi.org/10.1111/j.1467-842X.1998.tb01382.x. PMid:9629814.

Cancer Institute NSW. Cervical Cancer Screening in New South Wales. Annual Statistical Report 2009–2010, 2013. Available from: https://www.cancerinstitute.org.au/getattachment/fb808844-079e-454b-84b2-d65d935cbc55/cervical-screeningreport-13.pdf. Accessed 3 April 2014.

Australian Institute of Health and Welfare. Cervical Screening in Australia 2007–2008: Data Report. Cancer series no. 54. Cat. no. CAN 50. Canberra: AIHW, 2010.

de Lusignan S, Valentin T, Chan T, Hague N, Wood O, van Vlymen J et al. Problems with primary care data quality: osteoporosis as an exemplar. Inform Prim Care 2004;12(3):147–56. http://dx.doi.org/10.14236/jhi.v12i3.120. PMid:15606987.

Stout R. Cervical Screening Mini Collaborative (CSMC) – Pap Final Report, 2009. Available from: www.gpgc.com.au/getfilelibfile.aspx?fk=996. Accessed 18 Jan 2016.

Laurence C, Burgess T, Beilby J, Symon B and Wilkinson D. Electronic medical records may be inadequate for improving population health status through general practice: Cervical smears as a case study. Australian and New Zealand Journal of Public Health 2004;28:317–9. http://dx.doi.org/10.1111/j.1467-842X.2004.tb00436.x. PMid:15704693.

Schattner P, Saunders M, Stanger L, Speak M and Russo K. Clinical data extraction and feedback in general practice: a case study from Australian primary care. Inform Prim care 2010;18(3):205–12. http://dx.doi.org/10.14236/jhi.v18i3.773.

Peiris D, Agaliotis M, Patel B, Patel A, Taylor R and Mamoon HEA. Validation of a general practice audit and data extraction tool. Australian Family Physician 2013;42(11):816–9. PMid:24217106.

Parker D. An Audit of osteoporotic patients in an Australian general practice. Aust Fam Physician 2013;42:423–7. PMid:23781552.

Liaw ST, Taggart J, Yu H and de Lusignan S. Data extraction from electronic health records - existing tools may be unreliable and potentially unsafe. Aust Fam Physician 2013;42(11):820–3. PMid:24217107.

van Vlymen J, de Lusignan S, Hague N, Chan T and Dzregah B. Ensuring the quality of aggregated general practice data: lessons from the Primary Care Data Quality Programme (PCDQ). In: Engelbrecht R et al. Connecting Medical Informatics and Bio-Informatics. European Federation of Medical Informatics. 2005;116:1010–5. PMid:16160391.




DOI: http://dx.doi.org/10.14236/jhi.v23i3.835

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