The creation and maintenance of a hospital-based cancer registry system

@#<p style="text-align: justify;"><strong>Introduction:</strong> Cancer registries contain information essential to any rational program of evidence-based cancer control, including cancer epidemiology and outcomes, and can be site-specific, hospital-based, or population-based. The creation of a national population-based cancer registry and hospital-based cancer registries was mandated in the National Cancer Control Act of 2019. This paper reports on the creation and maintenance of the Cancer CARE Registry and Research Philippines (CARE PH) app, the country's first hospital-based cancer registry system, and its future directions in registry and research.</p><p style="text-align: justify;"><strong>Methods:</strong> A cancer registry in the form of a web-based application was developed through the collaboration between a clinician and a health information technology specialist. This registry was designed to follow the cancer patient's journey from diagnosis to staging to treatment and cure, relapse, or progression into death. Patient information is collected in a structured and secure process from designated catchment areas in each hospital by trained tumor registrars, with the main catchment area being the hospital's Surgical Pathology department. The CARE PH application is given to member hospitals for free through the support of grants given to the CARE PH Foundation, Inc.</p><p style="text-align: justify;"><br /><strong>Results and discussion:</strong> Today, 31 member hospitals in the CARE PH system have recorded a collective total of 9,880 new cancer patients for the year 2020. The most common cancer types recorded in CARE PH for 2020 include breast, colorectal, cervical, and head and neck cancers. In addition, the registry captures a myriad of information that can potentially answer questions relevant to the individual cancer patient and clinicians, and hospital administrators.</p><p style="text-align: justify;"><strong>Conclusion:</strong> HBCRs are an indispensable part of effective cancer control programs as they facilitate making evidence-based decisions that would result in better healthcare for Filipino cancer patients.</p>

Rapid review: Diagnostic accuracy of pooled Testing versus individual testing using RT-PCR for SARS-CoV-2 for screening and surveillance of individuals with suspected COVID-19

Background@#Pooled testing has been implemented on a limited scale, mainly for screening and surveillance in populations with a low prevalence of COVID-19 to save on limited resources. @*Objective@#To determine the diagnostic accuracy of pooled compared with individual RT-PCR testing for SARS-CoV-2 in individuals suspected of COVID-19.@*Methods@#We searched websites of living CPGs on COVID-19 (Australian COVID-19, COVID NMA, CEBM Oxford), Philippine DOH HTA, databases (PubMed, CENTRAL, medRXIV/bioRXIV), and Clinicaltrials.gov for studies that used pooled testing on individuals suspected of COVID-19. When appropriate, we pooled data for sensitivity and specificity and obtained the range and median of other data, such as positive predictive value and resource savings. We did a priori subgroup analysis for pool size, presence or absence of symptoms and use case, type of specimen, cutoff for positivity, type of kit, and post hoc subgroup analysis for method of pooling and timing of processing. @*Results@#We included 21 studies: 6 diagnostic accuracy studies, and 15 clinical validation studies. Studies had varying populations, index test kit and performance characteristics, positivity rate (0.02 to 15%), and pool size (5 to 16). There was moderate pooled sensitivity, 81% (95% CI 72, 88; I2=73.6%; 6 studies, 776 pools) and high pooled specificity, 99% (95% CI, 98 to 100; I2=1.84%; 5 studies, 666 pools). Positive predictive value based on 21 studies ranged from 67% to 100%. Resource savings in the number of test kits used ranged from 49 to 89%. Identified harms of pooled testing were delayed turnaround time for positive samples and laboratory errors.@*Conclusion@#There is moderate sensitivity and high specificity with pooled testing for the screening of individuals with suspected COVID-19. We recommend further studies to validate the utility based on community prevalence and other test variables.