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Completeness and selection bias of a Belgian multidisciplinary, registration-based study on the EFFectiveness and quality of Endometrial Cancer Treatment (EFFECT)

(2022) BMC CANCER. 22(1).
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Abstract
Background With the aim of obtaining more uniformity and quality in the treatment of corpus uteri cancer in Belgium, the EFFECT project has prospectively collected detailed information on the real-world clinical care offered to 4063 Belgian women with primary corpus uteri cancer. However, as data was collected on a voluntary basis, data may be incomplete and biased. Therefore, this study aimed to assess the completeness and potential selection bias of the EFFECT database. Methods Five databases were deterministically coupled by use of the patient's national social security number. Participation bias was assessed by identifying characteristics associated with hospital participation in EFFECT, if any. Registration bias was assessed by identifying patient, tumor and treatment characteristics associated with patient registration by participating hospitals, if any. Uni- and multivariable logistic regression were applied. Results EFFECT covers 56% of all Belgian women diagnosed with primary corpus uteri cancer between 2012 and 2016. These women were registered by 54% of hospitals, which submitted a median of 86% of their patients. Participation of hospitals was found to be biased: low-volume and Walloon-region centers were less likely to participate. Registration of patients by participating hospitals was found to be biased: patients with a less favorable risk profile, with missing data for several clinical-pathological risk factors, that did not undergo curative surgery, and were not discussed in a multidisciplinary tumor board were less likely to be registered. Conclusions Due to its voluntary nature, the EFFECT database suffers from a selection bias, both in terms of the hospitals choosing to participate and the patients being included by participating institutions. This study, therefore, highlights the importance of assessing the selection bias that may be present in any study that voluntarily collects clinical data not otherwise routinely collected. Nevertheless, the EFFECT database covers detailed information on the real-world clinical care offered to 56% of all Belgian women diagnosed with corpus uteri cancer between 2012 and 2016, and may therefore act as a powerful tool for measuring and improving the quality of corpus uteri cancer care in Belgium.
Keywords
EFFECT, Selection bias, Completeness, Cancer registration, Endometrial cancer, Corpus uteri cancer

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MLA
Vanbraband, J., et al. “Completeness and Selection Bias of a Belgian Multidisciplinary, Registration-Based Study on the EFFectiveness and Quality of Endometrial Cancer Treatment (EFFECT).” BMC CANCER, vol. 22, no. 1, 2022, doi:10.1186/s12885-022-09671-5.
APA
Vanbraband, J., Van Damme, N., Bouche, G., Silversmit, G., De Geyndt, A., de Jonge, E., … Amant, F. (2022). Completeness and selection bias of a Belgian multidisciplinary, registration-based study on the EFFectiveness and quality of Endometrial Cancer Treatment (EFFECT). BMC CANCER, 22(1). https://doi.org/10.1186/s12885-022-09671-5
Chicago author-date
Vanbraband, J, N Van Damme, G Bouche, G Silversmit, A De Geyndt, E de Jonge, G Jacomen, F Goffin, Hannelore Denys, and F Amant. 2022. “Completeness and Selection Bias of a Belgian Multidisciplinary, Registration-Based Study on the EFFectiveness and Quality of Endometrial Cancer Treatment (EFFECT).” BMC CANCER 22 (1). https://doi.org/10.1186/s12885-022-09671-5.
Chicago author-date (all authors)
Vanbraband, J, N Van Damme, G Bouche, G Silversmit, A De Geyndt, E de Jonge, G Jacomen, F Goffin, Hannelore Denys, and F Amant. 2022. “Completeness and Selection Bias of a Belgian Multidisciplinary, Registration-Based Study on the EFFectiveness and Quality of Endometrial Cancer Treatment (EFFECT).” BMC CANCER 22 (1). doi:10.1186/s12885-022-09671-5.
Vancouver
1.
Vanbraband J, Van Damme N, Bouche G, Silversmit G, De Geyndt A, de Jonge E, et al. Completeness and selection bias of a Belgian multidisciplinary, registration-based study on the EFFectiveness and quality of Endometrial Cancer Treatment (EFFECT). BMC CANCER. 2022;22(1).
IEEE
[1]
J. Vanbraband et al., “Completeness and selection bias of a Belgian multidisciplinary, registration-based study on the EFFectiveness and quality of Endometrial Cancer Treatment (EFFECT),” BMC CANCER, vol. 22, no. 1, 2022.
@article{01GYFQ3GW6Y84A5PB62Y0AT5NP,
  abstract     = {{Background With the aim of obtaining more uniformity and quality in the treatment of corpus uteri cancer in Belgium, the EFFECT project has prospectively collected detailed information on the real-world clinical care offered to 4063 Belgian women with primary corpus uteri cancer. However, as data was collected on a voluntary basis, data may be incomplete and biased. Therefore, this study aimed to assess the completeness and potential selection bias of the EFFECT database. Methods Five databases were deterministically coupled by use of the patient's national social security number. Participation bias was assessed by identifying characteristics associated with hospital participation in EFFECT, if any. Registration bias was assessed by identifying patient, tumor and treatment characteristics associated with patient registration by participating hospitals, if any. Uni- and multivariable logistic regression were applied. Results EFFECT covers 56% of all Belgian women diagnosed with primary corpus uteri cancer between 2012 and 2016. These women were registered by 54% of hospitals, which submitted a median of 86% of their patients. Participation of hospitals was found to be biased: low-volume and Walloon-region centers were less likely to participate. Registration of patients by participating hospitals was found to be biased: patients with a less favorable risk profile, with missing data for several clinical-pathological risk factors, that did not undergo curative surgery, and were not discussed in a multidisciplinary tumor board were less likely to be registered. Conclusions Due to its voluntary nature, the EFFECT database suffers from a selection bias, both in terms of the hospitals choosing to participate and the patients being included by participating institutions. This study, therefore, highlights the importance of assessing the selection bias that may be present in any study that voluntarily collects clinical data not otherwise routinely collected. Nevertheless, the EFFECT database covers detailed information on the real-world clinical care offered to 56% of all Belgian women diagnosed with corpus uteri cancer between 2012 and 2016, and may therefore act as a powerful tool for measuring and improving the quality of corpus uteri cancer care in Belgium.}},
  articleno    = {{600}},
  author       = {{Vanbraband, J and Van Damme, N and Bouche, G and Silversmit, G and De Geyndt, A and de Jonge, E and Jacomen, G and Goffin, F and Denys, Hannelore and Amant, F}},
  issn         = {{1471-2407}},
  journal      = {{BMC CANCER}},
  keywords     = {{EFFECT,Selection bias,Completeness,Cancer registration,Endometrial cancer,Corpus uteri cancer}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{13}},
  title        = {{Completeness and selection bias of a Belgian multidisciplinary, registration-based study on the EFFectiveness and quality of Endometrial Cancer Treatment (EFFECT)}},
  url          = {{http://doi.org/10.1186/s12885-022-09671-5}},
  volume       = {{22}},
  year         = {{2022}},
}

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