Pathology data in the central databases of multicenter randomized trials need to be based on pathology reports and controlled by trained quality managers

Purpose: Randomized multicenter trials form the basis of health care develo pment. Regarding cancer research, pathology data are crucial. To maintain t he quality of these trials, the auditing of subsequent processes is necessa ry. The aim of the present study was to examine the completeness and accura cy of data obtained from a special-purpose standardized pathology form comp ared with the data available through traditional hospital pathology reports . Patients and Methods: A retrospective comparison of pathology data case rec ord forms with hospital pathology reports was performed using the data from 300 patients with primary rectal cancer. All of these patients had been in cluded in a large multicenter trial in the Netherlands. Three independent a udits were carried out. Special attention was given to the accuracy of para meters, which are important for prognosis and treatment decisions. Furtherm ore, various factors that possibly influence the occurrence of errors were investigated. Results: Quality control of the pathology data revealed a high accuracy of 86.5% of all data items. However, only one third of the forms were complete and correct. Missing values were most prominent in the number of lymph nod es examined, whereas most errors were made in relation to the circumferenti al margin. Trained review pathologists made fewer major errors. Discrepanci es were detected in all control rounds. Conclusion: Successive rounds of quality control are required for accuracy and completeness of pathology data in multicenter trials. In addition to th e special-purpose pathology forms, original pathology reports have to be co llected, and the data should also be controlled by a trained pathology qual ity manager. J Clin Oncol 18:1771-1779. (C) 2000 by American Society of Clinical Oncolog y.