National Lung Cancer Audit 2011

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.

These data will be released in an open and standardised format for the first time in December 2011, and provided annually from then onwards.

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 in the National Lung Cancer Audit 2011 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; These data do 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 are provided either by cancer network or by place first seen in secondary care for the calendar year 2010. As a result, some trusts that only provide some specialist treatments for patients and do not 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' is 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. Therefore their performance should not be assessed from the results as published here. These trusts do however fully participate in the audit by providing treatment data for the referring MDTs.

The trusts concerned are:

The Christie NHS Foundation Trust

University Hospitals of South Manchester NHS Foundation Trust

Clatterbridge Centre for Oncology NHS Foundation Trust

Royal Brompton and Harefield NHS Foundation Trust

The Royal Marsden NHS Foundation Trust

Papworth Hospital NHS Foundation Trust

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 or mesothelioma are included.

What period does the data cover?

This data were extracted from the NLCA database in July 2011 and covers patients first seen in the calendar year 2010.

推动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，首相重申了将国家临床审计和患者结局计划中的临床审计数据公开的承诺。国家肺癌审计（NLCA）被选为此次数据发布的试点项目。

这些数据首次以开放和标准化的格式于2011年12月发布，并自此每年提供。

涵盖英格兰所有癌症网络和NHS信托机构，审计数据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格式包含在NLCA 2011年度报告中。

公开哪些信息？

关于对患者提供护理过程的相关指标
关于护理结果和治疗的信息。

此外，数据还提供了由信托机构和关键字段的数据完整性方面的审计参与情况；这些数据未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。

数据由癌症网络或2010年日历年度首次接受二级护理的地方提供。因此，一些仅提供某些专科治疗且不提供诊断数据的信托机构在这些数据中未能得到充分体现。这是因为迄今为止对NLCA的所有分析都是基于“首次接受治疗的地方”和癌症网络进行的。“首次接受治疗的地方”是指临床多学科团队（MDT），该团队（与坐在这些外围MDT上的专科中心代表合作）做出首次治疗决策。

我们大致了解这些MDT的基人口数量，这个数字提供了结果指标的分母。为专科中心和它们提供的服务定义人口分母要困难得多，它们提供的服务通常是复杂护理路径的一部分。因此，仅从原始数据出发会给出一个严重扭曲的活动和绩效图景。因此，不应从发布的结果中评估它们的绩效。然而，这些信托机构通过为转诊MDT提供治疗数据，充分参与了审计。

涉及的信托机构包括：

克里斯蒂NHS信托基金会
南曼彻斯特大学医院NHS信托基金会
克拉特布里奇癌症中心NHS信托基金会
皇家布隆顿和哈雷菲尔德NHS信托基金会
皇家马斯登NHS信托基金会
帕普沃斯医院NHS信托基金会
获取数据

数据将通过data.gov网站提供。每年将提供两份NLCA数据的文件，以CSV格式提供。信托机构和网络以名称和国家代码标识。

数据涵盖哪些内容？

这些数据衡量了提交给NLCA的数据完整性水平以及信托级别的审计性能指标，用于评估二级护理中肺癌的护理标准。这些标准的详细内容可以在NLCA报告的附录2中找到。

所有信托机构是否都被包括在内？

英格兰所有管理被诊断为肺癌或间皮瘤的患者信托机构都被包括在内。

数据覆盖哪个时期？

这些数据于2011年7月从NLCA数据库中提取，涵盖2010年日历年度首次接受治疗的患者。