ABSTRACT
Tumour-node-metastases (TNM) category distribution can be used as a short-term surrogate measure for survival probability to evaluate the impact of interventions for improved prevention and early detection of cancer. We aimed to demonstrate whether or not an association between registration completeness and TNM category distribution exists and whether accurate estimates of the TNM category distribution are possible before complete registration. With respect to the diagnosis year 2002, the number of registered cases of prostatic and testicular cancer at the Bavarian cancer registry was determined every 6 months between 2003 and 2006 together with the respective TNM category distributions and the completeness of registration. For the diagnosis year 2002, 6135 and 480 cases of newly developed prostatic and testicular cancer, respectively, were reported to the registry. After 2003, the proportion of prostatic cancer cases labelled 'T1' fluctuated by only 1%. A stable TNM category distribution was seen with a minimum registration completeness of 65-70%. No relevant association between registration completeness and TNM category distribution could be demonstrated for prostatic and testicular cancer. Therefore, in prostatic and testicular cancer, the TNM category distribution can be used for short-term evaluation of quality assurance projects and in health services research.
Subject(s)
Prostatic Neoplasms/classification , Prostatic Neoplasms/pathology , Registries , Testicular Neoplasms/classification , Testicular Neoplasms/pathology , Cohort Studies , Follow-Up Studies , Germany/epidemiology , Humans , Lymph Nodes/pathology , Lymphatic Metastasis , Male , Population , Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/mortality , Quality Control , Registries/standards , Testicular Neoplasms/epidemiology , Testicular Neoplasms/mortality , Time Factors , Tumor BurdenABSTRACT
The planned introduction of an electronic health card is seen as a milestone in the dissemination of extended electronic health records in Germany. This paper deals with the main issues likely to result from the use of the electronic health insurance card. The role of the patient in the health care process and the patients enhanced access to his or her personal medical record are reflected. A high level of acceptance of the electronic health insurance card and extended electronic documentation procedures can be expected if ethical, legal, and technological concerns of the public are addressed and appropriate incentives are established. Finally, the electronic health insurance card can serve as a useful aid to support the ongoing implementation of disease management programs for the most important chronic conditions in Germany.
