ATTACHMENT 3c CCDE Comparison Table

ATTACHMENT 3c CCDE Comparison Table.pdf

Colorectal Cancer Screening Program

ATTACHMENT 3c CCDE Comparison Table

OMB: 0920-0745

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List of Data Items Collected in CRCSDP vs. CRCCP
Colorectal Clinical Data Elements
(sorted by CRCSDP Item number)
CRCSDP
Item

12/02/2009

Variable Name

CRCCP
Item

1.1

Program

1.2

Date of eligibility

1.3.1

Knowledge of program (1)

1.3.2

Knowledge of program (2)

1.3.3

Knowledge of program (3)

1.3.4

Knowledge of program other
text field

2.1

Client identifier

1.2

2.2

Record identifier

1.3

3.1

Date of birth

2.1

3.2

Gender

2.2

3.3

Hispanic or Latino origin

2.3

3.4.1

Race 1

2.4.1

3.4.2

Race 2

2.4.2

3.4.3

Race 3

2.4.3

3.4.4

Race 4

2.4.4

3.4.5

Race 5

2.4.5

3.5

State of residence

2.5

3.6

County of residence

2.6

Has client ever had a
colorectal screening test?

3.1

4.1.1

Previous take-home CRC fecal
test (FOBT/FIT)

4.1.2

Previous take-home CRC fecal
test date

4.1.3

Previous take-home CRC fecal
test result

4.2.1

Previous sigmoidoscopy

4.2.2

Previous sigmoidoscopy test
date

4.2.3

Result of previous
sigmoidoscopy

4.3.1

Previous colonoscopy

Comments

1.1

Indicates no change between the CRCSDP
data set and the CRCCP data set

Indicates a CRCSDP data item that was
retained but modified in the CRCCP data set

Indicates a CRCSDP data item that was
NOT retained in the CRCCP data set

Indicates a new data item in the CRCCP data
set

1

List of Data Items Collected in CRCSDP vs. CRCCP
Colorectal Clinical Data Elements
(sorted by CRCSDP Item number)
CRCSDP
Item

12/02/2009

Variable Name

CRCCP
Item

4.3.2

Previous colonoscopy test
date

4.3.3

Result of previous
colonoscopy

4.4.1

Previous DCBE

4.4.2

Previous DCBE test date

4.4.3

Result of previous DCBE

5.1.1

Personal history of CRC

5.1.2

Year CRC diagnosed

5.2.1

Personal history of polyp(s)

5.2.2

Largest number of polyps
diagnosed during a single
procedure

5.2.3

Were any of these polyps
adenomatous?

5.3

Family history of CRC

4.2

Currently experiencing CRC
symptoms?

4.3

Initial test appointment date,
or date fecal kit distributed

5.1

Screening adherence

5.2

Comments

4.1

5.1.1 and 5.2.1 combined into one
question: “Personal history of CRC or
precancerous polyps”.

4.1

5.1.1 and 5.2.1 combined into one
question: “Personal history of CRC or
precancerous polyps”.

6.0

Initial test recommended

6.1.0

Indication for test 1

6.0

Added value of 3 = Diagnostic

6.x.01

Test performed

6.x.01

Added value 7 = Other

Test, other specify

6.x.02

6.x.02

Date of test

6.x.03

Date of FOBT/FIT kit distributed is now
reported in CRCCP Item 5.1

6.x.03

Provider specialty

6.x.04

Added value 12 = Radiologist
Added value 13 =
Obstetrician/Gynecologist (OB/GYN)

6.x.04

Clinical practice site

6.x.05

Results of take-home
FOBT/FIT

Fecal test results now reported in revised
“Test Results” field (6.x.05)

Indicates no change between the CRCSDP
data set and the CRCCP data set

Indicates a CRCSDP data item that was
retained but modified in the CRCCP data set

Indicates a CRCSDP data item that was
NOT retained in the CRCCP data set

Indicates a new data item in the CRCCP data
set

2

List of Data Items Collected in CRCSDP vs. CRCCP
Colorectal Clinical Data Elements
(sorted by CRCSDP Item number)
CRCSDP
Item

Comments

6.x.06

Result of test

6.x.05

Updated response categories:
1 = Normal/ negative/ diverticulosis/
hemorrhoids
2 = Other finding not suggestive of
cancer or polyp(s)
3 = Polyp(s), or Lesion(s) suspicious for
cancer
4 = Inadequate/Incomplete test with no
findings
5 = FOBT/FIT/Other Test Performed
Negative
6 = FOBT/FIT/Other Test Performed
Positive
7 = Pending
9 = Unknown

6.x.07

Was the bowel preparation
considered adequate by the
clinician performing the
endoscopy or DCBE?

6.x.07

Location of field moved in record

6.x.08

Was the cecum reached
during the colonoscopy?

6.x.08

6.x.09

Complications of endoscopy
or DCBE

6.x.10

Was a biopsy/polypectomy
performed during the
endoscopy?

6.x.11

Number of specimens sent to
pathology (from endoscopy)

6.x.12

Completeness of polyp
removal (from colonoscopy)

Removed from TEST level and added to
Final Diagnosis area to make this apply to
entire screening cycle.
6.x.06

Location of field moved in record

Test Outcome

6.x.09

Recommended next follow-up
procedure within this cycle

6.x.10

Other recommended test,
specify

6.x.11

7.0

Total number of adenomatous
polyps/lesions

7.2

Modified to report the total number of
adenomatous polyps/lesions

7.x.1

Location of 1 polyp/lesion

7.x.2

Size of largest adenomatous
polyp/lesion

7.3

Modified to report size of largest
adenomatous polyp/lesion.

7.x.3.1

Procedure for removal of 1
polyp/lesion (1)

7.x.3.2

Procedure for removal of 1
polyp/lesion (2)

6.x.13

12/02/2009

CRCCP
Item

Variable Name

Added value 7 – Other.

st

st

st

Indicates no change between the CRCSDP
data set and the CRCCP data set

Indicates a CRCSDP data item that was
retained but modified in the CRCCP data set

Indicates a CRCSDP data item that was
NOT retained in the CRCCP data set

Indicates a new data item in the CRCCP data
set

3

List of Data Items Collected in CRCSDP vs. CRCCP
Colorectal Clinical Data Elements
(sorted by CRCSDP Item number)
CRCSDP
Item

CRCCP
Item

Variable Name

Comments

st

7.x.3.3

Procedure for removal of 1
polyp/lesion (3)

7.x.4

Was 1 polyp/lesion
completely removed?

7.x.5

Histology of most severe
polyp/lesion

st

7.1

Location of field moved in record
Modified to report most severe histology.
No longer reporting data on up to 15
polyps/lesions.
11 = ‘Carcinoma, other’ updated to
11 = ‘Cancer, other’.

12/02/2009

8.1

Histology from surgical
resection

8.1

8.2

Date surgery performed

8.2

MMDDYYYY

9.1

Status of final diagnosis

9.01

Updated to:
1 = Complete (final diagnosis made)
2 = Pending final diagnosis
3 = Client refused diagnostic follow-up
4 = Client lost to follow-up before final
diagnosis was made
5 = Irreconcilable

9.2

Final diagnosis

9.02

Updated to:
1 = Normal/Negative
2 = Hyperplastic polyps
3 = Adenomatous polyp, no high grade
dysplasia
4 = Adenomatous polyp with high grade
dysplasia
5 = Cancer

9.3

Date of diagnosis

9.03

MMDDYYYY

9.4

Recommended screening or
surveillance test for next
cycle

9.04

Updated response option to be 8 = None.

9.5

Indication for screening or
surveillance test for next
cycle

9.05

9.6

Number of months before
screening or surveillance test
for next cycle

9.06

Complications (1) of
endoscopy or DCBE requiring
observation or treatment

9.07

Complications (2) of
endoscopy or DCBE requiring
observation or treatment

9.08

Complications, Other specify

9.09

Indicates no change between the CRCSDP
data set and the CRCCP data set

Indicates a CRCSDP data item that was
retained but modified in the CRCCP data set

Indicates a CRCSDP data item that was
NOT retained in the CRCCP data set

Indicates a new data item in the CRCCP data
set

4

List of Data Items Collected in CRCSDP vs. CRCCP
Colorectal Clinical Data Elements
(sorted by CRCSDP Item number)
CRCSDP
Item

Variable Name
CRCCP funds used for any
screening/diagnostic test?

CRCCP
Item
9.10

10.1

Stage at diagnosis/treatment

10.2

Recurrent cancers

10.1

10.3

Registry linkage status

11.01

Registry date of diagnosis

11.02

Registry histologic type

11.03

Registry behavior

11.04

10.4

Registry primary site

11.05

10.5

Registry CS-derived SS2000

11.06

10.6

Registry CS-derived AJCC
stage group

11.07

10.7

Registry CS extension

11.08

10.8

Registry CS lymph nodes

11.09

10.9

Registry CS mets at diagnosis

11.10

Registry CS tumor size

11.11

Status of treatment

10.2

11.1

Comments

Location of field moved in record
Updated to:
1 = Treatment started and/or completed
2 = Treatment pending
3 = Treatment not indicated due to
polypectomy
4 = Treatment not recommended
5 = Treatment refused
6 = Lost to follow-up
9=Unknown

11.2

Date of treatment

11.3

Who paid for treatment?

12.1

CCDE version

10.3

Location of field moved in record

12.1

Will be 100 for data collected beginning
10/1/2009.
Demonstration program data will not be
submitted in this dataset.

12/02/2009

Indicates no change between the CRCSDP
data set and the CRCCP data set

Indicates a CRCSDP data item that was
retained but modified in the CRCCP data set

Indicates a CRCSDP data item that was
NOT retained in the CRCCP data set

Indicates a new data item in the CRCCP data
set

5


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AuthorMattingl
File Modified2009-12-03
File Created2009-12-03

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