Blank pM when you have a valid pT & pN (not blank)

[Denise Jozwik]

We have several hospital registrars submitting 2016 abstracts with valid values for pT, pN and Stg Grp and leaving pM blank instead of entering c0. Are there any plans to add an Edit that will identify this issue?

[Jim Hofferkamp]

I think a lot of registrars are having a hard time adjusting to the fact they need to include a cM value in the pM data item in certain situations.

We do not have an edit in the current metafile to address this situation.

The edit would be relatively simple. If the pT was not empty, then the pM must not be empty.

The edits WG is making an effort not to introduce any new edits or make adjustments to current edits that tighten the allowable codes. We are trying to save these types of changes for v18.

However, if this is something central registries would really like to add to their metafiles, we could make an exception.

We are going to release the next metafile (v16d) in late January or early February. If I hear back from enough registries before that, we could add an edit to address this situation.

I encourage metafile administrators to respond to this thread if they see the empty pM as an issue at their registry.

[Nancy Rold]

I think that edits that help registrars self-correct are a good thing while many of us get used to entering AJCC fields. What are the downsides to timing it for 16d?

[Jim Hofferkamp]

That’s a good question Nancy.The TNM Edits WG is trying to minimize changes to v16 edits that tighten the coding rules. Our focus right now is on edits that are not allowing registrars to enter correct information.

Another consideration for this edit is it could potentially create a lot of work at the central and hospital registry level. I would hate to see registries that are already strapped for time have to go back and make all these changes manually.

However, if central registries feel strongly that this edit should be included, i think we could make an exception. The edit logic is fairly simple. We will have to make a decision in the next couple of weeks.

[Michael Castera]

Please consider creating an edit for this scenario. I am having to correct a lot of these fields and would definitely like to include it in my Web Plus edit set so that it would be caught and corrected prior to our QC staff having to do a manual review.

[Jim Hofferkamp]

A central registry sent me the comment below.

You mentioned on the forum (https://staging.naaccr.org/forums/topic/blank-pm-when-you-have-a-valid-pt-pn-not-blank/) that you will decide based on feedback from registries to see whether an edit will be added to address the issue where reporters submit 2016 diagnosis year cases with valid pT and pN and Stg Grp but leaving pM blank.

We did a search in our central registry database and as of today 1/5/2017, we have 2968 abstracts from reporters where pathologic T and N are completed but pathologic M is left blank. When these cases are in pending and staff consolidates the cases, we get a pop-up screen in our software (prior to edits) that prompts for the pathologic M field. But many cases go straight through into the database without being in pending so those will have to require a separate manual review. As Michael Castera mentioned in the same forum thread (link above), it would be a useful edit to include in our edit set so the missing field can be caught prior to it going into the database.

[Nancy Rold]

Perhaps the Edits Impact WG could help with this decision or could advise on best ways to fix the error in CCR db?

[Jim Hofferkamp]

FYI…we’ve developed some edits for this situation, but central registries will have to be careful about adding them to their edit sets. While AJCC says if the T value is not blank, then the N and M should not be blank, that really applies to registrars that have a chart to work from. NPCR want to allow path labs and other non-hospital facilities the ability to just enter the information they have. So if they just have a T value, they want them to enter the T value and leave the other fields blank.

We may only add these new edits to the CoC edit set. We’ll include the new edits in the metafile, but not in the any of the SEER or Central registry edit sets.

I think we are going to have an instructional webinar after the release of v16d to explain (among other things) the pros and cons of adding these edits to a central registry edit set.

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