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ODS EXAM 2024, PART 4 2024 WITH 100% ACCURATE
SOLUTIONS
NAACCR Edits Metafile, 7 key components - Answer✔✔agencies edits edit sets fields layouts messages tables Single-field (item) edits - Answer✔✔Check only one data field at a time Verify and validate values ex. race codes must have only allowable values Inter-field (multi-field) edits - Answer✔✔Compare related data item codes for corrections ex. females cannot have prostate cancer Inter-record (multi-record) edits - Answer✔✔Compare data on more than one like record Identify errors common to all records ex. multiple primaries must have the correct sequence numbers assigned in chronological order
Call for Data - Answer✔✔NAACCR and CDC publish annually Pareto Chart - Answer✔✔A good way to present findings from a recoding audit The chart helps identify areas that need attention by ranking them in decreasing order of importance (so data items with the most errors will be listed first) Re-abstracting studies - Answer✔✔Assess the quality of the collected data by having a qualified staff member re-abstract a sample of cases from the medical record documents Completeness Rate - Answer✔✔Casefinding audits can be used to determine completeness rates Completeness rate (%) = 100 - ((missed cases/total number identified) * 100) Missed Rate - Answer✔✔Missed rate = (# missed total/ # identified) * 100 Central Registries perform - Answer✔✔edits data linkage death clearance audits (case-fginding, consolidation, re-abstraction, recoding) de-duplication manual record consolidation process monitoring
Lean Overprocessing - Answer✔✔Rereviewing the same pathology report each time an addendum is added Lean Motion - Answer✔✔Switching between programs on the computer screen Defects - Answer✔✔Data errors/failed edits Ishikawa/Cause and Effect Diagram - Answer✔✔ex. If a registry identifies a high number of cases in their database with a missing SSN, the registrar might use a cause and effect diagram to identify the potential causes of this problem Check Sheet - Answer✔✔ex. A central registry contacts patients for enrollment in a special study wishes to know what time of day is best to call them - documents outcome of each phone call, caller's productivity by the hour Histogram - Answer✔✔Bar graph showing frequency of events over discreet categories ex. The number of successful patient contacts based on each hour attempted Pareto Chart - Answer✔✔Like a histogram but arranged largest to smallest from left to right highlighting the highest 20% (80/20 rule) Run Chart - Answer✔✔Line graph of data over time ex. Daily commute to work (while some variation is to be expected, extreme variability may indicate a need for improvement)
Scatter Plot - Answer✔✔Graph used to show the relationship between 2 continuous variables (independent on horizontal access and dependent on vertical) ex. Central registry wants to know if they should be offering registrars more or fewer cont ed opportunities, plots hours of ed on horizontal and abstracting accuracy rates on vertical Step Assessment - Answer✔✔An ordered list of all the steps necessary to complete a task Effective for a simple, linear process Work Flow Chart - Answer✔✔Uses the flow chart diagram to map the individual steps necessary to complete a task Effective for more complex processes Time and Motion Study - Answer✔✔Once the step assessment or workflow chart is completed, this can be used to measure the time to perform each step Goal is to eliminate wasted time and improve productivity Daily Productivity Worksheet - Answer✔✔Tracks the overall productivity of individuals without listing the details of each specific task Designed to show what has been accomplished in a specific task but not the steps needed to complete the task Can help identify tasks that don't occur daily, such a training, monthly meeting, unusual phone usage, computer trouble
National Comprehensive Cancer Network (NCCN) - Answer✔✔Not-for-profit alliance of 31 leading cancer centers in the US, most of which are designated by NCI as comprehensive care centers. Primary goal is to improve the quality, effectivenes and efficiency of oncology practices. Creates clinical practice guidelines for use by patients and clinicians NCCN Guidelines - Answer✔✔Apply to 97% of cancers in the US. Patient friendly translations "NCCN Guidelines for Patients" National Quality Forum - Answer✔✔A not-for-profit, nonpartisan membership- based organization that is involved in health care improvements across many diseases. Endorsed 5 quality-of-care measures that impact several areas of the cancer registry National standards of care Malignant tumors of epithelial cell origin - Answer✔✔Carcinomas Malignant tumors of epidermoid cells - Answer✔✔Squamous Cell Carcinomas Malignant tumors of glandular cells - Answer✔✔Adenocarcinomas Malignant tumors with mixed features of glandular and squamous cell carcinomas
- Answer✔✔Transitional Cell Carcinomas (Urothelial)
Benign tumors of glandular cells - Answer✔✔Adenomas Reportable for CNS - Answer✔✔tumor and neoplasm (not mass and lesion) In-Situ - Answer✔✔Develops on the surface on the organ and does not invade the basement membrane of the mucosa; also known as intraepithelial neoplasia Malignant tumors of mesenchymal origin (embryonic connective tissue) - Answer✔✔Sarcomas Synchronous - Answer✔✔diagnosed at the same time as the primary site, also known as de novo Metachronous - Answer✔✔diagnosed after the primary site had been diagnosed and treated Precocious - Answer✔✔diagnosed with an unknown primary site (a metastasis was the first indication of cancer in the patient) Two factors involved in carcinogenesis - Answer✔✔environment and heredity Gentoxic carcinogens - Answer✔✔Alter DNA and are mutagenic Almost all human carcinogens are genotoxic
Cancer epidemiology - Answer✔✔-second leading cause of death in adults and children in the US, after heart disease
- majority of cases in people over age 65
- breast is most common for women
- prostate is most common for men
- lung is second most common for men and women, but leading in cancer deaths
- colon is third most common in men and women, and second in deaths Most common cancers for men, in order from most - Answer✔✔Prostate Lung Colon Bladder Melanoma Most common cancers for women, in order from most - Answer✔✔Breast Lung Colon Uterine Ovarian Remission - Answer✔✔a period when the patient is free of the symptoms of the disease, even though they may not be free of the disease Excisional biopsy - Answer✔✔Removing the entire tumor lesion for diagnosis
Incisional biopsy - Answer✔✔Using a scalpel to remove a small portion of the tumor for diagnosis Laparoscopy - Answer✔✔the examination of the peritoneal cavity through an endoscope Laparatomy - Answer✔✔the exploration of the peritoneal cavity by surgically opening the abdomen Sentinel nodes - Answer✔✔the first node or nodes in the body to receive and filter the cancer cells as they leave the organ of origin and start to metastasize Recording non-specific dates - Answer✔✔Spring- April Middle of the year- July Fall of the year- October The winter of - either January or December (see if you can determine beginning or end of a year) Surgery - Answer✔✔Most effective on early-stage malignancies, when the organ or all of the cancer can be completely removed Cancers that can be cured by surgery if diagnosed early - Answer✔✔breast endometrium cervix testis
Intensity-modulated radiotherapy - Answer✔✔a type of three-dimensional conformal whose path changes to match the shape of the tumor and whose intensity varies to match its depth Stereotactic radiation therapy/radiosurgery - Answer✔✔a well-defined, narrow beam of high-dose radiation therapy that is delivered to places difficult to reach and treat; uses special procedures for tumor localization; delivers a large, single radiation dose with extreme accuracy to limited and well-defined tumor volumes Gamma Knife - Answer✔✔a machine that uses over 200 radioactive cobalt sources to produce a precise, small volume of concentrated radiation in a single session eradicate brain tumor cells from many angles fractionation is not possible because the frame has to be bolted on to the patient's head with metal bolts Intrathecal - Answer✔✔Agents are injected directly into the cerebrospinal fluid using an implanted access device (commonly used for leukemia or lymphoma) Infusion - Answer✔✔Insertion of a catheter into an artery that supplies blood to the affected area and the injection of the drugs through the catheter Chemoembolization - Answer✔✔Delivers cytotoxic drugs and embolic agents via a catheter positioned in an artery rather than through a needle or probe
Ambiguous Modifiers - Answer✔✔Considered to be [malignancy or reportable diagnosis] Characteristic of [malignancy or reportable diagnosis] Appears to be a [malignancy or reportable diagnosis] Most compatible with [malignancy or reportable diagnosis] Most certainly [malignancy or reportable diagnosis] In keeping with [malignancy or reportable diagnosis] NOT diagnostic - Answer✔✔Highly suspicious for, but not diagnostic of [malignancy or reportable diagnosis] Most compatible with a [non-reportable diagnosis] such as a [reportable diagnosis] High probability for [malignancy or reportable diagnosis] New Non-Reportables as of 2023 - Answer✔✔Colon atypical hyperplasia High grade dysplasia in colorectal and esophageal primary sites Adenocarcinoma in situ, HPV associated (8483/2)(C53) Pulmonary benign metastasizing leiomyoma Carcinoid tumorlet of the lung SEER Reportable if dx in 2023 - Answer✔✔Rathke Pouch Tumor Noninvasive mucinous cystic neoplasm of the pancreas with high grade dysplasia Solid pseudopapillary neoplasm of the pancreas Cystic pancreatic endocrine neoplasm (CPEN) High-grade astrocytoma with piloid features (HGAP)
Primary site C710 (excluding hypothalamus, pallium, thalamus) Anterior cranial fossa (C719) Corpus callosum (C718) Middle cranial fossa (C719) Tapetum (C718) Suprasellar (C719) 2023 primary sites were removed from the table, Sites for Which Laterality Codes Must Be Recorded: (NO LONGER CODE LATERALITY) - Answer✔✔C413 [Rib, clavicle (excluding sternum)] C414 [Pelvic bones (excluding sacrum, coccyx, symphysis pubis)] C300 Nasal cavity (excluding nasal cartilage, nasal septum) C340 Main bronchus (excluding carina) Meninge and Spinal Cord Placement - Answer✔✔Extradural: Outside the dura, outside the meninges Extramedullary: Outside the spinal cord Intradural: Within the dura, within the meninges Intramedullary: Within the spinal cord Code C509 when - Answer✔✔There are multiple tumors (two or more) in at least two quadrants of the breast. There are multiple tumors (two or more) located together at the 12, 3, 6, or 9- o'clock position on the breast Intracranial glands - Answer✔✔Pineal
Pituitary Code C508 when - Answer✔✔There is a single tumor in two or more subsites and the subsite in which the tumor originated is unknown There is a single tumor located at the 12, 3, 6, or 9 o'clock position on the breast Synonyms of LVI - Answer✔✔Angiolymphatic invasion Blood vessel invasion Lymph vascular emboli Lymphatic invasion Lymphvascular invasion Vascular invasion Lymphovascular space invasion TME - Answer✔✔Macroscopic pathologic assessment of the completeness of the mesorectum excision accurately predicts both local recurrence and distant metastasis TME improves local recurrence rates and the corresponding survival by as much as 20%. Coding this data item only applies to rectal cases Use information from the pathology report and/or the CAP protocol for this data item Leave this field blank when the primary site is other than rectum (C20.9) Neoadjuvant therapy does not alter coding of this data item Assign code 00 when a total mesorectal excision is not performed
overlaps the boundaries of two or more categories or subcategories and its point of origin cannot be determined. Only code the primary site associated with the appropriate tissues suggested in the ICD-O alphabetic index for each ill-defined site in preference to the "NOS" category when the site of origin is not specified by the pathologist or healthcare provider. Code 4 [Bilateral involvement at time of diagnosis, lateral origin unknown for a single primary] is seldom used EXCEPT for the following - Answer✔✔Both ovaries involved simultaneously with a single histology, or epithelial histologies (8000-
Diffuse bilateral lung nodules Bilateral retinoblastomas Bilateral inflammatory carcinoma of the breast Bilateral nephroblastomas (previously called Wilms tumors) Estimating Date of Dx - Answer✔✔Code "spring" to April. Code "summer" or "middle of the year" to July. Code "fall" or "autumn" as October. For "winter" try to determine whether the physician means the first of the year or the end of the year and code January or December as appropriate. If no determination can be made, use whatever information is available to calculate the month of diagnosis. Code the month of admission as the month of diagnosis when there is no basis for estimation Head of the pancreas (C250) - Answer✔✔Tumor arose in the uncinate process of the pancreas.
Tumor arose in the genu of the pancreas
