ATTACHMENT 4abc Sample Feedback

ATTACHMENT 4abc Sample Feedback.doc

Colorectal Cancer Screening Program

ATTACHMENT 4abc Sample Feedback

OMB: 0920-0745

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ATTACHMENT 4


SAMPLE FEEDBACK REPORTS

a. Error Summary/Edit Report

b. Data Quality Indicator Guide Report

c. Service Quality Indicator Guide Report




SUMMARY OF ITEM ERROR COUNTS

Program and Enrollment Data Section Count Pct


1.1 Program .................................................................. 0 0.0

1.2 Date of Eligibility ........................................................ 5 0.0

1.3.1 Knowledge of program (1)................................................. 33 0.1 %

1.3.2 Knowledge of program (2).................................................. 0 0.0


Client and Record Identification Section

2.1 Client Identifier ....................................................... 0 0.0

2.2 Record Identifier ...................................................... 0 0.0


Demographic Information Section

3.1 Date of Birth .............................................................. 0 0.0

3.2 Gender ............................................................. 0 0.0

3.3 Hispanic or Latino origin .................................................. 0 0.0

3.4.1 Race1 ..........................................................127 0.3 %

3.4.2 Race2 .......................................................... 0 0.3

3.5 State of Residence ......................................................... 0 0.0

3.6 County of Residence......................................................... 0 0.0


Screening History Section

4.1.1 Previous take-home CRC fecal test........................................ 0 0.0

4.1.2 Previous take-home CRC fecal test date .................................. 0 0.0

4.1.3 Previous take-home CRC fecal test result ........................... 0 0.0


Colorectal Cancer Risk Factors Section

5.1 Personal History of CRC .................................................... 0 0.0

5.1.2 Year CRC diagnosed ................................................. 0 0.0

5.2.1 Personal History of polyps ........... .................................... 0 0.0





. Continued for all CCDE variables




Date Your Program Began Screening: January, 2006




Cut-off Dates





Submission Cut-off Date: 05/31/2007





Diagnostic Cut-off Date: 02/28/2007

Note: Items 7-18 and 20-27 are not evaluated for screening exams that are performed after the diagnostic cut-off date, which is 3 months prior to the submission cut-off date. All screenings that are performed prior to the diagnostic cut-off date are expected to have complete diagnostic and treatment information, as necessary.

All screening data are used.








Overall Record Counts

(From start of program

01/2006 - 04/2006

(Previous 12 months) 03/2006 - 02/2007

(Recent 3 months)

03/2007 - 05/2007

Notes

Total Screen Cycles reported

xxxxx

xxxxx

xxxxx

These counts do not include screens

First Test:




with pending results

FOBT/FIT

xxx

xxx

xxx


Colonoscopy

xxx

xxx

xxx


Sigmoidoscopy

xxx

xxx

xxx


DCBE

xxx

xxx

xxx





Demographic Data


Variable

Attribute

01/2006 - 04/2006

03/2006 - 02/2007

03/2007 - 05/2007

Notes


1


Date of Birth


Percentage missing


xx%


xx%


xx%


< 5%


2


Gender


Percentage missing

xx%

xx%

xx%


< 2%


3


Hispanic or Latino Origin


Percentage unknown

xx%

xx%

xx%


unknown and missing combined should be



Percentage missing

xx%

xx%

xx%

< 5%


4


Race


Percentage unknown

xx%

xx%

xx%


unknown and missing combined should be



Percentage missing

xx%

xx%

xx%

< 5%


5


State of Residence


Percentage missing

xx%

xx%

xx%


< 5%


6


County of Residence


Percentage missing

xx%

xx%

xx%


< 5%



..… Continued for all CCDE data items ….




Refer to the CRCSDP Policy Manual for additional information and on Service Quality Indicators


Indicator Type, Number and Description

CDC Benchmark

Your Program Results

%, (Numerator/ Denominator)

All CRCSDP Programs Combined Results

%, (Numerator/Denominator)




Screening Priority Population



1


Percent of program screens that are provided to clients at average risk for CRC


> 75%

xx %, (xxx / xxxx)

xx %, (xxx / xxxx)


2



Percent of average risk clients screened who are aged 50 years and older


> 95%

xx %, (xxx / xxxx)

xx %, (xxx / xxxx)



Completeness of Clinical Follow-up


3



Abnormal test result with diagnostic follow-up completed



> 90%

xx %, (xxx / xxxx)

xx %, (xxx / xxxx)


4



Treatment Initiated following diagnosis of cancer



> 90%

xx %, (xxx / xxxx)

xx %, (xxx / xxxx)







Timeliness of Clinical Follow-up



5


Percent of positive tests (FOBT/FIT, sigmoidoscopy, or DCBE) followed-up with colonoscopy within 60 days


> 80%

xx %, (xxx / xxxx)

xx %, (xxx / xxxx)


6


Percent of abnormal colonoscopies followed-up to final diagnosis within 30 days.


> 80%

xx %, (xxx / xxxx)

xx %, (xxx / xxxx)


7



Treatment initiated within 60 days of diagnosis of cancer



> 80%

xx %, (xxx / xxxx)

xx %, (xxx / xxxx)




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