question

Cancer in humans was first seen

answer

In 2500 B.C

question

The word cancer was first used by

answer

The greek physician Hippocrates

question

The term surveillance as applied to public health means

answer

Monitoring of the occurrence of selected health conditions in the population

question

The oldest example of a modern cancer registry is

answer

The Hamburg Cancer Registry in Germany

question

Which are types of cancer registries

answer

Population-based registries Specialty registries Hospital-based registries

question

The first code manual used in cancer registries was published by

answer

ACS (american collage of surgeons)

question

NAACCR's PRIMARY ROLE IS TO REPRESENT AND SERVE AS A FORUM FOR THE ORGANIZATION, OPERATION, QUALITY CONTROL, AND STATISTICAL REPORTING

answer

For population-based cancer registries

question

The first national cancer registry program was established by

answer

SEER

question

The international Classification of Diseases for Oncology is published by

answer

WHO

question

The CTR, Certified Tumor Registrar credential is awarded by

answer

NCRA

question

United States Cancer Statistics (USCS) contains data from

answer

NPCR and SEER

question

The Self Instructional Manuals for Tumor Registrars series is published by

answer

SEER

question

Cancer Facts and figures published by

answer

ACS

question

Patient Care Evaluation Studies published by

answer

CoC

question

Cancer in North America published by

answer

NAACCR

question

Cancer in Five Continents published by

answer

IACR

question

Accreditation for formal education programs that provide entry-level professional preparation with a major emphasis in Cancer Registry Management is offered by

answer

NCRA

question

One of the biggest challenges to cancer registrars will continue to be

answer

Keeping up with changes in data collection coding, and reporting standards

question

Hospital based Cancer Registry

answer

Evaluating clinical care and hospital administration Providing advocacy and educational opportunities to cancer patients Improving patient care programs

question

Population-based cancer registry

answer

- Advancing clinical, epidemiological, and health services research on cancer - Exploration of trends in cancer care - Creation of regional and state benchmarks for hospitals - Determination of cancer patterns among various populations or sub-populations - Monitoring cancer trends over time - Guiding planning and evaluation of cancer control efforts to help prioritize health resource allocations - Improving patient care programs - Research into the cause of cancer

question

Specialty cancer registry

answer

- Advancing clinical, epidemiological and health services research on cancer - providing advocacy and educational opportunities to cancer patients - gathering and disseminating epidemiologic data on a specific type of cancer - research into the cause of cancer

question

The use of standard data item definitions facilitates

answer

Training procedures for coders Common editing procedures Comparability of data

question

Reliability refers to

answer

How consistently different people will code the same circumstances the same way

question

In 2010, the way registries transmit dates was changed to improve

answer

Intraoperability of date transmission

question

When an old item is no longer relevant

answer

One or more new response categories may be added to the older item The old item may be dropped, and no longer coded

question

New cancer registry data items may be added

answer

As a result of medical advances As a result of advances in computer communication technology As a result of more widespread access to and use of registry data

question

Data set

answer

The collections of data items maintained by a registry

question

Standard data item

answer

Data item whose codes, definitions, and coding instructions are shared among registry organizations

question

Data dictionary

answer

Provides coding instructions, code definitions, and the code options

question

Interoperability

answer

Consistency with which varied organizations and software systems handle the transmission of similar information

question

Lead time error

answer

Can occur when medical technology advances and some cancers are diagnosed earlier in their progression than in the past

question

Administrative data items

answer

Can be used to identify the coding scheme in used when a case was originally coded

question

Relevance of a data item

answer

Can occur when medical technology advances and some cancers are diagnosed earlier in their progression than in the past

question

How are accurate time frames determined for a specific process or task

answer

Assessment of steps studies Time-motion studies

question

Which items affect staffing

answer

The facility type Type and number of physician requests Number of meetings for which the registrar is a participant or staff Budget

question

Advantages of having permanent cancer registry staff

answer

- permanent staff can work remotely - traditionally, there are no housing costs - staff knows the facility and the job expected of them - there is consistent staffing

question

Advantages of outsourcing the cancer registry

answer

- the number of staff can often be increased or decreased quickly - short- or long-term commitments can be negotiated - on-site or remote staffing can be negotiated - specific aspects/projects or the entire responsibility of the cancer registry can be negotiated

question

How often should time-motion studies be performed

answer

At predetermined intervals or when a new or change of responsibility occurs

question

How many time-motion studies need to be done

answer

One for each registry process or grouping of processes as determined by the cancer registry

question

Registry staff can include

answer

Epidemiologists CTRs Abstractors Follow-up clerks Statistical analysts

question

Advantage of a remote staff

answer

Less office space needed at the facility Flexible hours Remote staff can work from anywhere, which gives the registry a larger pool of staff to choose from

question

Why would a registry need someone on-site

answer

To staff cancer conferences or committee meetings To process incoming mail To manage outside requests for follow-up To handle hard copy reports

question

Effect electronic medical records has on registry operation

answer

Allows for remote workers Allows for chart retrieval from computers Aggregates the patient information Provides information in real or near real time

question

Where should computer monitors be placed

answer

Computer monitors should be placed with the top line at or below eye level

question

Cancer registry budget items

answer

Funds for supplies, including providing snacks or drinks at meetings Travel costs for meetings Cost of electricity, heat, housekeeping, and maintenance staff Salaries for registry staff

question

Which procedures should be done to ensure that all costs have been included in the budget

answer

Keep records of invoices Analyze information from previous budgets Check with other registrars Review information supported by NAACCR or NCRA

question

What is a non revenue-producing department

answer

A department that depends on a sponsoring department and/or grants for support

question

Where can one look to find c urgent salary compensation

answer

The internet Human resources Other registers Want ads

question

Why does a registry continually monitor registry work flow

answer

To keep up with current requirements To keep appropriate staffing levels

question

Law that covers wrongful acts that result in harm to another person, such as invasion of privacy, and can result in compensation to the injured part

answer

Tort

question

A patient's right to personal privacy and confidential handling of medical records is covered under what important federal law concerned with health insurance portability?

answer

HIPAA

question

Usually, federal law preempt state law, except where state law is

answer

More strict than the federal law

question

A court order to provide certain documents, such as medical records, is called

answer

Subpoena

question

Which are federal administrative agencies that may affect cancer registry operation

answer

The national cancer institute The centers for Disease Control and Prevention

question

Under what circumstances can confidential cancer registry data be made available

answer

To provide follow up information to an approved facility

question

Solution to keeping data secure

answer

Passwords, audit control

question

Solution to transmission of confidential data

answer

Data encryption

question

Solution to appropriate release of data

answer

Explicit administrative authorization

question

Solution to computer failure

answer

Automatic back up system

question

Cancer registrars need to be concerned with confidentiality regarding

answer

Patient information Identity of health care professional Identification of institution

question

It is unethical for the cancer registry professional to place this ahead of service

answer

Material gain

question

Examples of possible duality of interest

answer

Outside consultation services Committee appointments Business enterprises interests

question

Any charges of unethical behavior or alleged violations are investigated by

answer

NCRA Ethics Committee

question

Guidelines addressed in the NCRA Professional Practice Code of Ethics are

answer

Cooperation with other professions and organizations

question

A complete listing of accredited college programs for registrars can be accessed at which organizations web sites

answer

NCRA

question

an emphasis on cancer surveillance may include what

answer

evaluation of efficacy of treatment analyzing referral patterns compliance with treatment guidelines

question

Some barriers to establishing a mentoring relationship for the cancer registry professional include what

answer

time constraints specialization of the field

question

benefits of mentoring for employers include what

answer

fewer errors shorter learning curve happier employees

question

which groups benefit from registrars working together and helping each other

answer

cancer surveillance community researchers cancer programs cancer patients

question

Registrars should no seek what through volunteerism

answer

financial or material gains

question

Privacy

answer

permissible means of access, use, and disclosure of the applicable patient information

question

security

answer

governs the operational and technical mechanism necessary to protect this information.

question

What device protects a registry's network from external intrusions?

answer

Firewall

question

What type of network allows registry staff in different cities to share computer resources

answer

Wide Area Network

question

Why is it important for laptop computers to be configured with disk encryption

answer

they may be easilty lost or stolen

question

which are open-source database applications

answer

MySQL Postgres

question

what computer language is often used to create, update, and delete data from a database

answer

SQL

question

Why is a relational database structure better for storing registry data than a NAACCR exchange record

answer

- registry data are logically grouped into records such as patient demographics and cases - the NAACCR record is designed for data exchange, not storage - some NAACCR data exchange fields simply do not make sense to store in a registry database - the NAACCR data exchange record can accommodate only a fixed number of therapy records

question

major functions of central registry software systems

answer

data entry and import record consolidation record linkage supporting quality assurance operations reporting and analysis data exchange and export provide access security task and record management

question

What software functions are unique to hospital registries

answer

conducting active patient follow-up submitting data to the American College of Surgeons' National Cancer Database

question

Why should central registries be concerned with registry data management systems used by their reporting hospitals

answer

- the majority of central registry data is first collected by the hospital data management system - edit checks and coding rules may or may not be consistently implemented by hospitals registry vendors - it may be important when coordinating transitions to new coding standards

question

Software applications important to registry operations

answer

record linkage statistical analysis geospatial analysis edit checking electronic pathology transmission collaborative stage data collection system

question

Why should a probabilistic record linkage application be used to link records in a central registry

answer

it makes it feasible and efficient to link data sets in a statistically justifiable manner

question

What are two advantages of increasing interoperability of registry data?

answer

- it enhances the central registry's ability to automatically incorporate data from other sources - it makes it easier for researchers and others to utilize registry data

question

Most important to achieving interoperability with other data systems is:

answer

Supporting and adopting widely used data standards

question

Semantic interoperability

answer

the ability of computer systems to exchange data with unambiguous, shared meaning.

question

Syntactic interoperability

answer

If two or more systems are capable of communicating with each other, when using specified data formats, communication protocols. XML or SQL standards are among the tools

question

What does HL7 stand for, and what is it

answer

Health Level Seven is a widely used data exchange standard in the healthcare industry

question

What are the three key roles for cancer registry technical staff

answer

Software development Systems administration Registry operations technical support

question

How much of IT staff time should be devoted to the registry

answer

100%

question

What is an essential element of proper disaster recovery planning

answer

Providing a reliable backup and recovery system

question

When can confidential patient data be transmitted over the web or internet

answer

- when using encrypted web connections - by attaching data to e-mail in an encrypted file - when data are encrypted on physical media

question

How often should a registry plan to replace desktop computers

answer

Every 3 to 5 years

question

What changes will technological advances likely bring to cancer registries?

answer

- Registry data will be available closer to real time - Registry data will become even more clinically relevant and important

question

What was the main reason data edits were developed

answer

Standardization of data collection

question

When were the first coding rules and guidelines established

answer

1950's

question

What group has members from all standard-setting organizations and whose goal is data standardization

answer

Uniform data standards committee (UDSC) of the American Association of Central Cancer Registries (AACCR)

question

Two organizations responsible for the development of Edits software

answer

1. The center for disease control and prevention (CDC) 2. The national program of cancer registries (NPCR)

question

When were the first standard edits made available

answer

1996

question

Major changes to registry data changes by standard setter are instituted every _______ years

answer

3

question

Three challenges to standardizing data edits

answer

- differing computer language in registry systems - Standard specifications may be programmed differently - Incomplete editing of data during data entry

question

Why are standard data edits created

answer

To test data against coding rules

question

What is the "why, when, where and how" of edits

answer

Why: to identify incorrect date When: state of SEER submission, NCDB call for data (hospital registries, NAACCR or NPCR call for data (central registries) Where: hospital or central registry How: Flag blank fields Indicate single field edit errors Specify disagreement between multiple data fields Indicate potential errors that require manual review

question

Three edit components

answer

METAFILE Edit set Individual edits

question

Metafile

answer

Set of instructions

question

What does the metafile contain

answer

Everything necessary to edit the data, except the data

question

Five key components of a metafile

answer

Data dictionary Record layouts Edit sets Standard setting agencies User lookup tables

question

What is the purpose of an edit set

answer

To group individual edits

question

Edits contain the _______ to edit each field

answer

Logic

question

Three types of edits

answer

Single-field edits Inter-field edits Inter-record edits

question

Edits are the ______________

answer

Quality control gatekeepers

question

Which is the most important to consider when trying to resolve an edit using the edit report

answer

Error message

question

Why might the error summary on the edit report be important to the cancer registry manager

answer

Frequently encountered errors may mean that staff educations is needed

question

What the name of the edits feature that allows a user to note that the data are unusual but correct

answer

Edit over-ride

question

ONCHIT

answer

Office of the national coordinator for health information

question

ONC

answer

Office of national coordinator

question

Vision of a computerized, or electronic medical record began in

answer

1991

question

During the George Bush administration (2001-2009), and also during the Obama administration

answer

Attention was paid to, and support was given to the emerging EHR environment

question

Progress toward the EHR evolution has included significant effort by which entities

answer

Government and nongovernment

question

What does the terminology "meaningful use" have to do with the EHR environment?

answer

A specific EHR must have "meaningful use" features and benefits to qualify for certain government funding

question

PHR

answer

Personal health record

question

RHIO

answer

Regional health information organization - group of organizations within a specific area that share healthcare related information electronically according to accepted healthcare information technology

question

HIE

answer

Health information technology - gathering of healthcare information electronically across organizations within a region or community

question

HL7

answer

Health Level 7 - produce standards/protocol for transmission of clinical and administrative data

question

ANSI

answer

American national standards institute - founded in 1018 as a nonprofit, voluntary collaboration for standardization activities

question

LOINC

answer

Logical Observation Identifiers Names and Codes - terminology database facilities the exchange of clinical results, such as blood. Hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research

question

CPRI

answer

Computer Based Patient Record Institute

question

Synoptic pathology reporting

answer

May help facilitate online abstracting Use of structured checklists to produce standardized clinical documentation.

question

PHP, CSS, Javascript

answer

Three current technologies that have evolved to create dynamic websites

question

Acrobat (.pdf)

answer

Which file format is recommended

question

Ncra-usa.org

answer

Example of a domain name

question

HTTP

answer

Hypertext transfer protocol

question

URL (Uniform Resource Locator)

answer

Synonym of web address

question

How can a file be attached to an e-mail

answer

By dragging and dropping the attachment on the e-mail By clicking the paper clip icon in the e-mail toolbar and browsing for the file

question

NCRA and NAACCR

answer

Only two nation-wide membership organizations with web sites for cancer registrars in the united states. They contain information that is useful for both members and nonmember

question

What would be the major concern of your IT/IS staff about storing data in the cloud

answer

Data security

question

Multiple myeloma

answer

Cancer of plasma cells Patient with this disease have impaired immune function Men are more likely than women to be diagnosed with the disease Fatigue in patients is caused by a decrease in the quantity of red blood cells

question

What is true about Virtual servers

answer

Several may exist on the same server hardware They may be easily scaled depending on the applications requirements Amazon web services is a major provider of virtual servers

question

Google chrome

answer

Operating system (OS) and a Web browser

question

When a file is "checked out" from SharePoint

answer

Only the user who checked out the file can edit the file before checking it back in

question

A web URL is entered into the _________________of the Web browser

answer

Address bar

question

Example of a Web 2.0 site

answer

Facebook.com Wikipedia.com LinkedIn.com Myspace.com YouTube.com

question

Which entity provides the rules and guidelines used by central registries to determine residency at diagnosis

answer

U.S. Census Bureau

question

Currently in the United States, which governing agencies set reporting standards for hospital and population based registries

answer

American college of surgeons commission on cancer ( National program of cancer registrars Surveillance, epidemiology, and end results

question

Approximately what percentage of cancer cases is histologically confirmed

answer

95%

question

Which data formats are recommended by NAACCR to laboratories for reporting pathology report text information electronically to central registries

answer

HL7 Pipe-delimited

question

Updates to the ICD-9-CM codes are effective. Annually in which month

answer

October

question

___________________ refers to the effective date on or after which all reportable cases should be registered in a registry database

answer

Reference date

question

A _________________ is a listing of patients seen in a hospital, both inpatient and outpatient with ID-9-CM diagnosis codes

answer

Disease index

question

A case is included on a _______________during the case finding process until the appropriate hospital or physician officially reports the case

answer

Suspense list

question

______________ is a systematic method of identifying all potentially eligible cases that are to be included in the registry database

answer

Case finding

question

_________________is the process of identifying cases quickly for epidemiologic protocols

answer

Rapid case ascertainment

question

Reportable list

answer

Usually developed by the central registry, is composed of all the reportable case types collected by a cancer registry, and clarifies the types of diagnoses that are not reportable

question

Reportable-by-agreement cases

answer

All kinds of registries are allowed to collect_____________cases. There is not law or regulation that forbids the reporting of those cases to population based registries

question

A cancer registry is _______________for an ACoS-approved cancer program

answer

Mandatory

question

Death clearance is performed only by _________________

answer

Central cancer registries

question

______________ are considered the primary casefinding source because 95% of all reportable cases are histologically confirmed.

answer

Pathology reports

question

Disease index

answer

Is used as a cross-check on the completeness of reporting of pathology cases at hospitals, as well as an effective method to identify clinically diagnosed cases

question

A __________ is an example of a codified source document, whereas a __________ is an example of a full-text case finding source document

answer

Disease index Pathology report

question

____________________ are responsible for providing to hospitals a list of the mandatory and optional ICD-9-CM codes that should be included for case finding purposes per the reporting rules of the state or region

answer

Central registries

question

Six common sections of a cancer registry abstract

answer

Patient identification Cancer identification Stage of disease at diagnosis First course of treatment Outcomes Case administration

question

Cancer registry abstract

answer

Contains all information available related to the diagnosis and treatment of the cancer.

question

The cancer data collection manual required to be used by the American college of surgeons commission on cancer is______________

answer

FORDS

question

The goals for abstracting are to have ________, _______, and _________, cancer data

answer

Timely, accurate, complete

question

According to the American college of surgeons commission on cancer program standards, abstracts must be completed within ______months of date of first contact

answer

6

question

Potentially reportable cases that have been identified and are waiting to be abstracted are stored in what is called

answer

Suspense system

question

Completing an abstract as information becomes available is called _____________ abstracting

answer

Concurrent

question

Patient identification

answer

Accession number Sequence number Social security number Race Date of birth

question

Cancer identification

answer

Laterality Date of initial diagnosis Behavior code Histology Diagnostic confirmation Class of case Primary site Grade/differentiation

question

Stage of disease of diagnosis

answer

Collaborative stage tumor extension Summery stage AJCC TNM Collaborative stage lymph nodes Collaborative stage metastasis at diagnosis

question

First course of treatment

answer

Hormone therapy Radiation therapy Surgical procedure of the primary site Chemotherapy

question

Outcomes

answer

Vital status Date of last contact Cancer status

question

When does quality control begin

answer

At the time of abstracting

question

Sequence number takes into consideration

answer

All reportable primaries over the lifetime of the patient

question

Accession number

answer

Once an _______________is assigned to a a patient, iris never changed or updated even if the patient returns at a later time with a subsequent primary

question

Class of case

answer

Defines the role of the reporting facility in the management of the patient's cancer

question

Analytic

answer

The facility participated in either initially diagnosing and/or delivering all or part of the first course of treatment

question

Accession number

answer

Unique number assigned to a patient that can be used as a numerical control to identify the patient

question

Sequence number

answer

Indicates the number of primaries a patient has had in his or her lifetime

question

Date of diagnosis

answer

The first time a medical practitioner confirms the presence of cancer

question

Visual review

answer

Individual abstracts are reviewed to identify incomplete or inaccurate codes and information

question

Edits

answer

A computer program that compares the coded data with the rules for abstracting

question

Text

answer

Validates the codes assigned in the abstract

question

The date of diagnosis is often confirmed ____________________ before a biopsy or surgical resection is performed

answer

Clinically (such as on physical examination, radiology, laboratory test)

question

Two agencies to which facilities accredited by the American college of surgeons commission on cancer will report their data

answer

NCDB State/territory's central cancer registry

question

Three agencies to which state/territory's central cancer registries may report their data

answer

NAACCR NPCR SEER Canadian Cancer Registry

question

Current coding books used in the united states for coding mortality

answer

ICD-10

question

Current coding books used in the United Staes for coding neoplasms for cancer registries

answer

ICD-O-3

question

How many characters does a complete ICD-O code for neoplasms contain?

answer

10

question

What are the principal parts of the ICD-O neoplasm code and what do they represent

answer

Topography (primary site) 4 characters Morphology (cell type) 4 digits Behavior - 1 digit Grade of differentiation - 1 digit

question

What is the most important concern in coding neoplasms

answer

Accuracy

question

Three organizations that have helped to develop the topography and morphology codes used to code neoplasms

answer

World health organization (WHO) College of American pathologists (CAP) American cancer society (ACS)

question

Some events or discoveries that precipitated the development of the MP/H rules

answer

Increased use of noninvasive imaging techniques Development of advanced laboratory procedures Increased documentation of clinical and pathologic information in the medical record Difficult to train on old rules - too many exceptions Old rules could not be flowcharted for computer applications New codes in ICD-O-3 were not always in hierarchical order

question

Why must the multiple primaries rules be applied before the histology coding rules

answer

Histology rules apply to a single abstract Multiple primaries rules determine how many abstracts to prepare

question

If a cancer case does not fit into the site-specific MP/H rules, what happens to it?

answer

The "Other Sites" rules apply

question

What additional modules are included in the hematopoietic and lymphoid neoplasm case reportability and coding rules

answer

Case reportability Primary site and histology (PH rules) Grade coding (G rules)

question

Staging is defined as

answer

A common language developed to communicate information on the extent of disease

question

The purpose of staging is

answer

To assess the cancer and choose the appropriate treatment To indicate prognosis To estimate survival rate

question

Prognostic factors are

answer

Key pieces of information for patient management

question

Why do staging systems change over time

answer

New information is found and changes occur in the practice of medicine

question

Cancer cells metastasize by which method

answer

Through the bloodstream or lymphatic system, by direct extension to other organs, or by implantation in body cavities

question

Cases treated with neoadjuvant therapy must be staged using which prefix in AJCC

answer

Lower case "y"

question

Neoadjuvant therapy is defined as

answer

Systemic or radiation therapy prior to surgical resection

question

Summary stage can be categorized as

answer

Broad categories with longitudinal stability

question

The national program of cancer registries uses which CS-derived stage

answer

Summary stage

question

CS resolved which issue between the other staging systems

answer

Timing rules

question

How many CS data items are there, excluding the site-specific factors

answer

9

question

AJCC staging system can be categorized as

answer

Forward flexibility and clinical utility

question

How did the number of CS site-specific factors expand from CSv1. To CSv2 ?

answer

From 6 to 25 Conversion of Blancs to 988

question

CS best stage is defined as

answer

A mixture of clinical and pathologic information using the most definitive information available

question

In 2011, CS expanded from best stage to include

answer

Pretreatment and post-treatment

question

CS pretreatment stage is defined as

answer

The information before any treatment

question

CS post-treatment stage is defined as

answer

The information from the surgical resection after neoadjuvant treatment

question

AJCC clinical classification is defined as

answer

Information before initiation of treatment or within 4 months of diagnosis, whichever is shorter

question

AJCC pathologic classification is defined as

answer

Information through completion of definitive surgery or within 4 months of diagnosis, whichever is longer

question

CS pretreatment and post-treatment staging is equivalent to which AJCC classifications

answer

Clinical and y pathologic

question

AJCC clinical (c) classification

answer

At time of diagnosis, before treatment

question

AJCC pathologic (p) classification

answer

After completion of definitive surgery

question

AJCC y clinical (yc) classification

answer

After systemic/radiation therapy of neoadjuvant and before surgery

question

AJCC y pathologic (yp) classification

answer

After neoadjuvant therapy including surgical resection

question

AJCC re-treatment (r) classification

answer

Recurrence after a disease-free interval

question

AJCC autopsy (a) classification

answer

Incidental finding on a postmortem examination

question

The goal of cancer treatment is to

answer

Either completely destroy or control the growth of neoplastic cells without significantly affecting the viability of host cells

question

The goal of palliative treatment for cancer patients is to

answer

Alleviate symptoms to improve the quality of life symptoms

question

What are the three main categories of cancer treatment

answer

Surgery, chemotherapy, radiation therapy

question

The acronym NOTES. Stands for

answer

Natural orifice transluminal endoscopic surgery

question

Laser ablation is utilized for what types of malignancy

answer

Superficial skin cancer Non-small-cell lung cancer Penile cancers

question

What type of surgery can be performed remotely

answer

Robotic

question

Radio frequency ablation (RFA) involves the use of

answer

Heat

question

Radio frequency ablation (RFA) is most frequently used for the treatment of

answer

Liver cancers, both primary and metastatic Lung cancer Brain tumors

question

Hormone refractory

answer

Hormone resistant

question

Why use a multi agent chemotherapy

answer

Each agent acts on the cancer cell in a different phase of its DNA function

question

Which cancer vaccine is in most common use

answer

Gardasil

question

What are the two types of monoclonal antibodies

answer

Rituximab and trastuzumab Heceptin and rituxan

question

Monoclonal antibodies work by

answer

Binding to specific antigens on cancer cells inducing an immunologic response

question

Two most common types of antiandrogens used for prostate cancer

answer

Flutamide and Casodex

question

What is the name of the small molecule inhibitors used for gastrointestinal stromatolites tumors and chronic myeloid nous leukemia

answer

Gleevec

question

What are the two most commonly used adrenocorticoids

answer

Prednisone and decadron

question

Three types of bone marrow transplants are

answer

Autologous, allogeneic, and syngeneic

question

Radiation therapy is useful in preventing what type of recurrence

answer

Local

question

The most widely used type of radiation therapy is

answer

External beam

question

IMRT

answer

Radiation given in beamlets

question

IGRT

answer

Image-guided radiation therapy using images taken each day before treatment

question

CyberKnife radiation therapy

answer

Treatment given using a miniaturized photon linear accelerator Treatment given using cobalt energy

question

When is total body irradiation (TBI) used

answer

Before stem-cell transplant

question

Brachytherapy

answer

Sealed radioactive sources placed in or near tumors

question

MammoSite

answer

Process that has been in use since 2002, to deliver radiation directed to the tumor for breast cancer patients

question

What is the most common radioisotope used, and what type of cancer is it used for

answer

I-131 for thyroid

question

The term multimodality refers to

answer

Combined forms of cancer-directed treatment

question

Four types of CAM (complementary and alternative medicine) commonly used by cancer patients are

answer

Massage therapy, acupuncture, laetrile, and krebiozen Massage therapy, acupuncture, hyperbaric oxygen, chemotherapy with mistletoe extract

question

What type of support services is used for some colon cancer patients

answer

Ostomy support from enterostomal therapist

question

Cryosurgery is the use of

answer

Freezing targeted cancer tissues with the use of argon gas

question

What the two types of follow-up

answer

Active and passive

question

What is the primary purpose of performing follow-up

answer

To ensure continued medical surveillance to evaluate success of therapy

question

Which are considered passive follow-up linkage sources

answer

Motor vehicle/driver license files Centers for medicare and medicaid services Stage voter registration files

question

What is the required rate for follow-up in programs approved by the commission on cancer of the American college of surgeons for all eligible analytic patients diagnosed within the last 5 years or from the cancer registry reference date, whichever is shorter

answer

90%

question

What type of follow-up letter is necessary

answer

Physician

question

When a follow-up letter is returned, what date do you use to update your database as the date of last contact

answer

The date patient or representative signed and completed the letter

question

Which are the core data items needed for successful follow-up

answer

Cancer status Date of last contact

question

The follow-up rate is calculated on which groups of patients

answer

Living and dead

question

Why is it necessary to put different verbiage on a patient letter versus a physician letter

answer

To allow letters to nonmedical contacts to be written in a language that is easily understood

question

What are some of the factors that contribute to the costs of performing follow-up

answer

Postage fees Staffing hours

question

Examples of active follow-up

answer

Physician letters Patient letters

question

Some registries perform_______________________ on a routine basis by checking local newspaper obituaries

answer

Passive follow-up

question

The commission on cancer of the American college of surgeons requires accredited cancer programs to meet which standard

answer

Maintain an 80% follow-up rate for for all eligible analytic patients from the cancer registry reference date 90% follow-up rate must be maintained for all eligible analytic patients diagnosed within the last 5 years, or from the cancer registry reference date, whichever is shorter

question

If a patient has multiple primary cancers

answer

All records will be updated with the date of last contact, but the cancer status will need to be entered separately

question

Linking data is the process of

answer

Matching data from different sources based on identical or similar items from each source

question

Two methods of matching

answer

Deterministic Probabilistic

question

Deterministic matching

answer

Requires that records must have an exact match on key fields to be considered the same patient

question

Probabilistic matching algorithm

answer

Creates a match score based on the mathematical likelihood that identical or similar field values indicate a match

question

Which matching method follows this rule "a match cannot be made of one data file is missing a critical data field"

answer

Deterministic

question

The basic premise of the __________________ system is that the higher the score, the closer the match probability

answer

Probabilistic

question

Which matching method is preferred

answer

Probabilistic

question

Four sources of electronic data files

answer

Facility electronic health record Pathology laboratory Physician office/clinic including outpatient oncology Central registry

question

Record consolidation

answer

Process of combining data from two or more records for the same patient and same tumor

question

Benefit to automation of the record consolidation process

answer

Consistency in data collection Saves both money and time

question

Record consolidation rules include

answer

Hierarchy rules Most frequent Known over unknown

question

Determining the number of primary tumors is

answer

Important if registry data are to be comparable

question

Which set of rules do cancer registries in north America use for determining multiple primaries

answer

SEER multiple primary and histology coding rules implemented January 1, 2007

question

When consolidating cases manually,

answer

The results of consolidation can be different based on the reviewers experience, caseload, and knowledge of special ascertainment or coding rules

question

Quality control

answer

Planned set of activities

question

Quality assurance

answer

Monitoring the process and methods used to ensure quality

question

What method of a designed study would be used to monitor data completeness

answer

Reabstracting study

question

What activity measures data consistency

answer

Reliability study

question

Reliability study

answer

Uses a set of standardized medical charts by a sample of data collectors. Reviewing the range of answers and checking on consistency of those answers

question

Reabstracting study

answer

Assesses the quality of the collected data by having a staff member reabstract a sample of abstracts from the medical records. Assessing discrepancies identified by the reabstractor

question

Monitoring activies

answer

Should take place in all aspects of the registry

question

Inter-record checks

answer

Examine data items between related records.

question

Pareto diagram

answer

Helps identify areas that need attention by ranking them

question

Computerized edit checks

answer

Most cost-effective

question

Quality of performance

answer

Degree to which the final product/service will meet the needs of the consumer

question

Death clearance only is an example of

answer

Case incidence completeness

question

Example of acceptance sampling

answer

Computer edit checks

question

Which quality method is most costly

answer

Independent case ascertainment

question

Historical data review involves

answer

Comparison of number of cases expected with those observed

question

Unknown values

answer

Are monitored through process controls Can be legitimately utilized Should have stable rates over time

question

Statistical quality-control principles include

answer

Acceptance sampling Process control Designed studies

question

Three categories of quality

answer

Design Conformance Performance

question

_________________ audit provides verification that coding guidelines and rules are correct as applied by the data collectors

answer

Recoding

question

____________________assesses completeness using estimations from an independent survey of cases

answer

Independent case ascertainment

question

Three industrial quality-control methodologies are

answer

Total quality management Benchmarking Six sigma

question

Example of quality control of data accuracy

answer

Recoding audit

question

Quality control of data consists of

answer

Completeness Timeliness Accuracy

question

Timeliness is critical to a registry quality-control process. The methods for evaluating timeliness are

answer

Lag-time report

question

An abstract has an edit error that states the surgery summary of scope of regional lymph nodes (SurgSumScopeRegLN) field conflicts with the number of lymph nodes examined and number of lymph nodes positive. What kind of edit check is this

answer

Interitem edit

question

A recoding audit will assess

answer

Training needs Inadequate text documentation Application of coding rules

question

SAR

answer

Survey Application Record

question

Which profession is represented on the surveyor team

answer

Surgeons Certified cancer registrars Medical oncologist

question

Two purposes of the survey

answer

Education Evaluation

question

Which is a use for the SAR

answer

Track program activities Customize the survey Report and analyze program activities across the country

question

How can a commission on cancer trained consultant assist a program

answer

By guiding the cancer committee to understand their role

question

The survey focuses on which activities

answer

How clinical care is provided Assurance of the accuracy of data collection How quality of care and patient outcomes are evaluated and improved

question

What is the primary role of the program coordinators

answer

Ensure that the activity for a specified program area fulfills the requirements

question

All of the following are true of the surveyor team

answer

Certified tumor registrars are coc surveyors Physicians from multiple specialties are coc surveyors The surveyor team has more than 40 members

question

Responsibilities of the key contact for survey

answer

Ensures the accuracy of data recorded in the SAR Works with the surveyor and cancer committee to identify the best date for the survey Works with the surveyor to develop the survey agenda

question

What is true about the accredited cancer program performance report

answer

Provides a summary of the program deficiencies Identifies the facility, surveyor, and date of the survey Provides the accreditation award

question

An appeal of an accreditation award is appropriate

answer

When the program had complied with the standard at the time of survey

question

What primary purpose does the cancer registrar database serve

answer

Research Quality management Marketing

question

What prerequisite class focuses on diseases in the human body

answer

Medical terminology

question

What prerequisite class focuses on the definition of common medical terms and their relation to medical diseases and procedures

answer

Medical terminology

question

What course focuses on the definition of cancer, how it develops, and its different types

answer

Cancer disease coding and staging

question

If you wanted to learn about the approved methods in providing comparable data analysis, which core class would you take

answer

Cancer registry operations

question

What methods do the oncology treatment and coding course focus on teaching

answer

How treatment works to eliminate cancer

question

What is a principle of an abstracting methods course

answer

Identification of cases that are eligible for cancer registry database inclusion Methods of documenting clinical information into data fields Independent practice on cancer registry data elements

question

What is necessary for CTRs to maintain their certification

answer

Complete the required CE credits every 2 years Complete 20 hours of CE credits

question

What does not count as an approved activity for continuing education

answer

Formal presentation of non-original work to cancer registry field or audience

question

What is the definition of an asynchronous learning environment

answer

Online learning environment that does not involve a coordinated live interaction

question

What is the program recognition committees role in developing education

answer

Reviews and determines program's criteria for continuing education credits

question

Which committee is represented by the board director of education

answer

Alternative methods committee Continuing education committee Education committee

question

Which committee is not represented by the board director of education

answer

Formal education committee

question

What committee is represented by the professional development board director

answer

Formal education program review committee

question

What is the education committee responsible for

answer

Overseeing the development and delivery of basic and advanced educational opportunities

question

What is the definition of a synchronous learning environment

answer

In-person learning environment that involves "real-time" interaction

question

Prospective cases

answer

Discussed at the time of initial diagnosis with an emphasis on establishing accurate staging, treatment options

question

Retrospective cases

answer

Discussed after the completion of all treatment, primarily for the purpose of education, and are not intended to influence the management of patient care

question

Do only CoC approved facilities hold cancer conferences

answer

No. Consultative meetings similar to cancer conferences occur in facilities not approved by CoC and further support the effectiveness of this type of discussion

question

Who is ultimately responsible for the developing of a cancer conference plan in a CoC approved facility

answer

Cancer Committee.

question

Do all categories of program approval have the same CoC cancer conference requirements

answer

No. The CoC standards for approved programs should be reviewed for category requirements

question

Determining factors for setting the frequency and format of a cancer conference

answer

Program category Number of annual analytic accessions Types of cases seen by the facility Need for consultative services Need for educational activities

question

Name some of the formats used for cancer conferences

answer

Departmental Facility wide Network wide Site focused Academic/teaching Community wide

question

What are some benefits of creating a presenter format for case presentation at a cancer conference

answer

Facilitate the discussions Adhere to the requirements of the CoC Provide useful information for registrar use

question

Name some challenges to physician attendance at cancer conferences

answer

Conflicting schedules for day or time Ease of meeting room access Administrative requirements or restrictions

question

Will commercial support change the format for cancer conferences

answer

No. The format should include the disclosures and transparency documents of CEs are provided

question

Should review of the cases seen within your facility by primary site be completed when selecting cases for presentation of cancer conferences

answer

Yes. If the facility is CoC approved, case presentations are required based on the major sites within the facility

question

Identify some sources for use in selecting cases for presentation at cancer conferences

answer

Physician presenters will personally select the cases for discussion Evaluation of current in-house admissions with a diagnosis of cancer Evaluation of weekly pathology cases with a cancer-related diagnosis Cancer registry involvement through disease index listings or other case find mechanisms

question

Name some services that a cancer conference coordinator provides

answer

Case selection Facilitating cancer conference discussions Reviewing CoC requirements Providing recommendations for improvement of cancer conference

question

Are notes of cancer conference discussion always discoverable during legal proceedings

answer

No It depends on the state's laws

question

Using national treatment guidelines is required by the ____________to a cancer conference in an approved facility

answer

CoC

question

Which step should be taken first in the report-writing tasks

answer

Determine how the recipient will use the report and their level of expertise

question

Which step must be taken to define the data used in a report

answer

Confirm the specific codes used to define variables such as site, morphology, and stage

question

What choices exist if the data requested are not routinely collected by the registry

answer

Restructure the request to use routine data Deny the request if data cannot be obtained for legal or practical reasons Perform a special study to collect the desired information

question

Method of creating complex logic for a report

answer

Start with a simpler version of the request that can be easily verified and add complexity

question

Tables and graphs should be used because

answer

Data are easier to understand when presented in a table or graph

question

What is assistive technology

answer

Computer programs and devices that people with disabilities commonly use to access electronic information

question

When is it appropriate to show data in a table rather than a graph

answer

When comparing exact values among several variables

question

Method for protecting confidential data

answer

Suppression of table cells that have low counts

question

Which is the best method for showing trends in cancer over time

answer

Line graph

question

What is a function of a central registry

answer

To perform as a data repository for a state Monitor cancer incidence trends and mortality Evaluate cancer-control initiatives

question

What type of information that is collected by a central registry is available for public access

answer

Incidence of cancer

question

No facility-specific patient information can be release unless authorized under law

answer

True

question

Casefinding is a system utilized to identify all eligible reporting cases

answer

True

question

Facility sources used to identify cases

answer

Disease indices, pathology and laboratory reports, patient logs

question

Each city has created rules and guidelines for cancer data collection

answer

False

question

Which organizations have established guidelines and standards for cancer reporting

answer

NCI, SEER, NPCR, NAACCR, ACoS

question

NAACCR standard metafiles are crucial to central registry reporting

answer

True

question

Assessing edits on a regular basis increases the time to review cases before submission

answer

False

question

NCDB

answer

Nationwide, facility-based oncology data set

question

Which CoC Standard is defined as complete data for all analytic cases submitted to the NCDB in accordance with the annual call for data

answer

3.6

question

Submission of class of case 6 is required

answer

False

question

What is the backbone of the NCDB metafile

answer

NAACCR standard edits

question

In addition to running the NCDB metafile, what other practice is beneficial to perform before NCDB file submission

answer

GenEdits Plus

question

Which types of cancer are evaluated by the clinical checks

answer

Breast and colorectal

question

Logistic regression

answer

mathematical model used in statistics to estimate (guess) the probability of an event occurring having been given some previous data

question

small p-value (typically ≤ 0.05)

answer

indicates strong evidence against the null hypothesis, so you reject the null hypothesis.

question

large p-value (> 0.05)

answer

indicates weak evidence against the null hypothesis, so you fail to reject the null hypothesis.

question

Survival measures are often expressed as the _____________of patients alive at some point subsequent to the diagnosis of their cancer, or represented as the ___________of a group of patients serving a specified amount of time

answer

Proportion Probability

question

Survival can be measured in various ways. The choice of measurement depends on the research question or ____________

answer

Event of interest

question

Event of interest

answer

Outcome being measured

question

What may lead to censored (incomplete) event

answer

When a patient is no longer followed, that is, los to follow-up When a patient dies of a cause that is not the event of interest When a patient dies from a car accident

question

There are two standard measures of survival

answer

Observed survival Net survival

question

Observed survival

answer

Estimate of the probability of surviving all causes of death

question

Hypothetical probability of survival of cancer in the absence of other causes of death

answer

Relative survival Cause specific survival

question

Two approaches for net survival can be estimated by

answer

Relative survival Cause specific survival

question

Clinical practice guidelines

answer

Nationally standardized recommendations for health care developed by a. Formal process Effective in translating research into clinical practice

question

Clinical treatment protocols

answer

document with the aim of guiding decisions and criteria regarding diagnosis, management, and treatment in specific areas of healthcare.

question

ASCO (american society of clinical oncology) are focused on

answer

A single question of group of question around an important topic in specific areas of cancer

question

The most comprehensive, most frequently updated and used guidelines available in any area of medicine are

answer

NCCN guidelines

question

A performance measure

answer

Is a set of technical specifics that define how to calculate a rate for a specific indicator of quality Uses the measures to determine whatever rate it is and how it compares

question

Cancer registries can provide measurement data to assess how CPGs are being followed or to monitor other aspects of care by

answer

Real-time reporting

question

Performance measurement data for comparison with other accredited commission on cancer facilities is provided by

answer

National cancer data base (NCDB)

question

How is central cancer registry data different from hospital cancer registry data

answer

Central cancer registry data can be used to accurately determine site-specific cancer incidence rates in the population

question

Why has interest in using central cancer registry data for research increased in recent years

answer

Data from the central cancer registry provide a framework for answering questions of external validity

question

Population-based cancer control research

answer

The conduct of basic and applied research in the behavioral, social, and population sciences to create or enhance interventions that, independently or in combination with bio-medical approaches, reduce cancer risk, incidence, morbidity and mortality

question

Four categories of cancer control research that use central cancer registry data

answer

Primary prevention and chemoprevention research Biomarkers, screening and early detection studies Patterns of care research Survivorship research

question

How can central cancer registry data be used for policy research

answer

Central cancer registry data provide a way to identify geographic areas that might benefit from policy initiatives Central cancer registry data provide a way to measure the impact of policy changes

question

Cancer control

answer

Use of evidence-based prevention, early detection, diagnosis, treatment, and continuing care intervention strategies to reduce cancer incidence, morbidity, and mortality in defined populations

question

Secondary prevention

answer

Slowing disease progression preventing complications, and limiting disability

question

Why is central cancer registry data so important to cancer control

answer

Without the type of information contained in most central cancer registries, we could not focus our limited cancer control resources on the areas with the greatest need, and we could not evaluate the effectiveness of our cancer control interventions

question

Screening effect

answer

The fact that when you screen for disease you find new previously unidentified cases of cancer causing the incidence rate to increase

question

Four data sources that are generally available in each US state and can be used for defining the burden of cancer

answer

US Census data Behavioral risk factor surveillance system data Central cancer registry data Vital records mortality data

question

Three major types of cancer for which evidence based cancer control intervention strategies are currently available

answer

Lung cancer Colorectal cancer Breast cancer

question

central cancer registries are _______________based

answer

population

question

central cancer registries try to collect information on all newly diagnosed cancer cases in a geographic are to ____

answer

describe the cancer burden

question

which state was the first to start collecting cancer incidence data

answer

Connecticut

question

as states formed their own cancer registries in the 1970s and 1980s, they used

answer

SEER rules hospital rules their own rules

question

which groups originally got together to form the American Association of Central Cancer Registries

answer

National Cancer Institute, American College of Surgeons, American Association of Cancer Institutes, and the American Cancer Society

question

Who is a founding and Sponsoring member of NAACCR

answer

NCRA

question

the American Association of Central Cancer Registries became the North American Association of Central Cancer Registries when

answer

several Canadian provinces sought membership and expressed interest in adopting the same standards

question

NAACCR is governed by

answer

a board of directors

question

employees of central cancer registries in North America are considered ______________members

answer

NAACCR

question

the mission of NAACCR is to

answer

promote uniform data standards, provide education and training, aggregate and publish data , certify registries, and promote data use

question

NAACCR work is done primarily by

answer

various committees, work groups, task forces, and ad hoc groups composed of volunteers

question

the NAACCR committee that evaluates new data items and codes is

answer

Uniform Data Standards Committee

question

NAACCR's first standards volume published in 1994 represented the status of agreed-on data items and codes. The groups agreeing to these standards were

answer

NAACCR, American College of Surgeons, National Cancer Institute, Center for Disease Control and Prevention, National Cancer Registrars Association

question

NAACCR certification criteria are based on measures to assess

answer

timeliness of data accuracy of data completeness of data

question

To aggregate cancer data over different jurisdictions, data must be

answer

collected using the same rules and definitions cover the same time period be of the same quality

question

the NAACCR committee structure provides an opportunity

answer

to have a national forum to discuss issues and develop a consensus

question

Cancer in North American (CINA) includes data on more than __ million cancer cases

answer

6

question

Data research products produced by NAACCR include

answer

CINA CINA +Online CINA Delux

question

Population-based cancer registration started at the provincial/territorial level in Canada in what year

answer

1932

question

Canada has _____ independent provincial/territorial registries that report to its national registry system

answer

13

question

How many provincial/territorial cancer registries cover less than a 1 million population

answer

8

question

Canada's provinces and territories administer publically funded health insurance programs by assigning a unique, lifetime identifier referred to as the

answer

Health Card Number or HCN

question

In Canadian Province the following is true

answer

cancer is not a reportable disease (by law) they do not offer a certification program for cancer registrars Ethnicity data are not a standard data element in the Canadian cancer registry

question

what is the goal of the Commision on Cancer

answer

to improve survival and quality of life for cancer patients through standard setting, prevention, research, education, and the monitoring of comprehensive quality care

question

how many member organizations are involved with the Commission on Cancer

answer

48

question

what the four cornerstones of cancer program accreditation

answer

cancer committee cancer conferences cancer registry quality improvement program

question

benefits of cancer program accreditation

answer

provides a framework for cancer program structure and process includes access to cancer program and data standards provides for external and internal assessments of the quality of care being provided to cancer patients allows access to the national cancer data base to assess and improve care provides educational tools, resources, and best practices to enhance cancer program performance results in promotion and recognition by the public, payers, and government agencies

question

what is the primary purpose of the Outstanding Achievement Award

answer

to recognize cancer programs that strive for excellence in providing quality care to the cancer patient

question

what are the three eligibility requirements that must be met before a cancer program can be considered for survey

answer

demonstrate 1 year of compliance with the standards have accrued 2 years of data with 1 year of successful follow-up have met the requirements for consideration for accreditation as outlined in the Cancer Program Standards manual

question

how many Commission on Cancer accredited cancer programs are there in United States and Puerto Rico

answer

more then 1450

question

What percentage of newly diagnosed cancer patients are accessioned annually into the National Cancer Data Base

answer

70%

question

How is the National Cancer Data Base data used

answer

measure treatment patterns and outcomes evaluate hospital provider performance conduct research and develop focused studies to meet the demand for an ongoing assessment of the quality of cancer care assess and validate nationally accepted quality measure for cancer care develop effective resources and tools to improve outcomes at the national, regional, and local levels

question

National Cancer Data Base Web-based tool

answer

benchmark hospital comparison reports NCDB Survival Reports Cancer Program Practice Profile Reports Rapid Quality Reporting System NCDB Public Benchmark Reports

question

What is the name of the Commission on Cancer's data standards manual

answer

FORDS (facility oncology registry data standards)

question

Primary role of the Cancer Liaison Physician

answer

interpret and monitor their facility's national Cancer Data Base data and the facility's plan to use the information to evaluate and improve quality of care. report NCDB data to the cancer committee on a quarterly basis (at least 4 time a year) report on CoC activities to the cancer committee, and serve as liaison for their cancer program with the American Cancer Society and facilitate development of a collaboration plan

question

What is a objective of the American Cancer Society/Commission on Cancer partnership

answer

expanding cancer awareness/information availability, as well as American Cancer Society services delivery at the community level. increasing utilization of ACS services and programs at Commission on Cancer accredited cancer programs. engaging the Cancer Liaison Physicians in the CoC accredited cancer programs to support implementation of local prevention and early detection programs and state cancer plans, promoting CoC accredited cancer programs and the quality of care provided at these facilities

question

In what year was the firs edition of Cancer Staging Manual published

answer

1977

question

The organizations that started the AJCC are known as

answer

Founding Members

question

Before being known as the AJCC, what was the group called

answer

American Joint Committee for Cancer Staging and End Results Reporting

question

Which organization is the administrative sponsor of the AJCC

answer

American College of Surgeons (ACoS)

question

What is the revision cycle for the AJCC Cancer Staging Manual

answer

6-8 years

question

In what year was version 1 of the Collaborative Staging System released

answer

2004

question

Which organization is the administrative sponsor for the Collaborative Stage Data Collection System

answer

AJCC

question

What does TNM staging system describe

answer

anatomic extent of cancer at the time of the initial diagnosis and before the application of definitive treatment

question

AJCC was founded by __________

answer

by American College of Surgeons in 1959

question

Nonanatomic factors were first added to the classifications that modified stage groups beginning with the _________________

answer

sixth edition of the AJCC Cancer Staging Manual

question

Collaborative Staging was originally developed to________

answer

provide a translation between the TNM staging system of the AJCC and the SEER Summary Staging System

question

Quality Assurance Programs transformed into _____________

answer

Performance Improvement Programs

question

A common performance improvement model used in many hospitals is the ______________ model

answer

plan, do, check, act

question

_________________are descriptions of key elements in the process of care that should be accomplished to achieve maximum quality and maximum cost

answer

Critical pathways

question

____________ was the name of TJC's (the joint commission) initiative to intergrade performance processes into the accreditation process

answer

ORYX

question

TJC (the joint commission) defines a core measure set as a ________________________carefully selected to provide, when viewed together, a robust picture of the care provided in a given area

answer

unique grouping of performance measures

question

The conception of TJC (the joint commission) began with

answer

Dr. Ernest Codman

question

Hospital standardization was one of the first activities of the newly formed_______________

answer

ACoS (American college of surgeons)

question

How many standards were there in the minimum standards

answer

5

question

The American College of Surgeons (ACoS) was founded by __________with other physicians in 1910

answer

Dr. Martin and Dr. Codman

question

What are the four underlying concepts for the Agenda for Change

answer

patient outcomes are influenced by all of the activities of a healthcare organization continuous improvement in the quality of care should be a priority of healthcare organizations TJC should focus on these activities of healthcare organizations that are most important to the quality of care traditional assessments of compliance with standards should be complemented by the accredited organizations collection, analysis, and feedback of data that reflect their actual performance I n undertaking key activities

question

Three major initiatives for the Agenda for Change include

answer

redesign of TJCs Standards to stress the entire organization's effectiveness in patient services redesign of the survey process to provide more interactive consultative services development of a national performance measurement system, commonly known as the indicator measurement system

question

Agenda for Change (AfC)

answer

a new movement in the 1980 that was a response to the dramatic increase in healthcare costs

question

Performance measurement system

answer

an inter-related set of outcome and/or processes that support internal comparisons or organizations performance over time and external comparison of performance among organizations at comparable times

question

Audit

answer

a retrospective tool to assess quality of care

question

Clinical practice guidelines

answer

outlines of strategies for patient management that describes a range of acceptable ways to diagnose, manage, or prevent specific diseases and conditions

question

Quality Assurance

answer

a formal approach to one of the original TJCs minimum standards

question

What law led to the establishment of the SEER program

answer

the National Cancer Act of 1971

question

SEER registries routinely collect data on what types of information on the patients and their cancers

answer

patient demographics primary tumor site tumor morphology and stage at diagnosis initial course of cancer treatment follow-up for vital status

question

Name local sources of initial case finding

answer

hospital registries pathology laboratories electronic pathology reports physicians offices and clinics

question

name sources of follow-up information

answer

social security administration state vital records department national death index motor vehicle registration

question

How recent is the complete data set submitted by the SEER registries in November of each year

answer

data submitted in November is complete to January 1 of the preceding year

question

What analytic software program is used to test trends in cancer statistics for statistical significance

answer

Joinpoint (http://srab.cancer.gov/joinpoint/) and Average Annual Percent Change

question

Three annual statistical reports where SEER data are combined with data from other national surveillance partner

answer

annual report to the nation on the status of cancer cancer in north America u.s. cancer statistics

question

Beyond the data/software package SEER*Stat, what is available on the web site for statistical inquiries

answer

fast*stats statistical fact sheets cancer query system (CANQUES)

question

Beginning in 2003, NCI funded SEER registries to link their data to what database, aimed at addressing racial misclassification in the cancer registries, and although not perfect, it is a logical step in the process of identifying addition cancer cases among American Indian and Alaska Native populations

answer

Indian Health Service (IHS)

question

Investigators have examined the use of cancer tests and procedures and the costs of cancer treatment through a collaborative effort inking SEER data to what other database

answer

Medicare claims data

question

SEER is being linked to the national Longitudinal Mortality Study to add socioeconomic data at the individual level that cannot be obtained from the SEER database itself. What data elements are available in the NLMS

answer

Self-reported race/ethnicity, marital status, education, income, occupation and industry, residence, nativity/immigrant status, smoking status, health status, and availability of health insurance

question

For more than two decades, NCI has utilized this flexible mechanism of Rapid Response Surveillance Studies to conduct studies by individual and collaborative groups of SEER investigators. What are the six categories of studies

answer

1. evaluating methodologic issues 2. evaluating cancer treatment and outcomes 3. monitoring screening practices 4. monitoring health behaviors and risk factors 5. linking databases 6. improving technical aspects of registry operations

question

What coding system formed the basis for the Collaborative Staging System implanted in 2004 as part of the effort to simplify and standardize the rules and guidelines for collecting cancer data in the United States

answer

SEER Extent of Disease coding system

question

What are the data quality goals for the Data Quality Profile (DQP) for death certificate only cases, completeness and follow-up

answer

less than 105% death certificate only cases greater than 98% estimated completeness more than 90% follow-up of patients (95% for those 65 years old or older)

question

The National Program of cancer Registries objectives are outlined in

answer

Cancer Registries Amendment Act

question

Evaluation activities conducted by the National Program of Cancer Registries

answer

NPCR-CSS Data Evaluation Reports NPCR Program Evaluation Instrument NPCR Data Completeness and Quality Audits

question

A National Program of Cancer Registries goal is to provide data to _____________so that the __________ can be monitored and that ________can be planned

answer

public health planners burden of disease cancer prevention and control programs

question

NCDB Reporting Tools available through the CoC Datalinks Portal include

answer

NCDB Hospital Comparison Benchmark Reports, NCDB Survival Reports, Cancer Program Practice Profile Reports (CP3R) Rapid Quality Reporting System (RQRS)

question

_________________cases are included in the National Program of Cancer Registries Cancer Surveillance System analytic file

answer

In situ bladder

question

What is the title of the publication of official annual federal cancer statistics

answer

United States Cancer Statistics

question

Content for educational programs is identified through

answer

quality assurance activities

question

The ___________________ provides new cancer registrars an opportunity to gain hands-on practice in cancer registry operation

answer

Cyber Cancer Registry

question

In what publication would you find an abstract/article about developing a trauma registry

answer

Journal of Registry Management (JRM)

question

What are the goals and objectives for education and professional development in NCRA

answer

provide comprehensive educational opportunities that are accessible, cost appropriate and forward thinking develop a comprehensive education plan to meet the changing demands of the profession and the CTR credentialed individual deliver basic and advanced (post-CTR) education opportunities expand and enhance formal education opportunities monitor and encourage informatics role in cancer registry profession

question

how long is the term of office for someone who is voted in as President-Elect/Secretary of the NCRA

answer

3 years

question

What committee determines the process and development of the Distinguished Member Award

answer

The Award Committee

question

What meets the eligibility requirements for the Council on Certification

answer

Has been a CTR for 5 years

question

Why was the education foundation formed

answer

The Foundation allows NCRA to receive and expend funds for educational development and products to benefit NCRA members at lower prices (tax exempt)

question

You work in a hospital. Your colleague, a CTR, has just been fired. You see her destroying registry records. What NCRA committee would you notify

answer

Ethics Committee

question

How long is the term of office for someone elected to the position of Treasurer Junior

answer

2 years

question

What year was the Education Foundation granted its 501C3 tax status

answer

2004

question

How many hours of practicum experience are required under Route A before taking the CTR examination

answer

160 hours

question

The goals and objectives and characteristics of Central registries and hospital registries are so similar, they may be considered identical

answer

False

question

Population-based central registries provide for calculation of incidence rates

answer

True

question

Some central registries like the National Cancer Data Base (NCDB) are not population based

answer

True

question

Specify two substantial funding sources/organizations for population-based central registries

answer

NCI/SEER CDC/NPCR

question

An Advisory Committee to a central registry can provide outreach to the local community and state, and provide helpful support when needed

answer

True

question

All central registries have similar staffs, despite their objectives, caseload, and catchment area

answer

False

question

Personnel, or staff, found in a central registry

answer

Medical or Scientific Director/Epidemiologist Registry/Project Manager Office/Accounts Manager Abstractors (CTR skill staff) Quality control/Management Data processing (IT personnel) Statistician Coding/processing Research analyst Data entry Secretarial/clerical

question

All National Program of Cancer Registries training materials are available with an annual subscription

answer

False

question

Recent events, including computerization, are lessening the need for security and confidentiality of central registry data

answer

False

question

IRB

answer

Institutional Review Board

question

It is better for each central registry to used its own coding systems to enhance security and confidentiality

answer

False

question

Five standard setters for central cancer registries

answer

ACoS/CoC AJCC SEER NPCR NCRA NAACCR WHO

question

Which is not a basic Data item for central registries

answer

Optimum patient vitamin doses

question

For case finding purposes, the Reportable List refers to allowable drug compounds that are approved for treatment

answer

False

question

All cancer patients are seen in hospitals. Nonhospital sources of patients are unlikely

answer

False

question

E-path reporting (electronic pathology reporting)

answer

to enhance the completeness, timeliness, consistency, and efficiency with which cancer data are transmitted by pathology laboratories, and then received and processed by central cancer registries.

question

Death Clearance ensures that

answer

all persons with cancer on their death certificate are correctly ascertained by the central registry

question

If an abstract is prepared by a hospital-based CTR, no quality control is necessary by the central registry

answer

False

question

The Central Registry need no be concerned with patients who live within their catchment area but are diagnosed or treated outside their catchment area

answer

False

question

Computers have become an important part of many processes within the central registry

answer

True

question

Name purposes for central registries to perform record linkages

answer

casefinding duplicate detection passive follow-up linking patients with other cohorts or risk exposure records

question

There are two types of record linkage

answer

deterministic probabilistic

question

The primary quality-control concerns of central registries involve which two straightforward questions

answer

How complete is case ascertainment How complete and accurate are the data that are collected

question

Using the data can provide important quality feedback

answer

True

question

Active follow-up

answer

refers to someone initiating direct contact with patients. From a central registry perspective, it may also include contacts made by hospital registrars with physician's offices

question

Passive follow-up

answer

Refers to methods that do not require registry contact with hospitals, physicians, or individual cancer patients. These methods usually involve computerized searches of existing non-registry files that may contain the cancer patient's name

question

Passive follow-up methods are preferred, but they are more expensive

answer

False

question

In comparing incidence rates between groups, use of age-specific incidence rates controls for difference in the age composition of the groups

answer

True

question

Relative survival rate

answer

ratio of the observed survival rate in the study population to the expected survival rate in the subset of the general population with the same characteristics as the study population. it is the observed survival rate, adjusted because some of the subjects can be expected to die of causes of death other than that under study

question

The Central registry is not obligated to use their data in any way

answer

False

question

Well-documented cancer clusters, or hot spots, have been identified in more than 40 states

answer

False (13 states)

question

Many different types of scientific studies can be performed on the population-based data of central registries

answer

True

question

Scientific studies that can be based on central registry data

answer

cancer mapping GIS (geographical information system) ecologic or correlation case-control cohort genetic patterns of care survival surveillance cancer control

question

The history of U.S. cancer registration began in

answer

1920s

question

The SEER Program of the NCI was started in

answer

1973

question

Legislation enabling the NPCR was passed in

answer

1992

question

Cancer is a reportable disease, under state law, in how many states

answer

50 (all states)

question

GIS (geographical information system) use in central cancer registries has been on the _____ in recent years

answer

increase

question

What is the open source language for managing and displaying geographic data on the internet

answer

KML

question

The process of assigning geographic information to a cancer patient record based on the place of usual residence is known as

answer

geocoding

question

Which tends to have better geocoding quality, urban or rural

answer

urban

question

a form of data analysis that incorporates information about the geographic location events is known as

answer

spatial analysis

question

A geographic area of unusually high or low occurrences of cancer is known as a

answer

cluster

question

Flexible aggregation refers to the ability to

answer

combine cases into any geographic unit for analysis

question

The National Cancer Data Base (NCDB) provides the means for all of the following

answer

comparative analysis to examine patterns of care active monitoring of cancer care in the United States Important information to those interested in the care of cancer patients

question

The activities of the NCDB are funded by

answer

ACS and ACoS

question

The NCDB was established in

answer

1989

question

The NCDB captures what percentage of all newly diagnosed malignant cancer cases in the United Staes annually

answer

70%

question

The NCDB contains information on almost _____million cases of reported cancer diagnoses for the period 1985 through 2007

answer

25

question

Categories of information that the collected data in the NCDB include

answer

Patient characteristics Tumor staging Histology characteristics Type of first course treatment administered Disease recurrence Survival information

question

The NCDB contains data submitted by

answer

Cancer programs accredited by the CoC

question

Data submission to the NCDB is a requirement specified in which standard of the CoCs Cancer Programs Standards

answer

3.6

question

Parts of the NCDB data cycle

answer

Annual call for data Data processing that includes edit checks and writing case records to the CoCs data warehouse Data analysis and evaluation

question

The NCDB requires that as many as 5 specified years of data be submitted during the annual call for data to facilitate obtaining the most recent data available, as well as ____________ and _____________ data for previously reported patients

answer

Follow-up recurrence Survival

question

The primary method of evaluating the quality of data during submission to the NCDB is the use of

answer

Edits

question

Which types of cases that failed an edit would not be written to the NCDB data warehouse

answer

Cases that accumulate a data quality score of 200 or greater Cases that received rejection edits

question

CoC accredited cancer programs are required to resolve which of the following types of cases that failed an edit

answer

Cases that accumulate a data quality score between 1 and 199 Cases that accumulate a data quality score of 200 or greater Cases that received rejection edits

question

The NCDB uses ______________________to identify duplicate casea

answer

A contextual code based on specific data item code values from the record

question

The NCDB does not contain information that can be sued to identify

answer

Patients name

question

For reporting and analysis of data, the NCDB organizes much of its data by

answer

Disease site

question

Name reports and publications based on NCDB data

answer

Public benchmark reports Hospital comparison benchmark reports NCDB Survival Reports Cancer Program Practice Profile Reports (CP3R)

question

The application that allows the public and hospitals to design customized reports based on selected data items is called

answer

Benchmark reports

question

The application that allows CoC accredited cancer programs to compare patterns of care and assess their own trends of care for breast and colorectal cancers is called

answer

CP3R (cancer program practice profile reports)

question

The acronym ACTUR stands for

answer

automated central tumors registry

question

What is the median age of the veteran population

answer

61 for men and 47 for women

question

Only active duty military patients are accessioned into the ACTUR database

answer

False

question

The department of Defense (DoD) includes information on patients' participation in military campaigns and exposure to toxic agents for ___________ and _________ purposes

answer

historical epidemiologic

question

ACTUR differs from its civilian counterparts in the type of data that is required to be collected. name some different data items

answer

the DoD requires that ACTUR data sets are military specific, and include documentation of the sponsor's (military participant) 1. social security number 2. branch of service 3. active duty status 4. participation in military campaigns, 5. exposure to toxic agents

question

Approximately what percentage of U.S. population is eligible for benefits from the VA

answer

24%

question

Only veterans eligible for benefits from the VA

answer

False

question

What is the current mission of the VAACCR

answer

collect data from all VA medical centers diagnosing and/or treating veterans with cancer, aggregate the data, and make it available for a variety of uses

question

Unlike the civilian sector________________is/are the first source of contact for follow-up information

answer

the patient

question

The DoD beneficiary pool age 65 and older is expected to _______ in future years

answer

increase

question

Which is not a use of the data collected by the VA

answer

transfer to the Department of Defense

question

Which describes an accurate depiction of the difference between DoD cancer registries and the civilian sector

answer

DoD registries maintain a patient convenience file: civilian registries, for the most part, do not

question

Which is not an example of Cooperative Oncology Group

answer

Cancer Therapy Evaluation Program (CTEP)

question

Which is an example of Cooperative Oncology Group

answer

Southwest Oncology Group Cancer and Leukemia Group B National Surgical Adjuvant Breast and Bowel Project

question

Through what decision was the National Cancer Institute (NCI) charged with the responsibility of conducting basic scientific research in oncology and applying the results to clinical practice

answer

National Cancer Act of 1937

question

Who is eligible to participate in Phase I clinical trails

answer

people with cancer who have no known effective treatment options or they have already tried other treatment options

question

What phase of clinical trials focuses on learning how a new treatment compares with standard, or the most widely accepted, treatment

answer

Phase III

question

In what phase of the clinical trial is the safety of a new agent tested against a specific type of caner using the dosage determined in the Phase I clinical trial

answer

Phase II

question

What is the main function of an institutional review board (IRB)

answer

To protect the rights of human subjects participating in research

question

Who is responsible to the clinical trials group for conducting research

answer

the principal investigator (PI)

question

What is true about informed consent documents

answer

it contains specific, required information about the clinical trial and is a legal document it is a patient's authorization to participate in a clinical trial it must be reviewed and approved by each centers' institutional review board (IRB)

question

The National Cancer Act of 1971 promoted the development of oncology training programs, facilities, and public education services

answer

True

question

clinical trials are the first step in the research process of moving scientific research from the laboratory to treatments for people

answer

False

question

The Belmont Report, published in 1978, mandated the establishment of institutional review board (IRB), outlined protocol design criteria, and required that written informed consent be provided to all research subject

answer

True

question

In Phase III trials, the dose is usually increased group by group to find the highest dose that does not cause unacceptable harmful side effect, called toxicity

answer

False

question

Phase I of clinical trial

answer

15-30 people to find a safe dosage to decide how the agent should be given to observe how the agent affects the human body

question

Phase II of clinical trial

answer

Less then 100 people to determine whether the agent of intervention has an effect on a particular cancer to see how the agent or intervention affects the human body

question

Phase III of clinical trial

answer

Generally, from 100 to thousands of people To compare the new agent of intervention (or new use of treatment) with the current standard

question

Phase IV of clinical trial

answer

Several hundred to several thousand people to further evaluate the long-term safety and effectiveness of a new treatment

question

Randomization is a method used to prevent bias in research

answer

True

question

Many community hospitals across the country participate in clinical trials as part of which NCI Program

answer

community clinical oncology program (CCOP)

question

What was the first organization to produce Cancer Incidence in Five Continents (CI5)

answer

UICC

question

IACR

answer

International Association of Cancer Registries, which is an association of cancer registries from around the world

question

IARC

answer

International Agency for Research on Cancer, which is a WHO agency whose mission is cancer research for cancer prevention

question

What two organizations took over production of CI5 with the third volume

answer

IARC (international association of cancer registries) IACR (international agency for research on Cancer)

question

Some advantages to research in comparing cancer rates across countries

answer

understanding cancer causes dissemination of cancer control and treatment comparison of risk factors

question

Where was the first cancer registry in the U.S.

answer

Connecticut

question

When and where was the meeting that jump-started the expansion of international data collection on cancer rates

answer

1946 in Copenhagen

question

What organization compiles the National Cancer Data Base and heads the Approvals Program for hospitals in the United States

answer

Commission on Cancer of the American College of surgeons

question

What countries currently belong to the MECC

answer

Israel Egypt Turkey Cyprus Jordan Palestinian Authority

question

The European Network of Cancer Registries (ENCR) was established in 1989 to improve the quality, comparability, and availability of cancer incidence data, and develop a basis for monitoring cancer rates in the

answer

European Union

question

Two large international studies focused on cancer survival are

answer

EUROCARE CONCORD

question

_____________ presents incidence, prevalence, and mortality estimates from 27 cancers for all countries in the world

answer

GLOBOCAN

question

Federal Government (main supporting agency of)

answer

National Exposure Registry Lupus Registry

question

State Government (main supporting agency of)

answer

Alzheimer's Disease Registry Special Needs Emergency Registry

question

Academic Center (main supporting agency of)

answer

early rheumatoid arthritis treatment evaluation registry environmental polymorphism registry temporomandibular joint replacement registry

question

Non-for-Profit organization

answer

United States Eye Injury Registry Cystic Fibrosis Registry

question

Commercial Enterprise

answer

Lamotrigine Pregnancy Registry

question

What is not a current trend in registry software development

answer

writing programs that open registry databases to general public inquiries

question

AFIP DNA registry

answer

identifying combat casualties

question

Nun Study

answer

tracking course of Alzheimers disease

question

national marrow donor program

answer

finding transplant matches

question

trauma registry

answer

preventing accidents

question

advance directive registry

answer

making giving wills accessible

question

case definition includes

answer

identification of population covered

question

Quality control encompasses

answer

data definitions personnel training data edits data submission tracking

question

Organizations contribute to registry infrastructure by

answer

supporting and funding registries, defining and monitoring data standards, collecting, reporting, and transmitting data

question

Individual contribute registry infrastructure by

answer

gathering and entering data into registry databases

question

software companies contribute to registry infrastructure by

answer

designing and providing electronic programs t brought which registry data are collected and transmitted

question

An allogeneic bone marrow transplant

answer

involves an infusion of bone marrow or stem cells from a donor that are given to the patient after they have received high-dose chemotherapy.

question

autologous bone marrow transplant

answer

a patient's own bone marrow or stem cells are given to them after they have received high-dose chemotherapy.

question

autologous stem cell transplantation,

answer

blood-forming stem cells are removed, stored, and later given back to the same person.

question

Syntactic interoperability

answer

If tower more systems are capable of communicating and exchanging data.

question

Semantic interoperability

answer

Ability to automatically interpret the information exchanged meaningfully and accurately in order to produce useful results as defined by the end users of both systems

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