National Lung Cancer Audit 2013

Making clinical audit data transparent

In his transparency and open data letter to Cabinet Ministers on 7 July 2011, the Prime Minister restated the commitment to make clinical audit data available from the national audits within the National Clinical Audit and Patient Outcomes Programme. The National Lung Cancer Audit (NLCA) was identified as the pilot for this data release.

The data was released in an open and standardised format for the first time in December 2011, and each year onward, data from the National Lung Cancer Audit will be made available in CSV format. The data are also being made available on the data.gov website.

Covering all Cancer Networks and NHS Trusts in England, the data from the audit includes information about data completeness, audit process and outcome measures. The data will be available in a pdf format with the National Lung Cancer Audit 2012 annual report.

What information is being made available?

Measures about the process of care given to patients

Information about care outcomes and treatment.

The data also provides Audit participation by Trust and data completeness for the key fields. This data does not list data about individual patients nor does it contain any patient identifiable data.

Using and interpreting the data

Data from the National Lung Cancer Audit requires careful interpretation, and the information should not be looked at in isolation when assessing standards of care.

Data is analysed either by cancer network or by place first seen in secondary care for the calendar year 2012. As a result, some trusts that only provide some specialist treatments for patients and do not routinely supply diagnostic data are not properly represented in these data. This is because all the analyses of the NLCA to date have been carried out by 'place first seen' and cancer networks. The ‘place first seen' most closely represents the Clinical Multi-Disciplinary Team (MDT) which makes the first treatment decisions (in partnership with representatives from the specialist centres who sit on these peripheral MDTs).

We largely know the population base for these MDTs and that number provides the ‘denominator' for the outcome measures. It is much more difficult to define a population denominator for specialist centres and the treatment they provide is usually only one part of a complex care pathway. So taking the raw data at face value gives a very distorted picture both of their activity and performance.

Accessing the data

The data are being made available on the data.gov website. Each year two files of data from the National Lung Cancer Audit will be made available in CSV format. Trusts and Networks are identified by name and their national code.

What does the data cover?

The data measure levels of completeness for data submitted to the NLCA and measures of performance in the audit at trust level for key performance measures for assessing standards of care for lung cancer in secondary care. Details of these standards can be found in appendix 2 of the NLCA report.

Are all Trusts included?

All Trusts in England that manage patients diagnosed with lung cancer (excluding mesothelioma) are included. The audit also covers Wales.

What period does the data cover?

This data were extracted from the NLCA database in July 2013 and covers patients first seen in the calendar year 2012.

将临床审计数据透明化

在2011年7月7日致内阁部长的透明度和开放数据信函中，首相重申了从国家临床审计和患者结局项目中的国家审计中公开临床审计数据的承诺。国家肺癌审计（NLCA）被确定为这项数据发布的试点。

数据首次以开放和标准化的格式于2011年12月发布，此后每年国家肺癌审计的数据将以CSV格式公开。这些数据也将发布在data.gov网站上。

涵盖英格兰所有癌症网络和NHS信托机构的数据从审计中包括关于数据完整性、审计流程和结果指标的信息。这些数据将以pdf格式与2012年国家肺癌审计年度报告一同提供。

公开哪些信息？

关于对患者提供的护理过程的指标

关于护理结果和治疗的信息。

数据还提供了由信托机构参与的审计以及关键字段的完整性数据。这些数据不列出关于个别患者的信息，也不包含任何可识别患者身份的数据。

使用和解读数据

国家肺癌审计的数据需要谨慎解读，在评估护理标准时，不应孤立地看待这些信息。

数据通过癌症网络或通过在2012年日历年度首次接受二级护理的地方进行分析。因此，一些仅提供某些专科治疗且不常规提供诊断数据的信托机构在这些数据中并未得到充分体现。这是因为迄今为止对NLCA的所有分析都是基于“首次就诊地点”和癌症网络进行的。‘首次就诊地点’最接近代表临床多学科团队（MDT），该团队作出首次治疗决策（与位于这些外围MDT上的专科中心代表合作）。

我们大体上了解这些MDT的群体基础，该数字为结果指标提供了‘分母’。为专科中心和它们提供的服务定义一个群体分母要困难得多，它们提供的服务通常是复杂护理路径的一部分。因此，仅从原始数据中获取数据会对其活动和表现给出非常扭曲的图景。

访问数据

数据将发布在data.gov网站上。每年将提供两份国家肺癌审计的数据文件，以CSV格式公开。信托机构和网络将通过名称和国家代码进行标识。

数据涵盖什么内容？

数据衡量了提交给NLCA的数据的完整性水平以及信托级别的审计绩效指标，用于评估肺癌在二级护理中的护理标准。这些标准的详细信息可在NLCA报告的附录2中找到。

是否所有信托机构都包括在内？

包括所有管理被诊断为肺癌的患者的英格兰信托机构（不包括间皮瘤）。审计还涵盖威尔士。

数据覆盖哪个时期？

这些数据于2013年7月从NLCA数据库中提取，涵盖了2012年日历年度首次接受治疗的患者。